Establishment of an infrastructure for rapid pandemic response at the Frederick National Laboratory

The sudden onset of the 2019 SARS-CoV-2 pandemic required agile development of standards and efficient validation of assays to assess prevalence of infection as well as immune responses to infection and vaccination. Leveraging their experience in HPV serology and standards, the Vaccine, Immunity and Cancer Directorate (VICD) at the Frederick National Laboratory for Cancer Research (FNCLR) pivoted to address this unmet need in SARS-Co-V2 serology clinical testing and research. This standardization effort required the collection and processing of large volumes of blood from SARS-Co-V2 infected and uninfected individuals into serum and peripheral blood mononuclear cells (PBMCs). Collaborations with specimen collection sites across the United States were established. Following qualification for anti-SARS-CoV-2 IgG and IgM levels in independent laboratories, VICD assembled reference evaluation panels, which were used to assist the FDA's performance evaluation of commercial assays submitted for EUA approval. To date, 185 different shipments of the standard or validation panel have been sent to both domestic and international labs. These materials are also available to the SARS-CoV-2 serology community for assay calibration and performance evaluation which greatly facilitates assay data harmonization. In addition, the NCI Serological Sciences Network (SeroNet) was born from this initiative and expertise, resulting in the establishment of Capacity Building Centers (CBCs) for sample collection from different healthy, cancer and immunocompromised cohorts at Mount Sinai, Arizona State University, the University of Minnesota, and Northwell Feinstein. The NCI and FNLCR simultaneously collaborated to develop a network of investigators focused on advancing research on the immune response to SARS-CoV-2 infection and vaccination among diverse and vulnerable populations, including cancer patients. Their research has resulted in over 326 peer-reviewed publications. The CBC's have enrolled patients in longitudinal studies, resulting in a centralized collection of annotated, well characterized serum, PBMCs and clinical data. Numerous cancer cohorts, but predominantly Multiple Myeloma, are included. Furthermore, technology development was supported at the CBC's. Based upon this success, the VICD in collaboration with NCI is pursuing an even more innovative effort in pandemic preparedness to establish a Center for Serology and Data Emergency Preparedness (CESDEP);a global network able to activate and pivot to address pandemic-level threats, while continuing to expand the development of immunological assays that can inform clinical decisions for cancer and other immunocompromised patients.

SARS-CoV2 infection after vaccination in patients requiring extracorporeal life support: An analysis from the EuroECMO-COVID study group

Objectives: At the beginning of the pandemic, it was believed that severe SARS-CoV2 infection would induce lifelong immunity and that reinfections would be unlikely. However, several cases of reinfection were documented in previously infected patient and the waning humoral immunity has raised significant concerns. Accordingly, long-term and durable vaccineinduce antibody protection against infection have also become a challenge, as several breakthroughs of COVID-19 have been identified in individuals partially or fully vaccinated. This study describes the incidence, the characteristics of severe COVID-19 infections requiring ECMO occurred after vaccination and the presence of side effects related to the vaccine. Method(s): EuroECMO COVID is a prospective, multicenter, observational study, developed by the EuroELSO, based on data from patients aged >=16 years who received ECMO support for refractory COVID-19 during the pandemic in 204 centers. The analysis investigates the survival of vaccinated patient, the associations between management-related variables, the incidence of vaccination during the different pandemic phases, the type of vaccines and the possible side effects. Result(s): Immunosuppressed patients are susceptible to reinfection even after being naturally infected or receiving a full vaccination. Ineffective antibody production, due to relatively ineffective vaccines, inadequate number of doses or the time after vaccination are involved in the pathogenesis of postvaccination infections. This population was found to have a partial immunity due to an inadequate number of doses and an overlapped time from vaccination and SARS-CoV2 incubation with PCR results after being vaccinated. Several manifestations of SARS-CoV2 infection are similar to vaccine-induce side effects and mild symptoms can be presented both as an adverse reaction after vaccination and a result of infection. In this subgroup no side effects were attributable to the vaccine. Conclusion(s): Vaccination does not entirely prevent SARS-CoV2 but will lead to less morbidity and mortality, as demonstrated by less need of ICU and ECMO care. In addition, the partial immunity for inadequate doses of vaccine or through the evolution of new variants demonstrated the importance of further analysis to differentiate the possible causes of waning humoral immunity.

