Prevalence and difference of COVID-19 symptoms, post-COVID conditions and duration of illness among the vaccinated and unvaccinated population: a cross-sectional study in Peshawar.

Studies on coronavirus disease 2019 (COVID-19) symptoms, post-coronavirus disease (COVID) conditions, and vaccination outcomes in Pakistan are limited and inconsistent. The study investigated differences in symptoms and post-COVID conditions between vaccinated and unvaccinated individuals and the impact of vaccination on illness duration based on existing literature. Methods: The study was a 3-month cross-sectional study conducted in Peshawar, Pakistan. It targeted individuals aged 16 and above who had contracted COVID-19 at least once during the recent pandemic, regardless of gender, and confirmed through reverse transcriptase polymerase chain reaction testing. The sample size was 250, determined using the WHO sample size calculator. Data were collected through questionnaires after obtaining verbal consent and analyzed using IBM SPSS version 26, taking into account their vaccination status along with other important variables. Results: Among the 250 respondents, 143 (57.2%) were unvaccinated, while 107 (42.8%) were vaccinated at the time of contracting COVID-19. Unvaccinated subjects developed a greater variety of symptoms that lasted for longer durations (P<0.001) with symptoms like dyspnea [55 (38.5%, P=0.011)], anosmia [76 (53.1%, P=0.001)], and chest pain [24 (16.8%, P=0.029)] occurring at greater percentages. Sixty-one (42.7%) unvaccinated subjects reported post-COVID conditions as opposed to 29 (27.1%) among the vaccinated group [P=0.011; odds ratio (OR)=0.5; 95% CI=0.29-0.86]. Conclusion: The study found that COVID-19 vaccination can reduce the duration and frequency of symptoms, as well as post-COVID conditions. This is the first research of its kind conducted in Peshawar, Pakistan, and may serve as a foundation for future research in this demographic.

SARS-CoV-2 S1 Subunit Booster Vaccination Elicits Robust Humoral Immune Responses in Aged Mice.

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants has raised concerns about reduced vaccine effectiveness and the increased risk of infection, and while repeated homologous booster shots are recommended for elderly and immunocompromised individuals, they cannot completely protect against breakthrough infections. In our previous study, we assessed the immunogenicity of an adenovirus-based vaccine expressing SARS-CoV-2 S1 (Ad5.S1) in mice, which induced robust humoral and cellular immune responses (E. Kim, F. J. Weisel, S. C. Balmert, M. S. Khan, et al., Eur J Immunol 51:1774-1784, 2021, https://doi.org/10.1002/eji.202149167). In this follow-up study, we found that the mice had high titers of anti-S1 antibodies 1 year after vaccination, and one booster dose of the nonadjuvanted rS1Beta (recombinant S1 protein of SARS-CoV-2 Beta [B.1.351]) subunit vaccine was effective at stimulating strong long-lived S1-specific immune responses and inducing significantly high neutralizing antibodies against Wuhan, Beta, and Delta strains, with 3.6- to 19.5-fold increases. Importantly, the booster dose also elicited cross-reactive antibodies, resulting in angiotensin-converting enzyme 2 (ACE2) binding inhibition against spikes of SARS-CoV-2, including Omicron variants, persisting for >28 weeks after booster vaccination. Interestingly, the levels of neutralizing antibodies were correlated not only with the level of S1 binding IgG but also with ACE2 inhibition. Our findings suggest that the rS1Beta subunit vaccine candidate as a booster has the potential to offer cross-neutralization against broad variants and has important implications for the vaccine control of newly emerging breakthrough SARS-CoV-2 variants in elderly individuals primed with adenovirus-based vaccines like AZD1222 and Ad26.COV2.S. IMPORTANCE Vaccines have significantly reduced the incidences of severe coronavirus disease 2019 (COVID-19) cases and deaths. However, the emergence of SARS-CoV-2 variants has raised concerns about their increased transmissibility and ability to evade neutralizing antibodies, especially among elderly individuals who are at higher risks of mortality and reductions of vaccine effectiveness. To address this, a heterologous booster vaccination strategy has been considered as a solution to protect the elderly population against breakthrough infections caused by emerging variants. This study evaluated the booster effect of an S1 subunit vaccine in aged mice that had been previously primed with adenoviral vaccines, providing valuable preclinical evidence for elderly people vaccinated with the currently approved COVID-19 vaccines. This study confirms the potential for using the S1 subunit vaccine as a booster to enhance cross-neutralizing antibodies against emerging variants of concern.

