Repeated COVID-19 infection in recipients of post-living donor liver transplantation: Two real-life cases

COVID-19 is an emerging pandemic. The course and management of the disease in the liver transplant setting may be difficult due to a long-standing immunosuppressive state. In Egypt, the only available option is living donor liver transplantation (LDLT). In our centre, we have transplanted 440 livers since 2008. In this study, we report a single-centre experience with COVID-19 infection in long-term liver transplant recipients. A total of 25 recipients (5.7 %) had COVID-19 infections since March 2020. Among these recipients, two developed COVID-19 infections twice, approximately three and two months apart, respectively.Copyright © 2021 The Author(s)

Promising Antimycobacterial Activities of Flavonoids against Mycobacterium sp. Drug Targets: A Comprehensive Review.

Tuberculosis (TB) caused by the bacterial pathogen Mycobacterium tuberculosis (Mtb) remains a threat to mankind, with over a billion of deaths in the last two centuries. Recent advancements in science have contributed to an understanding of Mtb pathogenesis and developed effective control tools, including effective drugs to control the global pandemic. However, the emergence of drug resistant Mtb strains has seriously affected the TB eradication program around the world. There is, therefore, an urgent need to develop new drugs for TB treatment, which has grown researchers' interest in small molecule-based drug designing and development. The small molecules-based treatments hold significant potential to overcome drug resistance and even provide opportunities for multimodal therapy. In this context, various natural and synthetic flavonoids were reported for the effective treatment of TB. In this review, we have summarized the recent advancement in the understanding of Mtb pathogenesis and the importance of both natural and synthetic flavonoids against Mtb infection studied using in vitro and in silico methods. We have also included flavonoids that are able to inhibit the growth of non-tubercular mycobacterial organisms. Hence, understanding the therapeutic properties of flavonoids can be useful for the future treatment of TB.

Maladie rénale chronique et COVID-19 : quelles particularités ?

Introduction La maladie rénale chronique (MRC) est un facteur de risque potentiel de sévérité des infections par rapport à la population générale. De nombreux auteurs ont rapporté les différents aspects de la maladie COVID 19 dans la population néphrologique. On s’est proposé de relever les caractéristiques des patients avec une MRC qui sont infectés par le SARS-Cov 2. Description On a mené une étude analytique de deux groupes de patients infectés par le SARS Cov2 (avec ou sans MRC) et hospitalisés dans le service de néphrologie de Monastir. Méthodes Les caractéristiques cliniques,biologiques ainsi que les facteurs pronostiques ont été analysé dans les deux groupes. Résultats Parmi 95 patients d’âge médian 59 ans±15 ans, 51 étaient des hommes (53,7 %) et 64 patients (67,4 %) avaient une MRC. Les patients avec MRC avaient plus de comorbidités par rapport au patients avec fonction rénale normale (PFRN) : diabète (57,8 % vs 29 %, p=0,008), HTA (62,5 % vs19,4 %, p=0,001). Les PFRN présentaient plus de toux (90 % vs 46,9 %, p=0,001) et de dyspnée (77,4 % vs 57,8 %, p=0,06). Par contre, les patients avec MRC avaient plus de vomissement (34,4 % vs 9,7 %, p=0,01) et de diarrhée (25 % vs 6,5 %, p=0,03). Les patients avec MRC ont aggravé leur fonction rénale au cours de l’infection dans 83 % des cas, ils avaient davantage de dyskaliémie (32,8 % vs 0 %, p=0,001), d’hypo-éosinophilie, de lymphopénie (77,8 % vs 58,1 %, p=0,03) et de taux de LDH élevés (90,5 % vs 64,5,p=0,002) Les malades rénaux chroniques ont nécessité, mais de façon non significative, plus de jours d’hospitalisation et d’oxygénothérapie. La MRC était liée de façon significative à la mortalité (12,5 % vs 0 %, p=0,04) Conclusion Notre étude a montré que les patients atteints de MRC sont vulnérables au SARS Cov2. Ces patients présentent des formes plus sévères avec une surmortalité intra-hospitalière.