Are Non-Structural Proteins From SARS-CoV-2 the Target of Hydroxychloroquine? An in Silico Study

COVID-19 is caused by SARS-CoV-2 which has structural and non-structural proteins (NSP) essential for infection and viral replication. There is a possible binding of SARS-CoV-2 to the beta-1 chain of hemoglobin in red blood cells and thus, decreasing the oxygen transport capacity. Since hydroxychloroquine (HCQ) can accumulate in red cells, there is a chance of interaction of this drug with the virus. To analyze possible interactions between SARS-CoV-2 NSP and hemoglobin with the HCQ using molecular docking and implications for the infected host. This research consisted of a study using bioinformatics tools. The files of the protein structures and HCQ were prepared using the AutoDock Tools software. These files were used to perform molecular docking simulations by AutoDock Vina. The binding affinity report of the generated conformers was analyzed using PyMol software, as well as the chemical bonds formed. The results showed that HCQ is capable of interacting with both SARS-CoV-2 NSP and human hemoglobin. The HCQ/NSP3 conformer, HCQ/NSP5, HCQ/NSP7-NSP8-NSP12, HCQ/NSP9, HCQ/NSP10-NSP16 showed binding affinity. In addition, the interaction between HCQ and hemoglobin resulted in polar bonds. Interaction between SARS-CoV-2 NSP and HCQ indicates that this drug possibly acts by preventing the continuity of infection.Copyright © 2023 Tehran University of Medical Sciences.

COVID-19 Infection Changes the Functions and Morphology of Erythrocytes: A Multidisciplinary Study

Hematological problems are associated with Coronavirus disease 2019 (COVID-19). Respiratory impairment is the higher point studied, although without experimental studies related to the oxygen transport performed by erythrocytes. Therefore, we decided to investigate if erythrocytes from COVID-19 patients have their functionality changed. The case-control study included hospitalized patients with a positive real-time polymerase chain reaction (RT-PCR) result admitted to University Hospital. Volunteers (negative RT-PCR results) were recruited as a control group. Thus, we assessed different erythrocytes parameters, oxidative stress markers, and biophysical studies using whole blood and isolated hemoglobin. We found a decrease of 51% in oxygen uptake and reduced antioxidant enzyme activity in COVID-19 patients compared to controls. Raman spectrometry showed structural changes in the hemoglobin and lipids of the erythrocytes from COVID-19 patients;thus, these results were consolidated with an increase in Young's modulus in erythrocytes followed by morphology changes. Besides, isolated hemoglobin from COVID-19 patients has a distinct interaction profile using a ligand model compared to the control. COVID-19 leads to structural, functional, and morphological damage to human erythrocytes. Our data showed structural and molecular changes and induction of oxidative stress in erythrocytes by COVID-19, a new perspective on the contribution of erythrocytes to a respiratory commitment in COVID-19.

Hospitalizations for acute bronchiolitis in infants after relaxation of COVID-19 mitigation strategies in Brazil

Background: The coronavirus disease 2019 (COVID-19) pandemic led to daycare and school closures and children staying home for several months. The season of the respiratory viruses have been significantly changed. Aims and objectives: This study aims to assess the course of acute bronchiolitis in Brazil during the 2020-2021 season and compare them with the previous seasons. Method(s): Data from hospitalizations of acute bronchiolitis in infants <1 year were obtained from the Brazilian Public Health database for the period between 2016 and 2021. These data were also analyzed by Brazilian macroregions. The absolute and relative reductions were calculated by analyzing the yearly subsets: 2016-2019 vs 2020, 2016- 2019 vs 2021 and 2020 vs 2021. Result(s): A statiscally significant reduction was observed between 2016-2019 vs 2020, -76% (incidence rate ratio [IRR], 0.23 [95% confidence interval {CI},. 21-.25]) while a significant increase was observed between 2020 vs 2021 +55% (IRR, 0.44 [95% CI,. 40-.48]). Conclusion(s): More than a year into the COVID-19 pandemic, intensified infection control measures have controlled most viral respiratory infections in Brazil. From March to June 2021, however, an increasing number of hospitalizations for acute bronchiolitis were reported in Brazil. This resurgence have probably resulted from restarting social activities for children.

