Recent Coronavirus Disease 2019 Research Articles

Sacubitril/valsartan and cardiovascular biomarkers among patients with recent COVID-19 infection: The PARACOR-19 randomized clinical trial.

The PARACOR-19 randomized controlled trial (RCT) was designed to examine the effects of sacubitril/valsartan on markers of cardiac injury, inflammation, structure, and function among patients who have recovered from acute coronavirus disease 2019 (COVID-19) infection. PARACOR-19 was a single-centre, double-blind RCT of patients with cardiovascular risk factors and a history of COVID-19 infection 4-16 weeks prior to enrolment. Patients were randomized to sacubitril/valsartan (titrated to the maximum dose of 97/103 mg twice daily) versus matching placebo. Co-primary endpoints were change from baseline to 12 weeks in high-sensitivity cardiac troponin T (hs-cTnT) and soluble ST2 (sST2). Exploratory endpoints included change from baseline to 12 weeks in additional circulating biomarkers. Overall, 42 patients were randomized between August 2021 and March 2023 (n = 20 sacubitril/valsartan, n = 22 placebo). Median (25th-75th) time from COVID-19 diagnosis to enrolment was 67 (48-80) days. Median age was 67 (62-71) years, 48% were female, and 91% were White. Compared with placebo, sacubitril/valsartan did not have a significant effect on the co-primary endpoints of change from baseline in hs-TnT and sST2 (all p ≥ 0.29). In exploratory analyses, sacubitril/valsartan led to a 46% greater reduction in N-terminal pro-B-type natriuretic peptide (NT-proBNP) and 51% greater reduction in C-terminal telopeptide of collagen type I (CITP). Permanent drug discontinuation occurred in four patients in the sacubitril/valsartan group and three patients in the placebo group. There were no deaths and one patient was hospitalized in each group. In this pilot RCT of patients who recovered from acute COVID-19, sacubitril/valsartan did not lower hs-cTnT or sST2 compared with placebo. Exploratory analyses suggested potential benefits of sacubitril/valsartan on cardiac wall stress and collagen turnover as measured by NT-proBNP and CITP. Sacubitril/valsartan was well tolerated. ClinicalTrials.gov NCT04883528.

Anti-COVID-19 Potential of Withaferin-A and Caffeic Acid Phenethyl Ester.

The recent COVID-19 (coronavirus disease 2019) pandemic triggered research on the development of new vaccines/drugs, repurposing of clinically approved drugs, and assessment of natural anti-COVID-19 compounds. Based on the gender difference in the severity of the disease, such as a higher number of men hospitalized and in intense care units, variations in sex hormones have been predicted to play a role in disease susceptibility. Cell surface receptors (Angiotensin-Converting Enzyme 2; ACE2 and a connected transmembrane protease serine 2- TMPSS2) are upregulated by androgens. Conversely, androgen antagonists have also been shown to lower ACE2 levels, implying their usefulness in COVID-19 management. In this study, we performed computational and cell-based assays to investigate the anti- COVID-19 potential of Withaferin-A and Caffeic acid phenethyl ester, natural compounds from Withania somnifera and honeybee propolis, respectively. Structure-based computational approach was adopted to predict binding stability, interactions, and dynamics of the two test compounds to three target proteins (androgen receptor, ACE2, and TMPRSS2). Further, in vitro, cell-based experimental approaches were used to investigate the effect of compounds on target protein expression and SARS-CoV-2 replication. Computation and experimental analyses revealed that (i) CAPE, but not Wi-A, can act as androgen antagonist and hence inhibit the transcriptional activation function of androgen receptor, (ii) while both Wi-A and CAPE could interact with ACE2 and TMPRSS2, Wi-A showed higher binding affinity, and (iii) combination of Wi-A and CAPE (Wi-ACAPE) caused strong downregulation of ACE2 and TMPRSS2 expression and inhibition of virus infection. Wi-A and CAPE possess multimodal anti-COVID-19 potential, and their combination (Wi-ACAPE) is expected to provide better activity and hence warrant further attention in the laboratory and clinic.

Small Bowel Obstruction Due to Abdominal Cocoon Syndrome in Post-COVID-19 Patients.

