COVID-19 Symptoms Research Articles

Randomized trial of influence of vitamin D on the prevention and improvement of symptomatic COVID-19

We aimed to investigate the preventive effect of vitamin D2 on COVID-19 and the improvement of symptoms after COVID-19 infection. The study recruited 228 health care workers who tested negative PCR or antigen for COVID-19. Subjects were randomly allocated to vitamin D2 or non-intervention at a ratio 1:1. Subjects recorded PCR or antigen tests and the symptoms of COVID-19 twice a week during the follow-up visit. The concentration of serum 25-hydroxyvitamin D (25(OH)D), C-reaction protein (CRP), complement component C1q and inflammatory cytokines were measured. The rates of COVID-19 infection were 50.5% in the vitamin D2 group and 52.4% in the non-intervention group (P = 0.785). There was no difference in the COVID-19 symptoms between the two groups. The mean 25(OH)D level significantly increased from 14.1 to 31.1 ng/mL after administration (P < 0.001). The difference between the two groups was not significant for the concentrations of CRP, C1q and inflammatory cytokines on the thirtieth day of the trial. According to the second level of vitamin D, there was a 14.3% difference in positive infection rates between the vitamin D adequate (> 30 ng/mL) and deficient groups (< 20 ng/mL). Adequate vitamin D had a tendency to prevent COVID-19.Trial registration: ClinicalTrials.gov NCT05673980, dated: 12/2022.

Internet access during COVID-19 and depressive symptoms in middle-aged and older adults: Evidence from a quasi-experimental study in China

BackgroundAmid the COVID-19 pandemic, the mental health of middle-aged and older adults has become an increasing concern, and the role of the internet in addressing this public health crisis has drawn the attention of researchers. This study evaluated the impact of internet access during COVID-19 on depressive symptoms among middle-aged and older adults. MethodsData were derived from China Health and Retirement Longitudinal Study (CHARLS) 2018 and 2020. Difference-in-differences analysis was performed to compare changes in depressive symptoms between the internet users during COVID-19 and those who didn't have access to the internet before and during the pandemic. ResultsWe found that internet access during COVID-19 pandemic significantly reduced middle-aged and older adults' depressive symptoms. Further investigation identified the underlying mechanisms through which internet access helps in alleviating depressive symptoms by reducing the likelihood of experiencing negative emotions about COVID-19. Heterogeneity analyses showed that rural residents and middle-aged individuals benefited more from internet access during the pandemic. ConclusionsSince internet access can alleviate middle-aged and older adults' depressive symptoms amidst public health crisis, policy makers should focus on enhancing their access to the internet.

Specific persistent symptoms of COVID-19 and associations with reinfection: a community-based survey study in southern China.

Surveillance remains fundamental to understanding the changes in epidemiological patterns regarding post-COVID conditions and reinfections. Persistent symptoms and reinfection in previously infected individuals are increasing being reported in many countries, but their associations among general populations were seldomly reported. Understanding the association with persistent symptoms of COVID-19 reinfection is essential to develop strategies to mitigate the long-term health and socio-economic impacts of the post-COVID conditions. This study aimed to investigate the incidence of COVID-19 persistent symptoms among previously infected Chinese community residents and explore associations of specific COVID-19 persistent symptoms with reinfection and other factors. A community-based survey was conducted in a southern city of China with about 20 million residents from August 3 to 24, 2023. Face-to-face questionnaires were distributed to a total of 1,485 residents to collect their information about COVID-19 infection, reinfection, specific ongoing persistent symptoms, and other COVID-19 related information. Multivariable logistic regression analysis was used to examine the association between specific persistent symptoms and reinfection of COVID-19, along with age, gender, and educational level. Of the 1,485 participants, 1,089 (73.3%) reported they had been infected with COVID-19. Among them, 89.1% reported having ongoing persistent symptoms and 14.2% reported had two or more times of infection. About 20% participants were infected 1 year or more since their initial infection. Fatigue, cough, and headaches were the top 3 symptoms being reported. Participants with reinfection were associated with a higher probability of reporting headaches (OR: 1.54, 95% CI: 1.06-2.25), loss of or change in smell and/or taste (OR: 1.90, 95% CI: 1.27-2.83), impaired sleep (OR: 1.55, 95% CI: 1.02-2.35), and brain fog (OR: 1.76, 95% CI: 1.12-2.76). Participants aged 45 and above and who had a bachelor's or higher degree were more likely to report chest tightness or shortness of breath, impaired sleep, and brain fog. During the post-emergency period of COVID-19 pandemic, the incidence of ongoing persistent symptoms among Chinese residents remains high. Individuals whose initial infection was longer than 1 year have the highest probability of reporting having multiple symptoms. Reinfection may increase the risk of reporting headaches, loss of or change in smell and/or taste, impaired sleep, and brain fog. It is important to maintain routine syndromic surveillance among previously infected people and provide recommendations for clinical management of individuals with multiple ongoing symptoms.