Are Patient Demographic Characteristics Associated with Family Presence at the Bedside in the Picu?

INTRODUCTION: Families are often not present at the bedside during their child's pediatric intensive care unit (PICU) admission. Family presence is important for participation in family-centered care (FCC), promoted by the American Academy of Pediatrics to improve health outcomes. It is unknown if demographic characteristics are associated with family presence during peak illness severity, the first 72 hours of admission. We describe associations between demographic characteristics and family presence during peak illness severity. METHOD(S): We performed a retrospective observational study of PICU admissions > 72 hours from July 2012-June 2021 at a single tertiary care children's hospital to determine associations with our primary outcome of bedside family presence percentage in the first 72 hours of admission. Predictor variables included patient and family demographic characteristics obtained from the electronic medical record. We completed descriptive bivariate analyses of the predictor variables and family presence percentage (Spearman Rho for continuous variables and Kruskal Wallis for categorical variables). RESULT(S): 3006 unique patients were included. Family members were present a mean of 81% and a median of 97% of the first 72 hours. Family presence percentage was weakly positively correlated with age (rs=0.108, p< 0.001) and weakly negatively correlated with length of stay (rs=-0.253, p< 0.001) and PELOD-2 score (rs=-0.217, p< 0.001). Decreased median family presence percentage was associated with Black race (81.1 v 97.2-98.1 all other races, p=< 0.001), non-Hispanic ethnicity (95.8 v 97.2 Hispanic ethnicity, p< 0.001), public insurance (94.8 v private 98.4, p< 0.001), and admissions after COVID (94.2 v 96.6 pre- COVID, p< 0.001). Increased family presence percentage was associated with Spanish speaking families (97.9 v 96.2 English, p = 0.01). Family presence percentage was not associated with distance from hospital, complex care conditions, or siblings. CONCLUSION(S): Family presence percentage during peak illness severity is associated with patient demographic characteristics. Families of racially and ethnically diverse patients and with public insurance may benefit from interventions to increase their ability to be present at the bedside.

Diagnostico Da Evolucao De Sindrome Mielodisplasica Para Leucemia Mieloide Aguda Atraves De Biopsia Intraoral: Relato De Caso

Objetivo: O presente trabalho tem como objetivo relatar um caso de evolucao de sindrome mielodisplasica para leucemia mieloide aguda, diagnosticada atraves de biopsia de lesao intraoral de sarcoma mieloide. Material e Metodos: Trata-se de um estudo descritivo, retrospectivo, do tipo relato de caso. Os dados foram coletados atraves dos registros em prontuarios eletronico e fisico da instituicao. Resultados: O caso apresentado envolveu um paciente do sexo masculino, de 51 anos, melanoderma, matriculado na instituicao devido ao diagnostico de sindrome mielodisplasica, tratado com 19 ciclos de decitabina. Devido a um quadro de odontalgia e abscessos de repeticao o paciente foi encaminhado ao setor de Odontologia onde, durante o exame clinico, foi constatada presenca de lesao eritematosa, amolecida, friavel, de superficie lisa, base sessil, de aproximadamente 3 x 1cm na regiao distopalatina do dente 26. No exame radiografico, foi observada imagem radiopaca associada a raiz mesial do dente 26, com margens definidas. Foi realizada biopsia excisional da lesao em regiao de palato com carater de urgencia e as hipoteses diagnosticas iniciais foram de granuloma piogenico e cisto radicular. O laudo histopatologico foi compativel com quadro de sarcoma mieloide comprometendo mucosa, com imuno-histoquimica positiva para CD34 e CD117 e negativa para CD163 e TdT. Diante do diagnostico previo de sindrome mielodisplasica, associado ao diagnostico de sarcoma mieloide oral, a equipe medica constatou a transformacao da doenca inicial em leucemia mieloide aguda. Foi definido novo protocolo terapeutico e realizado um ciclo de citorreducao com Citarabina (ara-C) subcutaneo e resgate com hidroxiureia + ara-c (HYDAC) + idarrubicina. Durante este ciclo, o paciente foi diagnosticado com Covid-19, evoluindo para obito, nao concluindo portanto, o protocolo terapeutico proposto. Discussao: O diagnostico de sarcoma mieloide oral permitiu que a equipe multiprofissional detectasse a transformacao da doenca primaria em leucemia mieloide aguda, resultando na reformulacao do tratamento e conduta do caso. O prognostico da leucemia mieloide aguda secundaria a sindrome mielodisplasica e pior quando comparado as primarias, bem como, apresenta baixas taxas de remissao apos quimioterapia intensiva e a sobrevida global mediana de 9-12 meses. O diagnostico dessas lesoes por parte do cirurgiao-dentista e considerado um desafio, visto que sao raras em cavidade oral e as apresentacoes clinicas costumam ser variadas e inespecificas. Conclusao: O presente relato de caso evidencia a importancia de uma avaliacao clinica minuciosa e do diagnostico preciso e completo de lesoes orais, que podem implicar diretamente na definicao da doenca de base, tratamento e prognostico do paciente. Alem disso, ratifica a importancia do cirurgiao-dentista na pratica clinica e na atuacao profissional de forma interdisciplinar e integrada com a equipe de saude. Copyright © 2022