Abdominal cocoon syndrome, also recognized as encapsulating peritoneal sclerosis, is an exceedingly rare medical condition characterized by an anomalous membranous envelopment of the small bowel. Despite its clinical rarity, the precise etiology and pathogenic mechanisms of this syndrome remain elusive. This comprehensive discussion presents a case series encompassing six patients who sought medical attention in the Emergency Room, all sharing a common presentation: severe abdominal distension and persistent constipation. Intriguingly, these symptoms manifested following recent severe coronavirus disease 2019 (COVID-19) infections. Remarkably, none of these patients had significant medical histories or had undergone prior surgical interventions, rendering their cases even more enigmatic. The defining feature across all six cases emerged during exploratory laparotomy, where a consistent finding stunned the surgical team: the discovery of a thick, fibrous membrane enveloping segments of the small bowel. The surgical procedure entailed meticulous dissection and subsequent removal of this membrane, with tissue samples dispatched for histopathological evaluation. This diagnostic approach conclusively confirmed the presence of abdominal cocoon syndrome in each of these patients. The focal point of our discussion revolves around a potential connection between recent severe COVID-19 infection, intensive care unit admissions, and the subsequent development of abdominal cocoon syndrome. This intriguing association compels further inquiry to unveil the precise pathogenesis of this syndrome, particularly within the context of COVID-19. Given the diagnostic complexities associated with abdominal cocoon syndrome, this report underscores the indispensability of maintaining a heightened clinical suspicion and the significance of rigorous intraoperative assessments to ensure timely diagnosis and effective management. Abdominal cocoon syndrome represents a rare and enigmatic medical condition characterized by its uncertain etiology. Our case series tantalizingly suggests a link between recent severe COVID-19 infection and the development of this syndrome. Nevertheless, comprehensive research endeavors are warranted to unravel the intricate mechanisms that underlie this intriguing association. In light of the diagnostic challenges associated with abdominal cocoon syndrome, this report underscores the pivotal role of exploratory surgery, in the absence of definitive radiological imaging, as the cornerstone for both diagnosis and therapeutic intervention. The pursuit of further investigations into the intricate relationship between COVID-19 and abdominal cocoon syndrome may ultimately yield the critical insights needed to demystify this complex medical enigma.

Impact of BioFire FilmArray Multiplex PCR in the Detection of Microbial Agents causing Severe Acute Respiratory Infection in the COVID-19 Era: A Cross-sectional Study from a Tertiary Care Hospital in Central India

Introduction: Many viral and bacterial respiratory tract infections can present with respiratory signs and progress to complicated pneumonia. In the recent Coronavirus Disease2019 (COVID-19) pandemic, it is crucial to test all Severe Acute Respiratory Infection (SARI) patients for other microbial infections in addition to COVID-19, enabling timely diagnosis and treatment to reduce morbidity and mortality. The automated system, BioFire FilmArray, utilises multiplex Polymerase Chain Reaction (PCR) to rapidly detect and identify multiple respiratory pathogens, including selected Antimicrobial Resistance (AMR) genes, within an hour. Aim: To detect bacterial and/or viral pathogens associated with hospitalised COVID-19-negative SARI patients using the BioFire FilmArray Pneumonia Panel (BFPP). Materials and Methods: This laboratory-based cross-sectional study was conducted at All India Institute of Medical Sciences (AIIMS), Nagpur, Maharashtra, India, from June 2020 to February 2021. Respiratory samples, such as sputum, tracheal aspirate, Endotracheal (ET) secretions, and Bronchoalveolar Lavage (BAL), were collected from COVID-19-negative hospitalised SARI cases. A total of 81 patients were included in the study. The samples were tested using the BFPP (multiplex PCR) system and processed using conventional culture techniques. Patient characteristics, clinical and laboratory investigation data, and findings of respiratory viral and bacterial agents, as well as antibiotic resistance genes detected by BioFire FilmArray, were recorded using paper case reports. The data were collected and analysed using Statistical Package for Social Sciences (SPSS) software. Results: Out of the 81 clinical samples processed, the BFPP detected 168 bacterial and 18 viral pathogens. Bacterial-viral codetection was observed in 13 (16%) samples. Atypical bacteria were detected in 3% of cases. Among the bacterial pathogens, the AMR gene for New Delhi Metallo-beta-lactamases (NDM) was detected in 42 (25.9%) cases, followed by CTX-M betalactamases, VIM, and the oxacillinase group of β-lactamases. Conclusion: The BFPP test is a valuable tool for the rapid detection of a wide range of pathogens, including associated AMR genes, with high sensitivity and specificity. This can greatly aid in treatment decisions.

