Typical and atypical chest computed tomography manifestations in COVID-19 patients

Background High-resolution computed tomography (CT) is the most reliable sensitive noninvasive imaging procedure recommended in the diagnosis, assessment, the severity, and follow-up of coronavirus disease 2019 (COVID-19).It has a qualitative and quantitative role. The COVID-19 Reporting and Data System evaluates the probability of COVID-19 pulmonary involvement, and the corresponding CT severity score, which evaluates the approximate percentage of each of the five lobes' involvement. Research question We aimed to illustrate chest CT typical and atypical manifestations in COVID-19 patients regarding their age, sex, patients' symptoms, and CT severity score. Study design and methods We conducted a cross-sectional study on 120 patients more than or equal to 18 years with confirmed COVID-19 infection (PCR positive) during the period from April 2021 to October 2021, who were admitted to Ain Shams University Isolation Hospitals, where all patients' clinical data and CT chest imaging for these patients will be collected.Copyright © 2023 Wolters Kluwer Medknow Publications. All rights reserved.

Bioactive metabolites of Streptomyces misakiensis display broad-spectrum antimicrobial activity against multidrug-resistant bacteria and fungi.

Background: Antimicrobial resistance is a serious threat to public health globally. It is a slower-moving pandemic than COVID-19, so we are fast running out of treatment options. Purpose: Thus, this study was designed to search for an alternative biomaterial with broad-spectrum activity for the treatment of multidrug-resistant (MDR) bacterial and fungal pathogen-related infections. Methods: We isolated Streptomyces species from soil samples and identified the most active strains with antimicrobial activity. The culture filtrates of active species were purified, and the bioactive metabolite extracts were identified by thin-layer chromatography (TLC), preparative high-performance liquid chromatography (HPLC), nuclear magnetic resonance (NMR) spectroscopy, and gas chromatography-mass spectrometry (GC-MS). The minimum inhibitory concentrations (MICs) of the bioactive metabolites against MDR bacteria and fungi were determined using the broth microdilution method. Results: Preliminary screening revealed that Streptomyces misakiensis and S. coeruleorubidus exhibited antimicrobial potential. The MIC50 and MIC90 of S. misakiensis antibacterial bioactive metabolite (ursolic acid methyl ester) and antifungal metabolite (tetradecamethylcycloheptasiloxane) against all tested bacteria and fungi were 0.5 µg/ml and 1 µg/mL, respectively, versus S. coeruleorubidus metabolites: thiocarbamic acid, N,N-dimethyl, S-1,3-diphenyl-2-butenyl ester against bacteria (MIC50: 2 µg/ml and MIC90: 4 µg/mL) and fungi (MIC50: 4 µg/ml and MIC90: 8 µg/mL). Ursolic acid methyl ester was active against ciprofloxacin-resistant strains of Streptococcus pyogenes, S. agalactiae, Escherichia coli, Klebsiella pneumoniae, and Salmonella enterica serovars, colistin-resistant Aeromonas hydrophila and K. pneumoniae, and vancomycin-resistant Staphylococcus aureus. Tetradecamethylcycloheptasiloxane was active against azole- and amphotericin B-resistant Candida albicans, Cryptococcus neoformans, C. gattii, Aspergillus flavus, A. niger, and A. fumigatus. Ursolic acid methyl ester was applied in vivo for treating S. aureus septicemia and K. pneumoniae pneumonia models in mice. In the septicemia model, the ursolic acid methyl ester-treated group had a significant 4.00 and 3.98 log CFU/g decrease (P < 0.05) in liver and spleen tissue compared to the infected, untreated control group. Lung tissue in the pneumonia model showed a 2.20 log CFU/g significant decrease in the ursolic acid methyl ester-treated group in comparison to the control group. The haematological and biochemical markers in the ursolic acid methyl ester-treated group did not change in a statistically significant way. Moreover, no abnormalities were found in the histopathology of the liver, kidneys, lungs, and spleen of ursolic acid methyl ester-treated mice in comparison with the control group. Conclusion: S. misakiensis metabolite extracts are broad-spectrum antimicrobial biomaterials that can be further investigated for the potential against MDR pathogen infections. Hence, it opens up new horizons for exploring alternative drugs for current and reemerging diseases.

Self-adaptive moth flame optimizer combined with crossover operator and Fibonacci search strategy for COVID-19 CT image segmentation.

