Treatment Of COVID-19 Patients Research Articles

Supply chain network design based on Big Data Analytics: heuristic-simulation method in a pharmaceutical case study

Digital technology is a pivotal aspect of the ongoing digital transformation upon which supply chain networks (SCNs) heavily rely. Through the utilization of Big Data Analytics (BDA), organizations can gain insights into sales, production and formulate decision support systems. The pharmaceutical supply chain emerges as a crucial player in producing and distributing medications vital for treating COVID-19 patients. In this study, we have innovatively designed a multi-echelon Pharmaceutical Supply Chain Network (PSCN) using BDA during the COVID-19 pandemic. We have developed a novel Mixed-Integer Non-Linear Programming model addressing allocation, production planning, and inventory control decisions, known as the LAPI problem. A transformation method is employed to convert the non-linear model into a linear one to enhance computational efficiency. The primary objective of our mathematical model is to minimize the total cost and CO2 emissions of the transportation system and established centres while maximizing the shelf life of medicines. Our experiments reveal that medium- and large-scale problems, characterized by the three main attributes of BDA – variety, velocity and volume (3 V‟s), pose challenges for optimal solutions. We present a case study of Iran to validate the mathematical model for large-scale problems. Employing a simulation approach, we estimate the demand for required pharmaceuticals, underscoring our proposed model’s real-world applicability and effectiveness. This research contributes to the growing necessity of eco-friendly and efficient supply chain strategies, especially in the critical domain of pharmaceuticals during pandemic situations.

Quality of care and emergency department throughput during the COVID-19 pandemic in a community health system Pandemic in a Community Health System

Objective: This retrospective study explores the strategic plan formulated by AHMC Health System in California, USA, to sustain and improve quality of care and emergency department (ED) efficiency during the COVID-19 pandemic. It also analyzes the plan’s outcomes.Background: The COVID-19 pandemic has posed challenges for both individuals and healthcare industries alike, impacting decision-making and access to care. AHMC faced staff and resource shortages, patient reluctance, and difficulties adapting to rapidly evolving public health guidelines. These challenges highlighted the critical need for effective plans to maintain or improve healthcare quality and ED performance.Methods: AHMC adopted a comprehensive three-layer strategic plan in 2020. The first layer, “Pandemic Response,” focused on leadership, staff training and education, infection control, new treatments, and employee vaccination rates. The second layer, “ED Throughput,” set objectives for metrics such as door-to-doctor (door-to-doc) time, ancillary turnaround time (TAT), ED length of stay (LOS), and the left-without-being-seen (LWBS) rates. Progress was monitored through monthly improvement meetings. The third layer, “Quality Excellence,” tracked improvements in COVID-adapted objectives on quality initiatives, based on CMS Quality Star Ratings, Leapfrog Hospital Safety Grades, and Yelp review scores.Results: By 2023, the three-layer strategic plan had led to many improvements in the quality of care and ED efficiency. AHMC identified 22,287 positive COVID-19 cases, expanded its ventilator inventory by 50%, and enhanced patient outcomes by applying updated treatments. Additionally, AHMC saw a 3% reduction in ED wait times and sustained its overall patient satisfaction rates, CMS Quality Star Rating, and Leapfrog Hospital Safety Grade scores.Conclusions: AHMC’s three-layer strategic plan showed effectiveness in maintaining quality of care and ED efficiency during the COVID-19 pandemic. By focusing on “Pandemic Response,” “ED Throughput,” and “Quality Excellence,” AHMC was able to adapt to the rapidly evolving public health guidelines, expand its capacity to treat COVID-19 patients and sustain its overall patient safety, satisfaction, and quality ratings. The implementation of this plan highlights the importance of proactive and comprehensive strategies in managing healthcare crises.

