Significance of Measuring the Proinflammatory Response Biomarkers in Covid-19 Patients

Objectives: In the management of COVID-19, bio-inflammatory cytokines (IL-6 and others) can be measured as inflammatory markers to detect conditions in response to treatment, risk assessment, monitoring disease progression, prognosis determination and treatment selection. The purpose of this study is to identify changes in inflammation markers of COVID-19 patients and to determine whether it should be used as a prognosis marker. Materials-Methods: Three groups of the patients consisting of 138 patients (12 non-survived, 35 severe and 91 mild/moderate) aged 16 to 86 years who were diagnosed with COVID-19 by real-time polymerase chain reaction were included in the study. Acute phase serum levels such as CRP, D-Dimer, Ferritin, IL-1B and IL-6 were measured and compared in serum samples taken from these patients. It was examined whether these parameters can be a biomarker that can be monitored for the course of the disease. IL-6 and ferritin were measured with CLIA, D-dimer immunassay, CRP with photometry and IL1-B was measured with flow cytometry methods. Result(s): It has been observed that all parameters, except for ferritin (P=0.94), increase significantly during the transition from mild to severe form of the disease. (CRP P:0.005, D-Dimer P<0.0001, IL-1B P:0.03, IL-6 P:0.002). A significant difference was observed in the levels of CRP, IL-6 and D-Dimer in the patient survival. (P=0.003, P=0.03, P:0,0001). According to our results, the use of IL-1B in the prognosis monitoring of patients with severe forms was not found to be significant (P:0.48). ROC curve analysis showed that the area under the ROC curve (AUC) of CRP, D-Dimer and IL-6 was 0.645 (0,559 to 0,725), 0.637 (0,551 to 0,717) and 0.663 (0,577 to 0,741) respectively, and the cutoff values were >3.77 (sensitivity, 72.3%;specificity, 55%), >0.48 (sensitivity 68.1%;specificity, 57.1%) and <14.9 (sensitivity, 65,9%;specificity, 62.6%), respectively. Conclusion(s): Our results confirmed that the dynamic change in IL-6, CRP, D-Dimer can be used as a marker for disease monitoring in patients with severe COVID-19.

Steroid-induced secondary immune deficiency.

Despite their widespread clinical use, oral corticosteroids (OCSs) are well known to be associated with a myriad of adverse effects, including immunosuppression. By inhibiting transcription factors and affecting leukocyte function, prolonged OCS use leads to significant CD4 lymphopenia and often a decrease in serum immunoglobulin (Ig)G. Conversely, OCS use has minimal impact on circulating B cell, serum IgM, or serum IgA levels. Although there is a paucity of literature, individuals treated with prolonged OCS seem to typically maintain humoral response to various vaccinations despite hypogammaglobinemia, but this area warrants additional research, especially in the setting of the coronavirus disease 2019 pandemic. Individuals treated with prolonged OCS use are most at risk for opportunistic infections, especially those with underlying malignancy and history of bone marrow transplant. Risk mitigation strategies to decrease infectious complication with OCS use include limiting the dose and duration of therapy, appropriately completing a full vaccination series, consideration for passive immunization, and prophylaxis against opportunistic infections.

Real-World Experience of Tixagevimab and Cilgavimab (Evusheld) in Rheumatologic Patients on Rituximab.

BACKGROUND/OBJECTIVE: Although vaccination is the primary strategy against severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), rheumatologic patients on B-cell depleting agent rituximab may have a suboptimal response. Tixagevimab and cilgavimab (Evusheld) could be administered under Food and Drug Administration emergency use authorization as pre-exposure prophylaxis. METHODS: A cohort study of rheumatologic patients on rituximab therapy who received Evusheld was followed longitudinally. Adverse events were monitored. RESULTS: Forty-three patients received Evusheld, with diagnoses including rheumatoid arthritis, ANCA vasculitis, immune-mediated myositis, Sjögren disease, and systemic lupus erythematosus. Average time to follow-up was 100 ± 33 days. One patient experienced symptomatic infection with SARS-CoV-2 confirmed by home antigen test twice. A total of 97.8% of patients during follow-up did not contract acute SARS-CoV-2 infection. At the same time, 32,074 new local cases were reported with a local cumulative SARS-CoV-2 incidence rate of 4.32%. Adverse events included myalgia, flu-like symptoms, fevers, injection site pain, or headache. No serious adverse events, anaphylaxis, or cardiac events occurred. CONCLUSIONS: Evusheld demonstrated effectiveness in preventing symptomatic SARS-CoV-2 infection in a real-world cohort of rheumatologic patients on rituximab therapy. Administration of Evusheld may be considered as part of a multilayered approach to risk mitigation in this high-risk population as pre-exposure prophylaxis.

