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Background: Previous studies had demonstrated that patients with hematologic malignancies had suboptimal antibody response after receiving COVID-19 vaccines, especially among those having previously treated with anti- CD20 monoclonal antibodies. Method(s): Adult patients with non-Hodgkin's lymphoma or chronic lymphocytic leukemia (CLL) were enrolled before receiving the second dose of SARS-CoV-2 vaccine. Determinations of anti-SARS-CoV-2 spike and nucleocapsid IgG titers were performed every 1-3 months, after they received the second and the third dose of SARS-CoV-2 vaccine, respectively. Patients were excluded from analysis if they were diagnosed with COVID-19. All serum samples were tested for anti-nucleocapsid antibody and those tested positive were excluded from subsequent analyses. Result(s): A total of 85 participants were enrolled, including 42 (49.4%) with diffused large B-cell lymphoma, and 13 (15.3) with follicular lymphoma and 9 with CLL. 72 (84.7%) participants had received anti-CD20 monoclonal antibodies, with a median interval of 24 months between last anti-CD20 treatment and the second dose of vaccine, and 21 (24.7%) had HIV infection. Factors associated with failure to achieve an anti-spike IgG titer >141 BAU/ mL within 12 weeks after the second dose of vaccine included HIV infection (adjusted odds ratio [aOR], 0.14;95% CI, 0.04-0.51), active hematologic disease (aOR, 5.50;95% CI 1.42-21.32), receipt of anti-CD20 monoclonal antibodies (aOR, 6.65;95% CI 1.52-29.07), and receipt of two doses of homologous mRNA vaccination (aOR, 0.17;95% CI 0.05-0.56). In the participants having previously treated with anti-CD20 regimen, only 8.6% achieved an antibody response ( >141 BAU/mL) in the first year, while 78.3% achieved anti-spike IgG titer > 141 BAU/mL after two years post B-cell depleting treatment. After the third dose of SARS-CoV-2 vaccine, 53.6% achieved an antispike IgG titer > 141 BAU/mL in the first year post anti-CD20 treatment. Conclusion(s): Our study demonstrated that previous treatment with anti-CD20 monoclonal antibodies was associated a lower antibody response among patients with lymphoproliferative disorders receiving two doses of SARS-CoV-2 vaccine. While two doses of SARS-CoV-2 vaccines might not be sufficient even one year apart from the last dose of rituximab, a third dose of vaccine may boost anti-spike IgG particularly in the subset of recent exposure to rituximab. Anti-spike IgG determined 1-3 months after the second (A) / third (B) dose of COVID-19 vaccine, stratified by the interval between last anti-CD20 regimen and the second / third dose of COVID-19 vaccine. (Figure Presented).
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Introduction: Diabetes is an independent predictor of poor outcomes in patients with COVID-19. We compared the effects of the preadmission use of antidiabetic medications on the in-hospital mortality of patients with COVID-19 having type 2 diabetes. Methods: A systematic search was performed until November 30, 2021. We used a random-effects meta-analysis to calculate the pooled OR (95% CI). Results: We included 61 studies (3,061,584 individuals). We found some medications protective against COVID-related death, including metformin, GLP-1RA and SGLT-2i. DPP-4i and insulin users were more likely to die during hospitalization. SU, TZD, and AGI were mortality neutral. Metformin use was associated with better outcome in a dose-response manner. Conclusions: Metformin, GLP-1RA, and SGLT-2i were associated with lower mortality rate in patients with COVID-19 having type 2 diabetes. DPP-4i and insulin were linked to increased mortality. SU, TZD and AGI were mortality neutral.Presentation: No date and time listed
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Lung diseases are among the most deadly infectious diseases worldwide. Covid-19 infection is a current disease that falls within this category and has impacted public health in countries across the globe. Accordingly, this study focuses on building a lung disease identification system using a state-of-the-art deep cascade learning classification model, EfficientNet-Vision Transformer. The proposed Real ESRGAN is utilized to enhance the input of EfficientNet, while image Relative Position Encoding (iRPE) is added to improve the attention of the transformer network. Moreover, weight balancing is applied to stabilize the performance of the proposed system. When trained on the X-Ray dataset, our model achieved 93.757% accuracy on five classes of lung disease: Normal, Covid-19, Viral Pneumonia, Bacterial Pneumonia, and Tuberculosis. © 2022 IEEE.
