Convalescent Plasma for Critically-ill Covid-19 Patients (preprint)

Background and aim: Convalescent plasma (CP) was early and successfully used in management of covid-19 infection. This report aimed to document our experience with use of CP in two critically-ill covid-19 patients.Main findings: Patients presented with fever, dry cough and difficulty of breathing with reduced oxygen saturation, massive radiological lung involvement and deteriorated Sequential Organ Failure Assessment (SOFA) Score. Use of two sessions of CP resulted in marked improvement of radiological and/or pulmonary findings. Both patients died of septic shock or thromboembolic events.Conclusions Use of CP may be associated with radiological and clinical improvement in critically-ill patients. However, it’s not related to better survival if used in late stages of the disease.

Genomic epidemiology of SARS-CoV-2 in Sudan: A retrospective analysis 2020-2022 (preprint)

SARS-CoV-2 was first detected in Sudan on 13th March 2020. Here, we describe the genomic epidemiology of SARS-CoV-2 in Sudan between May 2020 and April 2022 to understand the introduction and transmission of SARS-CoV-2 variants in the country. A total of 667 SARS-CoV-2 positive samples were successfully sequenced using the nCoV-19 Artic protocol on the Oxford Nanopore Technology ([≥]70% genome completeness). The genomes were compared with a select contemporaneous global dataset to determine genetic relatedness and estimate import/export events. The genomes were classified into 37 Pango lineages within the ancestral strain (107 isolates across 13 Pango lineages), Eta variant of interest (VOI) (78 isolates in 1 lineage), Alpha variant of concern (VOC) (10 isolates in 2 lineages), Beta VOC (26 isolates in 1 lineage), Delta VOC (171 isolates across 8 lineages) and Omicron VOC (242 isolates across 12 lineages). We estimated a total of 144 introductions of the observed variants from different countries across the globe. Multiple introductions of the Eta VOI, Beta VOC and Omicron VOC were observed in Sudan mainly from Europe and Africa. These findings suggest a need for continuous genomic surveillance of SARS-CoV-2 to monitor their introduction and spread consequently inform public health measures to combat SARS-CoV-2 transmission.

Inflammation

Inflammation was described as early as 4000 BC in an Egyptian papyrus and is still a common problem despite continuous advancements in prevention and treatment methods. Over the years new strains of microorganisms causing infections appear such as the recently discovered new Covid-19 infection. The proper diagnosis and delineation of the site and extent of inflammation are crucial to the clinical management of infection and for monitoring the response to therapy. The strategy to reach diagnosis by imaging depends on understanding the pathophysiologic basis of different types of infection and the mechanisms of accumulation of the radiotracers for scintigraphic diagnosis. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2015, 2022.

Problematic use of the internet, smartphones, and social media among medical students and relationship with depression: An exploratory study.

BACKGROUND: Students in sub-Saharan African countries experienced online classes for the first time during the COVID-19 pandemic. For some individuals, greater online engagement can lead to online dependency, which can be associated with depression. The present study explored the association between problematic use of the internet, social media, and smartphones with depression symptoms among Ugandan medical students. METHODS: A pilot study was conducted among 269 medical students at a Ugandan public university. Using a survey, data were collected regarding socio-demographic factors, lifestyle, online use behaviors, smartphone addiction, social media addiction, and internet addiction. Hierarchical linear regression models were performed to explore the associations of different forms of online addiction with depression symptom severity. RESULTS: The findings indicated that 16.73% of the medical students had moderate to severe depression symptoms. The prevalence of being at risk of (i) smartphone addiction was 45.72%, (ii) social media addiction was 74.34%, and (iii) internet addiction use was 8.55%. Online use behaviors (e.g., average hours spent online, types of social media platforms used, the purpose for internet use) and online-related addictions (to smartphones, social media, and the internet) predicted approximately 8% and 10% of the severity of depression symptoms, respectively. However, over the past two weeks, life stressors had the highest predictability for depression (35.9%). The final model predicted a total of 51.9% variance for depression symptoms. In the final model, romantic relationship problems (ß = 2.30, S.E = 0.58; p<0.01) and academic performance problems (ß = 1.76, S.E = 0.60; p<0.01) over the past two weeks; and increased internet addiction severity (ß = 0.05, S.E = 0.02; p<0.01) was associated with significantly increased depression symptom severity, whereas Twitter use was associated with reduced depression symptom severity (ß = 1.88, S.E = 0.57; p<0.05). CONCLUSION: Despite life stressors being the largest predictor of depression symptom score severity, problematic online use also contributed significantly. Therefore, it is recommended that medical students' mental health care services consider digital wellbeing and its relationship with problematic online use as part of a more holistic depression prevention and resilience program.