Graded Challenges to Penicillin in Icu Patients

Introduction: There is emerging data for safety and efficacy of graded challenges to penicillin (GCP), without penicillin skin testing, in patients with low risk reaction histories. We describe outcomes of GCP in ICU patients. Method(s): From 8/2021 to 6/2022, allergy/immunology physicians completed e-consults for ICU patients with a penicillin allergy label. Low risk history was defined as unknown reaction or a history of a cutaneous-only reaction >5 years ago and was verified by chart review or patient/family contact. GCP consisted of a 2-3 step challenge to amoxicillin or ampicillin. Patient demographics, GCP results, pre/post GCP antibiotics regimens, and a 2-4 week follow up were collected. Result(s): There were 40 ICU patients with low-risk reaction histories. Historical reactions included: rash (17, 43%), hives (10, 25%), angioedema (5, 13%), and unknown (8, 20%). The median age was 63.5 years (interquartile range: 58.8- 72.3). Patient characteristics included: 24/40 patients (60%) intubated, 12/40 (30%) receiving steroids, 10/40 (25%) COVID-19+, 8/40 (20%) receiving vasopressors, 7/40 (18%) on antihistamines, and 1/40 (3%) on ECMO. A total of 32/40 (80%) patients underwent GCP. There was a negative GCP in 31/32 (97%) patients;one patient developed self-limited abdominal pain. Twelve of 32 (38%) patients transitioned to penicillins: from cephalosporins (10/12), vancomycin (3/12), metronidazole (1/12), meropenem (1/12), macrolide (1/12). There were 15/40 (37.5%) deaths at 2-4 weeks follow up. Conclusion(s): : GCP was safe and efficacious in critically ill ICU patients with low risk reaction histories. Given the high ICU mortality, patients should be carefully identified for GCP. Copyright © 2022

Real-World Effectiveness of Tixagevimab and Cilgavimab (Evusheld) in Patients With Hematological Malignancies.

Background: Immunocompromised individuals with hematological malignancy have increased risk for poor outcomes and death from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This special population may mount a suboptimal response to vaccination. We assessed the effectiveness of tixagevimab and cilgavimab (Evusheld), a monoclonal antibody combination against SARS-CoV-2, in conjunction with standard preventative measures, at preventing symptomatic incident infection. Methods: Patients aged 18 years and older with hematological malignancy consented to receive Evusheld. Patients were followed longitudinally for development of symptomatic incident SARS-CoV-2 infections. Adverse events were monitored. Results: Two hundred and three patients (94 female) with hematological malignancies and mean age 72 ± 10 years were included. Of the patients, 99.5% had received at least one mRNA vaccination against SARS-CoV-2. Average time of follow-up was 151 ± 50 days. Nineteen patients (9.3%) developed incident symptomatic SARS-CoV-2 infection, with only one (0.5%) requiring hospitalization. During the same follow-up period, local incident rate of infection was 84,123 cases (11.3% of population). Of those, 3,386 cases (4%) of SARS-CoV-2 required hospital admission. The incidence rate ratio was 0.79. No serious adverse events occurred following administration of Evusheld. Conclusion: Patients with hematological malignancy who received Evusheld infrequently developed symptomatic infections or require hospitalization. The high-risk cohort incidence was at least as comparable to the average risk general population. Evusheld appears effective and is well tolerated, and may be administered in conjunction with vaccination and standard prevention measures, at decreasing incident SARS-Co-V2 cases in this high-risk population.

