How Culture Influences Individual Behavior During a Pandemic: A Social Simulation of the COVID-19 Crisis

Since its first appearance in Wuhan (China), countries have been employing, to varying degrees of success, a series of non-pharmaceutical interventions aimed at limiting the spread of SARS-CoV-2 within their populations. In this article, we build on scientific work that demonstrates that culture is part of the explanation for the observed variability between countries in their ability to effectively control the transmission of SARS-CoV-2. We present a theoretical framework of how culture influences decision-making at the level of the individual. This conceptualization is formalized in an agent-based model that simulates how cultural factors can combine to produce differences across populations in terms of the behavioral responses of individuals to the COVID-19 crisis. We illustrate that, within our simulated environment, the culturally-dependent willingness of people to comply with public health related measures might constitute an important determinant of differences in infection dynamics across populations. Our model generates the highest rates of non-compliance within cultures marked as individualist, progressive and egalitarian. Our model illustrates the potential role of culture as a population-level predictor of infections associated with COVID-19. In doing so, the model, and theoretical framework on which it is based, may inform future studies aimed at incorporating the effect of culture on individual decision-making processes during a pandemic within social simulation models. © 2022, University of Surrey. All rights reserved.

Clinical and Paraclinical Predictive Factors for In-hospital Mortality in Adult Patients with COVID-19: A Cross-sectional Study in Iran

Background: COVID-19, a type of coronavirus emerged in Wuhan, China in December 2019, causing an epidemic of pneumonia with unknown reasons. Objective: This study aimed to investigate the factors affecting in-hospital mortality of patients with COVID-19 hospitalized in one of the main hospitals in central Iran. Methods: This retrospective cross-sectional study (February-May 2020) was conducted on patients with a confirmed diagnosis of COVID-19 admitted to Yazd Shahid Sadoughi Hospital in Iran. The patients with uncompleted or missed medical files were excluded from the study. Data were extracted from the patients' medical files and then analyzed. The patients were categorized as survivors and non-survivors groups, and they were compared. Results: Total 573 patients were enrolled and 356 (62.2%) were male. The mean±SD of age was 56.29±17.53 years, and 93 (16.23%) died. All the complications were more in non-survivors. Intensive care unit (ICU) admission was in 20.5% of the patients, which was more in non-survivors (P<0.001). The results of multivariate logistic regression test showed that pleural effusion in lung computed tomography (CT) scan (OR=0.055, P=0.019), white blood cell (WBC) (OR=1.418, P=0.022), serum albumin (OR=0.009, P<0.001), non-invasive mechanical ventilation (OR=34.351, P<0.001), and acute respiratory distress syndrome (ARDS) (OR=66.039, P=0.003) were the predictive factors for in-hospital mortality. Conclusion: In-hospital mortality with COVID-19 was about 16%. Plural effusion in lung CT scan, increased WBC count, lower mount of serum albumin, non-invasive mechanical ventilation, and ARDS were obtained as the predictive factors for in-hospital mortality. © 2022 Bentham Science Publishers.

Exploring nurses' experiences of coping mechanisms used in COVID-19 pandemic: a qualitative study

Background and Objectives: It is necessary to apply appropriate coping methods to reduce destructive physical and psychological effects of stress during Covid-19 pandemics. This study was conducted to explore nurses' experiences of stress coping techniques during the Covid-19 pandemic.

Exploring nurses' experiences of coping mechanisms used in covid-19 pandemic: A qualitative study

Background and Objectives: It is necessary to apply appropriate coping methods to reduce destructive physical and psychological effects of stress during Covid-19 pandemics. This study was conducted to explore nurses' experiences of stress coping techniques during the Covid-19 pandemic. Methods: The present study used a qualitative methodology with interpretive phenomenology method. Purposive sampling was used. The participants, including nurses working in hospitals affiliated to Tehran University of Medical Sciences, shared their experiences through in-depth, individual and semi-structured interviews. The transcripts of interviews were analyzed based on the Dickelmann's approach using the MAXQDA 12 software. Results: The participants included nine nurses (six females and three males) with a mean age of 45 ± 5.3 years. The results of data analysis showed four main categories and fifteen subcategories conceptually named based on their nature. The main categories were self-support, family shelter, hospital support umbrella, and community support on both extremes. Conclusion: The participants practiced different coping strategies to deal with stress and anxiety. In addition to individual mechanisms, nurses sought help from other sources of support, such as family, workplace, and community. Based on the experiences of nurses participating in the study, it is recommended to teach nursing staffs coping methods with stress, especially in times of crisis such as the Covid-19 pandemic. © 2021 The Authors.

Challenges with healthcare workers' protection during the COVID-19 pandemic in Iran.

During the COVID-19 pandemic, healthcare workers stand in the frontline of the fight against the disease. This study aimed to assess the challenges with personal protection during the pandemic in Tehran, Iran. Seven-hundred healthcare workers were surveyed between April and May 2020, and the study was performed in surgical care wards. Questionnaires, which were sent to 1000 workers via online platforms, social networks, and emails to different associations, were used to assess the use of personal protective equipment (PPE) and the reasons for not using it. A total of 700 replied. Face masks and face shields had the highest and lowest use, respectively. Equipment shortage, time constraint, low supervision, and lack of information were the reasons for personnel not using PPE. To reduce the burden of COVID-19 and accelerate the process of patient care, it is important to protect and maintain the well-being of staff. Organised national and international arrangements to protect them are critical.