The COVID-19 is one of the most significant obstacles that humanity is now facing. The use of computed tomography (CT) images is one method that can be utilized to recognize COVID-19 in early stage. In this study, an upgraded variant of Moth flame optimization algorithm (Es-MFO) is presented by considering a nonlinear self-adaptive parameter and a mathematical principle based on the Fibonacci approach method to achieve a higher level of accuracy in the classification of COVID-19 CT images. The proposed Es-MFO algorithm is evaluated using nineteen different basic benchmark functions, thirty and fifty dimensional IEEE CEC'2017 test functions, and compared the proficiency with a variety of other fundamental optimization techniques as well as MFO variants. Moreover, the suggested Es-MFO algorithm's robustness and durability has been evaluated with tests including the Friedman rank test and the Wilcoxon rank test, as well as a convergence analysis and a diversity analysis. Furthermore, the proposed Es-MFO algorithm resolves three CEC2020 engineering design problems to examine the problem-solving ability of the proposed method. The proposed Es-MFO algorithm is then used to solve the COVID-19 CT image segmentation problem using multi-level thresholding with the help of Otsu's method. Comparison results of the suggested Es-MFO with basic and MFO variants proved the superiority of the newly developed algorithm.

"I Can't Breathe:” The Invisible Slow Violence of Breathing Politics in Minneapolis

Following the death of George Floyd in Minneapolis, his utterance, "I can't breathe,” reverberated internationally as the world population grappled with the twin specters of life-threatening COVID-19 respiratory morbidities and mounting years under increasingly polarized racist regimes. Despite crisis fatigue, national and international outpourings of solidarity trended on social and mainstream media. However, in this moment, the legacy of structural and slow violences against the living, breathing Minneapolis–St. Paul communities of color were obscured. This article addresses transdisciplinary breathing politics in this mid-sized American city to integrate atmospheric indicators (concentrations of criteria pollutants including particulate matter and gaseous pollutants), traffic indicators (Minnesota Department of Transportation permanent traffic monitoring station data), and social indicators (community responses in newspaper and Twitter archives), ultimately making visible how Floyd's utterance reflects much deeper patterns of stratified urban public health risks and socio-environmental airscape politics. Bullet Points of Findings Breathing politics are racialized in Minneapolis, demonstrating stark differences in traffic and air quality across neighborhoods. Through content analysis, it is shown that social media platforms like Twitter can be rich historical records for tracking local public discourse, providing valuable insight to the ways people talk about and conceive topics like environmental justice, breathing politics, and urban equity. While hashtag activism on social media flourished in 2020 to address anti-Black racism, it was neither a "tipping point” nor did it show a discernible impact on the nature of environmental justice discourse about breathing politics, despite the steep rise of #ICantBreathe. Integrating social, economic, and environmental indicators has the overarching benefit of addressing complex, lived systems. Breathing politics are racialized in Minneapolis, demonstrating stark differences in traffic and air quality across neighborhoods.Through content analysis, it is shown that social media platforms like Twitter can be rich historical records for tracking local public discourse, providing valuable insight to the ways people talk about and conceive topics like environmental justice, breathing politics, and urban equity.While hashtag activism on social media flourished in 2020 to address anti-Black racism, it was neither a "tipping point” nor did it show a discernible impact on the nature of environmental justice discourse about breathing politics, despite the steep rise of #ICantBreathe.Integrating social, economic, and environmental indicators has the overarching benefit of addressing complex, lived systems. [ FROM AUTHOR] Copyright of Society & Natural Resources is the property of Taylor & Francis Ltd 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.)

Rapid culture-independent loop-mediated isothermal amplification detection of antimicrobial resistance markers from environmental water samples.

