Abstract Introduction: We conducted this study to evaluate the impact of COVID-19 infection on maternal and neonatal prognosis. Methods: We retrospectively collected data on mothers who underwent emergency cesarean section and their neonates from October 2022 to December 2022. Data on demographic characteristics, comorbidities, and perioperative maternal and neonatal outcomes were collected. Propensity score matching (PSM) was performed with whether the parturient women were infected with COVID-19 (tested positive and combined with at least one of the clinical symptoms related to COVID-19 infectionwas defined as positive, vs tested negative was defined as negative). Outcomes were compared between positive and negative groups. Results: The study finally consisted of 58 parturient women (n= 29, positive; n = 29, negative). The anaesthesia satisfaction score and postoperative recovery quality score (QoR-15) of the noninfected parturient women group were higher (10 vs 10, P=0.005 and 144 vs 148, P=0.029, respectively). There was a lower incidence of fetal distress in noninfected newborns (17.24% vs 44.83%, OR=3.9, 95% CI 1.163-13.078, P=0.023). Conclusion: Infection with COVID-19 combined with related clinical symptoms could reduce maternal satisfaction with anaesthesia, postoperative recovery quality scores and with potential increasing risk of fetal distress, but it had no clear impact on neonatal development.

Background: In the wake of the coronavirus disease 2019 (COVID-19) pandemic, the World Health Organization recommended the use of alcohol-based hand rubs (ABHRs) to curb transmission, leading to increased production and use. This has posed a danger of production and use of poor-quality ABHRs. Methods This study assessed and compared the quality of ABHRs in the Kenyan market that were produced before and after the outbreak of the COVID-19 pandemic in March 2020. Quality testing was carried out against European EN 1500:2013 and Kenyan EAS 789:2013 Standards. Results The study found that 27.8% of the peri-pandemic sanitizers had less than 90% bactericidal reduction activity as compared to 12.5% manufactured pre-pandemic. Only 25% peri-pandemic ABHRs met the EAS 789:2013 acceptable limit of over 60% alcohol content. Product adulteration with methanol was found in 20 % of the samples with only 5% complying with FDA approval limit of <0.063% v/v methanol. Study found no correlation between the total alcohol content and the efficacy of ABHRs. Conclusions The study found that more substandard products were produced during the pandemic. This raises a concern about possible emergence of alcohol resistant strains of microorganisms. The study therefore recommends an adequate quality monitoring system to curb against substandard products.

Background: The purpose of this study was to evaluate whether the 2023-2024 formulation of the COVID-19 mRNA vaccine protects against COVID-19 caused by the JN.1 lineage of SARS-CoV-2. Methods: . Employees of Cleveland Clinic in employment when the JN.1 lineage of SARS-CoV2 became the dominant circulating strain, were included. Cumulative incidence of COVID-19 was examined prospectively. Protection provided by vaccination (analyzed as a time-dependent covariate) was evaluated using Cox proportional hazards regression. The analysis was adjusted for the propensity to get tested, age, sex, pandemic phase when the last prior COVID-19 episode occurred, and the number of prior vaccine doses. Results: . Among 47561 employees, COVID-19 occurred in 838 (1.8%) during the 16-week study period. In multivariable analysis, the 2023-2024 formula vaccinated state was associated with a significantly lower risk of COVID-19 while the JN.1 lineage was the dominant circulating strain (hazard ratio [HR], .77; 95% confidence interval [C.I.], .62-.94; P = .01), yielding an estimated vaccine effectiveness of 23% (95% C.I., 6%-38%). Compared to 0 or 1 prior vaccine doses, risk of COVID-19 was higher with 2 prior doses (HR, .1.46; 95% C.I., 1.12-1.90; P < .005), 3 prior doses (HR, 1.95; 95% C.I., 1.51-2.52; P < .001), and more than 3 prior doses (HR, 2.51; 95% C.I., 1.91-3.31; P < .001). Conclusions: . The 2023-2024 formula COVID-19 vaccine given to working-aged adults afforded a low level of protection against the JN.1 lineage of SARS-CoV-2, but a higher number of prior vaccine doses was associated with a higher risk of COVID-19.

We aimed to assess the epidemiological characteristics of hepatitis B virus (HBV) infection in Chinese adults at different phases of the coronavirus disease 2019 (COVID‐19) pandemic, that is, before, during the pandemic, and after the easing of restrictive measures. We included 20,357 adult patients who visited Mianyang Hospital and had hepatitis B DNA tests from January 1, 2018, to June 30, 2023. Clinical information and HBV test results were extracted from the laboratory information system. We calculated the positive rate of HBV detection by age groups, gender, seasons, types of patients, and stages of the COVID‐19 pandemic. Nonlinear associations between age and risk of HBV infection in three stages of the pandemic were assessed by restricted cubic spline regression models. Among 20,357 patients, 2,670 (13.1%) were tested as positive. The highest positive rate was observed in the 18-25 age group (i.e., 16%). HBV infection showed an insignificant pattern among seasons. Although there is no statistical significance regarding the positive rate at three phases of the pandemic, we observed that the rate went high during the pandemic and saw a sharp decline after easing the measures among the population ( p < 0.05), which consisted of our regression models. In addition, regression analyses suggested that the age effect became weaker after easing all restrictive measures compared with other stages. Based on our findings, we called for attention from health professionals and caregivers on the new epidemiological characteristics of HBV infection in advance to deal with the potential increase under restrictive measures.

