Kinetics of a Reaction-Diffusion Mtb/SARS-CoV-2 Coinfection Model with Immunity

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Mycobacterium tuberculosis (Mtb) coinfection has been observed in a number of nations and it is connected with severe illness and death. The paper studies a reaction–diffusion within-host Mtb/SARS-CoV-2 coinfection model with immunity. This model explores the connections between uninfected epithelial cells, latently Mtb-infected epithelial cells, productively Mtb-infected epithelial cells, SARS-CoV-2-infected epithelial cells, free Mtb particles, free SARS-CoV-2 virions, and CTLs. The basic properties of the model's solutions are verified. All equilibrium points with the essential conditions for their existence are calculated. The global stability of these equilibria is established by adopting compatible Lyapunov functionals. The theoretical outcomes are enhanced by implementing numerical simulations. It is found that the equilibrium points mirror the single infection and coinfection states of SARS-CoV-2 with Mtb. The threshold conditions that determine the movement from the monoinfection to the coinfection state need to be tested when developing new treatments for coinfected patients. The impact of the diffusion coefficients should be monitored at the beginning of coinfection as it affects the initial distribution of particles in space. © 2023 by the authors.

Analysis of the In-Host Dynamics of Tuberculosis and SARS-CoV-2 Coinfection

The coronavirus disease 2019 (COVID-19) is a respiratory disease that appeared in 2019 caused by a virus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). COVID-19 is still spreading and causing deaths around the world. There is a real concern of SARS-CoV-2 coinfection with other infectious diseases. Tuberculosis (TB) is a bacterial disease caused by Mycobacterium tuberculosis (Mtb). SARS-CoV-2 coinfection with TB has been recorded in many countries. It has been suggested that the coinfection is associated with severe disease and death. Mathematical modeling is an effective tool that can help understand the dynamics of coinfection between new diseases and well-known diseases. In this paper, we develop an in-host TB and SARS-CoV-2 coinfection model with cytotoxic T lymphocytes (CTLs). The model investigates the interactions between healthy epithelial cells (ECs), latent Mtb-infected ECs, active Mtb-infected ECs, SARS-CoV-2-infected ECs, free Mtb, free SARS-CoV-2, and CTLs. The model's solutions are proved to be nonnegative and bounded. All equilibria with their existence conditions are calculated. Proper Lyapunov functions are selected to examine the global stability of equilibria. Numerical simulations are implemented to verify the theoretical results. It is found that the model has six equilibrium points. These points reflect two states: the mono-infection state where SARS-CoV-2 or TB occurs as a single infection, and the coinfection state where the two infections occur simultaneously. The parameters that control the movement between these states should be tested in order to develop better treatments for TB and COVID-19 coinfected patients. Lymphopenia increases the concentration of SARS-CoV-2 particles and thus can worsen the health status of the coinfected patient. © 2023 by the authors.

Global Dynamics of a Within-Host COVID-19/AIDS Coinfection Model with Distributed Delays

Acquired immunodeficiency syndrome (AIDS) is a spectrum of conditions caused by infection with the human immunodeficiency virus (HIV). Among people with AIDS, cases of COVID-19 have been reported in many countries. COVID-19 (coronavirus disease 2019) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this manuscript, we are going to present a within-host COVID-19/AIDS coinfection model to study the dynamics and influence of the coinfection between COVID-19 and AIDS. The model is a six-dimensional delay differential equation that describes the interaction between uninfected epithelial cells, infected epithelial cells, free SARS-CoV-2 particles, uninfected CD4+ T cells, infected CD4+ T cells, and free HIV-1 particles. We demonstrated that the proposed model is biologically acceptable by proving the positivity and boundedness of the model solutions. The global stability analysis of the model is carried out in terms of the basic reproduction number. Numerical simulations are carried out to investigate that if COVID-19/AIDS coinfected individuals have a poor immune response or a low number of CD4+ T cells, then the viral load of SARS-CoV-2 and the number of infected epithelial cells will rise. On the contrary, the existence of time delays can rise the number of uninfected CD4+ T cells and uninfected epithelial cells, thus reducing the viral load within the host.

A Community Health Worker-Based Intervention on Anthropometric Outcomes of Children Aged 3 to 21 Months in Urban Pakistan, 2019-2021.