Severe Acute Respiratory Syndrome and Particulate Matter Exposure: A Systematic Review.

BACKGROUND: Particulate matter (PM) exposure is responsible for seven million deaths annually and has been implicated in the pathogenesis of respiratory infections such as severe acute respiratory syndrome (SARS). Understanding modifiable risk factors of high mortality, resource burdensome C19 and exposure risks such as PM is key to mitigating their devastating effects. This systematic review focuses on the literature available, identifying the spatial and temporal variation in the role of quantified PM exposure in SARS disease outcome and planning our future experimental studies. METHODS: The systematic review utilized keywords adhered to the PRISMA guidelines. We included original human research studies in English. RESULTS: Initial search yielded N = 906, application of eligibility criteria yielded N = 46. Upon analysis of risk of bias N = 41 demonstrated high risk. Studies found a positive association between elevated PM2.5, PM10 and SARS-related outcomes. A geographic and temporal variation in both PM and C19's role was observed. CONCLUSION: C19 is a high mortality and resource intensive disease which devastated the globe. PM exposure is also a global health crisis. Our systematic review focuses on the intersection of this impactful disease-exposure dyad and understanding the role of PM is important in the development of interventions to prevent future spread of viral infections.

A threefold approach including quantum chemical, molecular docking and molecular dynamic studies to explore the natural compounds from Centaurea jacea as the potential inhibitors for COVID-19.

In the current report, we studied the possible inhibitors of COVID-19 from bioactive constituents of Centaurea jacea using a threefold approach consisting of quantum chemical, molecular docking and molecular dynamic techniques. Centaurea jacea is a perennial herb often used in folk medicines of dermatological complaints and fever. Moreover, anticancer, antioxidant, antibacterial and antiviral properties of its bioactive compounds are also reported. The Mpro (Main proteases) was docked with different compounds of Centaurea jacea through molecular docking. All the studied compounds including apigenin, axillarin, Centaureidin, Cirsiliol, Eupatorin and Isokaempferide, show suitable binding affinities to the binding site of SARS-CoV-2 main protease with their binding energies -6.7 kcal/mol, -7.4 kcal/mol, -7.0 kcal/mol, -5.8 kcal/mol, -6.2 kcal/mol and -6.8 kcal/mol, respectively. Among all studied compounds, axillarin was found to have maximum inhibitor efficiency followed by Centaureidin, Isokaempferide, Apigenin, Eupatorin and Cirsiliol. Our results suggested that axillarin binds with the most crucial catalytic residues CYS145 and HIS41 of the Mpro, moreover axillarin shows 5 hydrogen bond interactions and 5 hydrophobic interactions with various residues of Mpro. Furthermore, the molecular dynamic calculations over 60 ns (6×106 femtosecond) time scale also shown significant insights into the binding effects of axillarin with Mpro of SARS-CoV-2 by imitating protein like aqueous environment. From molecular dynamic calculations, the RMSD and RMSF computations indicate the stability and dynamics of the best docked complex in aqueous environment. The ADME properties and toxicity prediction analysis of axillarin also recommended it as safe drug candidate. Further, in vivo and in vitro investigations are essential to ensure the anti SARS-CoV-2 activity of all bioactive compounds particularly axillarin to encourage preventive use of Centaurea jacea against COVID-19 infections.