Abstract Purpose This study aimed to assess the impact of coronavirus disease 2019 (COVID-19) inactivated vaccination doses on male fertility. Methods A retrospective cohort study was conducted, including 595 assisted insemination with husband's sperm (AIH) cycles involving 438 couples. Participants were categorized into three groups: the unvaccinated group, the 1 or 2 doses group, and the 3 doses group based on their vaccination status before insemination. Reproductive outcomes such as biochemical pregnancy, clinical pregnancy, ongoing pregnancy, and live birth were assessed across the different groups. Results The analysis revealed no significant differences in reproductive outcomes among the three groups. The rates of biochemical pregnancy, clinical pregnancy, ongoing pregnancy, and live birth were comparable among the unvaccinated group, the 1 or 2 doses group, and the 3 doses group ( P  = 0.433, P  = 0.637, P  = 0.583, and P  = 0.539, respectively). Multivariate logistic regression analysis indicated that the doses of COVID-19 inactivated vaccine did not independently impact the reproductive outcomes of AIH cycles. Conclusion The administration of COVID-19 inactivated vaccine doses did not adversely affect male fertility in AIH cycles.

Abstract Background The magnitude and durability of cell-mediated immunity in older and severely frail individuals following coronavirus disease 2019 (COVID-19) vaccination remain unclear. A controlled immune response could be the key to preventing severe COVID-19; however, it is uncertain whether vaccination induces an anti-inflammatory cellular immune response. To address these issues, this 48-week-long prospective longitudinal study was conducted. A total of 106 infection-naive participants (57 long-term care facility [LTCF] residents [median age; 89.0 years], 28 outpatients [median age; 72.0 years], and 21 healthcare workers [median age; 51.0 years]) provided peripheral blood mononuclear cell (PBMC) samples for the assessment of spike-specific T-cell responses before primary vaccination, 24 weeks after primary vaccination, and three months after booster vaccination. CD4 + T-cell responses to severe acute respiratory syndrome coronavirus 2 spike protein were examined by measuring interferon (IFN)-γ, tumor necrosis factor (TNF), interleukin (IL)-2, IL-4, IL-6, and IL-10 levels secreted from the spike protein peptide-stimulated PBMCs of participants. Results LTCF residents exhibited significantly lower IFN-γ, TNF, IL-2, and IL-6 levels than healthcare workers after the primary vaccination. Booster vaccination increased IL-2 and IL-6 levels in LTCF residents comparable to those in healthcare workers, whereas IFN-γ and TNF levels in LTCF residents remained significantly lower than those in healthcare workers. IL-10 levels were not significantly different from the initial values after primary vaccination but increased significantly after booster vaccination in all subgroups. Multivariate analysis showed that age was negatively associated with IFN-γ, TNF, IL-2, and IL-6 levels but not with IL-10 levels. The levels of pro-inflammatory cytokines, including IFN-γ, TNF, IL-2, and IL-6, were positively correlated with humoral immune responses, whereas IL-10 levels were not. Conclusions Older and severely frail individuals may exhibit diminished cell-mediated immune responses following COVID-19 vaccination compared to the general population. A single booster vaccination may not adequately enhance cell-mediated immunity in older and severely frail individuals to a level comparable to that of the general population. Furthermore, booster vaccination may induce not only a pro-inflammatory cellular immune response but also an anti-inflammatory cellular immune response, potentially mitigating detrimental hyperinflammation.

Abstract New-onset altered level of consciousness (ALC) is challenging in emergency rooms (ERs), requiring focused attention. The COVID-19 pandemic has impacted healthcare systems globally, influencing ER dynamics. This study compared ALC before (BC) and after (AC) the coronavirus disease 2019 outbreak, focusing on etiology, disposition, and outcomes. This was a retrospective, multicenter study of four university hospitals in charge of an area of about five million people in South Korea. All cases were reviewed within a consortium of board-certified faculties and compared between BC (February 2018 to January 2020) and AC (March 2021 to February 2023. We reviewed to find 17,913 patients who visited the ER due to ALC, of whom 7,988 and 9,925 were in BC and AC, respectively. The overall incidence of ALC in the ER was 3.1%, higher in AC (BC vs. AC, 2.5% vs. 3.7%, p  < 0.001). The most common etiology was Metabolic cause (24.8%), followed by Systemic infection (18.0%). Intracranial etiologies accounted for 29.7% of the total. Hospitalization rate increased from BC to AC (54.5–59.3%, p  < 0.001). The overall mortality was 16.2%, and 5.3% of the patients with ALC died in the ER. ALCs dut to cardiogenic and vascular etiology had the highest mortality (26.8%). This study marks the first investigation on ALC in the ER comparing BC and AC.

