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The COVID-19 outbreak revealed the fragility not only of our species but also of society, which has demonstrated its ability to adapt to challenging conditions and to learn from disasters. One of the most pressing issues during the pandemic was the delivery of education during lockdowns. Education in emergency was established using various communication media, hastening the digitalization of education. However, this also highlighted the impact on the mental health of students, who were already experiencing overuse of the internet and electronic devices prior to the pandemic. In response, Tecnologico de Monterrey, a private Mexican university that also offers high school programs, launched the "Unplugged Day” initiative, which encouraged students to disconnect from electronic devices and participate in physical, cultural, creative, or reflective activities. This study applied a voluntary survey to 1850 students from March to May 2021 on a weekly basis, with the aim of analyzing symptoms of insomnia, emotions, perceptions of online education, sources of stress, and the need for professional support to manage their emotions in relation to their participation in Unplugged Day activities. Our results, obtained through a quantitative methodology, confirmed the impact of the emergency, lockdown, and forced remote education on the mental health of students. Furthermore, the results revealed that the Unplugged Day initiative is a strategy that promoted students' well-being during online education. The respondents also suggested strategies for promoting mental health and well-being of learners, whether in an emergency or not. These findings provide valuable information for governments and educational institutions to implement policies and strategies for planning education in emergency situations and for addressing the ongoing global problems of stress and mental health, which are related to the increasing use of electronic devices and the volatility, uncertainty, complexity, and ambiguity of global society. It is our responsibility to improve education so that it can play its role in preserving cultural heritage, overcoming adversity, rebuilding after catastrophes, and shaping a better future for generations to come. © 2023 by the authors.
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Background: In traditional Persian medicine, an herbal cold remedy containing Sugarcane, Black Myrobalan, and mastic is mentioned and it was being widely provided by grocery stores. With the advent of the COVID-19 pandemic, the increased desire for this traditional remedy has led to a debate in society. Huge parts of the Iranian population have started using this remedy for the treatment of COVID-19;while no study has evaluated its efficiency and possible side effects. Thus, we aimed to evaluate the effects of Sugarcane, Black Myrobalan, and Mastic herbal medications for COVID-19 patients. Methods: This was a double-blinded randomized clinical trial study conducted over three months from May 2020 to July 2020 in SARS-COV2 PCR positive patients admitted in the COVID-19 ward of Peymaniyeh Hospital in Jahrom, Iran. Patients with severe COVID-19 infection were not recruited. The intervention group received the routine COVID-19 treatment protocol and the herbal supplement received the combination of black myrobalan and mastic and sugarcane, twice a day (3 g of herbal supplement). Study groups were compared in terms of demographic variables, vital signs, and clinical and laboratory variables for safety and efficiency assessment. Results: Seventy-two patients with COVID-19, divided into intervention (n=37) and control (n = 35) groups were studied. Intervention and control groups had not any significant difference in terms of baseline characteristics. The time-to-event analysis revealed a statistically significant difference in 4 symptoms of cough, fever, dyspnea, and myalgia (P<0.05). There was no significant difference in averaged O2 vital signs between the two groups (P>0.05). The Control group in comparison to the intervention group had a significantly lower decrease in C-reactive protein during 7 days (P<0.05). Patients in the herbal supplement group were hospitalized for 4.12 days and patients in the control group were hospitalized for 8.37 days (P=0.001). ICU admission and death only happened in 3 (8.6%) patients of the control group. Conclusion: This study showed that the proposed herbal remedy could be applied as supplementation to conventional management of COVID-19 patients with mild disease, while more research is needed for clinical application of this remedy. © 2023 by SPC (Sami Publishing Company)
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Technology-enhanced learning (TEL) is now at the heart of teaching and learning process in many higher education institutions (HEIs). Today, educators are faced with the challenges of pedagogically specifying what tools, methods, and technologies are used to support the teachers and students, and to help maintain/sustain a continuous education and practices. This study shows that there is an opportunity in the use of (educational) datasets derived about the teaching and learning processes to provide insights for fostering the education process. To this effect, it analyzed the students' evaluation of teaching (SET) dataset ( $n=471968$ ) collected within a higher education setting to determine prominent factors that influences the students' performance or the way (TEL-based) education is being delivered, including its didactical impact and implications for practice. Theoretically, the study employed a mixed methodology grounded on integration of the Data-structure approach and Descriptive decision theory to study the rationality behind the students' evaluation of the teaching and performance. This was done through the Textual data quantification (qualitative) and Statistical (quantitative) analysis. Qualitatively, the study applied the Educational Process and Data Mining (EPDM) model (a text mining method) to extract the different sentiments and emotional valence expressed by the students in the SET, and how those characteristically differ based on the period and type of evaluation they have completed (between 2019 to 2021). For the quantitative analysis, the study used a multivariate analysis of covariance (MANCOVA) and multiple pairwise comparisons post-hoc tests to analyze the quantified information (average sentiment and emotional valence) extracted from the SET data to determine the marginal means of effect the different SET types and evaluation period have on the students' learning outcomes/perception about the teaching-learning process. In addition, the study empirically discussed and shed light on the implications of the main findings for TEL-based Education, particularly implemented by the HEI during the analyzed periods. The scholastic indicator from the study shows that while the flexible digital models or instructional methods are effective for continuous education, innovative pedagogies, and teaching transformations. It also, on the other hand, serve as an incentive for more robust research that idiosyncratically look into their implications for the students' learning outcomes and assessment done in this study.
