Recent Coronavirus Disease 2019 Research Articles

37-Year-Old Man With Headache and Nasal Congestion

37-Year-Old Man With Headache and Nasal Congestion

P182 Mucormycosis in Northwest Iranian cases with a history of delta COVID-19, a brief report

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PMObjectives Mucoral fungi are the opportunistic organisms causing invasive or localized infections in persons with conditions such as diabetes mellitus, immune suppression, and corticosteroid therapy. During the recent surge of delta-type Coronavirus disease 2019 (COVID-19) in Iran, the rate of invasive mucormycosis considerably increased as a cluster in society. COVID-19-associated mucormycosis (CAM) immerged as a severe and life-threatening infection. The present report includes demographic, clinical and laboratory diagnostic information about newly emerged CAM in Northwest of Iran.MethodsDuring three months, from August to October 2021, about 65 cases with clinical manifests suspected of mucormycosis and a history of recent severe COVID-19 and corticosteroid therapy with dexamethasone were studied. Clinical specimens obtained from sinuses and upper respiratory tract, transported to Clinical Mycology Center, UMS University, Urmia, Iran for the detection of and molecular identifications of mucoral and other agents. Our subjects were the clinical specimens including 31 nasal biopsies, 24 paranasal sinus biopsies, 2 facial and palate biopsies, skin and sutures, one each. Also, two samples of bronco-alveolar lavage were used for investigating fungi in the respiratory tract.ResultsMore than 52% of the patients were men and the most frequent age range was 50-60 years. Most frequent clinical specimens were sent from ENT wards and ICUs, 22 (33.8%) and 12 (18.5%) respectively. Among all confirmed cases of CAM, 18 (27.7%) suffered from a background of diabetes but 46 (70.8%) had no underlying diseases. Our findings of direct examination showed 55 (84.6%) mucoral elements. The suspected cases of CAM showed clinical manifests including acute sinusitis, rhino-sino-cerebral 25 (38.5%), rhino-sino-orbital 7 (10.8%), and sino-facial 3 (4.6%), involvements. The culture and identification resulted in Rhizopus oryzae as the most frequent isolate (44.6%) and Candida yeasts (albicans and non-albicans Candida species) 6.2%-7.7% respectively. Aspergillus species were detected 5 (7.7%) as well. A considerable number of cultures, 20 (30.8%) could result no growth for any fungi.ConclusionAs a conclusion, delta-type Coronavirus causing a considerable increased invasive Mucormycosis in the recorded COVID-19 cases in the north west of Iran. Although, opportunistic candida and aspergillus were identified in lower frequencies as well.

New Canadians Working amid a New Normal: Recent Immigrant Wage Penalties in Canada during the COVID-19 Pandemic.

The global coronavirus disease 2019 (COVID-19) pandemic has exposed and arguably intensified many existing inequalities. This analysis explores the relationship between recent immigrant earnings and the pandemic. Specifically, we attempt to empirically answer the question "Has the COVID-19 pandemic exacerbated (or mitigated) recent immigrant-non-immigrant employment and wage gaps?" We find that the pandemic did not change the labour force activity profile of recent or long-term immigrants. Moreover, the pandemic did not disproportionately disadvantage recent immigrants' earnings. In fact, recent immigrant men who were employed during the COVID-19 crisis experienced a small but statistically significant earnings premium. This was insufficient, however, to overcome the overall earnings discount associated with being a recent immigrant. In addition, we find that the recent immigrant COVID-19 earnings boost is observable only at and below the median of the earnings distribution. We also use Heckman selection correction to attempt to adjust for unobserved sample selection into employment during the pandemic. The fact that COVID-19 has not worsened recent immigrant earnings gaps should not overshadow the large, recent immigrant earnings disparities that existed before the pandemic and continue to exist regardless of the COVID-19 crisis.

