Severe Acute Respiratory Illness Research Articles

Impaired Hepatitis B and COVID-19 vaccination responses show strong concordance in hemodialysis patients with end stage renal disease

BackgroundPatients with end stage renal disease (ESRD) undergoing hemodialysis are at increased risk for infection and impaired vaccination responses. We analyzed overlap and influencing factors of vaccination responses against severe acute respiratory syndrome corona virus disease 2 (SARS-CoV-2) and Hepatitis B virus (HBV).MethodsSARS-CoV-2 and HBV vaccination response was assessed in a cohort of German ESRD hemodialysis patients. Anti-HBs- and SARS-CoV-2 anti-S-IgG were analyzed by ELISA. Demographic and clinical data were extracted from clinical files.ResultsSixty-four patients with complete information on HBV and SARS-CoV-2 vaccination responses were included. More than one-third (35.4%) of non-responders upon HBV vaccination were identified. Unresponsiveness after HBV and poor response after SARS-CoV-2 vaccination showed strong overlap, and overall, 70.3% of patients were classified into concordant HBV/SARS vaccination response groups. HBV vaccination non-responsiveness, but not poor SARS-CoV-2 post-vaccination immunity was associated with obesity, while poor SARS-CoV-2 vaccination responses were associated increased age.ConclusionOur findings confirm previous reports on impaired vaccination response in hemodialysis patients and show that post-vaccination humoral responses against SARS-CoV-2 and HBV display strong overlap in this vulnerable patient group. These results may help to adapt vaccination strategies in this highly vulnerable population.Trial registration: German Clinical Trial Registry, DRKS00021152.

Detection of SARS-CoV-2 and a possible variant in shelter cats.

SARS-CoV-2 is the cause of mild to severe acute respiratory disease that led to significant loss of human lives worldwide between 2019 and 2022. The virus has been detected in various animals including cats and dogs making it a major public health concern and a One Health issue. In this study, conjunctival and pharyngeal swabs (n = 350) and serum samples (n = 350) were collected between July and December 2020 from cats that were housed in an animal shelter and tested for the infection of SARS-CoV-2 using real time reverse-transcription polymerase chain reaction (rRT-PCR) that targeted the N1 and N2 genes, and a SARS-CoV-2 surrogate virus neutralization Test (sVNT), respectively. 203 (58%) swab samples were negative (N1 and N2 not detected), 2 (0.6%) were positive (N1 and N2 detected) and 145 (41%) were inconclusive (only N1 detected). Analysis of the N2 region and multiple sequence alignment revealed base-pair deletions and substitutions in the N2 probe binding region of the feline samples RNA extracts in comparison with the positive control and human SARS-CoV-2 sequences in the GenBank database. Substituting the N2 probe with a probe derived from the cat sample amplicon sequences, 123 of 127 (96.9%) of the N2 negative samples returned positive. All but one of the 350 serum samples were negative for SARS-CoV-2 antibody. These observations indicated that although detection of SARS-CoV-2 infection was low in the samples tested, pet cats can harbor the virus and serve as potential source for virus spread that may lead to human infections. Additionally, cats may harbor a yet-to-be described virus that is somewhat related to SARS-CoV-2.

Radiological assessment of pulmonary vascular changes and gastrointestinal changes in patients with COVID-19 referred to a tertiary health care center in Chennai, India: a prospective cross-sectional study