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Studies suggest that there is a complex interaction between parasitic infections, human microbiota, and host immunity. Reports have shown that there is the prevalence of viral diseases have inverse correlations with their severities (as is the case for Covid-19), their resulting mortalities, and helminth infections in endemic areas. This review study was conducted to discover the possible association between parasitic infections and Covid-19 epidemics from immunological, pathological, and therapeutic aspects. Our studies were conducted by reviewing texts, reports, and articles on reputable websites such as PubMed, Science Direct, medRxvi, Google Scholar, and bioRxiv published by 2022 07 April for keywords such as a parasite, helminth, radioactive, COVID-19 or SARS-CoV-2. In particular, reports of co-infection with helminths with complications and severity of Covid-19 in endemic areas were considered. The findings indicate that parasitic helminths can regulate host immune responses associated with a viral infection. For example, intestinal parasitic infections may be effective in reducing the symptoms of SARS-CoV-2 and the complications of Covid-19. Infected hosts can induce an innate and Th2-compatible immune response to CD4+ T cells, eosinophils, and interleukins (IL-4, IL-5, and IL-10). Chronic helminth infections prevent strong immune responses by altering the host response to T helper 2 (Th2). Interestingly, some antimalarial drugs, such as Artemisinin-based combination therapies (ACTs), may inhibit SARS-CoV-2-induced severe acute respiratory syndrome (SARS). Parasitic infections may alter the host's immune response to SARS-CoV-2 with potentially beneficial or detrimental effects. However, more large-scale epidemiological studies are needed to uncover the links between parasitic infections and COVID-19 and to clarify existing ambiguities.
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Background: The large proportion of coronavirus disease 2019 (COVID-19) patients has been associated with a large number of neu-ropsychiatric manifestations. Despite the high prevalence of COVID-19, few studies have examined such manifestations, especially in children and adolescents. Objective(s): This study investigated neuropsychiatric manifestations in hospitalized children and adolescents admitted for COVID-19 infection in Iran. Method(s): This prospective observational study included admitted children and adolescents (4-18 years old) diagnosed with COVID-19 infection, pediatric neurologists, child and adolescent psychiatrists, and infectious disease specialists, and assessed 375 infected patients during August and December 2021. Result(s): Of the 375 patients, 176 (47%) were female, with a mean age of 9.0 +/- 3.39 years. Psychiatric and neurological manifestations were reported in 58 (15.5%) and 58 (15.5%) patients, respectively. The most prevalent psychiatric disorders were separation anxiety disorder (SAD) (5.1%), major depressive disorder (MDD) (3.5%), generalized anxiety disorder (GAD) (2.7%), insomnia (2.4%), and op-positional defiant disorder (ODD) (2.4%). Regarding neurological complications, seizures were the most prevalent (13.1%), followed by encephalitis (1.9%), transverse myelitis (0.3%), acute ischemic stroke (0.3%), and Guillain-Barre syndrome (0.3%). There was no significant relationship between the duration of COVID-19 infection (P = 0.54) and ICU admission (P = 0.44) with the emergence of psychiatric symptoms. Conclusion(s): The most prevalent neurologic and psychiatric complications among children and adolescents with COVID-19 infection were seizures and the symptoms of anxiety/mood disorders, respectively.Copyright © 2023, Author(s).
