Recent applications of nanomedicine in lung disease

Lung diseases include a wide spectrum of illnesses, such as asthma, COPD (chronic obstructive pulmonary disease), pneumonia, tuberculosis, lung cancers, and the recent COVID-19 pandemic, and have been a huge threat to human health and life. However, the treatment and diagnosis of various lung diseases are challenging. Among the several treatment strategies and diagnostic techniques, the adverse effect to chemotherapy in cancers, multidrug resistance in tuberculosis, side effects, toxicity, poor drug delivery, and metabolism require the development of novel and promising alternative treatments. Nanotechnology provides a promising tool for the development of innovative treatment overcoming many drug challenges. Nanotechnology being widely studied in medicinal field has given rise to the interdisciplinary nanomedicine field allowing fundamental changes in the diagnosis, treatment, and prevention of disease. Lungs provide a good target organ for drug delivery via an aerosol inhalation mode. Lungs provide a large surface area for local drug action and systemic drug absorption and hence nanomedicines have been a boon in treating many of the lung diseases without leading to any side effects or toxicity. The present chapter aims to review nanoparticles-based drug delivery systems studied over the last decade as therapeutic agents in lung diseases. © 2023 Elsevier Inc. All rights reserved.

Coexistence of malignancy and tuberculosis: is it double disease or double hit related to COVID-19? - Experience from a tertiary care center.

BACKGROUND: Coexistent malignancy and tuberculosis (TB) are rarely encountered. Cancer patients are a highly vulnerable subgroup during this Covid crisis. Delayed treatment for malignancy because of COVID-19 pandemic leads to higher chances to get infections. PURPOSE: The present study aimed to present the clinicopathologic profile of the patients with coexistent carcinoma and TB during the COVID-19 pandemic in a tertiary care center. MATERIALS AND METHODS: This was a retrospective study conducted during the COVID-19 pandemic between April 2020 to May 2021 in the Department of Pathology of our Institute. 11 patients with coexistent malignancy and caseous necrotizing granulomatous inflammation with Langhans giant cells and or acid-fast bacilli (AFB) positivity were included in the study. Cases of ill-defined granulomas coexistent malignancy were excluded. We studied varied clinical and histopathologic features of these cases. RESULTS: Eleven cases were reported with coexistent malignancy and tuberculosis, of which 8 were reported in 2021 and 3 cases were reported in 2020. Adenocarcinoma comprised 9 cases (81.8%) and the remaining 2 were squamous cell carcinoma (18.1%). Out of 11, 10 (90.9%) were new TB cases. Of these, 10 were extrapulmonary TB and one pulmonary TB case with cancer. Regarding chemotherapy, four patients accepted that chemotherapy was delayed because of the COVID-19 crisis. CONCLUSION: In this covid pandemic, India being the 2nd most populous country and endemic for TB, there is a higher chance of latent and active TB. The coexistence of two different pathologies is rare, even in a region with a high incidence of TB. Delayed chemotherapy in a pandemic situation leads to an increased incidence of infectious diseases such as TB.

Accelerated cell culture process development and characterization for cilgavimab/tixagevimab (AZD7442) for the prevention and treatment of COVID-19.

The global COVID-19 pandemic ignited an unprecedented race to develop vaccines and antibody therapeutics. AstraZeneca's pursuit to provide AZD7442 (EVUSHELD), two long-acting, SARS-CoV-2 spike receptor binding domain-specific neutralizing monoclonal antibodies, to individuals at risk on highly accelerated timelines challenged our traditional ways of process development and spurred the rapid adoption of novel approaches. Conventional upstream development processes were replaced by agile strategies that combined technological advances and highly accelerated workflows. With calculated business risks and close cross-functional collaborations, this process paved the way for hyper accelerated antibody development from discovery through manufacturing, process validation, emergency use authorization filing, and global regulatory approvals. The result was initiation of commercial manufacturing at a contract manufacturing organization less than 6 months from the selection of cilgavimab and tixagevimab-a process that historically has taken close to 10 years.

