Increased inflammatory cytokines and oxidative stress enhanced antibody production in breast and prostate cancer patients with COVID-19 related depression.

Cancer management is highly dependent on the immune status of the patient. During the COVID-19 pandemic, a large number of people suffered from anxiety and depression, especially cancer patients. The effect of depression on breast cancer (BC) and prostate cancer (PC) patients, during the pandemic has been analyzed in this study. Levels of proinflammatory cytokines (IFN-γ, TNF-α, and IL-6) and oxidative stress markers malondialdehyde (MDA) and carbonyl content (CC) were estimated in patients' serum samples. Serum antibodies against in vitro hydroxyl radical (•OH) modified pDNA (•OH-pDNA-Abs) were estimated using direct binding and inhibition ELISA. Cancer patients showed increased levels of proinflammatory cytokines (IFN-γ, TNF-α, and IL-6) and oxidative stress markers (MDA and CC levels), which were further significantly enhanced in cancer patients with depression compared to normal healthy (NH) individuals. Increased levels of •OH-pDNA-Abs were detected in breast cancer (0.506 ± 0.063) and prostate cancer (0.441 ± 0.066) patients compared to NH subjects. Serum antibodies were found to be significantly elevated in BC patients with depression (BCD) (0.698 ± 0.078) and prostate cancer patients with depression (PCD) (0.636 ± 0.058). Inhibition ELISA also exhibited significantly high percent inhibition in BCD (68.8% ± 7.8%) and PCD (62.9% ± 8.3%) subjects compared to BC (48.9% ± 8.1%), and PC (43.4% ± 7.5%) subjects. Cancer is characterized by enhanced oxidative stress and increased inflammation, which may be exaggerated with COVID-19 related depression. High oxidative stress and compromised antioxidant homeostasis exerts alterations in DNA, leading to formation of neo-antigens, subsequently leading to the generation of antibodies. COVID-19 pandemic related depression needs to be addressed globally for improved cancer patient care and cancer disease management.

Predicting Intensive Care Unit Admission for COVID-19 Patients from Laboratory Results.

Trends in routine laboratory tests, such as high white blood cell and low platelet counts, correlate with COVID-19-related intensive care unit (ICU) admissions. Other related biomarkers include elevated troponin, alanine aminotransferase, and aspartate transaminase levels (liver function tests). To this end, the aim of this study was to investigate the effect of changes in laboratory test parameters on ward-based and ICU COVID-19 patients. A total of 280 COVID-19 patients were included in the study and were divided based on admission status into ICU (37) or ward (243) patients. ICU admission correlated significantly with higher levels of several tested parameters, including lactate dehydrogenase, creatinine, D-dimer, creatine kinase, white blood cell count, and neutrophil count. In conclusion, routine laboratory tests offer an indication of which COVID-19 patients are most likely to be admitted to the ICU. These associations can assist healthcare providers in addressing the needs of patients who are at risk of COVID-19 complications.

Public Perceptions and Commitment to Social Distancing "Staying-at-Home" During COVID-19 Pandemic: A National Survey in Saudi Arabia.

OBJECTIVE: Social distancing measures, such as stay-at-home, are currently implemented to control the COVID-19 pandemic in many countries, including Saudi Arabia. The aim of this study was, therefore, to evaluate the awareness and adherence of the Saudi population to these measures. METHODS: A web-based questionnaire was designed with 16 questions (eight questions related to demographics, three related to the awareness of social distancing (stay-at-home) and five related to the overall practice of social distancing). RESULTS: A total of 5105 participants completed the survey [58.4% females, 66.3% young individuals (aged 18-37 years), 55.8% bachelor degree holders and 51.0% from the western region]. The Saudi Ministry of Health (MOH) was the main source of information about COVID-19 for most of the participants (78.2%). High awareness (81.3%) regarding stay-at-home was observed, associated mainly with female participants, those from the middle region and those with a high education and income. The overall implementation of social distancing was satisfactory (score 3.13/5), with 37.8% never leaving home during the stay-at-home period. Better adherence to social distancing was observed among female participants, higher degree holders and those aged over 38 years. CONCLUSION: Organised plans by the Saudi MOH have been effective in raising awareness and improving the practice of social distancing among public. However, the observed lower practice of social distancing by individuals with a lower education and income indicates the need for targeted interventions to achieve better outcomes.

Anticancer, antioxidant, antiviral and antimicrobial activities of Kei Apple (Dovyalis caffra) fruit.

Secondary plant metabolites remain one of the key sources of therapeutic agents despite the development of new approaches for the discovery of medicinal drugs. In the current study, chemical analysis, and biological activities of Kei apple (Dovyalis caffra) methanolic extract were evaluated. Chemical analysis was performed using HPLC and GC-MS. Antiviral and anticancer effect were assessed using the crystal violet technique and activity against human liver cells (HepG2), respectively. Antibacterial activity was tested with the disc diffusion method. The obtained results showed that chlorogenic acid (2107.96 ± 0.07 µg/g), catechin (168 ± 0.58 µg/g), and gallic acid (15.66 ± 0.02 µg/g) were the main bioactive compounds identified by HPLC techniques. While, compounds containing furan moieties, as well as levoglucosenone, isochiapin B, dotriacontane, 7-nonynoic acid and tert-hexadecanethiol, with different biological activities were identified by GC-MS. Additionally, inhibition of 2,2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH) scavenging was 79.25% at 2000 µg/mL, indicating its antioxidant activity with IC50 of 728.20 ± 1.04 µg/mL. The tested extract exhibited potential anticancer activity (58.90% toxicity) against HepG2 cells at 1000 µg/mL. Potential bacterial inhibition was observed mainly against Escherichia coli and Proteus vulgaris, followed by Staphylococcus aureus and Bacillus subtilis with a diameter of growth inhibition ranging from 13 to 24 mm. While weak activities were recorded for fungi Candida albicans (10 mm). The extract showed mild antiviral activity against human coronavirus 229E with a selective index (SI) of 10.4, but not against human H3N2 (SI of 0.67). The molecular docking study's energy ratings were in good promise with the experiment documents of antibacterial and antiviral activities. The findings suggest that D. caffra juice extract is a potential candidate for further experiments to assess its use as potential alternative therapeutic agent.