Towards a Notion of Relational Sacrifices: Nursing During the COVID-19 Pandemic in Wuhan

ABSTRACT In this article, we examine the relationship between nursing and sacrifice in the context of Shanghai-based nurses volunteering to treat COVID-19 patients in Wuhan during the pandemic in 2019 and 2020. In the paper, we explore the relationship between metaphors, such as ‘the war on COVID’ with the notion of sacrifice among our participants. The contribution that this article makes is to examine the lived experiences of the sacrifices made by individual nurses in a wider ‘relational’ framework. This relational framework examines, not just the sacrifices of the nurses but also the sacrifices made by their families during their service in Wuhan. As such, the article explores not only the relationship (or conflict) between self-love, self-prolonging and self-preservation and ‘self-sacrifice’ in the moral philosophical tradition of Kant – through the lived experiences of our participants – we extend sacrifice and the sacrificial beyond the individual (nurse) to examine the relational and familial lived experiences of the sacrifice of the nurses and their families in the context of their nursing on the COVID-19 wards in Wuhan.

Mental Health Burden and Facilitators Among Frontline Healthcare Professionals in Nigeria Amid COVID-19 Pandemic: A Cross-sectional Study.

During the COVID-19 pandemic, the frontline healthcare providers faced significant mental health stressors. Previous pandemics have revealed the need for psychosocial support and healthy coping mechanisms to mitigate mental health risks. The study aimed to assess psychological impact and supportive mechanisms experienced by frontline healthcare workers treating COVID-19 patients in Kaduna State. This study involved 38 frontline healthcare providers mainly from Kaduna State Infectious Disease Treatment Center. Participants' mental health burden was captured through Hospital Anxiety and Depression Scale. Mental health facilitators were assessed through six tools: Ten-Item Values Inventory, healthy defense section of the Defense Style Questionnaire, Existential Anxiety Questionnaire, Brief Resilience Scale, Oslo Social Support Scale, and the Insomnia Severity Index. The mean age of the study participants was 35.5 ± 6.6 years, with the majority being males (68.4%) and doctors (39.5%). More than a quarter of the participants showed appreciable symptoms of depression and anxiety. Psychosocial facilitators such as moral values, openness to change, self-transcendence, sublimation, anticipation, and humor scored above average for more than half of the participants. Most participants demonstrated moderate resilience and social support, with few experiencing sleep challenges. Comparisons of variables indicated "openness to change" was significantly higher among males, whereas symptoms of depression and anxiety were associated with higher levels of existential concerns and sleep challenges. Our study finds that Nigerian frontline health workers experienced significant mental health challenges during the COVID-19 pandemic. It identified specific facilitators linked to gender and psychological burdens, informing the need for tailored support interventions.

Cross-sectional study of personal protective equipment use, training and biosafety preparedness among healthcare workers during the first months of the SARS-CoV-2 pandemic in Brazil

ObjectivesBrazil has high rates of COVID-19 and tuberculosis among healthcare workers (HCWs). Personal protective equipment (PPE) is essential for their protection. We aimed to evaluate PPE use, training, and preparedness...

The impact of COVID-19 vaccination on the risk of hospitalization in Fayoum healthcare workers

Background: Healthcare workers (HCWs) face several challenges including treating COVID-19 patients. The immunization of the population through vaccination is recognized as a public health priority. The aim of the study is to assess the impact of vaccination on the risk of hospitalization and mortality in HCWs due to COVID-19 infection. Methods: This study was conducted in Egypt in El Fayoum governorate on the HCWs from April 2021 to the end of the year 2021. A cohort retrospective approach was carried out using (the national electronic disease surveillance system) NEDSS and COVID-19 vaccine registration system. Hospitalization is determined by assessment of the cases according to the protocol of COVID-19 management of MOHP November 2020. Results: There was no association between hospitalization and both sex and residence (p=0.1, and 0.06 respectively). There was no statistical significant association between hospitalization and vaccination (time, status, or type). The p=0.2, 0.6, and 0.07 respectively. Age and the presence of comorbidities were statistically significant predictors with p=0.004 and 0.04, respectively, as increasing age and the presence of comorbidities will increase the likelihood of hospitalization by 1.04 and 1.9 folds, respectively. Conclusions: This study shows no significant association between vaccination and hospitalization of HCWs.

