SARS-CoV-2 Omicron and its current known unknowns: A narrative review.

The emergence of the SARS-CoV-2 Omicron variant (B.1.1.529) has created great global distress. This variant of concern shows multiple sublineages, importantly B.1.1.529.1 (BA.1), BA.1 + R346K (BA.1.1), and B.1.1.529.2 (BA.2), each with unique properties. However, little is known about this new variant, specifically its sub-variants. A narrative review was conducted to summarise the latest findings on transmissibility, clinical manifestations, diagnosis, and efficacy of current vaccines and treatments. Omicron has shown two times higher transmission rates than Delta and above ten times more infectious than other variants over a similar period. With more than 30 mutations in the spike protein's receptor-binding domain, there is reduced detection by conventional RT-PCR and rapid antigen tests. Moreover, the two-dose vaccine effectiveness against Delta and Omicron variants was found to be approximately 21%, suggesting an urgent need for a booster dose to prevent the possibility of breakthrough infections. However, the current vaccines remain highly efficacious against severe disease, hospitalisation, and mortality. Japanese preliminary lab data elucidated that the Omicron sublineage BA.2 shows a higher illness severity than BA.1. To date, the clinical management of Omicron remains unchanged, except for monoclonal antibodies. Thus far, only Bebtelovimab could sufficiently treat all three sub-variants of Omicron. Further studies are warranted to understand the complexity of Omicron and its sub-variants. Such research is necessary to improve the management and prevention of Omicron infection.

Estimation of Serum Calcium on the Severity and Mortality in COVID-19 Infections in Sulaymaniyah City, Kurdistan Region of Iraq: A Cross-Sectional Study.

BACKGROUND: Coronaviruses (COV) are a large family of viruses that cause infections ranging from the common cold to more serious diseases. Mild to severe respiratory illnesses have been linked to coronavirus disease 2019 (COVID-19), which has been classified as a pandemic disease by the World Health Organization. It has been demonstrated that the severity of COVID-19 is highly positively linked with hypocalcemia. Furthermore, calcium imbalances among other electrolytes are linked to the prognosis of COVID-19. OBJECTIVES: This study demonstrates a connection between serum calcium levels and COVID-19 as biomedical indicators of COVID-19 infections in Sulaymaniyah city, Iraq. METHODS: A cross-sectional study was conducted at Baxshin Hospital for about two months from February 2022 to April 2022. The work was conducted with a total of 40 patients including 22 males and 18 females. The patients' ages ranged from 22 to 80 years old. By analyzing a sample from a nasopharyngeal swab and performing real-time reverse transcription-polymerase chain reaction (RT-PCR), all of the patients tested positive as having COVID-19 infection. Serum calcium was determined from the blood samples of the patients in order to evaluate their serum calcium levels. The statistical package for social science (SPSS) was utilized to examine the obtained data. RESULTS: The study revealed a level of calcium between 6.10 and 9.86 mg/dL in male and female patients. The majority of the female patients (61%) displayed low levels of serum calcium, and 33% of the males had a low level of calcium. It can be seen that the highest rate of male patients (66.6%) exhibited a normal level of serum calcium, while 33.3% showed decreased serum calcium. Based on gender and age groups, a statistically significant difference in calcium levels was observed. CONCLUSIONS: This study discovered that infection with COVID-19 has some significant laboratory abnormalities, including hypocalcemia, showing that serum calcium might be employed as a prognostic marker in the clinic.

Evaluation of risk factors associated with SARS-CoV-2 transmission.

OBJECTIVE: Coronavirus disease 2019 (COVID-19) has caused high morbidity and mortality worldwide. Since there is not enough evidence of risk factors of SARS-CoV-2 transmission, this study aimed to evaluate them. METHODS: This survey-based study was conducted across 66 countries from May to November 2020 among suspected and confirmed individuals with COVID-19. The stepwise AIC method was utilized to determine the optimal multivariable logistic regression to explore predictive factors of SARS-CoV-2 transmission. RESULTS: Among 2372 respondents who participated in the study, there were 1172 valid responses. The profession of non-healthcare-worker (OR: 1.77, 95%CI: 1.04-3.00, p = .032), history of SARS-CoV or MERS-CoV infection (OR: 4.78, 95%CI: 2.34-9.63, p < .001), higher frequency of contact with colleagues (OR: 1.17, 95%CI: 1.01-1.37, p = .041), and habit of hugging when greeting (OR: 1.25, 95%CI: 1.00-1.56, p = .049) were associated with an increased risk of contracting COVID-19. Current smokers had a lower likelihood of having COVID-19 compared to former smokers (OR: 5.41, 95%CI: 1.93-17.49, p = .002) or non-smokers (OR: 3.69, 95%CI: 1.48-11.11, p = .01). CONCLUSIONS: Our study suggests several risk factors for SARS-CoV-2 transmission including the profession of non-healthcare workers, history of other coronavirus infections, frequent close contact with colleagues, the habit of hugging when greeting, and smoking status.