Convalescent Plasma Therapy for COVID-19: Lessons from SARS-CoV, MERS-CoV, and H1N1 Infection

The global widespread mortality after the emergence of SARS-CoV-2 infection in China, has become a critical concern all around the world. Convalescent plasma (CP) therapy is one of the methods elevating the survival rate for COVID-19 infection cases. This technique, as a practicable therapy, was used in previous viral outbreaks including influenza, SARS and MERS. In CP therapy, the blood plasma is collected from persons rehabilitated from that specific infection in order to develop a passive immunity in other patients. Therefore, this review aimed to point out the role of CP therapy in aforementioned viral infections and illustrate different factors influencing the efficacy of CP therapy.

Natriuretic Peptide Levels and Clinical Outcomes among Patients Hospitalized with COVID-19 Infection

Purpose There is increasing evidence of adverse cardiovascular morbidity associated with SARS-CoV-2 (COVID-19). Pro-B-type natriuretic peptide (proBNP) is a biomarker of myocardial stress associated with outcomes in various respiratory and cardiac diseases. We hypothesized that proBNP level would be associated with mortality and clinical outcomes in hospitalized COVID-19 patients. Methods We performed a retrospective analysis of hospitalized COVID-19 patients (n=1232) using adjusted logistic and linear regression to assess the association of admission proBNP (analyzed by both categorical cutoff >125 pg/mL and continuous log transformed proBNP) with clinical outcomes. Covariates included age, sex, race, body mass index (BMI), hypertension, coronary artery disease (CAD), diabetes, smoking history, and chronic kidney disease stage (Model 1), with Troponin I added in Model 2. We performed survival analysis by a multivariate Cox proportional hazard model, incorporating log transformed proBNP. We additionally treated BMI, a strong potential confounder of both proBNP levels and COVID-19 outcomes, as an ordinal variable ordered across tertiles. Results Patients were mean age 62.9±17.6, 53.8% male, and 35.9% Black. Preadmission comorbidities were hypertension (57.1%), diabetes (31.6%), CAD (9.0%) and heart failure (HF, 10.6%). In Model 1 and 2, higher proBNP level was significantly associated with death, new HF, length of stay, ICU duration and need for ventilation among hospitalized COVID-19 patients. This significance persisted after ordinal compression of BMI across tertiles. The adjusted hazard ratio of death for log[proBNP] was 1.56 (95% CI: 1.23-1.97;P<0.0001). Conclusion Using a relatively large and racially diverse hospitalized COVID-19 patient cohort, we find that proBNP is associated with adverse clinical outcomes, including mortality and new HF in COVID-19. Further prospective investigation is warranted on the utility of proBNP for clinical prognostication in COVID-19.

Development of a novel platform of virus-like particle (VLP)-based vaccine against COVID-19 by exposing epitopes: an immunoinformatics approach.

The emergence of a rapidly spreading and highly infectious coronavirus disease 2019 (COVID-19) outbreak by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused a global pandemic with unprecedented social and economic dimensions. Therefore, the development of effective strategies is urgent to control the COVID-19 outbreak. According to recent investigations, cell entry of coronaviruses relies on binding of the viral spike glycoprotein to the host cellular receptors. Therefore, the present study aimed to predict immunogenic epitopes in silico by analysing the spike protein. In parallel, by screening the immunogenic SARS-CoV-2 spike-derived epitopes provided in the literature, we chose a set of epitopes that we believed would induce immunogenic response. Next, provided with the epitopes selected by using both approaches, we performed immunoinformatic analysis that mapped identically to the antigen regions and antigenic properties. Finally, after selecting a screened set of epitopes, we designed a novel virus-like particle vaccine optimized to be produced in plants by using molecular farming biotechnology techniques. Our assay may be used as a starting point for guiding experimental efforts towards the development of a vaccine against SARS-CoV-2.

Public knowledge, attitude and practice regarding home quarantine to prevent COVID-19 in Sabzevar city, Iran

Background and Aim: Prevention is the best way to break the transmission chain of COVID-19. The aim of this study was to determine the knowledge, attitude and practice of people regarding home quarantine to prevent COVID-19 in Sabzevar city, Iran. Methods: In the present cross-sectional study in 2020, 836 people from Sabzevar participated. Data were collected by the virtual questionnaire and released in social media by nonprobability methods (Convenience and Snowball). The study questionnaire was researcher-made. The questions included demographics, knowledge, attitude and practice. The validity and reliability of the questionnaire were confirmed. Results: The variables of gender, attitude and job on practice, variables of gender, education, job and attitude on knowledge and variables of knowledge, age, gender and underlying disease on attitude toward home quarantine have a significant impact (P.0.05). Conclusion: People's practice regarding home quarantine to prevent COVID-19 depends on a number of factors. Paying attention to the gender, attitude and occupation of individuals in policy making regarding home quarantine can improve the performance of the public. © 2020 Baqiyatallah University of Medical Sciences. All rights reserved.