Outcomes of urgent coronary artery bypass grafting in patients who have recently recovered from COVID-19 infection, with a median follow-up period of twelve months: our experience

BackgroundThe Coronavirus disease 2019 (COVID-19) was declared a worldwide pandemic in 2020 by the World Health Organization (WHO). Certain individuals are at higher risk, (age > 65 years, pre-existing lung or heart conditions, diabetes and obesity) especially those requiring cardiac surgery, including Coronary Artery Bypass Grafting (CABG). Here we present a case series of 11 patients, operated between April 2020 and April 2022, all of whom had recently recovered from COVID-19, who presented with unstable angina, and therefore required urgent Coronary Artery Bypass Grafting (CABG). Similar cases reported in the past, have had a high morbidity and mortality rate.Case presentationThe study included 11 males, and their age varied between 53 and 68 years (median of 65 years). They were either partially or fully vaccinated. All of them had a history of recent mild COVID-19 infection. The European system for cardiac operative risk evaluation, EuroSCORE II in-hospital mortality risk at admission, varied between 1.48% and 5.12%. Six out of 11 patients (54.55%) had a recent Acute Coronary Syndrome (ACS) which is associated with a higher risk and poor prognosis. All of them underwent urgent CABG (10 of them, 90.91% cases, using the off-pump technique and one patient had to be converted to the on-pump beating heart surgery technique during surgery). Ten of the 11 patients were operated using the off-pump technique, and there was one death (9.09%). All surviving patients made an uneventful recovery and have been followed up with a median follow-up period of 12 months.ConclusionsPrevious studies on a similar group of patients have resulted in high morbidity and mortality. A conscious effort was made to perform all surgeries off-pump, thereby eliminating the inflammatory effects and other hazards of cardiopulmonary bypass in this case series, with only one out of 11 (9.09%) being converted to the on-pump beating heart technique due to the hemodynamic instability faced during surgery. Our findings show a mortality rate of 9.09%, with the surviving patients doing well at a median follow-up period of 12 months, suggesting that it is a safe procedure in this patient subset.

Regulation of innate and adaptive immunity using herbal medicine: benefits for the COVID-19 vaccination.

http://links.lww.com/AHM/A31.

Comparison of mucormycosis infection between patients with and without a history of COVID-19 infection: a retrospective cohort study.

BackgroundMucormycosis infection is a complication seen in some coronavirus disease 2019 (COVID-19) patients. This study compares the characteristics of mucormycosis infection between COVID-19 and non-COVID-19 patients.MethodsThis retrospective cohort comprised 87 patients with mucormycosis divided into two groups. The first included 44 patients who had COVID-19 recently before hospitalization due to mucormycosis at Namazi Hospital, Shiraz, Iran, between February 2019 and August 2021. The second group included all 43 patients hospitalized at the same hospital due to mucormycosis between 2010 and 2019 (pre-pandemic).ResultsMucormycosis patients with a history of recent COVID-19 infection had a higher rate of diabetes mellitus, fewer malignancies and higher blood glucose, erythrocyte sedimentation rate and C-reactive protein levels (p<0.05). Glucocorticoid use was common (77%) in the COVID-19 group.ConclusionsIn the pre-COVID-19 era, mucormycosis mainly affected immunodeficient patients like those receiving chemotherapy due to malignancy but now seems to affect COVID-19 patients with uncontrolled blood glucose and glucocorticoids use. Special care must be taken in prescribing glucocorticoids and controlling the blood glucose levels of COVID-19 patients.

Clinical characteristics of patients with COVID-19 vaccine-related pneumonitis: a case series and literature review.

Background/AimsPulmonary toxicities of coronavirus disease 2019 (COVID-19) vaccination are exceedingly rare. However, there are a few reported cases after mRNA vaccination, especially from Asian countries. The purpose of this study was to report the clinical characteristics of patients with COVID-19 vaccine-related pneumonitis (CV-P) and to review cases reported in the literature.MethodsWe performed a prospective, observational case series analysis.ResultsEleven patients with a median age of 80 years were enrolled. Ten patients developed CV-P after BNT162b2-mRNA vaccination and one after ChAdOx1 nCoV-19 vaccination. We identified various patterns of CV-P, including transient infiltration, life-threatening acute respiratory distress syndrome, and aggravation of underlying interstitial lung disease. Most patients showed favorable outcomes with good responses to corticosteroid therapy.ConclusionsIdentifying the mechanism of CV-P requires further investigation; however, radiological and laboratory findings in our case series support inflammatory dysregulation in the lung parenchyma after vaccination. Clinicians should consider CV-P in patients with atypical lung infiltration, no specific etiologies, and recent COVID-19 vaccination.