25 (S)-Hydroxycholesterol acts as a possible dual enzymatic inhibitor of SARS-CoV-2 Mpro and RdRp-: an insight from molecular docking and dynamics simulation approaches.

The coronavirus disease (COVID-19) pandemic has rapidly extended globally and killed approximately 5.83 million people all over the world. But, to date, no effective therapeutic against the disease has been developed. The disease is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and enters the host cell through the spike glycoprotein (S protein) of the virus. Subsequently, RNA-dependent RNA polymerase (RdRp) and main protease (Mpro) of the virus mediate viral transcription and replication. Mechanistically inhibition of these proteins can hinder the transcription as well as replication of the virus. Recently oxysterols and its derivative, such as 25 (S)-hydroxycholesterol (25-HC) has shown antiviral activity against SARS-CoV-2. But the exact mechanisms and their impact on RdRp and Mpro have not been explored yet. Therefore, the study aimed to identify the inhibitory activity of 25-HC against the viral enzymes RdRp and Mpro simultaneously. Initially, a molecular docking simulation was carried out to evaluate the binding activity of the compound against the two proteins. The pharmacokinetics (PK) and toxicity parameters were analyzed to observe the 'drug-likeness' properties of the compound. Additionally, molecular dynamics (MD) simulation was performed to confirm the binding stability of the compound to the targeted protein. Furthermore, molecular mechanics generalized Born surface area (MM-GBSA) was used to predict the binding free energies of the compound to the targeted protein. Molecular docking simulation identified low glide energy -51.0 kcal/mol and -35.0 kcal/mol score against the RdRp and Mpro, respectively, where MD simulation found good binding stability of the compound to the targeted proteins. In addition, the MM/GBSA approach identified a good value of binding free energies (ΔG bind) of the compound to the targeted proteins. Therefore, the study concludes that the compound 25-HC could be developed as a treatment and/or prevention option for SARS-CoV-2 disease-related complications. Although, experimental validation is suggested for further evaluation of the work.Communicated by Ramaswamy H. Sarma.

COVID-19 Severity Shifts the Cytokine Milieu Toward a Proinflammatory State in Egyptian Patients: A Cross-Sectional Study.

Despite extensive research to decipher the immunological basis of coronavirus disease (COVID-19), limited evidence on immunological correlates of COVID-19 severity from MENA region and Egypt was reported. In a single-center cross-sectional study, we have analyzed 25 cytokines that are related to immunopathologic lung injury, cytokine storm, and coagulopathy in plasma samples from 78 hospitalized Egyptian COVID-19 patients in Tanta University Quarantine Hospital and 21 healthy control volunteers between April 2020 and September 2020. The enrolled patients were divided into 4 categories based on disease severity, namely mild, moderate, severe, and critically ill. Interestingly, interleukin (IL)-1-α, IL-2Rα, IL-6, IL-8, IL-18, tumor necrosis factor-alpha (TNF-α), FGF1, CCL2, and CXC10 levels were significantly altered in severe and/or critically ill patients. Moreover, principal component analysis (PCA) demonstrated that severe and critically ill COVID-19 patients cluster based on specific cytokine signatures that distinguish them from mild and moderate COVID-19 patients. Specifically, levels of IL-2Rα, IL-6, IL-10, IL-18, TNF-α, FGF1, and CXCL10 largely contribute to the observed differences between early and late stages of COVID-19 disease. Our PCA showed that the described immunological markers positively correlate with high D-dimer and C-reactive protein levels and inversely correlate with lymphocyte counts in severe and critically ill patients. These data suggest a disordered immune regulation, particularly in severe and critically ill Egyptian COVID-19 patients, manifested as overactivated innate immune and dysregulated T-helper1 responses. Additionally, our study emphasizes the importance of cytokine profiling to identify potentially predictive immunological signatures of COVID-19 disease severity.

