Rapid rise in COVID-19 among young people in England - learning for the future.

OBJECTIVES: We determined the age and sociodemographic distribution of COVID-19 cases between January and September 2020 to identify the group with the highest incidence rates at the beginning of the second wave in England. STUDY DESIGN: We undertook a retrospective cohort study design. METHODS: SARS-CoV-2 cases in England were linked with area-level socio-economic status indicators using quintiles of the Index of Multiple Deprivation (IMD). Age-specific incidence rates were stratified by IMD quintile to further assess rates by area-level socio-economic status. RESULTS: Between July and September 2020, SARS-CoV-2 incidence rates were highest amongst those aged 18-21 years, reaching rates of 213.9 (18-19 years) and 143.2 (20-21 years) per 100,000 population by week ending 21 September 2022. Stratification of incidence rates by IMD quintile evidenced that despite high rates observed in the most deprived areas of England amongst the very young and older age groups, the highest rates were observed in the most affluent areas of England amongst the 18- to 21-year-olds. CONCLUSIONS: The reversal of sociodemographic trend in COVID-19 cases in England for those aged 18-21 years at the end of the summer of 2020 and beginning of the second wave showed a novel pattern of COVID-19 risk. For other age groups, the rates remained highest for those from more deprived areas, which highlighted persisting inequalities. Combined, this demonstrates the need to reinforce awareness of COVID-19 risk for young people, particularly given the late inclusion of the 16-17 years age group for vaccination administration, as well as continued efforts to reduce the impact of COVID-19 on vulnerable populations.

The mechanisms of action of ivermectin against SARS-CoV-2-an extensive review

Considering the urgency of the ongoing COVID-19 pandemic, detection of new mutant strains and potential re-emergence of novel coronaviruses, repurposing of drugs such as ivermectin could be worthy of attention. This review article aims to discuss the probable mechanisms of action of ivermectin against SARS-CoV-2 by summarizing the available literature over the years. A schematic of the key cellular and biomolecular interactions between ivermectin, host cell, and SARS-CoV-2 in COVID-19 pathogenesis and prevention of complications has been proposed.Copyright © 2022 Japan Antibiotics Research Association. All rights reserved.

Retraction: The mechanisms of action of Ivermectin against SARS-CoV-2: An evidence-based clinical review article (Japanese Journal of Antibiotics DOI: 10.1038/s41429-021-00430-5)

The Editor-in-Chief has retracted this article. Following publication, concerns were raised regarding the methodology and the conclusions of this review article. Post-publication review confirmed that while the review article appropriately describes the mechanism of action of ivermectin, the cited sources do not appear to show that there is clear clinical evidence of the effect of ivermectin for the treatment of SARS-CoV-2. The Editor-in-Chief therefore no longer has confidence in the reliability of this review article. None of the authors agree to this retraction. The online version of this article contains the full text of the retracted article as Supplementary Information.Copyright © The Author(s), under exclusive licence to the Japan Antibiotics Research Association 2021.

Post COVID-19 medical complications

The infection triggered by the SARS-CoV-2 virus resulted in the novel coronavirus infection (COVID-19), which was firstly identified in city of China, namely Wuhan. The main symptoms such as muscle fatigability, aches, and pain are associated with this condition. Thus, a high proportion of patients who recovered manifest a plethora of long-lasting symptoms. Although, many patients fully recover, health complications can delay a person's complete return to a regular lifestyle. Fatigue is experienced by a considerable percentage of individuals who have recovered from COVID-19 disease. Thus, the neurological symptoms of COVID-19 are frequent and debilitating enough to have piqued the interest of the scientific and general press for their brief and long effect on population health. The authors have searched articles from various search engines. The articles on coronavirus have been collected from PubMed and Scopus databases from Jan., 2019 to July, 2021. On the basis of their importance and uniqueness, articles were included in this review. The study aims on COVID-19 infection on survivors and complications to return to normal life and role of consulting sessions, physiotherapy and other medications after recovery. Some long-term researches are created to investigate the COVID-19's medical, psychological, and socio-economic complications. To resume normal life, COVID-19 survivors are required to take aid to consultations, physiotherapy, and dermatological care.

Risk of hospitalisation or death in households with a case of COVID-19 in England: an analysis using the HOSTED data set.

