SARS COV-2 and other viral etiology as a possible clue for the olfactory dilemma

Background: Post-viral anosmia is responsible for more than 40% of cases of anosmia. Anosmia has been a neglected symptom in the primary healthcare setting until the emergence of the SARS-CoV-2 pandemic. The spread of SARS-CoV-2 infection highlighted new atypical symptoms of the disease, including anosmia, which has become one of the diagnostic symptoms of the disease, and epidemiological concern. We aimed to detect the incidence of SARS-CoV-2 infection within patients presented with anosmia and to test for other respiratory viruses in the negative COVID-19 patients. We also detected the recovery of anosmia and IgM/IgG against COVID-19. We prospectively included 60 outpatients with the major complaint of anosmia. Nasopharyngeal swabs were done for SARS-CoV-2 real-time PCR, and if negative, PCR to other respiratory pathogens was tested. After one month, we inquired about the recovery of smell loss together with testing for antibodies against SARS-CoV-2. Result(s): Sixty patients were enrolled in the study. Forty-six patients (76.7%) were SARS-CoV-2 PCR positive and 14 (23.3%) were negative. Rhinovirus was the commonest isolated pathogen in the negative cases (5/14). Complete recovery of anosmia occurred in 34 patients (56.7%), while partial recovery in 24 (40.0%), and no recovery in 2 patients (3.3%). The median time to complete recovery was 10 days. 28.3% (13/46) of the patients showed negative antibody response for both IgG and IgM. Conclusion(s): Sudden-onset anosmia is a symptom that is highly predictive of being COVID-19-infected. While recovery is expected within 2 weeks, some patients have no antibodies against SARS-CoV-2.Copyright © 2022, The Author(s).

Association between Multimorbidity and COVID-19 Mortality in Qatar: A Cross-Sectional Study

This study assessed the association between multimorbidity and mortality from COVID-19 in the Middle East and North Africa region, where such data are scarce. We conducted a cross-sectional study using data of all cases with COVID-19 reported to the Ministry of Public Health of Qatar from March to September 2020. Data on pre-existing comorbidities were collected using a questionnaire and multimorbidity was defined as having at least two comorbidities. Proportions of deaths were compared by comorbidity and multimorbidity status and multivariable logistic regression analyses were carried out. A total of 92,426 participants with a mean age of 37.0 years (SD 11.0) were included. Mortality due to COVID-19 was associated with gastrointestinal diseases (aOR 3.1, 95% CI 1.16-8.30), respiratory diseases (aOR 2.9, 95% CI 1.57-5.26), neurological diseases (aOR 2.6, 95% CI 1.19-5.54), diabetes (aOR 1.8, 95% CI 1.24-2.61), and CVD (aOR 1.5, 95% CI 1.03-2.22). COVID-19 mortality was strongly associated with increasing multimorbidity;one comorbidity (aOR 2.0, 95% CI 1.28-3.12), two comorbidities (aOR 2.8, 95% CI 1.79-4.38), three comorbidities (aOR 6.0, 95% 3.34-10.86) and four or more comorbidities (aOR 4.15, 95% 1.3-12.88). This study demonstrates a strong association between COVID-19 mortality and multimorbidity in Qatar.

Differential gene expression of SARS-CoV-2 transcriptome provides insight into the design of more sensitive diagnostic tests

The Coronavirus disease 2019 (COVID-19) pandemic is being addressed through RT-PCR, a frontline diagnostic technique. We evaluated gene expression patterns to improve the accuracy and sensitivity of current diagnostic tests. We downloaded relevant next-generation sequencing (NGS) data from the Sequence Read Archive (SRA) database, checked for quality, and mapped them onto the target reference sequence. It was determined that ORF1ab, N, S, and ORF8 genes are mainly expressed based on the results of the quantitative evaluation after normalization by HPRT and elimination of insufficient expression data. ORF8, ORF3a, and M genes were found to have higher expression values than the E gene as a routine RT-PCR detector gene (p*0.05). M gene expression values are also close to ORF8 values. Taking into account the importance of differential expression of genes in the design of diagnostic kits as well as the findings of from this study, it is likely that the M gene is worth further investigation due to its high expression and low mutation rate.

