Advancements in COVID- 19 Testing: An in-depth overview.

COVID-19 rapidly evolved as a pandemic, killing and hospitalising millions of people, creating unprecedented hurdles for communities and health care systems worldwide. The rapidly evolving pandemic prompted the head of the World Health Organisation to deliver a critical message: "test, test, test." The response from the diagnostic industry and researchers worldwide was overwhelming, resulting in more than a thousand commercial tests available in the market worldwide. Several sampling approaches and diagnostic techniques have been employed from the early stages of the pandemic, such as SARS-CoV-2 detection by targeting the viral RNA or protein, indirectly via antibody testing, biochemical estimation, and various imaging techniques, and many are still in the various stages of development and yet to be marketed. Accurate testing techniques and appropriate sampling are the need of the hour to manage, diagnose and treat the pandemic, especially in the current crisis, where SARS-CoV-2 undergoes constant mutation, evolving into various strains, which are pretty challenging. The article discusses various testing techniques as well as screening methods for detection, treatment, and management of COVID-19 transmission, such as NAAT, PCR, isothermal detection including RT-LAMP, RPA, NASBA, RCA, SDA, NEAR, and TMA, CRISPR strategy, nanotechnology approach, metagenomic profiling, point of care tests, virus neutralization test, ELISA, biomarker estimation, utilization of imaging techniques such as CT, ultrasonography, brain MRI in COVID-19 complications, and other novel strategies including microarray methods, microfluidic methods and artificial intelligence with an emphasis on advancements in the testing strategies for the diagnosis, management, and prevention of COVID-19.

Plant derived active compounds as potential anti SARS-CoV-2 agents: an in-silico study.

Plants are a valued potential source of drugs for a variety of diseases and are often considered less toxic to humans. We investigated antiviral compounds that may potentially target SARS-CoV-2 antigenic spike (S) and host proteins; angiotensin-converting enzyme2 (ACE2), and transmembrane serine protease2 (TMPRSS2). We scrutinized 36 phytochemicals from 15 Indian medicinal plants known to be effective against RNA viruses via molecular docking. Besides, the TMPRSS2 structure was modeled and validated using the SWISS-MODEL. Docking was performed using Autodock Vina and 4.2 followed by visualization of the docking poses on Pymol version 2.4.0 and Discovery Studio Visualizer. Molecular docking showed that 12 out of 36 active compounds interacted efficiently with S, ACE2, and TMPRSS2 proteins. The ADMET profile generated using the swissADME and pkCSM server revealed that these compounds were possessed druggable properties. The Amber 12 simulation package was used to carry out energy minimizations and molecular dynamics (MD) simulations. The total simulation time for both S protein: WFA and S protein: WND complexes was 300 ns (100 ns per replica). A total of 120 structures were extracted from the last 60 ns of each MD simulation for further analysis. MM-PBSA and MM-GBSA were employed to assess the binding energy of each ligand and the receptor-binding domain of the viral S-protein. The methods suggested that WND and WFA showed thermodynamically favorable binding energies, and the S protein had a higher affinity with WND. Interestingly, Leu455 hotspot residue in the S protein, also predicted to participate in binding with ACE2, was engaged by WND and WFA. HighlightsPlants' natural active compounds may aid in the development of COVID-19 therapeutics.MD simulation study revealed stable binding of withanolide D and withaferin A with spike proteinWithanolide D and withaferin A could be effective against SARS-CoV-2 spike protein.Discovery of druggable agents that have less or lack of binding affinity with ACE2 to avoid the organs associated with comorbidities.According to ADMET selected phytochemicals may be used as druggable compounds.Communicated by Ramaswamy H. Sarma.

Bedside naso-jejunal placement is more difficult, but successful in patients with COVID-19 in critical care: A retrospective service evaluation of a dietitian-led service

The COVID-19 pandemic presented clinical and logistical challenges in the delivery of adequate nutrition in the critical care setting. The use of neuromuscular-blocking drugs, presence of maxilla-facial oedema, strict infection control procedures, and patients placed in a prone position complicated feeding tube placement. We audited the outcomes of dietitian-led naso-jejunal tube (NJT) insertions using the IRIS® (Kangaroo, USA) device, before and during the COVID-19 pandemic. NJT placement was successful in 78% of all cases (n = 50), and 87% of COVID-19 cases. Anaesthetic support was only required in COVID-19 patients (53%). NJT placement using IRIS was more difficult but achievable in patients with COVID-19.