Environmental water is considered one of the main vehicles for the transmission of antimicrobial resistance (AMR), posing an increasing threat to humans and animals health. Continuous efforts are being made to eliminate AMR; however, the detection of AMR pathogens from water samples often requires at least one culture step, which is time-consuming and can limit sensitivity. In this study, we employed comparative genomics to identify the prevalence of AMR genes within among: Escherichia coli, Klebsiella, Salmonella enterica and Acinetobacter, using publicly available genomes. The mcr-1, blaKPC (KPC-1 to KPC-4 alleles), blaOXA-48, blaOXA-23 and blaVIM (VIM-1 and VIM-2 alleles) genes are of great medical and veterinary significance, thus were selected as targets for the development of isothermal loop-mediated amplification (LAMP) detection assays. We also developed a rapid and sensitive sample preparation method for an integrated culture-independent LAMP-based detection from water samples. The developed assays successfully detected the five AMR gene markers from pond water within 1 h and were 100% sensitive and specific with a detection limit of 0.0625 µg/mL and 10 cfu/mL for genomic DNA and spiked bacterial cells, respectively. The integrated detection can be easily implemented in resource-limited areas to enhance One Health AMR surveillances and improve diagnostics.

Hesperidin hexosomal loaded nanodispersion: insights of its antimycobacterial, cytotoxic and anti-HCoV effects.

Fruits of Citrus sinensis L. Osbeck var. Valencia contain hesperidin as a major flavanone glycoside. Hesperidin (H) was isolated from the peels of Valencia orange and formulated as hexosomal nanodispersions (F1) adopting the hot emulsification method. The antimycobacterial activity(anti-TB) was evaluated through a microplate Alamar blue (MABA) assay where F1 showed significant activity with MIC = 0.19 µM. To unravel the potential mechanism of the anti-TB, a molecular docking study of H using the Mycobacterial Dihydrofolate reductase (Mtb. DHFR) enzyme was performed. Hesperidin exhibited significant interactions with Mtb. DHFR active site. Sulforhodamine B assay was applied to evaluate cytotoxic activity against the lung cancer cell line (A-549). F1 showed a cytotoxic effect at IC50= 33 µM. It also has potent antiviral activity against Human Coronavirus 229E with IC50= 258.8 µM utilising crystal violet assay. Peels of Valencia orange could be a source of bioactive metabolites to control significant diseases.

Repurposing 1,2,4-oxadiazoles as SARS-CoV-2 PLpro inhibitors and investigation of their possible viral entry blockade potential

Although vaccines are obviously mitigating the COVID-19 pandemic diffusion, efficient complementary antiviral agents are urgently needed to combat the SARS-CoV-2. The viral papain-like protease (PLpro) is a promising therapeutic target being one of only two essential proteases crucial for viral replication. Nevertheless, it dysregulates the host immune sensing response. Here we report repositioning of the privileged 1,2,4-oxadiazole scaffold as promising SARS-CoV-2 PLpro inhibitor with potential viral entry inhibition profile. The design strategy relied on mimicking the general structural features of the lead benzamide PLpro inhibitor GRL0617 with isosteric replacement of its pharmacophoric amide backbone1,2,4-oxadiazole core. Inspired by the multitarget antiviral agents, the substitution pattern was rationalized to tune the scaffold's potency against other additional viral targets, especially the spike receptor binding domain (RBD) that is responsible for the viral invasion. The Adopted facial synthetic protocol allowed easy access to various rationally substituted derivatives. Among evaluated series, the 2-[5-(pyridin-4-yl)-1,2,4-oxadiazol-3-yl]aniline (5) displayed the most balanced dual inhibitory potential against SARS-CoV-2 PLpro (IC50=7.197 μM) and spike protein RBD (IC50 = 8.673 μM), with acceptable ligand efficiency metrics, practical LogP (3.8) and safety profile on Wi-38 (CC50 = 51.78 μM) and LT-A549 (CC50 = 45.77 μM) lung cells. Docking simulations declared the possible structural determinants of activities and enriched the SAR data for further optimization studies. Graphical Image 1

Bioactive Azadirachta indica and Melia azedarach leaves extracts with anti-SARS-CoV-2 and antibacterial activities.