BACKGROUND: The coronavirus disease pandemic (COVID-19), caused by severe acute respiratory syndrome coronavirus 2, has led to significant morbidity and mortality worldwide since its emergence in 2019. Although primarily a respiratory illness, COVID-19 can also affect other organ systems, including the vascular and gastrointestinal systems. COVID-19 is linked to both venous and arterial thrombosis, and numerous studies have indicated a heightened risk of pulmonary embolism. Autopsies have revealed pulmonary vasculature thrombosis and bowel ischemia in patients with COVID-19. AIM: To assess radiological pulmonary vascular changes, specifically pulmonary embolism, and gastrointestinal changes in patients with COVID-19 referred to a tertiary healthcare center in Chennai, India. MATERIALS AND METHODS: Computed tomography pulmonary angiography and contrast-enhanced computed tomography of the abdomen were conducted in 100 patients with COVID-19 who met the selection criteria. A radiologist with 5 years of experience evaluated pulmonary vascular and bowel changes. Subsequently, statistical analysis was performed to determine the significance of the relationship between patients with COVID-19 and the occurrence of pulmonary vascular and bowel changes. RESULTS: In this study, 11 patients exhibited pulmonary thromboembolism, and 7 showed significant bowel changes such as bowel wall thickening, mesenteric ischemia, and omental infarction, indicative of potential gastrointestinal involvement of patients with COVID-19. A positive correlation was found between pulmonary embolism prevalence in patients with COVID-19. Pulmonary embolism was diagnosed at a mean of 11 days from disease onset. Of the 24 patients with severe acute respiratory illness, 7 showed pulmonary embolism, detected by computed tomography pulmonary angiography. In addition, of the 10 patients on mechanical ventilation, pulmonary embolism was found in 7. Among the seven patients with bowel changes, four had pulmonary embolism, as detected by computed tomography pulmonary angiography, indicating a significant association between the two concomitant complications. The observed bowel changes were attributed to intravascular thrombosis. CONCLUSIONS: Based on our findings, pulmonary emboli and bowel changes often occur in patients with COVID-19. Multivariate analyses also revealed a connection between invasive mechanical ventilation and pulmonary embolism. The results indicate that patients with severe COVID-19 may also experience concurrent acute pulmonary embolism. Thus, for these patients, the use of contrast-enhanced computed tomography instead of standard non-contrast computed tomography may aid in treatment decision-making.

Prospective clinical surveillance for severe acute respiratory illness and COVID-19 vaccine effectiveness in Kenyan hospitals during the COVID-19 pandemic.

There are limited data from sub-Saharan Africa describing the demographic characteristics, clinical features and outcome of patients admitted to public hospitals with severe acute respiratory infections during the COVID-19 pandemic. We conducted a prospective longitudinal hospital-based sentinel surveillance between May 2020 and December 2022 at 16 public hospitals in Kenya. All patients aged above 18 years admitted to adult medical wards in the participating hospitals were included. We collected data on demographic and clinical characteristics, SARS-CoV-2 infection and COVID-19 vaccination status and, admission episode outcomes. We determined COVID-19 vaccine effectiveness (VE) against admission with SARS-CoV-2 positive severe acute respiratory illness (SARI) (i.e., COVID-19) andprogression to inpatient mortality among patients admitted with SARI, using a test-negative case control design. Of the 52,636 patients included in the study, 17,950 (34.1%) were admitted with SARI. The median age was 50 years. Patients were equally distributed across sexes. Pneumonia was the most common diagnosis at discharge. Hypertension, Human Immunodeficiency Virus (HIV) infection and Diabetes Mellitus were the most common chronic comorbidities. SARS-CoV-2 test results were positive in 2,364 (27.9%) of the 8,471 patients that underwent testing. After adjusting for age, sex and presence of a chronic comorbidity, SARI patients were more likely to progress to inpatient mortality compared to non-SARI patients regardless of their SARS-CoV-2 infection status (adjusted odds ratio (aOR) for SARI and SARS-CoV-2 negative patients 1.22, 95% CI 1.10-1.37; and aOR for SARI and SARS-CoV-2 positive patients 1.32, 95% CI 1.24-1.40). After adjusting for age, sex and presence of a chronic comorbidity, COVID-19 VE against progression to inpatient mortality following admission with SARI for those with a confirmed vaccination status was 0.59 (95% CI 0.27-0.77). We have provided a comprehensive description of the demographic and clinical pattern of admissions with SARI in Kenyan hospitals during the COVID-19 pandemic period as well as the COVID-19 VE for these patients. These data were useful in providing situational awareness during the first three years of the pandemic in Kenya and informing national response measures.

