ABSTRACT
The main objective of this randomized controlled trial was to analyze the acute effects of a nitrate-based nutritional formula on peripheral oxygen saturation (SpO(2)), patient-reported outcomes, and safety indices in patients with acute COVID-19 infection. The participants completing the protocol for the trial (n = 71) were allocated in a double-blind design to receive either a multicomponent nutritional formula (containing 1200 mg of potassium nitrate, 200 mg of magnesium, 50 mg of zinc, and 1000 mg of citric acid), or a placebo (2.5 g of inulin) during a 72-h monitoring period. All participants were requested to take an intervention (four capsules;weight of each capsule was similar to 2.5 g) every 4 h during the intervention period. A two-way mixed model ANOVA with repeated measures revealed a significant difference in SpO(2) between interventions (P = 0.007). As many as 30 out of 38 patients (78.9%) receiving nitrate-based nutritional formula, who all started the treatment with SpO(2) <= 95%, finished the intervention with SpO(2) of at least 95% at 72-h follow-up, whereas in the placebo group, 13 patients out of 33 (39.4%) finished the trial with SpO(2) of at least 95% (P < 0.05). The hospital admission rate after the 72-h follow-up was 21.1% in patients receiving nitrate-based formula compared to 33.3% in the placebo group (P = 0.25). The nitrate-based formula might be recognized as a potent strategy to tackle hypoxemia and concomitant features of the COVID-19 pandemic. In conclusion, it appears that the novel nitrated-based nutritional formulation described here was able to improve oxygen saturation and clinical outcomes in COVID-19 patients. Although the exact mechanism of action remains unknown, the nitrate-based formula might be recognized as a potent, safe, and convenient strategy to tackle hypoxemia and concomitant features of the COVID-19 pandemic.
ABSTRACT
As the COVID-19 pandemic reshapes our social landscape, its lessons have far-reaching implications on how online service providers manage their infrastructure to mitigate risks. This paper presents Facebook's risk-driven backbone management strategy to ensure high service performance throughout the COVID-19 pandemic. We describe Risk Simulation System (RSS), a production system that identifies possible failures and quantifies their potential severity with a set of metrics for network risk. With a year-long risk measurement from RSS we show that our backbone resiliently withstood the COVID-19 stress test, achieving high service availability and low route dilation while efficiently handling traffic surges. We also share our operational practices to mitigate risk throughout the pandemic. Our findings give insights to further improve risk-driven network management. We argue for incorporating short-term failure statistics in modeling failures. Common failure prediction models based on long-term modeling achieve stable output at the cost of assigning low significance to unique short-term events of extreme importance such as COVID-19. Furthermore, we advocate augmenting network management techniques with non-networking signals. We support this by identifying and analyzing the correlation between network traffic and human mobility.