Clinical features of pulmonary embolism in patients with previous recent COVID-19 infection

BACKGROUND: Pulmonary embolism (PE) is one of the most significant thromboembolic complications of coronavirus disease 2019 (COVID-19). Several studies have demonstrated the clinical features of PE in patients in the acute phase of COVID-19. The features of the course of PE diagnosed after an acute infection have not been sufficiently studied.
 AIM: To study the clinical picture of PE that occurred within 3 months after COVID-19.
 METHODS: A retrospective study was completed. Patients were hospitalized with a diagnosis of PE between January 2020 and December 2021. Two subgroups were formed: with a history of recent (up to 3 months) COVID-19 infection and without a history of COVID-19.
 RESULTS: Of the 278 patients hospitalized with PE, 44 had anamnesis of COVID-19, and 69 had no anamnesis of infection. In the remaining 165 patients with PE, determining the presence or absence of a history of COVID-19 was impossible. In the analysis of the clinical picture and examination results of 44 patients with COVID-19, distal localization of thrombotic lung lesions was predominant, the incidence of deep vein thrombosis of the lower extremities was lower, and right heart lesions were noted. A tendency toward the presence of diabetes mellitus, anemia, and thrombocytopenia was found.
 CONCLUSION: Patients with PE and history of COVID-19 have features of clinical presentation. The identified signs are consistent with the results of studies that have evaluated the course and clinical signs of PE in the acute period of COVID-19. Similar manifestations may indicate a significant effect of COVID-19 on PE signs both during and after the acute period of COVID-19. Clinical features were determined by the severity of the previous infection.

Drug-Drug Interactions Between COVID-19 Treatments and Psychotropic Medications: An Updated Study.

The recent evolution of coronavirus disease 2019 (COVID-19) treatments has created challenges for healthcare providers in terms of new potential interactions between these COVID-19 treatments and psychotropic drugs in patients with psychiatric disorders. Current clinical practice guidelines on managing interactions between psychotropic medications and COVID-19 treatments do not account for the newer COVID-19 medications. There is a need for updated patient management recommendations that take into account drug interactions between psychotropic drugs and the latest pharmacological approaches to COVID-19 treatment. Asearch of literature pertaining to drug interactions and outcomes in patients concurrently prescribed COVID-19 treatments and psychotropic medications was conducted. Drug databases were also analyzed to screen for interactions.Our review focuses on the most recent and effective COVID-19 treatments, including PaxlovidTM (nirmatrelvir/ritonavir), remdesivir, dexamethasone, tocilizumab, and baricitinib. The study provides condensed and easily interpretable tables for healthcare providers to screen for potentially harmful drug interactions. We discuss the implications of our findings on appropriate treatment plan selection by healthcare providers for patients taking select antipsychotics, antidepressants, mood stabilizers, and benzodiazepines while receiving COVID-19 treatments.Notably, PaxlovidTMmay interact with several medications, particularly antipsychotics and anxiolytics, necessitating close monitoring and, in some cases, reconsideration of use. We find that dexamethasone, remdesivir, tocilizumab, and baricitinib have fewer reported interactions with psychotropics, and while some monitoring is necessary, no major adjustments are recommended for their administration in conjunction with psychotropic medications.These findings underscore the importance of careful consideration and monitoring when combining COVID-19 treatments with other medications to mitigate the risk of adverse interactions and ensure patient safety.