Since there is not enough evidence of risk factors of SARS-CoV-2 transmission, this study aimed to evaluate them. The risk of SARS-CoV-2 infection was higher among non-healthcare workers and among those who had a history of being tested positive for SARS-CoV or MERS-CoV before the COVID-19 outbreak. The habit of frequent contact with colleagues or hugging when greeting significantly increased the risk of being infected with SARS-CoV-2. The current smokers had a lower risk of getting infected with SARS-CoV-2 than others who had a habit of smoking tobacco in the past or who had never smoked.

Diagnostic bias during the COVID-19. A rare case report of salmonella typhi.

INTRODUCTION: In poor countries, due to the limited resources, mostly they prescribe medications without proper diagnosis. The aim of this report is to show diagnostic bias of COVID-19 case. CASE PRESENTATION: A 17-year-old male patient was presented to the Hospital with a fever up to 39 °C associated with rigor, sweating, generalized body pain, myalgia, fatigue, loss of appetite, headache, and multiple joint pain with no swelling and redness. The vital signs were steady on physical examination, except temperature which was 39 °C. The chest was clear, and the pulse rate was 90 beats per minute. The heart rate relative bradycardia and lungs were normal. Both a PCR test for COVID-19, and a viral assay ELISA were negative. After further investigations, the culture findings revealed the strong development of Gram-negative coccobacilli (Salmonella serotype Typhi) bacteria under the microscope, which was confirmed by using VITEK 2 to identify it. and treated with ciprofloxacin tab, two times per day for five days and amikacin ampule 500 mg IV every 24 hours for 10 days. DISCUSSION: Fever is a well-known sign of COVID-19 infection which has been observed in 83%-98% of patients with COVID19. As a result, it may be difficult to tell the difference between COVID-19 and other febrile infections, causing delays in diagnosis and treatment and may blind the physician from considering other febrile illnesses. CONCLUSION: Physicians should construct more comprehensive differential diagnoses for people who experience fever, headache, or myalgia symptoms that are linked to a pandemic. COVID-19.

Awareness and preparedness of healthcare workers against the first wave of the COVID-19 pandemic: A cross-sectional survey across 57 countries.

BACKGROUND: Since the COVID-19 pandemic began, there have been concerns related to the preparedness of healthcare workers (HCWs). This study aimed to describe the level of awareness and preparedness of hospital HCWs at the time of the first wave. METHODS: This multinational, multicenter, cross-sectional survey was conducted among hospital HCWs from February to May 2020. We used a hierarchical logistic regression multivariate analysis to adjust the influence of variables based on awareness and preparedness. We then used association rule mining to identify relationships between HCW confidence in handling suspected COVID-19 patients and prior COVID-19 case-management training. RESULTS: We surveyed 24,653 HCWs from 371 hospitals across 57 countries and received 17,302 responses from 70.2% HCWs overall. The median COVID-19 preparedness score was 11.0 (interquartile range [IQR] = 6.0-14.0) and the median awareness score was 29.6 (IQR = 26.6-32.6). HCWs at COVID-19 designated facilities with previous outbreak experience, or HCWs who were trained for dealing with the SARS-CoV-2 outbreak, had significantly higher levels of preparedness and awareness (p<0.001). Association rule mining suggests that nurses and doctors who had a 'great-extent-of-confidence' in handling suspected COVID-19 patients had participated in COVID-19 training courses. Male participants (mean difference = 0.34; 95% CI = 0.22, 0.46; p<0.001) and nurses (mean difference = 0.67; 95% CI = 0.53, 0.81; p<0.001) had higher preparedness scores compared to women participants and doctors. INTERPRETATION: There was an unsurprising high level of awareness and preparedness among HCWs who participated in COVID-19 training courses. However, disparity existed along the lines of gender and type of HCW. It is unknown whether the difference in COVID-19 preparedness that we detected early in the pandemic may have translated into disproportionate SARS-CoV-2 burden of disease by gender or HCW type.