COVID-19 Vaccine-Associated Lymphadenopathy in Breast Imaging Recipients: A Review of Literature.

The unpredictability of the coronavirus disease 2019 (COVID-19) pandemic has created an ongoing global healthcare crisis. Implementation of a mass vaccination program to accelerate disease control remains in progress. Although injection site soreness, fatigue, and fever are the most common adverse reactions reported after a COVID-19 vaccination, ipsilateral lymph node enlargement has increasingly been observed. In patients undergoing routine screening and surveillance for breast cancer, interpreting lymphadenopathy (LAP) is challenging in the setting of a recent COVID-19 vaccination. With a growing proportion of the population receiving the vaccine, a multifaceted approach is necessary to avoid unnecessary and costly workup. In this comprehensive review, we summarize the existing literature on COVID-19 vaccine-associated LAP in breast imaging patients.

Olfactory dysfunction in COVID-19: pathology and long-term implications for brain health.

Decreased smell function is related to brain health, future mortality, and quality of life. Most people inflicted with the SARS-CoV-2 virus evidence some measurable smell dysfunction during its acute phase, although many are unaware of the loss. Long-term deficits occur in up to 30% of COVID-19 cases, although total anosmia is relatively rare. This review explores what is presently known about the nature and pathophysiology of olfactory dysfunction due to the SARS-CoV-2 virus, including reversible inflammation within the olfactory cleft, downregulation of olfactory receptor proteins, and long-lasting peripheral and central damage to olfactory structures. It also addresses the question as to whether long-term smell loss might increase the likelihood of future development of cognitive and neurological deficits.

Disease spreading modeling and analysis: a survey.

The control of the diffusion of diseases is a critical subject of a broad research area, which involves both clinical and political aspects. It makes wide use of computational tools, such as ordinary differential equations, stochastic simulation frameworks and graph theory, and interaction data, from molecular to social granularity levels, to model the ways diseases arise and spread. The coronavirus disease 2019 (COVID-19) is a perfect testbench example to show how these models may help avoid severe lockdown by suggesting, for instance, the best strategies of vaccine prioritization. Here, we focus on and discuss some graph-based epidemiological models and show how their use may significantly improve the disease spreading control. We offer some examples related to the recent COVID-19 pandemic and discuss how to generalize them to other diseases.

Coronavirus Disease 2019 Outcomes, Patient Vaccination Status, and Cancer-Related Delays During the Omicron Wave: A Brief Report From the TERAVOLT Analysis

IntroductionThe Thoracic Centers International coronavirus disease 2019 (COVID-19) Collaboration (TERAVOLT) registry found approximately 30% mortality in patients with thoracic malignancies during the initial COVID-19 surges. Data from South Africa suggested a decrease in severity and mortality with the Omicron wave. Our objective was to assess mortality of patients with thoracic malignancies with the Omicron-predominant wave and evaluate efficacy of vaccination. MethodsA prospective, multicenter observational study was conducted. A total of 28 institutions contributed data from January 14, 2022, to February 4, 2022. Inclusion criteria were any thoracic cancer and a COVID-19 diagnosis on or after November 1, 2021. End points included mortality, hospitalization, symptomatic COVID-19 infection, asymptomatic COVID-19 infection, and delay in cancer therapy. Analysis was done through contingency tables and a multivariable logistic model. ResultsWe enrolled a total of 346 patients. Median age was 65 years, 52.3% were female, 74.2% were current or former smokers, 86% had NSCLC, 72% had stage IV at time of COVID-19 diagnosis, and 66% were receiving cancer therapy. Variant was unknown for 70%; for those known, Omicron represented 82%. Overall mortality was 3.2%. Using multivariate analysis, COVID-19 vaccination with booster compared with no vaccination had a protective effect on hospitalization or death (OR = 0.30, confidence interval: 0.15–0.57, p = 0.0003), whereas vaccination without booster did not (OR = 0.64, confidence interval: 0.33–1.24, p = 0.1864). Cancer care was delayed in 56.4% of the patients. ConclusionsTERAVOLT found reduced patient mortality with the most recent COVID-19 surge. COVID-19 vaccination with booster improved outcomes of hospitalization or death. Delays in cancer therapy remain an issue, which has the potential to worsen cancer-related mortality.