Measuring the burden of SARS-CoV-2 infection among persons living with HIV and healthcare workers and its impact on service delivery in Mozambique: protocol of a prospective cohort study.

INTRODUCTION: As COVID-19 continues to spread globally and within Mozambique, its impact among immunosuppressed persons, specifically persons living with HIV (PLHIV), and on the health system is unknown in the country. The 'COVid and hIV' (COVIV) study aims to investigate: (1) the seroprevalence and seroincidence of SARS-CoV-2 among PLHIV and healthcare workers providing HIV services; (2) knowledge, attitudes, practices and perceptions regarding SARS-CoV-2 infection; (3) the pandemic's impact on HIV care continuum outcomes and (4) facility level compliance with national COVID-19 guidelines. METHODS AND ANALYSIS: A multimethod study will be conducted in a maximum of 11 health facilities across Mozambique, comprising four components: (1) a cohort study among PLHIV and healthcare workers providing HIV services to determine the seroprevalence and seroincidence of SARS-CoV-2, (2) a structured survey to assess knowledge, attitudes, perceptions and practices regarding COVID-19 disease, (3) analysis of aggregated patient data to evaluate retention in HIV services among PLHIV, (4) an assessment of facility implementation of infection prevention and control measures. ETHICS AND DISSEMINATION: Ethical approval was obtained from the National Health Bioethics Committee, and institutional review boards of implementing partners. Study findings will be discussed with local and national health authorities and key stakeholders and will be disseminated in clinical and scientific forums. TRIAL REGISTRATION NUMBER: NCT05022407.

Cognitively Enhanced Versions of Capuchin Search Algorithm for Feature Selection in Medical Diagnosis: a COVID-19 Case Study.

Feature selection (FS) is a crucial area of cognitive computation that demands further studies. It has recently received a lot of attention from researchers working in machine learning and data mining. It is broadly employed in many different applications. Many enhanced strategies have been created for FS methods in cognitive computation to boost the performance of the methods. The goal of this paper is to present three adaptive versions of the capuchin search algorithm (CSA) that each features a better search ability than the parent CSA. These versions are used to select optimal feature subset based on a binary version of each adapted one and the k-Nearest Neighbor (k-NN) classifier. These versions were matured by applying several strategies, including automated control of inertia weight, acceleration coefficients, and other computational factors, to ameliorate search potency and convergence speed of CSA. In the velocity model of CSA, some growth computational functions, known as exponential, power, and S-shaped functions, were adopted to evolve three versions of CSA, referred to as exponential CSA (ECSA), power CSA (PCSA), and S-shaped CSA (SCSA), respectively. The results of the proposed FS methods on 24 benchmark datasets with different dimensions from various repositories were compared with other k-NN based FS methods from the literature. The results revealed that the proposed methods significantly outperformed the performance of CSA and other well-established FS methods in several relevant criteria. In particular, among the 24 datasets considered, the proposed binary ECSA, which yielded the best overall results among all other proposed versions, is able to excel the others in 18 datasets in terms of classification accuracy, 13 datasets in terms of specificity, 10 datasets in terms of sensitivity, and 14 datasets in terms of fitness values. Simply put, the results on 15, 9, and 5 datasets out of the 24 datasets studied showed that the performance levels of the binary ECSA, PCSA, and SCSA are over 90% in respect of specificity, sensitivity, and accuracy measures, respectively. The thorough results via different comparisons divulge the efficiency of the proposed methods in widening the classification accuracy compared to other methods, ensuring the ability of the proposed methods in exploring the feature space and selecting the most useful features for classification studies.