Objectives. To evaluate the impact of a community health worker-based "in-home growth monitoring with counseling" (IHGMC) intervention on anthropometric outcomes in Pakistan, where 38% of children younger than 5 years are stunted. Methods. We used an individual, single-blind, step-wedge randomized controlled trial and a pure control group recruited at endline. We based the analysis on an intention-to-treat estimation using the coarsened exact matching (CEM) method for sample selection among treatments and the control. We conducted the baseline in July 2019 and completed endline in September-October 2021. We recruited 1639 households (treated: 1188; control: 451) with children aged 3 to 21 months who were residing in an urban informal settlement area. The CEM sample used for analysis numbered 1046 (treated: 636; control: 410). The intervention continued for 6 months. Results. Compared with the control group, the height-for-age z-score in the IHGMC group increased by 0.58 SD (95% confidence interval [CI] = 0.33, 0.83; P = .001) and the weight-for-age z-score by 0.43 SD (95% CI = 0.20, 0.67; P < .01), measured at endline. Conclusions. IHGMC substantially improved child anthropometric outcomes in disadvantaged localities, and this impact persisted during the COVID-19 pandemic. Trial Registration. AER-RCT registry (AEARCTR-0003248). (Am J Public Health. 2023;113(1):105-114. https://doi.org/10.2105/AJPH.2022.307111).

Step up to health, Nigeria! utilizing information from abuja's world cancer day walks for equity-based cancer prevention interventions

Background: Abuja, Nigeria's annual World Cancer Day Walk (WCDW) is a tool for promoting public awareness of cancer risk factors, preventative lifestyle strategies, and the importance of early screening as critical elements of prevention and control. The day includes physical activities (walk, race, ride, skate, cycle, marathon), as well as health education and free breast cancer, cervical, and prostate screenings. The effectiveness of the event to attract the most vulnerable Nigerian populations has not been studied. Aim: To determine the social-demographic characteristics of participants and evaluate the impact of outreach campaigns. Methods: Approximately 2,000 Nigerians attended Abuja WCDW on February 1, 2020. A similar number attended Abuja WCDW on February 5, 2022. Trained research assistants recruited participants to complete a one-sheet questionnaire that assessed basic demographic, social, and lifestyle information. Participants were given informed consent. In 2020, 237 (11%) participants, aged 18-68 years voluntarily completed survey (ClinicalTrials #NCT04248881). In 2022, 111 (6%), aged 17-74 years voluntarily completed survey (ClinicalTrials #NCT05239325). Note: In 2021, Abuja WCDW was canceled due to COVID. Results: In 2020, the mean age for participants was 28;SD 7.71. Sixty-eight percent were women. Eighty-seven percent had at least an undergraduate education. Of the 237 participants, 65% reported that they attended to obtain free cancer screening. More than 50% reported they had no health insurance. Of those insured, more had National Health Insurance Scheme (NHIS) than private insurance. The average body mass index (BMI) was between 24-28;BMI was highest among the mid-20 age group. Lifestyle data revealed more men than women were concerned with their health;those with health worries were more likely to have had cancer screening at the event. The 2022 WCDW data were being analyzed at the time of submission;findings will be presented at the meeting. Analysis: Data from 2020 revealed participants are predominately associated with a lower risk of developing cancer. They have higher levels of knowledge about cancer and lifestyle/health-related behaviors beneficial for early detection and prevention. WCDW is a great avenue for cancer awareness/lifestyle prevention interventions yet there is an urgent need to evaluate efficacy of current outreach to target underserved members of Nigerian population: those with lower levels of education, unemployed, lower income, and without insurance. Conclusions: Attendees in 2020 are younger people of higher socioeconomic status with lifestyle practices that could reduce cancer risk. If our 2022 data are similar, we must elaborate better strategies to reach populations at greater risk and encourage them to attend future events to have more impactful lifestyle/prevention outcomes.