Chapter 8 - Recent applications of nanomedicine in lung disease

Lung diseases include a wide spectrum of illnesses, such as asthma, COPD (chronic obstructive pulmonary disease), pneumonia, tuberculosis, lung cancers, and the recent COVID-19 pandemic, and have been a huge threat to human health and life. However, the treatment and diagnosis of various lung diseases are challenging. Among the several treatment strategies and diagnostic techniques, the adverse effect to chemotherapy in cancers, multidrug resistance in tuberculosis, side effects, toxicity, poor drug delivery, and metabolism require the development of novel and promising alternative treatments. Nanotechnology provides a promising tool for the development of innovative treatment overcoming many drug challenges. Nanotechnology being widely studied in medicinal field has given rise to the interdisciplinary nanomedicine field allowing fundamental changes in the diagnosis, treatment, and prevention of disease. Lungs provide a good target organ for drug delivery via an aerosol inhalation mode. Lungs provide a large surface area for local drug action and systemic drug absorption and hence nanomedicines have been a boon in treating many of the lung diseases without leading to any side effects or toxicity. The present chapter aims to review nanoparticles-based drug delivery systems studied over the last decade as therapeutic agents in lung diseases.

Comparative Analysis of Deep Learning Models Used in Impact Analysis of Coronavirus Chest X-ray Imaging.

The impact analysis of deep learning models for COVID-19-infected X-ray images is an extremely challenging task. Every model has unique capabilities that can provide suitable solutions for some given problem. The prescribed work analyzes various deep learning models that are used for capturing the chest X-ray images. Their performance-defining factors, such as accuracy, f1-score, training and the validation loss, are tested with the support of the training dataset. These deep learning models are multi-layered architectures. These parameters fluctuate based on the behavior of these layers, learning rate, training efficiency, or over-fitting of models. This may in turn introduce sudden changes in the values of training accuracy, testing accuracy, loss or validation loss, f1-score, etc. Some models produce linear responses with respect to the training and testing data, such as Xception, but most of the models provide a variation of these parameters either in the accuracy or the loss functions. The prescribed work performs detailed experimental analysis of deep learning image neural network models and compares them with the above said parameters with detailed analysis of these parameters with their responses regarding accuracy and loss functions. This work also analyses the suitability of these model based on the various parameters, such as the accuracy and loss functions to various applications. This prescribed work also lists out various challenges on the implementation and experimentation of these models. Solutions are provided for enhancing the performance of these deep learning models. The deep learning models that are used in the prescribed work are Resnet, VGG16, Resnet with VGG, Inception V3, Xception with transfer learning, and CNN. The model is trained with more than 1500 images of the chest-X-ray data and tested with around 132 samples of the X-ray image dataset. The prescribed work analyzes the accuracy, f1-score, recall, and precision of these models and analyzes these parameters. It also measures parameters such as training accuracy, testing accuracy, loss, and validation loss. Each epoch of every model is recorded to measure the changes in these parameters during the experimental analysis. The prescribed work provides insight for future research through various challenges and research findings with future directions.

Durability of antibodies post vaccination with two doses of inactivated BBIBP-CorV vaccine.

BACKGROUND: Breakthrough infections post-COVID-19 vaccination occur with the emerging variants of the SARS-CoV virus which might be either due to the newer variants escaping immune response or the waning of antibodies over time. However, there is lack of long-term follow-up evidence on the waning of immune response following inactivated COVID-19 vaccine. METHODS: A retrospective, observational study was conducted on serum samples of individuals who had received two doses of BBIBP-CorV vaccine. Individual's antibody responses were evaluated based on IgG anti-S and neutralizing antibodies measurements. Antibody samples were categorized into four groups, defined by the time interval from the individual's receipt of the BBIBP-CorV vaccine: <30 days, 30-90 days, 91-180 days and >180 days. RESULTS: A total of 6668 serum samples from inactivated BBIBP-CorV vaccine recipients were analyzed for IgG anti-S and neutralizing antibodies. 571 (8.6%) samples were tested during the first 29 days interval post vaccination, 3642 (54.6%) were tested during 30-90 days interval, 2173 (32.6%) samples were tested during 91 to 180 days interval and 282(4.2%) were tested at >180 days interval post vaccination. We found that more than 50% of the individuals had antibody titers below the average cut-off range at the 91-180 days interval post vaccination. Older age (>60 years), male gender, chronic kidney disease, hypertension, immunodeficiencies and increased interval post vaccination emerged as independent risk factors associated with lower immune response. CONCLUSION: Inactivated BBIBP-CorV vaccine recipients, based on age, gender and associated comorbid conditions might need booster doses at an earlier interval than the currently followed six months interval.

