The impact of mindfulness-based stress reduction on psychological health among patients with chronic diseases during COVID-19 outbreak lockdown.

Background: The emergence of COVID-19 has spurred a wide range of psychological morbidities. However, its influence on a vulnerable population with chronic conditions is less addressed. Therefore, this study aimed to investigate the psychological health among patients with chronic diseases during the elevated psychiatric distress associated with the outbreak and examine the efficacy and feasibility of mindfulness-based stress reduction intervention (MBSR). The study involved 149 participants recruited from university hospital outpatient clinics. Patients were allocated into two groups: MBSR training program and control group. Standardized questionnaires were administered to assess depression, anxiety and stress prior to the MBSR program and at completion of the training after 8 weeks. Results: The results showed that MBSR intervention improved psychological distress and decreased the mean scores of depression, anxiety and stress. Conclusions: Mindfulness training program based on audio and smartphone was feasible and effective when it was applied to patients with chronic diseases and showed positive impact on negative psychological stress domains. These findings pave the way for the integration of psychological support for patients with chronic illnesses in clinical settings.

Empiric Anticoagulation Therapy in Hospitalized COVID-19 Patients: An Evaluation of Bleeding Risk Scores Performances in Predicting Bleeding Events.

Currently, there is no standardized consensus on anticoagulation (AC) among patients with coronavirus disease (COVID-19), which has an overwhelming bleeding risk. We aimed to compare the patterns of AC in COVID-19 patients and compare two validated risk scores in predicting bleeding events. A retrospective review of medical records was conducted for COVID-19 patients who received empiric anticoagulation therapy. The primary outcomes included bleeding events, survival, and mechanical ventilation needs. We applied the HAS-BLED and ORBIT bleeding risk scores to assess the predictive accuracy, using c-statistics and the receiver operating curve (ROC) method. Of the included patients (n = 921), with a mean age of 58.1 ± 13.2, 51.6% received therapeutic AC and 48.4% received a prophylactic AC dose. Significantly higher values of d-dimer and C-reactive protein (CRP) among the therapeutic AC users (p < 0.001) were noted with a significantly prolonged duration of hospital stay and mechanical ventilation (p < 0.001 and p = 0.011, respectively). The mean value of the HAS-BLED and ORBIT scores were 2.53 ± 0.93 and 2.26 ± 1.29, respectively. The difference between the two tested scores for major bleeding and clinically relevant non-major bleeding was significant (p = 0.026 and 0.036, respectively) with modest bleeding predictive performances. The therapeutic AC was associated with an increased risk of bleeding. HAS-BLED showed greater accuracy than ORBIT in bleeding risk predictability.

Sanitizer-associated systemic side effects in the era of COVID-19: a pharmacovigilance study.

Background: The practice of proper hand sanitization became of utmost importance and one of the best protective measures during the pandemic outbreak of COVID-19. However, misuse of disinfectants can be an overwhelming issue because of increasing demands, public panic, and unawareness, which can negatively affect human health and the environment. Therefore, we aimed to determine whether the outbreak was associated with increased reports of adverse events related to hand sanitizers through the data of adverse events reported to the pharmacovigilance database of the Food and Drug Administration Adverse Event Reporting System (FAERS). FAERS database was analyzed for hand sanitizer reports including alcohol-based and alcohol-free formulations. Results: Adverse events reports associated with hand sanitizers increased significantly by 2020 with variable severity degrees, noting that most serious cases were reported with alcohol-based sanitizers. Conclusion: Based on data mining of the FAERS database, we claim that the increased reports associated with alcohol hand sanitizer use deserve attention. However, FAER's database has some limitations, such as case duplication and lack of a control group. Hence, further monitoring with more robust sources of data sources is critically needed.

Vitamins and other immune-supportive elements as cofactors for passing the COVID-19 pandemic.