Applying Essential Public Health Functions in building health systems’ resilience globally : Yu Zhang

Background The COVID-19 pandemic has exposed Public Health system weaknesses due to chronic underinvestment in Public Health. In this context, Essential Public Health Functions (EPHFs) have been revitalized as an integrated, cost effective and sustainable approach to operationalising Public Health. The World Health Organization's recent position paper on building health systems resilience towards universal health coverage and health security recommended investing in EPHFs as a key mean for countries’ health systems recovery and transformation during COVID-19 and beyond. There is a need for conceptual and operational clarity of EPHFs to support countries to build back better, fairer and more resilient health systems. Methods A rapid review of peer-reviewed and grey literature regarding the EPHFs was conducted to identify different actors’ understandings of EPHFs and key lessons of applying the EPHFs at the global, regional and national levels, in order to identify the added value and key enablers to operationalising EPHFs. A crosswalk analysis of different authoritative lists of EPHFs was conducted to develop a common list of EPHFs as a reference for countries in response to Public Health challenges. Results A consolidated list of 12 EPHFs derived from the crosswalk analysis of different authoritative lists is presented, underpinning the consideration of health systems components and pressing health challenges. Six key enablers are identified from evidence and experience. These enablers are fundamental for countries to build holistic and strong Public Health capacities. Conclusions The EPHFs provide a clear and integrated framing to operationalise Public Health in countries that can be adapted to country contexts to build resilience. Health authorities and other Public Health stakeholders must seize the opportunity brought by COVID-19 recovery to continue advocating for and strengthening Public Health as a priority in health systems’ reconstruction and reform.

Essential Public Health Functions in Ireland: Perspectives to strengthen capacities and stewardship : Geraldine McDarby

Background COVID-19 has caused unprecedented disruptions to health, social and economic systems in countries worldwide including Ireland. Weaknesses in Public Health capacities have undermined health system resilience compounding the effects of the pandemic. The Essential Public Health Functions (EPHFs) provide a comprehensive, cost-effective approach to operationalising public health and a means to build health systems resilience. As Ireland looks to recovery, the Department of Health engaged the World Health Organization (WHO) to undertake a mapping of the current state of delivery of EPHFs to identify opportunities for improvement and support wider health system strengthening towards resilience. Methods A strategic review of the delivery of EPHFs in Ireland was conducted with respect to policy, infrastructure, service provision and coordination and integration. Findings were reported in the context of international lessons identified through experience with COVID-19 and major health system challenges within the Irish context. Results There are significant capacities present within the Irish context to support the delivery of the EPHFs though they are limited in strategic cohesion, coordination and implementation. These include a high level of Public Health expertise, an agile and resourceful workforce, a strongly engaged community and significant evidence generation and synthesis capacities. Gaps recognised included ICT infrastructure and capacity, workforce resourcing and support, pandemic planning and public health governance, visibility, legislation, strategy and resourcing. COVID-19 has led to the development and strengthening of mechanisms to leverage a whole-of-government and -society approach to health that should be sustained to tackle ongoing and future stressors. Conclusions The use of the EPHFs within the Irish setting provides a comprehensive approach to strengthening capacities for public health and enhanced population health and wellbeing.

Online Counselling Reach Out Services to Alleviate Stress among Students during Online Distance Learning

Students in Malaysian higher education were forced to engage in learning using online distance approach due to restricted movement control order since the beginning of Covid-19 pandemic. The acclaim often given to online learning due its practicality, convenience and usage of latest technology has been dampened by the challenges and stress of online distance learning that students began to show after a while. This paper reports the level of comfort and satisfaction students perceived about learning from home. Three brief surveys were completed by 281, 132, and 54 students from the faculty who rated their level of stress, the importance of creating the reach-out blog, and the feedback on the blog after it was created. In terms of experiencing stress during this mode of learning, the majority of the respondents felt stress of various levels with virtual mode of distance learning. Students rated highest their sources of stress as being self-autonomous (learning independently, motivation, interest), followed by self-management (managing time, tasks, classes), home environment, IT facilities, faculty support, peer support, lecturers support, and last but not least family support. Students agreed that there should be a clear process to help students in need either face-to-face or online. The respondents all agreed that a counselling blog was a good idea for students to access information and seek early help. The faculty had taken a quick initiative to create a counselling blog as a venue for students to get information relating to stress and mental health. This step was received well by the students. It is obvious that online distance learning has taken a toll on students' mental, emotional and social well-being. The faculty must be aware of their students’ state of mental health and take appropriate initiatives to reach out to students in need. © 2022,Asian Journal of University Education. All Rights Reserved.