Corticosteroids and invasive fungal infections in hospitalized COVID-19 patients – A single-center cross-sectional study

Background: During the coronavirus disease 2019 (COVID-19) epidemic, an increase in the incidence of fungal infections was observed. However, the real magnitude of these fungal infections and their risk factors among COVID-19 patients in the Indian population is unknown. Aim: To study the frequency, and spectrum of invasive fungal infections (IFI) among hospitalized COVID-19 patients, and the risk factors associated with invasive fungal infections. Methods: We performed a retrospective, cross-sectional study; including all adult patients, admitted to Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), a tertiary care hospital in Southern India between April 2020 and August 2021, with COVID-19. Based on clinical-radiological features, patients with fungal infections were grouped into three diagnostic categories. Demographics, clinical, and laboratory features of patients with fungal infections were analyzed to identify the risk factors. Results: About 10% (449 out of 4650) of the admitted patients with recent COVID-19, had some form of IFI. Among the patients with IFI, 80% (366 out of 449) were hospitalized for active COVID-19, whereas almost all the patients admitted with post-COVID complications had IFI. Of the 449 patients with IFI, 377 had mold infections and 88 had invasive candidiasis. Mucormycosis was the most common mold infection. Diabetes and diabetic ketoacidosis were strong independent predictors of IFI. We also found an association between end-stage renal disease, central venous catheterization, antibiotic usage, prior stroke, and corticosteroid therapy with IFI. Conclusions: The frequency of fungal infections among hospitalized COVID-19 patients was high. Special precautions in COVID-19 patients with diabetes mellitus, corticosteroid therapy, and prior antibiotic usage may help to reduce invasive fungal infections.

Increased Risk of New-Onset Asthma After COVID-19: A Nationwide Population-Based Cohort Study

Previous studies have suggested that respiratory virus infections may be associated with new-onset asthma. However, whether coronavirus disease 2019 (COVID-19) is associated with an increased risk of new-onset asthma remains unclear. We aimed to evaluate whether recent COVID-19 increases the risk of new-onset asthma and whether COVID-19 vaccination could mitigate this risk. We constructed 3 different study designs using the Korean National Health Insurance claim-based database: study 1: COVID-19-diagnosed subjects (COVID-19 cohort) and their matched controls; study 2: COVID-19-vaccinated subjects (vaccination cohort) and their matched controls; and study 3: vaccination cohort and their matched controls, excluding subjects diagnosed with COVID-19. In study 1, 1.6% of the COVID-19 cohort and 0.7% of the matched cohort developed new-onset asthma, with incidences of 31.28 and 14.55 per 1,000 person-years, respectively (P < .001). The COVID-19 cohort had a higher risk of new-onset asthma (adjusted hazard ratio [aHR] 2.14; 95% CI 1.88-2.45) than matched controls. In study 2, the vaccination cohort had a lower risk of new-onset asthma than the matched controls (aHR 0.82; 95% CI 0.76-0.89). However, among subjects without a COVID-19 diagnosis, COVID-19 vaccination was not associated with a reduced risk of new-onset asthma in study 3 (aHR 0.95; 95% CI 0.87-1.04). In subgroup analysis, the risk of new-onset asthma was significantly lower in fully vaccinated subjects and higher in older subjects and in those with diabetes mellitus than in their counterparts. The COVID-19 was associated with a higher incidence of new-onset asthma, which might be preventable by COVID-19 vaccination.

Myocarditis and COVID-19 related issues.

The recent COVID-19 (Coronavirus Disease 2019) pandemic by SARS-CoV2 infection has caused millions of deaths and hospitalizations across the globe. In the early pandemic phases, the infection had been initially considered a primary pulmonary disease. However, increasing evidence has demonstrated a wide range of possible cardiac involvement. Most of systemic and cardiac damage is likely sustained by a complex interplay between inflammatory, immune-related and thrombotic mechanisms. Biventricular failure and myocardial damage with elevation of cardiac biomarkers have been reported in COVID-19 patients, although histological demonstration of acute myocarditis has been rarely documented. Indeed while cardiac magnetic resonance findings include different patterns of myocardial involvement in terms of late gadolinium enhancement, histological data from necropsy and endomyocardial biopsy showed peculiar inflammatory patterns, mostly composed by macrophages. On the other hand COVID-19 vaccines based on mRN technology have been also associated with increased risk of myocarditis. COVID-19 and mRNA vaccine-related myocarditis present different clinical and imaging presentations and recent data suggest the presence of distinctive immunological mechanisms involved.

