Transcriptomic approaches in COVID-19: From infection to vaccines

Transcriptomics technologies have enabled the rapid response to the coronavirus disease 2019 (COVID-19) pandemic. A variety of platforms including oligonucleotide microarrays, RNA sequencing (RNA-seq), and single-cell RNA-seq (scRNA-seq) have been applied to the most diverse set of samples acquired from cell cultures, organoids, and animal models experimentally infected with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), as well as from cells, tissues, and biofluids from COVID-19 patients. In this chapter, we will discuss transcriptomic approaches used to determine the aspects of SARS-CoV-2 structure, entry and replication, understand host responses to infection, identify diagnostic signatures, discovery, and repurpose drugs, and to elucidate the protective correlates of vaccination. © 2023 Elsevier Inc. All rights reserved.

No evidence of resistance to itraconazole in a prospective real-world trial of dermatomycosis in India.

BACKGROUND: The prevalence of superficial fungal infections in India is believed to have increased substantially in the past decade. We evaluated the treatment outcomes and risk factors associated with clinical response to a treatment course of itraconazole for the management of dermatomycosis in India. METHODS: In this real-world, prospective pilot study (August 2019 to March 2020), adult participants (18-60 years), diagnosed with T. cruris or T. corporis, received itraconazole 200 mg/day (any formulation) orally for 7 days, and were followed for an additional 7 days. RESULTS: The study was terminated early due to the COVID-19 pandemic. Of 40 enrolled participants (mean [SD] age, 35.5 [12.73] years; {62.5%}] male; 37 received itraconazole and 20 (50%) completed the study. The median (range) Clinical Evaluation Tool Signs and Symptoms total score at baseline was 5.5 (2-10). Clinical response of "healed" or "markedly improved" based on the Investigator Global Evaluation Tool at day 7 (primary objective) was 42.9% (12/28; 95% CI: 24.53%, 61.19%). Itraconazole minimum inhibitory concentration for identified microorganisms, T. mentagrophytes species complex (91.7%) and T. rubrum (8.3%), was within the susceptibility range (0.015-0.25 mcg/mL). At day 14, 8/13 (61.5%) participants achieved a mycological response, 2/13 participants (15.4%) had a mycological failure and 90% showed a clinical response. CONCLUSION: COVID-19 pandemic affected patient recruitment and follow-up, so the findings call for a careful interpretation. Nevertheless, this real-world study reconfirmed the clinical efficacy and microbial susceptibility to itraconazole for the fungi causing dermatophytosis in India. TRIAL REGISTRATION: Trial registration number: Clinicaltrials.gov NCT03923010.

The mental health of polytechnic higher education students in the COVID-19 pandemic

Background: The pandemic significantly changed social and academic routines of higher education students. Objective: Identify the mental health levels of higher education students and the associated factors. Methods: Cross-sectional study with a convenience sample of 567 students (mean age 23.92, ± 8.36;63.8% female), that answered an online survey at the beginning of the second lockdown, which in-cluded the General Health Questionnaire (GHQ-28), sociodemographic and academic aspects, and main changes that occurred during the pandemic. Results: The mean score of the GHQ was 29.18 (±12.99) and the lowest and highest scores were obtained in severe depression (3.55±4.46) and social dysfunction (11.44±3.81). 60.5% indicated risk for mental problems. Participants identifying changes at labor level had better mental health. The ones identifying changes at familiar routines had higher depressive symptomatology and changes in familiar relationships had higher anxiety symptomatology and insomnia. Conclusion: It is urgent to consider the mental health of students, promoting strategies to minimize the impact of the pandemic, namely in social dysfunction. © 2022, Escola Superior de Enfermagem de Coimbra. All rights reserved.

Mental health patterns during COVID-19 in emergency medical services (EMS)