OBJECTIVE: To determine whether household contacts of confirmed cases of COVID-19 have an increased risk of hospitalisation or death. METHODS: We used the HOSTED data set of index cases of COVID-19 in England between June and November 2020, linked to Secondary Uses Service data on hospital episodes and Office for National Statistics' mortality data. Multivariable logistic regression models of the odds of household contacts being hospitalised or dying within six weeks of an index case, adjusted for case type, age, sex and calendar month were calculated. Excess risk was determined by comparing the first six weeks after the index case with 6-12 weeks after the index case in a survival analysis framework. RESULTS: Index cases were more likely to be hospitalised or die than either secondary cases or non-cases, having adjusted for age and sex. There was an increased risk of hospitalisation for non-cases (adjusted hazard ratio (aHR) 1.10; 95% confidence interval (CI) 1.04, 1.16) and of death (aHR 1.57; 95% CI 1.14, 2.16) in the first six weeks after an index case, compared to 6-12 weeks after. CONCLUSION: Risks of hospitalisation and mortality are predictably higher in cases compared to non-cases. The short-term increase in risks for non-case contacts following diagnosis of the index case may suggest incomplete case ascertainment among contacts, although this was relatively small.

COVID-19 Vaccination May Provoke Intracranial Hypertension

In parallel to the spread of the novel severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), there has been the growing recognition that active SARS-CoV-2 infection has the potential to effect both the peripheral and central nervous systems. When it comes to the SARS-CoV-2 vaccine, however, reporting has been more uncertain. As the vaccination rate has risen, we have seen a rise in rare neurological complications thought to be associated with the vaccination including acute transverse myelitis, Guillain-Barre syndrome, optic neuritis, and Tolosa-Hunt syndrome. The Centers for Disease Control and Prevention (CDC) estimates 98 confirmed cases of Guillain-Barre syndrome out of 12.6 million doses. Given the initial age limits of vaccination eligibility, most reports have been limited to the adult population. Here, we report a case of intracranial hypertension (IH), evolving to fulminant IH in a healthy female after receiving the SARS-CoV-2 vaccine. While elevated intracranial pressure has been reported in the context of active SARS-CoV-2 infections and postinfection multisystem inflammatory syndrome (MIS-C), this is the first reported case of pediatric IH after vaccination alone.

Screening and Structure-Activity Relationship of Potential Compounds against Proposed Targets of COVID-19 Infection

Background: With reference to COVID-19 pandemic prevailing across the globe, chloroquine and hydroxychloroquine were reported as effective against the disease to some extent. This effectiveness can be attributed to the glycosylation interruption of the Angiotensin-converting enzyme 2 (ACE2) recep-tor, which is a known target for SARS-CoV-2 entery. On the other hand, studies suggest that the inhibition of ACE2 can be lethal in certain cases, thereby causing cardiovascular disorders, especially in patients already suffering from heart-related diseases. Methods: In this study, the most probable targets (other than ACE2) have been proposed for the treatment of COVID-19 infection by taking chloroquine and hydroxychloroquine as reference drugs. Swiss Tar-getPrediction and PASSonline tools were used in order to achieve this objective. Known drugs against each target possessing close relation to either viral infections or lung disorders were assessed from the DrugBank database, and simultaneous efficacy of these drugs towards other proposed targets has been analyzed. By taking the most effective drugs as a reference, similar compounds were screened from the ChEMBL library by using the Swiss Similarity tool. Finally, molecular docking studies were performed through MOE software by using screened compounds against proposed targets. Results: Four most probable targets have been proposed, which include chemokine receptors (CCRs), dipeptidyl peptidase 4 (DPP4), muscarinic acetylcholine receptors (CHRMs), and histamine N-methyltransferase (HNMT). Furthermore, it has been evaluated that quinacrine and vildagliptin are effective against most of the proposed targets. By taking vildagliptin as well as quinacrine as reference drugs, further eight compounds with similar effectiveness against these targets have been screened from the ChEMBL library. Molecular docking studies with CCR5, DPP4, and CHRM5 suggest that the quinacrine and its analogue (ChEMBL1782742) as well as vildagliptin and its analogue (ChEMBL511785) are the most suitable compounds as HITs for these targets. Conclusion: It has been established that the quinacrine, ChEMBL1782742, vildagliptin, ChEMBL511785, mavorixafor, atropine, and N-(2-aminoethyl)-1-aziridineethanamine in descending order can be considered as effective drugs for the treatment of COVID-19 infection.

Neutralizing antibody responses against SARS-CoV-2 spike receptor-binding domain 13 months after the recovery from the disease.

