Immunogenetic studies on SARS-CoV-2: Our experience at SKIMS

Background: The pathophysiology of viral-infections is highly complex and involves host immunocompetence, host genetics, and gene-environment interactions. We hypothesized that polymorphic variants in host genes, blood group and previous vaccination status against H1N1 may affect the clinical course of covid-19 infection. Method(s): A total of 202 subjects who were RT-PCR negative after Covid-19 infection were recruited. We investigated association between Covid-19 infection (Severity and recovery period) and multiple factors including ABO and Rh blood groups, H1N1 vaccination, polymorphism in Viral susceptibility genes (ACE2 G8790A), and polymorphism in host response genes (ACE I/D rs4646994, IL6- 174G/C, GSTT1/GSTM1 I/D and GSTP1 Ile 105 Val). Result(s): B-ve and O-ve ABO and Rh blood groups had significantly higher Covid-19 recovery period applied on one-vs.-all in a nonparametric t-test (p<0.05). Subjects who had vaccinated themselves against H1N1 presented with a lower recovery-period (p<0.05). Both variables (blood group and H1N1 vaccination) were not however associated with Covid-19 severity. Out of the studied polymorphisms, ACE2 G8790A and GSTT1/GSTM1 were significantly associated with covid-19 infection. Our results indicated that G/G genotype of ACE2 G8790A (OR 3.52, P 0.007) and GSTT1/ GSTM1 null (M1 - / - OR = 3.98, P = 0.0004;T1 - / - OR 3.84, P = 0.004) and double null (M1 - / - /T1 - / - OR = 9.66, P = 0.001) are likely to be associated with an increased risk for severe-critical outcomes in individuals with COVID-19. Other polymorphisms analyzed in this study were found to have no significant association with Covid-19 outcome. Conclusion(s): This study suggests that outcome of Covid-19 infection is affected by both clinical and genetic factors. Thus it seems plausible to utilize these factors as prediction and susceptibility markers in the prognosis of COVID-19, which may help to personalize the treatment.

Rash with Atypical Pneumonia: Varicella Pneumonia in a Young Immunocompetent Male

Varicella pneumonia is a serious complication of varicella infection. It occurs more often in adults than in children, although it is now infrequently seen since the introduction of the chickenpox vaccines. In immunocompetent adults, varicella pneumonia has a reported incidence of about 1 in 400 cases of varicella infection and it also carries significant mortality. Here, we report a case of varicella pneumonia in a young male who was immunocompetent and had no comorbidities. This case teaches us to be always careful and thorough with our clinical assessment and to think about the alternative etiologies for the cause of atypical pneumonia even during the times of the COVID-19 pandemic and not get swayed by the sheer numbers of coronavirus infections.

Advances on concrete strength properties after adding polypropylene fibers from health personal protective equipment (PPE) of COVID-19: Implication on waste management and sustainable environment.

Using Health personal protective equipment (PPE) such as face masks, safety foot shoes and protective suits has expanded dramatically due to COVID-19 pandemic leading to a widespread distribution of the PPE, particularly the face masks, in the environments including streets, dump sites, seashores and other risky locations. The environmental degradation of polypropylene, the essential plastic component in single-use face masks (SUM), takes between 20 and 30 years and thus it is essential to develop experimental approaches to recycle the polypropylene or to reuse it in different ways. This paper explores the integration of SUM into concrete structures to improve its mechanical properties. We first to cut the inner nose wire and ear loops, then distribute the PPE material among five different mixed styles. The PPE were applied by volume at 0%, 1%, 1.5%, 2.0%, and 2.5%, with tests focusing on UCS, STS, FS, and PV to determine the concrete's overall consistency and assess the improvement in its mechanical properties. The results showed that adding PPE improves the strength properties and general performance of the concrete specimens. The pattern of rising intensity started to fade after 2%. The findings demonstrated that adding PPE fibers enhanced the UCS by 9.4% at the optimum 2% PPE. The PPE fibers, on the other side, are crucial in calculating the STS and FS of the reinforcement concrete.

How Does COVID-19 Affect Demographic, Administrative, and Social Economic Domain? Empirical Evidence from an Emerging Economy

Worldwide, the COVID-19 pandemic has had a significant impact on social and economic conditions as well as mental and physical health. Pakistan is considered in high ranks on Uncertainty Avoidance Index (UAI). The people of Pakistan have already faced numerous obstacles in terms of food and housing prospects. Job security, inflated prices of food items, and financial distress are the foremost vital challenges of Pakistan’s people during the Pandemic. This study examines the people’s perception of social, economic, and psychological impact and explores the causes and trends of spreading the COVID-19 pandemic in Pakistan. A primary survey method was conducted to collect the data from all Punjab divisions via questionnaire, and 471 respondents were finally selected for data analysis. The data collection instrument was a questionnaire, and the data analysis tool was SPSS. Investors, analysts, business professionals, economists, business faculty staff, and civil society are the study’s popu-lations. The findings show that the overall social and economic life has been affected (82% of respondents agree) by the COVID-19 pandemic. 60.5% of respondents manage their spending through salary (mean value = 4.45), while 45% use savings (mean value = 4.25). Moreover, Government support (mean value = 3.95) plays a vital role in managing expenditure in this COVID-19 outbreak in Pakistan. Consequently, this study confirms that the lock-down implementation measure (mean value = 2.20) is not considered useful in reducing COVID-19 due to Pakistan’s financial and economic uncertainty. This study concluded the social distance and testing measures are vital tools in reducing the COVID-19 pandemic in Pakistan. However, the study established that micro-smart lockdown, increased COVID-19 testing kits, and adequate medical equipment in the Hospital of Pakistan are the key mechanism to control the pandemic. Consequently, this study recommends that thorough long-term plan-ning be undertaken to mitigate the pandemic’s worst effects and develop a comprehensive strategy with society as the primary focus. © 2022, Tech Science Press. All rights reserved.