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The aim of this study was to compare serum telomerase, CBC and insulin resistance and their relationship with physical fitness factors in active and sedentary elderly people under quarantine of coronavirus. In this study, healthy men and women with a mean age of 61.43+/-6/07 in coronavirus pandemic conditions participated in this study voluntarily. Subjects were divided into three groups of physical activity: high, medium and low. The international Physical Activity Level Questionnaire (IPAQ) was used to assess the level of physical activity. Serum telomerase, CBC and insulin resistance were measured in different groups after measuring physical fitness factors. Results showed that BMI is higher in the sedentary group than the groups with moderate and high levels of physical activity;In addition, blood Hb and Hct levels were higher in the moderate physical activity group than in the sedentary group, but blood Plt levels were lower in the moderate physical activity group than in the sedentary group. Another result of the present study was the negative correlation of telomerase with BMI and the positive correlation of telomerase with Hb, Hct and RBC, although there was no correlation between telomerase and physical fitness factors. In addition, BMI was negatively correlated with fitness factors, glucose levels, insulin resistance and CBC. Physical fitness in the elderly people under quarantine of coronavirus has a positive relationship with some blood parameters but no correlation was observed between telomerase and insulin resistance with physical fitness.Copyright © 2022, Venezuelan Society of Pharmacology and Clinical and Therapeutic Pharmacology. All rights reserved.
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Background: Since the Coronavirus disease 2019 (COVID-19) pandemic outbreak, medical personnel have undergone a considerable amount of physical and mental pressure. Medical interns (Mis) are a distinct population of healthcare workers. In Iran, Mis refers to senior medical students who are undergoing their clinical training. We aimed to determine the prevalence of anxiety due to COVID-19 among Mis and identify personal factors associated with anxiety. Methods: A cross-sectional study was carried out during April 18th to 24th, 2021. An online questionnaire containing a demographic characteristics questionnaire and the Corona Disease Anxiety Scale (CDAS) was sent to all of the 679 Mis of Shahid Beheshti University of Medical Sciences, Iran, through WhatsApp© messenger and 420 individuals (62% response rate) were enrolled in the study voluntarily. Independent t-test, one-way ANOVA, and Tuke/s HSD post hoc test were conducted using SPSS software to identify the predictive factors for anxiety. Results: The results showed that 70.2% of the participants had no or mild anxiety, 25% had moderate, and 4.8% had severe anxiety. The most significant factors associated with anxiety were female gender (P 0.001) and living with parents (P 0.01). However, there was no significant difference between single and married groups (P = 0.42). Conclusion: It is suggested that medical universities and the government collaborate to provide an adequate psychological service for Mis, focusing on female interns who are living with their family members. © 2022, Vesnu Publications. All rights reserved.
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Introduction: Transmission of bioaerosols through the air is known as an important route for a wide range of nosocomial infections. Therefore, in the present study, we aimed to evaluate the type and diversity of bioaerosols and antibiotic resistance of bacterial bioaerosols in the indoor environments of Sina educational and treatment hospital, Tabriz, Iran. Methods and materials: 150 samples of bacteria and fungi (75 fungi and 75 bacteria) bioaerosol samples were collected on petri dish containing Sabouraud dextrose agar from February to March and June to July 2020 in three periods of daytime (morning, noon and evening) according to National Institute for Occupational Safety and Health (NIOSH 0-800) standard. After sampling, fungal and bacterial samples were incubated and the disk diffusion agar method (Kirby-Bauer) was used for assessing the antibiotic resistance. Results: The concentration of bioaerosols varied significantly in different wards. In addition, the concentration of bioaerosols in winter was observed to be higher than in summer. The highest and lowest airborne fungal concentrations were found in burns operating room and men's infectious ward (49 CFU/m3) and children's burns ward (28 CFU/m3), respectively. The predominantly isolated bacteria were Streptococcus spp. (38%) and Staphylococcus spp. (37%). Also, the main isolated fungi belonged to the genera Aspergillus (75.9%) and Penicillium (22.5%). The highest rates of antibiotic resistance were observed for colistin (100%) in Gram-negative and penicillin (84.2%) in Gram-positive. Conclusion: Timely and regular disinfection of hospital wards can affect the density of bioaerosols. Owing to the prevalence of COVID-19 epidemic in the world, the staff and patients often were wearing masks, gloves and special clothing as well as using disinfectants to prevent coronavirus infection in wards during the summer sampling. © 2022 Tehran University of Medical Sciences. Published by Tehran University of Medical Sciences.