Objective screening for olfactory and gustatory dysfunction during the COVID-19 pandemic: a prospective study in healthcare workers using self-administered testing.

BackgroundSmell and taste loss are highly prevalent symptoms in coronavirus disease 2019 (COVID‐19), although few studies have employed objective measures to quantify these symptoms, especially dysgeusia. Reports of unrecognized anosmia in COVID‐19 patients suggests that self‐reported measures are insufficient for capturing patients with chemosensory dysfunction.ObjectivesThe purpose of this study was to quantify the impact of recent COVID‐19 infection on chemosensory function and demonstrate the use of at‐home objective smell and taste testing in an at‐risk population of healthcare workers.MethodsTwo hundred and fifty healthcare workers were screened for possible loss of smell and taste using online surveys. Self‐administered smell and taste tests were mailed to respondents meeting criteria for elevated risk of infection, and one‐month follow‐up surveys were completed.ResultsAmong subjects with prior SARS‐CoV‐2 infection, 73% reported symptoms of olfactory and/or gustatory dysfunction. Self‐reported smell and taste loss were both strong predictors of COVID‐19 positivity. Subjects with evidence of recent SARS‐CoV‐2 infection (<45 days) had significantly lower olfactory scores but equivalent gustatory scores compared to other subjects. There was a time‐dependent increase in smell scores but not in taste scores among subjects with prior infection and chemosensory symptoms. The overall infection rate was 4.4%, with 2.5% reported by PCR swab.ConclusionHealthcare workers with recent SARS‐CoV‐2 infection had reduced olfaction and normal gustation on self‐administered objective testing compared to those without infection. Rates of infection and chemosensory symptoms in our cohort of healthcare workers reflect those of the general public.

Comprehensive narrative review of real-world COVID-19 vaccines: viewpoints and opportunities.

Currently, people all over the world have been affected by coronavirus disease 2019 (COVID-19). Fighting against COVID-19 is the top priority for all the countries and nations. The development of a safe and effective COVID-19 vaccine is considered the optimal way of ending the pandemic. Three hundred and 44 vaccines were in development, with 149 undergoing clinical research and 35 authorized for emergency use as to March 15 of 2022. Many studies have shown the effective role of COVID-19 vaccines in preventing SARS-CoV-2 infections as well as serious and fatal COVID-19 cases. However, tough challenges have arisen regarding COVID-19 vaccines, including long-term immunity, emerging COVID-19 variants, and vaccine inequalities. A systematic review was performed of recent COVID-19 vaccine studies, with a focus on vaccine type, efficacy and effectiveness, and protection against SARS-CoV-2 variants, breakthrough infections, safety, deployment and vaccine strategies used in the real-world. Ultimately, there is a need to establish a unified evaluation standard of vaccine effectiveness, monitor vaccine safety and effectiveness, along with the virological characteristics of SARS-CoV-2 variants; and determine the most useful booster schedule. These aspects must be coordinated to ensure timely responses to beneficial or detrimental situations. In the future, global efforts should be directed toward effective and immediate vaccine allocations, improving vaccine coverage, SARS-CoV-2 new variants tracking, and vaccine booster development.

Emerging Paradigms in Type 2 Immunity.