Near real-time severe acute respiratory illness surveillance characterising influenza and COVID-19 epidemiology in hospitalised adults, 2021-22

We report the findings of a novel enhanced syndromic surveillance thatcharacterised influenza- and SARS-CoV-2-associated severe acute respiratory illness (SARI) in the 2021/2022 winter season. Prospective cohort study of adults admitted to the Queen Elizabeth University Hospital, Glasgow, with a severe acute respiratory illness. Patient demographics, clinical history, admission details, and outcomes were recorded. Data were available to Public Health Scotland (PHS) and clinicians weekly. Between November 2021 and May 2022, 1063 hospitalised SARI episodes in 1037 adult patients were identified. Median age was 72.0 years, and 44.5% were male. Most (82.6%) SARI cases had ≥1 co-morbidity; chronic lung disease (50.0%) and malignancy (22.5%) were the most frequently reported. Overall, 229 (22%) and 33 (3%) SARI episodes were SARS-CoV-2 and influenza A PCR positive, respectively. 74.7%, 6.5% and 43.0% SARI episodes received antibiotics, antivirals, and steroids, respectively (54.5%, 11.0% and 51.3% among COVID-19 patients). 1.1% required mechanical ventilation and 7.8% died. Male sex, multimorbidity, frailty, respiratory rate >30, low GCS and chest X-ray consolidation were predictive of in-hospital mortality. Near real-time hospitalised SARI syndromic surveillance characterised the evolving clinical epidemiology of SARS-CoV-2 and influenza, high antimicrobial use, and predictors of inpatient mortality among hospitalised SARI patients.

Risk factors for severe respiratory syncytial virus-associated respiratory tract infection in a high HIV prevalence setting, South Africa, 2012 – 2018

BackgroundIdentifying risk factors for respiratory syncytial virus (RSV)–associated severe acute respiratory illness (SARI) will assist with targeting vaccine interventions.MethodsUsing surveillance data from South Africa (2012–2018), we compared the characteristics of individuals with RSV-associated influenza-like illness (ILI) (reference group) to those with RSV-associated SARI to describe factors associated with SARI using a multivariable analysis.ResultsRSV was detected in 6% (483/7792) of ILI cases and 15% (844/5672) of SARI cases. Factors associated with SARI in children included age < 2 months, compared to age 2–4 years (adjusted odds ratio (aOR) 54.4; 95% confidence interval (CI) 23.5–125.8), malnutrition (aOR 1.9; 95% CI 1.2–3.2), prematurity (aOR 2.4; 95% CI 1.3–4.6) and living with HIV (LWH) (aOR 22.5; 95% CI 2.9–174.3). In individuals ≥ 5 years, factors associated with SARI included age ≥ 65 years compared to age 5–24 years (aOR 10.7; 95% CI 1.1–107.5), symptom duration ≥ 5 days (aOR 2.7; 95% CI 1.1–6.3), underlying illness (aOR 2.7; 95% CI 1.5–26.1) and LWH (aOR 16.8, 95% CI: 4.8–58.2).ConclusionIndividuals at the extremes of age and those with identified risk factors might benefit most from RSV prevention interventions.Clinical trial numberNot applicable, this is not a clinical trial.

Interim Effectiveness Estimates of 2024 Southern Hemisphere Influenza Vaccines in Preventing Influenza-Associated Hospitalization - REVELAC-i Network, Five South American Countries, March-July 2024.

To reduce influenza-associated morbidity and mortality, countries in South America recommend annual influenza vaccination for persons at high risk for severe influenza illness, including young children, persons with preexisting health conditions, and older adults. Interim estimates of influenza vaccine effectiveness (VE) from Southern Hemisphere countries can provide early information about the protective effects of vaccination and help guide Northern Hemisphere countries in advance of their season. Using data from a multicountry network, investigators estimated interim VE against influenza-associated severe acute respiratory illness (SARI) hospitalization using a test-negative case-control design. During March 13-July 19, 2024, Argentina, Brazil, Chile, Paraguay, and Uruguay identified 11,751 influenza-associated SARI cases; on average, 21.3% of patients were vaccinated against influenza, and the adjusted VE against hospitalization was 34.5%. The adjusted VE against the predominating subtype A(H3N2) was 36.5% and against A(H1N1)pdm09 was 37.1%. These interim VE estimates suggest that although the proportion of hospitalized patients who were vaccinated was modest, vaccination with the Southern Hemisphere influenza vaccine significantly lowered the risk for hospitalization. Northern Hemisphere countries should, therefore, anticipate the need for robust influenza vaccination campaigns and early antiviral treatment to achieve optimal protection against influenza-associated complications.