A Retrospective Study on Azvudine in Hospitalized Elderly Patients with COVID-19

Background:: The ongoing 2019 novel coronavirus pneumonia pandemic continues to pose a serious threat to public health and safety. In response, numerous specific anti-SARS-CoV-2 drugs have been urgently approved for use. Azvudine has been recommended as a priority treatment for COVID-19 patients, but its efficacy and safety in elderly patients remain unexplored. Methods:: In this retrospective, single-center, observational study, we assessed the impact of Azvudine treatment on elderly hospitalized patients aged over 70 years. We analyzed parameters such as the time of SARS-CoV-2 negative conversion, clinical outcomes, length of hospital stay, and respiratory support requirements. Additionally, we compared changes in blood routine indicators, liver and kidney function indicators, and the incidence of adverse events before and after Azvudine administration to provide real-world data concerning elderly patients. Results and Discussion:: The study included 36 elderly patients aged 70 to 95 years. Following Azvudine administration, the average time for SARS-CoV-2 negative conversion was 5.15 days. Clinical outcomes revealed improvement and discharge in 74.3% of the patients, exacerbation in 5.7% of the patients, and mortality in 20% of the patients. Analysis of blood routine indicators and liver function indicators before and after medication showed no clinically significant changes. However, serum creatinine levels (Scr) demonstrated a statistically significant increase (71.12 ± 44.22 vs. 87.88 ± 57.39, p < 0.05). Conclusion:: Although correlation analysis was not conducted, limited by the small sample size and retrospective nature of the study, these findings underscore the importance of monitoring Azvudine’s impact on renal function.

Promising role of traditional Indian Ayurvedic medicine in treatment, management and better clinical outcomes of COVID-19 patients: a retrospective study

IntroductionThe Coronavirus disease (COVID-19) has negatively impacted the lives of people globally. To date, no specific treatment has emerged to combat the disease. Hence, there is an urge for immediate therapy against infections like COVID-19 through the inclusion of various traditional medicines including Ayurveda. MethodsThis retrospective study was performed on 300 patients who were treated using the Holistic Ayurveda protocol at the COVID Health Care (CHC) centre. Out of 300 patients, 258 who took the AYURAKSHA Kit regularly along with the other Ayurvedic medicines for treatment were selected for this study. Demographic distribution, viral clearance, and haematological parameters of COVID-19 patients were analysed. ResultsThe maximum number of COVID-19 positive cases (31.4%) were found in the age group 20–29 years whereas the age group 40–49 years (11.52 days) and ≥ 60 years (11.5 days) took the maximum time (P = 0.035) for viral clearance. The haematological investigations showed that the Ayurveda treatment maintained the admitted patients' blood profile and coagulation profile. Strikingly, liver and kidney profiles improved post-treatment as Serum Glutamic-Oxaloacetic Transaminase (P = 0.000), Serum Glutamic Pyruvic Transaminase (P = 0.000), Urea (P = 0.000), and Creatinine (P = 0.002) levels were significantly reduced. Likewise, a significant reduction in inflammation markers like C-reactive Protein (P = 0.000), Erythrocyte Sedimentation Rate (P = 0.003), and serum Ferritin (P = 0.000) was also observed. No adverse treatment effects were observed during follow-up of the patients. ConclusionThe above outcomes showed that the Holistic Ayurveda Protocol in treating COVID-19 patients is safe, acceptable and effective. Thus, suggesting the possible integration of Ayurvedic treatment in combating such deadly diseases.

Surge Capacity of Taipei's Regional Emergency Medical System during COVID-19: A System Dynamics Approach.

The community transmission of COVID-19 has caused the breakdown of the regional emergency medical system (REMS), impacting the rights and care of regional patients with acute and severe conditions. This study proposes a model for the surge capacity of REMS to plan for readiness and preparedness during challenging events that overload capacity. The surge capacity of REMS during the COVID-19 pandemic was studied. The data collection included 26 hospitals that received the data. To simulate the dynamics of Taipei's REMS surge capacity, we observed its ability to treat COVID-19 patients with moderate to severe acute respiratory distress syndrome (ARDS). This will involve monitoring the stock of ventilators, physicians, and nurses within the subsystem loops. Healthcare managers and administrators can use the overload model and hypothetical scenarios to develop new scenarios with different demands on surge capacity. The REMS system capacity model can be used as an aid to guide planning and cross-checking for address Prepare to plan. We combined data regarding the availability of ventilators, physicians, nurses, specialized beds, and general acute care beds in our simulations. Thus, our simulations, with support from a well-established regional command and management structure, could help REMS achieve the optimal surge capacity.