Risk Factors and a Novel Score (CARI-65) Predicting Mortality in COVID-19 Patients

Purpose: The rapid spread of severe acute respiratory syndrome coronavirus-2 infection resulted in an exponential increase in hospitalizations and mortality. We aimed to explore the determinants of mortality and formulate a score that can predict mortality in patients hospitalized due to coronavirus disease 2019 (COVID-19). Materials and Methods: In this retrospective study, 1024 COVID-19 patients hospitalized between March 2020 and October 2020 were included. Patient demographics, underlying comorbid illnesses, clinical features, vital signs at admission, disease severity, and laboratory parameters, were collected from hospital medical records and analyzed to derive risk factors for in-hospital mortality and formulate a mortality prediction score. Results: The median age of the study population was 56 years (interquartile range [IQR], 45-65) and was significantly higher in nonsurvivors than in survivors (62 [IQR 55-70] vs. 52 [IQR 40-65];P = 0.001). Hypertension and diabetes were the most common associated comorbid illnesses seen in 50.5% (n = 518) and 29.1% (n = 299) of patients, respectively. The presence of altered level of consciousness (C), azotemia with serum creatinine >1.5 mg/dl (A), respiratory rate >25/min (R), interleukin-6 >25 pg/ml (I), and age >= 65 years were independent predictors of mortality. A six-point COVID-19 mortality prediction score, "CARI-65," was developed using variables predicting mortality in multivariate regression analysis. The CARI-65 score >= 3 had a sensitivity and specificity of 87.1% and 57.3%, respectively, and positive and negative predictive values of 42.52% and 92.45%, respectively, in predicting mortality. Conclusion: This study demonstrated various demographic, clinical, and laboratory parameters that predict mortality in hospitalized COVID-19 patients. We also proposed a simple risk stratification score to predict mortality in hospitalized COVID-19 patients, so that effective triaging of patients can be done to utilize health-care resources efficiently.

Real-Time Face Mask Detection in Deep Learning using Convolution Neural Network

COVID-19 Pandemic has affected human being without distinguishing the region and religion around the world. Even though vaccine is available now, we should still be use precautionary steps to avoid being affected by this virus. Use of face mask will help to stop the spread of the virus. COVID - 19 face mask detector will help in detecting whether a person is wearing mask or not by the use of its on face mask net with deep learning techniques. With suggested technique of deep learning get an accuracy of 98 percent. Our suggested technique also works with still pictures and give effective results with live video stream captured using the CCTV cameras and able to identify whether person is using face mask or not. It is very useful at the place of the mass gathering and screening like shopping mall and railway station and shopping streets and colleges. By using this tool for the face mask will help in regulating the use of it and if person found not using it will be easily warned by the regulator. © 2021 IEEE.

Reliability of provider assessment to predict respiratory pathogen positivity in children with CF admitted for pulmonary exacerbation

Introduction: Pulmonary exacerbations (PEx) in cystic fibrosis (CF) may be caused by viruses, bacterial infections, environmental or host triggers. For children admitted for a PEx, the admitting provider often decides whether to test for viral infections based upon clinical assessment. Given the similarity of symptoms between bacterial and viral causes, providers may miss patients who are viral positive and thus, institute inadequate infection control measures. To address this epidemiologic concern, we performed a quality improvement project to determine the frequency of viral infections in children with CF admitted for PEx and to assess the reliability of provider assessment to predict viral infections. Methods: From December 2019 to May 2020, all patients with CF admitted for PEx had a PCR-based respiratory pathogen panel (RPP) performed at the time of admission. In March 2020, SARS-CoV-2 testing was added. A questionnaire was filled out by the admitting clinician prior to the resulted RPP. Clinicians provided yes/no responses regarding viral symptoms and stated whether they suspected a viral infection. If a patient had confirmed viral studies prior to admission, the questionnaire was not completed. Results: From December to May, there were 28 admissions for CF pulmonary exacerbations. Of these, 15 patients with CF admitted for 16 pulmonary exacerbations had provider questionnaires completed. The RPP was positive in 4 (25%) of patients (two non-SARS-CoV-2 coronavirus strains, one rhino/enterovirus, one Mycoplasma). Clinicians correctly identified the etiology of the exacerbation in 11 (68.8%) cases, missing only one viral-positive infection. The question “do you think this patient has a virus?” showed a sensitivity of 42.8% (9.9% to 81.6%) and a specificity of 88.9% (51.6% to 99.7%) based on RPP results. Discussion: Clinicians at our institution were able to correctly identify almost 70% of presenting PEx based upon RPP results, with one RPP-positive infection being missed. Sensitivity was low, suggesting that children may be placed in unnecessarily strict isolation precautions or conversely, have unsuspected viral infections at the time of PEx that may result in inadequate precautions and thus risking spread to other patients and hospital staff based on clinical assessment alone. The number of children admitted with PEx was unexpectedly small likely due to the initiation of elexacaftor/ tezacaftor/ivacaftor in many of our patients. Also, given COVID-19 screening implementations, many patients had RPP results available prior to clinician assessment.