Waning humoral immunity of SARS-CoV-2 vaccination in a rheumatoid arthritis cohort and the benefits of a vaccine booster dose.

OBJECTIVES: We aimed to assess SARS-CoV-2 spike-specific antibody kinetics postvaccination and the benefit of a mRNA vaccine booster dose in rheumatoid arthritis (RA) patients treated with immunosuppressive drugs. METHODS: Consecutive RA patients on immunosuppressive therapies, with no known history of SARS-CoV-2 infection or high-risk contact, vaccinated with 2 doses SARS-CoV-2 mRNA, BNT162b2 or mRNA-1273, or viral vectored ChAdOx1 nCoV-19 vaccine were recruited during their routine rheumatology consultation. Anti-SARS-CoV-2 IgG spike-specific antibodies were quantified at 1, 3 and 6 months respectively following the second vaccine dose. The incidence of SARS-CoV-2 infection post-vaccination during this 6-month longitudinal study was also assessed. RESULTS: Of the 104 RA patients included, 79 patients completed the 6-month trial follow-up. A significant decrease in anti-SARS-CoV-2 spike-specific IgG titres was observed between 1-month and 3-month postvaccination (p<0.01). Among the 46 patients (46/79) receiving a booster dose, all developed detectable anti-SARS-CoV-2 spike-specific IgG antibodies at the 6-month follow-up with significantly higher titres compared to 1-month (p<0.001) and 3-month (p<0.0001) post-vaccination. Conversely, the antibody titres among the 33 patients (33/79) not receiving a booster dose decreased significantly at the 6-month follow-up compared to 1-month (p<0.0001) and 3-month (p<0.01) post-vaccination. The incidence of COVID-19 disease postvaccination was 8.9% without severe forms. CONCLUSIONS: To our knowledge, this is the first study to report on anti-SARS-CoV-2 spike-specific antibody kinetics postvaccination and the effect of a booster dose in a cohort of RA patients. The latter is essential given the waning humoral immunity observed in vaccinated RA patients and the increased incidence of COVID-19 diseases postvaccination in this 6-month longitudinal study.

Inhibitory effect of thymoquinone from Nigella sativa against SARS-CoV-2 main protease. An in-silico study.

Nigella sativa is known for the safety profile, containing a wealth of useful antiviral compounds. The main protease (Mpro, 3CLpro) of severe acute respiratory syndrome 2 (SARS-CoV-2) is being considered as one of the most attractive viral target, processing the polyproteins during viral pathogenesis and replication. In the current investigation we analyzed the potency of active component, thymoquinone (TQ) of Nigella sativa against SARS-CoV-2 Mpro. The structures of TQ and Mpro was retrieved from PubChem (CID10281) and Protein Data Bank (PDB ID 6MO3) respectively. The Mpro and TQ were docked and the complex was subjected to molecular dynamic (MD) simulations for a period 50ns. Protein folding effect was analyzed using radius of gyration (Rg) while stability and flexibility was measured, using root means square deviations (RMSD) and root means square fluctuation (RMSF) respectively. The simulation results shows that TQ is exhibiting good binding activity against SARS-CoV-2 Mpro, interacting many residues, present in the active site (His41, Cys145) and also the Glu166, facilitating the pocket shape. Further, experimental approaches are needed to validate the role of TQ against virus infection. The TQ is interfering with pocket maintaining residues as well as active site of virus Mpro which may be used as a potential inhibitor against SARS-CoV-2 for better management of COVID-19.

Trivalent SARS-CoV-2 S1 Subunit Protein Vaccination Induces Broad Humoral Responses in BALB/c Mice.