Relationship between children with neurodevelopmental disorders and their caregivers and friends during early phase of COVID-19 school closure in Japan: Association with difficulty in implementing infection prevention measures.

BACKGROUND: Due to the COVID-19 pandemic people had to implement various infection prevention measures. Researchers have reported the difficulties experienced by children with neurodevelopmental disorders in implementing these measures and their caregivers' resultant anxiety and stress. This study examined the relationship between these difficulties and the deterioration of the children's relationships with their caregivers and friends during school closure and after school reopened. METHODS: A total of 150 caregivers of children with neurodevelopmental disorders answered a questionnaire asking about parent‒child relationships, their child's friendships, and the presence or absence of difficulty in implementing infection prevention measures at three time points: before the pandemic, while schools were closed, and after school reopened. The frequency and percentages of the child's behavioral problems, deterioration in their relationships, and difficulty implementing infection control measures were calculated. Using the relationship deterioration scores, independent and multiple regression analyses were performed for the presence or absence of difficulty implementing infection control measures, presence or absence of caregivers' mental health concerns, and the presence or absence of deterioration of one or more problematic behaviors. RESULTS: Overall, 84.1% of the children displayed difficulties implementing infection prevention measures. No relationship was observed between difficulty with infection prevention measures and deterioration in their relationships with parents and friends when schools were closed. After school reopened, however, deterioration in parent‒child relationships correlated positively with difficulty in hand-washing, and deterioration of friendships correlated positively with the maintenance of social distancing and difficulty in hand-washing. Deterioration of friendships correlated negatively with difficulty in voluntarily complying with stay-at-home requests. CONCLUSION: Difficulty in implementing infection prevention measures was related to deterioration in social relationships with parents and friends of children with neurodevelopmental disorders during the school reopening period, following COVID-19 school closure in Japan. Under a condition requiring heightened infection control, close monitoring may be necessary for the social relationships in children with neurodevelopmental disorders.

An Explorative Study of Affiliate Stigma, Resilience, and Quality of Life Among Parents of Children with Autism Spectrum Disorder (ASD).

Purpose: Children diagnosed with ASD usually have impaired social functions, exhibit repetitive, stereotyped and self-stimulatory behaviors, which make them prone to be stigmatized by the public. However, stigma not only affects those with stigmatization characteristics such as children with ASD but also tends to include other people related to them including parents. This is called affiliate stigma. However, affiliate stigma is unlikely to occur if public awareness is high. Considering that awareness of ASD is still comparatively low in this region and that, as a review of the literature showed, there have been limited studies on stigma and ASD conducted in South-East Asia, particularly in Malaysia, this study is of great significance, especially in the context of the East and other developing countries. The aim of this study was to explore parents' experiences of caring and perceptions of affiliate stigma, resilience and quality of life (QoL) when caring for a child with ASD. Methods: This paper is part of the sequential explanatory mixed-methods study in which, after a cross-sectional study of 144 parents, a qualitative approach was used to explore parents' experiences of caring and their perceptions of affiliate stigma, resilience, and QoL. Participants were recruited when they were accompanying their children to therapy at two tertiary public hospitals in one of the north-eastern states of Malaysia. Eleven parents of children with ASD aged 2-12 years participated. Qualitative data analysis followed Braun and Clarke's methodology of thematic analysis. Results: Four themes were identified: the meaning of QoL, ASD and life adjustment, perceived stigma, and resilience. Conclusion: This is the first Southeast Asian study on parent-perceived affiliate stigma, resilience, and QoL in the context of ASD. These findings can inform healthcare personnel and policymakers into day-to-day parenting realities and therefore an effort to coordinate support services across all disciplines could be made to improve outcomes for both parents and children.

Detection of Face Mask: A Systematic Approach

The COVID-19 coronavirus pandemic is causing health crises around the world. According to the World Health Organization (WHO), wearing a face mask is an effective means of protection in public places. In most public gatherings such as shopping centers, theaters, parks, it is increasingly necessary to make sure that people in the crowd are wearing masks. Developing an artificial intelligence solution that determines regardless of whether an individual is wearing a cover and letting it in will be great help for the society. In this case, a simple face mask detection system is built using deep learning techniques such as machine learning and persuasive neural network. The model is built with machine learning and OpenCV libraries often used for real-time applications. This model can also be used to develop complete software that scans each person before going to a public meeting © 2022 IEEE.