Epidemiology of COVID-19 and the Utility of Cycle Threshold (Ct) Values in Predicting the Severity of Disease.

Advanced molecular diagnostic methods like real-time polymerase chain reaction (PCR) play a vital role in the early recognition of viral infections, including the coronavirus disease 2019 (COVID-19). Therefore, in the context of the recent COVID-19 pandemic, this study aimed to determine the correlation of cycle threshold (Ct) values with symptoms in COVID-19-positive patients. A retrospective study was conducted in a virus research diagnostic laboratory (VRDL) at a COVID-19-dedicated tertiary care hospital in South India. A total of 5563 COVID-19-positive patients were analyzed for symptom spectrum and duration of illness with Ct values of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Around 80% (n= 4401) of the patients were symptomatic and the rest were asymptomatic. Among the symptomatic patients, fever (66%) was the most common symptom. About 44% of symptomatic patients had a low Ct value (Ct ≤ 24). There was a significant difference in symptoms among patients with low, medium, and high Ct values. In the subpopulation of symptomatic patients analyzed for the association of Ct value and duration of illness, the mean duration of illness was three days and almost 88% of the patients were tested within five days of onset of symptoms. It has been observed that a shorter duration of illness lowers the Ct values. A significant association was seen between the mean Ct value and days since symptom onset (p-value = 0.016). Most of the symptomatic patients had lower Ct values in comparison to the asymptomatic patients. A significant association between low Ct values and the duration of symptoms observed in our study explains the viral dynamics, i.e., higher viral shedding at the onset of symptoms and declinesthereafter.

Is Transplantation With Coronavirus Disease 2019–Positive Donor Lungs Safe? A US Nationwide Analysis

BackgroundSince the beginning of the pandemic, coronavirus disease 2019 (COVID-19) has caused debilitating lung failure in many patients. Practitioners have understandably been hesitant to use lungs from donors with COVID-19 for transplantation. This study aimed to analyze the characteristics and short-term outcomes of lung transplantation from donors with recent positive COVID-19 testing results. MethodsLung transplantations performed between January 2020 and June 2022 were queried from the United Network for Organ Sharing database. Pediatric, multiorgan, and repeat lung transplantations were excluded. Propensity scoring matched recipients of lungs from donors with recent positive COVID-19 testing results to recipients of lungs from donors with negative COVID-19 testing results, and comparisons of 30-day mortality, 3-month mortality, and perioperative outcomes were performed. ResultsA total of 5270 patients underwent lung transplantation during the study dates, including 51 patients who received lungs from donors with recent positive COVID-19 testing results. Forty-five recipients of lungs from donors with recent positive COVID-19 testing results were matched with 135 recipients of lungs from donors with negative COVID-19 testing results. After matching, there was no difference in 30-day (log-rank P = .42) and 3-month (log-rank P = .42) mortality. The incidence of other perioperative complications was similar between the groups. ConclusionsThe 30-day and 3-month survival outcomes were similar between recipients of lungs from donors with recent positive COVID-19 testing results and recipients of lungs from donors with negative COVID-19 testing results. This finding suggests that highly selected COVID-19–positive donors without evidence of active infection may be safely considered for lung transplantation. Further studies should explore long-term outcomes to provide reassurance about the safety of this practice.

Multi-source dynamic ensemble prediction of infectious disease and application in COVID-19 case.