The prevalence and course of COVID-19 and the Cardiovascular Diseases

The SARS-CoV2 virus has infected over 545 million people and has claimed over 6 million lives globally by the end of June 2022. The global case fatality rate ranged from 5.5% in Mexico, 2.1-2.5% in South Africa, Brazil, Guatemala, Russia, 1.1-1.5% in the United States, Canada, India and Chile, 0.5-0.9% in Western European countries, 0.3% in Japan, 0.2% in Taiwan to 0.1% in Australia. Among hospitalized COVID-19 patients, the prevalence of pre-existing cardiovascular diseases was approximately 10%. The prevalence of cardiovascular diseases among COVID-19 non-survivors and COVID-19 patients requiring intensive care unit admission were approximately 20-30%. In a multicenter study of 8910 COVID-19 patients from 169 hospitals in Asia, Europe and North America, presence of pre-existing coronary artery disease, chronic heart failure and cardiac arrhythmia was associated with increased mortality of 10.2%, 15.3% and 11.5% respectively, compared with 5-6% mortality in those without the above co-morbidities. The systemic inflammation caused by SARS-CoV-2 could lead to a wide spectrum of cardiovascular complications including acute cardiac injury, acute coronary syndrome, coronary artery dissection, acute myocarditis, cardiomyopathy, chronic heart failure, cardiac arrhythmia, pulmonary embolism, cardiogenic shock, circulatory failure or even cardiac arrest. Copyright © 2022 Heart, Vessels and Transplantation. All right reserved.

How a Successful Implementation and Sustainable Growth of e-Commerce can be Achieved in Developing Countries;a Pathway Towards Green Economy

Apart from the goal of the digital world and other benefits of e-commerce, it becomes the need of time during this COVID-19 pandemic. Successful implementation and sustainable growth of e-commerce in developing countries is a challenge. The goal of the digital world without the implementation and sustainable growth of e-commerce in developing countries is incomplete. Based on UTAUT theory, we have developed an integrated model to study the developing countries' consumers' adoption intentions towards e-commerce. We collected a valid useable sample of 796 respondents from a developing country, applied the SEM-ANN two-step hybrid approach to testing the proposed hypothesis, and ranked the antecedents according to their importance. Results revealed that Trust in e-commerce, Perceived risk of using e-commerce, Ease of use in e-commerce, Curiosity about e-commerce, Facilitating Conditions, and Awareness of e-commerce benefits influence the adoption intentions of developing countries' consumers. Sensitivity analysis results revealed that Ease of use in e-commerce platforms and awareness of e-commerce benefits are the two most crucial factors behind the adoption intentions in developing countries. The study's findings help authorities adopt sustainable e-commerce, multinational companies effectively market their goods online, and academics better understand how inhabitants of developing nations perceive e-commerce.

Could red cell distribution width be used for predicting cardiac injury in neonates with COVID-19?

BACKGROUND: Coronavirus disease 2019 (COVID-19) can affect people of all age groups and it can occasionally cause life-threatening clinical illnesses in immunologically immature populations, especially in newborns. High red cell distribution width (RDW) values were used as an early prognostic biomarker of some neonatal diseases. We aimed to determine the prognostic value of RDW in severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infected neonates. METHODS: Newborns with positive SARS-CoV-2 polymerase chain reaction (PCR) test from a nasopharyngeal swab sample, who had refractory fever (>38°C and lasting more than 24 h during hospitalization), were screened for multisystem inflammatory syndrome in newborns (MIS-N), systemic inflammatory indexes calculated and cardiologic evaluations. Due to troponin levels (high: >45 ng/L and low: ≤45 ng/L) patients were grouped. RESULTS: Out of the 68 SARS-CoV-2 PCR-positive newborns, 26 patients had refractory fever. Comparison of laboratory findings between the high and low-troponin groups showed that RDW and neutrophil/lymphocyte ratio values were significantly higher in patients with high troponin levels (p = 0.022 and p = 0.030, respectively). The cut-off values with optimal sensitivity and specificity were determined as 1.00 for neutrophil/lymphocyte ratio (p = 0.205) and 16.6 for RDW (p = 0.014). None of the patients died. CONCLUSIONS: Neonatal COVID-19 generally has a benign prognosis, but can progress to severe disease and cases of MIS-N are rare. RDW could be prognostic in the diagnosis and management of neonates with SARS-CoV-2 infection with high troponin levels.