A principal purpose of type 2 immunity was thought to be defense against large parasites, but it also functions in the restoration of homeostasis, such as toxin clearance following snake bites. In other cases, like allergy, the type 2 T helper (Th2) cytokines and cells present in the environment are detrimental and cause diseases. In recent years, the recognition of cell heterogeneity within Th2-associated cell populations has revealed specific functions of cells with a particular phenotype or gene signature. In addition, here we discuss the recent data regarding heterogeneity of type 2 immunity-related cells, as well as their newly identified role in a variety of processes ranging from involvement in respiratory viral infections [especially in the context of the recent COVID-19 (coronavirus disease 2019) pandemic] to control of cancer development or of metabolic homeostasis.

Built by epidemiologists for epidemiologists: an internal COVID-19 dashboard for real-time situational awareness in New York City.

ObjectiveNew York City (NYC) experienced a large first wave of coronavirus disease 2019 (COVID-19) in the spring of 2020, but the Health Department lacked tools to easily visualize and analyze incoming surveillance data to inform response activities. To streamline ongoing surveillance, a group of infectious disease epidemiologists built an interactive dashboard using open-source software to monitor demographic, spatial, and temporal trends in COVID-19 epidemiology in NYC in near real-time for internal use by other surveillance and epidemiology experts.Materials and methodsExisting surveillance databases and systems were leveraged to create daily analytic datasets of COVID-19 case and testing information, aggregated by week and key demographics. The dashboard was developed iteratively using R, and includes interactive graphs, tables, and maps summarizing recent COVID-19 epidemiologic trends. Additional data and interactive features were incorporated to provide further information on the spread of COVID-19 in NYC.ResultsThe dashboard allows key staff to quickly review situational data, identify concerning trends, and easily maintain granular situational awareness of COVID-19 epidemiology in NYC.DiscussionThe dashboard is used to inform weekly surveillance summaries and alleviated the burden of manual report production on infectious disease epidemiologists. The system was built by and for epidemiologists, which is critical to its utility and functionality. Interactivity allows users to understand broad and granular data, and flexibility in dashboard development means new metrics and visualizations can be developed as needed.ConclusionsAdditional investment and development of public health informatics tools, along with standardized frameworks for local health jurisdictions to analyze and visualize data in emergencies, are warranted.

Circadian Disruption and Occupational Toxicants Exposure Affecting the Immunity of Shift Workers During SARS CoV-2 Pandemic.

In several regions of the world, the recent Coronavirus Disease-2019 (COVID-19) pandemic outbreak increased morbidity and mortality. The pandemic situation disrupted many workers' previously established lifestyles. The main aim of the present review was to describe the circadian disruption and occupational toxicant exposure affecting the immunity of shift workers during the SARS CoV-2 pandemic. We retrieved pertinent published literature from the Google Scholar, PubMed, and Scopus databases. In the present review, we discuss the circadian rhythm involving the hypothalamic-pituitary-adrenal (HPA) axis at the molecular level, its disruption, occupational toxicant exposure causing immunomodulatory effects, and the role of immunity during the SARS CoV-2 pandemic. The severity of the progression of the viral infection depends on multiple factors affecting immunity. Hence, shift workers may need to be aware of those factors such as circadian rhythm disruption as well as occupational toxicant exposure. The timing of shift workers' energy intake is also important concerning the shift of the workers. The information in the present review may be important for all workers who are at risk during the pandemic. In the absence of any published literature related to association of circadian rhythm disruption with occupational toxicant exposure, the present review may have greater importance.

