Characterizing the Severity of SARS-CoV-2 Variants at a Single Pediatric Center.

Since March 2020, SARS-CoV-2 has plagued the world with COVID-19 and individuals of all ages have experienced varying symptoms of disease. Older adults were experiencing more severe disease compared to children and were prioritized by vaccination efforts. While biologic therapies and vaccinations were implemented, there were changes in public health restrictions with subsequent surges resulting in more infected children. During these surges there was a rise of different SARS-CoV-2 variants with the dominant variant initially alpha (B.1.1.7 and other Pango lineages) and epsilon (B.1.427/B.1.429) in early 2021 and a dramatic shift to delta (B.1.617.2 and other Pango lineages) by mid-summer 2021. In this study we aimed to characterize the clinical severity and host factors associated with disease by SARS-CoV-2 variant and evaluate if there are differences in disease severity by circulating variant. We retrospectively included all individuals 0-25 years of age who presented to our center and had a positive SARS-CoV-2 RT-PCR, SARS-CoV-2 variant mutation testing, and documented clinical notes from 1 January 2021 through 31 December 2021. We identified 745 individuals who met inclusion criteria and found the delta variant was associated with severe/critical disease compared to the other variants studied. The results of the model showed that underlying respiratory disease and diabetes were risk factors for progression to severe disease. These insights are important when evaluating public health measures and treatment options for children as more variants arise.

Awareness regarding COVID-19 and its effects on mental health among pre-professional health sciences students at King Saud bin Abdulaziz University for health sciences in Riyadh and Jeddah, Saudi Arabia.

In light of the outbreak caused by the COVID-19 and its impact on the physical and mental wellbeing, we explored the consequences of this pandemic on the mental health among pre-professional health sciences students and their awareness regarding the virus. A descriptive observational cross-sectional study was conducted at King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) in Jeddah and Riyadh campuses. Data was collected from 770 participants using an online questionnaire, and statistical analysis was performed using SPSS. The majority of the participants (87.5%) considered governmental authorities as their main source of information, and therefore, they were up to date on the general information regarding COVID-19. For findings on mental health, it was found that 61.9% were exhibiting variant degrees of depression, as well as 50% expressing signs of extremely severe anxiety. However, 50.9% of the participants expressed no signs of stress during this pandemic. An association was found between gender and mental health showing females to have higher tendencies to express signs of extremely severe depression, anxiety, and stress. An association was also found between parents' marital status and anxiety. Analysis revealed that participants with separated parents were the least among the participants to show no signs of anxiety, as well as reporting the highest numbers in the "extremely severe" anxiety category. With the increased awareness and higher than normal levels of the investigated mental illnesses, we advise that proper action should be considered to address this issue.

Comparison of online learning effectiveness in The ELE during COVID-19 in Malaysia and Indonesia

The COVID-19 pandemic has an impact on education. It has changed the learning system from conventional interaction into digital interaction. The lecturers and students in Malaysia and Indonesia are required to master online learning to conduct the teaching and learning processes. However not many lecturers apply it maximally. This study aims to find out the comparison of online learning effectiveness in English Language Education (ELE) in Malaysia and in Indonesia. This quantitative research used a questionnaire survey to collect data. The data were analyzed descriptively with tabulations and distributions of empirical data. The result reveals that 75% of Malaysian lecturers and 83% of Indonesian lecturers prefer to use synchronous learning;25% of Malaysian lecturers and 17% of Indonesian lecturers prefer to use asynchronous learning;65% of Malaysian students and 71% of Indonesian students prefer to use synchronous learning;35% of Malaysian students and 29% of Indonesian students prefer to use asynchronous learning. For synchronous learning 58% of the total respondents in Malaysia like virtual meeting as an online learning tool. In Indonesia 59% of the total respondents like phone calls as an online learning tool. For asynchronous learning 54% of the total respondents in Malaysia and Indonesia like blogs as an online learning tool. Online learning has good effects on English learning skills, especially listening. Academics in both countries agree that online learning is beneficial in the ELE learning and teaching process. It can be generally concluded that the use of online learning and teaching is effective in ELE.

Burnout and resilience in doctors in clinical and preclinical departments in a tertiary care teaching and dedicated COVID-19 hospital.