Circulating miRNAs in the Plasma of Post-COVID-19 Patients with Typical Recovery and Those with Long-COVID Symptoms: Regulation of Immune Response-Associated Pathways.

Following the acute phase of SARS-CoV-2 infection, certain individuals experience persistent symptoms referred to as long COVID. This study analyzed the patients categorized into three distinct groups: (1) individuals presenting rheumatological symptoms associated with long COVID, (2) patients who have successfully recovered from COVID-19, and (3) donors who have never contracted COVID-19. A notable decline in the expression of miR-200c-3p, miR-766-3p, and miR-142-3p was identified among patients exhibiting rheumatological symptoms of long COVID. The highest concentration of miR-142-3p was found in healthy donors. One potential way to reduce miRNA concentrations is through antibody-mediated hydrolysis. Not only can antibodies possessing RNA-hydrolyzing activity recognize the miRNA substrate specifically, but they also catalyze its hydrolysis. The analysis of the catalytic activity of plasma antibodies revealed that antibodies from patients with long COVID demonstrated lower hydrolysis activity against five fluorescently labeled oligonucleotide sequences corresponding to the Flu-miR-146b-5p, Flu-miR-766-3p, Flu-miR-4742-3p, and Flu-miR-142-3p miRNAs and increased activity against the Flu-miR-378a-3p miRNA compared to other patient groups. The changes in miRNA concentrations and antibody-mediated hydrolysis of miRNAs are assumed to have a complex regulatory mechanism that is linked to gene pathways associated with the immune system. We demonstrate that all six miRNAs under analysis are associated with a large number of signaling pathways associated with immune response-associated pathways.

Anxiety and depression among individuals with long COVID: Associations with social vulnerabilities

BackgroundWe examined the association between symptoms of anxiety and depression among individuals with long COVID and five social vulnerabilities (expenses, employment, food insufficiency, housing, and insurance). MethodsData from the Census Bureau's Household Pulse Survey (HPS) detailing COVID incidence, duration, and symptoms between June 1st and November 14th, 2022 contained versions of the Generalized Anxiety Disorder (GAD-2) and the Patient Health Questionnaire (PHQ-2) questionnaires. Associations between anxiety, depression, and the five social vulnerabilities among respondents from different racial and ethnic groups experiencing long COVID were evaluated using generalized binomial logistic regression. Structural equation models tested whether social vulnerabilities mediated the pathway between race/ethnicity and anxiety/depression. ResultsBlacks, Asians/others, and Hispanics with long COVID were significantly more likely to report anxiety and depression and various social vulnerabilities than Whites. Anxiety among Blacks was significantly associated with difficulty with expenses [Odds Ratio (OR) = 1.743, 95 % Confidence Interval (CI) = 1.739, 1.747], employment (OR = 1.519, 95 % CI = 1.516, 1.523), and housing (OR = 1.192, 95 % CI = 1.19, 1.194). Anxiety among Hispanics was significantly associated with food insufficiency (OR = 1.048, 95 % CI = 1.044, 1.052). Depression among Blacks was significantly associated with trouble with expenses (OR = 1.201, 95 % CI = 1.198, 1.205) and employment (OR = 1.129, 95 % CI = 1.127, 1.132). Mediation analysis showed that the number of social vulnerabilities partially mediated the association between race and anxiety. LimitationsThis retrospective study utilized secondary, observational, self-reported data from the HPS. Therefore, results may not be generalizable outside of the context in which they were collected. ConclusionsThe development of tailored programs for population health should address the differential associations of anxiety and depression with social difficulties among racial and ethnic groups.