Effectiveness of influenza vaccines in children aged 6 to 59 months: a test-negative case-control study at primary care and hospital level, Spain 2023/24.

During 2023/24, all children aged 6 to 59 months were targeted for seasonal influenza vaccination in Spain nationally. Using a test-negative case-control design with sentinel surveillance data, we estimated adjusted influenza vaccine effectiveness (IVE) against any influenza type to be 70% (95% confidence interval (CI): 51 to 81%) for primary care patients with acute respiratory illness (ARI) and 77% (95% CI: 21 to 93%) for hospitalised patients with severe ARI. In primary care, where most subtyped viruses (61%; 145/237) were A(H1N1), adjusted IVE was 77% (95% CI: 56 to 88%) against A(H1N1)pdm09.

Acute angle-closure glaucoma before, during, and after the outbreak of COVID-19 in China

ObjectivesAcute angle-closure glaucoma (AACG) is a major cause of irreversible and severe visual function loss. Robust rise in AACG was observed in the ophthalmic outpatient clinics concomitant with the outbreak of COVID-19 infection in China after the relaxing of “zero-COVID policy” in early December 2022. Here we compared the demographic and clinical profiles of patients with AACG before, during and after the COVID-19 outbreak. Underlying mechanisms were tentatively investigated. MethodsThis is a retrospective comparative study. Consecutive cases with newly diagnosed AACGs in a tertiary eye hospital were retrospectively collected during December 17, 2022 to January 8, 2023. Data from the same period in 2018–2019 and 2019–2020, 2020–2021 and 2021–2022, and 2023–2024 were collected as pre-pandemic, pandemic-control, and post-pandemic control, respectively. For the patients in 2022–2023 outbreak group, COVID-19 infection was confirmed by reversed transcriptase-polymerase chain reaction or antibody test for severe acute respiratory syndrome coronavirus disease 2 (SARS-CoV-2) from nasopharyngeal swabs. Ocular parameters, serum electrolytes and coagulative parameters were compared between COVID-19 positive and negative AACGs in observational group. SARS-CoV-2 nucleic acid in the aqueous humor was detected. ResultsA total of 106 AACG cases were diagnosed during the outbreak period in 2022–2023. In contrast, 18 (in 2018–2019) and 22 (in 2019–2020) cases were included during pre-pandemic period, and 21 (in 2023–2024) during the post-pandemic period. Only 13 and 4 newly onset AACG were included in 2020–2021 and 2021–2022 during the pandemic-control period, respectively. Younger age and higher proportion of bilateral involvement were detected in COVID-19 outbreak group than that of other groups (p = 0.034 and p = 0.080). Sixty-eight (64.2 %) patients in the outbreak group had a confirmed COVID-19 infection. Intervals between infection and AACG attack was 52 ± 85h (0-15d). Fifty-three patients (77.9 %) reported the applications of ibuprofen or other antipyretic medications and 25 (36.8 %) reported large volume water intake before AACG attack. COVID-19-positive AACG patients had higher level of D-dimer than their negative counterparts (1.13 ± 2.60 mg/L vs. 0.46 ± 0.43 mg/L, p = 0.083). No difference in IOP, serum electrolytes, and coagulative parameters other than D-dimer was observed between COVID-19 positive and negative cases. SARS-CoV-2 were negative in the aqueous humor from 14 COVID-19 positive and 8 negative patients. ConclusionCOVID-19 infection surged the onset of AACG in patients at risk. Mental stress, water intake, increased choroidal thickness due to SARS-CoV-2 induced ACE receptor activation, and hyper-coagulation, may contribute to the disease onset. Ocular involvement should not be ignored in both routine and new systemic emergent conditions.

