Healthcare adjustments and concerns: a qualitative study exploring the perspectives of healthcare providers and administrative staff during the COVID-19 pandemic in Saudi Arabia.

Background: Healthcare systems have modified their strategies to manage their staff, supplies, and space to deal systematically with the COVID-19 pandemic. This research aimed to explore the nature of hospital adjustments and the concerns of healthcare providers and administrative staff working in Governmental and private hospitals throughout the Qassim Region of the Kingdom of Saudi Arabia (KSA) during the pandemic. Methods: A qualitative phenomenological study using semi-structured in-depth interviews were conducted with 75 purposively selected healthcare providers and administrative staff working at three main hospitals in the Qassim Region, KSA. The maximum variation sampling technique was utilized. Recruitment of participants was continued until data saturation was reached. All interviews were audiotaped, transcribed verbatim, and analyzed thematically. Results: Four core themes were identified in this paper: (1) changes in hospital policy and procedures, (2) workforce management, (3) the well-being of the workforce, and (4) apprehensions and expectations of the workforce. The participants showed satisfaction with timely administrative decisions and new policies during the COVID-19 pandemic. Furthermore, the psychological health of healthcare professionals was affected more than their physical state. Finally, the providers perceived the emergence of multiple concerns in the coming months. Conclusion: Although healthcare providers were initially overwhelmed, they gradually accepted new administrative policies. Numerous innovative interventions effectively reduced their physical workload and increased their productivity, but they remained significantly affected by a wide range of psychological disorders, with a high prevalence of obsessive-compulsive disorder. There were some concerns about the new SARS-CoV-2 variant, but the majority were optimistic.

Low-Dose Chest CT Protocols for Imaging COVID-19 Pneumonia: Technique Parameters and Radiation Dose.

Chest computed tomography (CT) plays a vital role in the early diagnosis, treatment, and follow-up of COVID-19 pneumonia during the pandemic. However, this raises concerns about excessive exposure to ionizing radiation. This study aimed to survey radiation doses in low-dose chest CT (LDCT) and ultra-low-dose chest CT (ULD) protocols used for imaging COVID-19 pneumonia relative to standard CT (STD) protocols so that the best possible practice and dose reduction techniques could be recommended. A total of 564 articles were identified by searching major scientific databases, including ISI Web of Science, Scopus, and PubMed. After evaluating the content and applying the inclusion criteria to technical factors and radiation dose metrics relevant to the LDCT protocols used for imaging COVID-19 patients, data from ten articles were extracted and analyzed. Technique factors that affect the application of LDCT and ULD are discussed, including tube current (mA), peak tube voltage (kVp), pitch factor, and iterative reconstruction (IR) algorithms. The CTDIvol values for the STD, LDCT, and ULD chest CT protocols ranged from 2.79-13.2 mGy, 0.90-4.40 mGy, and 0.20-0.28 mGy, respectively. The effective dose (ED) values for STD, LDCT, and ULD chest CT protocols ranged from 1.66-6.60 mSv, 0.50-0.80 mGy, and 0.39-0.64 mSv, respectively. Compared with the standard (STD), LDCT reduced the dose reduction by a factor of 2-4, whereas ULD reduced the dose reduction by a factor of 8-13. These dose reductions were achieved by applying scan parameters and techniques such as iterative reconstructions, ultra-long pitches, and fast spectral shaping with a tin filter. Using LDCT, the cumulative radiation dose of serial CT examinations during the acute period of COVID-19 may have been inferior or equivalent to that of conventional CT.

