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Background: Coronavirus disease 2019 (COVID-19) is an emerging respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARSCoV- 2). Recent studies have suggested numerous hypotheses that may explain multi-organ dysfunction during a COVID-19 infection. One possible hypothesis posits that the renin-angiotensin system dysregulation before SARS-CoV-2 infection could exacerbate disease symptoms and severity, especially in COVID-19 patients with underlying comorbidities. Objective: This study sought to investigate the effect of exogenous angiotensin II (Ang II) on peripheral blood mononuclear cells (PBMCs) stimulated with SARSCoV- 2 peptide pool. Methods: PBMCs from recovered COVID-19 patients (n = 18) were used in this study. SARS-CoV-2 specific t-cell responses were measured using activation induced cell marker assay and intracellular cytokine staining (ICS) assay, while enzyme-linked immunosorbent assay (ELISA) and ICS assays determined functional capability and polarization. Additionally, the relative level of protein phosphorylation in PBMCs was measured using a phosphokinase array. Results: Our results showed that in vitro Ang II treatment significantly increased the magnitude of SARS-CoV-2 specific t-cell response in stimulated PBMCs with SARS-CoV-2 peptide pool. Moreover, the phosphorylation level of numerous proteins implicated in cardiovascular diseases, inflammation, and viral infection showed significant increase in the presence of Ang II. Mitogenic stimulation of PBMCs after Ang II and SARS-CoV-2 peptide pool stimulation showed functional polarization of CD4+ and CD8+ t-cells toward Th1/Th17 and Th17 phenotypes, respectively. Meanwhile, ELISA showed an increased production of IL-1b and IL-6 in Ang II-stimulated PBMCs without affecting the reduction of IL-10 level resulting from SARS-CoV-2 peptide pool stimulation. Conclusion: To our knowledge, the present study is the first to demonstrate that Ang II exaggerates SARS-CoV-2 specific t-cells response. Therefore, during COVID-19 infection Ang II may aggravate the inflammatory response and change the immune response toward a more inflammatory profile against SARS-CoV-2 infection, leading to serious complications and worse outcomes during COVID-19 infection.
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Background: Acute respiratory distress syndrome (ARDS) is a distinctive feature of severe COVID-19 infections that occurs mainly in patients with coexisting health problems, such as hypertension, atherosclerosis, and diabetes. Endothelial dysfunction is a major contributing factor during ARDS development in COVID- 19 patients with pre-existing comorbidities. Objective: Studying the mechanism by which endothelial activation and dysfunction could provide a therapeutic target for COVID-19 treatment. Design and method: The current study measured endothelial dysfunction and oxidative stress by incubating human umbilical vein endothelial cells (HUVECs) with plasma from patients with mild, moderate, severe and extremely severe COVID- 19. Using flow cytometry, wound-healing assays and phosphokinase arrays, Results: We detected increases in cell apoptosis;reactive oxygen species (ROS) formation;hypoxia-inducible factor-1 alpha (HIF-1 alpha), vascular cell adhesion molecule-1 (VCAM-1), and vascular endothelial growth factor receptor-1 (VEGFR-1) expression;viral entry;and inflammatory-related protein activity. We also found an impairment in the wound-healing process. Moreover, we found that AT1R blockade and P38 MAPK inhibition reversed all of these effects, especially in the severe group. Conclusions: These findings indicate that AT1R/P38 MAPK-mediated oxidative stress and endothelial dysfunction occur during COVID-19 infection.