Structural definition of pseudorabies virus dUTPase reveals a novel folding dimer in the herpesvirus family

The pseudorabies virus (PRV) causes severe and fatal acute respiratory disease in pigs. During PRV proliferation, the enzyme deoxyuridine 5′-triphosphate nucleotide hydrolase (dUTPase) plays a pivotal role in maintaining a low dUTP/dTTP ratio, thereby ensuring the accuracy of viral DNA replication. However, its structure and catalytic mechanisms have not been fully elucidated. Here, we report the crystal structure of PRV dUTPase at a 2.24 Å resolution and demonstrate an unprecedented dimeric architecture, with a conserved enzyme activity center of the herpesvirus family. The enzyme activity center is located in a cavity between the two domains, forming a pocket for binding substrate dUMP and magnesium ions. Remarkably, the exquisite interface of the dimer is primarily composed of four antiparallel β-sheets, which form 11 hydrogen bonds between the residues P33-V36 and R242-A248 to maintain protein stability. To the best of our knowledge, this is the first report demonstrating that dUTPase exists as a dimer in the herpesvirus family. These findings not only present a novel fold dimeric structure but also deepen the scope of our comprehension of structural diversity in dUTPase family.

Sex differences in the outcome of critically Ill patients with COVID-19 - An international multicenter critical care consortium study

BackgroundSex differences in severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) susceptibility, illness severity, and hospital course are widely acknowledged. The effects of sex on outcomes experienced by patients with severe Coronavirus Disease 2019 (COVID-19) admitted to the intensive care unit (ICU) remains unknown. ObjectivesTo determine the effects of sex on ICU mortality in patients with COVID-19 MethodsThis retrospective analysis of an international multi-center prospective observational database included adults admitted to ICU for treatment of acute COVID-19 between 1st January 2020 and 30th June 2022. The primary outcome was ICU mortality. Multivariable Cox regression was used to ascertain the hazard of death (Hazard Ratio=HR) adjusted for pre-selected covariates. The secondary outcome was sex differences in complications of COVID-19 during hospital stay. ResultsOverall, 10,259 patients (3,314 females, 6,945 males) were included with a median age of 60 (interquartile range [IQR]=49–68) and 59 (IQR=49–67) years, respectively. Baseline characteristics were similar between sexes. More females were non-smokers (65% vs. 44 %, p < 0.01) and obese (39% vs. 30 %, p < 0.01), compared to males. Also, males received greater ICU intervention (mechanical ventilation, prone ventilation, vasopressors, and tracheostomy) than females. Males had a greater hazard of death (compared to females, HR=1.14; 95 % CI=1.02–1.26). Adjustment for complications during hospital stay did not alter the hazard of death (HR=1.16; 95 % CI=1.05–1.28). Males had a significantly elevated hazard of death among patients who received ECMO (HR=1.24; 95 % CI=1.01–1.53). Male sex was associated with cardiac arrest (adjusted OR [aOR]=1.37; 95 % CI=1.16–1.62) and PE (aOR=1.28; 95 % CI=1.06–1.55). ConclusionAmong patients admitted to ICU for severe COVID-19, males experienced higher severity of illness and more frequent intervention than females. Ultimately, the hazard of death was moderately elevated in males compared to females despite greater PE and cardiac arrest.

In silico Molecular Docking of SARS-CoV-2 Surface Proteins with Benzimidazole Scaffolds: Strategy to Discover Lead Compounds

Background: The severe acute respiratory illness that was brought on because of the outbreak of COVID-19 caused by the SARS-CoV-2 infection has been designated as a public health emergency of worldwide concern. There is an immediate and pressing need to establish an effective therapeutic strategy to bring infections under control. COVID-19 viral spike glycoproteins and proteases both play important roles in the process of viral entrance as well as in the process of virus reproduction. Methods: Benzimidazole derivatives show antiviral activity against various RNA and DNA viruses and stop the early viral replication cycle. Based on this information, we designed eighteen new benzimidazole derivatives and screened them against the proteins S-glycoprotein 6VSB and papain-like protease 6W9C using molecular docking studies. Compounds that bind strongly to these proteins were evaluated again in an in vitro study. Results: When docked with SARS-CoV-2 spike glycoprotein, the binding affinity of R1 and R7 was –7.1 kcal/mol and -7.3 kcal/mol, respectively. This showed that they might be able to stop the SARS spike protein from binding to the ACE2 receptor on the human host, making it harder for the virus to get into the cells. The binding affinity of SARS-CoV-2 papain-like protease with R4, R14, and R15 was –6.7 kcal/mol, -6.5 kcal/mol, and –6.5 kcal/mol, respectively. COVID-19 could stop the protease from working by binding it. Conclusion: It was suggested, on the basis of the binding energy score, that these pharmacologically potent benzimidazole derivatives may be tested against SARS-CoV-2 and utilized in the production of efficient antiviral medicines

