Negative prognostic impact of electrolyte disorders in patients hospitalized for Covid-19 in a large multicenter study.

BACKGROUND: The prognostic impact of electrolyte disorders in hospitalized COVID-19 patients is unclear. METHODS: The study included all adult patients hospitalized for COVID-19 in four hospitals in Northern Italy between January 2020 and May 2021 with at least one serum potassium and sodium measurement performed within 3 days since admission. Primary outcome was in-hospital death; secondary outcome was Intensive Care Unit (ICU) admission. A cause-specific Cox proportional-hazards regression model was used for investigating the association between potassium and sodium (as either categorical or continuous variables) and mortality or admission to ICU. RESULTS: Analyses included 3,418 adult hospitalized COVID-19 patients. At multivariable analysis, both hyperkalemia (Hazard Ratio, [HR] 1.833, 95% Confidence Interval [CI] 1.371-2.450) and sK above the median (K 5.1 vs 4.1 mmol/L: HR 1.523, 95% CI 1.295-1.798), and hypernatremia (HR 2.313, 95%CI 1.772-3.018) and sNa above the median (Na 149 vs 139 mmol/L: HR 1.442, 95% CI 1.234-1.686), were associated with in-hospital death, whereas hypokalemia and hyponatremia were not. Hyponatremia was associated with increased hazard of ICU admission (HR 1.884, 95%CI 1.389-2.556). CONCLUSIONS: Electrolyte disorders detected at hospital admission may allow early identification of COVID-19 patients at increased risk of adverse outcomes.

Pandemic or Panzootic--A Reflection on Terminology for SARS-CoV-2 Infection

As of October 2022, a total of 675 natural outbreaks of SARS-CoV-2 infection have occurred in animal species worldwide. Here, we provide a linguistic and etymologic critique of the term "pandemic" being used to describe the COVID-19 health crisis, as opposed to the term "panzootic," and discuss policy ramifications of more inclusive terminology. [ FROM AUTHOR]

Association Between Sex Hormone Levels and Clinical Outcomes in Patients With COVID-19 Admitted to Hospital: An Observational, Retrospective, Cohort Study.

Understanding the cause of sex disparities in COVID-19 outcomes is a major challenge. We investigate sex hormone levels and their association with outcomes in COVID-19 patients, stratified by sex and age. This observational, retrospective, cohort study included 138 patients aged 18 years or older with COVID-19, hospitalized in Italy between February 1 and May 30, 2020. The association between sex hormones (testosterone, estradiol, progesterone, dehydroepiandrosterone) and outcomes (ARDS, severe COVID-19, in-hospital mortality) was explored in 120 patients aged 50 years and over. STROBE checklist was followed. The median age was 73.5 years [IQR 61, 82]; 55.8% were male. In older males, testosterone was lower if ARDS and severe COVID-19 were reported than if not (3.6 vs. 5.3 nmol/L, p =0.0378 and 3.7 vs. 8.5 nmol/L, p =0.0011, respectively). Deceased males had lower testosterone (2.4 vs. 4.8 nmol/L, p =0.0536) and higher estradiol than survivors (40 vs. 24 pg/mL, p = 0.0006). Testosterone was negatively associated with ARDS (OR 0.849 [95% CI 0.734, 0.982]), severe COVID-19 (OR 0.691 [95% CI 0.546, 0.874]), and in-hospital mortality (OR 0.742 [95% CI 0.566, 0.972]), regardless of potential confounders, though confirmed only in the regression model on males. Higher estradiol was associated with a higher probability of death (OR 1.051 [95% CI 1.018, 1.084]), confirmed in both sex models. In males, higher testosterone seems to be protective against any considered outcome. Higher estradiol was associated with a higher probability of death in both sexes.

Thermostable Vaccines in Veterinary Medicine: State of the Art and Opportunities to Be Seized.

The COVID-19 pandemic has highlighted the weakness of the vaccine supply chain, and the lack of thermostable formulations is one of its major limitations. This study presents evidence from peer-reviewed literature on the development of thermostable vaccines for veterinary use. A systematic review and meta-analysis were performed to evaluate the immunogenicity and/or the efficacy/effectiveness of thermostable vaccines against infectious diseases. The selected studies (n = 78) assessed the vaccine's heat stability under different temperature conditions and over different periods. Only one study assessed the exposure of the vaccine to freezing temperatures. Two field studies provided robust evidence on the immunogenicity of commercial vaccines stored at temperatures far in excess of the manufacturer's recommended cold-chain conditions. The drying process was the most-used method to improve the vaccine's thermostability, along with the use of different stabilizers. The pooled vaccine efficacy was estimated to be high (VE = 69%), highlighting the importance of vaccination in reducing the economic losses due to the disease impact. These findings provide evidence on the needs and benefits of developing a portfolio of heat- and freeze-stable veterinary vaccines to unleash the true potential of immunization as an essential component of improved animal health and welfare, reduce the burden of certain zoonotic events and thus contribute to economic resilience worldwide.