Secondary bacterial and fungal infections in critically ill COVID‐19 patients: Impact on antimicrobial resistance

Background: The primary burden among severely ill COVID-19 cases allocated to ICUs is secondary bacterial and fungal infections. Antimicrobial resistance is aggravated more likely by empiric overusing of antimicrobials. This study aimed to assess the microbiological profile of fungal and bacterial superinfections in laboratory confirmed COVID-19 cases and their antimicrobial susceptibility pattern. Methods: Various clinical samples were obtained from 117 critically ill COVID-19 patients in the clinical suspicion of secondary infections for assessing the pathogens accountable for the superinfections and their antimicrobial susceptibility pattern according to standard microbiological procedures. Results: Among 117 COVID‐19 patients allocated to ICU, 68 (58%) had secondary infections. The most prevalent infection was of the lower respiratory tract. Most infections were bacterial 85.8%. Gram-negative isolates were the most predominant strains, accounting for 71.7%. among them, Klebsiella pneumoniae 43.4 % and Acinetobacter baumannii 20.7% were the most predominant. Majority of the bacterial strains were multidrug-resistant, all gram-negative strains showed one hundred percent resistance rate to cephalosporins, amoxicillin, and amoxicillin-clavulanic. The lowest resistance was observed for tigecycline. All gram-positive strains were susceptible to linezolid and vancomycin. Additionally, all candida isolates were susceptible to the tested antifungals. Conclusions: In hospitalized severely ill COVID-19 patients, secondary infections are most frequently caused by Gram-negative pathogens exhibiting high rate of antibiotic resistance and are associated with poor outcomes. Strict adherence to infection control measures as well as regular microbiological surveillance are required. © 2020 The author (s).

WEB-BASED APPLICATION FOR ENHANCING ON-SITE AND REMOTE DATA COLLECTION PROCESS DURING PANDEMIC: AN EXPLORATORY STUDY

The COVID-19 pandemic has changed the way data collection for research takes place around the world. Such adaptation has forced a turn of research methodologies in conducting research. This study focuses on on-site and remote digital data collection methods that can be adopted during the pandemic. The method of research and data collection often requires a group of researchers to travel to a specific site to meet communities for data collection, which is not permissible during the pandemic. This paper explores the use of web-based application for documentation of the existing natural and built features, and land management system for identification of the rural community's land information. In this paper, the use of a web-based application, namely i-LULACAST, is highlighted. The application was designed and used for data entry and management of the rural community with fewer human resources on-site while still maximizing the number of datasets needed for analysis. The system was built using Codelgniter Application 4.0.4 to develop libraries to link databases and perform operations such as data entry, location, and uploading pictures for particular data. This system has also shown prospects for other purposes, such as census, landscape data entry, and contact tracing for medical purposes. © 2022 by MIP.

Strategies to Address Vaccine Hesitancy in Adults: A Systematic Review

Objectives: To combat the COVID-19 pandemic, vaccination of the population is essential. However, attitudes regarding vaccination can range from full acceptance to absolute refusal. Vaccination hesitancy is complex and context-specific, varying across pandemic phases, country, sociodemographic characteristics, and vaccines. Evidence-based strategies to address vaccine hesitancy behavior are needed. The aim of this systematic review is to identify and assess the effectiveness of strategies in addressing vaccine hesitancy in adults. Method(s): A systematic literature review was conducted in PubMed, Embase, and PsycInfo (2016-2021) building on Jarret's et al. (2015) review. The review adheres to PRISMA guidelines and uses the Cochrane Risk of Bias Assessment Tool. For data analysis, interventions were categorized into: 1) dialogue-based;2) educational;3) incentive-based;4) recall-based;and 5) multi-component interventions. Outcomes of included interventions were categorized into vaccination coverage rate and behavioral outcomes. Result(s): Out of 5,023 retrieved studies, six were included in the review in addition to one study from Jarret's et al. review and three studies from snowballing. All studies focused on influenza vaccine except one which focused on Hepatitis B. Five studies evaluated educational interventions, two dialogue-based interventions, and three multi-component interventions. Multi-component interventions had a significant effect in increasing the vaccination rate (6.5% to 10.2%). Educational interventions had a positive effect in behavioral outcomes. Comparability of studies was limited due to the heterogeneity in study outcome(s), study designs and target populations. Conclusion(s): This review has shown statistically significant results of different strategies in increasing the knowledge and vaccination rates in adults. In a next step, our findings should be contrasted with interventions that may have been implemented during the COVID-19 pandemic to increase vaccination rates. In addition, research is needed to better understand the determinants of vaccine hesitant behavior, which might involve trust in the healthcare system or governmental institutions and their capability to design adequate interventions. Copyright © 2022

