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Background: COVID-19 is an emerging infectious disease that affected multiple countries and sustained person-to-person transmission making it a concerning and serious public health threat. This pandemic has emphasized that good nutrition and a healthy life is the key to strengthening immunity. Aim of the study: To assess knowledge of nutrition toward the COVID-19 among the Palestinian population. Methods: A cross-sectional online survey was launched at West Bank and Gaza Strip. A total number of 554 participants have shared the completion of this survey and the response rate was 90.2%. Results: The mean level of knowledge among participants was 65.38% and the study indicated that 55.8% behaving healthy nutritional habits. The analysis revealed that the mean score of knowledge increased by 1.61 comparing the oldest age groups (>30 years) against the youngest group. As the same as, the knowledge mean score increased by 2.46 among the obese individuals according to BMI classification (>30). Whereas, the knowledge mean score was increased significantly among those who work in medical sectors compared to others unemployed individuals. As well, the knowledge score increased by 2.04 among individuals with comorbidity than healthy ones. Conclusion: Nutritional knowledge score during COVID-19 was 67.03% and the knowledge about the body immunity system and the protective measures against COVID-19, scored a weighted mean of 76.21%. The level of knowledge among all participants did not reflect a satisfactory level of knowledge among the public regard COVID-19 while the level of behaving healthy nutritional habits illustrated that nearly 45% of the participants were practicing unhealthy nutritional behaviors.
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To record the experience of caregivers for neurologically impaired children during the lockdown periods. Data from 286 children's caregivers were collected through an administered questionnaire to record: access to care services during the lockdown periods, causes underlying loss of access to care, mitigations adopted by caregivers and patients' outcomes. The mean age of children was 8.11 years-old and sex ratio (F/M) was 0.66. They were mainly followed-up for epilepsy or epileptic encephalopathy (53%) and cerebral palsy (21%). During the lockdown periods, caregivers reported that 45% of children had no access to healthcare majorly for neurorehabilitation (76.7%) and medicines (70.7%). Most caregivers (36%) related limitations in access to fear from catching the virus. The majority resorted to continuation of the same treatment via primary healthcare facilities (41%) and postponement of their appointments (24%). Our results show that access to healthcare for children with neurological disorders was deeply disrupted during the COVID-19 pandemic. The already precarious health systems' infrastructures might have been the main causes for this and should be thus considered in the health policy and planing. © 2023, Intelektual Pustaka Media Utama. All rights reserved.
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Objective: To present a single-health system retrospective analysis of post-mRNA-based COVID-19 vaccination CNS autoimmunity conducted in the greater New York City area. Background: There have been rare reports associating mRNA-based COVID-19 vaccines with central nervous system (CNS) inflammation. We report a case series of five patients with newonset neurological disorders of immunological origin temporally associated with these vaccines. Design/Methods: Case-series. Results: Five cases of post-vaccination CNS disorders of immune origin were observed within two weeks of inoculation with either the first or second dose of mRNA-based COVID-19 vaccines (Moderna = 3, Pfizer = 2). This includes: Fatal ADEM (n = 1), new-onset NMO (n = 2), new-onset fulminant MS (n = 1), and meningoencephalitis (n = 1). The age of our patients ranged from 27 to 81, and three were female. None of the patients had pre-existing neurological illnesses and one had a pre-existing autoimmune condition (immune thrombocytopenia purpura). New-onset focal neurological symptoms were present in all five patients, including quadriparesis, numbness, diplopia, and encephalopathy. CSF pleocytosis was present in all patients, and three had elevated protein. All but one patient (meningoencephalitis) had contrastenhancing lesions involving either the cerebrum or spinal cord. Both NMO patients had longitudinally extensive transverse lesions involving the central thoracic cord. Aquaporin-4 serum antibody was present in one NMO patients and aquaporin-4 CSF antibody present in the other. All but one patient (fatal ADEM) clinically improved with pulse steroids or plasmapheresis. Conclusions: These are among the emerging cases of CNS immunological events temporally associated with mRNA-based COVID-19 vaccines. These findings should be interpreted with great caution as they neither prove a link nor imply a potential long-term increased risk in postvaccination CNS autoimmunity. Larger prospective studies are needed. The mRNA-based SARS-CoV-2 vaccines should continue to be strongly encouraged given their high efficacy in overcoming this pandemic.
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The novel Wuhan coronavirus, known as SARS-CoV-2, and the disease it causes, COVID-19, are declared as a global pandemic thus breaking havoc on lives and economies around the world.The extent of the outbreak of COVID-2019, which was discovered quite recently, and its massive impact on lives, societies as well as the economies of the affected countries is unprecedented. Cases of COVID -19 infection have so far been reported in 212 countries and territories where more than 71.2 million individuals have been affected till December 2020, resulting in more than 1.6 million deaths. Both, outside and inside China all around the world, COVID-19 is transmitted via human-to-human transmission,which has resulted in such a global outcome. To decrease the cases all the affected countries were under lockdown and eventhoug the cases were incresed dramaticlly. However, all the dailly activiets were moved to a virtual reality which adds more impact to investigate the future of the virtual reallity and its great impact during this hard time. This paper presents a critical study on the outbreak of COVID-19 by providing an analysis on the confirmed cases at Corona's first wave along with discussing the impact of the disease on social lives and economies all around the world.