Rhizopus homothallicus rhino-orbital-cerebral mucormycosis: Six cases from a tertiary care Centre, North India.

OBJECTIVE: To report six cases of Rhizopus homothallicus rhino-orbital-cerebral mucormycosis in North India between April 2021 and July 2021. CASE DETAILS: All six patients had diabetes, concomitant SARS-CoV-2 infection, a history of oxygen requirement and steroid intake. Among these six cases 4 were female. All patients presented with sinus pain and peri-orbital swelling. COVID-19-associated mucormycosis (CAM) was diagnosed based on microbiological examination of the biopsied tissue, and its staging was determined radiologically by CT and MRI. Three patients were in stage III-C, the others were in stage II-C, II-D and IV-A. A multidisciplinary team treated the patients with extensive surgical debridement of the affected tissue, correction of predisposing comorbidities and administration of an antifungal agents. Patients were followed up for 6 months with routine direct nasal endoscopy to check the sinonasal cavity for any recurrence. All the six patients survived at 6 months of follow-up. CONCLUSION: A timely initiated multidisciplinary team-based approach can reduce the mortality in rhino-orbital-cerebral mucormycosis cases caused by R. homothallicus.

Patients' Satisfaction on Telemedicine Service in Relation to COVID-19 and Non-COVID-19 Problems: A Cross-Sectional Comparative Study.

BACKGROUND: Telemedicine service was historically started for ambulatory and hospice care patients. Since 2020, we have been in the midst of the COVID-19 pandemic. The availability of healthcare facilities became limited due to repeated locked down during the COVID-19 pandemic. Thus, telemedicine service has gained tremendous popularity among healthcare services. Telemedicine service was started at All India Institute of Medical Sciences (AIIMS), Deoghar, as a COVID Helpline facility to provide guidance and care to the home isolated COVID-19 patients during the second wave of COVID-19. But we observed that more than 40% of calls were due to non-COVID-19-related problems, but we managed the non-COVID-19-related calls by discussing with a specialist in conference calls or WhatsApp consultation. Therefore, we planned to compare individual satisfaction with telemedicine services in patients with COVID-19 and non-COVID-19-related problems. METHODS AND MATERIALS: This study was a cross-sectional retrospective analysis of the register of telemedicine maintained in AIIMS, Deoghar, callers were grouped into two- COVID-19 and non-COVID-19-related problems. We obtained feedback from the patients and recorded it in a google form, collected data were analyzed in both groups. Telephonic consent was taken for participating in the study. The sample size was calculated to be 252, the COVID-19 group: 126, and the non-COVID-19 group: 126, and simple random sampling was used to choose the participants from the 730 total callers of the first month of telemedicine service. Their response was graded on 4 points Likert scale (1=Poor, 2=fair, 3=Good, 4=Excellent) and outcomes were analyzed by IBM SPSS (version 20.0) software. A p-value of <0.05 was considered statistically significant. OBJECTIVE: The primary objective is to estimate the level of satisfaction in both groups and compare their level of satisfaction. The secondary objective is to determine the department-specific telemedicine services requirement for people in need. RESULTS: Out of a total of 252 patients, most (54%) callers were 18-45 years old, and 44% were above 45 years old. 64% of patients were male. 90% of callers were from urban or semi-urban districts. 90% of callers had a 10th-grade or more education. 89% of patients were willing to use telemedicine services in the future. An Independent sample t-test was used to compare the means of both the groups showed a significant difference (p < 0.05) in the level of satisfaction in the COVID-19 group to the non-COVID-19 group. It showed that satisfaction in the COVID-19 group was higher than the group with non-COVID-19-related problems. CONCLUSION: COVID-19 has changed the whole spectrum of healthcare needs of the community. Our study findings showed that there is a need for separate department-wise telemedicine services to provide satisfactory service for attending to problems related to that department. For example, problems with diabetes should be attended to by an endocrinologist or an internal medicine specialist. This study finding helped us to change the policy and start department-wise telemedicine service.