The development of an epidemic always exhibits multiwave oscillation owing to various anthropogenic sources of transmission. Particularly in populated areas, the large-scaled human mobility led to the transmission of the virus faster and more complex. The accurate prediction of the spread of infectious diseases remains a problem. To solve this problem, we propose a new method called the multi-source dynamic ensemble prediction (MDEP) method that incorporates a modified susceptible-exposed-infected-removed (SEIR) model to improve the accuracy of the prediction result. The modified SEIR model is based on the compartment model, which is suitable for local-scale and confined spaces, where human mobility on a large scale is not considered. Moreover, compartmental models cannot be used to predict multiwave epidemics. The proposed MDEP method can remedy defects in the compartment model. In this study, multi-source prediction was made on the development of coronavirus disease 2019 (COVID-19) and dynamically assembled to obtain the final integrated result. We used the real epidemic data of COVID-19 in three cities in China: Beijing, Lanzhou, and Beihai. Epidemiological data were collected from 17 April, 2022 to 12 August, 2022. Compared to the one-wave modified SEIR model, the MDEP method can depict the multiwave development of COVID-19. The MDEP method was applied to predict the number of cumulative cases of recent COVID-19 outbreaks in the aforementioned cities in China. The average accuracy rates in Beijing, Lanzhou, and Beihai were 89.15%, 91.74%, and 94.97%, respectively. The MDEP method improved the prediction accuracy of COVID-19. With further application to other infectious diseases, the MDEP method will provide accurate predictions of infectious diseases and aid governments make appropriate directives.

Airport-based pharmacies: Products, services and challenges essential for patients in a global travel landscape

The role of airport pharmacies has grown in recent years to provide a range of services to travelers, including over-the-counter and prescription medicines, as well as advice on prevention of infectious and other diseases. Prevention, including protective equipment, is especially important during pandemics, as seen with the recent coronavirus disease-2019 (COVID-19) pandemic. In addition, offering vaccinations where appropriate. However, this is not universal, and there are currently no acknowledged guidelines for pharmacists operating within airports. In addition, research into their role as well as potential ways to improve this is lacking. This is a concern with community pharmacists playing a valuable role during the COVID-19 pandemic. Potential ways forward include greater research into their activities to enhance their role and address challenges. These include issues of brand names and language, as well as encouraging travel pharmacy in future university curricula. In addition, producing guidelines for their activities and monitoring their implementation. This can help build a greater role for their services, benefiting airport staff and travelers in the future.

Changes in early postoperative outcomes and complications observed in a single center during the 2022 COVID-19 pandemic wave in China: A single-center ambispective cohort study.

Currently, the effect of the 2022 nationwide coronavirus disease 2019 (COVID-19) wave on the perioperative prognosis of surgical patients in China is unclear. Thus, we aimed to explore its influence on postoperative morbidity and mortality in surgical patients. An ambispective cohort study was conducted at Xijing Hospital, China. We collected 10-day time-series data from December 29 until January 7 for the 2018-2022 period. The primary outcome was major postoperative complications (Clavien-Dindo class III-V). The association between COVID-19 exposure and postoperative prognosis was explored by comparing consecutive 5-year data at the population level and by comparing patients with and without COVID-19 exposure at the patient level. The entire cohort consisted of 3350 patients (age: 48.5 ± 19.2 years), including 1759 females (52.5%). Overall, 961 (28.7%) underwent emergency surgery, and 553 (16.5%) had COVID-19 exposure (from the 2022 cohort). At the population level, major postoperative complications occurred in 5.9% (42/707), 5.7% (53/935), 5.1% (46/901), 9.4% (11/117), and 22.0% (152/690) patients in the 2018-2022 cohorts, respectively. After adjusting for potential confounding factors, the 2022 cohort (80% patients with COVID-19 history) had a significantly higher postoperative major complication risk than did the 2018 cohort (adjusted risk difference [aRD], 14.9% (95% confidence interval [CI], 11.5-18.4%); adjusted odds ratio [aOR], 8.19 (95% CI, 5.24-12.81)). At the patient level, the incidence of major postoperative complications was significantly greater in patients with (24.6%, 136/553) than that in patients without COVID-19 history (6.0% [168/2797]; aRD, 17.8% [95% CI, 13.6-22.1%]; aOR, 7.89 [95% CI, 5.76-10.83]). Secondary outcomes of postoperative pulmonary complications were consistent with primary findings. These findings were verified through sensitivity analyses using time-series data projections and propensity score matching. Based on a single-center observation, patients with recent COVID-19 exposure were likely to have a high incidence of major postoperative complications. NCT05677815 at https://clinicaltrials.gov/.

Double Trouble Co-Infections: Understanding the Correlation Between COVID-19 and HIV Viruses.