The leaves of Azadirachta indica L. and Melia azedarach L., belonging to Meliaceae family, have been shown to have medicinal benefits and are extensively employed in traditional folk medicine. Herein, HPLC analysis of the ethyl acetate fraction of the total methanolic extract emphasized the enrichment of both A. indica L., and M. azedarach L. leaves extracts with phenolic and flavonoids composites, respectively. Besides, 4 limonoids and 2 flavonoids were isolated using column chromatography. By assessing the in vitro antiviral activities of both total leaves extracts against Severe Acute Respiratory Syndrome Corona virus 2 (SARS-CoV-2), it was found that A. indica L. and M. azedarach L. have robust anti-SARS-CoV-2 activities at low half-maximal inhibitory concentrations (IC50) of 8.451 and 6.922 µg/mL, respectively. Due to the high safety of A. indica L. and M. azedarach L. extracts with half-maximal cytotoxic concentrations (CC50) of 446.2 and 351.4 µg/ml, respectively, both displayed extraordinary selectivity indices (SI>50). A. indica L. and M. azedarach L. leaves extracts could induce antibacterial activities against both Gram-negative and positive bacterial strains. The minimal inhibitory concentrations of A. indica L. and M. azedarach L. leaves extracts varied from 25 to 100 mg/mL within 30 min contact time towards the tested bacteria. Our findings confirm the broad-spectrum medicinal value of A. indica L. and M. azedarach L. leaves extracts. Finally, additional in vivo investigations are highly recommended to confirm the anti-COVID-19 and antimicrobial activities of both plant extracts.

Repurposing 1,2,4-oxadiazoles as SARS-CoV-2 PLpro inhibitors and investigation of their possible viral entry blockade potential.

Although vaccines are obviously mitigating the COVID-19 pandemic diffusion, efficient complementary antiviral agents are urgently needed to combat SARS-CoV-2. The viral papain-like protease (PLpro) is a promising therapeutic target being one of only two essential proteases crucial for viral replication. Nevertheless, it dysregulates the host immune sensing response. Here we report repositioning of the privileged 1,2,4-oxadiazole scaffold as promising SARS-CoV-2 PLpro inhibitor with potential viral entry inhibition profile. The design strategy relied on mimicking the general structural features of the lead benzamide PLpro inhibitor GRL0617 with isosteric replacement of its pharmacophoric amide backbone by 1,2,4-oxadiazole core. Inspired by the multitarget antiviral agents, the substitution pattern was rationalized to tune the scaffold's potency against other additional viral targets, especially the spike receptor binding domain (RBD) that is responsible for the viral invasion. The Adopted facial synthetic protocol allowed easy access to various rationally substituted derivatives. Among the evaluated series, the 2-[5-(pyridin-4-yl)-1,2,4-oxadiazol-3-yl]aniline (5) displayed the most balanced dual inhibitory potential against SARS-CoV-2 PLpro (IC50=7.197 µM) and spike protein RBD (IC50 = 8.673 µM), with acceptable ligand efficiency metrics, practical LogP (3.8) and safety profile on Wi-38 (CC50 = 51.78 µM) and LT-A549 (CC50 = 45.77 µM) lung cells. Docking simulations declared the possible structural determinants of activities and enriched the SAR data for further optimization studies.

Delayed seropositivity is associated with lower levels of SARS-CoV-2 antibody levels in patients with mild to moderate COVID-19.

BACKGROUND: Patients with COVID-19 can develop a range of immune responses, including variations in the onset and magnitude of antibody formation. The aim of this study was to investigate whether SARS-CoV-2 antibody levels vary in patients with mild to moderate COVID-19 in relation to the onset (days) of their post-symptom seropositivity and to explore host factors that may affect antibody production METHODS: This was a prospective, multiple measurements study involving 92 PCR-confirmed patients with mild to moderate COVID-19. Antibody testing for anti-nucleocapsid (anti-NP) and spike proteins (anti-S) was performed using ELISA tests. Serum samples were collected over a period of 55 days from symptom onset of COVID-19 infection, and repeated as necessary until they turned positive. RESULTS: No significant differences were found between the positivity rates of anti-S or anti-NP regarding any clinical symptom (p > 0.05). The majority of patients who tested positive for anti-NP and anti-S showed early seropositivity (within 15 days of symptom onset) (75.9% for anti-NP and 82.6% for anti-S). Younger patients, those without chronic diseases, and non-healthcare workers had the highest percentage of seroconversion after day 35 post-symptom onset (p = 0.002, 0.028, and 0.036, respectively), while older patients and those with chronic diseases had earlier seropositivity and higher anti-NP levels (p = 0.003 and 0.06, respectively). Significantly higher anti-S ratios were found among older (p = 0.004), male (p = 0.015), and anemic patients (p = 0.02). A significant correlation was found between both antibodies (p = 0.001). At the end of the study, the cumulative seroconversion rate for both antibodies was almost 99%. CONCLUSIONS: Some COVID-19 patients may exhibit delayed and weak immune responses, while elderly, anemic patients and those with chronic diseases may show earlier and higher antibody responses.