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic has had significant impacts worldwide, especially among older adults. Frailty is a determinant of susceptibility to morbidity and mortality due to COVID-19 in the elderly. This study aimed to determine frailty status and identify factors associated with the suburban elderly population in Cirebon Regency, Indonesia, after the one-year COVID-19 pandemic. Methods A cross-sectional study of community-dwelling individuals aged ≥ 60 years was conducted in Klangenan, Cirebon Regency, Indonesia, from March to June 2021. A questionnaire was used to determine the baseline characteristics of participants, healthcare access, comorbidity, and frailty status. The Ina-FRAIL scale was used to determine the frailty status (frail/non-frail). The chi-square test and logistic regression analysis were used to determine the association between independent variables and frailty. Results A total of 383 participants were recruited, with a median age of 67 (IQR 64-73) years. The prevalence of frailty in the present study was 10.2%. Multivariate analysis showed that age (OR 2.73; 95%CI 1.21-6.12), multimorbidity (OR 7.86; 95% CI 3.01-20.57) and financial dependence (OR 13.40, 95% CI 5.66-31.73) were significantly associated with frailty. Conclusion One-year COVID-19 pandemic has had a considerable burden on frailty among the suburban elderly population in Indonesia. The factors associated with frailty were age, multimorbidity, and financial dependence.

Abstract Polymerase chain reaction (PCR) is an effective method for diagnosing infectious diseases and has been the primary method throughout the novel coronavirus disease (COVID-19) pandemic. PCR tests (from specimen collection to result acquisition) involve sample pretreatment, nucleic acid extraction, and PCR procedure. Automating the pretreatment process is crucial to mitigate the risk of infection for workers and to reduce the likelihood of sample contamination-triggered misdiagnosis, particularly when handling centrifuge tubes, cryopreservation tubes, and microtubes. Robotic systems have been engineered to automate cell culture and PCR-based diagnosis , predominantly designed for use with screw-capped containers. However, this leaves a notable gap in automation solutions for microtubes equipped with press-type caps. To address this gap, we developed a versatile microtube capper/decapper system. On the other hand, many tasks of manual operation using microtubes, which are routinely conducted in clinical tests and biological experiments, were performed. Despite the risks of contamination and infection derived from the manual handling of microtube caps, which can compromise diagnosis/experiment accuracy and worker safety, devices for manually opening and closing microtube caps without direct contact remain lacking. Therefore, leveraging the technology from the developed versatile microtube capper/decapper system for laboratory automation, we created a manually operated microtube equipped with an automatic capper/decapper system tailored for personnel in clinical and biological laboratories. In this study, we first examined the required specifications and prerequisites for a manual microtube capper/decapper and clarified the operating methods, operating procedures, operation environment, device size, accompanying functions, etc. Based on the required specifications and preconditions, we proceeded with the mechanical and control design of the conceptual model, manufactured a prototype, and confirmed its basic functions and performance. The compliant to the required specifications and preconditions and the usefulness of the proposed manual microtube capper/decapper were validated through various experiments and demonstrations. Because microtubes are used in various clinical tests and biological experiments, we believe that the proposed system can markedly reduce the workload for personnel across numerous clinical and biological laboratories.

Abstract Environmental factors are crucial in the global health landscape and the burden of diseases. Scientometrics is a quantitative method used to better analyze research status and trends in a specific subject area. This study aims to analyse the role of environmental health in preventing and controlling diseases. A total of 50,274 documents were retrieved. The US and Harvard University were the most prolific and influential countries and organizations. The top three journals were PLOSONE, International Journal of Environmental Research and Public Health, and Environmental Health Perspectives. The highest interest is in burden of disease and air pollution, mainly particulate matter and PM2.5. The main focus are on air pollution, cardiovascular diseases, coronavirus disease, inflammatory bowel disease, multiple sclerosis, cognitive decline, and COVID-19 lockdown. In the early years, studies predominantly centered on exposures, but investigating the relationship between these factors and medical science and health has become a significant area of interest in recent years. Air pollutants and burden of disease are topics of interest recognized as global environmental challenges.