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Changes in everyday activities, such as adapting to the new online format due to lockdowns during the COVID-19 pandemic and being far away from family and friends, greatly influenced the emotions and feelings of students and their parents. Assessing the emotions of students' parents at the higher education level is necessary since their emotional well-being has a direct impact on the emotional well-being of students throughout their distant learning experience. In this article, we held a quantitative study over 8 subsequent weeks from the onset of the COVID-19 pandemic in students and parents from the Mexican institution Tecnologico de Monterrey. Using a questionnaire from Inteligencia Audiencias (Intelligence Hearings), students and their parents could register their feelings and their valence from April 13th to July 20th, 2020. The results indicate that the most predominant emotions in both groups were very unpleasant and unpleasant in nature, being "worried"and "tired"the most common ones. The current study also provides some approaches for addressing the negative repercussions of the COVID-19 pandemic. © 2022 IEEE.
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The Education 4.0 Framework calls for Higher Education Institutions (HEIs) to innovate their curriculum for developing the competencies of the future. Tecnologico de Monterrey started a transition from an active-learning educational model to Tec21, a challenge-based learning educational model focused on competency development. After one semester of this transition, the COVID-19 pandemic disrupted education worldwide, causing most universities to adapt to online education. We found the opportunity to analyze the institutional Student Evaluation of Teaching (SET) survey at different stages of the COVID-19 pandemic, prior to the outbreak, in the transition to online learning, and after the transition to fully online course delivery. We performed this analysis separately for the two coexisting educational models and each of the schools at the university. We also compared the SET scores for the spring semester of 2021, when the two educational models had a comparable number of students. We found that SET scores were not negatively impacted by the COVID-19 pandemic hinting toward positive implications about the institutional response to the pandemic. Another finding is that the Tec21 educational model has received higher SET scores, which implies a positive perception by students. There were a few exceptions to these results, which we address explicitly;for instance, the COVID-19 pandemic might have affected SET scores in the School of Medicine and Health Sciences. Further research is necessary to evaluate the implementation of the Tec21 model comprehensively.
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Background: Most cycling behaviour studies have defined it using objective variables and focused on normal conditions. Objective: This study applies latent class analysis to a sample of 375 survey respondents in Tehran, the Capital city of Iran, exploring the variables influencing cycling behaviour during pandemic covid-19. Methods: We made a statistical comparison among the data obtained from the questionnaires and the statistical data of the 2016 census. A structural equation modeling (SEM) was developed. Results: Fourteen indicators define three latent variables. Cycling behaviour is defined by these three latent factors and three indicators. This paper goes through each of the indicators and their impact on latent variables. The findings show that latent factors have a direct impact on cycling behaviour. Conclusion: Structural equation modeling (SEM) is a great tool for defining cyclist behaviour analysis that shows the positive and negative influence of variables on cycling rate during a covid-19 pandemic. There are some limitations in the area of this study in developing countries discussed in the paper. © 2022 Rashidi et al.
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Due to lack of effective treatment for novel pandemic coronavirus disease (COVID-19) caused by severe acute respiratory syndrome corona-virus-2 (SARS-CoV-2), the prevention strategies are the best choices to significantly control increasing number of patients. Numerous studies suggest an association between vitamin D and C and the outcomes of SARS-CoV-2 infection. Therefore, supplementation of vitamins such as D and C has been recommended prevention and treatment of the COVID-19. Vitamin D as an immunomodulator hormone could affect various respiratory infections by maintaining the immune system and blocking hyper-inflammatory responses like cytokine storm through decreasing viral replication and regulating the levels of proinflammatory/anti-inflammatory cytokines. There are also some evidences that vitamin D could alter severity of COVID-19. The effectiveness of vitamin C in the prevention and treatment of coronavirus has also been undertaken by several studies. Due to the important role of vitamin C in the immune system, a deficiency of this vitamin may increase the incidence, severity and the risk of death of COVID-19 disease. This could explain by this fact that vitamin C deficiency increases the risk of infections, decreases the immune system response and increases the risk of pneumonia. People with chronic diseases as high-risk COVID-19 patients also showed deficiency of these vitamins which could explain the severity and the high rate of mortality among them. Thus, it seems that sufficient vitamin D and C level in serum may have positive impact on decreasing risk of COVID-19 infection. Considering all aspects, we try to overviewed on the potential role of supplementation of vitamin D and C in COVID-19 disease. We summarized suggested impacts of these vitamins on SARS-CoV-2 and its pathogenesis. We also discussed mechanisms in which these two vitamins involved that could alter the COVID-19 infection.