BACKGROUND: The worldwide COVID-19 pandemic has significantly altered our life. Doctors more so than the general public because of their involvement in managing the COVID-infected individuals, some of them 24/7 end in burnout. Burnout in doctors can lead to reduced care of patients, increased medical errors, and poor health. Burnout among frontline health-care workers has become a major problem in this ongoing epidemic. On the other hand, doctors in preclinical department have a lack of interaction with patients, with not much nonclinical professional work to boot, find the profession less gratifying which perhaps increase their stress level. AIM: The aim was to study the prevalence of burnout and measure resilience in doctors in clinical and in preclinical departments. MATERIALS AND METHODS: This observational, cross-sectional, comparative study was carried out in a tertiary care teaching hospital and COVID care center. By purposive sampling 60 preclinical and 60 clinical doctors in a tertiary health care center were included in the study. After obtaining the Institutional Ethics Committee approval and informed consent, the doctors were administered a self made socio-demographic questionnaire, the Copenhagen Burnout Inventory, and the Connor-Davidson Resilience Scale. Doctors were given a self-made questionnaire, the Copenhagen Burnout Inventory, and the Connor-Davidson Resilience Scale. RESULTS: The prevalence of burnout was seen more in clinical doctors (55.47) and the resilience was observed more in preclinical doctors (88.9). DISCUSSION: Resident doctors are a major force to combat COVID-19 as frontline health workers; hence, one can visualize burnout amongst them. On an individual basis, the work-related burnout was severely high in the clinical group owing to the workload which has been corresponding to a number of western studies. Nonclinical department doctors from pathology, community medicine, and microbiology did show burnout but showed a greater score in resilience. Psychological resilience has been identified as a component in preventing burnout. CONCLUSION: Therapy sessions can be used in clinical doctors facing burnout to build up their resilience.

Association of Healthy Diet with Recovery Time from COVID-19: Results from a Nationwide Cross-Sectional Study.

The world is still in need of an effective therapy to treat coronavirus disease-19 (COVID-19). This cross-sectional study was conducted on COVID-19 survivors in Saudi Arabia to investigate the influence of a healthy diet on the recovery time from COVID-19. A questionnaire was developed to assess participants' dietary habits, based on the 2015 Dutch food-based dietary guidelines. A total of 738 COVID-19 survivors participated in the study, of whom 237 (32.1%) were hospitalized for COVID-19 treatment while 501 (76.9%) were not hospitalized, and 320 (43.4%) were females and 418 (56.6%) were males. Overall, no significant difference was noted in healthy diet score between males and females; however, this score was significantly lower for Saudis compared to non-Saudis. Among the non-hospitalized patients, eating a more healthy diet was associated with a shorter duration of recovery (p < 0.05) and was significantly affected by gender (15.8 ± 9.3 male vs. 12.1 ± 8.9 female; p < 0.001) and marital status (12.1 ± 8.4 singles vs. 13.7 ± 9.3 married vs. 16.1 ± 11.8 divorced; p < 0.05). In contrast, no significant correlation was found with age or BMI. In this study, a more healthy diet was associated with a shorter duration of recovery from COVID-19. However, further studies are needed to thoroughly investigate the relationship between diet and recovery time from COVID-19.

A 3-week-old girl with vesicular rash

Laboratory studies revealed an unremarkable complete blood cell count in addition to differential, comprehensive metabolic panel, C-reactive protein, procalcitonin, and urinalysis. A lumbar puncture produced blood-tinged fluid on the second attempt, and initial cerebrospinal fluid (CSF) studies showed 416 white blood cells per microliter and 605,000 red blood cells per microliter, with 4% neutrophils, 83% lymphocytes, 1% reactive lymphocytes, and 12% monocytoid cells. In cases that require laboratory confirmation, the diagnostic method of choice for varicella is a VZV DNA PCR test from vesicular fluid or a scab-vesicles contain large amounts of virus and PCR is more sensitive than a viral culture or a direct fluorescent antibody assay.1,5,6,11 In otherwise healthy children, treatment for varicella is supportive care to address fever and pruritus and to maintain adequate hydration.1 Varicella in a newborn does not universally require antiviral treatment, and there is no consensus by experts in the literature about management.9 However, the decision to treat is determined by host characteristics, illness severity, and initial response to therapy.5,10 The antiviral treatment of choice is acyclovir, which prevents viral DNA synthesis by inhibiting the viral DNA polymerase and is most effective if administered intravenously within 72 hours of disease.1,7,12 Blumental et al recently recommended acyclovir treatment for all patients less than 1 month of age with clinical signs of varicella.7 Both of the infant's parents reported having a childhood illness consistent with varicella and tested positive for VZV immunoglobulin G. As the patient's mother tested positive, it is likely that maternal transfer of antibody contributed to a less severe course of varicella (though this is confounded by the fact that the infant was started empirically on intravenous acyclovir upon admission).9,10 Given varicella's incubation period, we presume the patient was exposed to VZV during the first week of life.