The Worldwide Prevalence of Sleep Problems Among Medical Students by Problem, Country, and COVID-19 Status: a Systematic Review, Meta-analysis, and Meta-regression of 109 Studies Involving 59427 Participants.

Purpose of Review: Several studies have found that medical students have a significant prevalence of sleep issues, such as poor sleep quality, excessive daytime sleepiness, and inadequate sleep duration. The purpose of this review is to carefully evaluate the current research on sleep problems among medical students and, as a result, estimate the prevalence of these disturbances. The EMBASE, PsychINFO, PubMed/MEDLINE, ScienceDirect, Scopus, and Web of Science and retrieved article reference lists were rigorously searched and rated for quality. Random effects meta-analysis was performed to compute estimates. Recent Findings: The current meta-analysis revealed an alarming estimated pooled prevalence of poor sleep quality (K = 95, N = 54894) of 55.64% [95%CI 51.45%; 59.74%]. A total of 33.32% [95%CI 26.52%; 40.91%] of the students (K = 28, N = 10122) experienced excessive sleepiness during the day. The average sleep duration for medical students (K = 35, N = 18052) is only 6.5 h per night [95%CI 6.24; 6.64], which suggests that at least 30% of them get less sleep than the recommended 7-9 h per night. Summary: Sleep issues are common among medical students, making them a genuine problem. Future research should focus on prevention and intervention initiatives aimed at these groups. Supplementary Information: The online version contains supplementary material available at 10.1007/s40675-023-00258-5.

Deferoxamine in the management of COVID-19 adult patients admitted to ICU: a prospective observational cohort study.

COVID-19 infection is associated with high mortality, and despite extensive studying the scientific society is still working to find a definitive treatment. Some experts postulated a beneficial role of Deferoxamine. Aim: The aim of this study was to compare the outcomes of COVID-19 adult patients admitted to the ICU who received deferoxamine to those who received standard of care. Methods: Prospective observational cohort study, in the ICU of a tertiary referral hospital in Saudi Arabia to compare all-cause hospital mortality between COVID-19 patients who received deferoxamine and standard of care. Results: A total of 205 patients were enrolled, with an average age of 50.1±14.3, 150 patients received standard of care only, and 55 patients received deferoxamine additionally. Hospital mortality was lower in deferoxamine group (25.5 vs. 40.7%, 95% CI=1.3-29.2%; P=0.045). Clinical status score upon discharge was lower in deferoxamine group (3.6±4.3 vs. 6.2±4, 95% CI: 1.4-3.9; P<0.001), as was the difference between discharge score and admission score (indicating clinical improvement). More patients admitted with mechanical ventilation were successfully extubated in the deferoxamine group (61.5 vs. 14.3%, 95% CI: 15-73%; P=0.001), with a higher median ventilator-free days. There were no differences between groups in adverse events. Deferoxamine group was associated with hospital mortality [odds ratio=0.46 (95% CI: 0.22-0.95); P=0.04]. Conclusions: Deferoxamine may have mortality and clinical improvement benefits in COVID-19 adults admitted to ICU. Further powered and controlled studies are required.

Impact of viral co-infection on clinical outcomes and mortality of COVID-19 patients: a study from Saudi Arabia.