A broadly neutralizing monoclonal antibody overcomes the mutational landscape of emerging SARS-CoV-2 variants of concern.

The emergence of new variants of SARS-CoV-2 necessitates unremitting efforts to discover novel therapeutic monoclonal antibodies (mAbs). Here, we report an extremely potent mAb named P4A2 that can neutralize all the circulating variants of concern (VOCs) with high efficiency, including the highly transmissible Omicron. The crystal structure of the P4A2 Fab:RBD complex revealed that the residues of the RBD that interact with P4A2 are a part of the ACE2-receptor-binding motif and are not mutated in any of the VOCs. The pan coronavirus pseudotyped neutralization assay confirmed that the P4A2 mAb is specific for SARS-CoV-2 and its VOCs. Passive administration of P4A2 to K18-hACE2 transgenic mice conferred protection, both prophylactically and therapeutically, against challenge with VOCs. Overall, our data shows that, the P4A2 mAb has immense therapeutic potential to neutralize the current circulating VOCs. Due to the overlap between the P4A2 epitope and ACE2 binding site on spike-RBD, P4A2 may also be highly effective against a number of future variants.

Psychological distress and coping styles among baccalaureate nursing students: Promoting mental health of future nurses in COVID-19 pandemic.

BACKGROUND: Coronavirus disease (COVID-19) causes significant psychological distress among nursing students. College-bound nursing students might have preferred different types of coping strategies to deal with psychological distress. This study aims to measure the psychological distress and role of coping styles to mediate the stress level among the baccalaureate nursing students amid the COVID-19 pandemic. MATERIAL AND METHODS: A cross-sectional online survey was conducted in December 2020 at a nursing college attached to a tertiary care teaching hospital, North India. Nearly 251 baccalaureate nursing students completed the Impact of Event Scale-Revised (IES-R) and Coping Orientation to Problems Experienced Inventory (Brief-COPE) scale to report their psychological distress and coping styles, respectively. Chi-square test, independent sample t-test followed by binary and multivariable regression were used to identify the factors associated with distress in students during the pandemic. RESULTS: Students' mean age was 22.22 ± 1.24 years. The mean IES-R was 19.59 ± 12.45 in nursing students. Psychological distress found a significant association with age (P = 0.022), academic class (P = 0.016), travel history (P = 0.034), and being positive reverse transcription-polymerase chain reaction (RT-PCR) for COVID-19 status of self (P = 0.018) and family members in the medical profession (P = 0.013). In binary logistic regression, stress level found a significant association with first-year academic level (OR: 3.250, 95% CI: 1.429-7.390, P = 0.005) and family members in the medical profession (OR: 4.44, 95% CI: 1.019-19.382, P = 0.047). Adaptive coping styles were more frequently preferred than maladaptive coping styles (54% vs 41%). Adaptive (r = 0.295, P < 0.001) and maladaptive coping (r = 0.403, P < 0.001) shows a significant positive relationship with stress in students, respectively. CONCLUSIONS: Coronavirus pandemic causes significant distress among nursing students. Students were able to manage stress using acceptance and religious/spiritual coping strategies. During the pandemic, stress management to support mental health is highly recommended.

SARS-CoV-2 Spike Protein-Activated Dendritic Cell-Derived Extracellular Vesicles Induce Antiviral Immunity in Mice.