Detection of COVID-19 incidence among attendees of the 2022 Hajj season

ObjectivesThis study investigated the presence of COVID-19 cases among pilgrims, health care workers (HCWs), and non-HCWs of Hajj 2022. MethodsNasopharyngeal samples were collected from 491 attendees of Hajj 2022. All participants received three doses of COVID-19 vaccines. Paired (n = 138; 69 participants) and unpaired (n = 422; 422 participants) nasopharyngeal swabs were subjected to reverse transcription–polymerase chain reaction targeting E gene of β-coronaviruses and RNA-dependent RNA polymerase of SARS-CoV-2. The results were linked to the participants’ profiles, including role during Hajj, presence of respiratory symptoms or comorbidities, contact with symptomatic individuals, smoking status, and COVID-19 recovery. ResultsA total of 20 (20 of 560; 3.6%) samples tested positive for COVID-19. Most cases (18 of 20; 90%) were pilgrims and non-HCWs. Six (30%) samples belonged to participants with previous positive reverse transcription–polymerase chain reaction. A total of 12 (60%) samples belonged to participants with respiratory symptoms. Three (15%) cases were linked to participants who had contact with individuals with respiratory symptoms. All cases belonged to individuals with no comorbidities, apart from a single case who has a chronic sinusitis. Five (25%) cases were smokers. No significant association was found between positive COVID-19 test and participants’ profiles. ConclusionsFew COVID-19 cases were detected in this study. Sustainable surveillance of COVID-19 and other respiratory viruses during Hajj seasons remains necessary.

Post-acute sequelae of COVID infection and cerebral venous outflow disorders: Overlapping symptoms and mechanisms?

Neurological long Covid (NLC) is a major post-acute sequela of SARS-CoV-2 infection, affecting up to 10% of infected patients. The clinical presentation of patients with NLC is varied, but general NLC symptoms have been noted to closely mimic symptoms of cerebral venous outflow disorders (CVD). Here we review key literature and discuss evidence supporting this comparison. We also aimed to describe the similarity between CVD symptomatology and neuro-NLC symptoms from two perspectives: a Twitter-distributed survey for long covid sufferers to estimate nature and frequency of neurological symptoms, and through a small cohort of patients with long covid who underwent CVD work up per our standard workflow. Over 700 patients responded, and we argue that there is a close symptom overlap with those of CVD. CVD workup in a series of 6 patients with neurological long COVID symptoms showed jugular vein stenosis by CT venography and varying degrees of increased intracranial pressure. Finally, we discuss the potential pathogenic association between vascular inflammation, associated with COVID-19 infection, venous outflow congestion, and its potential involvement in NLC.

Somatic, emotional, and gastrointestinal symptom severity are increased among children and adolescents with COVID-19.

Post-infectious disorders of gut-brain interaction (PI-DGBI) have significant impact on children and adolescents. The effect of COVID-19 on PI-DGBI-associated symptoms in this population, however, is unknown. We performed electronic medical record searches to identify patients 8-17 years old with a SARS-CoV2 PCR test at Lurie Children's Hospital between November 2020 and March 2021 (cohort 1) and April-October 2021 (cohort 2). Questionnaires were administered to assess symptoms prior to and 3 months following the test. This included the Pediatric Eosinophilic Esophagitis Symptom Score (PEESS), questionnaire of pediatric gastrointestinal symptoms-Rome IV, Nausea Profile (NP), dyspepsia symptom survey (DSS), nausea severity profile (NSP), and Pediatric Quality of Life Inventory (PedsQL). We grouped patients based on the presence of symptoms prior to COVID-19 test or the test result. One hundred and ninety-six parent(s) or guardian(s) in cohort 1 and 274 in cohort 2 completed surveys and self-reported their child's COVID-19 result. Cohort 1 had increased PEESS and DSS scores, lower PedsQL scores, and increased frequency of abdominal pain disorders among patients with symptoms prior to COVID-19 testing. Both cohorts had increased NP and NSP scores among patients with symptoms prior to COVID-19 testing that was highest among patients with a positive COVID-19 test. Abdominal pain and diarrhea prior to COVID-19 testing predicted higher NP scores. Among symptomatic COVID-19 tested children, we found increased severity of nausea-associated somatic, emotional, and gastrointestinal symptoms in the 3 months following the test that was most increased among patients with a positive COVID-19 test.