Background: In COVID-19 patients undetected co-infections may have severe clinical implications associated with prolonged hospitalization, ICU admission, and mortality. Therefore, we aimed to investigate the impact of viral coinfections on the outcomes of hospitalized patients with COVID-19 in a large tertiary Saudi Arabian Hospital. Methods: A total of 178 adult patients with confirmed SARS-CoV-2 who were hospitalized at the Armed Forces Hospital Southern Region (AFHSR), Saudi Arabia, from March 1st to June 30th 2022, were enrolled. Real-time PCR for the detection of viral co­infections was carried out. Cases (SARS-CoV-2 with viral coinfections) and control (SARS-CoV-2 mono-infection) groups were compared. Results: 12/178 (7%) of enrolled COVID-19 patients had viral coinfections. 82/178 (46%) of patients were males. 58% of patients had comorbidities. During the study period, 4/12 (33%) and 21/166 (13%) cases and control patients died, p=0.047, respectively. Duration of hospitalization was the only significant independent factor associated with SARS-CoV-2 coinfections, OR 1.140, 95% CI 1.020-1.274, p=0.021. Conclusions: The findings of this study from a large tertiary Saudi Arabian Center revealed a prevalence of 7% for SARS-CoV-2 viral coinfections. SARS-CoV-2 coinfected patients had a significantly prolonged duration of hospitalization and higher mortality than those with SARS-CoV-2 alone. Future studies are needed.

Assessment of concerns about vaccination among recovered COVID-19 patients in Saudi Arabia

Background: Vaccine hesitancy re-emerged as a critical public health issue during the COVID-19 pandemic. Aims: This study assessed the concerns of recovered COVID-19 patients about vaccination and the predictors of vaccine hesitancy. Methods: This was a cross-sectional study of 319 adult patients who recovered from COVID-19 in Saudi Arabia. It was conducted during 1 May to 1 October 2020 at King Abdulaziz Medical City, Riyadh. Each participant was interviewed 6–12 months post-recovery using the vaccination attitude examination scale. Data were collected on COVID-19 illness severity, sociodemographic characteristics, history of chronic disease, and post-COVID-19 vaccination. Level of vaccination concern was assessed based on the percentage mean score (PMS). Results: Most (85.3%) of the patients who recovered from COVID-19 expressed moderate overall concern (PMS = 68.96%) about vaccination. Concern was highest for mistrust in vaccine benefits (PMS = 90.28%), followed by natural immunity preference (PMS = 81.33%) and worries about the vaccine side-effects (PMS = 60.29%). Concern over commercial profiteering was low (PMS = 43.92%). The overall PMS for concern about vaccination was significantly higher among patients aged 45+ years (t = 3.12, P = 0.002) and among those who had experienced severe COVID-19 illness (t = 1.96, P = 0.05). Conclusion: Overall concern about vaccination was high, and specific concerns were prevalent. Patient education on how the vaccine protects against reinfection should be targeted at COVID-19 patients before being discharged from hospital.

Semantic segmentation of CT images for the detection of coronavirus lesions: the case of Algeria

Deep learning has acquired a central position in recent times in the medical field, in particular conditions that are delicate to diagnose by the croaker Coronavirus complaint 2019, given its recent appearance and its complexity. The majority of people with COVID- 19 have endured only mild or moderate symptoms and recovered without specific treatment. We propose in this work four purely deep learning infrastructures using classification and semantic segmentation algorithms for the vaticination of coronavirus complaint 2019 grounded on scanographic images from two Algerian medical institutes. After a dataset collection and preprocessing steps, we propose to apply a classic CNN as a point extractor and the XGBoost algorithm as a classifier, as a alternate armature we replace the classic CNN by the pretrained VGG16 as a point extractor. The third armature is grounded on segmentation using a U-Net armature and for the last one is grounded on the U-Net-VGG16 combination. The experimental results show that the combination of U-Net and VGG16 algorithms as a CT image segmentation model yielded better results with an IoU of 97%, a precision of 95%, and a loss of 30%. © 2023 IEEE.