Insuffisance rénale aiguë et COVID-19 : expérience du service de néphrologie de Monastir

Introduction L’insuffisance rénale aiguë (IRA) est une complication redoutable chez les patients infectés par le coronavirus. Plusieurs publications suggèrent une forte association de l’IRA à une surmortalité. On va présenter les facteurs de risque ainsi que les facteurs pronostics de l’IRA associée à la COVID 19 chez des patients Tunisiens. Description Nous avons colligé rétrospectivement les patients atteints par le coronavirus qui ont développé une IRA et qui étaient hospitalisé au service de néphrologie de Monastir. Méthodes Une analyse des facteurs cliniques et biologiques associés à la mortalité des patients COVID avec IRA a été faite. Résultats Notre population était composée de 10 hommes (50 %) et 10 femmes (50 %). L’âge médian était de 63,7 ans. Les principaux antécédents étaient : L’hypertension artérielle, le diabète, des pathologies cardiovasculaires et respiratoires. Le signe clinique le plus fréquent était la fièvre (65 % des patients). Au total, 10 patients (50 %) avaient une toux sèche et 12 patients (60 %) ont présenté une dyspnée. Les signes digestifs étaient moins fréquents. Selon la classification KDIGO de l’IRA, 40 % de nos patients étaient classés au stade 1, 25 % au stade 2 et 35 % au stade 3. Les anomalies biologiques les plus fréquentes étaient : un taux de LDH élevé une lymphopénie et une hypo-éosinophilie. L’évolution était fatale pour 4 patients (20 %). La mortalité était associée aux antécédents cardiovasculaires (25 % vs 15 %en absence de maladie cardiaque), au taux de LDH élevé (17,6 % vs 0 % si LDH normale), aux complications de l’IRA notamment à l’hyperkaliémie (50 % de décès, p=0,01) et au degré de l’atteinte pulmonaire à l’imagerie (45 % de décès en cas d’atteinte sévère, p=0,08). Conclusion La mortalité chez les patients atteints d’IRA secondaire à une maladie COVID-19 est élevée. L’individualisation d’un profil clinique et biologique de patient particulièrement associé à l’IRA incitera les cliniciens à détecter et prendre en charge précocement cette complication redoutable.

Particularités des patients en hémodialyse durant la pandémie COVID-19 : expérience du service de néphrologie de Monastir-Tunisie

Introduction Les patients insuffisants rénaux chroniques au stade d’hémodialyse sont vulnérables à la COVID-19 du fait de leur âge avancé et de leurs multiples comorbidités. Le but de notre étude est de chercher les particularités de l’infection par le SARS-CoV-2 chez les patients hémodialysés. Description On a mené une étude comparative de deux groupes de patients : hémodialysés et ayant une fonction rénale normale, qui étaient hospitalisés dans notre service suite à une maladie COVID-19. Méthodes On a analysé les caractéristiques clinicobiologiques et pronostique des hémodialysés par rapport aux patients avec une fonction rénale normale (PFRN) qui sont infectés par le SARS-CoV-2. Résultats Nous avons colligé 96 patients dont 51,3 % étaient des hommes. L’âge moyen des patients était de 55 ans±15 ans. Soixante-cinq patients avaient une insuffisance rénale chronique (IRC) au stade d’hémodialyse (HD). Les principaux antécédents de ces patients sont : l’HTA (72,6 %), le diabète (37,1 %) et les pathologies cardiovasculaires (14,5 %). Ces patients présentaient, par rapport aux PFRN plus de diarrhée (27,9 % vs 6,5 % [p=0,016]). Par contre, les PFRN avaient plus d’asthénie (83,9 % vs 47,5 % [p=0,001]) et de dyspnée (77,4 % vs 47,7 % [p=0,06]). L’analyse biologique a montré chez les patients en HD vs les PRFN : un taux des LDH élevé (96,3 % vs 64,5 % [p=0,003]), une lymphopénie (83,3 % vs 58,1 % [p=0,03]) et des troubles d’hémostase (24,1 % vs 6,5 % [p=0,05]). Cinquante-deux pour cent des patients HD ont présenté une pneumopathie COVID sévère à la tomodensitométrie contre 33 % pour les PFRN. Quarante-quatre pour cent des patients HD ont présenté des formes pulmonaires sévères. La mortalité intra-hospitalière était significativement plus élevée chez cette population 16,9 % vs 0 % chez les PFRN (p=0,015). Conclusion Les résultats de notre étude suggèrent que les patients HD infectés par le SARS-CoV-2 ont un profil clinicobiologique plus sévère de l’infection et surtout une mortalité plus importante comparée aux PFRN.

The Increasing Prevalence of DM in COVID-19 Patients in North Sudan: Is it a Matter of Diabetogenicity?