The Covid-19 Influence on the Desire to Stay at Home: A Big Data Architecture

The COVID-19 pandemic has had an impact on many aspects of society in recent years. The ever-increasing number of daily cases and deaths makes people apprehensive about leaving their homes without a mask or going to crowded places for fear of becoming infected, especially when vaccination was not available. People were expected to respect confinement rules and have their public events cancelled as more restrictions were imposed. As a result of the pandemic's insecurity and instability, people became more at ease at home, increasing their desire to stay at home. The present research focuses on studying the impact of the COVID-19 pandemic on the desire to stay at home and which metrics have a greater influence on this topic, using Big Data tools. It was possible to understand how the number of new cases and deaths influenced the desire to stay at home, as well as how the increase in vaccinations influenced it. Moreover, investigated how gatherings and confinement restrictions affected people's desire to stay at home. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

The importance of art and architecture regarding the idea that we have about a city

This article intends to make people reflect about the importance of artworks and architecture in the cities, as a way to turn them into memories and icons, regarding the idea we have about a city itself. The importance of new technologies and artificial intelligence have become a vehicle of dissemination of a certain image and attractiveness. The importance of communication in terms of a city image as a whole and of urban sites of specific cultural, artistic or historical interest. This is a contemporary subject, since tourism and the number of visitors to a city have practically disappeared or been suspended due to the current situation in the world. The crisis that has arisen with the emergence of the COVID-19 virus. A very important question arises now, when the pandemic ends, how to restore the attraction of people into certain historic and touristic places, which have meanwhile become deserted? During this period, art and traditional forms of artistic expression have been transformed. Digital and technological resources have been increasingly combined, thus giving rise to new forms of artistic expression combined with new technologies. We can see with great facility, in the most varied internet platforms, museum tours, virtual exhibitions, conferences and lectures. The city as it was known before the pandemic no longer exists. People now move around the city, silently or by car with their glasses tightly closed, they don't go to cultural places as they previously did, and they don't use restaurants in the same way. The city has become a place where people live inside and where they only travel outside for short, occasionally necessary journeys. Therefore, we are in a moment of convergence, a kind of turning of the page, where we will all learn again how to live and enjoy the city. In this article we relate the new paradigm of the increasingly digital city with the conventional city as we knew it. how can the most iconic places in cities help to make cities better known and more attractive? We did some research on some cities, and we tried to verify what were the main icons of these cities? In what way did those icons make them well-known? © 2022 Author(s).

Hospitalizations Associated With Mental Health Conditions Among Adolescents in the US and France During the COVID-19 Pandemic.