Hypercoagulability and thromboembolic abnormalities were observed in patients with coronavirus disease (COVID-19). COVID-19 has been suggested to cause retinal vascular damage. Uncertain associations of COVID-19 and its vaccines with retinal vascular occlusion (RVaO) were previously published. We believe that big data are needed for analysis of the association of RVaO and COVID-19. TriNetX is a federated cloud-based health research network providing access to anonymized, deidentified patient-specific electronic health records of >100 million patients from >70 healthcare organizations, which majority were located in the United States of America. Our team conducted thorough literature search on 31st May 2023 via PubMed, MEDLINE, EMBASE, Scopus, Web of Science on TriNetx related studies concerning RVaO and COVID-19. Big data studies were only available in May 2023. We summarized the results of the two TriNetX big data studies in table and text. Li et al. study showed no significant risk of RVaO at 12 weeks after vaccinations for each individual type of COVID-19 vaccine, no matter the mRNA or viral vector-based vaccines studied. However, when analyses were done with all brands of vaccines mixed together, there were increased risk at every bi-weekly time points up to 12 weeks. Dorney et al. study found no increased risk of RVaO by receiving the COVID-19 mRNA vaccines when compared to Influenza or Tdap vaccines. However, COVID-19 infection has a higher risk (4.25 times) of RVaO than COVID-19 vaccinations. Our review compared the similarities and differences on the two currently available TriNetX big data literature on the association of RVaO and COVID-19 vaccinations. These studies have different comparison groups, and possible limitations on the study design as we discussed in the main text. Despite they are not presenting directly conflicting results, further meta-analysis or other epidemiologic studies would be needed to answer the scientific question on the association of RVaO and COVID-19.

Abstract Background Lung injury and pulmonary fibrosis are common sequelae of severe and acute lung disease, including coronavirus disease 2019 (COVID-19), for which there are presently no effective drugs. Mesenchymal stem cells (MSCs) with immunomodulatory and tissue repair functions have the potential to treat lung injury and pulmonary fibrosis. However, the best administration route, timing, and frequency remain unclear. Human embryonic stem cell-derived immunity-and-matrix-regulatory cells (IMRCs) have shown therapeutic potential for lung injury and pulmonary fibrosis. Methods Here, the best treatment scheme of IMRCs for pulmonary fibrosis was evaluated. In a mouse pulmonary fibrosis model induced by bleomycin (BLM), IMRCs were administered by single or double intravenous or tracheal injection on the first and seventh days after bleomycin injection. Results Intravenous infusion of IMRCs improved the survival rate, body weight, and Ashcroft and Szapiel scores of model mice more effectively than intratracheal infusion, including more profound suppression of lung inflammation and fibrosis. Moreover, earlier timing of administration and more frequent administration were beneficial to improve the therapeutic effects. Indeed, early administration of two infusions better improved body weight, the lung organ coefficient, pulmonary ventilation and diffusion functions, and pulmonary fibrosis; increased numbers of alveolar type I and type II epithelial cells; and inhibited macrophage infiltration. Conclusion This study provides basic scientific evidence for the clinical application of stem cell therapy products to treat lung diseases including COVID-19.

Background The prognostic significance of liver dysfunction in coronavirus disease 2019 (COVID-19) patients remains unclear. This study aimed to investigate the association between liver function test results and severe disease progression in COVID-19 patients. Methods We conducted a retrospective study that included consecutive Japanese COVID-19 patients between February 2020 and May 2021. We identified the predictive variables for severe disease progression by utilizing established factors and multivariate logistic analysis. The Kaplan‒Meier method was used to estimate severe disease-free survival. Furthermore, we evaluated the hazard ratios (HRs) among three aspartate aminotransferase (AST) grades using Cox regression analysis: grade 1, AST < 30 U/L; grade 2, 30 U/L≤ AST < 60 U/L; and grade 3, AST >60 U/L. Results After exclusion, 604 symptomatic COVID-19 patients were enrolled during the study period, and 141 (23.3%) of them developed severe disease at a median of 2 days postadmission. The median hospital stay was 10 days, and 43 patients (7.1%) died during hospitalization. Multivariate regression analysis of the fourteen significant variables revealed that hypertension, decreased lymphocyte count, and elevated LDH, CRP, and AST levels (grade 2 and grade 3 relative to grade 1) were significant predictive variables. Severe disease-free survival times were significantly separated according to AST grade severity (HR: grade 2 to grade 1: 4.07 (95% CI: 2.06-8.03); HR: grade 3 to grade 1: 7.66 (95% CI: 3.89-15.1)). Conclusion AST levels at admission were an independent risk factor for severe disease in hospitalized Japanese patients with COVID-19.