Background: COVID-19 had made more than 197 million infections and 4 million death. Therefore, we need to assess the prevalence of DM among COVID-19 patients and its effect on the outcome. Objectives: We aim to assess the prevalence, risk factors and outcome of diabetes among COVID-19 patients. Methods: This was a prospective, cross-sectional, hospital-based study enrolled 400 COVID-19 patients and was conducted in COVID-19 isolation centres in North Sudan. Results: Males constituted 275 (68.9%) of the study participants, and the majority of participants were aged between 40 and 60 years 150(37.4%). The prevalence of DM was found to be 49.25% in the study participants. Diabetics were significantly more likely to have a respiratory rate higher than 30 (P=0.012), and oxygen saturation less than 93% (P<0.001), to develop shock (P=0.004), to require oxygen therapy (P<0.001), to be intubated (P<0.001), to develop respiratory failure and organ failure (P<0.001), and to have a poorer outcome (P<0.001). New-onset diabetes occurred in 20 (5%) participants and their mortality was higher compared to non-patients with diabetes (P=0.04). The total mortality of participants was 15.8%. Factors associated with poorer outcome were older age (P<0.001), and having type 1 diabetes (P=0.025).Conclusion: The prevalence of diabetes is very high among COVID-19 patients, and is associated with a more severe disease and a poorer outcome. New onset diabetes was associated with poorer outcome compared to non-diabetics.

The Increasing Prevalence of Diabetes Mellitus in COVID-19 Patients: Why?

Coronavirus infection disease 2019 (COVID-19) is caused by SARS COV-2 and it has been increasing continuously in a number of cases and mortalities. COVID-19 had caused more than 197 million infections and 4 million deaths. This study aimed to assess the prevalence, risk factors and outcome of Diabetes Meletus (DM) among COVID-19 patients. Prospective, cross-sectional, hospital-based study conducted in which 400 COVID-19 patients enrolled in COVID-19 isolation centers in North Sudan. In this study, we noticed that most of the participants were males and constituted 275 (68.9%) of the study participants, the majority of participants' ages ranged were between 40 to 60 years and was 150 (37.4%). The prevalence of DM was found to be 49.25% among the study participants. Diabetics were significantly more likely to have a respiratory rate higher than 30 (P=0.012), and oxygen saturation less than 93% (P<0.001), to develop shock (P=0.004), to require oxygen therapy (P<0.001), to be intubated (P<0.001), to develop respiratory failure and organ failure (P<0.001), and to have a poorer outcome (P<0.001). New-onset diabetes occurred in 20 (5%) participants and their mortality was higher compared to non-patients with diabetes (P=0.04). The total mortality of participants was 15.8%, factors associated with poorer outcomes were older age (P<0.001), and having type I diabetes (P=0.025). The prevalence of diabetes is very high among COVID-19 patients, and is associated with a more severe disease and a poorer outcome. New onset diabetes was associated with poorer outcomes compared to non-diabetics. More researches requested to discover more risk factors and complications associated with Covid-19.

The Increasing Prevalence of DM in COVID-19 Patients: Is it a Matter of Diabetogenicity?

Background: COVID-19 had made more than 197 million infections and 4 million deaths. Therefore, we need to assess the prevalence of DM among COVID-19 patients and its effect on the outcome. Objectives: We aim to assess the prevalence, risk factors and outcome of diabetes among COVID-19 patients. Methods: This was a prospective, cross-sectional, hospital-based study enrolled 400 COVID-19 patients and was conducted in COVID-19 isolation centers in North Sudan. Results: Males constituted 275 (68.9%) of the study participants, and the majority of participants were aged between 40 and 60 years 150(37.4%). The prevalence of DM was found to be 49.25% in the study participants. Diabetics were significantly more likely to have a respiratory rate higher than 30 (P=0.012), and oxygen saturation less than 93% (P<0.001), to develop shock (P=0.004), to require oxygen therapy (P<0.001), to be in tubated (P<0.001), to develop respiratory failure and organ failure (P<0.001), and to have a poorer outcome (P<0.001). New-onset diabetes occurred in 20 (5%) participants and their mortality was higher compared to non-patients with diabetes (P=0.04). The total mortality of participants was 15.8%. Factors associated with poorer outcome were older age (P<0.001), and having type I diabetes (P=0.025). Conclusion: The prevalence of diabetes is very high among COVID-19 patients, and is associated with a more severe disease and a poorer outcome. New onset diabetes was associated with poorer outcome compared to non-diabetics.

A Generative Approach to Enrich Arabic Story Text with Visual Aids

Enriching the script of a story with visual aids is an effective approach for promoting language learning and literacy development for young children and learners. In this paper, we propose a new system, that can generate short Arabic stories with generated images that accurately represent the story, scene and context of the given input. We use a text generation technique with a text-to-image synthesis network and minimize the human intervention. We build a corpus of Arabic stories with vocabulary and visualizations. The obtained results with various generative models to create text-image contents show the effectiveness of the proposed approach. The system can be used in education and assist the instructors to build stories on different domains. It can be used in distance learning to deliver online tutorials during COVID-19. © 2021 ACM.