Information and Communications Technology (ICT) as a Teaching and Learning Tool: A Study of Students' Readiness and Satisfaction

Students and academics in higher education institutions (HEIs) were perilously hit by the unparalleled changes due to the COVID-19 pandemic. Within a span of less than a month, teaching and learning activities were shifted online to warrant continuity. This study intends to probe the online learning readiness and satisfaction among university students within the scope of students' prior ICT knowledge and the university's ICT infrastructure. This study employs a quantitative approach with a questionnaire as the research instrument. A sample size of 1,692 Sunway University students in the Ministry of Education (MOE) General Studies subjects were chosen. The data were analysed descriptively, and the results revealed that students are generally ready for online learning, and they are satisfied with the ICT amenities provided. As a result, both students and Sunway University are wellprepared, with the major implication that student preparation and satisfaction, as well as infrastructures, are critical to scaffold the accelerated transition in the use of online learning. ©Authors.

CONTRIBUTION OF THE BIOPHILIC DESIGN APPROACH TO THE UN SUSTAINABLE DEVELOPMENT GOALS

In the last decade, biophilic design under the concept of creating strong connections between nature and manmade environments have spread significantly. Because of the rapidly increasing environmental crises and climate change phenomena globally. Consequently, biophilic design has become associated with sustainable applications, the question this research discusses is if this approach contributes to achieve the aspects of sustainability, under the umbrella of the UN Sustainable Development Goals (SDGs). This study will investigate biophilic approach contribution to sustainable design through defining aspects of nature that most influence human satisfaction of built environment. Aligned with the European Commission (2015) series actions titled “nature-based solutions” that are inspired by nature systems. During the COVID-19 lockdown, humans had minimal interaction with nature, and access to green public spaces, at the same time, an increasing interest to integrate nature in design, reducing humans impact on nature were recognized in the contemporary built environment. The study adopts William Browning’s (2014) “14 Patterns of Biophilic Design” framework, that lays out a series of tools experiencing science and nature contribution for promising opportunities creating sustainable built environment design applications. In addition to identifying and analysing the current practices for biophilic design in the built environment and its’ impacts on nature and human wellbeing. The results conduct design strategies, and guidelines that integrate biophilic approach as a base, within the 14 patterns framework for better practices creating innovative and responsible built environment. © 2022 WIT Press.

Implementation of Data Mining Using k-Nearest Neighbor Algorithm for Covid-19 Vaccine Sentiment Analysis on Twitter

The purpose of this research was to determine public sentiment towards the preparation and implementation of the COVID-19 vaccine in Indonesia through the social media platform Twitter that contained ‘Tweets’ with positive or negative sentiments. The research method was divided into data retrieval on Twitter related to the COVID-19 vaccine in Indonesia, gathering the preprocessing data, and followed by classification based on the K-Nearest Neighbor algorithm. The results of this research determined positive and negative sentiments from the data. From the 800 data points tested, there were 529 positive sentiments and 271 negative sentiments. The accuracy value of the K-Nearest Neighbor algorithm in this research was 78% with k = 3. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Formulating Physical Exterior Design Factors in Creating Exciting Retail Stores in Malaysia

The Covid-19 outbreak in 2020 has caused hard time for the physical retail store. As to recovery, to increase profits retailer need to look for alternative way to improve shopping value. Past studies had identified several customers-oriented on store environment attributes impact consumers perception. However, until today there are no specific guidelines available regarding creating a good store design mainly after the post-pandemic on the retail stores environment context in Malaysia. Therefore, the aim of this study is to identify and propose the influences of various store environment physical exterior design factors in retail stores and study their effect on customers behavior. The study applied qualitative research methodology a case study which employed observation and interviews, on a selected fashion retail store. The results shows that behavior intentions among customers included store choice and purchasing can be induced by creating unique shopping experiences with the help of store environment physical exterior design factors. Therefore, to give little attention to the store environment physical exterior design elements by the retails owner are important without set aside the safety SOP to stay advantages in today’s competitive market. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Perceptions of Existing Small Business Retailers on the Emerging Modern Stores Design in Malaysia;Case Study Existing Small Fashion Retails Store in Georgetown, Penang