The onset and spread of the SARS-CoV-2 virus have created an unprecedented universal crisis. Although vaccines have been developed against the parental SARS-CoV-2, outbreaks of the disease still occur through the appearance of different variants, suggesting a continuous need for improved and effective therapeutic strategies. Therefore, we developed a novel nanovesicle presenting Spike protein on the surface of the dendritic cell-derived extracellular vesicles (DEVs) for use as a potential vaccine platform against SARS-CoV-2. DEVs express peptide/MHC-I (pMHC-I) complexes, CCR-7, on their surface. The immunogenicity and efficacy of the Spike-activated DEVs were tested in mice and compared with free Spike protein. A 1/10 Spike equivalent dose of DEVs showed a superior potency in inducing anti-Spike IgG titers in blood of mice when compared to dendritic cells or free Spike protein treatment. Moreover, DEV-induced sera effectively reduced viral infection by 55-60% within 15 days of booster dose administration. Furthermore, a 1/10 Spike equivalent dose of DEV-treated mice was found to be equally effective in inducing CD19+CD38+ T-cells in the spleen and lymph node; CD8 cells in the bone marrow, spleen, and lymph node; and CD4+CD25+ T-cells in the spleen and lymph node after 90 days of treatment. Thus, our results support the immunogenic nature of DEVs, demonstrating that a low dose of DEVs induces antibodies to inhibit SARS-CoV-2 infection in vitro, therefore warranting further investigations.

Risk of self-contamination because of improper doffing of personal protective equipment: A randomised cross-over study.

Background and Aims: Many health care staff have been pressed into coronavirus disease-19 patient care with little experience of working in bio-hazard zones because of the overwhelming requirements of manpower. They wear personal protective equipment (PPE) and follow all rules for their safety. However, despite precautions, during doffing, they carry a risk of self-contamination. This randomised cross-over study assessed the risk of self- contamination because of improper doffing of PPEs. Methods: A colourless lotion that glows with a bright-green fluorescent hue under ultraviolet light was applied to simulate germ contamination in various health care workers (HCWs) who volunteered for the study. The primary objective of this study was to know the percentage of HCWs getting self-contaminated. The secondary objectives were to assess which portions of the body get maximally contaminated and infestation of germs on which portions of the PPE carry more risk of self-contaminating after doffing. Results: A total of 152 doffings by 76 participants were analysed, and the volunteers self-contaminated in 43 doffings (28.28%). In 18 of these 43 doffings, self-contamination was noted at more than one location. The most commonly contaminated areas were the arms (33%), clothes on the abdomen (24%), and areas in the lower limb (23%). Germ infestation on the upper parts of a PPE is 2.39 times more likely to cause self-contamination after improper doffing. Conclusion: Faulty doffing resulted in self-contamination in 28.28% of all doffings. Risk is 2.39 times more when germs are nested in the upper body portions of the PPE suit.

Blockchain and homomorphic encryption based privacy-preserving model aggregation for medical images.

Medical healthcare centers are envisioned as a promising paradigm to handle the massive volume of data for COVID-19 patients using artificial intelligence (AI). Traditionally, AI techniques require centralized data collection and training models within a single organization. This practice can be considered a weakness as it leads to several privacy and security concerns related to raw data communication. To overcome this weakness and secure raw data communication, we propose a blockchain-based federated learning framework that provides a solution for collaborative data training. The proposed framework enables the coordination of multiple hospitals to train and share encrypted federated models while preserving data privacy. Blockchain ledger technology provides decentralization of federated learning models without relying on a central server. Moreover, the proposed homomorphic encryption scheme encrypts and decrypts the gradients of the model to preserve privacy. More precisely, the proposed framework: (i) train the local model by a novel capsule network for segmentation and classification of COVID-19 images, (ii) furthermore, we use the homomorphic encryption scheme to secure the local model that encrypts and decrypts the gradients, (iii) finally, the model is shared over a decentralized platform through the proposed blockchain-based federated learning algorithm. The integration of blockchain and federated learning leads to a new paradigm for medical image data sharing over the decentralized network. To validate our proposed model, we conducted comprehensive experiments and the results demonstrate the superior performance of the proposed scheme.

Probabilistic Approach to COVID-19 Data Analysis and Forecasting Future Outbreaks Using a Multi-Layer Perceptron Neural Network.