Selectively T cell phosphorylation activation of azvudine in the thymus tissue with immune protection effect

Thymus is the important immune organ, responsible for T cell development and differentiation. The lower circulating T counts have been observed in patients who died from COVID-19 compared with survivors. Azvudine, also known as FNC, is a thymus-homing anti-SARS-CoV-2 drug in treating COVID-19 patients. In this study, single-cell transcriptome, proteomics, and parallel reaction monitoring (PRM) were applied to insight into the activation process of FNC in rat and SARS-CoV-2 rhesus monkey thymus. The results indicated that thymic immune cells possess a robust metabolic capacity for cytidine-analogue drugs such as FNC. Key enzymes involved in the FNC phosphorylation process, such as Dck, Cmpk1, and Nme2, were highly expressed in CD4+ T cells, CD8+ T cells, and DP (CD4+ CD8+) cells. Additionally, FNC could upregulate multiple phosphorylated kinases in various cell types while downregulating the phosphatases, phosphoribosyl transferases, and deaminases, respectively. The robust phosphorylation capacity of the thymus for cytidine analogue drug FNC, and the activation effect of FNC on the NAs metabolism system potentially contribute to its enrichment in the thymus and immune protection effect. This suggests that it is crucial to consider the expression level of phosphorylation kinases when evaluating NA drug properties, as an important factor during antiviral drug design.

Cinnamomum impressinervium meisn.: antioxidant and antimicrobial activities

Background: Medical interns develop apprehensions about the vulnerability of their exposure to infection while treating COVID-19 patients, which may further affect their work patterns and efficiency. Studies have shown that the outbreak of infectious diseases would result in mental health issues. Because of this, our study aims to assess psychosocial factors such as anxiety, depression, stress, relationships with peers, and changes in personal roles among medical interns at a private medical college. Methodology: This cross-sectional was conducted among 248 medical interns using a simple random sampling method. Depression, anxiety, and stress were assessed using a standardized 21-item depression, anxiety, and stress questionnaire (DASS– 21). A pretested semi-structured questionnaire was used to acquire information regarding the study participants' socio-demographic data and social elements. Results: The overall prevalence of Depression [58%], Anxiety [70%], and Stress [44%] were found among the 248 study participants. Around [70.6%] of the study participants reported that their social life had been affected. The prevalence of various factors associated with depression, anxiety, and stress were assessed. Conclusion: This study reports higher levels of psychosocial distress among the study participants. Adequate knowledge about the pandemic and stress management measures will be the top priority among these budding medicos during such unfavorable pandemic situations.

Frontline Nurses’ Job Satisfaction and Missed Nursing Care in a COVID-19 Dedicated Hospital in China: A Cross-Sectional Study

This study examined the current situation and relationship between missed nursing care (MNC) and job satisfaction among frontline nurses in a hospital dedicated to treating COVID-19 patients in China. Many dedicated hospitals were constructed or refurbished to centrally manage patients with COVID-19. Most nurses and doctors in these hospitals were redeployed from other departments or hospitals. This may have compromised nursing quality and job satisfaction. The omission of nursing care is a critical factor in assessing nursing quality; therefore, focusing on both MNC and job satisfaction is essential. This cross-sectional study used convenience and snowball sampling techniques to recruit frontline nurses working in a hospital for treating COVID-19 patients from November to December 2022. The questionnaires used in this study included sociodemographic information, job satisfaction, and the MISSCARE survey. Differences in job satisfaction and MISSCARE scores among participants’ demographic deviations were explored using the Mann–Whitney Z test (two groups) and the Kruskal–Wallis H test (three or more groups). The correlation between participants’ job satisfaction and missed nursing actions was analysed using Spearman’s correlation analysis. The analysis included 306 frontline nurses. Frontline nurses’ job satisfaction was high, and their MNC was low. The highest MNC was “offer rehabilitation care and guidance to patients in need every day.” The most reported reasons for the MNC were “urgent patient situations.” In addition, the job satisfaction scale, MNC scores, and reasons for MNC scores showed statistically significant differences among participants’ demographic variables. Moreover, this study identified a negative correlation between frontline nurses’ job satisfaction and MNC. Frontline nurses’ job satisfaction was high, and their MNC was low. Frontline nurses’ demographics were shown to affect their job satisfaction, MNC, and reported reasons. Furthermore, participants’ job satisfaction can influence the MNC. Tailored interventions aimed at maintaining low levels of MNC should consider frontline nurses’ demographic characteristics and job satisfaction.