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The ongoing COVID-19 pandemic has wreaked havoc on social and economic systems worldwide. The variance in the rapidly increasing number of illnesses and deaths in each country is primarily due to national policies and actions. As a result, governments and institutions need to get insights into the critical factors influencing COVID-19 future case counts to properly manage the adverse effects of pandemics and promptly prepare appropriate measures. Thus, in this paper, we conduct extensive experiments on the real-world covid-19 datasets to examine the important factors influencing in the pandemic growth. In particular, we perform an exploratory data analysis to get the statistic and characteristics of multivariate time-series data on pandemic dynamic. Also, we utilize a statistical measure such as Pearson correlation to compute the relations of the past on the future daily new cases. The experimental results demonstrate that some restrictions have a positive effect on daily new confirmed cases at the early stage of the local pandemic transmission. Also, the results show that the early trend of COVID-19 can be explained well by human mobility in various categories. Thus, our proposed framework can be served as a guideline for future pandemic prevention and control decision-making. © 2022 IEEE.
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Background: Geriatric patients with COVID-19 have had poor clinical outcomes globally, especially during the first wave of the pandemic. In Taiwan, the first wave of the COVID-19 pandemic occurred from May to July 2021. This retrospective study aimed to compare the characteristics and outcomes between geriatric and younger patients with COVID-19 infection. Methods: A total of 257 confirmed COVID-19 cases who were hospitalized from May to June 2021 were included. Their characteristics and outcomes, including in-hospital mortality, use of mechanical ventilation, and hospital stay, were collected for analysis. Results: There were 98 elderly patients (aged >= 65 years, median, 72.5 (interquartile range, 69.0-78.0) years) and 159 younger patients (aged < 65 years, median 55.0 (46.0-60.0) years). The elderly patients had a significantly higher Charlson comorbidity score (4.0 (3.0-5.0) vs. 1.0 (1.0-2.0), p < 0.001), and significantly higher D-dimer, procalcitonin, ferritin, and creatinine levels, but lower albumin level than the younger patients. The elderly group also had higher in-hospital mortality (7.1% vs. 1.9%, p < 0.05), were more likely to develop severe disease (83.7% vs. 67.9%, p < 0.01), and had a longer hospital stay (15.0 (11.0-23.0) vs. 12.0 (9.0-16.5) days, p < 0.001). Nevertheless, the elderly patients did not have a higher risk of using high-flow nasal cannulas (17.3% vs. 15.1%, p = 0.63) or mechanic ventilation (23.5% vs. 17.0%, p = 0.20). Conclusion: Elderly COVID-19 patients had significant higher risks of severe disease, mortality, and lon-ger duration of hospitalization, possible due higher rates of comorbidities and pro-inflammatory status. Copyright (c) 2022, Taiwan Society of Geriatric Emergency & Critical Care Medicine.
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Background: To evaluate the feasibility, baseline characteristics, and satisfaction of patients receiving telemedicine care during the coronavirus 2019 (COVID-19) pandemic in Taiwan. Methods: We retrospectively analyzed patients during the COVID-19 pandemic between May 2021 and December 2021 in a tertiary medical center in northern Taiwan. Information on the distribution of physician divisions, patients' clinical characteristics, and patterns of prescription use in telemedicine care was analyzed. Data were extracted from both the ordinary outpatient department (OPD) and nursing home systems. Results: A total of 6587 patients (55.8% female, mean age: 57.3 +/- 25.8 years) included in our telemedicine care conducted during the pandemic COVID-19 epidemic. Those who were older, female, and patients of Internal Medicine and Family Medicine utilized telemedicine more frequently than ordinary OPD, with a high refill prescription rate (82.6%) and low mail-back prescription use (35.9%). Patients of Family Medicine comprised the majority (40.3%) of nursing home telemedicine, with lower refill pre-scription use (37.3%). Overall satisfaction was high regarding telemedicine care, physicians profession-alism, and medical problem solving (98.3% and 97.7%, respectively). Conclusion: Older age, female sex, and potentially more health conditions were associated with higher willingness to access telemedicine. We identified medical divisional and disease-based differences in prescription patterns. Copyright (c) 2022, Taiwan Society of Geriatric Emergency & Critical Care Medicine.
