Health-Related Quality of Life Among Patients Recovered From COVID-19.

The Coronavirus disease 2019 (COVID-19) has impacted the lives and well-being of individuals worldwide, affecting both short-term and long-term quality of life. This study aimed to assess health-related quality of life (HRQoL) and associated factors among patients who have recovered from COVID-19. A cross-sectional survey was conducted at 2 hospitals in Ho Chi Minh City, Vietnam between January and March 2022. Data were obtained from patients who recovered from COVID-19 using a structured questionnaire which included the EuroQoL-5 Dimension-5 Level (EQ-5D-5L) scale to quantify problems in 5 health dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) and the EuroQoL-Visual Analog Scale (EQ-VAS) to determine self-rated health status. Factors associated with HRQoL were determined using a generalized linear model (GLM). A total of 325 participants were included in the analysis. The overall mean score from the EQ-5D-5L and EQ-VAS was 0.86 (SD 0.21) and 78.6 (SD 19.9), respectively. Anxiety/Depression and Pain/Discomfort were the major problems experienced by the participants. Lower HRQoL scores were reported among those who were 60 years and older, female, had comorbidities, persistent symptoms, living alone and experiencing stress (all P < .05). This study showed that there was a significant reduction in HRQoL among individuals who recovered from COVID-19, compared with the general population. The findings suggest that more interventions need to be implemented to increase such individuals' quality of life, particularly for those who exhibit high-risk factors such as females, those with comorbidities, persistent symptoms, living alone and experiencing from stress.

A Community-Based Model of Care During the Fourth Wave of the COVID-19 Outbreak in Ho Chi Minh City, Vietnam.

In response to a call for help during a surge in coronavirus disease-19 (COVID-19) cases in Ho Chi Minh City in July 2021, the University of Medicine and Pharmacy at Ho Chi Minh City developed and implemented a community care model for the management of patients with COVID-19. This was based on three main principles: home care; providing monitoring and care at a distance; and providing timely emergency care if needed. One team supported patients at home with frequent contacts and remote monitoring, while a second team transferred and cared for patients requiring treatment at field emergency care facilities. COVID-19-related mortality rates at the two districts where this approach was implemented (0.43% and 0.57%) were substantially lower than the overall rate in Ho Chi Minh City over the same period (4.95%). Thus, utilization of a community care model can increase the number of patients with COVID-19 who can be effectively managed from home, and use of field emergency care facilities limited the number of patients that had to be referred for tertiary care. Importantly, the community care model also markedly reduced the mortality rate compared with traditional methods of COVID-19 patient management.

An Empirical Study on the Relationship between Cognition and Metacognition in Technology-Enhanced Self-Regulated Learning

Self-regulated learning (SRL) has become an indispensable ability for learners to succeed in self-study. A fast-growing number of learners worldwide opt for studying via technology-enhanced learning environments (TELEs) to enrich their education. Since the outbreak of the global COVID-19 pandemic, learners have relied more and more on online and distance learning for their own education purposes;this circumstance urges learners to self-regulate their learning processes. Striving for understanding learners' SRL ability in TELEs to provide them with sufficient support, this research analyzed the relationship between the two key factors of SRL, cognition and metacognition, from the context of self-study in TELEs. Applying our proposed hypothetical model on the relationship between cognition and metacognition, we conducted a pilot study in which 20 postgraduate students solved a complex academic task delivered via a TELE-the learning management system Moodle. In this experiment, the correlation between the students' cognitive and metacognitive scores was analyzed. The experimental results showed that there is a positive linear correlation between cognition and metacognition of a learner when he or she performs a complex task in TELEs, and such a correlation can be classified into different profiles. Implications include opportunities to help learners understand their SRL profiles and provide recommendations for further research on the granularity of SRL characteristics.

Multiple Evanescent White Dot Syndrome following COVID-19 mRNA Vaccination in Two Patients.