Humoral immune response as an indicator for protection against Covid-19 after anti-SARS-COV2-booster vaccination in hematological and oncological patients.

Cancer patients are at a higher risk to develop severe COVID-19 symptoms after SARS-CoV-2 infection compared to the general population and regularly show an impaired immune response to SARS-CoV-2 vaccination. In our oncological center, 357 patients with hematological and oncological diseases were monitored for neutralizing antibodies from October 2021 over 12 months. All patients had received three anti-SARS-CoV-2 vaccinations with an mRNA-(Comirnaty/BionTech or Spikevax/Moderna) or a vector vaccine (Vakzevria/AstraZeneca or JCOVDEN/Johnson&Johnson). Neutralizing anti-SARS-CoV-2 IgG antibodies in the patients' sera were detected within 3 months before, 3-10 weeks and 5-7 months after the booster vaccination (third vaccination). 112 patients developed a breakthrough SARS-CoV-2 infection during the observation period. High anti-SARS-Cov-2 antibody levels before infection significantly protected against symptomatic Covid-19 disease (p = .003). The median antibody titer in patients with asymptomatic Covid-19 disease was 2080 BAU/ml (binding antibody units per Milliliter) and 765 BAU/ml in symptomatic patients. 98% of the solid tumor patients reached seroconversion after the booster vaccination in comparison to 79% of the hematological patients. High antibody titers of >2080 BAU/ml after the booster vaccination were detected in 61% of the oncological and 34.8% of the hematological patients. 7-10 months after the booster vaccination, the anti-SARS-CoV-2 antibody titer declined to an average of 849 BAU/ml. Considering the heterogenous humoral immune response of cancer patients observed in this study, an individual vaccination strategy based on regular measurement of anti-SARS-CoV-2 antibody levels should be considered in contrast to fixed vaccination intervals.

Mitigating COVID-19 in meat processing plants: what have we learned from cluster investigations?

Several COVID-19 outbreaks have been reported in meat processing plants in different countries. The aim of this study was to assess the environmental and socio-economic risk factors favouring the transmission of SARS-CoV-2 in meat processing plants and to describe the prevention measures implemented. Data from epidemiological investigations of COVID-19 clusters in France, the scientific literature, structured interviews and site visits were collected and summarised to investigate the main risk factors for SARS-CoV-2 infection in meat processing plants, including determinants within and outside the workplace. An increased risk of infection was identified among workers with unfavourable socio-economic status (temporary/non-permanent workers, migrants, ethnic minorities, etc.), possibly related to community activities (house-sharing, car-sharing, social activities). Working conditions (proximity between workers) and environmental factors (low temperatures and inadequate ventilation) also appear to be important risk factors. These environmental conditions are particularly prevalent in cutting and boning plants, where the majority of reported cases are concentrated. Preventive measures applied included screening for COVID-19 symptoms, testing, wearing masks, increased hygiene and sanitation, physical and temporal distancing, control of ventilation. Certain food safety hygiene measures were compatible with protecting workers from SARS-CoV-2. The hygiene culture of agri-food workers made it easier to implement preventive measures after adaptation. This study made it possible to identify the environmental and socio-economic factors conducive to the transmission of SARS-CoV-2 in meat processing plants. The knowledge gained from this work was used in simulations to understand the transmission of the virus in the plants.