The present outbreak of COVID-19 is a worldwide calamity for healthcare infrastructures. On a daily basis, a fresh batch of perplexing datasets on the numbers of positive and negative cases, individuals admitted to hospitals, mortality, hospital beds occupied, ventilation shortages, and so on is published. Infections have risen sharply in recent weeks, corresponding with the discovery of a new variant from South Africa (B.1.1.529 also known as Omicron). The early detection of dangerous situations and forecasting techniques is important to prevent the spread of disease and restart economic activities quickly and safely. In this paper, we used weekly mobility data to analyze the current situation in countries worldwide. A methodology for the statistical analysis of the current situation as well as for forecasting future outbreaks is presented in this paper in terms of deaths caused by COVID-19. Our method is evaluated with a multi-layer perceptron neural network (MLPNN), which is a deep learning model, to develop a predictive framework. Furthermore, the Case Fatality Ratio (CFR), Cronbach's alpha, and other metrics were computed to analyze the performance of the forecasting. The MLPNN is shown to have the best outcomes in forecasting the statistics for infected patients and deaths in selected regions. This research also provides an in-depth analysis of the emerging COVID-19 variants, challenges, and issues that must be addressed in order to prevent future outbreaks.

Vaccine-induced thrombotic thrombocytopenia (VITT): first report from India.

BACKGROUND: Vaccine-induced thrombotic thrombocytopenia (VITT) is a rare but devastating adverse event following adenoviral vector-based vaccinations for COVID-19, resulting in thrombosis, especially of the cerebral and splanchnic vasculature. Despite the progress in laboratory techniques for early diagnosis, VITT remains a clinical diagnosis supplemented by coagulation studies. We report on VITT for the first time from India. CASE: We describe cortical venous sinus thrombosis and intracerebral bleed associated with severe thrombocytopenia in two young men who had no other contributory cause besides a recent ChAdOx1 nCoV-19 vaccination. The diagnosis was supported with PF-4 antibodies in one patient. The second patient's test could not be processed to technical limitations. Both patients were treated with IVIG at 1 g/kg for 2 days and anticoagulation (Apixaban). One patient fully recovered with no residual deficits, and the other is under treatment and recovering. CONCLUSION: VITT can cause devastating fatality and morbidity in otherwise healthy patients via potential immune-mediated effects. Clinicians should have a high suspicion index and treat VITT in the appropriate setting even if the PF-4 antibody testing by ELISA is unavailable or delayed. Though counterintuitive, clinicians must not delay the administration of non-heparin anticoagulation, IVIG and restrict platelet transfusion even in the presence of intracerebral haemorrhage.

Sustainability and materials centered corporate social responsibility research in the year 2000s: A bibliometric analysis

Primarily this paper empirically analyses and explore, whether sustainability centered CSR practices has gained significant attention in the academic and research topics. Secondly it analyse the ways whether and if available CSR practices are enough to address sustainability issue and are transparent. We have used bibliometric analysis in this research to study the knowledge development and research direction on sustainability centered corporate social responsibility and its reflection on academic and research topics. Findings of bibliometric analysis presented in this empirical research put insights for academicians’, researchers, industrial strategists and managers to find out the ways to achieve Industrial sustainability. Secondly results of bibliometric analysis emphasis to explore robust and transparent sustainability centered CSR practices in industries. Thus significant understandings have been developed to adapt sustainability centered CSR practices which could lead further better research in new areas of sustainability centered CSR practices. The research contributes towards enhanced academic and industrial research focusing on sustainability centered CSR activities. This paper is one of the rare pieces of sustainability centered CSR practices adapted among different industries and respond to call for continue study on CSR practices and its impact on environment, economic and social activities to achieve sustainability, thus for better industrial, academic and research perspective.

Gene Therapy Approach with an Emphasis on Growth Factors: Theoretical and Clinical Outcomes in Neurodegenerative Diseases.