Healthcare professionals’ understanding and perception of drug-related issues linked to off-label pharmacological medications used for COVID-19

ABSTRACT Background To evaluate the opinions of healthcare workers regarding drug therapy problems linked to anti-infective medicines used for the treatment of COVID-19 infection in Pakistan. Research methodology This cross-sectional study was conducted from January to October 2022 using a self-administered questionnaire developed by the authors, having three sections: demographics, knowledge, and perception. The study was validated by research experts and pilot-tested on 30 subjects. The study included medical doctors, nurses, pharmacists from Punjab’s government and private medical institutes. Results In this study, 382 of 400 participants replied. The mean knowledge score was 9.52 (SD 2.97), showing that participants had adequate knowledge of COVID-19 pharmacological interventions. The knowledge scores were significantly higher of those who treated COVID-19 patients and were from Lahore. Many doctors considered that elderly patients and those with blood disorders were at greater risk of experiencing drug-related problems. Most pharmacists support electronic prescription systems. Many doctors thought the lack of unified treatment guidelines, multiple prescribers, and self-medication were key obstacles in managing COVID-19 patients. Conclusion Most respondents had adequate knowledge. Older patients with comorbidities are at risk of adverse effects. Self-medication, polypharmacy, and multiple prescriptions can lead to misdiagnosis and complications. Electric prescriptions, team effort, and training programs can decrease these issues.

Knowledge, Attitude, and Practice of Physiotherapists in COVID-19 ICUs: A National Survey.

COVID-19 belongs to the beta-corona cluster that spreads enormously via aerosols. Physiotherapists must be knowledgeable about the symptoms, mode of transmission, risk mitigation strategies, and practice guidelines for COVID-19. This study aimed to assess physiotherapists' knowledge of COVID-19 guidelines, their attitude toward this new evolving field, and their practice routines in India's COVID-19 ICUs. It was a cross-sectional study. A total of 600 questionnaires were distributed through e-mail and WhatsApp to physiotherapists using Google Forms between February 2022 and January 2023. The questionnaires consisted of demographics and 23 questions in three sections about the knowledge, attitude, and practice of physiotherapists working in the COVID-19 ICU. Data analysis was carried out using Jamovi. A total of 136 responses were obtained from 18 states of India. Of 136 participants, 89 were female (65.4%) and 47 were male (34.6%). The highest level of qualification was BPT (n = 69 (50.7%)), followed by MPT (n = 62 (45.6%)) and Ph.D. (3 (3.7%)). The knowledge about COVID-19 guidelines is fair. Only 21.3% of the physiotherapists received training before being deployed in COVID-19 ICUs, and the CARP protocol was well known by only as few as 10.3%. The criteria advised for close monitoring of patients during treatment was aware by 29.4%. Most physiotherapists have a good attitude toward treating COVID-19 patients; 70.63% strongly agree that physiotherapy is vital in these patients despite the risk of self-exposure, and 64.7% agree that physiotherapy should be initiated during all phases of COVID-19. Physiotherapists follow good practices for COVID-19 patients in the ICU, which is as per the guideline recommendation. Physiotherapists working in COVID-19 ICUs have a fair knowledge of the existing physiotherapy guidelines for COVID-19, and they exhibit good attitudes and practice patterns.