Long COVID Illness: Disparities in Understanding and Receipt of Care in Emergency Department Populations

BackgroundMost Long COVID studies rely on traditional surveillance methods that miss underserved populations who use emergency departments (EDs) as their primary health care source. ObjectivesIn medically-underserved ED populations, we sought to determine 1) whether there are gaps in awareness and self-declared understanding about Long COVID illness, and 2) the prevalence, impact, and receipt of care for Long COVID symptoms. Design, Setting and ParticipantsCross-sectional, convenience sample survey study of adult patients at 11 geographically representative US EDs from 12/2022-10/2023. MeasurementsAwareness and self-declared understanding about Long COVID illness; prevalence, impact, and receipt of care for Long COVID symptoms. ResultsOf 1618 eligible patients,1455 (89.9%) agreed to participate: 33.4% African American, 30.9% Latino/a, and 17.1% lacked primary care; 33.2% had persistent COVID symptoms lasting > 1-month, 20.3% had symptoms > 3-months; 49.8% with Long COVID symptoms missed work/school because of symptoms; 30.3% of all participants and 33.5% of participants who had Long COVID symptoms had prior awareness and self-declared understanding of Long COVID. Characteristics associated with poor understanding of Long COVID were: African American race (adjusted odds ratio [aOR] 3.68, 95% confidence interval [CI] 2.66-5.09) and Latino/a ethnicity (aOR 3.16, 95% CI 2.15-4.64). Participants lacking primary care were less likely to have received Long COVID care (24.6% vs 51.2%; difference 26.6%; 95% CI 13.7-36.9%). Conclusions/RelevanceDespite high prevalence and impact of Long COVID symptoms, most of this ED population had limited awareness and self-declared understanding of Long COVID and many had not received care. EDs should consider development of protocols for diagnosis, education, and treatment of Long COVID illness.

Prevalence and risk factors of long COVID among maintenance hemodialysis patients post SARS‐CoV‐2 infection: A one‐year follow‐up study in China

AbstractPatients undergoing maintenance hemodialysis (MHD) are a high‐risk group susceptible to SARS‐CoV‐2 infection and long‐COVID syndrome appearance. However, there is limited and unclear evidence for long COVID in MHD patients. We collected the general information, symptoms, signs and laboratory indices of 366 MHD patients infected with COVID‐19 and conducted 12 months follow‐up with a series of questionnaires. As a result, 285 MHD patients had long COVID, with the most common symptoms were fatigue (84.69%) and muscle weakness (72.45%). Mobility problem (p &lt; 0.001), anxiety/depression (p = 0.002) and breathlessness (p &lt; 0.001) were more prevalent in long COVID patients than in non‐long COVID patients. Persistent long COVID people were more likely to report all domains problems of the EQ‐5D‐5L. Age, female, inadequate dialysis (Kt/V &lt; 1.2), coagulation abnormalities (d‐dimer &gt; 1 mg/L) and more comorbidities were risk factors for the development of long COVID. In addition to these factors, elevated inflammatory markers (CRP &gt; 10 mg/L) represent an extra risk factor for the persistence of long COVID symptoms in MHD patients. And more than 80% of long COVID symptoms would resolve after 1 year in MHD patients, of which the sixth month after COVID‐19 infection is a critical turning point. In conclusion, more than 68% of MHD patients have long COVID, which has a poor impact on their health status and quality of life. These risk factors for the development and persistence of long COVID deserve the attention of clinicians.

Long COVID or Post-Acute Sequelae of COVID-19 (PASC) in Children and Adolescents.

Introduction: Few studies of children with long COVID (post-COVID-19 condition) or post-acute sequelae of SARS CoV-2 (PASC) have been reported. Those terms describe symptoms that persist for weeks or months or as new symptoms that develop after SARS-CoV-2 infection. This condition might be found to various degrees in the severity of COVID-19. This study aimed to describe long COVID in confirmed SARS-CoV-2-infected children.Design: An observational cross-sectional study.Setting: Tertiary care hospital between January and November 2021.Participants: Children, age 5-17 years, with virologically confirmed COVID?19.Methods: This study was conducted by completing an electronic form after informed consent was obtained. The subject's characteristics and parent's or guardian's phone numbers were retrieved from the pediatric COVID-19 registry. Parents were contacted to complete a structured electronic questionnaire about the long COVID symptoms noticed in their children. Descriptive statistics were displayed in percentages and median.Results: Parent contact numbers were documented in 125/135 children who fulfilled the study criteria. There were 61 parents (48.8%) who gave consent, while the rest either did not respond or refused. There were 16 children reported as deceased primarily due to chronic renal disease and leukemia. Of the 45 children enrolled, the median (IQR) age was 11 years (5.3-17.6); 51.1% were female; and 75.6% had comorbidities. Two-thirds developed long COVID symptoms, most frequently in the age 5-9 years group, and mostly fatigue (45.2%), decreased appetite (38.7%), and muscle aches (32.3%). All patients with moderate to severe and more than half asymptomatic to mild COVID-19 developed long COVID.Conclusion: Most children had long COVID symptoms similar to adults despite being otherwise asymptomatic or having mild COVID-19.