Patient and Clinician Attitudes Toward Telemedicine for Allergy and Immunology.

The use of telemedicine has increased in allergy/immunology, with rapid uptake of its use during the coronavirus disease 2019 pandemic. Existing data indicate an overall positive view of telemedicine by patients, particularly during the coronavirus disease 2019 pandemic. However, patients and clinicians prefer in-person visits for specific types of allergy/immunology encounters, such as those requiring a physical examination or diagnostic testing. The most data for telemedicine exist with asthma, and provide a model for treatment technique, therapeutic monitoring, and education in other allergic and immunologic conditions. Clinician satisfaction is also necessary for telemedicine to be an enduring option for patient/clinician interactions, and this is influenced by a multitude of factors, including technology quality, reimbursement, and maintenance of patient/clinician relationships. Areas of future research should include the need for more outcome data in additional disease states, which will likely help facilitate improved logistical policies around telemedicine that would facilitate its adoption.

To evaluate the Prevalence of anxiety and depression during COVID-19 pandemic

Aim: To evaluate the Prevalence of anxiety and depression during COVID-19 pandemic. Methods: This study was conducted during the Coronavirus outbreak. Following development by the research team, the online survey was tested during these study periods. 100 participants were included in this study. Results: 40% of participants reported feeling tight or wounded up from time to time (sometimes), whereas 23% reported feeling this way all of the time. Many (35%) were worried as if something terrible was going to happen, but 'not too severely,' while 33 percent felt frightened 'a bit' as if something terrible was about to happen, but it did not bother them. Many people (38 percent) had anxious thoughts from time to time, while others (24 percent) had them all the time. Only 41% said they sat at ease and felt calm "generally," while others said they didn't sit at ease and felt relaxed "very frequently" (33 percent). More than half of the students (55%) reported not being afraid or having a 'butterfly' feeling in their stomach, whereas many others (24%) had that scared emotion 'sometimes.' Only 15% of the participants reported being restless and on the move. In terms of experiencing a sudden sense of panic attacks, just a small percentage (9%) reported having had this 'often' or 'very frequently' (20 percent). When asked if they still enjoyed the things they used to appreciate, just 36% said they didn't enjoy them as much anymore. Only half of the students (50%) said they could laugh and see the funny side of things "as much as they always could." A fresh look at the participants' emotions indicated that just 47 percent of them felt joyful'sometimes,' while others felt cheery 'not often/not at all' (24 percent, 14 percent respectively). Conclusion: During the COVID-19 pandemic, participants' anxiety and depression levels were found to be high. Furthermore, more than half of the pupils did not embrace the learning method throughout the epidemic. Implementing psychological therapies for healthcare students during pandemics is strongly advised in order to improve students' mental health as well as their learning process.

Applying Convolution Neural Network to Facemask Detection from Varied Images

In this study, Convolution Neural Network (CNN)-based learning method, which is well-used in deep learning is applied to facemask detection from facial images of diverse persons wearing varied facemasks. During the covid-19 era, the wearing of facemasks has become important to curb the spread of the deadly virus and mandatory at times in some places. To ensure rules on wearing of facemasks are adhered to, face detection and recognition systems are being adopted to be able to detect masks worn on the faces of individuals. While good results have been obtained from some of such systems, the data set of images are not as diverse in terms of race and the types of facemasks detected are typically surgical masks. However, in real-world application, the society is made up of people of different races, age groups and wearing different kinds of facemasks. Therefore, there is room for improvement in the training, testing, and optimization of the detection systems by introducing a more diverse set of image inputs. The convolutional layer in this study is made up of numerous convolution kernels which are used to compute different feature maps for representations of the inputs. The model is evaluated by varying the image data and optimizing the hyperparameters for improved performance in facemask detection. Statistical Analysis performed to obtain Accuracy of 76.79% and area under the curve result of 0.8525 that demonstrates the capabilities of CNN. © 2021 IEEE.