This paper presents a novel approach for improving the efficacy of COVID-19 vaccines against emergent SARS-CoV-2 variants. We have evaluated the immunogenicity of unadjuvanted wild-type (WU S1-RS09cg) and variant-specific (Delta S1-RS09cg and OM S1-RS09cg) S1 subunit protein vaccines delivered either as a monovalent or a trivalent antigen in BALB/c mice. Our results show that a trivalent approach induced a broader humoral response with more coverage against antigenically distinct variants, especially when compared to monovalent Omicron-specific S1. This trivalent approach was also found to have increased or equivalent ACE2 binding inhibition, and increased S1 IgG endpoint titer at early timepoints, against SARS-CoV-2 spike variants when compared monovalent Wuhan, Delta, or Omicron S1. Our results demonstrate the utility of protein subunit vaccines against COVID-19 and provide insights into the impact of variant-specific COVID-19 vaccine approaches on the immune response in the current SARS-CoV-2 variant landscape. Particularly, our study provides insight into effects of further increasing valency of currently approved SARS-CoV-2 vaccines, a promising approach for improving protection to curtail emerging viral variants.

Assessment of Severity of Anxiety and Depression in Covid-19 Patients Admitted to Rawalpindi Medical University and Allied Hospitals Rawalpindi Pakistan

Objective: To determine the prevalence of anxiety and depression among the COVID-19 infected patients. Study design: Descriptive cross-sectional study. Place and Duration of Study: Rawalpindi Medical University and Allied Hospitals Covid designated wards from 1stApril 2019 and 30thJune 2020 Methodology: Hundred patients of either gender presented with Covid-19 infection were enrolled. Detailed demographics and complete medical examination was done after taking informed written consent. Those patients who fulfil the clinical criteria Hamilton rating scale for anxiety (HAMA) and Hamilton rating scale for depression (HRSD) were applied to assess the severity of anxiety and/or depression. Result(s): There were 69 (69%) males and 31 (31%) females. Eighty two (82%) patients fall in the age range of 21 to 50 years with the mean of 38 years. There is high level of anxiety as well as depression among admitted patients suffering from COVID-19. Seventy five (75%) patients suffered from depression and 72 (72%) of patients suffered from anxiety ranging from mild to severe. Conclusion(s): It is concluded that patients suffering from Covid-19 disease had high prevalence of depression and anxiety. Copyright © 2022 Lahore Medical And Dental College. All rights reserved.

The Pattern of Non-Covid-19 Paediatric Admissions in Malaysia Teaching Hospitals: Before and during the Covid-19 Pandemic with Movement Control Order

To study the characteristics of paediatric patients admitted to two non-COVID-19 teaching hospitals before and during the implementation of the Movement Control Order (MCO) in Malaysia. The retrospective study was performed in two phases (before MCO between February to March 2020, and during MCO lockdown between March to April 2020) in two teaching hospitals on the East Coast of Peninsular Malaysia. Hospitalized children <18 years were included and those coming for elective procedures or oncology treatment were excluded. The clinical data were retrieved from both hospitals' admission records. There was a total of 496 and 191 admissions to two teaching hospitals on the East Coast of Peninsular Malaysia, respectively. A significant reduction in the number of non-COVID-19 hospital admissions was seen in both hospitals. For Hospital Universiti Sains Malaysia, the daily hospital admissions were reduced with a mean of 10 (before MCO) to 7 (during MCO) admissions/day (95% CI 1.54,7.54, p=0.001). In Sultan Ahmad Shah Medical Centre, a reduction in hospital admission was seen from 5 (before MCO) to 3 (during MCO) admissions/day (95% CI 0.61, 3.15, p=0.005). Our study observed a general drop in non-COVID-related respiratory illnesses and infectious disease cases during the MCO period. There were significant differences in neurological (p=0.029) and accident (p = 0.001) cases admissions observed between the two periods. Copyright © 2022, Faculty of Medicine, University of Malaya. All rights reserved.

Development of myocarditis and pericarditis after COVID-19 vaccination in children and adolescents: A systematic review.