BACKGROUND: Information regarding the kinetics and longevity of acquired immunity in recovered COVID-19 patients requires thorough analysis and documentation. This is an update to an ongoing monocentric pilot observational study, that longitudinally analyzed the presence of antibodies after SARS-CoV-2 infection. STUDY DESIGN: Antibody titers against nucleocapsid protein (NCP) of SARS-CoV-2 analyzed at 8 months was followed by adoption of a more specific immunoassay, anti-Spike-Receptor binding domain IgG CLIA for analysis at 12 and 13 months post infection. METHODS: MAGLUMI® SARS-CoV-2 S-RBD IgG Chemiluminescence immunoassay (CLIA) was adopted for measurement of antibody titres at 12 and 13 months after SARS-CoV-2 infection. RESULTS: 97% (34 out of 35) patients resulted positive for anti-SARS-CoV-2 RBD IgG at 12 and 13 months. DISCUSSION AND CONCLUSIONS: In areas with vaccine and resource scarcity, vaccination could be prioritized for those individuals who have never been infected or for the ones who have recovered but show the absence of protective antibodies.

CrowdMap: Spatiotemporal Visualization of Anonymous Occupancy Data for Pandemic Response

CrowdMap is an anonymous occupancy monitoring system developed in response to the COVID-19 pandemic. CrowdMap collects, cleans, and visualizes occupancy data derived from connection logs generated by large arrays of Wi-Fi access points. Thus, CrowdMap is a passive digital tracking tool that can be used to reopen buildings safely, as it helps actively manage occupancy limits and identify utilization trends at scale. Occupancy monitoring is possible at various levels of resolution over large spatial (e.g., from individual rooms to entire buildings) and temporal (e.g., from hours to months) extents. The CrowdMap web-based front-end implements powerful spatiotemporal querying and visualization tools to quickly and effectively explore occupancy patterns throughout large campuses. We will demonstrate CrowdMap and its spatiotemporal GUI that was deployed for an entire university campus with data continuously being collected since summer 2020. © 2021 Owner/Author.

Empowerment of SME's sustainability in halal cosmetics' ecosystem by diagnosing growth constraints

Purpose This study aims to identify and examine the growth constraints of the halal cosmetics ecosystem in which SMEs are operating in, with special focus on the situation in Malaysia. Design/methodology/approach The study adopted a qualitative methodology consisting of a systematic literature review and interviews with selected consumers and policymakers. The instruments were developed based on cybernetics and a systems-based approach, which allows for the understanding of the dynamics of growth variables in the halal cosmetics ecosystem. Based on data gathered, their relationships were mapped and major growth constraints were identified. Findings Cybernetics and systems approach coupled with growth diagnostics framework has enabled identification of comprehensive growth constraint variables for halal cosmetics ecosystem and mapping of growth constraints (variables) in a relationships network. The study found that the enforcement activities of the National Pharmaceutical Research Agency (Cosmetics Unit) directly affect five growth constraints and is associated with three other growth constraint variables;subsequently the most binding growth constraint. The relationship network derived from the mapping of the growth constraints indicated that changes in the behaviour of any element will affect the overall operations of the ecosystem. Research limitations/implications While the cosmetics industry is large and varied, this study is centred on halal colour cosmetics only. The growth constraint variables studied are those chosen by researchers and other growth constraints could be studied to guide policymakers. Future research can revolve around other halal cosmetics business sectors;impact of IR4.0 technology, COVID-19 pandemic impact;crisis and risk management issues, in the halal cosmetics industry. Practical implications The results derived from the cybernetics analysis affirms the "outside-in" marketing perspective, thus stakeholders should continuously monitor changes in the halal cosmetics ecosystem to ensure to ensure sustainability and profitability. Small and medium enterprises (SMEs) and policymakers can initiate pre-emptive actions by conducting simulations of various situations on the halal ecosystem. Social implications Enabled to simulate the effect of changes to the halal cosmetics ecosystem, stakeholders are able to take intervention initiatives, safeguard accessibility to halal cosmetics and make the halal cosmetics industry sustainable. Originality/value To the best of the authors' knowledge, this is the first comprehensive research to identify the growth constraints of the halal cosmetics industry in Malaysia that focusses on three groups of stakeholders (consumers, SMEs and government institutions) concurrently. The growth constraints relationship network of the halal cosmetics ecosystem can be further used to simulate the impact of changes within the system.