Occurrences of post-traumatic stress disorder, anxiety, depression, and burnout syndrome in ICU staff workers after two-year of the COVID-19 pandemic: the international PSY-CO in ICU study

PurposeThe present study aimed at assessing the prevalences of post-traumatic stress disorder (PTSD) (main objective), anxiety, depression, and burnout syndrome (BOS) and their associated factors in intensive care unit (ICU) staff workers in the second year of the COVID-19 pandemic.Materials and methodsAn international cross-sectional multicenter ICU-based online survey was carried out among the ICU staff workers in 20 ICUs across 3 continents. ICUs staff workers (both caregivers and non-caregivers) were invited to complete PCL-5, HADS, and MBI questionnaires for assessing PTSD, anxiety, depression, and the different components of BOS, respectively. A personal questionnaire was used to isolate independent associated factors with these disorders.ResultsPCL-5, HADS, and MBI questionnaires were completed by 585, 570, and 539 responders, respectively (525 completed all questionnaires). PTSD was diagnosed in 98/585 responders (16.8%). Changing familial environment, being a non-caregiver staff worker, having not being involved in a COVID-19 patient admission, having not been provided with COVID-19-related information were associated with PTSD. Anxiety was reported in 130/570 responders (22.8%). Working in a public hospital, being a woman, being financially impacted, being a non-clinical healthcare staff member, having no theoretical or practical training on individual preventive measures, and fear of managing COVID-19 patients were associated with anxiety. Depression was reported in 50/570 responders (8.8%). Comorbidity at risk of severe COVID-19, working in a public hospital, looking after a child, being a non-caregiver staff member, having no information, and a request for moving from the unit were associated with depression. Having received no information and no adequate training for COVID-19 patient management were associated with all 3 dimensions of BOS.ConclusionThe present study confirmed that ICU staff workers, whether they treated COVID-19 patients or not, have a substantial prevalence of psychological disorders.

Beyond the stethoscope: a COVID-19 lens on the halal, business and ethical dimensions of hospitals in a Muslim majority country

Purpose This study aims to examine the perceptions and evaluations of Muslim COVID-19 survivors and health workers regarding the halal, business and ethical attributes of hospitals during their interactions related to COVID-19 treatment. Design/methodology/approach Descriptive qualitative research with semi-structured online interviews was used to gather insights from COVID-19 survivors and health workers who treated COVID-19 patients. The findings were then compared with existing literature on hospital services and Sharia attributes. Findings The study found that patients and health-care workers in hospitals are concerned about whether the hospital follows Sharia law, the quality of health-care and hospital services and the ethical conduct of hospital staff. This is especially true during the COVID-19 pandemic, when patients are more anxious about religious conduct and the afterlife. Research limitations/implications Hospitals need to address halal attributes in all aspects of their services for Muslim patients and business attributes such as standard health-care quality, service quality and ethical attributes. Participants indicated that when these needs are met, they are more likely to revisit the hospital and recommend it to others. Originality/value This study contributes to understanding the expectations of Muslim patients regarding hospital services that meet Islamic ethical and business requirements. Using the COVID-19 pandemic as a case study broadens the understanding of how to better serve Muslim customers.

Factors associated with mental health burdens in physical therapists during the late stage of the COVID-19 pandemic

IntroductionIt has been a long time since the emergence of COVID-19 in China and its spread worldwide. Vaccines are a promising solution to overcome COVID-19 infection. Still, vaccine hesitancy is the only barrier to controlling the pandemic, as thinking about its side effects induces psychological exhaustion. There is still a lack of research targeting the mental health of Physical Therapists (PTs), especially during the late stage of the COVID-19 pandemic, so the study’s main aim was to identify the prevalence of anxiety, depression and insomnia and identify risk factors that influence anxiety and depression.MethodsA cross-sectional online survey via anonymous questionnaires and questions about socio-demographic information was launched on social media in the second half of February 2021.ResultsPrevalence of anxiety, depression, and insomnia was 42.7%, 50.10%, and 89.30%, respectively, among physical therapists. Common factors that induce anxiety and depression were having children and needing psychological support. Other risk factors for anxiety only were working in a quarantine hospital, being infected with COVID-19, self-isolation after return from the hospital, and hesitance about vaccine effectiveness. Treating COVID-19 patients and having a family member who had died from COVID-19 were risk factors for depression. Consulting a psychiatrist reduced this risk of depression.ConclusionsElevated mental health disturbances triggered the alarm for urgent psychological rehabilitation to prevent the failure of health care systems in this critical period. Additionally, fighting the anti-vaccine movement should be a priority along with enhancing telerehabilitation programs in hospitals.