Evaluation of Antibody Response to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Immunizations in Patients with B-Cell Malignancies

Background Multiple vaccines have been granted emergency use authorization by the Food and Drug Administration against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Of the currently available vaccines, none have been systematically studied for efficacy or toxicity in patients with immunodeficiency or with immunosuppressed states, such as B cell malignancy. The purpose of the study was to evaluate the immune response to currently available vaccines against COVID-19 in patients with hematologic and solid organ malignancies. Methods This prospective study enrolled 53 patients;12 with CLL, 10 with multiple myeloma (MM), 11 with non-Hodgkin's lymphoma (NHL) and 21 with a solid organ malignancy. Using a quantitative assay, IgG antibodies to SARS-CoV-2 Spike (S) protein, and nucleocapsid (N) protein by enzyme immunoassay were measured at baseline prior to vaccination and at 2 weeks after completion of vaccination. A fourfold increase in IgG was considered a positive response to vaccination. Through a predesigned survey, patients also self-reported side effects from each dose of vaccination. Results Seroconversion with vaccination was seen in 9/10 (90%) patients with MM, 5/12 (41.7%) patients with CLL, 6/11 (54.1%) patients with NHL, and 17/21 (80.9%) patients with solid organ malignancy. Per univariate analysis, CLL (OR 0.23, 95% CI 0.05-0.88;p= 0.033) was associated with lower odds of seroconversion while NHL (OR 0.48, 95% CI 0.12-1.8;p =0.291), MM (OR 5.33, 95% CI 0.61-46.08;p= 0.128) and solid organ malignancy (OR 2.90, 95% CI 0.79-10.64;p= 0.107) were not. Among patients with hematological malignancies, 5/13 (38.3%) patients treated with rituximab and 2/7 (28.5%) patients on immunoglobulin replacement (IgR) therapy responded to vaccination. This corresponded to reduced odds of seroconversion, 0.18 (95% CI 0.047-0.69;p = 0.013) in patients treated with rituximab and 0.14 (95% CI 0.024-0.826;p=0.030) in patients on IgR. Among patients with solid organ malignancies, treatment with chemotherapy (OR 2.05, 95% CI 0.48-8.61;p=0.320), immunotherapy (OR 4.57, 95% CI 0.52-39.9;p=0.169) or endocrine therapy (OR 1.0) did not lower odds of seroconversion with vaccination. Multivariate analysis revealed patients who received rituximab were less likely to respond to vaccination as compared to patients not previously treated with rituximab (OR 0.22, 95% CI 0.05-0.955;p=0.044). Injection site soreness was the most commonly reported side effect. The only severe side effect occurred in a patient with solid organ malignancy who developed Parsonage Turner syndrome. Conclusion Our study, to the best of our knowledge, is the first study comparing pre and post vaccination IgG titers against the SARS-CoV-2 S protein. Majority of patients with MM and solid organ malignancies, including those receiving active treatment, responded adequately to immunization. Patients with CLL appear less likely to respond to vaccination against COVID-19 as compared to patients with NHL, MM or solid organ malignancies. Previous treatment with rituximab was the most significant risk factor for suboptimal response to vaccination, regardless of underlying hematologic malignancy. These data highlight the importance of continuing risk mitigation strategies against COVID-19 in individuals with hematologic malignancy, particularly those with CLL or on treatment with rituximab. Future research is needed to investigate approaches to provide protective IgG against SARS-CoV-2 in this at-risk population. [Formula presented] Disclosures: Mustafa: Genentech: Speakers Bureau;GalaxoSmithKline: Speakers Bureau;CSL Behring: Speakers Bureau;Regeneron: Speakers Bureau;AstraZeneca: Speakers Bureau. Walsh: Janssen: Research Funding;Merck: Research Funding;Pfizer: Research Funding. Jamshed: Takeda: Honoraria.

Two-step Feature Selection for Predicting Mortality Risk in COVID-19 Patients

COVID-19 pandemic is causing serious impact on our society. The whole world is suffering from financial, social, psychological, and other health crisis. One of the various challenges faced is the lack of health and medical facilities around the globe. It is very crucial to properly manage the available resources to save the lives of COVID-19 affected patients. This study proposes an intelligent model to facilitate the hospitals and medical facilities to diagnose which patients are in serious conditions and needs priority health services. The proposed model is based on feature selection-based mechanism, where most dominating features are identified to best discriminate among the serious patients and the less affected patients. We adopted two-step strategy, where filter measure is applied to rank the features according to their relevance in the first step, and Genetic Algorithm is applied with Decision Tree classifier to find the best feature subset in the second step. The results are reported in terms of classification accuracy and the most dominating features are also identified to help the medical practitioners. © 2021 IEEE.