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Background During and after the coronavirus disease 2019 (COVID-19) pandemic, there was a significant increase in the demand for aesthetic procedures nationwide. We believe that one of the factors contributing to this increase was the use of video conferencing apps. Therefore, the purpose of this study was to analyze the aesthetic concerns that were identified by video conferencing. Methodology In Saudi Arabia, an observational, cross-sectional study was conducted from February to April, 2022. An online survey was used to assess the aesthetic concerns raised by video conferencing. The survey addressed multiple aspects, including demographic data, information on video call utilization, the attentional focus of the participants during video calls, and new appearance concerns identified on video calls. Results The survey successfully captured 432 adult participants. More than 85% of participants disliked at least one character of their appearance during video conferencing. The skin color type (based on the Fitzpatrick scale), time spent on video calls, and visual focus during the virtual meeting were significantly correlated with self-perception of new disliked features. Conclusion Video conferencing showed a significant statistical correlation with identified disliked facial/body features in both genders. People with skin color type III were less likely to perceive a disliked feature through video conferencing applications. The likelihood of having a disliked feature was significantly higher among individuals who spent up to one hour per day using video calls. Additionally, those who mainly paid attention to their face or body during virtual meetings were more likely to have disliked features.
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Health-care professionals play an essential role in fighting the Covid-19 pandemic. Currently, most of the collected Covid-19 specimens are collected manually by health care workers and by using sterile cotton swab. The close contact between the health workers and the patients put them at high risk of being infected. One of approaches toward protecting the health workers, is to reduce the direct contact between the health care workers and the Covid-19 patients through deploying robots. In this study, a robotic system for Covid-19 swab sampling is designed and built. The robotic system consists of a 3 DOF arm, 2 DOF end effector with force sensor, and head holder. The robot is controlled remotely and from a safe distance. The preliminary experimental tests show that the robot is able to position the swab tip at the opening of the nasal cavity with the orientation and location that makes the swab insertion parallel to the palate. A force sensor is integrated in the end effector design to measure the normal contact force between the swab tip and the interior of the nasal cavity. The experimental results show that the normal contact force was successfully controlled and maintained within the acceptable force range, between 0.35N and 0.68N, as reported in literature. Maintaining the contact force within such range is essential in protecting the interior tissue of the nasal cavity from any injury © 2021 IEEE.
ABSTRACT
Introduction: The COVID-19 pandemic has disrupted routine cancer care and training globally. Breast units adopted modified national guidelines in the UK, and significant changes were implemented to ensure the safety of patients and staff. The national breast screening services were temporarily suspended from March 2020. Patients underwent surgery in COVID-19 free zones. Complex oncoplastic procedures and immediate reconstructions were not offered. Adjuvant treatments were modified to reduce the risk of complications and hospital readmission. The objective of our study is to assess the impact of COVID-19 on breast cancer management and surgical training. Methods: The resource reallocation was implemented for 100 days, commencing from the 16th of March,2020. Patients diagnosed with breast cancer during this period were identified from the cancer database, and a comparison was made with patients diagnosed last year within the same time frame. We assessed the time taken from the decision to treatment and modifications made to cancer management due to the pandemic. The impact on resident training was evaluated by comparing the number of cases performed or assisted during this period. Results: During the pandemic period, out of 1064 patients seen in the Breast one-stop clinic, 64 patients (6.0%) were diagnosed with breast cancer. During the same time frame in 2019, out of 1881 new symptomatic patients, 90 (4.8%) were diagnosed with cancer. In 2019, sixty-three patients were treated for screen-detected cancer, whereas only 23 patients entered the screening pathway before the services were suspended. Majority of patients underwent surgery in 2019 as compared to 2020 (80% versus 36%). Fifty-six percent of patients received endocrine treatmentas primary or bridging therapy;whereas, in 2019, only 12% received primary endocrine therapy. In 2020, time fromdecision to surgical treatment has decreased by half as compared to 2019 (8.6 versus 19.1 days). One patient whounderwent surgery developed COVID-19 infection after two weeks, and no postoperative mortality was reported. Onaverage, each trainee was involved in 35 procedures during 2020;whereas in 2019, 54 procedures were assisted orperformed by a trainee. Conclusion: Our study shows that COVID-19 has made a significant impact on patients'management and surgical training. Majority of the patients were commenced on neoadjuvant endocrine therapyinstead of surgery. The conversion rate to cancers in one-stop clinic improved possibly due to a smaller number of benign referrals during the pandemic. The impact on surgical training is due to the reduction in the number of patients operated during this period, and constraints of performing complex oncoplastic procedures and breastreconstruction.