Importance: The COVID-19 pandemic has been associated with an increase in mental health diagnoses among adolescents, though the extent of the increase, particularly for severe cases requiring hospitalization, has not been well characterized. Large-scale federated informatics approaches provide the ability to efficiently and securely query health care data sets to assess and monitor hospitalization patterns for mental health conditions among adolescents. Objective: To estimate changes in the proportion of hospitalizations associated with mental health conditions among adolescents following onset of the COVID-19 pandemic. Design, Setting, and Participants: This retrospective, multisite cohort study of adolescents 11 to 17 years of age who were hospitalized with at least 1 mental health condition diagnosis between February 1, 2019, and April 30, 2021, used patient-level data from electronic health records of 8 children's hospitals in the US and France. Main Outcomes and Measures: Change in the monthly proportion of mental health condition-associated hospitalizations between the prepandemic (February 1, 2019, to March 31, 2020) and pandemic (April 1, 2020, to April 30, 2021) periods using interrupted time series analysis. Results: There were 9696 adolescents hospitalized with a mental health condition during the prepandemic period (5966 [61.5%] female) and 11 101 during the pandemic period (7603 [68.5%] female). The mean (SD) age in the prepandemic cohort was 14.6 (1.9) years and in the pandemic cohort, 14.7 (1.8) years. The most prevalent diagnoses during the pandemic were anxiety (6066 [57.4%]), depression (5065 [48.0%]), and suicidality or self-injury (4673 [44.2%]). There was an increase in the proportions of monthly hospitalizations during the pandemic for anxiety (0.55%; 95% CI, 0.26%-0.84%), depression (0.50%; 95% CI, 0.19%-0.79%), and suicidality or self-injury (0.38%; 95% CI, 0.08%-0.68%). There was an estimated 0.60% increase (95% CI, 0.31%-0.89%) overall in the monthly proportion of mental health-associated hospitalizations following onset of the pandemic compared with the prepandemic period. Conclusions and Relevance: In this cohort study, onset of the COVID-19 pandemic was associated with increased hospitalizations with mental health diagnoses among adolescents. These findings support the need for greater resources within children's hospitals to care for adolescents with mental health conditions during the pandemic and beyond.

The Project to Complete the Regional Topographic Geodatabase in Lombardy, Italy

The Regional Topographic Geodatabase (DBTR) was officially defined in 2005 as the multi-scale (1:1,000 - 1:2,000 - 1:5,000 - 1:10,000) cartographic reference for urban and regional planning in Lombardy Region. The DBTR had been previously introduced at national level to take over traditional numerical topographic maps adopted for urban planning, with the aim to provide a base map to be implemented either at regional level (Regional Geoportal) and by local administrations. The DBTR is structured by following some national guidelines that define either the content and the topological structure, that makes simple its implementation in GIS environment. The construction of the entire DBTR has historically gone through different phases, with the consistent support of the regional subsidiary policy. But when the effects of the world economic crisis in 2008 became tangible in the budget of public administrations, the growth of the project faced an important break. In 2017 the administration of Lombardy Region has promoted and financed a new project finalized to the completion of the DBTR. A temporary association of mapping companies won the tender and completed the project by summer 2020, despite of the difficulties related to the COVID-19 pandemic. A team led by Politecnico di Milano was appointed for the quality assessment. The proposed paper would like to present this project and the operational solutions applied for the production of the new subsections of the DBTR, as well as its quality assessment/validation.

DiCOVA Challenge: Dataset, task, and baseline system for COVID-19 diagnosis using acoustics

The DiCOVA challenge aims at accelerating research in diagnosing COVID-19 using acoustics (DiCOVA), a topic at the intersection of speech and audio processing, respiratory health diagnosis, and machine learning. This challenge is an open call for researchers to analyze a dataset of sound recordings, collected from COVID-19 infected and non-COVID-19 individuals, for a two-class classification. These recordings were collected via crowdsourcing from multiple countries, through a website application. The challenge features two tracks, one focusing on cough sounds, and the other on using a collection of breath, sustained vowel phonation, and number counting speech recordings. In this paper, we introduce the challenge and provide a detailed description of the task, and present a baseline system for the task.

Convalescent plasma therapy in COVID-19 patients: a non-randomized case-control study with concurrent control.