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Purpose Characteristics and outcomes of heart transplant (HT) recipients who contract coronavirus (SARS-CoV-2) have been poorly described. The current study was undertaken to better understand the risk obesity may pose in this patient population Methods A prospectively-maintained Trans-CoV-VAD Registry containing HT recipients at 11 participating institutions who presented with SARS-CoV-2 were reviewed. Presenting characteristics, hospitalization rates, ventilator & intensive care unit usage, and mortality were queried. Patients were grouped by body mass index (BMI) into obese (BMI≥30 k/m2) and non-obese cohorts (BMI<30 kg/m2). Comparisons between groups were made utilizing chi-squared, Fisher's exact, and Mann-Whitney U-tests. Multivariable logistic regression models were utilized Results Across all centers, 85 HT recipients who tested positive for SARS-CoV-2 were identified, of whom 26 (31%) were obese. Median time from HT to diagnosis was 4.6 (1.8-13.8) years. No differences in age (57 vs 60 p 0.85) or female gender (31% vs 24% p 0.5) were noted between obese and non-obese patients. On presentation, obese patients were more symptomatic with higher rates of cough (76% vs 48% p 0.02), dyspnea (62% vs 41% p 0.09), diarrhea (60% vs 35% p 0.03), and headache (35% vs 14% p 0.03). No differences in rates of admission (62% vs 64% p 0.8), ICU presentation (44% vs 35% p 0.6) or need for mechanical ventilation were noted (38% vs 22% p 0.2). More secondary infections were noted amongst obese patients (32% vs 13% p 0.04). On follow-up, mortality was similar between groups (12% vs 9% p 0.7). On multivariable modeling, BMI was not associated with increased adjusted odds of hospital/ICU admission or mechanical ventilation (p>0.10) Conclusion Acute presentations of SARS-CoV-2 amongst HT recipients carry significantly higher mortality over the general population. Obesity appears to impact presenting symptoms and secondary infections, but does not strongly impact ICU requirements or mortality
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Purpose Infection with the Coronavirus (SARS-CoV-2) is particularly dangerous for patients with left ventricular assist devices (LVAD). Obesity is associated with worse outcomes among both LVAD and SARS-CoV-2 patients. This study evaluated the risk of obesity among LVAD patients who contracted SARS-CoV-2. Methods A prospectively maintained Trans-CoV-VAD Registry of LVAD patients from 11 institutions who presented with SARS-CoV-2 was analyzed. Two cohorts, 1) non-obese and 2) obese, were formed utilizing a body mass index (BMI) cutoff of 30 k/m2. Presenting characteristics, hospitalization rates, ventilator & intensive care unit usage, and mortality were compared. Chi-squared, Fisher's exact test, Mann-Whitney U-tests and multivariable logistic regression models were utilized. Results Across all centers, 46 LVAD patients contracted SARS-CoV-2 during the study period of whom 19 (41%) were obese. Time from LVAD implantation to infection was 2.4±2.5 years. Age and gender profiles were similar. Non-obese and obese patients had similar presenting symptoms, most commonly cough (52% vs 47%), fever (48% vs 37%), dyspnea (41% vs 47%) and fatigue (41% vs 37%). No difference in rates of hospital (70% vs 63%, p 0.8) and ICU admissions (26% vs 37%, p 0.3) was observed. Hospital (20.0±23.2 vs 17.1±14.2) and ICU length of stay were similar (16.2±26.1 vs. 13.9±13.1 days). Obese patients were more likely to require mechanical ventilation than non-obese patients (7% vs 26%, p<0.05). Overall risk of mortality was significantly elevated but similar (19% vs 16%, p 0.9). On multivariable modeling, BMI was not associated with increased risk of hospitalization, ICU admission or mechanical ventilation (p>0.10). Conclusion Among LVAD patients who contract SARS-CoV-2, obese patients appear to have higher risk of intubation, but did not experience increased ICU requirements or mortality.
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BACKGROUND AND PURPOSE: Coronavirus disease 2019 (COVID-19) appears to be an independent risk factor for stroke. We hypothesize that patients who develop stroke while hospitalized for severe COVID-19 will have higher inflammatory markers and distinct stroke imaging patterns compared with patients positive for COVID-19 with out-of-hospital stroke onset and milder or no COVID-19 symptoms. MATERIALS AND METHODS: This is a retrospective case series of patients positive for COVID-19 on polymerase chain reaction testing with imaging-confirmed stroke treated within a large health care network in New York City and Long Island between March 14 and April 26, 2020. Clinical and laboratory data collected retrospectively included complete blood counts and creatinine, alanine aminotransferase, lactate dehydrogenase, C-reactive protein, ferritin, and D-dimer levels. All CT and MR imaging studies were independently reviewed by 2 neuroradiologists who recorded stroke subtype and patterns of infarction and intracranial hemorrhage. RESULTS: Compared with patients with COVID-19 with outside-of-hospital stroke onset and milder or no COVID-19 symptoms (n = 45, 52.3%), patients with stroke already hospitalized for severe COVID-19 (n = 41, 47.7%) had significantly more frequent infarctions (95.1% versus 73.3%, P = .006), with multivascular distributions (56.4% versus 33.3%, P = .022) and associated hemorrhage (31.7% versus 4.4%, P = .001). Patients with stroke admitted with more severe COVID-19 had significantly higher C-reactive protein and ferritin levels, elevated D-dimer levels, and more frequent lymphopenia and renal and hepatic injury (all, P < .003). CONCLUSIONS: Patients with stroke hospitalized with severe COVID-19 are characterized by higher inflammatory, coagulopathy, and tissue-damage biomarkers, supporting proposed pathogenic mechanisms of hyperinflammation activating a prothrombotic state. Cautious balancing of thrombosis and the risk of hemorrhagic transformation is warranted when considering anticoagulation.