Olfactory and Gustatory Dysfunctions Following COVID-19 Infection: Factors That Affect Their Duration in Saudi Arabia.

INTRODUCTION:  Many people infected with coronavirus disease 2019 (COVID-19) have developed post-COVID-19 symptoms, which are defined as symptoms and signs (e.g., anosmia and ageusia) that persist for more than 12 weeks after getting infected with COVID-19. These symptoms may appear after or during the infection and cannot be explained by any alternative disease. In this study, we aim to investigate the factors that affect the duration of anosmia and ageusia in Saudi Arabia. METHODS:  We conducted a nationwide, cross-sectional study using an online survey in Saudi Arabia from 14 February 2022 to 23 July 2022. The electronic survey was distributed using social media platforms, such as Twitter, WhatsApp, and Telegram. RESULT:  The study enrolled 2497 individuals who were infected with COVID-19. A total of 60.1% of the participants showed symptoms of anosmia, ageusia, or both after getting infected with COVID-19. According to our data, we found that being a female and not having a repeated COVID-19 infection were risk factors (independent predictors) of the long duration of anosmia after COVID-19 recovery (p = <0.05). While being a male patient, a smoker, and being admitted to the ICU were risk factors (independent predictors) of long duration of ageusia after COVID-19 recovery (p = <0.05). CONCLUSION:  In conclusion, the prevalence of chemosensory dysfunction symptoms, both olfactory and gustatory, after COVID-19 infection among the Saudi population was high. However, several factors can influence their duration, including gender, smoking, and severity of the infection.

Development of a Discharge Criteria Checklist for COVID-19 Patients From the Intensive Care Unit.

This study aims to develop and validate a checklist of discharge readiness criteria for COVID-19 patients from the intensive care unit (ICU). We conducted a Delphi design study. The degree of agreement among 7 experts had been evaluated using the content validity index (CVI) through a 4-point Likert scale. The instrument was validated with 17 items. All the experts rated all items as very relevant which scored the item-CVI 1, which validates all checklist items. Using the mean of all items, the scale-CVI was calculated, and it was 1. This meant validation of the checklist as a whole. With regard to the overall checklist evaluation, the mean expert proportion of the instrument was 1, and the S-CVI/UA was 1. This discharge criteria checklist improves transition of care for COVID-19 patients and can help nurses, doctors, and academics to discharge COVID-19 patients from the ICU safely.

Development and Validation of a Red Flag Prediction Model for Admission of COVID-19 Patients to the Intensive Care Unit.

We aimed to develop and validate a model for the criteria for admission of COVID-19 patients to the intensive care unit (ICU). A Delphi design study was conducted. The content validity index (CVI) was used to determine the degree of agreement among the experts to validate the content of the admission criteria tool. Eleven experts determined the validity. The evaluation was conducted using a 4-point rating scale. The accepted CVI value was 0.50 and more. The model was validated with 31 items in the 5 dimensions, with the item-CVI of 1, a face validity index of 1, and a scale-level content validity index (S-CVI) value of 1. We have developed and validated a red flag prediction model for ICU admission of COVID-19 patients. The accurate implementation of this model could improve the outcomes of those patients and possibly decrease mortality.

Camus’ Oran and Saramago’s Blind City: A Representation of the World during the COVID-19 Pandemic

This article studies the city spaces in Albert Camus’ “The Plague” and Jose Saramago’s “Blindness.” In light of COVID-19, the article reads these two literary texts in terms of their spatial settings that represent fictional microcosms of the real world engulfed in the COVID-19 pandemic. It also demonstrates how pandemics expose and exacerbate the flaws that are inherent in the social, ideological, and infrastructural dimensions of city spaces. The pandemics reshape Camus’ and Saramago’s cities, intensify human antagonism, and expose the fragility of the urban structure. We rely on George Simmel’s viewpoints of the city as a space of constant conflicts and antagonism, so one can understand the struggles that take place on the spaces of Camus’ Oran and Saramago’s blind city. The article also employs Julian Wolfreys’ concept of the urban uncanny to interpret the mystery and fear that accompany the emergence of diseases in cities. Finally, our experience with the COVID-19 pandemic provides new insights into Albert Camus’ “The Plague” and Jose Saramago’s “Blindness” as they become a fictional reflection of our own experience.