PURPOSE: To describe two cases of multiple evanescent white dot syndrome (MEWDS) occurring after administration of COVID-19 vaccine. STUDY DESIGN: Case Report. RESULTS: Two patients presented soon after receiving their second-dose of the BNT162b2 Pfizer-BioNTech COVID-19 vaccine with findings consistent with MEWDS. Due to the significant reduction in vision, patients were treated with a short dose of oral corticosteroids. Both had complete resolution of their symptoms, visual acuity and retinal findings. CONCLUSIONS: The onset of inflammatory ocular adverse events following COVID-19 vaccinations suggest a maladaptive inflammatory response triggered by the vaccine. Onset of symptoms after COVID-19 vaccinations should prompt the ophthalmologist to assess for these rare adverse events. Despite the extremely rare occurrences of ocular adverse events, we unequivocally recommend that patients receive the full vaccine due to the vast benefit for both individuals and society that far outweighs the inconsiderable risk of harm.

Determinants of COVID-19 vaccine hesitancy among parents in Ho Chi Minh City, Vietnam.

BACKGROUND: COVID-19 vaccines are critical tools to manage the current pandemic. The objective of this study is to assess determinants of COVID-19 vaccine hesitancy among parents in Ho Chi Minh City, Vietnam. METHODS: A cross-sectional study of parents were performed, who had at least one child aged 5-17 years. The data were collected by a self-report questionnaire, which was based, predominately, on the Health Belief Model (HBM), between January 21 and 20 April 2021. The main outcome of this study aims to investigate the self-reported parental COVID-19 vaccine hesitancy for their children that has been approved by health authorities in Vietnam. RESULTS: A total of 1,015 parents completed the survey. Parental COVID-19 Vaccine Hesitancy for their children (26.2%) was decreased with blue-collar workers, intended to get vaccinated themselves, indicated sufficient knowledge toward COVID-19, and their older children reported having comorbidities. In the HBM structure, the barriers were positively related to parents' hesitancy to vaccinate their children, whilst perceived susceptibility and severity to illness, benefits of vaccination, and cues to action were less likely to cause a refusal of a vaccination for their children (all p < 0.05). The reasons for vaccine hesitancy included, predominately, concerns about side effects (81.6%), and vaccine safety (76.3%). CONCLUSION: The findings show that almost a quarter of the study population are hesitant to vaccinate their children. Factors were associated with parental vaccination hesitancy for their children include sufficient knowledge of the COVID-19, older children and those with chronic conditions, and domains of HBM like the perception of susceptibility and severity to illness, benefit and barriers of vaccination, and cues to action. These will contribute to make planning in health communication strategies for the upcoming vaccination campaigns, as well as managing the pandemic.

Knowledge, Attitude, and Practice Towards COVID-19 Among Healthcare Students in Vietnam.

BACKGROUND: Healthcare students are a force that will aid healthcare workers in responding to the COVID-19 pandemic. This study aims to evaluate the knowledge, attitude, and preventive practices (KAP) towards COVID-19 for this population in Vietnam. METHODS: An online-based cross-sectional survey was considered with all students at the University of Medicine and Pharmacy in Ho Chi Minh City (UMP), Vietnam, between June and August 2020. A structured questionnaire was used to assess KAP towards COVID-19 with response having considerable data missing in the areas of KAP being excluded from the analysis. All data were analysed by using STATA 14 software, to determine the factors associated with preventive practices, and a multivariable regression analysis was performed, along with odds ratio (OR) and 95% confidence interval (95% CI). RESULTS: A total of 2351 eligible participants completed the survey, 65.6% of whom were female, and their mean age was 21.9 years old (SD = 2.7). Almost all had sufficient knowledge (86.6%) and good preventive practice (92.8%) towards COVID-19; however, there was also a rather low level of positive attitude recorded, at 68.8%. The multivariable logistic regression analysis showed that the female participants, and the receiving of information from the official websites, reported a significantly higher level of good practice. Besides, students who had a high level of sufficient knowledge and positive attitude towards COVID-19 were more likely to have good preventive practices (All p<0.001). CONCLUSION: The findings demonstrated good preventive practice towards COVID-19; however, sufficient knowledge and positive attitude were lower. Therefore, it is an identified requirement to continue with additional education and training strategies to offer a better understanding and positive viewpoint of the pandemic for all students, including healthcare students.