Functions and viral infection mechanisms of coronavirus disease 2019 (COVID-19) have been recently investigated extensively, focusing on Spike (S) protein together with its receptor, ACE2. Although their relationships with COVID-19 are obvious, less attention has been paid to intracellular regulation of S protein-protein interaction. Here, we identified STIM1 (stromal interaction molecule 1 precursor) as a novel binding protein of S protein for the first time. Their association was further characterized. We found that S [ 1259 DD 1260 ] acidic motif specifically interacted with STIM1 C-terminal basic motif [ 671 RKKFPLKIFKKPLKK 685 ]. Both motifs were demonstrated to be essential for STIM1 and S protein interaction using immunoprecipitation and immunoblotting and confocal co-localization. We also elucidated that the association between the acidic tail motif of S protein and the C-terminal basic motif of STIM1 promoted Ca 2+ cytoplasmic release from the store-operated Ca 2+ ion entry (SOCE) by disrupting STIM1 function, suggesting that disrupting STIM1 function by S protein was one of its mode of actions for COVID-19 infection. For the first time, we demonstrated that S protein played a role as a Ca 2+ ion releasing enhancer for COVID-19 infection from SOCE through interrupting normal STIM1’s roles. Our findings may provide one of the new ways for curing or preventing COVID-19 pandemic recurrence.

Background: The coronavirus disease (COVID-19) pandemic led to the implementation of social distancing laws in the UK. This had several negative consequences on health, wellbeing and social functioning within the general population. Military veterans may have had unique experiences of social isolation during this time. This study examined the level of, and relationship between, structural and functional social support, and its association with mental health and wellbeing in a sample of UK veterans during the COVID-19 pandemic. Methods: Throughout the first summer of the pandemic (June-September 2020), an additional wave of cross-sectional data was collected from UK Armed Forces personnel who had left regular military service and were participating in a longitudinal cohort study. In total, 1562 participants (44.04% response rate) completed a series of online questionnaires measuring sociodemographic characteristics, COVID-19 experiences and psychosocial health and wellbeing. Multivariable logistic and ordinal regression analyses were conducted. Results: For structural social support, 86.8% were in a relationship and 89.0% lived with others. For functional social support, one-quarter reported feelings of loneliness (27.4%) and low levels of perceived social support (28.1%). Structural support was associated with functional support. Being single, living alone and experiencing loneliness were associated with worse mental health and wellbeing, while living with other adults and reporting high levels of perceived social support were associated with better mental health and wellbeing. Conclusions: UK veterans showed greater social support than the UK general population during the first summer of the COVID-19 pandemic. This study has enhanced our understanding of social support among veterans and its implications for health and wellbeing. This knowledge is essential for advising the development of psychosocial interventions and policies to improve the psychological wellbeing of veterans in future pandemics and more broadly in their daily lives.

Background: Existing data on adverse effects of coronavirus disease 2019 (COVID-19) vaccines among university students are limited. This study aimed to investigate the characteristics of adverse effects that may arise from administering COVID-19 vaccines to university students in Thailand. Methods An online survey study was conducted among students from 12 Health Sciences faculties, and from 16 non-Health Sciences faculties of two universities from October 2021 to January 2022 to assess types and adverse effects of COVID-19 vaccines received by the students. Results There were 1,439 participating students; 522 (36%) were from Health Sciences faculties, and 917 (64%) were from 16 non-Health Sciences faculties. The types of the first-dose vaccine received were inactivated (49%), viral vector (46%), and mRNA (5%), while the types of the second-dose vaccine received were viral vector (53%), inactivated (40%) and mRNA (7%). The first-dose vaccines’ most common adverse effects of inactivated, viral vector, and mRNA vaccines were muscle pain (47%, 82%, and 58%, respectively). The second-dose vaccines’ most common adverse effects were cough (47%) for inactivated vaccines and muscle pain (49% for viral vector vaccines and 56% for mRNA vaccines). Viral vector vaccines were more likely to cause fever, muscle pain, diarrhoea, headache, and rashes than the others. The mRNA vaccines caused injection site pain more than inactivated vaccines. The majority of adverse effects occurred 24-48 hours after vaccination (68%), were more severe with the first dose compared with the second dose, and resolved spontaneously without any treatment at a hospital. Conclusions The adverse effects experienced by the students were various according to the types and number of doses of COVID-19 vaccines. The adverse effects were mostly non-severe and occurred less for the second dose compared with the first dose.