Myocarditis and pericarditis have been reported after COVID-19 vaccine administration in children and adolescents, raising the concern about their possible association with these vaccines. The objective was to explore the incidence, clinical presentation, and association of myocarditis and pericarditis with COVID-19 vaccines in children and adolescents. We conducted a systematic literature search on three databases, that is, Cochrane, MEDLINE/PubMed, and EMBASE from inception till March 2022. A total of three case reports, four case series, and six observational studies were included in the review. For case reports and case series, the mean age of the patients was 17.4 years, with 96.9% being male. Chest pain (n = 31, 93.9%), fever (n = 18, 54.5%), myalgias (n = 15, 45.4%) and headache (n = 9, 27.2%) were the most common presentations. Out of 33 patients, 32 (96.9%) of patients received Pfizer-BioNTech whereas only one (3.03%) received Moderna (mRNA 1273). Clinical investigations revealed ST elevation (n = 32, 97%), and elevated CRP (n = 9, 27.2%) and cardiac troponin (n = 29, 87.8%). The pooled incidence of myocarditis and pericarditis from observational studies was (0.00063%) and (0.000074%) %, respectively. Myocarditis and pericarditis in children and adolescents after the COVID-19 vaccines were more prevalent among males and more commonly observed after the second dose of Pfizer. Though the overall incidence was low, however, the clinicians should consider myocarditis and pericarditis as probable diagnosis when encountering young patients, with a history of vaccine administration, presenting with suggestive findings.

Molecular docking, dynamics, and quantum chemical study of vanillylacetone and beta-hydroxy ketone derivatives against Mproof SARS-CoV-2

This study is carried out to find novel active drug candidates which can effectively bind to key residues of main protease (Mpro) of SARS-CoV-2. We performed molecular docking of fifty-seven (57) ligands from two classes: vanillylacetone and its derivatives and beta-hydroxy ketone derivatives against Mpro of SARS-CoV-2. We also docked three antiviral drugs as reference/benchmark drugs including remdesivir (RDV), chloroquine (CQ), and hydroxychloroquine (HCQ) against Mpro for comparison of inhibition tendencies of selected ligands. Binding energies of our reference drugs are as: CQ = -5.1 kcal mol-1 (with predicted inhibition constant (Ki pred) = 177 mu mol), HCQ = -5.7 kcal mol-1 (Ki pred = 64.07 mu mol) and RDV -6.3 kcal mol-1 (Ki pred = 13.95 mu mol). We got remarkable results for our docked ligands as 79% of total ligands indicated binding energies better than CQ, 39 % better than both HCQ and CQ, and 19 % better than all reference drugs. More interestingly interaction analysis of eight best-docked ligands showed that they interacted with desired key residues of Mpro. We further selected the four best-docked ligands L1 = -6.6 kcal mol-1 (Ki pred=13.95 mu mol), L6 = -7.0 kcal mol-1 (Ki pred = 7.08 mu mol), L34 = -6.0 kcal mol-1 (Ki pred = 38.54 mu mol), and L50 = -6.6 kcal mol-1 (Ki pred=13.95 mu mol) for further analysis by quantum chemical study, molecular dynamic (MD) simulations and ADMET analysis. We have also carried out MD-simulations of six more docked ligand L2, L14, L20, L36, L46 and L48 some of which were showing weak binding affinities and some average binding affinities to check their simulation behavior. Their RMSD, RMSF and binding free energy results were also quite satisfying. We believe the current investigation will evoke the scientific community and highlights the potential of selected compounds for potential use as antiviral compounds against Mpro of SARS-CoV-2.

Editorial introduction to the special issue: Social customer journey – behavioural and social implications of a digitally disruptive environment

This editorial provides an overview of this Special Issue of Technological Forecasting & Social Change on “Social Customer Journey - Behavioural and Social Implications of a Digitally Disruptive Environment”, bringing together insights from the papers accepted for inclusion in this special issue. Fifteen articles on a variety of topics relevant to this special issue have been accepted for publication. These articles examine the behavioural and social implications of a digitally disruptive environment from a variety of theoretical, contextual and methodological perspectives.