Stress among health care providers in NICU department, tertiary pediatric care hospital during COVID-19 pandemic in Egypt.

Background: Many of the pediatric health care workers (HCWs) suffered from sleep disturbance, anxiety, and potential stress disorder during the COVID-19 pandemic. Work-related stress is a potential cause of concern in HCWs and is associated with decreased job satisfaction, anxiety, depression, medical errors, and near misses. This study aims to investigate the various psychological consequences on medical personnel working in the neonatal intensive care unit (NICU) in the context of the COVID-19 pandemic. Design and methods: A cross-sectional analytical study was conducted on a convenient sample of doctors and nurses working in NICU in pediatric hospitals at Cairo University teaching hospitals, Egypt. Two anonymous self-administered validated questionnaires were used to assess the level of stress, and the COVID-19 Rapid Quantitative Assessment Tool to assess the knowledge, attitude, and perception about COVID-19. Results: Among 96 participants, 66.7% were nurses, and 33.3% were physicians, 79.2% of the participants showed a reasonably safe level of stress. The mean work stress score was 43.89 ± 5.77. The mean score for commonly experienced stress symptoms was 7.53 ± 4.54, median 7, IQR (4, 10). Females and physicians were found to be with a statistically significantly higher median score of commonly experienced stress symptoms than males (p-value < 0.001 and 0.028 simultaneously). Conclusion: While such descriptive research provides valuable information on the scope of the problem, a strong theoretical framework is required to interpret these findings appropriately and develop preventive and therapeutic strategies. Particular attention should be warranted to the mental health well-being of women treating patients with COVID-19.

Prevalence and influencing factors of self-medication during the COVID-19 pandemic in the Arab region: a multinational cross-sectional study.

BACKGROUND: The novel coronavirus pandemic (COVID-19) has begun with a wave of misinformation and fear of infection. This may have led people to self-medicate inappropriately. The World Health Organization describes self-medication (SM) as utilizing medicines to relieve symptoms or health conditions without consulting a physician. Inappropriate drug use is a burden on both health resources and patient health in the Arab region. This study aimed to detect the prevalence and influencing factors of self-medication among the general Arab population during the COVID-19 pandemic. METHODS: A multinational cross-sectional study was conducted among the general population of ten Arab countries from early August to late October 2021. Participants aged 18 years or older could join the study via social media platforms. A convenience sampling technique was used. A developed and validated web-based questionnaire was used to collect data on self-medication practice, associated influencing factors, information sources, commonly used medications, and commonly treated conditions. Descriptive, univariate, and multivariate regression analyses were applied using IBM SPSS v 26 and R v 4.0.0 software. RESULTS: A total of 8163 participants completed the questionnaire, and 518 participants were excluded from the analysis due to inconsistencies in their data. Almost two-thirds (62.7%) of participants reported practicing self-medication during the COVID-19 pandemic. At the country level, Egypt had the highest prevalence of self-medication practice (72.1%), while Palestine had the lowest prevalence (40.4%). The most commonly used drugs were analgesics, antipyretics, and vitamins (86, 65.1, and 57.1%, respectively), while antitussives and antibiotics scored 47.6 and 43.3%, respectively. Experience with similar health conditions (74.6%) and urgency of the problem (47.2%) were the most frequent factors that led to self-medication. Additionally, 38.2% of the self-medicated participants (SMPs) used drugs as prophylaxis against COVID-19. Pharmacist consultation was the most common source of information about self-medication (66.7%). Multivariate analysis showed that predictors of self-medication were older age (p = 0.008), presence of chronic illness (p = 0.015), and having monthly income or medical insurance that does not cover the treatment cost (p = 0.001, p < 0.001, respectively). CONCLUSION: Self-medication is considered a common practice across the Arab population. It is necessary to regulate policies and raise awareness among the public about self-medication.