The Impact of Vaccination on COVID-19 Pandemic in the Kurdistan Region of Iraq: A Mathematical Modelling

The spreading of COVID-19 became a global issue that had a significant impact on health, life, and economic sectors. Efforts from all over the world are focused on discussing a variety of healthcare approaches to reduce the effect of COVID-19 among individuals. Mathematical tools with numerical simulations are important approaches that help international efforts to determine critical transmission factors as well as controlling the virus spread. In this paper, we develop a mathematical model that considers a vaccination compartment in terms of ordinary differential equations. This study focuses on the real data of confirmed cases in Kurdistan Region of Iraq from July 17th, 2021 to January 1st, 2022. Model results and real data for the total number of infected people were compared using computational tools in MATLAB. Additionally, non-normalization, half-normalization, and full-normalization methods are used to determine the local sensitivities between model variables and parameters. Interestingly, computational results show that the dynamics of model results and real confirmed cases are very close to each other. Accordingly, the elasticity coefficients provide a great understanding of the impact of vaccination on transmissions. The model results here can also help international efforts for further suggestions and improvements to control this disease more effectively. © Palestine Polytechnic University-PPU 2023.

Assessment of concerns about vaccination among recovered COVID-19 patients in Saudi Arabia

Background: Vaccine hesitancy re-emerged as a critical public health issue during the COVID-19 pandemic. Aims: This study assessed the concerns of recovered COVID-19 patients about vaccination and the predictors of vaccine hesitancy. Methods: This was a cross-sectional study of 319 adult patients who recovered from COVID-19 in Saudi Arabia. It was conducted during 1 May to 1 October 2020 at King Abdulaziz Medical City, Riyadh. Each participant was interviewed 6–12 months post-recovery using the vaccination attitude examination scale. Data were collected on COVID-19 illness severity, sociodemographic characteristics, history of chronic disease, and post-COVID-19 vaccination. Level of vaccination concern was assessed based on the percentage mean score (PMS). Results: Most (85.3%) of the patients who recovered from COVID-19 expressed moderate overall concern (PMS = 68.96%) about vaccination. Concern was highest for mistrust in vaccine benefits (PMS = 90.28%), followed by natural immunity preference (PMS = 81.33%) and worries about the vaccine side-effects (PMS = 60.29%). Concern over commercial profiteering was low (PMS = 43.92%). The overall PMS for concern about vaccination was significantly higher among patients aged 45+ years (t = 3.12, P = 0.002) and among those who had experienced severe COVID-19 illness (t = 1.96, P = 0.05). Conclusion: Overall concern about vaccination was high, and specific concerns were prevalent. Patient education on how the vaccine protects against reinfection should be targeted at COVID-19 patients before being discharged from hospital.

The Negative Impact of the Succession of Crises and the Ineffectiveness of the E-learning System on Tertiary Education in Sudan from (2018) to Present

This study attempts to determine the social, economic, and psychological impacts of the 2018 temporary closure of educational institutions in Sudan amid several internal incidents and the ongoing closure due to the COVID-19 pandemic on students, teachers, and families. Most educational systems worldwide were temporarily closed and negatively affected. Nevertheless, it seemed as if the crises in Sudan extremely damaged the process of the overall educational system simply because the closure of the institutions initially began as a result of several internal incidents by the end of the academic year 2017-2018. The closure lasted until August 2019, when schools were reopened, and within almost six months;again, a decision was made in February 2020 for the entire closure of educational institutions due to the COVID-19 pandemic and continued for more than one and a half years. The impact of total closures of universities and colleges in Sudan affected students' academic achievement in different ways because the situations in Sudan were primarily different before the spread of COVID-19. Therefore, the negative implications of the long–term closure were greater not only on the students' academic achievement but also on the teachers' sources of income, which resulted in economic issues for many families. To undertake this study, both quantitative and qualitative research methodologies were used. The researchers designed and distributed a questionnaire to a sample of 39 Sudanese university teachers to examine their attitudes towards the impact of the several internal incidents behind the closure of the entire educational institutions on overall academic achievement and online education as an alternative to face-to-face or traditional teaching. Although very few universities launched e-learning units during the last two decades, it seemed as if their purposes were very limited and mainly designed to serve a few students under certain conditions. Additionally, the researchers observed the efficient application of the e-learning educational system during the COVID-19 pandemic, represented by the Blackboard platform at both Qassim University and Prince Sattam Bin Abdulaziz University. The data analysis resulted in some significant findings, among which are the following: First, students were regularly paying the price of the poor infrastructure that contributed to preventing the application of an effective e-learning system in Sudan. Second, the long–term closure throughout 2018 has resulted in the accumulation of several student batches and generally complicated the scene. Third, the long–term closure influenced university students in different ways: academically, socially, economically, and psychologically. © The Author(s) 2023.