The etiology of many neurological diseases affecting the central nervous system (CNS) is unknown and still needs more effective and specific therapeutic approaches. Gene therapy has a promising future in treating neurodegenerative disorders by correcting the genetic defects or by therapeutic protein delivery and is now an attraction for neurologists to treat brain disorders, like Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, spinal muscular atrophy, spinocerebellar ataxia, epilepsy, Huntington's disease, stroke, and spinal cord injury. Gene therapy allows the transgene induction, with a unique expression in cells' substrate. This article mainly focuses on the delivering modes of genetic materials in the CNS, which includes viral and non-viral vectors and their application in gene therapy. Despite the many clinical trials conducted so far, data have shown disappointing outcomes. The efforts done to improve outcomes, efficacy, and safety in the identification of targets in various neurological disorders are also discussed here. Adapting gene therapy as a new therapeutic approach for treating neurological disorders seems to be promising, with early detection and delivery of therapy before the neuron is lost, helping a lot the development of new therapeutic options to translate to the clinic.

A systematic review of mucormycosis cases in COVID-19: Is it an unholy trilogy of COVID-19, diabetes mellitus, and corticosteroids?

Background: A significant surge of cases of mucormycosis is seen in individuals with COVID-19 with presence of diabetes mellitus (DM) and usage of corticosteroids. We aim to conduct a systematic analysis of the cases involving presence of mucormycosis and to find out its association with COVID-19, diabetes mellitus, and corticosteroids. Method: The electronic records of PubMed, Google Scholar, and Science Direct were searched for the case reports and case series that reported mucormycosis in association of COVID-19. The particulars of each case report and case series were retrieved, stored and analyzed. Results: In this study, 476 cases of mucormycosis were reported. In 346 cases of mucormycosis, the patients were found to be COVID-19 positive. The incidence of diabetes Mellitus (DM) was 67.01%. Corticosteroid was administered in 57.77% of the cases. Mortality was reported in 36.34% of the cases. Conclusion: An immunosuppressive environment created due to the COVID-19, diabetes mellitus, and extensive use of corticosteroid provide a suitable background for the increased incidence of mucormycosis. The COVID task force should adopt an aggressive multidisciplinary approach to optimize the use of corticosteroids and maintain glucose in the optimal range.

Effects of an online yoga program on anthropometric parameters among overweight female students during the COVID-19 pandemic.

The coronavirus disease 2019 (COVID-19) outbreak is a public health concern. However, stay-at-home regulations to prevent disease spread increased sedentary behavior with unintended adverse outcomes. Overweight is a major global health issue, and standard treatments have a poor track record of long-term effectiveness. The purpose of this study was to evaluate how online yoga affected participants who were overweight in terms of anthropometric measurements. The study, which was designed as a experimental study, enrolled sixty overweight adolescents. The participants were divided into two groups: a control group (n = 30) and an intervention group (n = 30) who performed an online yoga home exercise program comprising basic yoga practice with 15 poses and minimal rest periods on Monday Wednesday and Friday, from 5.00 to 5.45 pm for 12 weeks. The intensity of the exercise was 65-75 percent of maximum heart rate (MHR). Anthropometric parameters, including body weight (BW), body mass index (BMI), body circumference measurements (BCM), and resting heart rate (RHR) were assessed. All parameters were measured at weeks 0, 8, and 12. Within group and between group comparisons were performed. The results revealed improved BW, BMI, BCM, and RHR in the intervention group; the median BW and BMI of the intervention group was significantly decreased at week 12, and the BCM of the intervention group showed a significant decrease in the chest, waist, hip, and thigh. This declining trend started from week 8. This 12-week online yoga program decreased BW, BMI, BCM, and RHR, which indicates that practicing yoga at home is effective on anthropometric parameters and may be an alternative therapy for health promotion and controlling body weight during the COVID-19 pandemic. However, an appropriate and continuous exercise program must be followed.