Recent Advances in Marine Microalgae Production: Highlighting Human Health Products from Microalgae in View of the Coronavirus Pandemic (COVID-19)

Blue biotechnology can greatly help solve some of the most serious social problems due to its wide biodiversity, which includes marine environments. Microalgae are important resources for human needs as an alternative to terrestrial plants because of their rich biodiversity, rapid growth, and product contributions in many fields. The production scheme for microalgae biomass mainly consists of two processes: (I) the Build-Up process and (II) the Pull-Down process. The Build-Up process consists of (1) the super strain concept and (2) cultivation aspects. The Pull-Down process includes (1) harvesting and (2) drying algal biomass. In some cases, such as the manufacture of algal products, the (3) extraction of bioactive compounds is included. Microalgae have a wide range of commercial applications, such as in aquaculture, biofertilizer, bioenergy, pharmaceuticals, and functional foods, which have several industrial and academic applications around the world. The efficiency and success of biomedical products derived from microalgal biomass or its metabolites mainly depend on the technologies used in the cultivation, harvesting, drying, and extraction of microalgae bioactive molecules. The current review focuses on recent advanced technologies that enhance microalgae biomass within microalgae production schemes. Moreover, the current work highlights marine drugs and human health products derived from microalgae that can improve human immunity and reduce viral activities, especially COVID-19. © 2022 by the authors.

Sharded Blockchain-based Online Diagnostic System for Suspected Patients During Pandemics

During pandemics, diagnostic tests are essential to provide quick treatment of patients and limit the disease spread. The high demand for testing resources can stress the healthcare system. Thus, a remote collection of symptoms and reporting the results via an automated diagnostic system is highly desirable. However, such a system is challenged by privacy and scalability issues. Hence, we propose a sharded blockchain-based system that (a) introduces a set of shards that distributes the testing load among a group of local nodes (LNs), hence, offering high scalability for country-wide adoption, (b) uses ring signatures and unique random identifiers to ensure the anonymity of the users and the unlinkability of test requests, hence, supporting privacy-preservation, (c) deploys a detection strategy at the LNs based on deep neural networks, which is implemented on smart contracts, hence, enabling autonomous diagnosis, and (d) provides healthcare entities with authorized access to the symptoms and test results, hence, enabling efficient data sharing that supports future research. We provide an implementation of the proposed system and our experimental results demonstrate the high scalability and privacy of the system while achieving a testing accuracy up to 90%. We present a case study for U.S. wide deployment showing that a total daily test request of 2, 407, 462 can be performed and reported in 11 minutes compared to 63 days in absence of sharding. Moreover, sharding decreased the user storage requirement to be 0.18 MB at maximum instead of 723 MB without sharding.

Association between pregnancy and severe COVID-19 symptoms in Qatar: a cross-sectional study (preprint)

BackgroundThere is inconclusive evidence whether pregnancy exacerbates COVID-19 symptoms or not, and scarce data from the Middle East and North Africa region. The aim of this study was to investigate the association between pregnancy and COVID-19 symptoms in Qatar. MethodsThis cross-sectional study was carried out using data of all women with confirmed COVID-19, comparing pregnant and non-pregnant women of child-bearing age (18-49 years). Data of all COVID-19 cases were collected by the Ministry of Public Health (MoPH) in Qatar, between March and September 2020. Symptoms were compared by pregnancy status and classified into moderate and severe. Multivariable logistic and poisson regression was carried out to investigate the association between pregnancy and severity of COVID-19 symptoms. ResultsDuring the study period, 105744 individuals were diagnosed with COVID-19, 16908 were women of childbearing age. From that sample, 799 women who were pregnant (mean age 29.9 years (SD 5.2)) and 16109 women who were not pregnant (mean age 33.1 years (SD 7.8)). After multivariable logistic regression, pregnancy was associated with a 1.4-fold higher odds of reporting any symptoms of COVID-19 (OR 1.41, 95% CI 1.18-1.68), and 1.3-fold higher odds of reporting shortness of breath (OR 1.29, 95% CI 1.02-1.63). After multivariable poisson regression, pregnancy was also associated with a higher number of symptoms (IRR 1.03, 95%CI 0.98-1.08). ConclusionOur findings suggest that, in this setting, pregnant women are more likely to have symptomatic COVID-19, and shortness of breath, compared to non-pregnant women of childbearing age.