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Background: Coronavirus disease 2019 (COVID-19) can cause acute respiratory failure and acute respiratory distress syndrome (ARDS). The prone position (PP) is widely used in patients with severe hypoxemia due to ARDS as it improves oxygenation. The aim of this study was to investigate whether improvements in gas exchange and lung mechanics with the PP were associated with survival in ventilated COVID-19 patients. Methods: Fourteen ventilated patients who were placed in the PP were included from May to June 2021. Clinical manifestations and lung mechanics parameters were collected. Results: The overall intensive care unit (ICU) mortality rate was 42.9%. Nonsurvivors were older (p = 0.014) and had higher Charlson comorbidity index (2.1 +/- 1.5 vs. 4.8 +/- 2.4, p = 0.035) and Sepsis-related Organ Failure Assessment (SOFA) (3.3 +/- 1.0 vs. 7.3 +/- 3.5, p = 0.019) scores compared to survivors. There was no difference in PaO2/FiO(2) (P/F ratio) at baseline between the survivors and nonsurvivors. The improvement in P/F ratio (p = 0.0037) and reduction in driving pressure (Pdrive) (p = 0.046) on the second day after first PP were correlated with lower mortality. Significant predictors of successfully stopping prone treatment included a reduction in Pdrive at the first hour, lower tidal volume (Vt) at the fourth hour, and P/F ratio improvement on the second day after PP. Conclusion: Improvement in P/F ratio and reduction in driving pressure on the second day after PP were correlated with reduced mortality. Three parameters could predict successful resumption of the supine position. Copyright (c) 2022, Taiwan Society of Geriatric Emergency & Critical Care Medicine.
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Face mask detection and recognition have been incorporated into many applications in daily life, especially during the current COVID-19 pandemic. To mitigate the spread of coronavirus, wearing face masks has become commonplace. However, traditional face detection and recognition systems utilize main facial features such as the mouth, nose, and eyes to determine a person’s identity. Masks make facial detection and recognition tasks more challenging since certain parts of the face are concealed. Yet, how to improve the performance of existing systems with a face mask overlaid on the original face input images remains an open area of inquiry. In this study, we propose an improved face mask-aware recognition system named ‘MAR’ based on deep learning, which can tackle challenges in face mask detection and recognition. MAR consists of five main modules to handle various kinds of input images. We re-train the CenterNet model with our augmented face mask inputs to perform face mask detection and propose four variations on face mask recognition models based on the pre-trained ArcFace to handle facial recognition. Finally, we demonstrate the effectiveness of our proposed models on the VGGFACE2 dataset and achieve a high accuracy score on both detection and recognition tasks. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
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On analyzing the results of cell-based assays, we have previously shown that perilla (Perilla frutescens) leaf extract (PLE), a food supplement and orally deliverable traditional Chinese medicine approved by the Taiwan Food and Drug Administration, effectively inhibits SARS-CoV-2 by directly targeting virions. PLE was also found to modulate virus-induced cytokine expression levels. In this study, we explored the anti-SARS-CoV-2 activity of PLE in a hamster model by examining viral loads and virus-induced immunopathology in lung tissues. Experimental animals were intranasally challenged with different SARS-CoV-2 doses. Jugular blood samples and lung tissue specimens were obtained in the acute disease stage (3-4 post-infection days). As expected, SARS-CoV-2 induced lung inflammation and hemorrhagic effusions in the alveoli and perivascular areas;additionally, it increased the expression of several immune markers of lung injury - including lung Ki67-positive cells, Iba-1-positive macrophages, and myeloperoxidase-positive neutrophils. Virus-induced lung alterations were significantly attenuated by orally administered PLE. In addition, pretreatment of hamsters with PLE significantly reduced viral loads and immune marker expression. A purified active fraction of PLE was found to confer higher antiviral protection. Notably, PLE prevented SARS-CoV-2-induced increase in serum markers of liver and kidney function as well as the decrease in serum high-density lipoprotein and total cholesterol levels in a dose-dependent fashion. Differently from lung pathology, monitoring of serum biomarkers in Syrian hamsters may allow a more humane assessment of the novel drugs with potential anti-SARS-CoV-2 activity. Our results expand prior research by confirming that PLE may exert an in vivo therapeutic activity against SARS-CoV-2 by attenuating viral loads and lung tissue inflammation, which may pave the way for future clinical applications.
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We aimed to discuss several selected topics related to problematic Internet use (PIU), including fear of missing out, nomophobia, cyberchondria, cyberbullying, and certain health conditions (e.g. autism-spectrum disorder and schizophrenia) among youth. We also aimed to review some recent evidence examining PIU during COVID-19. The review was conducted using keywords relevant to the selected topics and searching in the PubMed database and Google Scholar. The results of this review indicate that PIU could be associated with health issues in a minority of the youth population. Moreover, the COVID-19 pandemic may lead to PIU and subsequent health problems. Information from this review could help healthcare providers to design individualized and appropriate interventions to tackle health issues related to PIU among youth.