Adenoviral infection in children admitted with severe acute respiratory infection at tertiary care hospital from North India: A case series

Abstract There has been a recent surge in adenoviral infections with poor outcomes. This case series describes the clinical profile and outcome of 38 children admitted with adenovirus infection with severe acute respiratory illness (SARI). The majority (68.4%) were infants, 25 (65.7%) were immunocompetent, and 13 (34.2%) had an underlying comorbidity. Twenty-seven (71%) patients required mechanical ventilation and 5 (13.1%) were managed on a heated high-flow nasal cannula. Nine (23.6%) children developed acute respiratory distress syndrome and four (10.5%) cases developed postinfectious bronchiolitis obliterans (PIBO). The median duration of mechanical ventilation was 24 days interquartile range [11.5–34.5] days. Eleven (28.9%) children in the study population expired.

Technologies and main functionalities of the telemonitoring application reCOVeryaID.

The COVID-19 pandemic has highlighted the need to take advantage of specific and effective patient telemonitoring platforms, with specific reference to the constant monitoring of vital parameters of patients most at risk. Among the various applications developed in Italy, certainly there is reCOVeryaID, a web application aimed at remotely monitoring patients potentially, currently or no longer infected with COVID-19. Therefore, in this paper we present a system model, consisting of a multi-platform intelligent telemonitoring application, that enables remote monitoring and provision of integrated home care to both patients symptomatic, asymptomatic and pre-symptomatic with severe acute respiratory infectious disease or syndrome caused by viruses belonging to the Coronavirus family, as well as simply to people with respiratory problems and/or related diseases (chronic obstructive pulmonary disease or asthma). In fact, in this paper we focus on exposing the technologies and various functionalities offered by the system, which constitute the practical implementation of the theoretical framework described in detail in another paper. Specifically, the reCOVeryaID telemonitoring application is a stand-alone, knowledge base-supported application that can promptly react and inform physicians if dangerous trends in a patient's short- and long-term vital signs are detected, thus enabling them to be monitored continuously, both in the hospital and at home. The paper also reports an evaluation of user satisfaction, carried out by actual patients and medical doctors.

Changes in the etiological structure of severe acute respiratory viral infections in children and adults under the influence of the COVID-19 pandemic

Introduction. The traditional surveillance system for influenza and ARVI provides a general description of epidemics, but does not provide information on the age-related characteristics of the etiology and clinical peculiarities of severe acute respiratory diseases (SARI) in hospitalized patients. Aim. To monitor the etiology of SARI in hospitalized children and adults, assessing the impact of the COVID-19 pandemic on this process. Materials and methods. Standardized clinical and laboratory monitoring of SARI among 18,458 hospitalized patients was carried out in hospitals in three cities of Russia with weekly PCR detection of 11 types of pathogens. Results. According to the investigation of hospitalized patients with SARI for the period from 2018 to 2023, the viral etiology of respiratory diseases was deciphered in 58.3% of cases. Weekly monitoring showed a change in the etiological mosaic of SARI pathogens during the SARS-CoV-2 pandemic with a sharp decrease in the frequency of detection of influenza and respiratory syncytial virus (RSV) during the 2020–2021 season against the background of a significant increase of metapneumovirus and rhinovirus infections in children. During the 2022-2023 season an increase in the proportion of RSV infection in children under 6 years of age (up to 36.2%) was noted against the background of a significant decrease in the frequency of SARS-CoV-2. In the intensive care units (ICU), RSV infection was most often in children during the post-pandemic period (up to 30.1–53.6% of positive cases, p 0.001); in adults, SARS-CoV-2 was mostly detected (76,5–100% of cases, p 0.001). Conclusion. Hospital surveillance data significantly complements the epidemiological information obtained in the traditional surveillance system. Monitoring of infections has shown a continuously changing etiological infrastructure of SARI, with the disappearance of influenza and RSV during the COVID-19 pandemic and their return to circulation in the post-pandemic period.