Fear of COVID-19 among Healthcare Workers of a Tertiary Care Cardiac Facility Before- and After-Vaccination and Serology

Objective: This study aimed to assess the changes in the perceptions and practices during the coronavirus disease-2019 (COVID-19) era before and after vaccination and antibodies titer among the healthcare workers (HCWs) at a tertiary care cardiac center. Materials and Methods: This descriptive study included HCWs working at a tertiary care cardiac center in Karachi, Pakistan. A predefined structured questionnaire was used to assess the sense of security, practice, and perception of the HCWs before vaccination, after vaccination, and after knowing the antibodies titer. Results: Out of 151 HCWs, 70.2% (106) were male, and a majority, 65.6% (99), were ≤35 years old with an overall mean age of 34.92 ± 7.64 years. Nearly half of the individuals, (n=74;49%), were doctors, 10 individuals (6.6%) were non-clinical staff, and reaming were nursing staff. The mean day since COVID-19 vaccination was 89.6 ± 40.07 before COVID-19 infection. Antibodies titer levels were >250 U/mL in 108 cases (71.5%) and ≤100 U/mL in 18 cases (11.8%). A significant increase in perception score was observed after serology with a mean of 61.04 ± 25.23 vs 53.86 ± 28.96;(p=0.008) compared to the post-vaccination perception score. A significant declining trend has been witnessed in mean practice scores, with a pre-vaccination mean of 69.93 ± 27.12, post-vaccination mean of 59.47 ± 30.61 (p<0.001). And post-serology mean of 55.1 ± 27.1 (p<0.001). Conclusion: An increase in the sense of security and leniency in adherence to personal protective measures has been observed among HCWs after vaccination and after knowing the antibodies titer (English) [ FROM AUTHOR] Amaç: Bu çalışmada, üçüncü basamak bir kalp merkezindeki sağlık çalışanları arasında koronavirüs hastalığı-2019 (COVID-19) döneminde aşılama öncesi ve sonrası algı ve uygulamalardaki değişikliklerinin ve antikor titrelerinin değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Bu tanımlayıcı çalışma, Pakistan, Karaçi’deki üçüncü basamak bir kalp merkezindeki sağlık çalışanlarını içermektedir. Sağlık çalışanlarının aşılamadan önce, aşılamadan sonra ve antikor titresini öğrendikten sonra güvenlik hissi, uygulama ve algılarını değerlendirmek için önceden tanımlanmış yapılandırılmış bir anket kullanılmıştır. Bulgular: Yüz elli bir sağlık çalışanının %70.2 (n=106) erkek ve katılımcıların çoğunluğu, %65.6 (n=99) 35 yaşında ya da daha geç yaştaydı ve ortalama yaş 34.92 ± 7.64 yıl olarak saptandı. Neredeyse yarısı, (n=74;%49) hekim ve %6.6 (n=10) klinik dışı personel, geri kalan kişiler hasta bakım personeli görevindeydi. Önceki COVID-19 enfeksiyonu, doğası gereği 10 kişide (%6.6) ciddi, 1 kişide (%0.7) kritik olmak üzere 62 kişide (%41.1) rapor edilmiştir. COVID-19 aşılamasından bu yana geçen ortalama gün sayısı 89.6 ± 40.07 ve 11 kişide (%7.3) aşılama sonrası COVID-19 bildirildi. Antikor titre seviyeleri 108 kişide (%71.5) >250 U/mL ve 18 kişide ise (%11.9) ≤100 U/mL ve altında saptandı. Aşılama sonrası algı puanı ile karşılaştırıldığında algı skorunda seroloji sonrası ortalama 61.04 ± 25.23 ile 53.86 ± 28.96 arasında anlamlı bir artış gözlendi (p=0.008). Aşılama öncesi ortalama 69.93 ± 27.12, aşılama sonrası ortalama 59.47 ± 30.61 (p<0.001) ve seroloji sonrası 55.1 ± 27.1 olmak üzere (p<0.001) olan ortalama uygulama puanlarında önemli bir düşüş eğilimi görülmüştür (Turkish) [ FROM AUTHOR] Copyright of Turkish Journal of Immunology is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Pandemic Fatigue in Nursing Undergraduates: Role of Individual Resilience and Coping Styles in Health Promotion