Bacterial Coinfection and Antibiotic Resistance Profiles among Hospitalised COVID-19 Patients.

While it is reported that COVID-19 patients are more prone to secondary bacterial infections, which are strongly linked to the severity of complications of the disease, bacterial coinfections associated with COVID-19 are not widely studied. This work aimed to investigate the prevalence of bacterial coinfections and associated antibiotic resistance profiles among hospitalised COVID-19 patients. Age, gender, weight, bacterial identities, and antibiotic sensitivity profiles were collected retrospectively for 108 patients admitted to the intensive care unit (ICU) and non-ICU ward of a single center in Saudi Arabia. ICU patients (60%) showed a significantly higher percentage of bacterial coinfections in sputum (74%) and blood (38%) samples, compared to non-ICU. Acinetobacter baumannii (56%) and Klebsiella pneumoniae (56%) were the most prevalent bacterial species from ICU patients, presenting with full resistance to all tested antibiotics except colistin. By contrast, samples of non-ICU patients exhibited infections with Escherichia coli (31%) and Pseudomonas aeruginosa (15%) predominantly, with elevated resistance of E. coli to piperacillin/tazobactam and trimethoprim/sulfamethoxazole. This alarming correlation between multi-drug resistant bacterial coinfection and admission to the ICU requires more attention and precaution with prescribed antibiotics to limit the spread of resistant bacteria and improve therapeutic management.

Awareness and Practice of COVID-19 Precautionary Measures Among Healthcare Professionals in Saudi Arabia.

OBJECTIVE: Healthcare workers (HCWs) are the backbone of the healthcare system and a skilled and healthy workforce is vital during a health crisis, such as the present coronavirus disease 2019 (COVID-19) pandemic. Healthcare workers are at higher risk of exposure to and transmission of the severe acute respiratory coronavirus-2 (SARS-CoV-2). Hence, HCWs should possess good knowledge and attitudes toward COVID-19 to protect not only themselves but also their colleagues, families and the larger community. Thus, the current study aims to assess the knowledge and practice of protective measures by HCWs in Saudi Arabia during the first wave of the COVID-19 pandemic to identify awareness of the disease, potential trends and associated predictors. METHODS: A cross-sectional, web-based study was conducted among HCWs about knowledge related to COVID-19 and practice of protective measures, such as social distancing and use of personal protective equipment (PPE) during the pandemic. A Fisher exact test and one-way analysis of variance (ANOVA) were used to investigate the level of association among variables. RESULTS: A total of 674 HCWs were recruited in the study (51.8% male, 42.7% aged 28-37 years old and 52% specialists). The Saudi Ministry of Health (MoH) was the main source of knowledge for most of the HCWs (89%) followed by the WHO (44.5%) and social media (42.3%). Washing hands before touching the face was the most selected choice (97.9%) as a precautionary method to limit SARS-CoV2 transmission. Most of the HCWs (74.6%) scored low for staying at home while the majority (71.2%) showed a high practice of personal protective methods, with pharmacists and general physicians scoring the highest. CONCLUSION: Saudi HCWs showed high knowledge and practice of protective measures for COVID-19. Good knowledge correlates with adoption of appropriate practices to prevent spread of infection. The current findings highlight the importance of interventions such as tailored education and training courses for those with low scores to improve overall knowledge and practice.

Knowledge and practice of personal protective measures during the COVID-19 pandemic: A cross-sectional study in Saudi Arabia.

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is an emergent infectious pathogen causing an acute respiratory disease called corona virus disease 2019 (COVID-19). Virus transmission may occur by contact, droplet, airborne or via contaminated surfaces. In efforts to effectively control the COVID-19 outbreak, the world health organization (WHO) and the Saudi Ministry of Health (MOH) have advised the public to practice protective measures to reduce transmission of the virus and reduce incidence of infection. These measures include hand washing, wearing masks and gloves and avoidance of touching the face with unwashed hands. The current study aimed to investigate knowledge and adherence of the Saudi population to these protective actions during the pandemic. After determining the required sample size using power analysis, a cross-sectional online self-reported survey of 5105 Saudi residents was conducted between 25th March to 17th April 2020 to evaluate public knowledge of COVID-19. Participants were all aged 18 years or above, Arabic speakers and residents of Saudi Arabia. Scores were calculated based on knowledge and adherence of the individuals to protective measures. About 90% of participants exhibited a high level of knowledge (scored 2/2) and practice (scored > 3/6) in relation to hand hygiene and wearing gloves and masks. Practice scores were positively associated with females and individuals with high income. Lower practice scores were linked to youth and residents of the northern and western regions of the Kingdom. Over two thirds of participants preferred hand washing to alcohol disinfection, and the frequency and performance of hand washing improved during the pandemic for more than half of respondents. Overall, the findings reflected high public knowledge of SARS-CoV2 transmission routes and adherence to personal protective measures. However, public awareness campaigns with an emphasis on the youth and individuals with low education and income are required to improve overall practice.