The retail industry is going through a transformation and the emerging market is witnessing a significant change in its growth pattern;modernization and post pandemic Covid-19 recovery safety SOP. Both existing and new players are experimenting with new retail formats without neglecting the health safety SOP by the government. Customers are also in favor of these retail formats;for trendy shopping environment and safety. This study was conducted to assess the impact of the emerging modern fashion stores design mainly regarding store environment attributes towards existing small local business fashion retails. Also the actions needed to remain competitive. A qualitative approach was chosen by performing interview with several existing small local fashion store retailers. The study used structured questionnaires for collecting primary data followed by data analysis and interpretation. The early findings revealed that there was gaps that existing small local fashion retailers faced. Lacking on the knowledge and guidelines on creating good fashion store environment design mainly after the post-pandemic strategies left them with little information in deciding which store design attributed more appropriate for their operations in an attempt to stay competitive without set aside the safety SOP. Therefore to survive into and through the next decade, it is important for the existing small local fashion business retailers to repositioning themselves by upgrading providing an exciting store environment shopping experience with comply to the current post-pandemic issued health safety (SOP). Thus this study underlines the dilemma that existing small store retailers faced due of modernization and after pandemic. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Strong anti-SARS-CoV-2 activity of Lucilia cuprina maggots’ excretion/secretion and its effect on viral entry and notch pathway in vitro: First work

The global pandemic caused by SARS-CoV-2 requires new lines of treatment to hinder viral entry and pathogenesis. Lucilia cuprina maggots’ excretion/secretion (E/S) contains proteases and antioxidants, among other active ingredients that contribute to its antibacterial, antifungal, and antiviral activity. This study aims to assess the potential effects of E/S on the entry and molecular pathogenesis of a SARS-CoV-2 isolate “NRC-03-nhCoV” in vitro for the first time. E/S was obtained from the collected maggots of L. cuprina that were maintained under controlled laboratory conditions. The E/S was used to treat VERO-E6 cells infected with SARS-CoV-2. The predicted antiviral activity of the E/S and the expression of the Notch pathway and viral pathogenesis-related genes were assessed at three time points. E/S showed potential antiviral activity against SARS-CoV-2 (IC50 = 0.324 µg/ml) with a high selectivity index value (SI = 572.997). Serine protease present in E/S was predicted to interact with transmembrane protease, serine 2 and cathepsin B. E/S was able to significantly downregulate Notch-related genes, SUMO1, and TDG in SARS-CoV-2-infected cells, shifting their expression toward levels of the control. Therefore, E/S of L. cuprina maggots is a potential strong inhibitor for SARS-CoV-2. © 2022. Mohammad R. K. Abdel-Samad et al. This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).

Relation between Sex Hormones and COVID 19

Coronavirus is one of the major viruses that mainly attack human respiratory system . there are similarities in symptoms between COVID – 19 and earlier Coronavirus infections such as fever, dry cough, however, COVID – 19 showed unique clinical feature, that involve the targeting of the lower airways as evident by upper respiratory tract symptoms such as rhinorrhea, sneezing and sore throat . The severity of COVID- 19 as indicated by hospitalization, admission to intensive care unit, has been greater in men than women . Many hypotheses have been found to explain this difference in susceptibility and severity of the disease . The difference in immune response between sex is consider the main factor in outcomes of viral infection . Estrogen has immunoenhancing effect on the immune system, while testosterone has immunosuppressive role, also progesterone inhibits inflammatory innate immune response . In this review, its concluded that sex hormones have relation with COVID-19 severity .It was concluded that estrogen and progesterone reduce disease severity in contrast, testosterone increase the severity and susceptibility for COVID-19 .