Funny thyroid function tests - TSHoma and post-COVID 19 thyroiditis leading to confusing thyroid function tests dynamics, a case report

Background: We present the case of a male patient with a diagnosis of TSH-secreting pituitary adenoma (TSHoma) who became infected with SARS-CoV-2 and developed a post-COVID-19 thyroiditis with resultant confusing changes in his thyroid function tests (TFTs). Case Presentation: The patient presented with an incidental finding of elevated Free T4 and inappropriately normal TSH, confirmed on multiple analytical platforms. A TRH test showed a flat TSH response, and an MRI pituitary showed a 2.4 cm macroadenoma. Somatostatin analogue treatment was commenced pending surgery, with rapid normalization of TFTs. The patient then became symptomatic of headache, pyrexia, dysgeusia and anosmia lasting two weeks, at a time when the first wave of the COVID-19 pandemic was affecting Ireland. The patient had been a close contact of two confirmed COVID-19 cases. He did not have a SARS-CoV2 PCR test at the time but later tested positive for COVID-19 spike and nucleocapsid antigen IgG antibodies (vaccine naïve), indicating previous exposure to SARS-CoV-2. Two months after this illness, the patient’s TFTs showed a pattern typical of primary hyperthyroidism with grossly elevated FT4 and fully suppressed TSH (with co-existent thyrotoxicosis symptoms), followed by a pattern of primary hypothyroidism with a low FT4 and high TSH – a pattern consistent with subacute thyroiditis post-viral illness. TRAb was negative. The patient’s TFTs later showed high normal TSH and normal FT4 while continuing lanreotide therapy. He is currently euthyroid and awaiting pituitary surgery which was delayed due to the COVID-19 emergency. Conclusion: To our knowledge, this is the first case of post-COVID-19 thyroiditis in a patient with underlying TSHoma. The case highlights the importance of considering an alternative or new diagnosis in the setting of rapidly changing patterns in thyroid function tests, and for close clinical and biochemical follow-up in these situations. The patient gave written consent to this publication. SARS-CoV-2 = Severe Acute Respiratory Syndrome Coronavirus 2 TFT = Thyroid Function Test FT4 = Free Thyroxine TSH = Thyroid-Stimulating Hormone TRH = Thyrotropin-Releasing Hormone MRI = Magnetic Resonance Imaging TRAB = TSH Receptor Antibodies Anti-TPO Ab = Anti-Thyroid Peroxidase Antibodies

Global dynamics of SARS-CoV-2/malaria model with antibody immune response.

Coronavirus disease 2019 (COVID-19) is a new viral disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Malaria is a parasitic disease caused by Plasmodium parasites. In this paper, we explore a within-host model of SARS-CoV-2/malaria coinfection. This model consists of seven ordinary differential equations that study the interactions between uninfected red blood cells, infected red blood cells, free merozoites, uninfected epithelial cells, infected epithelial cells, free SARS-CoV-2 particles, and antibodies. We show that the model has bounded and nonnegative solutions. We compute all steady state points and derive their existence conditions. We use appropriate Lyapunov functions to confirm the global stability of all steady states. We enhance the reliability of the theoretical results by performing numerical simulations. The steady states reflect the monoinfection and coinfection with malaria and SARS-CoV-2. The shared immune response reduces the concentrations of malaria merozoites and SARS-CoV-2 particles in coinfected patients. This response reduces the severity of SARS-CoV-2 infection in this group of patients.

Burnout in diabetes and endocrinology specialist registrars across England, Scotland and Wales in the pre-COVID era.

BACKGROUND: Presence of either emotional exhaustion, depersonalization or lack of personal accomplishment define Burnout Syndrome which may lead to decreased workforce productivity, increased absenteeism, depression and medical errors as well as decreased patient satisfaction. OBJECTIVE: The aim of this study was to assess the frequency of burnout syndrome among Diabetes Specialist Registrars across England, Scotland and Wales and to identify any self-reported factors which may be contributory to burnout. METHODS: Over 430 Diabetes Specialist Registrars were invited to anonymously participate in an electronic survey which used Maslach Burnout Inventory and selfreporting questionnaire to identify burnout and contributory factors. RESULTS: In this pre-pandemic times study, Burnout was identified in 61 (57.5%; n = 106) respondents using Maslach burnout cut-off scores. 45.2% (48/106) participants had scored high in Emotional Exhaustion, while lack of personal accomplishment and depersonalization was seen in 24.5% (26/106) and 21.6% (23/106) of the respondents respectively. The commonest self-reported stressors by participants were "General Internal Medicine workload" 60.4% (64/106) followed by "Lack of specialty training" 36.8% (39/106) and "Lack of audit/research/Continuing Professional Development time" 10.8% (11/106) CONCLUSION: Burnout syndrome is frequent among the participating Diabetes Specialist Registrars and urgent steps may be required address this problem nationally to ensure that these physicians remain physically and mentally healthy, especially after the pandemic.