Estimating the relationship between serum electrolytes and COVID-19: a systematic review and meta-analysis

Background and purpose: There are controversies on the association between electrolytes and Coronavirus disease 2019 (COVID-19) and its severity. Studies on these issues may help in resolving ambiguities. The purpose of this study was to assess the association between electrolyte indices and being infected with COVID-19 and developing severe symptoms using a meta-analysis. Materials and methods: A thorough search was done in national and international electronic databases using Medical Subject Headings (MeSH) terms. Quality assessment was conducted by Newcastle-Ottawa scale (NOS) checklist. We estimated the standardized mean difference between electrolyte indices and the incident of COVID-19 infection and its severity.

Impact of Smoking on COVID-19 Symptoms in Non-Vaccinated Patients: A Matched Observational Study from Qatar

Purpose Predisposition to acute illness from COVID-19 is suggested to correlate with cigarette smoking as it augments the risk of developing cardiovascular and respiratory illnesses, including infections. However, the effects of smoking on COVID-19 symptoms are not well described and controversial. In this study, we aim to explore the associations between smoking and COVID-19 symptoms. Subjects and Methods A cross-sectional study using the Ministry of Public Health (MoPH), Qatar database was administered to a Qatari population with confirmed COVID-19 disease who filled in pre-defined phone-call questionnaire between 27th February 2020 and 31st December 2020. We analyzed 11,701 non-vaccinated COVID-19 individuals (2952 smokers and 8749 non-smokers) with confirmed RT-PCR test results. The association of smoking and the presence of symptoms as well as patient characteristics was calculated using Pearson’s Chi-square and Fisher’s exact tests, adjusting for potential covariates. Results Compared with the non-smokers, symptomatic COVID-19 infection is significantly higher in smokers. In addition, we found fever as the most common symptom developed in COVID-19 patients followed by cough, headache, muscle ache, and sore throat. As compared to other symptoms, association of smoking with chills and abdominal pain was less evident (P < 0.05 and P < 0.001, respectively). However, both groups showed similar rates of developing cough. Conclusion In conclusion, smoking is associated with COVID-19 symptoms frequency in non-vaccinated patients;nevertheless, further investigations are necessary to understand the mechanism of this association which could generate new targets for the management of COVID-19 in smoker patients.

Oral mucosal lesions during SARS-CoV-2 infection: a case series and literature review

Background: The most common manifestations of infection with COVID-19 are fever, sore throat, dry cough, headache, and body aches. The available evidence for successful and safe pharmacological therapy against COVID-19 has not yet been identified, and the possible evidence relates to many adverse reactions. Taste disorders, petechiae, desquamative gingivitis, unspecific oral ulcerations, xerostomia, and candidiasis are the oral manifestations related to SARS-CoV-2 infection. Main body of the : We reviewed the literature regarding the reported oral mucosal lesions in cases with confirmed COVID-19 infection together with presenting five cases with oral mucosal lesions associated with COVID-19 infection. Direct causal association between COVID-19 infection and oral mucosal lesions is still vague, hence further research is required. Conclusion: Oral examination is mandatory in cases with suspected or confirmed COVID-19 infection.

The prevalence of adaptive immunity to COVID-19 and reinfection after recovery - a comprehensive systematic review and meta-analysis.

This study aims to estimate the prevalence and longevity of detectable SARS-CoV-2 antibodies and T and B memory cells after recovery. In addition, the prevalence of COVID-19 reinfection and the preventive efficacy of previous infection with SARS-CoV-2 were investigated. A synthesis of existing research was conducted. The Cochrane Library, the China Academic Journals Full Text Database, PubMed, and Scopus, and preprint servers were searched for studies conducted between 1 January 2020 to 1 April 2021. Included studies were assessed for methodological quality and pooled estimates of relevant outcomes were obtained in a meta-analysis using a bias adjusted synthesis method. Proportions were synthesized with the Freeman-Tukey double arcsine transformation and binary outcomes using the odds ratio (OR). Heterogeneity was assessed using the I2 and Cochran's Q statistics and publication bias was assessed using Doi plots. Fifty-four studies from 18 countries, with around 12,000,000 individuals, followed up to 8 months after recovery, were included. At 6-8 months after recovery, the prevalence of SARS-CoV-2 specific immunological memory remained high; IgG - 90.4% (95%CI 72.2-99.9, I2 = 89.0%), CD4+ - 91.7% (95%CI 78.2-97.1y), and memory B cells 80.6% (95%CI 65.0-90.2) and the pooled prevalence of reinfection was 0.2% (95%CI 0.0-0.7, I2 = 98.8). Individuals previously infected with SARS-CoV-2 had an 81% reduction in odds of a reinfection (OR 0.19, 95% CI 0.1-0.3, I2 = 90.5%). Around 90% of recovered individuals had evidence of immunological memory to SARS-CoV-2, at 6-8 months after recovery and had a low risk of reinfection.RegistrationPROSPERO: CRD42020201234.