Effective design of barrier enclosure to contain aerosol emissions from COVID-19 patients.

Facing shortages of personal protective equipment, some clinicians have advocated the use of barrier enclosures (typically mounted over the head, with and without suction) to contain aerosol emissions from coronavirus disease 2019 (COVID-19) patients. There is, however, little evidence for its usefulness. To test the effectiveness of such a device, we built a manikin that can expire micron-sized aerosols at flow rates close to physiological conditions. We then placed the manikin inside the enclosure and used a laser sheet to visualize the aerosol leaking out. We show that with sufficient suction, it is possible to effectively contain aerosol from the manikin, reducing aerosol exposure outside the enclosure by 99%. In contrast, a passive barrier without suction only reduces aerosol exposure by 60%.

Tocilizumab for severe COVID-19 pneumonia: Case series of 5 Australian patients.

AIM: To describe the first Australian cases of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV2) disease (COVID-19) pneumonia treated with the interleukin-6 receptor antagonist tocilizumab. METHODS: Retrospective, open-label, real-world, uncontrolled, single-arm case series conducted in 2 tertiary hospitals in NSW, Australia and 1 tertiary hospital in Victoria, Australia. Five adult male patients aged between 46 and 74 years with type 1 respiratory failure due to COVID-19 pneumonia requiring intensive care unit (ICU) admission and biochemical evidence of systemic hyperinflammation (C-reactive protein greater than 100 mg/L; ferritin greater than 700 µg/L) were administered variable-dose tocilizumab. RESULTS: At between 13 and 26 days follow-up, all patients are alive and have been discharged from ICU. Two patients have been discharged home. Two patients avoided endotracheal intubation. Oxygen therapy has been ceased in three patients. Four adverse events potentially associated with tocilizumab therapy occurred in three patients: ventilator-associated pneumonia, bacteremia associated with central venous catheterization, myositis and hepatitis. All patients received broad-spectrum antibiotics, 4 received corticosteroids and 2 received both lopinavir/ritonavir and hydroxychloroquine. The time from first tocilizumab administration to improvement in ventilation, defined as a 25% reduction in fraction of inspired oxygen required to maintain peripheral oxygen saturation greater than 92%, ranged from 7 hours to 4.6 days. CONCLUSIONS: Tocilizumab use was associated with favorable clinical outcome in our patients. We recommend tocilizumab be included in randomized controlled trials of treatment for patients with severe COVID-19 pneumonia, and be considered for compassionate use in such patients pending the results of these trials.

Coronaviruses pandemics: Can neutralizing antibodies help?

For the first time in Homo sapiens history, possibly, most of human activities is stopped by coronavirus disease 2019 (COVID-19). Nearly eight billion people of this world are facing a great challenge, maybe not "to be or not to be" yet, but unpredictable. What happens to other major pandemics in the past, and how human beings went through these hurdles? The human body is equipped with the immune system that can recognize, respond and fight against pathogens such as viruses. Following the innate response, immune system processes the adaptive response by which each pathogen is encoded and recorded in memory system. The humoral reaction containing cytokines and antibodies is expected to activate when the pathogens come back. Exploiting this nature of body protection, neutralizing antibodies have been investigated. Learning from past, in parallel to SARS-CoV-2, other coronaviruses SARS-CoV and MERS-CoV who caused previous pandemics, are recalled in this review. We here propose insights of origin and characteristics and perspective for the future of antibodies development.