Insights into Long COVID: Unraveling Risk Factors, Clinical Features, Radiological Findings, Functional Sequelae and Correlations: A Retrospective Cohort Study

BackgroundThe long-term symptomatology of COVID-19 has yet to be comprehensively described. The aim of the study was to describe persistent COVID-19 symptoms in a cohort of hospitalized and home-isolated patients. MethodsA retrospective cohort study was conducted on long COVID patients. Long COVID symptoms were identified, and patients were divided into hospitalized (in-patients) and home-isolated (out-patients) as well as according to the number of symptoms. Patients were examined by a multydisciplinary medical team. Blood tests, high resolution chest computed tomography (CT), physical and infectious examination were performed. Finally, in-patients were evaluated at two time-points: on hospital admission (T0) and after three months from discharge (Tpost). ResultsThree hundred and sixty-four COVID-19 patients were enrolled. 82% of patients reported at least one or more symptoms. The most reported symptom was fatigue. Chest CT showed alteration in 76% of patients and pulmonary function alterations were observed in 44.7% of patients.A higher risk of presenting at least one symptom was seen in patients treated with corticosteroid and a higher risk of presenting chest CT residual lesion was observed in hospitalized patients and in patients that received hydroxychloroquine treatment. Moreover, a higher risk of altered pulmonary function was observed in older patients. ConclusionLong-term sequelae are present in a remarkable number of long COVID patients and pose a new challenge to the healthcare system to identify long-lasting effects and improve patients’ wellbeing. Multi-disciplinary teams are crucial to develop preventive measures, and clinical management strategies.

The Interplay of Microbiota, Long COVID, and Musculoskeletal Pain: A Narrative Review

Context: Long COVID, a condition that persists after the acute phase of COVID-19, poses a significant burden, with 10 - 45% of recovered patients experiencing persistent symptoms. Among these, approximately 46% report musculoskeletal pain. This narrative review explores the potential connections between gut microbiota, Long COVID, and musculoskeletal pain, aiming to introduce new therapeutic avenues and preventive strategies for managing musculoskeletal symptoms in Long COVID patients. Evidence Acquisition: A comprehensive search was conducted using Google Scholar, Lens.org, and ConnectedPaper.com to identify relevant articles published between 2019 and 2024. Keywords related to microbiota, Long COVID, and musculoskeletal pain were used. Articles were selected based on predefined inclusion and exclusion criteria, and their quality was assessed. Data from the selected articles were synthesized to provide an overview of the interplay between microbiota, Long COVID, and musculoskeletal pain. Results: Recent research highlights the significant role of gut microbiota in modulating immune responses and systemic inflammation. Dysbiosis has been linked to the severity and progression of COVID-19 and the persistence of Long COVID symptoms. Individuals with Long COVID often experience new-onset musculoskeletal manifestations, such as joint pain, myalgia, and chronic musculoskeletal pain. Additionally, gut dysbiosis has been associated with conditions like lower back pain and knee osteoarthritis. This suggests that the relationship between gut dysbiosis and musculoskeletal problems in general may also extend to musculoskeletal pain in Long COVID patients, indicating broader implications for musculoskeletal outcomes. Therapeutic strategies targeting the gut microbiota, such as probiotics, prebiotics, and dietary interventions, have shown promise in managing these symptoms and improving overall health outcomes. Conclusions: The evidence underscores the importance of understanding the microbiota-musculoskeletal nexus in Long COVID. Gut dysbiosis contributes to systemic inflammation, exacerbating musculoskeletal symptoms in Long COVID patients. The associations between gut dysbiosis and other musculoskeletal conditions emphasize the need for microbiota-targeted therapeutic strategies. Future research should focus on elucidating the mechanisms linking gut dysbiosis to musculoskeletal pain, exploring the gut-brain axis, and developing personalized approaches to modulate the microbiota. Advancing our understanding of this nexus can pave the way for innovative therapeutic strategies to address the complex health challenges posed by Long COVID and other musculoskeletal conditions.