Multisystem Inflammatory Syndrome in Children (MIS-C)

Purpose of ReviewThe novel coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and has developed into a pandemic. A unique challenge of this pandemic has been the emergence of multisystem inflammatory syndrome in children (MIS-C), a rare post-infectious hyperinflammatory disorder associated with SARS-CoV-2. This syndrome is characterized by overwhelming systemic inflammation, fever, hypotension, and cardiac dysfunction. This disorder may also have features overlapping with Kawasaki disease (KD), macrophage activation syndrome (MAS), and toxic shock syndrome (TSS). The goal of this review is to outline the presenting features, presumed immunopathogenesis, management, and outcomes of patients with MIS-C.Recent FindingsPatients with MIS-C present with characteristics that fall within a wide clinical spectrum. Main features include fever, gastrointestinal symptoms such as abdominal pain and diarrhea, and cardiac complications such as myocarditis and coronary artery aneurysms, although various other features have been reported. Younger children may present with features of Kawasaki-like disease, and older children are often admitted to the intensive care unit with cardiogenic shock. Current treatment guidelines recommend intravenous immunoglobulins (IVIG) and glucocorticoids, with utilization of biologics in refractory cases. Fortunately, the majority of patients recover, with resolution of the systemic inflammation and cardiac abnormalities. Mortality from MIS-C is rare.SummaryThis review provides an overview of the presenting features, proposed pathogenesis, suggested therapies, and outcomes of MIS-C. Clinicians must have a high clinical suspicion for this disorder in children who have had recent COVID-19 infection or exposure and present with a significant inflammatory response. Understanding of this disorder continues to evolve, and prompt diagnosis and treatment allow for the best possible outcome for patients with MIS-C.

Psychological Impact Assessment in Patients with Noncommunicable Diseases during COVID-19 Pandemic through Validated Fear of COVID-19 scale: A Cross-Sectional Online Survey

Abstract Background The novel coronavirus disease 2019 (COVID-19) pandemic has created immense panic globally with its advent in December 2019 and now showing readvent with its camouflage of different dangerous mutant strains. Its psychological repercussions on the community are very disastrous and immeasurable. At this juncture, the most vulnerable group are the patients of Noncommunicable diseases (NCDs) who are the most sufferers due to the impact caused by the anxiety and fear of COVID-19 apart from its high rate of infectivity. In this context, an online survey to assess the levels of anxiety and fear of COVID-19 in patients with lifestyle diseases has been taken up. Methods This was an online cross-sectional survey using the Fear of COVID-19 Scale (FCV-19S) to assess the levels of anxiety and fear in patients with NCDs. The survey was made available for both genders and an age group of 30 years and above in India. Results and Discussion A total of 627 participants participated in this online survey. The Indian residents with NCDS )Noncommunicable diseases) were found to suffer from significantly increased levels of anxiety and fear of COVID-19 and almost 60.4% of the participants were found to acquire these lifestyle diseases as diabetes and hypertension during this recent COVID-19 times. Conclusion This survey shows the real-time psychological impact of COVID-19 which has a disastrous effect upon the community especially on the patients with NCDs who are the most vulnerable group. The study findings corroborate with the recent studies conducted on NCDs.

Colonoscopy Following COVID-19 Delays in Procedures: Risk Stratification for Procedures Is Critical.

Colonoscopy Following COVID-19 Delays in Procedures: Risk Stratification for Procedures Is Critical.

Cavernous Sinus Thrombosis Due to Mucormycosis After COVID-19 Pneumonia

Coronavirus disease 2019 (COVID-19) could be complicated by venous or arterial stroke. However, to the best of our knowledge, there is a limited number of cases reported to develop cavernous sinus thrombosis (CST) after COVID-19. Herein, we present a 61-year-old diabetic male with persistent pain in his right forehead and periorbital region after COVID-19 pneumonia and diagnosed with CST after developing diplopia and periorbital ecchymosis. Magnetic resonance imaging revealed right maxillary sinusitis, inflammatory changes extending through the medial wall of the orbit and medial rectus muscle. CST was diagnosed. The mucormycosis was diagnosed by examining the extracted material with surgical thrombectomy. Appropriate surgical intervention, anticoagulant, and antifungal treatment yielded in a significant improvement in pain and orbital movements. In conclusion, in the presence of prothrombotic risk factors, like uncontrolled diabetes or recent COVID-19 infection, the physicians should consider the probability of CST in the differential diagnosis of persistent periorbital headache.