Faktor-Faktor yang Berhubungan dengan Kelengkapan Vaksinasi Covid-19 pada Masyarakat di Wilayah Kerja Puskesmas Kenali Besar Kota Jambi

The Covid-19 pandemic caused by the Sars Cov-2 virus has the effect of triggering mild to severe acute respiratory tract disease with symptoms namely fever, shortness of breath, cough, fatigue, runny nose, sore throat, diarrhea, loss of the ability to smell and taste on the tongue and can cause death. Indonesia is the country with the most new cases and deaths in Southeast Asia as of 24-30 October 2022 with 19,661 new cases or 7.2 new cases per 100,000 population, even though the previous week there were 14,093 cases. This means that the addition occurred as much as 40%. This type of research is quantitative with a cross sectional design. The population of this study was all people aged &gt; 17 years in the working area of the Puskesmas Iknew Besar, totaling 42,796 people with a sample of 172 respondents. The sampling technique used multistage random sampling. Data were collected using questionnaires and observation sheets, then univariate data analysis using the chi-square test. The results of the multivariate analysis show that there is a relationship between the completeness of the Covid-19 vaccination and attitudes, history of Covid-19, history of non-communicable diseases, perception of Covid-19 risk, family support and health information among the community in the working area of the Puskesmas Kenali Besar, Jambi City in 2022.

COVID-19 vaccine hesitancy among a rural and urban population in South India: A community-based cross-sectional study

Abstract Background: This pandemic has been accompanied by an overabundance of misinformation, ‘infodemic’ on a global scale. The objective of the study is to explore the attitude and hesitancy of rural versus urban adults (&gt;18 years) towards the severe acute respiratory syndrome coronavirus-2 disease (COVID-19) vaccine. Methods: A community-based analytical cross-sectional survey was conducted in rural and urban field practice area. Systematic random sampling technique was applied; face-to-face interview was conducted amongst 523 participants. The World Health Organization Strategic Advisory Group of Expert on Immunisation (SAGE) questionnaire was used. Results: Amongst the total participants (n = 523), 274 participants were from rural area. Amongst the rural participants, majority of the participants were male 149 (54.4%), nearly 238 (86.9%) were married and 211 (77%) belonged to nuclear family. It was found from urban 94% of the participants and 53.6% from rural were reluctant to COVID-19 vaccine. One of the important factors which gives pressure and prevents them from get vaccinated were found to be stigma and it was more common in urban (66.6%) when compared to rural (13.9%) and the family members (16.1%) were another factor of participants for not taking the vaccine. Other reasons were side effects and fear death due to vaccine from urban and rural were 50%, 19.3% and 4.8%, 13.5%, respectively. Conclusions: Intense behaviour change interventions must focus on trust building through active community engagement, social mobilisation and transparent dissemination of vaccine-related information.

Platelet Indices as Novel Surrogate Markers for the Prognosis of COVID-19 Infection: An Observational Study.