SARS-CoV-2 S1 Subunit Booster Vaccination Elicits Robust Humoral Immune Responses in Aged Mice (preprint)

Currently approved COVID-19 vaccines prevent symptomatic infection, hospitalization, and death of the disease. However, the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants raises concerns of reduced vaccine effectiveness and increased risk of infection. Repeated homologous booster in elderly individuals and immunocompromised patients is considered to solve severe form of disease caused by new SARS-CoV-2 variants but cannot protect completely against breakthrough infection. In our previous study we assessed the immunogenicity of an adenovirus-based vaccine expressing SARS-CoV-2-S1 (Ad5.S1) in mice, resulting in that a single immunization with Ad5.S1, via subcutaneously injection or intranasal delivery, induced robust humoral and cellular immune responses. As a follow up study, here we showed that vaccinated mice had high titers of anti-S1 antibodies at one year after vaccination compared to PBS immunized mice. Furthermore, one booster dose of non-adjuvanted recombinant S1Beta (rS1Beta) subunit vaccine was effective in stimulating strong long-lived S1-specific immune responses and inducing significantly high neutralizing antibodies against the Wuhan, Beta, and Delta strain with 3.6- to 19.5-fold change increases. Importantly, the booster dose elicits cross-reactive antibody responses resulting in ACE2 binding inhibition against spike of SARS-CoV-2 variants (Wuhan, Alpha, Beta, Gamma, Delta, Zeta, Kappa, New York, India) as early as two-week post-boost injection, persisting over 28 weeks after a booster vaccination. Interestingly, levels of neutralizing antibodies were correlated with not only level of S1-binding IgG but also level of ACE2 inhibition in the before- and after-booster serum samples. Our findings show that S1 recombinant protein subunit vaccine candidate as a booster has potential to offer cross-neutralization against broad variants, and has important implications for vaccine control of new emerging breakthrough SARS-CoV-2 variants in elderly individuals primed with adenovirus-based vaccine like AZD1222 and Ad26.COV2.S.

Positive externality matters in the COVID-19 pandemic: the case of women informal businesses in District Mardan, Pakistan

The sharp outbreak of the COVID-19 pandemic has had a severe economic impact across the globe. It has affected human and business life and specifically led to drastic changes that how businesses and individuals behave. Therefore, this study aims first, to explore the impact of the COVID-19 pandemic on informal businesswomen;and second, to know the attitude of these businesswomen toward following the pandemic SOPs (standard operating procedures). Primary data were collected from 400 respondents randomly in district Mardan, Khyber Pakhtunkhwa province. Chi-square test analysis was performed to see the differences between rural-urban locations. The results of six products showed that pandemic increased the sales of both urban and rural informal businesses, i.e., cloth, cosmetics, tailoring, and grocery. However, dairy products and beautician businesses were affected adversely. Mix results were obtained about the respondents' attitudes toward pandemic SOPs. We recommend emerging rethinking for policymakers to promote these women businesses as it has played a role in maintaining family livelihood during the pandemic. © 2022 Elsevier Inc. All rights reserved.

Changes in the Emergency General Surgery Operations in the Setting of COVID-19 and Impact of Strategy of Non-Operative Management on Outcomes in Acute Appendicitis.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has posed significant challenges to the provision of elective and emergency general surgical care. Patterns of presentation have changed and management pathways have also been adapted, moving to more non-operative management (NOM) for some conditions. We investigated how COVID-19 changed the volume of emergency general surgery operating in our district general hospital (DGH). We aimed to evaluate the impact of NOM on outcomes in acute appendicitis. METHODS: A retrospective case review of operating lists, patient handover lists, and patient notes was undertaken for patients presented between 1st January 2020 and 3rd June 2020. The study period was divided into two, with the period between 1st January 2020 and 23rd March 2020 representing the pre-COVID cohort. RESULTS: Some 393 emergency general surgery operations were performed in the study period. There was a clear reduction in operating volume after 23rd March 2020. During that same period, 325 patients were assessed with right iliac fossa (RIF) pain. Median age was 21 (range 5-87) and 201 patients were female (61.8%). The rate of NOM for suspected acute appendicitis was 8.8% in the pre-COVID group, which increased to 36.4% in the COVID group. The incidence of normal histology following appendicectomy did not change with this difference in management (16.1% compared to 17.9%, p = 0.78). CONCLUSIONS: This study summarizes the changes brought to the provision of emergency general surgery in the setting of a DGH by the COVID-19 pandemic. In particular, NOM was the preferred option for acute appendicitis but this did not alter the negative appendicectomy rate.