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Background: Control of the COVID-19 pandemic, its treatment, and prevention of mortality and morbidity have been the main focus of researchers over the past two years. Due to disagreement on the usefulness of different corticosteroids in the treatment of COVID-19, this work compared the efficacy of dexamethasone and methylprednisolone in the treatment outcomes of intensive critical care (ICU) patients. Methods: The present retrospective cohort study examined clinical records of 105 COVID-19 patients hospitalized in the ICUs of Firoozabadi Hospital in 2021. Clinical outcomes, including the length of hospital stay, the need for a ventilator, and mortality, were compared between patients who received either dexamethasone (DXM) or methylprednisolone (MP). Data were analyzed by SPSS V.20 software at P < 0.05 as statistical significance. Results: The mean ± SD ages of the patients in the DXM and MP groups were 58.82 ± 19.29 and 60.66 ± 14.17 years, respectively, without a statistically significant difference (P > 0.05). The mean duration of hospitalization was 8.14 ± 4.36 days in the DXM group and 6.80 ± 3.34 days in the MP group (P = 0.295). Also, 19 (33.3%) cases in the DXM group an, 19 (39.6%) in the MP group needed mechanical ventilation during hospitalization (P = 0.546). Finally, 30 (52.6%) patients in the DXM group and 27 (56.2%) in the MP group died. Conclusions: The findings indicated no significant difference in the mean duration of hospitalization, the need for a ventilator, and mortality in COVID-19 ICU patients treated with methylprednisolone or dexamethasone. There is a need to perform meta-analyses owing to conflicting results regarding the effects of different corticosteroids on the COVID-19 course. © 2022, Author(s).
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The present study aimed to examine the mediating role of ego-strength in the relationship between religious health behaviors and mental health symptoms during the COVID-19 pandemic in Iran. A total of 346 university students (301 women, 45 men) completed the Ego-Strength Scale, Religious Health Promoting Behaviors Inventory, and Mental Health Inventory from May 2021 to August 2021. The structural equation modeling and the Pearson correlation method were used. The results revealed that religious health behaviors have a positive and significant relationship with, psychological wellbeing, and ego-strength, as well as a negative significant relationship with psychological distress. The results also showed ego-strength has a negative relationship with psychological distress. Ego-strength mediated the relationship between religious health behaviors and symptoms of mental health. Ego-strength can be considered as a very important variable in religious health psychology;reinforcing ego-strength may have some implications for mental health during the Covid-19 pandemic.
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Background: Phobia as a psychological disorder seems to be aggravated during health crises like the current COVID-19 outbreak. On the other hand, people's knowledge about a situation can help decrease the resulting fear. Study design: This is a cross-sectional analytical study to evaluate the COVID-19 related phobia and to measure knowledge, attitude, and practice of our target Iranian population about COVID-19. Methods: In this study, DSM-5 specific phobia questionnaire, adapted to SARS-CoV2-19 infection, was used to evaluate the COVID-19 related phobia. Moreover, the knowledge, attitude, and practice (KAP) questionnaire, specific for SARS-CoV-2 infection, was applied. Results: Phobia score was significantly higher in 1st-degree relatives of healthcare staff (20.38±5.82) than healthcare staff (18.36±5.68) (p=0.021). Females showed a significantly more severe phobia (20.27±5.41) than males (17.72±5.35, p=0.001). COVID-19 phobia was significantly more severe in those with past psy-chiatric conditions than in those without psychiatric history (p<0.05). The 1st-degree relatives of healthcare staff had a significantly lower level of knowledge about SARS-CoV-2 infection (8.19±1.65) than healthcare staff (9.08±1.28, p=0.001). Additionally, age had a positive significant correlation with knowledge and practice towards SARS-CoV-2 infection. Conclusion: Both Iranian healthcare staff and 1st-degree relatives of healthcare workers are suffering from moderate COVID-19 phobia. Females are more concerned than males about COVID-19. Phobia is more severe in people with underlying psychiatric conditions than other people. The knowledge level of Iranian healthcare workers and 1st-degree relatives of healthcare staff about COVID-19 is acceptable but it needs improvement in certain areas.