Covid 19 And Human Immune Function: The Chemistry Of Vitamin - D

The epidemic COVID-19 is the utmost dreadful disaster of current human life that led to public health's global health as a major health care issue. Patients of COVID-19 have the signs, for instance, fever, dry cough, dyspnoea, sore throat, nasal congestion, besides glassy lung opacities. The infection of COVID-19 has two immune protective and damaging phases, and physicians attempt to improve the patient immune reactions. Vitamin D has various ways of action to reduce infection risk and death and has beneficial effects on viral infections. Supplementation of vitamin D during infection conditions of COVID-19 is still controversial. Scientific investigations are required to define improved cut-offs for vitamin D levels and, finally, which quantity will be the better as supplementations. Most of the works showed the people who are deficient in Vitamin D are more prone to infection. Broad familiarity with Vitamin D will make it supportive and protective for health. The present study focused on the worth of Vitamin D for the immune role, its presence in optimal amounts, and its effectiveness in COVID-19. Sun exposure synthesizes vitamin D in the human body, which ultimately enhances immunity, and protects from many viral infections, including COVID-19.

Graded Administration of Second Dose of Moderna and Pfizer-BioNTech COVID-19 mRNA Vaccines in Patients With Hypersensitivity to First Dose.

Two mRNA coronavirus disease 2019 (COVID-19) vaccines, Moderna and Pfizer-BioNTech, require 2 doses for maximum efficacy. This case series reports the safety and immunogenicity of a graded administration of the second dose of the Moderna and Pfizer-BioNTech COVID-19 vaccines in patients with immediate hypersensitivity reactions to the first dose.

Clearing the air about airborne transmission of SARS-CoV-2.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that has created the current pandemic, has caused a worldwide worry. Different countries have since enforced varying levels of lockdowns and guidelines for their populations to follow in a serious effort to mitigate the spread. Up until recently, the majority of these regulations and policies were established on the assumption that the dominant routes of transmission of this virus are through droplets and fomite contact. However, there is now a substantial amount of research pointing towards the strong possibility that SARS-CoV-2 can spread through airborne means. The World Health Organization (WHO) and the Center for Disease Control and Prevention (CDC) have recently recognized this, which poses the question of whether our collective methods of lessening transmission risk and keeping people safe have been sufficient. This paper is a comprehensive review of the evidence on SARS-CoV-2 being an airborne disease, through different epidemiological, experimental, and animal-model based published research. Studies opposing this evidence have also been discussed. The majority of these studies are favoring the high plausibility of SARS-CoV-2 aerosol transmission, and therefore the many implications of aerosol transmission have been discussed in this paper to suggest effective mitigation and control strategies.

Dynamical Modeling and COVID-19 Pandemic

The world health organization (WHO) has declared the Coronavirus (COVID-19) a pandemic in 2020. Considering this ongoing global issue, different health and safety measure has been recommended by the WHO to ensure the proactive, comprehensive, and coordinated steps to bring back the whole world into a normal situation. There are around 100 plus research groups across the world trying to develop a vaccine for previous and new versions of coronavirus. All the work is at an early stage, contains huge uncertainties and a long list of unanswered questions however, continuous efforts lead to success. Therefore, the quantitative and qualitative analysis of the COVID–19 pandemic is needed for the identification and controlling the spread of COVID-19. Mathematical models with computational simulations are the effective tools that help global efforts to estimate key transmission parameters and further improvements for controlling this disease. This is an infectious disease and can be modeled as a system of non-linear differential equations with reaction rates. In this chapter, we develop two simple models for coronavirus disease spreading within a mathematically/biologically feasible region, i.e., positively invariant for the model and boundedness solution of the system. So that the system becomes well-posed mathematically and epidemiologically for sensitive (stability) analysis. Then computational results show the occurrence of a forward bifurcation when the basic reproduction number is equal to unity. The proposed method gives a major step forward to evaluate the models and identify the key critical parameters, i.e., recovery factors. These critical model-parameters allow the biologist/chemist to specify/distinguish control strategies to adopt further precaution measures with improvements. This is another way of controlling the individuals from the spreading called control monitoring strategy. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.