BACKGROUND: Coronavirus disease 2019 (COVID-19) is a viral disease that causes a respiratory disorder, started in December of 2019 in China. Several vitamins and trace elements could help in enhancing host immunity producing antioxidant or anti-inflammatory action. This work aimed to identify the role of different nutrition, vitamins, and trace elements on the immunity status of the infected subject and the possibility of the beneficial role of these elements in the management of COVID-19. MAIN BODY: After collecting (PubMed, scholar, OVID, Embase, Cochrane Library) and investigating published articles, testing the effect of these elements on viral infection, it was found that most of these elements have a significant role during viral infection through a different mechanism, like antioxidant, anti-inflammatory, and immunomodulation. Nutritional interventions in COVID-19 infections are very important currently, and it was reported that vitamin C and D reduce the risk of acute respiratory infections. In addition, low vitamin A diets compromise the effectiveness of inactivated bovine coronavirus vaccines. Administration of N-acetyl cysteine showed a beneficial inhibitory effect in viral infections and enhanced glutathione production. The deficiency of selenium on COVID-19 subjects has a significant impact on the clinical outcome of the subjects. In addition, supplementation with vitamins proved to enhance immune response during viral infection. Vitamins and trace elements not only showed a beneficial effect but also Omega 3 fatty acids showed an immunomodulating effect during infections. SHORT CONCLUSIONS: Assessment of levels for these trace elements at the baseline and providing supplementation containing different vitamins and elements could result in better control and clinical outcomes in the case of COVID-19.

Effect of mutation and vaccination on spread, severity, and mortality of COVID-19 disease.

Coronavirus disease 2019 (COVID-19) has had different waves within the same country. The spread rate and severity showed different properties within the COVID-19 different waves. The present work aims to compare the spread and the severity of the different waves using the available data of confirmed COVID-19 cases and death cases. Real-data sets collected from the Johns Hopkins University Center for Systems Science were used to perform a comparative study between COVID-19 different waves in 12 countries with the highest total performed tests for severe acute respiratory syndrome coronavirus 2 detection in the world (Italy, Brazil, Japan, Germany, Spain, India, USA, UAE, Poland, Colombia, Turkey, and Switzerland). The total number of confirmed cases and death cases in different waves of COVID-19 were compared to that of the previous one for equivalent periods. The total number of death cases in each wave was presented as a percentage of the total number of confirmed cases for the same periods. In all the selected 12 countries, Wave 2 had a much higher number of confirmed cases than that in Wave 1. However, the death cases increase was not comparable with that of the confirmed cases to the extent that some countries had lower death cases than in Wave 1, UAE, and Spain. The death cases as a percentage of the total number of confirmed cases in Wave 1 were much higher than that in Wave 2. Some countries have had Waves 3 and 4. Waves 3 and 4 have had lower confirmed cases than Wave 2, however, the death cases were variable in different countries. The death cases in Waves 3 and 4 were similar to or higher than Wave 2 in most countries. Wave 2 of COVID-19 had a much higher spread rate but much lower severity resulting in a lower death rate in Wave 2 compared with that of the first wave. Waves 3 and 4 have had lower confirmed cases than Wave 2; that could be due to the presence of appropriate treatment and vaccination. However, that was not reflected in the death cases, which were similar to or higher than Wave 2 in most countries. Further studies are needed to explain these findings.

Role of repeating quarantine instructions and healthy practices on COVID-19 patients and contacted persons to raise their awareness and adherence to quarantine instructions.

OBJECTIVE: This study aimed to develop a model evaluating the role of repeating quarantine instructions and healthy practices among COVID-19 patients and contact persons at-home quarantine and to evaluate the instructions' adequacy in decreasing the rate of disease spread with better clinical outcomes. METHODS: A structured questionnaire was distributed to COVID-19 patients (mild and moderate cases isolated at home) and contacting persons during May and June 2020. Data were collected using a structured online survey collected every five days for three times from each participant. The questionnaire was divided into three sections, consisting of 35 questions for a total possible score of 0 to 35. RESULTS: A total of 150 valid participant's responses out of 304 participants were obtained. Among the150 total participants, 88 were infected with COVID-19, and 62 were contacting with COVID-19 patients. The improvement in the score of awareness and adherence to instructions for the infected patients and their contacts was significantly high in the third questionnaire than in the second and the first questionnaire. The people who live in cities followed the instructions provided at the home quarantine better than those who live in the country. The city patients improved in symptoms better than the country patients. Also, patients followed the instructions better than their contacts. City females adhered to the instructions better than city males. Young people had high awareness score than older people. City people are committed to taking both immune boosters supplements as prophylaxis or prescribed medications on time for treatment more than country people. CONCLUSION: This study offers useful insights into factors associated with the role of repeating quarantine instructions and healthy practices to overcome the COVID-19 pandemic. So, repeating the instructions is important to increase adherence to the instructions, decrease the rate of disease progression and decrease the spread of the infection.