Subject(s)
COVID-19 , Phobic Disorders , Cross-Sectional Studies , Female , Health Knowledge, Attitudes, Practice , Health Personnel/psychology , Humans , Iran/epidemiology , Male , Phobic Disorders/epidemiology , RNA, Viral , SARS-CoV-2ABSTRACT
Background: Coronavirus disease 2019 (COVID-19) is caused by an infection in the respiratory tract leading to extrapulmonary manifestations, including dysregulation of the immune system and hepatic injury. Objectives: Given the high prevalence of viral hepatitis and a few studies carried out on severe acute respiratory syndrome coronavirus 2 and hepatitis B virus (HBV), this study investigated the impact of COVID-19 on chronic hepatitis B (CHB) patients in the northeast region of Iran. Methods: In this cross-sectional study, the blood samples were collected from 93 CHB patients registered in the Patient Detection Data Bank of Golestan University of Medical Sciences, Gorgan, Iran, and 62 healthy individuals as controls. Reverse transcription-polymerase chain reaction was adopted to detect COVID-19 infection in all the participants' nasopharyngeal samples. All the participants were subjected to anti-hepatitis C virus, anti-hepatitis delta virus, and liver function tests. Then, HBV deoxyribonucleic acid load was detected in CHB patients. The collected data were analyzed by statistical tests using SPSS software (version 20). A P-value less than 0.05 was considered statistically significant. Results: In this study, 14% (13/93) and 32.25% (20/62) of CHB patients and control individuals were infected with COVID-19, respectively. The mean age of CHB patients was 39.69 +/- 19.58 years, and 71% of them were female. The risk of developing COVID-19 in healthy controls was observed to be 2.3 times higher than in patients with CHB (0.95% confidence interval: 1.242 -4.290). On the other hand, the mean values of aspartate aminotransferase, alanine aminotransferase, and alkaline phosphatase in CHB patients superinfected with COVID-19 were higher than other participants. Out of 35.4% of patients with viral hepatitis B that were taking antiviral drugs, only 5.4% had COVID-19. Conclusions: Although CHB infection did not predispose COVID-19 patients to more severe outcomes, the data of this study suggest that antiviral agents also decreased susceptibility to COVID-19 infection. Alternatively, careful assessment of hepatic manifestations and chronic viral hepatitis infections in COVID-19 patients can lead to more favorable health outcomes.
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Introduction: The World Health Organization on March 11, 2020 declared the outbreak of severe acute respiratory syndrome Corona virus 2 disease (COVID-19) a pandemic situation. The main aim of this study was investigating mortality of COVID 19 by considering chronic diseases. Materials and methods: this study was conducted as a cross-sectional in which all confirmed cases were examined. The variables considered in this study were age, sex, diabetes mellitus, cancers, hypertension, heart diseases, kidney diseases, and liver diseases. Independent sample t test, Chi-square and binary logistic regression were used to data analysis. All statistical analysis was done in SPSS 16 and significant level was set at 0.05.
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Successful vaccination (adequate elevation of anti-spike protein antibodies) is attributed with sufficient protection against a severe course of coronavirus disease 2019 (COVID-19). For patients with chronic inflammatory diseases (CID) and immunosuppression the success of vaccination is an ongoing scientific discourse. Therefore, we evaluated the antibody titer against the S1 antigen of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 2 weeks after complete immunization in patients with an underlying neuromuscular disease (NMD), who presented to our neurological day clinic and outpatient department for regular infusions of immunoglobulins. The data show that patients with chronic autoimmune NMD and simultaneous immunosuppressive or immune modulating treatment show an antibody response after vaccination with both mRNA and vector vaccines. In comparison to healthy subjects there is a comparable number of seroconversions due to the vaccination. A correlation between immunoglobulin dose and vaccination response could not be found; however, in contrast, there was a significant reduction of specific antibody synthesis, especially for the combination of mycophenolate mofetil (MMF) and prednisolone.