Efficacy of Facemasks in Prevention of Covid- 19: A Systematic Review

Purpose of study The efficacy of facemasks in prevention of disease transmission is widely debated with a paucity of underlying evidence. In the face of COVID-19, officials began considering potential benefits of facemask use, such as preventing transmission to others or protecting health care workers interacting with infected individuals. However, the efficacy of facemasks in the context of COVID-19 is not well studied and its impact on transmission has not yet been fully elucidated. Methods used A systematic review was conducted in Pubmed, Web of Science, Embase and Cochrane library from database inception up until August 2020 to analyze the efficacy of facemasks, regardless of type, on the prevention of SARS-CoV-2 transmission in both healthcare and communal settings. Only English language articles were retrieved, and conference proceedings were omitted. Results were reported according to the Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) criteria. Summary of results Of the 2720 articles that were identified, 27 studies were included based on predetermined criteria. Of these, ten had complete data. Of 1200 subjects, 953 (79.4%) reported wearing masks while 246 (20.5%) did not. Of the 228 (19.0%) who received a positive COVID test, 73 (32.0%) wore masks and 155 (68.0%) did not. Health care settings comprised 829 subjects, 692 (83.5%) reported wearing masks while 136 (16.4%) did not, and 114 (13.8%) received a positive COVID test. Of these, 50 (43.9%) wore masks and 64 (56.1%) did not. In 371 subjects in non health care settings, 261 (70.4%) reported wearing masks while 110 (29.7%) did not. Of these, 114 (30.7%) received a positive COVID test, while 23 (20.2%) wore masks and 91 (79.8%) did not. Conclusions Wearing a facemask was associated with lower COVID-19 rates in both healthcare settings and non-healthcare settings. From the current data, it appears that a lower percentage of healthcare workers tested positive for COVID-19 compared to subjects in non-healthcare settings, regardless of mask usage. Study limitations include limited data regarding the types of mask worn, level of exposure risk, and other personal protective measures taken.

SAA-UNet: Spatial Attention and Attention Gate UNet for COVID-19 Pneumonia Segmentation from Computed Tomography.

The disaster of the COVID-19 pandemic has claimed numerous lives and wreaked havoc on the entire world due to its transmissible nature. One of the complications of COVID-19 is pneumonia. Different radiography methods, particularly computed tomography (CT), have shown outstanding performance in effectively diagnosing pneumonia. In this paper, we propose a spatial attention and attention gate UNet model (SAA-UNet) inspired by spatial attention UNet (SA-UNet) and attention UNet (Att-UNet) to deal with the problem of infection segmentation in the lungs. The proposed method was applied to the MedSeg, Radiopaedia 9P, combination of MedSeg and Radiopaedia 9P, and Zenodo 20P datasets. The proposed method showed good infection segmentation results (two classes: infection and background) with an average Dice similarity coefficient of 0.85, 0.94, 0.91, and 0.93 and a mean intersection over union (IOU) of 0.78, 0.90, 0.86, and 0.87, respectively, on the four datasets mentioned above. Moreover, it also performed well in multi-class segmentation with average Dice similarity coefficients of 0.693, 0.89, 0.87, and 0.93 and IOU scores of 0.68, 0.87, 0.78, and 0.89 on the four datasets, respectively. Classification accuracies of more than 97% were achieved for all four datasets. The F1-scores for the MedSeg, Radiopaedia P9, combination of MedSeg and Radiopaedia P9, and Zenodo 20P datasets were 0.865, 0.943, 0.917, and 0.926, respectively, for the binary classification. For multi-class classification, accuracies of more than 96% were achieved on all four datasets. The experimental results showed that the framework proposed can effectively and efficiently segment COVID-19 infection on CT images with different contrast and utilize this to aid in diagnosing and treating pneumonia caused by COVID-19.