Convalescent plasma therapy has shown controversial results in coronavirus disease-19 (COVID-19) patients. We performed a non-randomized case-control study with contemporaneous controls in a hospital in southern Brazil. Patients were selected for treatment with convalescent plasma by medical decision and compared with patients who did not receive plasma and were hospitalized due to COVID-19 at the same time. The outcomes of interest were intensive care unit (ICU) admission and in-hospital death. Patients that received convalescent plasma had lower in-hospital mortality than patients that did not receive plasma (relative risk (RR) 0.48; 95% confidence interval (CI) 0.29 to 0.79) and these results were consistent after changing the subset of control patients. There were no differences regarding ICU admission between groups (RR=0.80; 95%CI: 0.47 to 1.35). In this study, patients that received convalescent plasma for COVID-19 had lower in-hospital mortality, but this finding requires further confirmation given the retrospective nature of the study.

Physical Distancing and Mental Well-Being in Youth Population of Portugal and Brazil during the COVID-19 Pandemic

Background: The COVID-19 pandemic may affect youth's physical and mental well-being, partially because of the countries' rules to contain the virus from spreading. However, there is still uncertainty about the impact of physical distancing on youth's mental health. We aimed to estimate the prevalence of feeling agitated, anxious, down, sad, or low mood (FNF) due to physical distance measures and verify which factors are associated with young Portuguese and Brazilian people. Methods: We used cross-sectional data from the instrument "COVID-19 Barometer: Social Opinion"in Portugal (March 2020 and September 2021) and from "COVID-19 Social Thermometer"in Brazil (August 2020 to April 2021);these surveys included data regarding the health and socioeconomic impact on the population. The health and sociodemographic variables of the two countries were summarized as absolute and relative frequencies. A multivariable logistic regression model was fit by country to estimate the relation between FNF and selected variables of interest. Results: Approximately 36% of the sample studied reported anxiety, agitation, sadness, or low mood almost every day in Portugal and 52% in Brazil due to physical distancing. In Portugal, having more than two comorbidities represented a greater chance of experiencing FNF every day or almost every day (odds ratio [OR] = 1.51 [CI: 1.22-1.87]) than those without comorbidities. In contrast, having a university education level represented a protector factor (OR = 0.76 [CI: 0.67-0.88]). In Brazil, being unemployed increased the chance of FNF compared to students (OR = 11.2). Conclusions: Physical distancing measures have impacted the mental well-being of the young population in Portugal and Brazil. The countries must make a quick effort to attend to and protect young people's well-being and mental health in the changing context of the current pandemic.

Potential of the triad of fatty acids, polyphenols, and prebiotics from cucurbita against COVID-19 in diabetic patients: A review

Though the scientific community of the entire world has been struggling to create preventive and therapeutic drugs for coronavirus disease 2019 (COVID-19), the role of nutraceuticals has been hitherto neglected. Established role of fatty acids and polyphenols in combating lifestyle disease can be harnessed to play a significant role in the prevention of this disease. The synergistic effect of these phytonutrients and prebiotics is anticipated to prove beneficial for prevention as well as attenuation of COVID-19 infection. Presence of fatty acids, polyphenols and prebiotics in vegetables from the Cucurbitaceae family makes them an attractive choice for being used as a nutritional supplement during COVID-19. These are known to attenuate the excessive immune response which may prove to be beneficial in preventing and mitigating COVID-19. Use of prebiotics to promote the growth of probiotics has also been recommended for the prevention and cure of COVID-19. However, no such report exists in literature that throws light on such role of cucurbita plants. The present review focuses on the role of the triad of fatty acids, prebiotics and polyphenols present in cucurbita plants in controlling systemic inflammation and endothelial damage, the two main etiopathological factors involved in COVID-19. Cucurbita plants are rich in all these components and their inclusion in diet would be an effective strategy to combat COVID-19. The main focus of the review is to discuss the role of various components of the plants of Cucurbita family, taken as dietary component, in prevention and control of the ongoing pandemic COVID19.