Fear of COVID-19, hotel employee outcomes and workplace health and safety management practices: Evidence from Sharm El-Sheikh, Egypt

This paper investigates the effect of fear of COVID-19 on employee turnover intention and depression, hypothesizing the mediating effect of psychological well-being and the moderating effect of workplace health and safety management practices. Data was gathered from 687 employees of five-star hotels in Sharm El-Sheikh using a structured survey instrument with time-lag approach. A partial least-square-based path modeling (PLS-PM) was applied to analyze the dataset. The findings reveal the partial mediation of psychological well-being in the relationships of fear of COVID-19 with both turnover intention and depression. While workplace safety and management practices significantly moderate the relationship between fear of COVID-19 and both turnover intentions, depression also mediates the relationship. The findings add to the existing literature on the effects of COVID-19 through the dual lenses of protection motivation theory and attribution theory. We can employ these findings to overcome issues of employee well-being in the hotel setting.

NMR spectroscopy spotlighting immunogenicity induced by COVID-19 vaccination to mitigate future health concerns

In this review, the disease and immunogenicity affected by COVID-19 vaccination at the metabolic level are described considering the use of nuclear magnetic resonance (NMR) spectroscopy for the analysis of different biological samples. Consistently, we explain how different biomarkers can be examined in the saliva, blood plasma/serum, bronchoalveolar-lavage fluid (BALF), semen, feces, urine, cerebrospinal fluid (CSF) and breast milk. For example, the proposed approach for the given samples can allow one to detect molecular biomarkers that can be relevant to disease and/or vaccine interference in a system metabolome. The analysis of the given biomaterials by NMR often produces complex chemical data which can be elucidated by multivariate statistical tools, such as PCA and PLS-DA/OPLS-DA methods. Moreover, this approach may aid to improve strategies that can be helpful in disease control and treatment management in the future. Graphical Image 1

Impact of COVID-19 pandemic on hemodialysis access thrombosis.

BACKGROUND: Delay in care of suspected stenosis or thrombosis can increase the chance of losing a functioning hemodialysis access. Access to care and resources were restricted during the COVID-19 pandemic. To evaluate the impact of the pandemic on arteriovenous fistula (AVF) and arteriovenous graft (AVG) procedures we have assessed the number and success of thrombectomies done before and during the COVID-19 pandemic. METHODS: We examined all AVF and AVG angiograms with and without interventions, including thrombectomies, performed at a single center during April 2017-March 2021 (pre-COVID-19 era) and April 2020-March 2021 (COVID-19 era). RESULTS: The proportion of procedures that were thrombectomies was higher during the COVID-19 era compared to the pre-COVID-19 era (13.3% vs 8.7%, p = 0.009). The proportion of thrombectomy procedures was higher during COVID-19 for AVF (8.2% vs 3.0%, p < 0.001) but there was no difference for AVG (26.5% vs 27%, p = 0.99). There was a trend toward a higher likelihood of unsuccessful thrombectomy during COVID-19 (33.3% vs 20.4%, p = 0.08). CONCLUSIONS: More dialysis access thromboses and unsuccessful thrombectomies were noted during the COVID-19 pandemic. This difference could be due to a delay in patients getting procedures to maintain their dialysis accesses.