Global analysis of within-host SARS-CoV-2/HIV coinfection model with latency.

The coronavirus disease 2019 (COVID-19) is a respiratory disease caused by a virus called the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In this paper, we analyze a within-host SARS-CoV-2/HIV coinfection model. The model is made up of eight ordinary differential equations. These equations describe the interactions between healthy epithelial cells, latently infected epithelial cells, productively infected epithelial cells, SARS-CoV-2 particles, healthy CD 4 + T cells, latently infected CD 4 + T cells, productively infected CD 4 + T cells, and HIV particles. We confirm that the solutions of the developed model are bounded and nonnegative. We calculate the different steady states of the model and derive their existence conditions. We choose appropriate Lyapunov functions to show the global stability of all steady states. We execute some numerical simulations to assist the theoretical contributions. Based on our results, weak CD 4 + T cell immunity in SARS-CoV-2/HIV coinfected patients causes an increase in the concentrations of productively infected epithelial cells and SARS-CoV-2 particles. This may lead to severe SARS-CoV-2 infection in HIV patients. This result agrees with many studies that discussed the high risk of severe infection and death in HIV patients when they get SARS-CoV-2 infection. On the other hand, increasing the death rate of infected epithelial cells during the latency period can reduce the severity of SARS-CoV-2 infection in HIV patients. More studies are needed to understand the dynamics of SARS-CoV-2/HIV coinfection and find better ways to treat this vulnerable group of patients.

Global stability of a within-host SARS-CoV-2/cancer model with immunity and diffusion

Coronavirus disease 2019 (COVID-19) is a new respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It started in China and spread quickly to all continents. This virus has changed the life style and the education system in many countries. As for other viruses, mathematical models have been rated as a useful tool to support the research on COVID-19. In this work, we develop a reaction–diffusion model to describe the within-host dynamics of SARS-CoV-2 in cancer patients. This model studies the interactions between nutrient, healthy epithelial cells, cancer cells, SARS-CoV-2 particles, and immune cells. The model incorporates the spatial mobility of the cells and viruses. The model includes parameters for measuring the effect of lymphopenia on SARS-CoV-2/cancer patients. We verify the basic features of the model’s solutions including the uniqueness, nonnegativity and boundedness. We list all equilibrium points of the proposed model. We show the global stability and the local instability of the most meaningful equilibria. We display some numerical simulations to enhance our theoretical results. The results indicate that diffusion can have a clear effect at the beginning of SARS-CoV-2 infection. Lymphopenia in SARS-CoV-2/cancer patients impairs the immune responses against cancer and SARS-CoV-2, and worsens the health state of patients. [ABSTRACT FROM AUTHOR] Copyright of International Journal of Biomathematics is the property of World Scientific Publishing Company and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Global dynamics of SARS-CoV-2/cancer model with immune responses.

The world is going through a critical period due to a new respiratory disease called coronavirus disease 2019 (COVID-19). This disease is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Mathematical modeling is one of the most important tools that can speed up finding a drug or vaccine for COVID-19. COVID-19 can lead to death especially for patients having chronic diseases such as cancer, AIDS, etc. We construct a new within-host SARS-CoV-2/cancer model. The model describes the interactions between six compartments: nutrient, healthy epithelial cells, cancer cells, SARS-CoV-2 virus particles, cancer-specific CTLs, and SARS-CoV-2-specific antibodies. We verify the nonnegativity and boundedness of its solutions. We outline all possible equilibrium points of the proposed model. We prove the global stability of equilibria by constructing proper Lyapunov functions. We do some numerical simulations to visualize the obtained results. According to our model, lymphopenia in COVID-19 cancer patients may worsen the outcomes of the infection and lead to death. Understanding dysfunctions in immune responses during COVID-19 infection in cancer patients could have implications for the development of treatments for this high-risk group.