A study of the possible factors affecting COVID-19 spread, severity and mortality and the effect of social distancing on these factors: Machine learning forecasting model.

BACKGROUNDS: SARS-CoV-2 is affecting different countries all over the world, with significant variation in infection-rate and death-ratio. We have previously shown a presence of a possible relationship between different variables including the Bacillus Calmette-Guérin (BCG) vaccine, average age, gender, and malaria treatment, and the rate of spread, severity and mortality of COVID-19 disease. This paper focuses on developing machine learning models for this relationship. METHODS: We have used real-datasets collected from the Johns Hopkins University Center for Systems Science and Engineering and the European Centre for Disease Prevention and Control to develop a model from China data as the baseline country. From this model, we predicted and forecasted different countries' daily confirmed-cases and daily death-cases and examined if there was any possible effect of the variables mentioned above. RESULTS: The model was trained based on China data as a baseline model for daily confirmed-cases and daily death-cases. This machine learning application succeeded in modelling and forecasting daily confirmed-cases and daily death-cases. The modelling and forecasting of viral spread resulted in four different regions; these regions were dependent on the malarial treatments, BCG vaccination, weather conditions, and average age. However, the lack of social distancing resulted in variation in the effect of these factors, for example, double-humped spread and mortality cases curves and sudden increases in the spread and mortality cases in different countries. The process of machine learning for time-series prediction and forecasting, especially in the pandemic COVID-19 domain, proved usefulness in modelling and forecasting the end status of the virus spreading based on specific regional and health support variables. CONCLUSION: From the experimental results, we confirm that COVID-19 has a very low spread in the African countries with all the four variables (average young age, hot weather, BCG vaccine and malaria treatment); a very high spread in European countries and the USA with no variable (old people, cold weather, no BCG vaccine and no malaria). The effect of the variables could be on the spread or the severity to the extent that the infected subject might not have symptoms or the case is mild and can be missed as a confirmed-case. Social distancing decreases the effect of these factors.

COVID-19; current situation and recommended interventions.

BACKGROUND: The new coronavirus (SARS-COV-2) that emerged at the end of 2019 was stated in China and infected millions of people around the world, with the highest spread rate amongst humans compared with other coronaviruses. This paper aimed to review and analyse the published studies about COVID-19 diagnosis, prevention, and treatment. METHOD: The reviewed studies were clinical trials, in-vivo, in-vitro, guidelines, reports from the world health organization (WHO), and the centre for disease control and prevention (CDC) in addition to systemic reviews. All data extracted and analysed to stand on the latest updates and recommendations for fighting this severe attack of COVID-19. RESULTS: Most important antiviral therapy of COVID-19 clinical trials is still running without clear results, but a few trials have indicated the role of numerous drugs in the treatment of COVID-19. Specific recommendations for aerosol therapy should be followed for the management of COVID-19. CONCLUSION: Nature of COVID-19 is still not very clear, however, management of the condition is similar to the previous attacks of coronaviruses.

Bacillus Calmette-Guérin vaccine, antimalarial, age and gender relation to COVID-19 spread and mortality.

COVID-19 is affecting different countries all over the world with great variation in infection rate and death ratio. Some reports suggested a relation between the Bacillus Calmette-Guérin (BCG) vaccine and the malaria treatment to the prevention of SARS-CoV-2 infection. Some reports related infant's lower susceptibility to the COVID-19. Some other reports a higher risk in males compared to females in such COVID-19 pandemic. Also, some other reports claimed the possible use of chloroquine and hydroxychloroquine as prophylactic in such a pandemic. The present commentary is to discuss the possible relation between those factors and SARS-CoV-2 infection.