Predictors of severity and mortality in COVID-19 patients

Background Due to limited capacity, health care systems worldwide have been put in challenging situations since the emergence of COVID-19. To prioritize patients who need hospital admission, a better understanding of the clinical predictors of disease severity is required. In the current study, we investigated the predictors of mortality and severity of illness in COVID-19 from a single center in Cairo, Egypt. Methods This retrospective cohort study included 175 patients hospitalized with COVID-19 pneumonia and had positive real-time polymerase chain reaction (RT-PCR) results for SARS-CoV-2 from 1 May 2020 to 1 December 2020. Severe COVID-19 was defined as requiring high-flow oxygen (flow rate of more than 8 L/min or use of high flow oxygen cannula), noninvasive ventilation, or invasive mechanical ventilation at any time point during the hospitalization. We used univariate and multivariate regression analyses to examine the differences in patient demographics and clinical and laboratory data collected during the first 24 h of hospitalization related to severe disease or death in all 175 patients. Results Sixty-seven (38.3%) of the study subjects had a severe or critical disease. Elevated d-dimer, leukocytosis, and elevated CRP were found to be independent predictors of severe disease. In-hospital mortality occurred in 34 (19.4%) of the cases. Elevated TLC, urea, the use of invasive mechanical ventilation, and the presence of respiratory bacterial co-infection were found to be independently associated with mortality. Conclusion Clinical and laboratory data of COVID-19 patients at their hospital admission may aid clinicians in the early identification and triage of high-risk patients.

Covid-19 in recipients of living donor liver transplantation: a worse or an equivalent outcome?

BACKGROUND: Coronavirus disease 2019 (Covid-19) pandemic is representing a massive burden to the community with the new virus. There is few data regarding Covid-19 in liver transplant patients. Concerns were raised regarding the course of the disease in transplanted patients due to immunosuppression and risk of hepatic injuries. AIM: To describe the outcomes of Covid-19 infection in recipients of living-donor liver transplantation (LDLT). METHODS: Retrospective analysis of 41 recipients of LDLT diagnosed with Covid-19 by real-time PCR or CT chest criteria of Covid-19 between April 2020 and April 2021. This Cohort was derived from Ain Shams Center for Organ Transplantation database, Ain Shams Specialized Hospital, Cairo, Egypt, which is considered one of the largest centers of LDLT in the Middle East. Patients were classified to mild, moderate, severe and critics according to clinical classification released by the National Health Commission of China. RESULTS: A total of 41 patients and 2 patients with reinfection were included in this cohort with mean age 54 years with 74% male and 26% female. The body mass index ranged from 19.3 to 37. About 30% were described as a mild case, 46.5% were moderate, 14% were severe and 9% were critical cases. Two cases developed infection twice. Total of 20 patients (46.5%) were managed in home isolation setting, 17 patients (39.5%) needed admission to ward, 4 patients (9%) in intermediate care unit and 2 patients (4%) admitted to intensive care unit. About 60% of cases were on room air, only 3 patients needed invasive methods, 2 patients needed face mask and 1 case needed invasive CPAP. In total, 41 patients recovered (95%) and 2 patients (5%) died; 1 was Covid related and the other one was non-Covid related. Female gender, higher BMI and hypertension were associated with severe course of the disease. CONCLUSION: In the setting of LDLT, the possibilities of catching Covid-19 infection are high due to chronic immunosuppression use. Yet, the outcome of infection in term of morbidity and the needs for hospital admission or intensive care is generally matched to general population.

Employing of object tracking system in public surveillance cameras to enforce quarantine and social distancing using parallel machine learning techniques

Like many countries, Jordan has resorted to lockdown in an attempt to contain the outbreak of Coronavirus (Covid-19). A set of precautions such as quarantines, isolations, and social distancing were taken in order to tackle its rapid spread of Covid-19. However, the authorities were facing a serious issue with enforcing quarantine instructions and social distancing among its people. In this paper, a social distancing mentoring system has been designed to alert the authorities if any of the citizens violated the quarantine instructions and to detect the crowds and measure their social distancing using an object tracking technique that works in real-time base. This system utilises the widespread surveillance cameras that already exist in public places and outside many residential buildings. To ensure the effectiveness of this approach, the system uses cameras deployed on the campus of Al-Zaytoonah University of Jordan. The results showed the efficiency of this system in tracking people and determining the distances between them in accordance with public safety instructions. This work is the first approach to handle the classification challenges for moving objects using a shared-memory model of multicore techniques. © Al-Zaytoonah University of Jordan (ZUJ).