Herbal medicines for long COVID: A phase 2 pilot clinical study

BackgroundInfections of Coronavirus Disease-2019 (COVID-19) can cause long-term effects known as long COVID. This pilot study aimed to evaluate the feasibility of a clinical study as well as the efficacy and safety of traditional East Asian herbal medicines in alleviating fatigue and cognitive dysfunction in patients with long COVID. MethodsThis prospective pilot study investigated the use of three types of herbal medicines, Bojungikgi-tang (BIT), Kyungok-go (KOG), and Cheonwangbosim-dan (CBD), for a 12-week period as potential treatments for fatigue and cognitive dysfunction in patients with long COVID. Forty-five patients with long COVID were recruited, and one of three drugs was given based on the patient's symptoms and pattern identification. The effect of herbal medications on fatigue and cognitive function outcomes was assessed over a 36-week period, with patient adherence closely monitored. ResultsAfter 12 weeks of herbal drug administration, fatigue symptoms improved significantly across all groups, with treatment success rates of 80 %, 53.33 %, and 46.67 % in the BIT, KOG, and CBD groups, respectively. However, cognitive dysfunction symptoms showed less improvement, with treatment success rates of 40 %, 46.67 %, and 13.33 % in the BIT, KOG, and CBD groups, respectively. All adverse events reported were mild and unrelated to the medication. The study design was found to be feasible with high medication adherence. ConclusionsThis study demonstrated the feasibility of conducting a clinical trial with three herbal medicines to treat long COVID symptoms like fatigue and cognitive dysfunction.

Post COVID-19 syndrome among 5248 healthcare workers in England: longitudinal findings from NHS CHECK

ObjectivesThe objectives of this study were to examine post COVID-19 syndrome (PCS) among healthcare workers (HCWs) in England and explore risk factors for the condition.MethodsData were collected by National Health...

Mathematical model for understanding the relationship between diabetes and novel coronavirus

A new model is proposed to explore interactions between diabetes and novel coronavirus. The model accounted for both the omicron variant and variants varying from omicron. The model investigated compartments such as hospitalization, diabetes, co-infection, omicron variant, and quarantine. Additionally, the impact of different vaccination doses is assessed. Sensitivity analysis is carried out to determine disease prevalence and control options, emphasizing the significance of knowing epidemics and their characteristics. The model is validated using actual data from Japan. The parameters are fitted with the help of ”Least Square Curve Fitting” method to describe the dynamic behavior of the proposed model. Simulation results and theoretical findings demonstrate the dynamic behavior of novel coronavirus and diabetes mellitus (DM). Biological illustrations that illustrate impact of model parameters are evaluated. Furthermore, effect of vaccine efficacy and vaccination rates for the vaccine’s first, second, and booster doses is conducted. The impact of various preventive measures, such as hospitalization rate, quarantine or self-isolation rate, vaccine dose-1, dose-2, and booster dose, is considered for diabetic individuals in contact with symptomatic or asymptomatic COVID-19 infectious people in the proposed model. The findings demonstrate the significance of vaccine doses on people with diabetes and individuals infectious with omicron variant. The proposed work helps with subsequent prevention efforts and the design of a vaccination policy to mitigate the effect of the novel coronavirus.

Recent Scenario of the Indian Healthcare System Post COVID-19 Emergence and in Severely ill Patients

Abstract: The coronavirus disease 2019 pandemic has brought fundamental changes to our priorities and problems, especially those related to the healthcare sector. The COVID-19 pandemic put even the world's most advanced healthcare systems to the test and India's healthcare system has been rattled as well. In this accordance, the Indian government has introduced many new policies and schemes like free vaccination drive, Atmanirbhar Bharat, and free COVID care under Ayushman Bharat. With the continuation of COVID-19, problems like Self-medication and hoarding of medicines among the common population keep on rising and this was due to flu-like symptoms of COVID-19, miss information on social media, or due to less or no interaction between patients and doctors as the population is now shifting to telemedicine which offers the benefit of consultation at their own home. These situations served as a boon to the Pharma sector as stocks of many pharma companies and industries have been reported to have increased in the past 2 years of the pandemic due to an increase in demand and manufacturing and consumption of pharmaceutical goods and also reportedly being increased by alot in coming years. However, this rapid growth of the pharmaceutical sector is beneficial for pharmacists, businessmen, and others who are directly or indirectly associated with the healthcare fraternity but in our opinion, it will negatively impact the Indian economy or can be viewed as a problem which can lead to the downfall of the qualitative aspect of the pharma sector in the long term.