Since the coronavirus disease 2019 (COVID-19) pandemic, wastewater-based epidemiology (WBE) has been widely applied in many countries and regions for monitoring COVID-19 transmission in the population through testing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in wastewater. However, the lack of dynamic level of viral shedding in the wastewater and accurate number of infections in the community creates challenges in predicting COVID-19 prevalence in the population and interpreting WBE results. In this study, we measured SARS-CoV-2, pepper mild mottle virus (PMMoV), and human mitochondrial DNA (mtDNA) in longitudinal fecal samples collected from 42 COVID-19 patients for up to 42 days after diagnosis. SARS-CoV-2 RNA was detected in 73.1% (19/26) of inpatient study participants in at least one of the collected fecal specimens during the sampling period. Most participants shed the virus within three weeks after diagnosis, but five inpatient participants still shed the virus between 20 and 60 days after diagnosis. The median concentration of SARS-CoV-2 in positive fecal samples was 1.08x105 genome copies (GC)/gram dry fecal material. PMMoV and mtDNA were detected in 99.4% (154/155) and 100% (155/155) of all fecal samples, respectively. The median concentrations of PMMoV RNA and mtDNA in fecal samples were 1.73x107 and 2.49x108 GC/dry gram, respectively. These results provide important information about the dynamics of fecal shedding of SARS-CoV-2 and two human fecal indicators in COVID-19 patients. mtDNA showed higher positive rates, higher concentrations, and less variability between and within individuals than PMMoV, suggesting that mtDNA could be a better normalization factor for WBE results than PMMoV.

A full-term newborn was delivered by emergency cesarean section due to intrauterine distress with a mother infected with coronavirus disease (COVID-19) in another hospital. Grade III meconium-stained amniotic fluid was observed at delivery. The neonate developed respiratory distress soon after birth and was transferred to our neonatal intensive care unit 3.5 h after birth. After admission, the neonate had progressively worsening dyspnea and was diagnosed with severe meconium aspiration syndrome and acute respiratory distress syndrome. Despite respiratory and circulatory support, as well as treatment with pulmonary surfactants, the neonate developed severe respiratory distress, severe pulmonary hypertension, cardiac failure, and acute renal injury during the first 24 h of birth, with a maximum oxygenation index of 27. After initiating invasive high-frequency assisted ventilation with inhaled nitric oxide (iNO) therapy, the neonate’s condition gradually stabilized. But after a brief improvement, the infant's condition worsened again on the 11th day after birth, likely due to pulmonary infection, alveolar collapse, and cardiac failure. The treatment plan was adjusted, and prone positioning ventilation was applied to improve oxygenation. Invasive ventilation was eventually successfully withdrawn after 19 days, and the neonate was successfully weaned off oxygen 33 days after birth without significant persistent neurological complications. This case occurred during the peak of the COVID-19 pandemic. By using iNO with multiple pulmonary vasodilators and cardiopulmonary circulatory support, prone ventilation, and point-of-care ultrasonography, the neonate was successfully treated without ECMO.

Aim: Affective disorders such as depression and anxiety are one of the most prevalent symptoms observed in patients following coronavirus disease 2019 (COVID-19). The aim of the TELESPHOR study was to evaluate the antidepressant effectiveness and tolerability of agomelatine therapy in daily clinical practice in patients with major depressive episodes (MDE) post-COVID-19. Methods: This multicenter, observational study enrolled outpatients aged 18-65 years who experienced an MDE (17 item Hamilton Rating Scale for Depression [HAMD-17] total score of 8-24) within 3 months of laboratory confirmed SARS-CoV-2 infection and who had initiated treatment with agomelatine. Study visits occurred at weeks 2, 4 and 8. The primary outcome was the antidepressant effectiveness of agomelatine assessed by change in HAMD-17 total score at week 8. Secondary outcomes included changes in HAMD-17 item 10 (anxiety psychic) and item 11 (anxiety somatic), the proportion of responders (≥50% decrease in baseline HAMD-17) and remitters (HAMD-17 score ≤7 at week 8), and impact on quality of life (QoL) (Short Form Survey [SF-36] questionnaire). Tolerability was assessed at each study visit. Results: The full analysis set comprised 103 patients of whom 73 (70.9%) were women. Median age was 45 years, and in the past 3 months 81 (78.6%) had experienced mild and 22 (21.4%) moderate COVID-19. The mean time from onset of infection to study inclusion was 2.1±0.7 months. At study entry, 55 (53.4%) had mild and 48 (46.6%) had moderate MDE. Agomelatine was associated with a significant improvement in depression severity with decreases in mean total HAMD-17 score compared with baseline of 2.6±3.3, 6.7±5.3, and 10.9±4.9 at weeks 2, 4, and 8, respectively (P<0.0001 for all). Significant reductions in anxiety psychic and anxiety somatic were also observed. Mental and physical components of SF-36 were significantly improved compared with baseline (P<0.0001). The proportion of responders was 81.4% and the proportion of remitters was 71.6%. Agomelatine was well tolerated over the 8-week follow-up. Conclusion: Treatment with agomelatine was associated with rapid and significant antidepressive and anxiolytic effectiveness, improved QoL, and good tolerability in the treatment of patients with an MDE after COVID-19.