Subject(s)
COVID-19 , Neuromuscular Diseases , Humans , SARS-CoV-2 , COVID-19 Vaccines , Antibody Formation , COVID-19/prevention & control , Antibodies, Viral , Vaccination , Neuromuscular Diseases/drug therapy , Disease ProgressionABSTRACT
Einer erfolgreichen Impfung (adäquater Anstieg der Anti-S[Spike]-Protein-Antikörper) gegen SARS-CoV‑2 (engl. severe acute respiratory syndrome coronavirus type 2) wird ein suffizienter Schutz gegen einen schweren Verlauf von COVID-19 (engl. coronavirus disease 2019) zugeschrieben. Bei Patient*innen mit chronisch-inflammatorischen Erkrankungen (engl. „chronic inflammatory diseases“ [CID]) und Immunsuppression ist der Impferfolg weiterhin im wissenschaftlichen Diskurs. Daher evaluierten wir bei Patient*innen mit einer neuromuskulären Erkrankung (NME), die zu regelmäßigen Infusionen von Immunglobulinen in unserer neurologischen Tagesklinik/Ambulanz vorstellig wurden, 2 Wochen nach vollständiger Immunisierung die Antikörpertiter gegen das S1 (S1-Untereinheit des Spike-Proteins) -Antigen von SARS-CoV‑2. Unsere Daten zeigen, dass Patient*innen mit einer chronischen autoimmunen NME und gleichzeitiger immunsuppressiver bzw. immunmodulierender Therapie nach einer Impfung sowohl mit einem mRNA- als auch mit einem Vektorimpfstoff eine Antikörperantwort aufwiesen. Im Vergleich zu gesunden Proband*innen zeigte sich eine vergleichbare Anzahl an Serokonversionen durch die Impfung. Eine Korrelation zwischen Immunglobulindosierung und Impfantwort sowie Infusionsintervall und Impfantwort ließ sich nicht feststellen. Demgegenüber zeigte jedoch insbesondere die Kombination aus Mycophenolatmofetil (MMF) und Prednisolon eine signifikante Reduktion der spezifischen Antikörpersynthese.
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Objective: The patient was a 61-year-old woman who typically underwent mitral valve replacement and tricuspid valve repair in 2011. During these years, she underwent an annual checkup and experienced no particular problems. The potential patient contracted Covid 19 a month ago and underwent conservative treatment. The patient displayed no specific symptoms, no fever, and her Covid 19 disease was mild. In the accompanying echocardiography, we notice a lump on the atrial surface of the Tricuspid valve that we instantly suspect of local vegetation or heart mass. As a result, we admitted the patient to resume the examination. Design and method: Multi-slice (16) spiral thoracic CT scan: Sternotomy and MVR are seen. Cardiomegaly is evident. Patchy peripheral ground-glass opacities are seen bilaterally, suggesting covid-19 pneumonia;correlation with clinical and paraclinical data is recommended. Degenerative changes are perceived in the thoracic spine. There is no pleural effusion. Blood cultures and urinary trachea were requested to diagnose endocarditis, and she was also asked to have an esophageal echocardiogram. The antibiotic Meropenem 500 was started three times a day with vancomycin 1 gram twice a day for prophylaxis. After these examinations, the mass diagnosis was rejected as the image of vegetation on echocardiography did not found echogenicity similar to cardiac tissue and was denser. Consequently, we diagnosed vegetation. According to the negative culture results, and the patient had no symptoms (chills, heart pain), this patient's diagnosis of an immunological reaction caused by Covid disease was made. Libman -sacks endocarditis is a type of sterile nonbacterial thrombotic endocarditis (NBTE) secondary to inflammation. Results: In this rare case, the vital point is that immunological reaction after covid can give rise to vegetation on the heart artificial valve and can be typically established with endocarditis. Covid can cause libman sac endocarditis, then we consider patients with heart disease maybe get limban sac or other forms of immunological reaction after covid virus. Conclusions: Concerning the explicit rejection of all the causes, the patient was diagnosed correctly with limb sac endocarditis. She underwent anticoagulant therapy and corticosteroid therapy accordingly and was recovered fully.