BAL sensitivity and specificity in interstitial pneumonia

Introduction and Purpose of the study: The sensitivity of genomic tests to identify SARS-CoV2 is around 65-75%. It is very common to find clinical and radiological pictures suggestive of infection but with a negative nasopharyngeal swab. The aim of our study was to use BAL fibrobronchoscopy in subjects with negative swab but with clinical and radiological signs suggesting SARS-CoV2 infection. Materials and Methods: 52 subjects admitted to the observation area (gray area) Covid of the F. Miulli Hospital in 2020 were examined. All had negative nasopharyngeal swab (even in several determinations), also performed on sputum, but a clinical and radiological picture (Ground Glass Opacity with or without consolidations) suggestive of infection. In all subjects a fibrobronchoscopy with BAL was performed with the microbiological research also of bacteria and other viruses (pneumo plus film array). The examination was performed about 10 days after the onset of symptoms. Results: The BAL allowed microbiological diagnosis (Covid and non-Covid) in 30.8% of cases, while the positivity rate for SARSCoV 2 was 11.5%. Conclusions: Our data shows that the negativity of BAL in the search for the SARS-CoV 2 virus agrees with the outcome of the nasopharyngeal and sputum swab (89.5%), highlighting 11.5% of positive subjects. However, BAL negativity does not exclude SARS-CoV2 etiology, especially in typical radiological cases. The time interval between the onset of infection and BAL may have allowed the clearance of the virus.

Acute Upper Airway Disease in Children With the Omicron (B.1.1.529) Variant of SARS-CoV-2-A Report From the US National COVID Cohort Collaborative.

This cohort study uses data from the US National COVID Cohort Collaborative to evaluate upper airway infections in children during the surge of the Omicron (B.1.1.529) variant of SARS-CoV-2 in the US.

Impact of COVID-19 lockdown on mental health of patients with multi-drug resistant tuberculosis (MDRTB) in tertiary care centre Mumbai

Background &Objective : Multi-Drug Resistant Tuberculosis (MDRTB) and depression act synergistically that magnify the burden of disease. The present study aims to understand the differences in depression scale using Patient Health Questionnaire-9 (PHQ-9) over the time during the COVID-19 pandemic which may cause mental and psychological changes in the patients with MDRTB. Method: A total of 155 treatment naive adults and adolescents MDRTB are enrolled in an ongoing cohort. Each participant completes PHQ-9 to assess depression at baseline, 2 weeks, 1, 2, 3, 4, 5, 6, 12, 18, 24 months of treatment and post treatment 6 and 12 months. Differences in the PHQ9 scores for visits before COVID-19, during 1st lockdown, in unlock phase and 2nd lockdown were assessed by Chi-squared test and t-test and p<0.05 were considered statistically significant. Results: Out of 155 participants with median age of 27 years' 102 (65.8%) were females A significant difference was seen in the overall PHQ-9 scores across each time period (p<0.001). Also, significant changes were seen in overall PHQ-9 scores before COVID-19 and 1st lockdown (p<0.001), during unlock phase, 2nd lockdown (p<0.001) and without lockdown and during 1st and 2nd lockdowns (p<0.001). During 1st lockdown and unlock phase (p=0.165), there were no significant differences seen in the PHQ-9 scores. Conclusion: In this ongoing study, changes in the overall depression scale were significantly associated with COVID-19 lockdown, during unlock phase and 2nd lockdown phase. PHQ-9 screening can be useful for patients who may benefit from additional support and counselling during the treatment during COVID-19 pandemic.

Why do men have worse COVID-19-related outcomes? A systematic review and meta-analysis with sex adjusted for age.

We aimed to study the mechanism behind worse coronavirus disease-19 (COVID-19) outcomes in men and whether the differences between sexes regarding mortality as well as disease severity are influenced by sex hormones. To do so, we used age as a covariate in the meta-regression and subgroup analyses. This was a systematic search and meta-analysis of observational cohorts reporting COVID-19 outcomes. The PubMed (Medline) and Cochrane Library databases were searched. The primary outcome was COVID-19-associated mortality and the secondary outcome was COVID-19 severity. The study was registered at PROSPERO: 42020182924. For mortality, men had a relative risk of 1.36 (95%CI: 1.17 to 1.59; I2 63%, P for heterogeneity <0.01) compared to women. Age was not a significant covariate in meta-analysis heterogeneity (P=0.393) or subgroup analysis. For disease severity, being male was associated with a relative risk of 1.29 (95%CI: 1.19 to 1.40; I2 48%, P for heterogeneity <0.01) compared to the relative risk of women. Again, age did not influence the outcomes of the meta-regression (P=0.914) or subgroup analysis. Men had a higher risk of COVID-19 mortality and severity regardless of age, decreasing the odds of hormonal influences in the described outcomes.