Aim To describe the potential role of thromboinflammation in thromboembolism and the progress of coronavirus disease 2019 (COVID-19). Methods The retrospective study included sequentially hospitalized patients with the diagnosis of COVID-19 pneumonia during the first pandemic (December 1, 2022, to January 31, 2023) at a medical center in Beijing, China. Risks of critical medical support requirements, thrombosis events, and death were valued in the multivariate logistic regression models, where age (≥ 80 vs. < 80 years old), nadir platelets level (≤100 vs. > 100 10^9/L), C-reactive protein (CRP) level at admission (≥ 80 vs. < 80 mg/L), D-dimer level at admission (≥ 1.0 vs. < 1.0 mg/L) were dichotomized. Results A total of 88 patients were included (median age 77 years, 72% male). During hospitalization, 35 (40%) patients required critical medical support, 22 (29%) had disseminated intravascular coagulation (DIC), 11 (13%) had radiologically supported thrombosis events, and 26 (30%) died. Increased age (odds ratio [OR]: 5.22,95% confidence interval [CI]: 1.27-21.53; p =0.02), elevated CRP levels (OR: 9.26, 95% CI: 2.24-38.37; p <0.01), decreased nadir platelet level (OR: 13.47, 95% CI: 1.91-94.84; p <0.01), elevated D-dimer level (OR: 5.21, 95 CI%: 0.96-28.21; p =0.06) were associated with the requirements of critical care. Increased age (OR: 10.87, 95% CI: 3.05-38.80; p <0.01), elevated CRP levels (OR: 6.14, 95% CI:1.68-22.47; p <0.01), decreased nadir platelet levels (OR: 5.96, 95% CI: 1.34-26.47; p =0.02) and D-dimers (≥1.0 vs. <1.0 mg/L, OR: 2.26, 95% CI: 0.68-7.44; p =0.18) were associated with death. Increased age (OR: 2.40,95% CI: 0.60-9.67; p =0.22), decreased nadir platelet levels (OR: 1.31, 95% CI: 0.22-7.96; p =0.77), inflmmation status, including D-dimers (≥1.0 vs. <1.0 mg/L, OR:4.62, 95% CI: 0.89-24.04; p =0.07) and CRP (≥80 vs. <80 mg/mL, OR:5.44, 95% CI: 1.05-28.27; p =0.04) were significantly associated with the risks of thromboembolism. Conclusions The retrospective study indicated thromboinflammation promoted thromboembolism and was associated with the outcomes of COVID-19 pneumonia.

Background: given the various clinical manifestations that characterize coronavirus disease 2019 (COVID-19), the scientific community is constantly searching for biomarkers with prognostic value. Surfactant protein A (SP-A) and D (SP-D) play a crucial role in ensuring proper alveolar function and an alteration of their serum levels have been reported in several pulmonary diseases characterized by acute respiratory distress syndrome (ARDS) and pulmonary fibrosis. Consid-ering that such clinical manifestations can also occur during severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, we wondered if these collectins could act as prognostic markers. Methods: in this regard, serum levels of SP-A and SP-D were measured by enzyme immunoassay in patients with SARS-CoV-2 infection (n=51) at admission (T0) and after 7 days (T1) and compared with healthy donors (n=11). Results: SP-D increased in COVID-19 patients com-pared to healthy controls during the early phases of infection, while a significant reduction was observed at T1. Stratifying SARS-CoV-2 patients according to disease severity, increased serum SP-D levels were observed in severe compared to mild patients. Conclusions: In the light of these results SP-D, but not SP-A, seems to be an eligible marker of COVID-19 pneumonia and the early detection of SP-D serum levels could be crucial for a preventive clinical management.

Objective: The 2019 novel coronavirus is still rapidly mutating and spreading worldwide, posing a great global health challenge, especially vulnerable groups, including cancer patients. Studies comparing the clinical outcomes of cancer patients receiving or not receiving the 2019 coronavirus disease (COVID-19) vaccines have not yet shown significant benefits. Therefore, this study mainly focused on the attitudes and willingness of cancer patients toward COVID-19 booster vaccines and to distinguish independent predictors that may impact the vaccination of cancer patients. Methods An online cross-sectional study was conducted between July 1 2022 and January 1 2023 in China. Patients were selected using a convenience sampling method, and a self-reporting questionnaire was developed based on a literature review to evaluate the attitude of cancer patients towards the intensive use of COVID-19 vaccines and the willingness of patients to accept the COVID-19 vaccine. Independent predictors associated with accepting a COVID-19 booster vaccine were determined through multivariate logistic regression. Results A total of 1055 participants were included in this study. The vaccine acceptance rate was 56.11% (592/1055), while the hesitancy rate was 43.89% (463/1055). Frequent smoking, those who had received two doses of the COVID-19 vaccine, belief that the COVID-19 booster vaccine was necessary, belief that the COVID-19 booster vaccine was safe and effective, willingness to pay for the COVID-19 booster vaccine, and recommendation of COVID-19 booster vaccine by friends and family were contributing factors for vaccine acceptance. Conclusion This study recommends developing healthcare policies appropriate for cancer patients to facilitate their acceptance of vaccines, such as publishing the safety and effectiveness of vaccines, providing individualized treatment options after adequate risk assessment and developing specific COVID-19 vaccines suitable for cancer patients.