Background The new severe acute respiratory syndromecoronavirus 2 (SARS-CoV-2) causes severe acute respiratory illness accountable for causing the coronavirus disease 2019 (COVID-19) illness. Thrombotic issues, acute respiratory distress syndrome (ARDS), and cytokine storm are significant contributors to morbidity and mortality in patients with COVID-19. Elevated D-dimer levels and prothrombin times are further indicators of abnormal coagulation parameters in COVID-19 patients. This study aimed to study the platelet indices as prognostic markers in COVID-19 infection. Methods In this prospective observational study, 150 real-time reverse transcription-polymerase chain reaction (RT-PCR)-positive COVID-19 patients were enrolled between October 2020 and September 2021. All the subjects were screened and explained the study procedure in their native language. Following enrolment, a detailed history and physical examination were performed. Subsequently, laboratory investigations were performed, and patients were subjected to high-resolution computed tomography (HRCT) examination to classify patients into mild, moderate, and severe according to the severity of the illness. The platelet indices taken into account were plateletcrit (PCT) in percentage, platelet count (PLT) in lakh per microlitre, mean platelet volume (MPV) in femtolitres, and platelet distribution width (PDW) in femtolitres. Results The mean PLT was significantly greater among survivors than non-survivors (2.03 ± 0.72 versus 1.76 ± 0.47; p-value = 0.018). The mean MPV (10.42 ± 0.53 versus 9.22 ± 0.64; p-value <0.0001) and PDW (17.99 ± 1.53 versus 16.54 ± 0.91 fl; p-value <0.0001) were significantly greater among non-survivors than survivors. However, the mean PCT was significantly greater among survivors than non-survivors (0.22 ± 0.03% versus 0.18 ± 0.33%; p-value <0.0001).At a cut-off of 0.213, the sensitivity and specificity of PCT in predicting death were found to be 79.2% and 74.5%, respectively. At a cut-off of 16.75, the sensitivity and specificity of PDW in predicting death were found to be 68.8% and 59.8%, respectively. The findings demonstrated a relationship between elevated MPV and PDW and mortality and severe COVID-19 infection. Increased PCT was connected to higher survival, with a specificity and sensitivity of 87.5% and 75.5%, respectively, and MPV >9.75 may predict death. PDW >16.75 exhibited a specificity and sensitivity of 68.8% and 59.8%, respectively, in predicting death. With comparable sensitivity and specificity of 79.2% and 74.5%, PCT >0.213 may predict death. Conclusion In severely sick COVID-19 patients, platelet indices should be routinely calculated and can be utilized as simple, low-cost prognostic indicators.

Clinical Profile and Outcome of Severe Acute Respiratory Illness (SARI) in Children Amidst the COVID-19 Pandemic.

Beginning in December 2019, COVID-19 rapidly emerged as a global pandemic. Though its severity in children was reported to be less than that in adults, data on its epidemiology in relation to severe acute respiratory illness (SARI) caused by other microbes needed to be generated. This study compares theclinical profile and outcome of children hospitalized with COVID-19-positive and negative SARI. This is a prospective observational analytical study involving children 1 month to 18 years old, hospitalized with COVID-19-positive and negative SARI during the pandemic. All eligible patients were enrolled after obtaining informed parental consent. Their clinical manifestations, investigations, and outcomes were documented on a predesigned case record form. A nasopharyngeal swab sample for COVID-19 reverse transcription polymerase chain reaction was sent, and results were noted. From May 2020 to July 2021, 267 children were hospitalized with a diagnosis of SARI. Out of these, 146 (54.7%) were boys and 78.7% were under five years of age. Other presentations included fever and cough, breathlessness, nausea, vomiting, diarrhea, rash, seizures, and altered sensorium. Twenty-eight patients (10.5%) tested positive for COVID-19. COVID-19 patients were similar in terms of demographic characteristics and presenting symptoms to non-COVID-19 patients but had a lower absolute lymphocyte count (p = 0.019) and higher serum alanine transaminase levels (p = 0.013). Acute respiratory distress syndrome (OR, 4.3; 95% CI, 1.8-10.0),shock (OR, 3.9; 95% CI, 1.9-7.9), and need for intensive care unit admission (OR, 9.9; 95% CI, 6.9-14) were more common in COVID-19 SARI patients. Death occurred in 18% of COVID-19 and 9% of non-COVID-19 patients (p = 0.07). SARI nonsurvivors had significantly lower blood pH and platelet counts than survivors. Comparison of COVID-19-positive and negative SARI patients showed subtle differences between the two groups, with COVID-19-positive children having an increased severity of illness. Also, laboratory evidence of multiorgan dysfunction at admission was associated with higher mortality.

Comparison of hematologic parameters as predictors of severity in COVID-19: A single-center cross-sectional study

COVID-19 disease was a global pandemic that marred humanity globally from 2019 end till early 2023. The diseases caused by the novel SARS cov2 virus had a wide array of presentations, from asymptomatic to mild illness to severe acute respiratory illness, with patients presenting with ‘happy hypoxia and sudden deterioration of clinical condition to multiorgan involvement and proven to be fatal in many cases. There was an effort to identify a point-of-care test to screen patients so as to predict the disease course; therefore, this study was designed to compare hematologic parameters to predict the severity of the disease. This study showed that TLC,dNLR, and NLR can be effectively used in diagnosing severe COVID-19.