Creating a post-pandemic sustainable environment in the context of technical and reputational business transformation

The purpose of this article is to propose a new design for a sustainable built environment using a specific business system as an example that transforms and implements modular systems and ultraviolet (UV) lighting to prevent the spread of infectious agents after COVID-19, which directly affects the ability of some types of businesses to function. The paper explores the possibility of purchasing, introducing and using UV radiation for disinfection of premises and the destruction of potentially dangerous viruses and bacteria. The proposed model allows self-isolating persons to adapt to the changing reality and remain productive consumers of goods and services within the business system under study. The modular system, combined with germicidal UV lamps, due to their ability to inactivate viruses, effectively creates a safe hygienic environment, which affects the attractiveness of the territory for visitors and increases the number of 'contacts' of the consumer with the company and brand.

A Numerical Study on Indoor Air Quality (IAQ) Designs for Hospital Waiting Room in the Context of COVID-19 for Hot and Warm Humidity Climate

COVID-19 is a virus originated from Corona Virus which can severe acute respiratory syndrome (SARS) symptoms such as chest pain, dry cough, fever, and difficulty breathing. The AC and ventilation system is not only important for the thermal comfort occupants but to ensure the room is safe and free from infectious virus. Thermal comfort is important measurement in indoor space which influenced by temperature, Relative Humidity (RH), airflow velocity and others. This research was executed and focused on lecture room in Bilik Persatuan 10, Universiti Malaysia Perlis (UniMAP) instead of real hospital waiting room. It comes with the room dimensions 11.87m (Length) x 5.17m (Width) x 2.93m (Height) for the numerical study. In addition, Computational Fluid Dynamics (CFD) analysis is used to investigate the air flow pattern and temperature distribution inside the room. By using software Ansys FLUENT 19, field experimental and simulation work can be compared which have 14.55% difference in temperature distribution. It is expected by increasing the air velocity of the AC inlet diffuser influence the pattern of airflow in the room, but average temperature remains same for all these conditions. © 2021 Institute of Physics Publishing. All rights reserved.

Sars-Cov-2 Infection Associated with Aplastic Anemia and Pure Red Cell Aplasia

Introduction: Aplastic anemia (AA) is a life-threatening disorder characterized by pancytopenia and a hypocellular bone marrow. Pure red cell aplasia (PRCA) is a similar disorder with primary reduction in the red blood cell population and virtual absence of erythroid precursors in the bone marrow. While the etiology of immune mediated marrow failure is multifactorial, preceding viral infections have been associated with the disease;these include parvovirus B19, cytomegalovirus, and Epstein-Barr virus. We present four cases of immune mediated marrow failure with either preceding or simultaneous SARS-CoV-2 infection. Methods: The medical records of patients treated for AA or PRCA at the University of Texas Southwestern Medical Center, Parkland Hospital, and the National Institutes of Health (NIH) were reviewed for SARS-CoV-2 infection. Four patients without prior hematological diseases were identified who had SARS-CoV-2 infection prior to or with simultaneous the diagnosis of AA or PRCA. Results: Patient #1 was a 22-year-old white female who was diagnosed with asymptomatic COVID-19 10 days prior to her pancytopenia and AA diagnosis was confirmed by bone marrow biopsy (5% cellularity;Table 1). Her extensive work-up including HIV, hepatitis panel, immunoglobulins, B12 and folate was negative, and she underwent HLA-matched family donor hematopoietic stem cell transplant. Patient #2 was a 69-year-old Asian female who presented to her primary care physician with symptoms of fatigue and was found to be pancytopenic. CBC from a few months prior was completely normal. Further work-up was positive for COVID-19 and negative for HIV, nutritional deficiency, or hemolysis. She did not have respiratory symptoms, was eventually diagnosed with pRBC and platelet transfusion-dependent severe AA (5-10% cellularity on bone marrow), and underwent treatment with cyclosporine, equine antithymocyte globulin, and eltrombopag. She has had a partial response to this therapy. Both patients had bone marrow specimens stained for SARS-CoV-2 by immunohistochemistry that were negative. Patient #3 was a 76-year-old white male who was diagnosed with COVID-19 4 months prior to presenting with a non-ST segment myocardial infarction and found to be profoundly anemic, requiring pRBC transfusion. He re-presented with chest pain one week later and was found to be anemic again, and required transfusion. A trial of darbepoetin alfa was unsuccessful. Extensive work-up for malignancy, infection, and autoimmune etiologies were negative. He was diagnosed with PRCA based on the bone marrow biopsy and initiated treatment with cyclosporine. Patient # 4 was diagnosed with severe AA (presenting as pancytopenia) and COVID-19 infection. He had fatigue for one month and fever, chills and sore throat one-week prior seeking medical care. Testing for hepatitis, HIV, EBV, and CMV was negative. He was treated on a clinical trial (NCT04304820) at NIH with cyclosporine and eltrombopag until SARS-CoV-2 PCR was negative then received equine anti-thymocyte globulin. He has achieved a complete hematologic response at 6 months and remains well at last follow-up. Conclusion: The four patients described had minimal respiratory COVID-19 symptoms, but they presented with cytopenia and were eventually diagnosed with bone marrow failure. It is possible that this is co-incidental due to the high prevalence of SARS-CoV-2. However, there is emerging evidence that COVID-19 pneumonia is a hyperinflammatory and immune dysregulated state improved by dexamethasone therapy. Other immune mediated hematologic conditions, such as autoimmune hemolytic anemia and immune thrombocytopenia, have been reported. The onset from infection to cytopenia appears rapid, although patients often presented with symptoms for many days prior to diagnosis and thus testing may have been delayed from the onset of infection. This case series does not provide a mechanistic link between SARS-CoV-2 infection and bone marrow failure, but it raises the possibility that SARS-CoV-2 may mediate an immunologic response that cont ibutes to marrow failure. Patients appear to respond well to standard immunosuppressive treatment. Further cases and studies are needed to determine if this is directly linked to SARS-CoV-2 and whether the natural history and response to standard therapy is different than idiopathic cases. [Formula presented] Disclosures: Young: Novartis: Research Funding.