A global outbreak of coronavirus disease 2019 (COVID-19), an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), mounted a substantial threat to public health worldwide. It initially emerged as a mere outbreak in Wuhan, China, in December 2019and quickly engulfed the entire world, evolving into a global pandemic, consuming millions of lives and leaving a catastrophic effect on our lives in ways unimaginable. The entire healthcare system was significantly impacted and HIV healthcare was not spared. In this article, we reviewed the effect of HIV on COVID-19 disease and the ramifications of the recent COVID-19 pandemic over HIV management strategies. Our review highlights that contrary to the instinctive belief that HIV should render patients susceptible to COVID-19 infection, the studies depicted mixed results, although comorbidities and other confounders greatly affected the results. Few studies showed a higher rate of in-hospital mortality due to COVID-19 among HIV patients; however, the use of antiretroviral therapy had no consequential effect. COVID-19 vaccination was deemed safe among HIV patients in general. The recent pandemic can destabilize the HIV epidemic control as it hugely impacted access to care and preventive servicesand led to a marked reduction in HIV testing. The collision of these two disastrous pandemics warrants the need to materialize rigorous epidemiological measures and health policies, but most importantly, brisk research in prevention strategies to mitigate the combined burden of the two viruses and to battle similar future pandemics.

Association between recent COVID-19 diagnosis, depression and anxiety symptoms among slum residents in Kampala, Uganda.

Despite the known link between poor living conditions and mental health, there has been little research on the mental health of slum dwellers worldwide. Although the Coronavirus disease 2019 (COVID-19) pandemic has led to an increase in mental health issues, little focus has been given to the impact on slum dwellers. The study aimed to investigate the association between recent COVID-19 diagnosis and the risk of depression and anxiety symptoms among people living in an urban slum in Uganda. A cross-sectional study was conducted among 284 adults (at least 18 years of age) in a slum settlement in Kampala, Uganda between April and May 2022. We assessed depression symptoms and anxiety using validated Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder assessment tool (GAD-7) questionnaires respectively. We collected data on sociodemographic characteristics, and self-reported recent COVID-19 diagnosis (in the previous 30 days). Using a modified Poisson regression, adjusted for age, sex, gender and household income, we separately provided prevalence ratios and 95% confidence intervals for the associations between recent COVID-19 diagnosis and depressive and anxiety symptoms. Overall, 33.8% and 13.4% of the participants met the depression and generalized anxiety screening criteria respectively and 11.3% were reportedly diagnosed with COVID-19 in the previous 30 days. People with recent COVID-19 diagnosis were more likely to be depressed (53.1%) than those with no recent diagnosis (31.4%) (p<0.001). Participants who were recently diagnosed with COVID-19 reported higher prevalence of anxiety (34.4%) compared to those with no recent diagnosis of COVID-19 (10.7%) (p = 0.014). After adjusting for confounding, recent diagnosis with COVID-19 was associated with depression (PR = 1.60, 95% CI 1.09-2.34) and anxiety (PR = 2.83, 95% CI 1.50-5.31). This study suggests an increased risk of depressive symptoms and GAD in adults following a COVID-19 diagnosis. We recommend additional mental health support for recently diagnosed persons. The long-term of COVID-19 on mental health effects also need to be investigated.

Coronary artery bypass grafting in active or recent COVID-19 infection: a systematic review.

Even though there have been few studies on coronary artery bypass grafting (CABG), data on patients with coronavirus disease-2019 (COVID-19) infection show that cardiac surgery has poor outcomes in this subset. From the available studies in the literature, we conducted a systematic review with the aim of determining the outcome of COVID-19 patients who underwent CABG. Between December 2019 and October 2022, searches were conducted in PubMed, the Directory of Open Access Journals, and Google Scholar to find studies reporting results of COVID-19 patients undergoing CABG. We extracted data on the clinical profile and outcomes of the patients from the eligible studies. The quality of the studies was assessed using a standardised tool. The total sample size across the 12 included studies was 99 patients who underwent CABG in active disease or within 30days of COVID-19 infection. The median and interquartile range (IQR) for the length of time spent on a mechanical ventilator, stay in the intensive care unit (ICU), and the total hospital stay were 0.9 (0.47-2), 4.5 (2.5-8), and 12.5 (8.5-22.5) days respectively. Seventy-six patients developed postoperative complications, and there were eleven deaths. The findings of the present study indicate that mortality risk goes down when the time between COVID-19 diagnosis and surgery increases. When compared to data from other high-risk urgent or emergent CABG patients around the world who were not infected with COVID-19, patients who underwent CABG in the COVID-19 subgroup had similar postoperative outcomes. The online version contains supplementary material available at 10.1007/s12055-023-01495-7.