Niacinamide enhances cathelicidin mediated SARS-CoV-2 membrane disruption (preprint)

The continual emergence of SARS-CoV-2 variants threatens to compromise the effectiveness of worldwide vaccination programs, and highlights the need for complementary strategies for a sustainable containment plan. An effective approach is to mobilize the body's own antimicrobial peptides (AMPs), to combat SARS-CoV-2 infection and propagation. We have found that human cathelicidin (LL37), an AMP found at epithelial barriers as well as in various bodily fluids, has the capacity to neutralise multiple strains of SARS-CoV-2. Biophysical and computational studies indicate that LL37's mechanism of action is through the disruption of the viral membrane. This antiviral activity of LL37 is enhanced by the hydrotropic action of niacinamide, which may increase the bioavailability of the AMP. Interestingly, we observed inverse correlation between LL37 levels and disease severity of COVID-19 positive patients, suggesting enhancement of AMP response as an interesting therapeutic avenue to mitigate disease severity. The combination of niacinamide and LL37 is a potent antiviral formulation that targets viral membranes of various variants and can potentially overcome vaccine escape.

Effectiveness of BBIBP-CorV vaccine against severe outcomes of COVID-19 in Abu Dhabi, United Arab Emirates.

The effectiveness of the inactivated BBIBP-CorV vaccine against severe COVID-19 outcomes (hospitalization, critical care admission and death due to COVID-19) and its long-term effectiveness have not been well characterized among the general population. We conducted a retrospective cohort study using electronic health records of 3,147,869 adults, of which 1,099,886 vaccinated individuals were matched, in a 1:1 ratio to 1,099,886 unvaccinated persons. A Cox-proportional hazard model with time varying coefficients was used to assess the vaccine effectiveness adjusting for age, sex, comorbidity, ethnicity, and the calendar month of entry into the study. Our analysis showed that the effectiveness was 79.6% (95% CI, 77.7 to 81.3) against hospitalization, 86% (95% CI, 82.2 to 89.0) against critical care admission, and 84.1% (95% CI, 70.8 to 91.3) against death due to COVID-19. The effectiveness against these severe outcomes declined over time indicating the need for booster doses to increase protection against severe COVID-19 outcomes.

Vaccine Side Effects Following COVID-19 Vaccination Among the Residents of the UAE-An Observational Study.

COVID-19 vaccines have proven to be very safe in the clinical trials, however, there is less evidence comparing the safety of these vaccines in real-world settings. Therefore, we aim to investigate the nature and severity of the adverse effects reported and the differences based on the type of vaccine received. A survey was conducted among 1,878 adult (≥18 years) COVID-19 vaccine recipients through online survey platforms and telephonic interviews during March to September 2021. The factors potentially associated with the reported side effects like age, gender, ethnicity, comorbidities, and previous COVID-19 infection were analyzed based on the type of vaccine received. Differences in adverse events and the severity were compared between inactivated and mRNA vaccine recipients. The major adverse effects reported by the COVID-19 vaccine recipients were pain at the site of injection, fatigue and drowsiness, and headache followed by joint/muscle pain. The adverse effects were more common among recipients of mRNA Pfizer-BioNTech vaccine than among recipients of inactive Sinopharm vaccine with the odds ratio of 1.39 (95% CI 1.14-1.68). The average number of adverse effects reported between individuals who had received Sinopharm and Pfizer-BioNTech vaccines was 1.61 ± 2.08 and 2.20 ± 2.58, respectively, and the difference was statistically significant (p <0.001). Severe adverse effects after COVID-19 vaccinations were rare and 95% of the adverse effects reported after either an inactivated or mRNA vaccine were mild requiring no or home-based treatment. The study found that individuals less than 55 years of age, female gender, with history of one or more comorbid conditions, who had received mRNA Pfizer- BioNTech vaccine, and with history of COVID-19 infections are at higher odds of developing an adverse effect post COVID-19 vaccination compared to the others.

The incidence of COVID-19 infection following emergency use authorization of BBIBP-CORV inactivated vaccine in frontline workers in the United Arab Emirates.