Integrating digital and field surveillance as complementary efforts to manage epidemic diseases of livestock: African swine fever as a case study.

SARS-CoV-2 has clearly shown that efficient management of infectious diseases requires a top-down approach which must be complemented with a bottom-up response to be effective. Here we investigate a novel approach to surveillance for transboundary animal diseases using African Swine (ASF) fever as a model. We collected data both at a population level and at the local level on information-seeking behavior respectively through digital data and targeted questionnaire-based surveys to relevant stakeholders such as pig farmers and veterinary authorities. Our study shows how information-seeking behavior and resulting public attention during an epidemic, can be identified through novel data streams from digital platforms such as Wikipedia. Leveraging attention in a critical moment can be key to providing the correct information at the right moment, especially to an interested cohort of people. We also bring evidence on how field surveys aimed at local workers and veterinary authorities remain a crucial tool to assess more in-depth preparedness and awareness among front-line actors. We conclude that these two tools should be used in combination to maximize the outcome of surveillance and prevention activities for selected transboundary animal diseases such as ASF.

Natural language processing and network analysis provide novel insights on policy and scientific discourse around Sustainable Development Goals.

The United Nations' (UN) Sustainable Development Goals (SDGs) are heterogeneous and interdependent, comprising 169 targets and 231 indicators of sustainable development in such diverse areas as health, the environment, and human rights. Existing efforts to map relationships among SDGs are either theoretical investigations of sustainability concepts, or empirical analyses of development indicators and policy simulations. We present an alternative approach, which describes and quantifies the complex network of SDG interdependencies by applying computational methods to policy and scientific documents. Methods of Natural Language Processing are used to measure overlaps in international policy discourse around SDGs, as represented by the corpus of all existing UN progress reports about each goal (N = 85 reports). We then examine if SDG interdependencies emerging from UN discourse are reflected in patterns of integration and collaboration in SDG-related science, by analyzing data on all scientific articles addressing relevant SDGs in the past two decades (N = 779,901 articles). Results identify a strong discursive divide between environmental goals and all other SDGs, and unexpected interdependencies between SDGs in different areas. While UN discourse partially aligns with integration patterns in SDG-related science, important differences are also observed between priorities emerging in UN and global scientific discourse. We discuss implications and insights for scientific research and policy on sustainable development after COVID-19.

Is the COVID-19 pandemic impacting on the risk of African Swine Fever virus (ASFV) introduction into the United States? A short-term assessment of the risk factors.

African swine fever (ASF) is a contagious disease with high mortality in domestic and feral swine populations. Although it is not a zoonosis, its spread may have severe socio-economic and public health consequences. The activities of veterinary services are essential for controlling ASF outbreaks within a country, but also for diminishing its threat of spread to neighbouring countries, and for recognizing its entry into countries that are currently free. ASF requires quick responses and permanent monitoring to identify outbreaks and prevent spread, and both aspects can be heavily undercut during the COVID-19 pandemic. This paper analyses changing patterns of the main drivers and pathways for the potential introduction of ASFV into the United States during the COVID-19 pandemic, including international movements of people, swine products and by-products. Data on commercial flights and merchant ships was used as a proxy to indirectly assess the flow of illegal products coming from ASF affected countries. Results from this study highlight a decreasing trend in the legal imports of swine products and by-products from ASF affected countries (Sen's slope = -99, 95% CI: -215.34 to -21.26, p-value < 0.05), while no trend was detected for confiscations of illegal products at ports of entry. Additionally, increasing trends were detected for the monthly number of merchant ships coming from ASF affected countries (Sen's slope = 0.46, 95%CI 0.25-0.59), the monthly value of imported goods ($) through merchant ships (Sen's slope = 1513196160, 95%CI 1072731702-1908231855), and the monthly percentage of commercial flights (Sen's slope = 0.005, 95%CI 0.003-0.007), with the majority of them originating from China. Overall, the findings show an increased connection of the United States with ASF affected countries, highlighting the risk posed by ASF during a global public health crisis.

Erasing the Invisible Line to Empower the Pandemic Response.

A challenging debate has arisen on the role of veterinary expertise in facing the SARS-CoV-2 pandemic. It seems totally unreasonable that in most countries, veterinary diagnostic and tracing forces were not deployed at the start to perform strategic tasks, which could have mitigated the outcome of this dramatic health emergency. Erasing the invisible line between human and veterinary virology will empower the response to future pandemics.

Age-sex population adjusted analysis of disease severity in epidemics as a tool to devise public health policies for COVID-19.