Stress among health care providers in NICU department, tertiary pediatric care hospital during COVID-19 pandemic in Egypt

Background: Many of the pediatric health care workers (HCWs) suffered from sleep disturbance, anxiety, and potential stress disorder during the COVID-19 pandemic. Work-related stress is a potential cause of concern in HCWs and is associated with decreased job satisfaction, anxiety, depression, medical errors, and near misses. This study aims to investigate the various psychological consequences on medical personnel working in the neonatal intensive care unit (NICU) in the context of the COVID-19 pandemic. Design and methods: A cross-sectional analytical study was conducted on a convenient sample of doctors and nurses working in NICU in pediatric hospitals at Cairo University teaching hospitals, Egypt. Two anonymous self-administered validated questionnaires were used to assess the level of stress, and the COVID-19 Rapid Quantitative Assessment Tool to assess the knowledge, attitude, and perception about COVID-19. Results: Among 96 participants, 66.7% were nurses, and 33.3% were physicians, 79.2% of the participants showed a reasonably safe level of stress. The mean work stress score was 43.89 ± 5.77. The mean score for commonly experienced stress symptoms was 7.53 ± 4.54, median 7, IQR (4, 10). Females and physicians were found to be with a statistically significantly higher median score of commonly experienced stress symptoms than males (p-value < 0.001 and 0.028 simultaneously). Conclusion: While such descriptive research provides valuable information on the scope of the problem, a strong theoretical framework is required to interpret these findings appropriately and develop preventive and therapeutic strategies. Particular attention should be warranted to the mental health well-being of women treating patients with COVID-19.

Asymptomatic versus symptomatic SARS-CoV-2 infection: a cross-sectional seroprevalence study.

BACKGROUND: Although symptomatic SARS-CoV-2 infection predisposes patients to develop complications, the asymptomatic SARS-CoV-2 infection state is of public health importance being a hidden source of infection. Moreover, the asymptomatic state may camouflage the actual burden of the disease. METHODS: Data of 1434 seropositive participants for SARS-CoV-2 spike (anti-S) and/or nucleocapsid antibodies (anti-N) were retrieved from a larger cross-sectional survey on COVID-19. Relevant data were retrieved from records including socio-demographic, medical, and behavioral characteristics of seropositive participants as well as history of COVID-19 symptoms during the last 6 months. Symptomatic/asymptomatic SARS-CoV-2 infection was categorized based on the history of the presence or absence of COVID-19 symptoms. RESULTS: The rate of asymptomatic SARS-CoV-2 infection was 34.9%. There was a statistically significant difference between symptomatic and asymptomatic participants regarding age, residence, medical conditions, habits, and infection control measures. The number of symptoms was positively correlated with anti-S titer and both were positively correlated with adult body mass index. Slum areas residence, client-facing occupation or being a healthcare worker, having lung disease, having blood group type A, never practicing exercise or social distancing, never using soap for hand washing, and minimal engagement in online working/studying were independent factors associated with the symptomatic state. Patients having less than three symptoms were less likely to be diagnosed by any means. CONCLUSIONS: One-third of SARS-CoV-2 infections in our study were asymptomatic. This mandates applying proper measures to prevent transmission even from apparently healthy individuals. Modifiable factors associated with symptomatic infection should be controlled to reduce the risk of COVID-19 complications.

Major royal jelly proteins elicited suppression of SARS-CoV-2 entry and replication with halting lung injury.

For reasons of high transmissibility and virulence, Alpha (UK, B.1.1.7) and Beta (South African, B.1.351) SARS-CoV-2 variants are classified with other types as variants of concern. Here we report on the influence of royal jelly (RJ) protein fraction (PF)50 (major RJ protein 2 and its isoform X1) on the entry of these variants into the ACE2-human embryonic kidney (HEK) 293 cells using the lentiviral system. The efficiency of PF50 on SARS-CoV-2 replication (RNA-dependent RNA polymerase "RdRp" activity), as well as its impact on bleomycin-induced lung injury in vitro, were also assessed. The PF50 efficiently inhibited infection of kidney cells with the UK and S. African variant spikes of pseudotyped lentivirus particles (IC50 = 7.25 µM and 16.92 µM, respectively) and suppressed the RdRp activity (IC50 = 29.93 µM). Moreover, PF50 displayed protective and therapeutic efficacy against lung injury due to its antioxidant, anti-inflammatory, and angiotensin II blocking activities. The current findings, taken together, offer a novel perspective on PF50 as a promising agent against COVID-19.

Violence against healthcare workers during coronavirus (COVID-19) pandemic in Egypt: a cross-sectional study.