Based on the findings from the Phase III clinical trials of inactivated SARS COV-2 Vaccine, (BBIBP-CORV) emergency use authorization (EUA) was granted for the vaccine to frontline workers in the UAE. A prospective cohort study was conducted among frontline workers to estimate the incidence rate and risk of symptomatic COVID-19 infection 14 days after the second dose of inoculation with BBIBP-CORV inactivated vaccine. Those who received two doses of the BBIBP-CORV vaccine in the period from 14th of September 2020 (first dose) to 21st of December 2020 (second dose) were followed up for COVID-19 infections. 11,322 individuals who received the two-dose BBIBP-CORV vaccine were included and were followed up post the second dose plus fourteen days. The incidence rate of symptomatic infection was 0.08 per 1000-person days (95% CI 0.07, 0.10). The estimated absolute risk of developing symptomatic infection was 0.97% (95% CI 0.77%, 1.17%). The confirmed seroconversion rate was 92.8%. There were no serious adverse events reported and no individuals suffered from severe disease. Our findings show that vaccinated individuals are likely to remain protected against symptomatic infection or becoming PCR positive for SARS COV 2 following the second dose of the vaccination.

Diagnostic accuracy of the Cobas 6800 RT-PCR assay for detection of SARS-CoV-2 RNA (preprint)

Background The COVID-19 pandemic has led to the rapid development and launch of several commercial RT-PCR based assays for identification of SARS-CoV-2. However, there is lack of peer-reviewed literatures apart from manufacturers’ on the evaluation of these commercial kits. Therefore, in this study we aim to conduct an inhouse evaluation of the automated Cobas 68000 RT-PCR assay in detecting SARS-CoV-2 infections using different pooling techniques.Methods An observational study was conducted to evaluate the clinical performance of the Cobas 6800 SARS-CoV-2 assay in comparison with the Labgun Exofast RT-PCR kit using a by using both the pooled and the non-pooled sample techniques. A total of 300 nasopharyngeal swab samples, 40 known positive samples and 260 negative samples were used for pooling and the performance was evaluated in three different pool sizes of four, five and six sample pools.Results The sensitivity and specificity of the Cobas 6800 was 100% when compared to the comparator assay. Sample pooling technique showed that specificity was 100% in all pool sizes and the sensitivity varied from 95% in six pooled sample to 100% in both five and four pooled samples. The lower limit of detection was verified to be 25 copies/ml and strong correlation was observed between the Ct values of the target genes of both the assays.Conclusion Cobas 6800 RT-PCR assay is a reliable platform for qualitative and rapid detection of SARS-CoV-2 and can be effectively utilized for pooling of samples with highly efficient performance when the disease prevalence is less.

Deep Learning Based Covid-19 Diagnosis Using Lung Images (preprint)

In 2019, a new virus named corona virus had changed the life of every individual in the world. As the number of covid positive cases had been increased, it causes a very big pressure in the medical field. To overcome this situation, we are in need of some algorithm which predicts whether the person is affected by COVID-19 or not. The most known deep learning method is used to detect whether the person’s lung is affected by covid or not. In this project, lung CT images are segmented and then it is given into the simple convolutional neural network. The image segmentation techniques followed are canny edge detection, thresholding technique and U-Net algorithm. From these techniques the better one is chosen and its result is pushed into the convolutional neural network. By segmenting the image and then predicting whether the lung is affected by covid or not increases the accuracy rate and the accuracy value is 95%.

Immune response of booster doses of BBIBP-CORV vaccines against the variants of concern of SARS-CoV-2.

BACKGROUND: Booster doses for COVID-19 vaccinations are currently recommended and approved in many countries. However, we need more evidence on the immune response of individuals to booster doses of inactivated vaccines and the neutralizing effect against the variants of concerns of SARS-CoV-2. OBJECTIVE: To compare the fold reduction in antibody titers against the variants of concerns of SARS-CoV-2 between the primary doses and booster dose vaccine cohorts of inactivated BBIBP-CorV vaccine. STUDY DESIGN: In this observational study Plaque Reduction Neutralization Test (PRNT) assay was done on pooled serum samples of the recipients of primary two doses of inactivated BBIBP-CorV and on the pooled serum samples of recipients of a booster dose of inactive BBIBP-CorV. The neutralizing antibody titers against the wild (Wuhan) strain and the variants of concern (alpha, beta and delta) were compared. RESULTS: The serum sample pool from the booster cohort had high neutralizing antibody titers against the SARS-CoV-2 variants compared to the pooled serum samples of the recipients of primary two doses of inactivated BBIBP-CorV and the difference was statistically significant. The observed fold reduction in antibody titers from the serum pool of recipients of two doses of BBIBP-CorV vaccine were 3.7-fold, 14.6-fold and 10.4-fold compared to 1.8 -fold, 6.5-fold and 3.8-fold reduction against the alpha, beta and delta lineages respectively in the serum pool of recipient of a booster dose (three doses of BBIBP-CorV). CONCLUSION: Booster doses of inactive BBIBP-CORV offered better protection against the variants of concern of SARS-CoV-2.