Immature Platelets and Disease Severity in Patients Hospitalized with Acute COVID-19 Who Are Vaccinated Against COVID-19

Introduction: COVID-19 has killed more than four million people worldwide and resulted in strained health resources globally(Dong Lancet ID 2020). There is a critical need for prognostic biomarkers to predict severity and outcomes in COVID-19 patients to allow more efficient resource allocation. Studies using pre-vaccination hospitalized patient data have demonstrated that elevated initial and peak immature platelet fraction (IPF), as well as related platelet indices, were associated with progression to severe COVID-19 outcomes (Welder Br J Haem 2021). This suggests the potential role of immature platelets as a cost-effective biomarker. The underlying pathophysiology of immature platelets in COVID-19 is unclear but these results support the hypothesis of higher inflammatory response, leading to thrombopoiesis mediated by pro-inflammatory cytokines and platelet hyper-reactivity in this population (Manne Blood 2021). It is unclear if this holds true in patients vaccinated against COVID-19. This study aims to assess the relationship between immature platelets in patients vaccinated against COVID-19 and hospitalized with acute COVID-19. Methods: This study used a COVID-19 patient registry established by the University of Texas Southwestern that comprises patients between May 2020 to July 2021. The database was approved by the Institutional Review Board. The study included 22 fully vaccinated adult patients with the mRNA COVID-19 vaccines hospitalized with acute COVID-19 and had IPF measurements during the hospitalization as well as 519 non-intensive care unit (ICU) patients admitted with acute COVID-19 prior to availability of a COVID-19 vaccine (pre-vaccination era). The study conducted non-parametric tests to compare hospital outcomes and covariates of interest between vaccinated patients and pre-vaccination era non-ICU patients. Covariates included for analysis are age, gender, race, length of hospital stay (LOS), dexamethasone use, platelet count, immature platelet count (IPC), IPF, thrombotic events and mortality. Results: All patients vaccinated against COVID-19 were alive without thrombotic events at the time of analysis. One out of 22 vaccinated patients required ICU admission and use of a ventilator. IPF and platelet counts at admission were similar between vaccinated patients and non-ICU patients from pre-vaccine era while IPC was significantly lower in the vaccinated group (Table 1). The vaccinated patient requiring ICU admission and mechanical ventilation was a heavy tobacco user with chronic obstructive pulmonary disease (IPF 6.1%, IPC 4x10 9/L, platelet count 66x10 9/L). There was a disproportionate number of Hispanic patients in the vaccinated cohort (44%, P = 0.02). The LOS was significantly shorter in vaccinated patients compared to pre-vaccination era non-ICU patients by a day and a half (P = 0.047). The admission IPF and IPC were not correlated with increased LOS (IPF Spearman ρ = 0.23, P = 0.31;IPC ρ = -0.34, P = 0.13), while platelet count at admission negatively correlated with LOS (ρ = -0.41, P = 0.06). Discussion: IPF, IPC, and platelet count have previously been demonstrated to be a predictor of increased ICU and hospital LOS, ventilator duration, and in-hospital mortality. To our knowledge, this is the first study assessing the relationship between IPF and platelet indices in hospitalized patients vaccinated against COVID-19. Due to the lack of severe COVID-19 outcomes in these vaccinated patients, LOS was the only variable able to be analyzed and lower platelet count was found to be associated with increased LOS. These preliminary results demonstrated similar initial IPF and platelet counts but lower IPC in a small cohort of vaccinated COVID-19 patients compared with the pre-vaccination era patients with no severe outcomes. This suggests that the predictive value of these biomarkers may also apply to the vaccinated patient population. As IPC in this current study is derived from IPF and platelet counts, independent measure of IPC is needed to confirm this finding in a larger cohort. This tudy also potentially suggests the protective benefits of COVID-19 vaccines as reported in prior randomized trials (Polack NEJM 2020). Further research is needed to confirm these findings in a larger vaccinated cohort assessing severe outcomes, hospitalization, and death, especially with future infection waves with contagious COVID-19 variants rapidly emerging. [Formula presented] Disclosures: No relevant conflicts of interest to declare.