Background: Healthcare workers are on the front lines of COVID-19 and are subject to risks. A rise in the cases of violence and aggressiveness against HCWs has been observed worldwide, adding to the already existing burnout. The purpose of this research is to determine the prevalence of workplace violence, its risk variables, and the pattern of violence directed towards healthcare workers in the context of COVID-19 pandemic. The research used a cross-sectional analytic design. Purposive sampling was utilized to identify research participants using an online survey. Form's link was distributed to accessible social media groups such as Facebook and WhatsApp from July 2020 to the end of October 2020. A self-administered structured survey was adapted from the World Health Organization survey questionnaire about violence in healthcare settings. The Google Form's link was distributed to the social media groups until the total sample of 405 was collected. Results: During the COVID-19 pandemic, workplace violence against Egyptian healthcare workers was prevalent (63.2%). The most prevailing type of violence among the exposed participants was verbal violence (87.9%). Violence is more common in the (< 40 years old) age group (80.9% of exposed healthcare workers). Violence was more statistically significant against females (60.5% of the exposed healthcare workers) (p-value = 0.023). Regarding the work specialty, violence was more committed against physicians (84.3% of exposed healthcare workers) than nurses (12.8% of exposed healthcare workers). The primary perpetrators of violence were the patient's family (74.6%). The majority of the exposed HCWs (96%) reported no physical injury from the violent event, and 71.5% deemed the violent incident preventable. The majority (90.6%) of HCWs exposed to violent incidents declared non-reporting. Conclusions: Effective risk communication at all levels of society is critical for reducing fear, stigma, and ultimately workplace violence, as recent assaults on healthcare institutions demonstrate. To reduce violence and safeguard the safety of the medical profession, the government, health policymakers, media organizations, and community engagement groups must collaborate for healthcare workers' safety.

Cognitive impairment in health care workers recovering from COVID-19 infection: a cross-sectional comparative study

Background The COVID-19 outbreak has infected people all over the world where many clinics are being constructed to diagnose and treat lingering symptoms or long COVID. Neurological and long-term cognitive consequences are very worrisome. Many of COVID-19’s neurological symptoms are likely the result of the body’s extensive immunological response to infection rather than the virus attacking the brain or nervous system directly. At the same time, the extent and type of COVID-19’s cognitive consequences are unknown. The goal of this study was to assess the cognitive functions of healthcare workers 2 weeks to 3 months after COVID-19 infection. Ninety-two healthcare workers participated in the study;32 were post-COVID-19 cases, and 60 were healthy people (the comparison group). The cognitive functions of the participants were assessed using the Addenbrooke’s Cognitive Examination (ACE-III) test, which evaluated attention, memory, language, and visuospatial skills, as well as the Arabic version of the Patient Health Questionnaire Anxiety GAD-7 and Depression Assessments PHQ-9. Results The study revealed that there was a highly significant direct correlation between post-infection with COVID-19 and scores of both anxiety and depression and an inverse correlation in the case of attention and memory. On the other hand, there is no statistical effect of post-COVID-19 on verbal fluency, language scores, and visio-spatial abilities. Using multiple linear regression, there was a powerful significant decrease effect of post-COVID-19 on memory scores controlling both anxiety and depression degrees (Beta = − 0.745, P < 0.001). Also, there was a strong negative correlation post-COVID-19 on attention scores controlling both anxiety and depression degrees (Beta = − 0.745, P < 0.001). Conclusions The study showed a strong negative effect of post-COVID-19 on the attention and memory of patients. Furthermore, both anxiety and depression scores increased significantly among the post-COVID-19 patients.

Violence against healthcare workers during coronavirus (COVID-19) pandemic in Egypt: a cross-sectional study