It Is Time for an Oil Change: Polyunsaturated Fatty Acids and Human Health

Polyunsaturated fatty acids (PUFAs) such as docosahexaneoic acid (DHA) and eicosapentaneoic acid (EPA), play a critical role in a variety of neuronal functions, including facilitating neuronal growth and differentiation, increasing the density of the neuritic network, modulating cell membrane fluidity, regulating intracellular signaling and gene expression, and exhibiting antioxidant characteristics. Dietary DHA is selectively enriched and actively retained in the central nervous system, mainly in synaptic membranes, dendrites, and photoreceptors. In this review, we highlight the myriad roles of PUFAs in brain function and human health. Diets rich in DHA are inversely proportional to cognitive decline and incidence of neurodegenerative disorders. Conversely, diets deficient in DHA impair the proper development of brain and the visual system in children and increase risk of brain disorders in the elderly. Finally, DHA and EPA have been shown to reduce inflammation and may prove to be beneficial in reducing the severity of the SARS-COVID infection.

Use of Adhesive Tape to Facilitate Optimal Mask Positioning and Use in the Emergency Department: A Randomized Controlled Trial

Study Objective: We hypothesize that placing a piece of surgical tape at the bridge of the nose over the mask, creating a physical deterrent to mask removal, will improve proper mask use among emergency department (ED) patients. Methods: 123 patients were enrolled in a randomized controlled trial at Eskenazi Hospital from April 2020 until October 2020. We permitted participants to either use their own mask (due to low resources institutionally) or we provided a surgical/cloth mask (early on relied on donated cloth masks for patients). Participants were randomized to a control (no tape over the mask/nose) or to the intervention (placing tape over the bridge of the nose of the face mask). The primary outcome of this study is the frequency at which participants correctly wear their masks in the intervention and control groups at 60 minutes into their ED visit. Results: At 60- minutes in the no-tape control group, 31.1% participants were incorrectly wearing the masks, compared to 100% of the intervention group correctly wearing their masks. Subjects who were observed wearing their masks incorrectly (91.1%) exhibited some combination of either their mask removed or their nose and/or mouth exposed. Conclusions: Applying a piece of tape to the bridge of the nose affords a simple, low-cost, low-risk solution that improved the rate of proper mask usage to 100%.

Sickle Cell Pain: Intervention with Capsaicin Exposure (SPICE)

Background Pain is a common and debilitating complication of sickle cell disease (SCD) often requiring high doses of opioids for relief. The stigma associated with pain and opioid use has made it difficult for those with SCD to obtain needed treatment for pain, which can be acute or chronic, and nociceptive or neuropathic in nature. Given these difficulties, coupled with the inconsistency of opioids in successfully treating chronic and neuropathic pain, there is a need for non-opioid alternatives to treat this increasingly recognized subset of patients with SCD. Topical capsaicin for neuropathic pain has been studied extensively in adults with comparable efficacy to gabapentinoids, but it has not been investigated for SCD-related pain. We investigated the safety and feasibility of high dose (8%) topical capsaicin for treatment of neuropathic pain in children with SCD. The primary objective was to assess drug safety. Secondary objectives were to assess the feasibility and optimal utilization strategy of various measures of neuropathic and chronic pain states, and to obtain preliminary efficacy data. Prior to this study there has been very little published data regarding quantitative sensory testing as a trended datapoint to assess therapeutic effect on neuropathic pain. Methods Patients between ages 14-21 years with SCD and reported symptoms of neuropathic pain were included. During each of 7 visits scheduled at 6 week intervals, mechanical quantitative sensory testing (QST) was conducted using an electronic von Frey instrument (Bioseb) at a control site (thenar eminence) and the two most common sites of vaso-occlusive pain as reported at enrollment. Participants also completed the PainDETECT® questionnaire (Pfizer) for neuropathic pain assessment. During visits 1, 3, and 5 an 8% capsaicin patch was applied to the previously established most common site of pain. Safety was evaluated via CTCAE based analysis of adverse events in real time and at study completion. Efficacy was primarily evaluated by improvement in mechanical pain threshold at the site of most frequent pain (treated with capsaicin) relative to the 2nd most common site of pain (not treated). Trends in PainDetect scores also contributed to a preliminary understanding of capsaicin efficacy. Results 10 out of 13 patients approached (5 male, 5 female) were enrolled as planned within 8 weeks. 9 participants completed visits 1-5, and 7 completed visit 6 prior to study suspension due to COVID restrictions. There were no CTCAE grade 3 adverse events attributable to capsaicin. There were no vaso-occlusive pain crises triggered by a patch application. One participant requested that the second patch be removed early due to intolerance of the burning sensation associated with the patch. She subsequently did not have the third patch applied at visit 5. All participants were informed at enrollment of the likelihood of this side effect, which was nearly universal among participants but generally well tolerated. The other 9 participants completed all possible study activities and felt the second patch application was more tolerable than the first. 6 participants felt after 2 treatments the treated area was no longer their most common site of pain. These subjective reports were supported by more objective measures. The average difference in pain threshold as measured by QST between the two painful sites (QSTTreated - QSTuntreated) was used to evaluate a beneficial effect of capsaicin. This difference from visit 1 to visit 5 changed from -31.94g to +11.51g over the first 5 visits for an average improvement in pain threshold at the treated site relative to the untreated site of +43.45g (p=0.02) (Fig. 1), indicating that by visit 5 the threshold was higher at the treated site than the untreated site, a reversal from visit 1. Statistical analysis could not be completed for subsequent visits due to incomplete datasets. Conclusion Our pilot study indicates 8% topical capsaicin is safe and feasible for children with SCD. The data indicates this therapy may be efficacious in a eliorating neuropathic pain for this population and warrants further investigation in a follow-up efficacy study to be initiated in the coming months. The initial negative difference in QST values and subsequent trends between the two sites coincided with patient reported relative pain severity and supports the potential of QST as a tool in trending medication effect on peripheral hypersensitivity. [Formula presented] Disclosures: Callaghan: Octapharma: Honoraria, Membership on an entity's Board of Directors or advisory committees;Global Blood Therapeutics: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other, Speakers Bureau;Sancillio: Other;Spark: Honoraria, Membership on an entity's Board of Directors or advisory committees;Grifols: Honoraria, Membership on an entity's Board of Directors or advisory committees;Biomarin: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Site Investigator/sub-I Clinical Trial, Speakers Bureau;Roche/Genentech: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Site Investigator/sub-I Clinical Trial, Speakers Bureau;Pfizer: Honoraria, Membership on an entity's Board of Directors or advisory committees, Other: Site Investigator/sub-I Clinical Trial, Research Funding;Alnylum: Current equity holder in publicly-traded company;Bayer: Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Bioverativ: Membership on an entity's Board of Directors or advisory committees;Hema Biologics: Honoraria, Membership on an entity's Board of Directors or advisory committees;Shire: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding, Speakers Bureau;NovoNordisk: Other, Speakers Bureau. Zaidi: Imara: Consultancy, Honoraria;bluebird bio: Consultancy, Honoraria;Cyclerion: Consultancy, Honoraria;Novartis: Consultancy, Honoraria;Global Blood Therapeutics: Consultancy, Honoraria, Membership on an entity's Board of Directors or advisory committees, Speakers Bureau;Emmaus Life Sciences: Consultancy, Honoraria. OffLabel Disclosure: High dose (8%) topical capsaicin (Qutenza) is approved for the treatment of neuropathic pain associated with either postherpetic neuralgia or diabetic peripheral neuropathy.