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The novel coronavirus disease 2019 (COVID-19) pandemic is a threat to global public health. The disease is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and characterized by high transmission, high mortality, lack of effective treatment, and prolonged hospitalization. Currently, there is no clear management strategy for COVID-19 infection. Some clinical evidence suggests that the use of inhaled ciclesonide and enoxaparin subcutaneous injection maybe helpful for disease treatment. In this article, we report the successful treatment of a 65-year-old male with COVID-19 pneumonia with Inhaled corticosteroid and enoxaparin subcutaneously, which also shortened the course of the disease without significant complications. Copyright (C) 2022, Taiwan Society of Geriatric Emergency & Critical Care Medicine.
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Background: Children are a vulnerable population in terms of the impact of COVID-19 on their psychological well-being. When restricted to their homes, children are susceptible to problematic Internet gaming (PG). Primary school boys are particularly at risk of PG, which may lead to negative psychological effects, such as distress. Emerging research has identified perceived weight stigma (PWS) as a variable closely associated with both PG and psychological distress, particularly during the COVID-19 pandemic. The purpose of this study was to evaluate the trajectory of psychological distress among this vulnerable population from a longitudinal perspective, evaluating the role of PG and PWS. Methods: Self-report measures were used to assess psychological distress, PG, and PWS among primary school boys (grades 4 to grade 6; N = 283). Data were collected across three waves: before the pandemic, during school closure, and following the lifting of restrictions. Results: The trajectory of psychological distress among primary school boys was concave, indicating their mental health was negatively impacted during home restriction but recovered after the lockdown ended (linear change = 0.98, p < 0.01; quadratic change = -0.19, p < 0.01). PG was a significant covariate in terms of the trajectory of psychological distress (b = 0.02, p < 0.01). Moreover, baseline values for PWS were shown to have a negative direct effect on mental health before the pandemic (b = 0.05, p < 0.01), and moderated the time factor for boys' psychological distress over time (b of PWS × linear change = 0.04, p = 0.006; b of PWS × Quadratic change was negative at -0.01, p = 0.002). Conclusions: Although mental health gradually improved as home restrictions subsided, future studies are required to address changes in mental health upon return to school for students reporting higher levels of weight stigma.
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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a highly infectious disease that emerged in December of 2019, threatening human health and leading to global public health crises. Airborne transmission via droplets and aerosol has been recently recognized as one of the infection modes for the SARS-CoV-2 virus. Hospitals have deployed/incorporated indoor air purifiers with the hope to minimize the transmission risk of SARS-CoV-2 virus. Nevertheless, the effectiveness of the indoor air purifier in reducing the transmission risk remained unknown. This study uses computational fluid dynamics to model the dispersion of the aerosol particles exhaled from the patient under the influence of an air conditioner, exhaust fans and air purifier. The numerical model showed that airflow from the diffusers, exhaust fans and placement of the air purifier significantly influenced the dispersion pattern of the aerosol particles in the common ward. Multiple air purifiers placed at 1 meter above the floor and next to a patient can increase the total efficiency from 37.14 to 59.91% for weak exhalation and from 36.44% to 48.81% for medium exhalation. No aerosol particles flew out from the door for weak and medium exhalation when multiple air purifiers were deployed in the common ward. Location and matching the clean air delivery rate with the size of the room are the important factors that affect the performance of the air purifier. © The Author(s).
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Background The effectiveness of vaccination campaigns in the midst of a pandemic depends on both the vaccine's effectiveness and the general population's willingness to be vaccinated. To estimate the proportion of the general population willing to get COVID-19 vaccination and to identify factors, ie, the number of COVID-19 cases and deaths, and WHO Regions contributing to the willingness rate, we conducted a systematic review and meta-analysis compliant with PRISMA 2020 guidelines. Methods A search of the existing relevant literature was conducted by means of Cochrane Library, Medline, Embase, Registers, and other sources in order to identify studies published between November 2019 and April 2021. A total of 19 studies from 11 countries that satisfied the inclusion criteria (ie, studies exclusively on the general population, and participants aged 16 years and above) were retrieved. Data extraction and quality assessment were conducted. Heterogeneity was quantified using the I2 statistic, and publication bias was assessed using funnel plots and the Egger's test. A meta-analysis and a meta-regression analysis were conducted using STATA 16.1 software. Results The pooled rate of willingness to receive a COVID-19 vaccine among the general population was calculated to be 60.1% (95% confidence interval (CI) = 51.5, 68.4). Meta-analyses showed, on the one hand, that the highest pooled willingness to get vaccinated was 73% (95% CI = 62.3, 84.1) in the studies of countries with 1000-4000 COVID-19 cases per million population and, on the other, that the same measure was 71% (95% CI = 53.2, 89.1) in countries reporting >400 COVID-19 deaths per million population. The acceptance rates also varied in different WHO regions of the world. The meta-regression analysis showed that a COVID-19 death rate of >400 per million population or higher was significantly associated (P = 0.02) with the willingness rate. Conclusions The overall willingness among the general global population to get a COVID-19 vaccine is moderately high;however, the existence of hesitancy might be a major obstacle to the global efforts to control the current pandemic. Understanding the critical factors influencing the acceptance of pandemic vaccines may help health authorities to manage emerging public health threats better.