Background Healthcare workers are on the front lines of COVID-19 and are subject to risks. A rise in the cases of violence and aggressiveness against HCWs has been observed worldwide, adding to the already existing burnout. The purpose of this research is to determine the prevalence of workplace violence, its risk variables, and the pattern of violence directed towards healthcare workers in the context of COVID-19 pandemic. The research used a cross-sectional analytic design. Purposive sampling was utilized to identify research participants using an online survey. Form’s link was distributed to accessible social media groups such as Facebook and WhatsApp from July 2020 to the end of October 2020. A self-administered structured survey was adapted from the World Health Organization survey questionnaire about violence in healthcare settings. The Google Form’s link was distributed to the social media groups until the total sample of 405 was collected. Results During the COVID-19 pandemic, workplace violence against Egyptian healthcare workers was prevalent (63.2%). The most prevailing type of violence among the exposed participants was verbal violence (87.9%). Violence is more common in the (< 40 years old) age group (80.9% of exposed healthcare workers). Violence was more statistically significant against females (60.5% of the exposed healthcare workers) (p-value = 0.023). Regarding the work specialty, violence was more committed against physicians (84.3% of exposed healthcare workers) than nurses (12.8% of exposed healthcare workers). The primary perpetrators of violence were the patient’s family (74.6%). The majority of the exposed HCWs (96%) reported no physical injury from the violent event, and 71.5% deemed the violent incident preventable. The majority (90.6%) of HCWs exposed to violent incidents declared non-reporting. Conclusions Effective risk communication at all levels of society is critical for reducing fear, stigma, and ultimately workplace violence, as recent assaults on healthcare institutions demonstrate. To reduce violence and safeguard the safety of the medical profession, the government, health policymakers, media organizations, and community engagement groups must collaborate for healthcare workers’ safety.

Prognostic Significance of Platelet Activation Marker CD62P in Hospitalized Covid-19 Patients.

BACKGROUND: CD62P is a surface marker for platelet activation. Platelet dysfunction contributes to disproportionate intravascular microthrombosis in SARS-CoV-2. We aimed to assess the clinical significance of CD62P as a biomarker of platelet activation and its correlation to the clinical severity and outcome of COVID-19 infections. METHODS: The study included 80 COVID-19 patients and, in addition, there were 20 age and gender-matched healthy controls. Laboratory measurements included CBC, serum ferritin, LDH, CRP, D-dimer and flow cytometric assessments of the platelet markers CD42b and CD62P. The primary study outcome was patients' survival at the end of study. RESULTS: Among the studied patients, 24 patients (30.0%) died by the end of the study. Survivors had significantly lower CD62P values when compared with non-survivors [median (IQR): 75.5 (73.0 - 91.0) versus 96.0 (93.5 - 97.8), p < 0.001]. Patients with severe disease had significantly higher levels of CD62P levels [median (IQR): 95.5 (92.0 - 97.8) versus 75.0 (72.0 - 76.8), p < 0.001]. Logistic regression analysis identified D-dimer levels [OR (95% CI): 0.14 (0.03 - 0.74) and CD62P levels: OR (95% CI): 0.4 (0.17 - 0.94)] as significant predictors of mortality in multivariate analysis. CONCLUSIONS: CD62P expression on admission may be a useful prognostic maker in hospitalized Covid-19 patients. Its expression is related to other markers of inflammation and coagulopathy.

Influence of Manual Diaphragm Release Technique Combined with Inspiratory Muscle Training on Selected Persistent Symptoms in Men with Post-Covid-19 Syndrome: A Randomized Controlled Trial.

OBJECTIVE: To determine whether the addition of manual diaphragm release to an inspiratory muscle training programme is more  effective than inspiratory muscle training alone in reducing blood pressure, dyspnoea, fatigue, and aerobic performance capacity in men with post-COVID-19 syndrome. DESIGN: A prospective, randomized-controlled trial. SETTING: Chest Disease Department, Outpatient Clinic, Cairo University, Egypt. PARTICIPANTS: Fifty-two men with post-COVID-19 syndrome were allocated randomly to the study and control groups. INTERVENTION: The study group underwent diaphragm release plus inspiratory muscle training, whereas the control group received inspiratory muscle training only. OUTCOME MEASURES: All patients were assessed with the following measures at baseline and 6 weeks postintervention: maximum static inspiratory pressure for inspiratory muscle strength, peripheral arterial blood pressure, Modified Medical Research Council scale for dyspnoea, Fatigue Severity Scale, serum lactate level, and 6-min walk test distance for aerobic performance. RESULTS: All outcome measures showed a significant improvement in favour of the study group (p < 0.001) over the control group. However, maximum static inspiratory pressure increased significantly, by 48.17% (p < 0.001) in the study group with no significant change in the control group. CONCLUSION: Addition of manual diaphragm release to an inspiratory muscle training programme potentiates the role of inspiratory muscle training in the management of men with symptomatic post-COVID-19 syndrome.