Biomarkers for Thrombosis in COVID-19: A Role for High Sensitivity Troponin-I and Immature Platelet Fraction?

Biomarkers for Thrombosis in COVID-19: A Role for High Sensitivity Troponin-I and Immature Platelet Fraction? Introduction Coronavirus disease 2019 (COVID-19) is associated with increased risk of thrombosis with both venous and arterial thromboembolism observed. While d-dimer elevation has been shown to be associated with thrombosis, this elevation is present in over 50% of COVID-19 infections demonstrating a clear need for more specific biomarkers of thrombosis in this population. While there are a variety of theories to explain the increased risk for thrombosis: all center on Virchow's triad, specifically hypercoagulability and inflammation. Platelets play a significant role in hypercoagulability. Immature platelets, which are thought to be hyper-reactive, may specifically be associated with thrombosis in COVID-19. It would thus be reasonable to expect immature platelet fraction (IPF) and immature platelet count (IPC) to be predictive biomarkers of thrombosis in this population. Beyond hypercoagulability, High-Sensitivity (HS) Cardiac troponin-I can be a biomarker of inflammation and may also be predictive of thrombotic events in COVID-19. The aim of this study was to evaluate the relationship between IPF, IPC, HS cardiac troponin-I and thrombotic events in COVID-19. Methods Using a single center COVID-19 data registry, we extracted all patients with COVID-19 at our single center between May 1, 2020 and January 1, 2021. Patients were stratified into two groups based on thrombotic events during hospitalization, the thrombosis and no thrombosis groups. Biomarker values, including IPF, IPC, platelet counts, d-dimer, and HS cardiac troponin I were extracted. Two-sided Wilcoxon rank test was conducted to test group differences in IPF, IPC, platelet, d-dimer, and HS cardiac troponin-I values. Results There were no significant differences in measurements of IPF at admission, peak IPF, platelet count at admission, peak platelet count, IPC at admission, and peak IPC between the thrombosis and no thrombosis groups. Minimum platelet count values were significantly lower in the thrombosis group compared to the no thrombosis group. D-dimer and troponin values were significantly higher in the thrombosis group than the no thrombosis group. (Table 1) Discussion To our knowledge this is the first study assessing the relationship between IPF, IPC, HS cardiac troponin-I and thrombosis in COVID-19. HS cardiac troponin did appear to be a predictive biomarker for thrombosis in COVID-19. This may be related to vascular inflammation playing a significant role in thrombosis. It may also be secondary to myocardial inflammation associated with severe disease in COVID-19.3 Patients with more severe disease are more prone to thrombosis. Unsurprisingly, our study corroborates evidence in the literature that d-dimer is associated with thrombotic events in COVID-19. On the other hand, IPF and IPC do not appear to be predictive biomarkers for thrombosis in this cohort. This appears consistent with the limited data assessing the relationship between IPF, IPC, and thrombosis outside of COVID-19. This does not dispel the importance of immature platelets in COVID-19, however. IPF and IPC are increased in patients with COVID-19, and our published data indicates they are predictors of COVID-19 severity. However, the relationship between immature platelets and outcomes in acute illness can be complex, as in sepsis, where the trend of IPC is associated with mortality, rather than the initial value. Future studies should delineate the relationship between trends in IPF or IPC and outcomes in COVID-19. Furthermore, it is crucial to define biomarkers of thrombosis and disease severity and mortality in COVID-19 which can potentially guide therapeutic interventions. [Formula presented] Disclosures: No relevant conflicts of interest to declare.