Longitudinal SARS-CoV-2 Testing among the Unvaccinated Is Punctuated by Intermittent Positivity and Variable Rates of Increasing Cycle Threshold Values.

The coronavirus disease 2019 (COVID-19) pandemic is complicated by cases of vaccine breakthrough and reinfection and widespread transmission of variants of concern (VOCs). Consequently, the need to interpret longitudinal positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) tests is crucial in guiding clinical decisions regarding infection control precautions and treatment. Although diagnostic real-time reverse transcription (RT)-PCR tests yield CT values that are inversely correlated with RNA quantity, these tests are only approved for qualitative interpretation. In this study, we performed a retrospective review of 72,217 SARS-CoV-2 positive tests and identified 264 patients with longitudinal positivity prior to vaccination and VOC circulation. Patients with longitudinal positivity fell into two categories: short-term (207, 78%) or prolonged (57, 22%) positivity, defined as ≤28 (range, 1 to 28; median, 16) days and >28 (range, 29 to 152; median, 41) days, respectively. In general, CT values increased over time in both groups; however, 11 short-term-positive patients had greater amounts of RNA detected at their terminal test than at the first positive test, and 6 patients had RNA detected at CT values of <35 at least 40 days after initial infection. Oscillating positive and negative results occurred in both groups, although oscillation was seen three times more frequently in prolonged-positive patients. Patients with prolonged positivity had diverse clinical characteristics but were often critically ill and were discharged to high-level care or deceased (22%). Overall, this study demonstrates that caution must be emphasized when interpreting CT values as a proxy for infectivity, a predictor of severity, or a guide for patient care decisions in the absence of additional clinical context, particularly among the unvaccinated population. IMPORTANCE We describe the duration of positivity and the COVID-19 treatment and outcome characteristics of an unvaccinated population of patients with prolonged SARS-CoV-2 positivity. This investigation serves to highlight challenges in using CT values to guide clinical decisions among unvaccinated individuals.

An Enhanced Approach to Detect Covid-19 Patients and Level of Infection using FSM

The present situation is this world is pathetic and very uncertain. The killer disease Covid-19 dramatically turn down the regular activities of human beings. The normal life procedure of people is impacted. The society is highly stressed. To identifying covid 19 patients and their level of infection is a challenging task. In this paper proposes a Finite State Machine based classification model to identify the covid 19 patients and their level of infections. This model will help the physicians to diagnose and treat the patients in well advance. The experimental results shows the efficiency of the proposed system. © 2021 IEEE.

Development and validation of English version of COVID-19 Depression Scale for health-care workers

BACKGROUND: Health-care workers (HCWs) are highly vulnerable to depression during an epidemic outbreak. Protecting the mental well-being of HCWs is a priority while battling with COVID-19. However, documentation on COVID-19-related depression among HCWs is scarce due to the limited availability of measuring scales. Hence, this study was purposed to develop a scale to measure depression relating to COVID-19 and evaluate its psychometric properties among HCWs. MATERIALS AND METHODS: A validation study was carried out among 320 HCWs including physicians of various medical specialties, dental specialists, and nurses in the year 2020. Exploratory factor analysis using Promax rotation with Kaiser normalization for the determination of factor structure was employed in data analysis using SPSS version 16 software. RESULTS: COVID-19 Depression Scale for HCWs (CDS-HW) demonstrated a two-component structure identified as “work-related anxiety” and “psychological distress.” The mean CDS-HW score of the study participants was observed to be 23.67 ± 2.82, and the scale demonstrated good internal consistency reliability (Cronbach's alpha: 0.741). CONCLUSION: CDS-HW is a rapidly administrable, valid, and reliable tool that can be used to measure COVID-19-related depression among HCWs.