Purpose This study aims to explore patterns of Emergency Medical Services (EMS) personnel's mental health, regarding their levels of anxiety, depression, stress, COVID-19 anxiety, obsessive-compulsive symptoms and well-being;and to explore variables that contribute to these patterns, among sociodemographic/professional and COVID-19 experience variables. Design/methodology/approach Participants were 214 EMS personnel, who answered the Patient-Health Questionnaire, Perceived Stress Scale, COVID-19 Anxiety Scale, Obsessive-Compulsive Inventory, Well-Being Questionnaire and COVID-19 related questions. Findings EMS personnel showed an adequate psychological adjustment during COVID-19. Two clusters/patterns were found: the poorly (34%) and the well (66%) psychologically-adjusted. Personnel's age, COVID-19 fear and workplace security measures' adequacy contributed to which pattern they were more likely to belong to. Research limitations/implications Despite being cross-sectional and not controlling for pre-COVID-19 data, this study adds to the COVID-19 literature. Findings call for the need to explore: other COVID-19 fears;how personnel perceive workplace security measures;COVID-19 valid instruments;pre-COVID-19 data;and mental health patterns with different rescuers. Practical implications Findings explored EMS personnel's patterns of mental health during the COVID-19, as well as its covariates. Results allow to better prepare emergency management, which can develop prevention strategies focused on older professionals, COVID-19 related fears and how personnel assess security measures. Originality/value This study contributes to the scarce literature focused on COVID-19 mental health patterns instead of focussing on isolated mental health variables, as well as what contributes to these patterns. Moreover, it is one of the few studies that focused on EMS personnel rather than hospital staff.

Hydatid brain cyst: A delayed diagnosis in a rural setting during COVID-19.

A previously healthy 10-year-old girl, living in a sheep-farming community in South Africa with exposure to dogs, presented to her local hospital with generalised tonic-clonic seizures. The initial clinical assessment and laboratory work-up were unremarkable. When she presented with further seizures 6 months later, attempts to arrange neuroimaging and specialist assessment were unsuccessful owing to restrictions on routine healthcare services during the SARS-CoV-2 nationwide lockdown. Subsequently, 11 months after her first presentation, she developed focal neurological signs suggestive of raised intracranial pressure. A brain computed tomography scan revealed a left-sided cerebral cyst and imminent tonsillar herniation. An emergency burr-hole procedure was performed to relieve the raised intracranial pressure, followed by definitive neurosurgical excision of cysts. Hydatid protoscolices and hooklets were seen on microscopy of cyst fluid, and treatment with albendazole and praziquantel was initiated. While her infection was treated successfully, long-term sequelae including permanent blindness and hemiparesis could potentially have been prevented with early neuroimaging and surgical intervention.

Compliance with 24-hour movement recommendations and health in university students during COVID-19 confinement

Objectives: i) examine the proportion of university students who meet Canadian 24- hour movement guidelines (Sleep + Screen + Physical Activity) during COVID-19 lockdown;ii) determine the physical and mental health risks associated with non-adherence with Canadian 24-hour movement guidelines. Method: a convenience sample of 98 university students (64 boys and 34 girls), aged 18-25 years, attending the Sports Science degree at University of Tras-os-Montes e Alto Douro, Portugal, were include. Self-reported physical activity was measured with the International Physical Activity Questionnaire (IPAQ), screen time was assessed with two questions reporting the total of hours and minutes, per weekday or weekend, the students spend watching videos and playing video games, as well as the duration and quality of sleep during the weekdays or on weekends. Results: only 30.6% of the students meet the guidelines for sleep plus physical activity and sedentary behavior. Multivariate logistic regression shows that the variables associated with non-compliance with any of the recommendations are: father's professional status, unemployed or lay-off (OR=10.412, 95% CI: 1.256-86.325), poor and average health perception (OR=24.213, 95%CI: 1.323-443.074) and the quality of sleep, who never and sometimes sleeps well (OR=8.896, 95%CI: 1.807-43.788). Conclusion: students who did not meet with the guidelines were at higher risk of having disturbed sleep and lower self-perception of health.

Predictors of COVID-19 Anxiety in Pre-Hospital Medical Emergency Professionals: Gender Differences

With the COVID-19 pandemic, pre-hospital medical emergency professionals, a group at risk for psychological illness, are even more exposed to stressful critical incidents at work. However, scientific literature focused on the psychological impact and on gender differences is still scarce. This study aimed to analyse the levels of well-being and COVID-19 anxiety of pre-hospital medical emergency professionals, as well as to characterize the COVID-19 experience and to explore the predictors of COVID-19 anxiety, while exploring gender differences. A sociodemographic/professional questionnaire, the Well-Being Questionnaire, the Coronavirus Anxiety Scale and COVID-19 related questions, were applied to 194 professionals (67% males). Low COVID-19 anxiety and moderate well-being were found, which shows a good adjustment to this pandemic. It was also found few gender differences related to the COVID-19 experience, as well as COVID-19 anxiety being associated with less well-being. However, for women COVID-19 anxiety was associated with higher negative well-being and COVID-19 related fear, while for men COVID-19 anxiety was associated with higher negative well-being and COVID-19 workplace security measures. This research adds to the study of COVID-19 impact on frontline professionals and to the study of gender differences on first responders at pre-hospital settings.