Knowledge, attitudes, and practices of dentists regarding mucormycosis as a possible orofacial manifestation of COVID-19 in postpandemic times: A cross-sectional study

Introduction: Mucormycosis, also known as black fungus, is a rare but serious fungal infection usually seen in immunocompromised hosts. There are cluster of cases being reported and diagnosed as mucormycosis in treated COVID-19 patients in the postpandemic times. The aim of the present study was to assess awareness among dentists regarding mucormycosis and other possible oral manifestations of COVID-19 in the postpandemic times and the associated complications. Materials and Methods: In the present cross-sectional study, a well-structured questionnaire composed of a total of 17 closed-ended questions was used to cover questions to assess awareness among dentists regarding the possible oral manifestations of post-COVID-19. Furthermore, statistical analysis was done using the Statistical Package for the Social Sciences (SPSS) version 21.0 (IBM, Chicago, IL, USA), while the Chi-square test and Pearson’s correlation coefficient were used to analyze the data statistically. Results: The Chi-square test was used to analyze the association of the knowledge, attitude, and practice scores regarding COVID-19 and the academic qualification of the participants revealed that despite having sufficient information (knowledge and attitude scores), no significant difference (P = 0.7288) was observed in the practices of the participants irrespective of their academic qualification. On analyzing the data further, though, a significant positive correlation was observed between all the components of the knowledge, attitude, and practice scores of the participants (P = 0.0001) using Pearson’s correlation coefficient. Conclusion: From the findings of the present study, it could be concluded that dentists were well aware of the possible oral manifestations of COVID-19, including mucormycosis, though the possibility of increasing awareness among dentists regarding the multidisciplinary approach required for the management of deep fungal infections such as mucormycosis cannot completely be ruled out. The following core competencies are addressed in this article: Practice-based learning and improvement, Patient care and procedural skills, Systems-based practice, Medical knowledge.

Therapeutic Challenges in COVID-19.

SARS-CoV2 is a novel respiratory coronavirus and, understanding its molecular mechanism is a prerequisite to developing effective treatment for COVID-19. This RNA genome-carrying virus has a protein coat with spikes (S) that attaches to the ACE2 receptor at the cell surface of human cells. Several repurposed drugs are used to treat COVID-19 patients that are proven to be largely unsuccessful or have limited success in reducing mortalities. Several vaccines are in use to reduce the viral load to prevent developing symptoms. Major challenges to their efficacy include the inability of antibody molecules to enter cells but remain effective in the bloodstream to kill the virus. The efficacy of vaccines also depends on their neutralizing ability to constantly evolve new virus strains due to novel mutations and evolutionary survival dynamics. Taken together, SARS-CoV2 antibody vaccines may not be very effective and other approaches based on genetic, genomic, and protein interactome could be fruitful to identify therapeutic targets to reduce disease-related mortalities.

Steroid prescribing practices for mildly symptomatic and asymptomatic COVID-19 patients, among doctors of selected Sri Lankan hospitals

Introduction: Effects of infection by SARS-COV-2 virus (COVID-19) range from asymptomatic infection to respiratory failure with multi-organ dysfunction. Steroids are indicated in patients with severe pneumonia, who require oxygen supplementation. There is evidence of harm if steroids are given for asymptomatic or mildly symptomatic patients.Objectives: This study assesses the steroid prescribing practices among Sri Lankan doctors for mildly symptomatic and asymptomatic COVID-19 patients.Methodology: This clinical survey was conducted during 20/11/2021 to 15/03/2022 using an electronic questionnaire, sent to doctors in 16 hospitals, representing all provinces of Sri Lanka. Doctors who have not treated nor advised patients with COVID-19 were excluded.Results: Hundred and thirty-five participants were incorporated into the study. The mean age was 33.7 years (SD=7.82). The majority did not prescribe steroids routinely for asymptomatic (n=132, 97.8%) and mildly symptomatic (n=124, 91.9%) COVID-19. Dexamethasone was the most prescribed steroid. Doctors who treated COVID-19 patients in the private sector were more likely to prescribe steroids for mild symptoms (p=0.016). The majority (n=101, 81.5%) identified a decrease of oxygen saturation to below 94% on room air as an indication to start steroids.Conclusions: Most of the study participants adhered to the recommended guidelines and refrained from prescribing steroids in mildly symptomatic and asymptomatic COVID-19 patients.