Association between COVID-19 infection and ABO blood types in Mazandaran Province, Iran: A cross-sectional study

Background and purpose: The association between ABO blood types and Coronavirus disease 2019 (COVID-19) have been investigated in several studies but there are inconsistencies in results. The purpose of this study was to investigate the association between ABO blood types and COVID-19 infection based on serologic results. Materials and methods: A cross-sectional seroepidemiologic study was carried out in 1504 people living in Mazandaran province, north of Iran. Blood samples were drawn to determine blood groups. Also, IgG and IgM antibodies were measured by ELISA. Data analysis was done using Chisquare, Fisher’s exact test, univariate and multivariate logistic regression analyses in SPSS V25. Results: The frequency of IgG positive among blood groups A, B, AB, and O was 12.7%, 11.8%, 9.4%, and 9.6%, respectively. After adjusting for suspicious confounding factors, the odds ratio of COVID-19 infection was 1.19 (95% CI:0.85-1.67) in blood group A, 1.33 (95% CI:0.94-1.87) in blood group B, 0.82 (95% CI:0.44-1.55) in blood group AB, and 0.70 (CI 95%:0.50-0.98) in blood group O based on serologic results (IgG+/IgM+). Conclusion: The odds ratio for COVID-19 was significantly lower (30%) in blood group O compared to other blood groups, so blood group O can be considered as a protective factor against COVID-19.

Stress-, anxiety-, and cellphone use-induced sleep deficits and psychological conditions during the pandemic and a potential remedy

Stress-induced sleep and psychological problems are common in modern life. The rapid spread of COVID-19 and implementation of social isolation has diminished social activities, leading to major changes in daily lifestyles.Unprecedented changes, coupled with the fear induced by the pandemic, have added stress and anxiety for a large segment of the population. Interestingly, within this timeframe, there has been a significant increase in cellphone dependence, which may be linked to social isolation. These events could result in a disruption in sleep patterns and increase in psychological challenges. In this study, we surveyed 288 volunteers to gain insight into how stress, anxiety, and time spent on cellphones affected sleep and mood. In addition, we developed an herbal compound preparation, “Smarto-One”, which is rich in flavonoids that play a role in GABAA receptor modulation. We tested its therapeutic effects on these conditions presumably linked to social isolation. We found 1) a negative linear correlation between sleep duration vs stress level and time on cellphone. 2) a negative correlation between wake-up mood/symptoms vs stress. 3) volunteers taking Smarto-One showed substantial improvements in stress levels, hours of sleep, cellphone dependence, and wake-up mood/symptoms as compared to taking placebo. Overall, this work illustrates the value of Smarto-One as an alternative remedy for improving overall mental health and wellbeing. (Int J Biomed Sci 2021;17 (3): 40-49).

Serum vitamin d concentrations in covid19 patients

Background and purpose: Vitamin D deficiency is highly prevalent in Iran. Death toll due to the Coronavirus Disease 2019 (COVID-19) is high in this country. The purpose of the present investigation was to provide more information on the relationship between serum levels of vitamin D in confirmed cases of COVID-19 in north of Iran. Materials and methods: This cross-sectional descriptive study was performed in COVID-19 patients (n=80) attending Sari Imam Khomeini Hospital, Iran 2020, who were confirmed for COVID-19 infection with CT-Scan or RT-PCR. Seventy healthy individuals were also examined as the control group. SPSS V19 was applied for data analysis. Results: In this study, 80 patients with COVID-19 (mean age: 57.22 ± 17.44 years old) and 70 healthy individuals (mean age: 48.69 ± 12.99 years) were studied. There were 38 and 35 males in these two groups, respectively. Serum Vitamin D levels were significantly lower in patients with COVID-19 than those in the control group (18.72 ± 12.53 vs. 30.86 ± 15.19 ng/ml, P< 0.001). Conclusion: This study showed that serum levels of Vitamin D were lower in patients with COVID-19 than healthy individuals and frequency of Vitamin D deficiency was higher in these patients. Hence, further studies are needed to clarify the role of serum Vitamin D concentrations in patients with COVID-19 infection.