COVID-19 Vaccination Among Healthcare Workers: Trend and Protection in a Tertiary Care Hospital in Northern India.

Background Coronavirus disease 2019 (COVID-19) is an infectiousdisease that poses health risks to everyone exposed to the virus and frontline healthcare workers (HCWs) are at very high risk. COVID-19 vaccines have been developed to offer protection from the disease and reduce the severity of illness. Objective This questionnaire-based cross-sectional survey aimed to determine COVID-19 vaccination trends and protection among HCWs in a dedicated COVID-19 tertiary care hospital in Northern India. Methods A printout of the questionnaire was distributed. Part 1 of the questionnaire included voluntary consent and demographics information, and part 2 dealt with COVID-19 vaccination, COVID-19 illness, and post-vaccination illness. The outcomes of the study comprised trends and protection offered by COVID-19 vaccination, post-vaccination side-effects, and reasons for vaccine hesitancy. The responses were analyzed using Stata version 15.0. Results: A total of 256 HCWs were approached to take the questionnaire, out of whom 241 consented to participate in the survey. One-hundred and fifty-five (64.3%) of these HCWs were fully vaccinated, 53 (21.9%) were partially vaccinated, and 33 (13.7%) were non-vaccinated. The overall rate of infection was 45.64% (110/241). The rate of infection was 58.18% among non-vaccinated HCWs, 21.81% after partial vaccination, and 20% after full vaccination. The odds of infection among vaccinated versus non-vaccinated HCWs was 0.338 (95% CI: 0.224 to 0.512; P<0.001). The overall hospitalization rate among infected HCWs was 6.36% and there was no incidence of hospitalization among fully vaccinated HCWs. Conclusions: Vaccination was shown to reduce the rates of infection and hospitalization among HCWs. A sizeable number of HCWs remained unvaccinated due to either recent COVID-19 infection or apprehension about vaccine-related side-effects.

Emerging and re-emerging viral diseases, predisposing risk factors, and implications of international travel: a call for action for increasing vigilance and imposing restrictions under the current threats of recently emerging multiple Omicron subvariants.

Emerging and re-emerging viral diseases, predisposing risk factors, and implications of international travel: a call for action for increasing vigilance and imposing restrictions under the current threats of recently emerging multiple Omicron subvariants.

Hyperacute optic neuritis in a patient with COVID-19 infection and vaccination: a case report

BackgroundAs scientific knowledge continues to grow regarding coronavirus disease 2019 (COVID-19) infection, several neuro-ophthalmological manifestations have emerged, including rare reports of optic neuritis. Optic neuritis is an inflammatory demyelinating condition of the optic nerve that typically presents as subacute, unilateral vision loss and pain on eye movement. Several cases of COVID-19 infection and COVID-19 vaccination related cases of optic neuritis have been reported. We present a case of hyperacute, unilateral optic neuritis after both recent COVID-19 infection and subsequent booster vaccination.Case presentationWithin two hours after receiving her COVID-19 booster vaccination, a 58-year-old female began experiencing bilateral eye pain, worsened by eye movements. The patient had previously contracted a mild COVID-19 infection three weeks prior to receiving her booster vaccination, confirmed by a rapid antigen test. The pain persisted in her right eye for a week at which time she presented to an ophthalmology clinic. She denied any changes to her visual acuity. Neuroimaging revealed right optic nerve enhancement, and the patient was admitted to the hospital for a course of intravenous steroids, which quickly resolved her eye pain.ConclusionTo our knowledge, this is the first reported case of COVID-19 related optic neuritis following both COVID-19 infection and vaccination. High clinical suspicion is needed to make the appropriate diagnosis, as cases of COVID-19 related optic neuritis may exhibit mild presentations, as was the case with our patient.