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Introduction: Enhanced personal protective equipment (PPE) can expose health care workers (HCWs) to high heat stress and dehydration. The objective of this study was to assess the risk of acute kidney injury (AKI) among HCWs during the pandemic. Material and Methods: We recruited 52 HCWs worked on the mobile COVID-19 screening bus in the summer of 2021. We measured the body water content, pulse, core body temperature, blood pressure, creatinine, and urinary analysis before and after the work shift. We obtained the amount of water intake, environmental and personal measurements of temperature, humidity, and heat stress index during the work shift. Physicians interviewed the study subjects to confirm their medical history. Paired sample t-tests were used to test the pre and post-measurements. Results and Conclusions: After excluding 18 subjects who did not wear PPE in the pilot study, 34 HCWs were used in the analyses (male: 11.8%;female: 88.2 %). Most of them were nurses, with a mean age of 30.53 years old (SD 6.82). After a work shift, 14.7% of the subjects had incident AKI (1.5 times reference value or increase≧0.3 mg/dl). Core body temperature increased 0.27 degree (95% confidence interval [CI]: 0.16 to 0.38), creatinine level increased 0.161 mg/dl (95% CI: 0.11 to 0.22, p<0.001). The estimated glomerular filtration rate (eGFR) showed a significant decline in renal function (-16.82 ml/min/1.73m2, 95% CI: -22.47 to -11.17, p<0.001). There was a protective effect of hydration (p= 0.09). In conclusion, wearing enhanced PPE can cause kidney injuries. There is an urgent need to develop regulations to prevent AKI among HCWs.
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Background and Objective: Improving the health literacy in the different populations regarding COVID-19 may be useful in the control of its prevalence. This study examined the psychometric properties of a newly developed disease-specific measure of health literacy related to COVID-19 to be used as a standard measure. Materials and Methods: Relevant literature was reviewed to identify an item pool, and an expert panel was convened to choose items that might be included in the scale. Content validity ratio (CVR) and content validity index (CVI) was determined and face validity was examined by calculating the impact score in a group of social media users. The factor structure of the initial scale was examined in 590 Iranian individuals participating in online social networks in September 2020. Internal consistency of the scale was assessed by Cronbach’s alpha and test-retest reliability of responses was measured by Pearson correlation coefficients. Results: A five-factor solution for the 51-items scale was obtained through exploratory factor analysis. The five main dimensions were understanding, communication, information seeking, analysis, and behavior. The dimensions explained 47% of the variance in scale scores. Participants whose scores fell in the high category (27%) were significantly different compared to those whose scores fell in the low category (27%) on all dimensions (p<0.001). The CVR values for all items were greater than 0.85 and all items also got CVI values higher than 0.79 based on nine-person expert panel. The Cronbach’s alpha for the overall scale was 0.89, and it was ranged from 0.71 to 0.90. Test-retest reliability for the scale was high (r=0.89). Conclusion: Health Literacy Scale for protect against COVID-19is a valid and reliable measure for Iranian population. This measure should be translated, and administered, in other settings to replicate the results obtained here. © 2022, Mashhad University of Medical Sciences. All rights reserved.
Subject(s)
COVID-19 , Encephalitis , Status Epilepticus , COVID-19 Vaccines , Electroencephalography , Humans , SARS-CoV-2 , Status Epilepticus/etiologyABSTRACT
We train an artificial neural network (ANN) model to recognize the pattern of the financial market and use this model to detect whether and when the market pattern has changed. Over 2000–2021, we find that the market has experienced five significant changes. The timings of these changes coincide with critical historical events (e.g. Great Recession and COVID-19) and changes in the monetary policy regime. © 2021 Elsevier Inc.