Neutralizing antibody responses against SARS-CoV-2 spike receptor-binding domain 13 months after the recovery from the disease

Background: Information regarding the kinetics and longevity of acquired immunity in recovered COVID-19 patients requires thorough analysis and documentation. This is an update to an ongoing monocentric pilot observational study, that longitudinally analyzed the presence of antibodies after SARS-CoV-2 infection. Study design: Antibody titers against nucleocapsid protein (NCP) of SARS-CoV-2 analyzed at 8 months was followed by adoption of a more specific immunoassay, anti-Spike-Receptor binding domain IgG CLIA for analysis at 12 and 13 months post infection. Methods: MAGLUMI R SARS-CoV-2 S-RBD IgG Chemiluminescence immunoassay (CLIA) was adopted for measurement of antibody titres at 12 and 13 months after SARS-CoV-2 infection. Results: 97% (34 out of 35) patients resulted positive for anti-SARS-CoV-2 RBD IgG at 12 and 13 months. Discussion and Conclusions: In areas with vaccine and resource scarcity, vaccination could be prioritized for those individuals who have never been infected or for the ones who have recovered but show the absence of protective antibodies.

Covid 19: Evaluate of liver and renal function tests in iraqi patients

The clinical features of COVID-19 are varied, ranging from asymptomatic state to acute respiratory distress syndrome and multi organ dysfunction. We aim to evaluate renal and liver functions of patients with COVID 19. Laboratory results were obtained from 107 patients with laboratory-confirmed COVID-19 who were admitted to the only Al-Furat General Hospital in Baghdad, Iraq from March 3 to June 9, 2020 and followed up until recovery. Normal levels of renal functions were presented. Meanwhile elevated levels of alanine aminotransferase (ALT) was observed in 10% and of aspartate aminotransferase (AST) was observed in 40% of patients with COVID 19,yet on comparison of the results at entering with at recovery it was observed significant differences (p<0.01) of all patients. From these findings we conclude that the virus might be responsible for systemic inflammation.