Synthesis of new Spiropyrazole derivatives under microwaves irradiation and docking study for inhibition the microbes and COVID-19.

Synthesis of a new series of spiropyrazole derivatives using microwaves irradiation with high yield in minutes was achieved through a cycloaddition reaction of nitrile imines and arylidenes of 5-bromo-indan-1-one. The structure of the new spiropyrazoles was assured based on their available spectral analyses and the comparison of the extracted data with the literature reports. Molecular docking simulations of all new synthesized spiropyrazole derivatives into leucyl-tRNA synthetase editing domain of Candida albicans (Pdb: 2WFC) indicated that about seven spiropyrazole derivatives can fit deeply in the active site via the formation of stable complexes. In addition, the docking study was utilized to tested the ability of these spiropyrazoles to inhibit COVID-19 through the interaction with COVID-19 main protease (Pdb: 6LU7). The results were surprising which revealed high docking score ranging from -7.764 to -5.9464 kcal/mol. Moreover, the nitrogen atom of pyrazole, Br atom and the C=O group of indanone are essential parts in the binding mode of almost the active derivatives. The results of the docking study are a glimmer of hope to complete the study on these compounds and examine them in the laboratory to ensure their effectiveness as antimicrobials and antiviral, especially Covid-19. Moreover, pharmacokinetics and physicochemical properties were studied.

A rare case of grave's disease after SARS-CoV-2 vaccine: is it an adjuvant effect?

The COVID-19 virus has been responsible for the development of several systemic diseases. Recently, the COVID-19 vaccine has also been incriminated in the development of autoimmune diseases. Currently, researchers have focused on the relationship between the COVID-19 vaccine and the activation of autoimmune phenomenon. We report a case of Graves' disease (GD) whose symptoms appeared 3 days after vaccination against COVID-19. A forty-three-year-old female, without pathological history, presented with diarrhea and palpitation. She received her first SARS-CoV-2 Vaccine dose (Pfizer-BioNTech), in August 2021. Three days after the vaccine, she felt palpitations, sleep disorders, muscle weakness, and heat intolerance. On examination, her pulse was 119 beats per minute, she weighed 63 kg, and she had lost 4 kg in only two months. GD was suspected. Thyroid hormone testing showed low thyroid-stimulating hormone, and an elevated serum free thyroxine hormone T4 level. Serology tests were positive for TSH receptor autoantibodies (TRAB). A GD induced by adjuvants of SARS-CoV-2 vaccine has been retained as a final diagnosis. Several autoimmune diseases have been attributed to adjuvant-induced autoimmune/inflammatory syndrome, including systemic sclerosis, systemic lupus erythematosus and rheumatoid arthritis, and recently few cases of GD have been explained by this phenomenon.

Tocilizumab effectiveness in mechanically ventilated COVID-19 patients (T-MVC-19 Study): a multicenter real-world evidence.

BACKGROUND: This study aimed to evaluate the effectiveness of tocilizumab in mechanically ventilated patients with coronavirus disease 2019 (COVID-19). RESEARCH DESIGN AND METHODS: This retrospective multicenter study included adults (≥18 years) diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) by real-time polymerase chain reaction (RT-PCR) from nasopharyngeal swab, and requiring invasive mechanical ventilation during admission. Survival analyses with inverse propensity score treatment weighting (IPTW) and propensity score matching (PSM) were conducted. To account for immortal bias, we used Cox proportional modeling with time-dependent covariance. Competing risk analysis was performed for the extubation endpoint. RESULTS: A total of 556 (tocilizumab = 193, control = 363) patients were included. Males constituted the majority of the participants (69.2% in tocilizumab arm,74.1% in control arm). Tocilizumab was not associated with a reduction in mortality with hazard ratio [(HR) = 0.82,95% confidence interval (95%CI): 0.62-1.10] in the Inverse propensity score weighting (IPTW) analysis and (HR = 0.86,95% CI: 0.64-1.16) in the PSM analysis. However, tocilizumab was associated with an increased rate of extubation (33.6%) compared to the control arm (11.9%); subdistributional hazards (SHR) = 3.1, 95% CI: 1.86-5.16). CONCLUSIONS: Although tocilizumab was not found to be effective in reducing mortality, extubation rate while on mechanical ventilation was higher among tocilizumab treated group.