SARS-COV-2 breakthrough infection and its covariates among healthcare providers of a hospital in Bangladesh during the omicron wave

IntroductionBreakthrough infection by SARS-COV-2 virus among vaccinated individuals has been reported from all over the world and it has created a substantial challenge in designing strategies to live with the virus in the post-pandemic era. Factors affecting the extent and nature of breakthrough infection are still not fully understood and those are known to vary depending on host and agent factors. Health Care Workers (HCWs), especially in hospital settings, are front-liners in combating the epidemic and, consequently, they are more vulnerable to breakthrough infection by SARS-COV-2. Like most of the countries of the world, Bangladesh went through several waves of COVID-19 and the last (3rd wave) was the widespread Omicron wave during the winter of 2022. HCWs in Bangladesh have been disproportionately affected by the virus. Under this context, the aim of the present study was to explore breakthrough infection (BTI) and its host-related covariates among HCWs of a COVID-dedicated city-based hospital during the Omicron wave in Bangladesh. Materials and methodsAn observational cross-sectional study was conducted on 267 HCWs of the Narayanganj Tertiary (300-bed) hospital during February–March 2022 which coincided with the terminal part of the 3rd wave. Data were collected by trained Field Assistants using Interviewer-administered Data Collection Forms with Questionnaires as instruments. Previous COVID-19 status (any time after the onset of the pandemic and within last 3 months) was explored by the history of specific symptoms as well as by the confirmatory rtPCR test reports from DGHS approved laboratories Anti-nucleocapsid antibody (Anti-N-Ab) in venous blood samples, assayed by a chemiluminescent ELISA technique, was used as a seroprevalence-based marker of breakthrough infection during the preceding few months. Data were analyzed by bivariate as well as multivariate statistics using the IBM-SPSS software. ResultsThe median age (range) of the HCWs was 38 (21–65) years; Body Mass Index (BMI, kg/m2) 25 (15–49); and Waist-Hip Ratio (WHR) was 0.92 (0.46–1.21). The male subjects had significantly higher median age (p = 0.01) and higher WHR (p = 0.001) as compared to the female subjects. As per the BMI category, subjects with overweight and obesity constituted 83.3 % of the male subjects as compared to 61.6 % of the female subjects (p = 0.001). The time lapse between receiving of 3rd dose and blood sampling was significantly higher among females compared to males (median days 60 vs 49, p < 0.02) indicating earlier vaccination with 1st booster dose among females. A proportion of 51.85 % male and 49.68 % female subjects showed Anti-N-Ab positivity; there was no significant difference between the gender groups. Also, there was no significant difference among male and female subjects regarding the Ab levels. On Spearman correlation analysis, a tendency of association of WHR with Ab level was observed among the male subjects; however, the association did not show statistical significance (p = 0.09). On binary logistic regression Ab positivity was found to be independently associated with WHR (p = 0.03), and prior SARS-COV-2 infection within the last 3 months (p = 0.02) among males. When all the subjects were considered together, COVID symptom positivity during the last 3 months (p = 0.067) and receiving the 1st booster dose (p = 0.07) showed a tendency of association with Ab positivity. On multiple regression analysis, Ab levels showed a negative association with WHR (p = 0.035) among males. ConclusionsMore than 50 % of the vaccinated hospital-based HCWs in Bangladesh suffered from BTI during the winter of 2022 when the Omicron wave (the 3rd wave) of COVID-19 was at its peak. The data also indicate that overweight and obesity are major host-related risk factors underlying BTI. Inadequate coverage by a booster dose seems to be another determinant of BTI and the level of immune response in this population.