Governments continue to update social intervention strategies to contain COVID-19 infections. However, investigation of COVID-19 severity indicators across the population might help to design more precise strategies, balancing the need to keep people safe and to reduce the socio-economic burden of generalized restriction precedures. Here, we propose a method for age-sex population-adjusted analysis of disease severity in epidemics that has the advantage to use simple and repeatable variables, which are daily or weekly available. This allows to monitor the effect of public health policies in short term, and to repeat these calculations over time to surveille epidemic dynamics and impact. Our method can help to define a risk-categorization of likeliness to develop a severe COVID-19 disease which requires intensive care or is indicative of a higher risk of dying. Indeed, analysis of suitable open-access COVID-19 data in three European countries indicates that individuals in the 0-40 age interval and females under 60 are significantly less likely to develop a severe condition and die, whereas males equal or above 60 are more likely at risk of severe disease and death. Hence, a combination of age-adaptive and sex-balanced guidelines for social interventions could represent key public health management tools for policymakers.

Could Mustelids spur COVID-19 into a panzootic?

The ongoing pandemic caused by SARS-CoV-2 has spilled over into humans from an animal reservoir. Notably, the virus is now spilling back into a variety of animal species. It appears striking that American (Neovison vison) and European (Mustela vison) minks are the first intensively farmed animal to experience outbreaks. Neither of these have occurred in Asia or Africa but rather in Europe - namely Spain, Denmark, Netherlands and in the US, at a mink farm in Utah. Current evidence indicates that the virus was transmitted to the animals through infected human workers on the farm.At the time of writing, SARS-CoV-2 infection has not been documented in any other intensively farmed species, suggesting that mustelids may exhibit a higher susceptibility to the virus. Studies have shown that domestic ferrets have an extremely low resistance to COVID-19 infection (Shi et al. 2020). Mustelids comprise approximately 60 different species (Kollas et al. 2015) and are widely distributed across a number of habitats, both aquatic (marine and freshwater), and terrestrial (prairies, steppes, tundra, forests). Several wild mustelids have become acclimated to urban areas - such as raccoons, otters and badgers, and some are raised in households as pets - such as ferrets. The latter are perhaps at greater risk of infection than their cousins inhabiting the wild, but it is the former that we should be most worried about. If infection by SARS-CoV-2 spills into wild mustelids, these have the potential to become a permanent reservoir of infection for other animal species. Such a scenario has been seen before with rabies in raccoons and skunks (Rupprecht et al. 1995) and with bovine tuberculosis in badgers (Gallagher and Clifton-Hadley 2000).We believe that it is important to prioritize studies in mustelids on their putative role as reservoirs and amplifiers of SARS-CoV-2 infection in animals and subsequently humans. The development of appropriate surveillance and intervention strategies will determine if mustelids are one of the key links in the chain to the initiation of an unprecedented epochal event: a panzootic.

Toward Nanotechnology-Enabled Approaches against the COVID-19 Pandemic.

The COVID-19 outbreak has fueled a global demand for effective diagnosis and treatment as well as mitigation of the spread of infection, all through large-scale approaches such as specific alternative antiviral methods and classical disinfection protocols. Based on an abundance of engineered materials identifiable by their useful physicochemical properties through versatile chemical functionalization, nanotechnology offers a number of approaches to cope with this emergency. Here, through a multidisciplinary Perspective encompassing diverse fields such as virology, biology, medicine, engineering, chemistry, materials science, and computational science, we outline how nanotechnology-based strategies can support the fight against COVID-19, as well as infectious diseases in general, including future pandemics. Considering what we know so far about the life cycle of the virus, we envision key steps where nanotechnology could counter the disease. First, nanoparticles (NPs) can offer alternative methods to classical disinfection protocols used in healthcare settings, thanks to their intrinsic antipathogenic properties and/or their ability to inactivate viruses, bacteria, fungi, or yeasts either photothermally or via photocatalysis-induced reactive oxygen species (ROS) generation. Nanotechnology tools to inactivate SARS-CoV-2 in patients could also be explored. In this case, nanomaterials could be used to deliver drugs to the pulmonary system to inhibit interaction between angiotensin-converting enzyme 2 (ACE2) receptors and viral S protein. Moreover, the concept of "nanoimmunity by design" can help us to design materials for immune modulation, either stimulating or suppressing the immune response, which would find applications in the context of vaccine development for SARS-CoV-2 or in counteracting the cytokine storm, respectively. In addition to disease prevention and therapeutic potential, nanotechnology has important roles in diagnostics, with potential to support the development of simple, fast, and cost-effective nanotechnology-based assays to monitor the presence of SARS-CoV-2 and related biomarkers. In summary, nanotechnology is critical in counteracting COVID-19 and will be vital when preparing for future pandemics.

Is COVID-19 the first pandemic that evolves into a panzootic?

SARS-CoV-2 is a zoonotic virus that has achieved community spread among humans and become a pandemic. Transmission from humans to dogs, domestic cats, tigers, and lions has occurred. Pigs, cats, ferrets, and primates have been identified as good candidates for susceptibility to SARS-CoV-2. The potential implications indicate the need for One Health surveillance, intervention, and management strategies to mitigate the effects on animal populations and prevent a second preparedness failure during this health emergency.