Lung Delivery Systems to Optimize Pharmacotherapy of COVID-19: A Concise Review

Background: COVID-19 is an ongoing viral pandemic caused by the SARS-COV-2 virus. Several drugs were repurposed for its management;however, most of these drugs were not ideal treatments by traditional methods of administration, whether given by injection or orally. This is due to many reasons including pharmacokinetic limitations or drug-induced adverse effects. There is an urgent need to develop these drugs to target the virus in the lung tissue through inhalation. Objective: To address the gap in knowledge regarding efficacy and safety of pulmonary drug delivery of repurposed antiviral against COVID-19. Findings: Ongoing trials for inhalable formulations of several drugs such as Niclosamide;Remdesivir, Hydroxychloroquine, and Azithromycin among others showed promising results. Conclusion: The development of pharmaceutical forms for inhaled administration of antiviral and anti-inflammatory drugs is an important direction that needs more attention to achieve the optimal management of respiratory infectious diseases.

Severe acute respiratory syndrome coronavirus-2 antibody prevalence in people with and without HIV in rural Western Kenya, January to March 2020.

Among 582 participants in Western Kenya who were retrospectively tested from January through March 2020, 19 (3.3%) had detectable SARS-CoV-2 antibodies. The prevalence of detectable SARS-CoV-2 antibodies was similar between participants with and without HIV (3.1% vs. 4%, P = 0.68). One participant reported a cough in the preceding week but others denied symptoms. These may represent cross-reactivity or asymptomatic infections that predated the first reported COVID-19 cases in Kenya.

Prediction model of balanced nutrition practices among university students in the covid-19 outbreak

AIM: Students included in the category of youth need balanced nutrition practices, especially during the COVID-19 outbreak. This study aims to determine the model of balanced nutrition behavior in youth in Gowa Regency, Makassar, Indonesia. MATERIALS AND METHODS: This study was a quantitative study with a cross-sectional study, in which primary data were collected from June to July 2020. The respondents were 597 students at public and private universities located in Gowa Regency who filled the questionnaires. RESULTS: The bivariate analysis results, which were based on the respondents’ characteristics, showed that only age significantly affected balanced nutrition practices (p = 0.048). Based on the independent variables studied, poor knowledge (p = 0.000, ORcrude = 2.229 [CI 1.601–3.105]) and poor attitude (p = 0.001, ORcrude = 1.735 [CI 1.250-2.409]) obtained a significant correlation with poor balanced nutrition practices. The final model of balanced nutrition practices using multivariate analysis indicated that knowledge was the biggest predictor of balanced nutrition (p = 0.000, OR = 2.067 [CI 1.476–2.893]). The number implied that respondents with good knowledge had 2.067 times the opportunity to take balanced nutrition practices than those with less knowledge after controlling for age and attitude variables. CONCLUSION: Producing well-balanced nutrition behavior requires well-balanced nutrition knowledge, including university students who belong to the late adolescent stage.