Background: The outbreak of coronavirus disease COVID-19, caused by Severe Acute Respiratory Coronavirus-2 (SARS-CoV-2) has become an urgent public health concern worldwide. Although several clinical trials have pointed to new drugs with some anti-COVID-19 activity, we are far from having a safe and effective drug. In this study, we tested the effect of ivermectin on several coronaviruses (serotypes), including variants of SARS-CoV-2. Methods: The effect of ivermectin was tested on cells infected with four different coronaviruses: NL63 (Alphacoronavirus genus.), OC43, SARS-CoV-2, and Omicron (all Betacoronavirus genus). Two hours post-infection, different doses of ivermectin were added to the cell culture. Results: There was no effect of even a high dose of ivermectin on NL63, however, we found a significant effect on OC43 PFU with a 40% inhibition at a dose of 5M. The impact of ivermectin on SARS-CoV-2 and on its Omicron variant was much more pronounced and at a dose of 5M there was inhibition of 90% and 95% respectively. Discussion: Although coronaviruses have been recognized as human pathogens for more than 50 years, no effective treatment strategy exists. Our current study did not demonstrate any effect of ivermectin on Alphacoronavirus but it had a specific impact on the Betacoronavirus genus with a mild impact on OC43 and a decidedly pronounced effect on SARS-CoV-2 including its Omicron variant. Ivermectin should be further studied as a single agent or as part of combined treatment against Coronaviruses.

Background: Coronavirus disease-2019 is caused by the severe acute respiratory syndrome coronavirus-2 virus. Impacting various many systems in the human body including the hematological system. Consequently, anemia has become a significant public health concern in developing countries, such as Ethiopia. Objective: This systematic review and meta-analysis aim to determine the overall prevalence of anemia among COVID-19 patients in Ethiopia. Methods: Following PRISMA guidelines, literature search was conducted in PubMed/MEDLINE, Cochrane Library, Google Scholar, HINARI, and the Ethiopian Journal of Health Development for articles published before 2024, Manual searches were also performed to identify relevant studies. Authors independently selected studies, extracted data, and assessed study quality. The I 2 test statistics was used to assess heterogeneity among studies and overall prevalence was calculated using the random-effects restrict maximum likelihood model. Results: Out of 590 obtained studies, 8 articles were included in the meta-analysis. The pooled prevalence of anemia among COVID-19 patients in Ethiopia was 26.09% (95% CI 16-36%). The prevalence of anemia in Addis Ababa and Amhara was 27.13% (95%CI: 14.59%-39.66%) and 23.41% (95%CI: 3.46%-43.36%) respectively. Conclusions: This study indicates that anemia is a moderate public health issue among COVID-19 patients in Ethiopia. Therefore, preventive measures and control strategies for of anemia among COVID-19 patients in Ethiopia are crucial.

The nasopharynx and its microbiota are implicated in respiratory health and disease. The interplay between viral infection and the nasopharyngeal microbiome is an area of increased interest and of clinical relevance. The impact of SARS-CoV-2, the etiological agent of the Coronavirus Disease 2019 (COVID-19) pandemic, on the nasopharyngeal microbiome, particularly among individuals living with HIV, is not fully characterized. Here we describe the nasopharyngeal microbiome before, during and after SARS-CoV-2 infection in a longitudinal cohort of Kenyan women (21 living with HIV and 14 HIV-uninfected) and their infants (18 HIV-exposed, uninfected and 18 HIV-unexposed, uninfected), followed between September 2021 through March 2022. We show using genomic epidemiology that mother and infant dyads were infected with the same strain of the SARS-CoV-2 Omicron variant that spread rapidly across Kenya. Additionally, we used metagenomic sequencing to characterize the nasopharyngeal microbiome of 20 women and infants infected with SARS-CoV-2, 6 infants negative for SARS-CoV-2 but experiencing respiratory symptoms, and 34 timepoint matched SARS-CoV-2 negative mothers and infants. Since individuals were sampled longitudinally before and after SARS-CoV-2 infection, we could characterize the short- and long-term impact of SARS-CoV-2 infection on the nasopharyngeal microbiome. We found that mothers and infants had significantly different microbiome composition and bacterial load (p-values <.0001). However, in both mothers and infants, the nasopharyngeal microbiome did not differ before and after SARS-CoV-2 infection, regardless of HIV-exposure status. Our results indicate that the nasopharyngeal microbiome is resilient to SARS-CoV-2 infection and was not significantly modified by HIV.