Blood cancer in children infected with COVID-19: A comprehensive systematic review (preprint)

Background: Blood cancer is the most common type of cancer and the leading cause of death by disease past infancy among children. Children with blood cancer are vulnerable population to viral infections such as coronavirus disease 2019 (COVID-19). Objectives: To estimate the incidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in blood cancer children and analyse the demographic parameters, clinical characteristics and treatment outcomes in blood cancer children with COVID-19 illness. Methods: For this systematic review, we searched ProQuest, Medline, Embase, PubMed, CINAHL, Wiley online library, Scopus and Nature through the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guideline for studies on the development of COVID-19 in children with blood cancer, published from December 1, 2019 to April 30, 2023, with English language restriction. Results: Of the 3077 papers that were identified, 155 articles were included in the systematic review (83 case report, 54 cohort and 18 case-series studies). Studies involving 1289 blood cancer children with confirmed COVID-19 were analysed. Leukaemias (1141 cases) were the most frequent types of blood cancer observed in children who developed COVID-19, followed by non-Hodgkin’s lymphomas (59 cases), Hodgkin’s lymphomas (36 cases), Langerhans cell histiocytosis (7 cases), myelodysplastic syndrome (7 cases) and myeloid neoplasm (1 case). Among all 1289 blood cancer paediatric cases who transmitted SARS-CoV-2, some children were documented to be admitted to the intensive care unit (ICU) (n = 175, 13.6%), intubated and placed on mechanical ventilation (n = 111, 8.6%), suffered acute respiratory distress syndrome (n = 144, 11.2%) or died (n = 111, 8.6%). Overall, COVID-19 in children with different types of blood cancer resulted in no or low severity of disease in more than 78.6% of all included cases (COVID-19 severity: asymptomatic = 239, mild = 603, or moderate = 171). Treatment for COVID-19 was not necessary in a high number of blood cancer children (n = 94, 7.3%). Fatality in blood cancer children with COVID-19 was reported in any of the included blood cancer categories for leukaemias (n = 99, 8.7%), non-Hodgkin’s lymphomas (n = 7, 11.9%), Hodgkin’s lymphomas (n = 2, 5.5%), myelodysplastic syndrome (n = 1, 14.3%) or myeloid neoplasm (n = 1, 100%). Fatality rate in blood cancer children infected with SARS-CoV-2 was the highest in patients with Hispanic ethnicity (n = 44/111, 39.6%) and COVID-19–related fatality was highest in male patients (76.5% of deceased patients). Most studies reported to alter the intensity and regimen of anticancer treatment in blood cancer children during course of SARS-CoV-2 infection, however, many studies have reported to successfully treat COVID-19 without any changes to the anticancer treatment. Conclusion: Globally, leukaemias were the most prevalent and myeloid neoplasms were the least prevalent blood cancer types in children who developed SARS-CoV-2 infection. Children with blood cancer tend to have milder COVID-19 symptoms and are less likely to be hospitalized and have better prognosis when compared to adults. Continuation of anticancer treatment in individual paediatric blood cancer patients with COVID-19 seems to be possible.