Prevalence and determinants of symptomatic COVID-19 infection among children and adolescents in Qatar: a cross-sectional analysis of 11 445 individuals.

There is a paucity of evidence about the prevalence and risk factors for symptomatic infection among children. This study aimed to describe the prevalence of symptomatic coronavirus disease 2019 (COVID-19) and its risk factors in children and adolescents aged 0-18 years in Qatar. We conducted a cross-sectional study of all children aged 0-18 years diagnosed with COVID-19 using polymerase chain reaction in Qatar during the period 1st March to 31st July 2020. A generalised linear model with a binomial family and identity link was used to assess the association between selected factors and the prevalence of symptomatic infection. A total of 11 445 children with a median age of 8 years (interquartile range (IQR) 3-13 years) were included in this study. The prevalence of symptomatic COVID-19 was 36.6% (95% confidence interval (CI) 35.7-37.5), and it was similar between children aged <5 years (37.8%), 5-9 years (34.3%) and 10 + years (37.3%). The most frequently reported symptoms among the symptomatic group were fever (73.5%), cough (34.8%), headache (23.2%) and sore throat (23.2%). Fever (82.8%) was more common in symptomatic children aged <5 years, while cough (38.7%) was more prevalent in those aged 10 years or older, compared to other age groups. Variables associated with an increased risk of symptomatic infection were; contact with confirmed cases (RD 0.21; 95% CI 0.20-0.23; P = 0.001), having visited a health care facility (RD 0.54; 95% CI 0.45-0.62; P = 0.001), and children aged under 5 years (RD 0.05; 95% CI 0.02-0.07; P = 0.001) or aged 10 years or older (RD 0.04; 95% CI 0.02-0.06; P = 0.001). A third of the children with COVID-19 were symptomatic with a higher proportion of fever in very young children and a higher proportion of cough in those between 10 and 18 years of age.

Efficacy of chloroquine and hydroxychloroquine in treating COVID-19 infection: A meta-review of systematic reviews and an updated meta-analysis.

OBJECTIVE: To synthesize findings from systematic reviews and meta-analyses on the efficacy and safety of chloroquine (CQ) and hydroxychloroquine (HCQ) with or without Azithromycin for treating COVID-19, and to update the evidence using a meta-analysis. METHODS: A comprehensive search was carried out in electronic databases for systematic reviews, meta-analyses and experimental studies which investigated the efficacy and safety of CQ, HCQ with or without Azithromycin to treat COVID-19. Findings from the reviews were synthesised using tables and forest plots and the quality effect model was used for the updated meta-analysis. The main outcomes were mortality, the need for intensive care services, disease exacerbation, viral clearance and occurrence of adverse events. RESULTS: Thirteen reviews with 40 primary studies were included. Two meta-analyses reported a high risk of mortality, with ORs of 2.2 and 3.0, and the two others found no association between HCQ and mortality. Findings from two meta-analyses showed that HCQ with Azithromycin increased the risk of mortality, with similar ORs of 2.5. The updated meta-analysis of experimental studies showed that the drugs were not effective in reducing mortality (RR 1.1, 95%CI 1.0-1.3, I2 = 0.0%), need for intensive care services (OR 1.1, 95%CI 0.9-1.4, I2 = 0.0%), virological cure (OR 1.5, 95%CI 0.5-4.4, I2 = 39.6%) or disease exacerbation (OR 1.2, 95%CI 0.3-5.9, I2 = 31.9%) but increased the odds of adverse events (OR 12,3, 95%CI 2.5-59.9, I2 = 76.6%). CONCLUSION: There is conclusive evidence that CQ and HCQ, with or without Azithromycin are not effective in treating COVID-19 or its exacerbation. REGISTRATION: PROSPERO: CRD42020191353.