Introduction The COVID-19 pandemic was soon declared a global health threat and had significant economic and health implications. Unprecedented government measures brought massive shifts in teaching-learning pedagogy in nursing to curb the infection. The study was conducted to explore the predictors of pandemic fatigue among nursing undergraduates and mediating role of individual resilience and coping styles during the third wave in India. Methods This online survey included 256 undergraduate nursing students studying at Tertiary Care Teaching Hospital in North India. Lockdown/Pandemic Fatigue Questionnaire, Brief Resilience Scale, and Coping Behavior Questionnaire were used to collect the information. Appropriate descriptive and inferential statistics were applied to compute the results. Results Nursing undergraduates reported a moderate level of fatigue during the restrictions imposed at the time of the third wave. Students’ year of study (p = 0.001), tested positive during pandemic (p = 0.003), and post-COVID-19 hospitalization (p = 0.026) were found associated with higher fatigue status. Advanced age (p = 0.046) and higher personal resilience status (p < 0.001) were associated with lower fatigue levels. Resilience status (ß = − 4.311 p < 0.001) and second year of study (ß = 3.198, p = 0.015) were reported as independent predictors of pandemic fatigue in students. Conclusion Findings suggest that lockdown-related fatigue was common in nursing undergraduates. Considering negative consequences on mental health, routine psychosocial screening of the nursing students should be conducted. Recommending stress-relieving measures should be enforced to help nursing undergraduates to combat lockdown-induced exhaustion.

COVID-19-associated Mucormycosis: A clinico-epidemiological study.

BACKGROUND: There was an unprecedented increase in COVID-19-associated-Mucormycosis (CAM) cases during the second pandemic wave in India. METHODS: This observational study was done to know the epidemiological profile of CAM cases andincluded all patients admitted with mucormycosis between May 2021 and July 2021. RESULTS: Out of the enrolled 208 CAM cases (either SARS-CoV-2 RT-PCR or serology positive), 204, three and one had rhino-orbital-cerebral, pulmonary and gastrointestinal mucormycosis, respectively. 95.7 % of the patients had diabetes, out of which 42.3 % were recently diagnosed. Mean HbA1c was 10.16 ± 2.56 %. 82.5 % of the patients were unvaccinated. During their COVID-19 illness, 86.5 % were prescribed antibiotics, 84.6 % zinc preparations, 76.4 % ivermectin, and 64.9 % steroids, while only 39.5 % required oxygen therapy. The frequency of blood groups A, B, O and AB in our CAM patients was 29.5 %, 18.9 %, 38.9 % &12.6 %, respectively. At three months follow up, 60 (28.8 %) patients died, four (1.9 %) stopped antifungal treatment, and 144(69.23 %) were on antifungal treatment. 55 % (n = 33) of deaths occurred within 15 days of admission. Mortality was significantly associated with higher age, RT-PCR positive for SARS-CoV-2, raised serum creatinine and alkaline phosphatase during treatment. At 6 months follow-up, eight more patients died, three due to chronic kidney disease, four patients who had stopped treatment and one patient who was on a ventilator due to COVID-19 associated pneumonia and the rest 140(67.3 %) survived. CONCLUSION: Uncontrolled hyperglycemia, SARS-CoV-2 infection, rampant use of antibiotics, zinc supplementation and steroids were some of the risk factors for mucormycosis. Despite the overwhelming number of patients with an uncommon disease like mucormycosis, the six months mortality was much lower than expected.

Characterization of a broadly cross reactive tetravalent human monoclonal antibody, recognizing conformational epitopes in receptor binding domain of SARS-CoV-2.

We used human semi-synthetic phage antibody gene libraries to select anti-SARS-CoV-2 RBD scFv antibody fragment and subsequent characterization of this novel tetravalent monoclonal antibody targeting conformational epitopes in the receptor binding domain of SARS-CoV-2. Binding studies suggest that II62 tetravalent antibody cross-reacts with RBD protein of SARS-CoV2 and its different variants of concerns. The epitope mapping data reveals that II62 tetravalent antibody targets an epitope that does not directly interferes with RBD: ACE2 interaction. Neutralization studies with live authentic SARS-CoV2 virus suggests that increase in valency of II62 mAb from monovalent to tetravalent doesn't perturbate virus interactions with the ACE2 expressing host cells in cytopathic effect-based (CPE) assay. Supplementary Information: The online version contains supplementary material available at 10.1007/s13205-022-03272-6.