Clinical characteristics and outcomes of critically ill coronavirus disease 2019 patients in Malaysia during the first wave: A multi-center observational study (COVIDICU-MY).

Background: Coronavirus disease 2019 (COVID-19) emerged with a wide range of clinical presentations; Malaysia was not spared from its impact. This study describes the clinical characteristics of COVID-19 patients admitted to intensive care unit, their clinical course, management, and hospital outcomes. Methods: COVIDICU-MY is a retrospective analysis of COVID-19 patients from 19 intensive care units (ICU) across Malaysia from 1 March 2020 to 31 May 2020. We collected epidemiological history, demographics, clinical comorbidities, laboratory investigations, respiratory and hemodynamic values, management, length of stay and survival status. We compared these variables between survival and non-survival groups. Results: A total of 170 critically ill patients were included, with 77% above 50 years of age [median age 60, IQR (51-66)] and 75.3% male. Hypertension, diabetes mellitus, hyperlipidemia, chronic cardiac disease, and chronic kidney disease were most common among patients. A high Simplified Acute Physiology Score (SAPS) II score [median 45, IQR (34-49)] and Sequential Organ Failure Assessment (SOFA) score [median 8, IQR (6-11)] were associated with mortality. Patients were profoundly hypoxic with a median lowest PaO2/FiO2 ratio of 150 (IQR 99-220) at admission. 91 patients (53.5%) required intubation on their first day of admission, out of which 38 died (73.1% of the hospital non-survivors). Our sample had more patients with moderate Acute Respiratory Distress Syndrome (ARDS), 58 patients (43.9%), compared to severe ARDS, 33 patients (25%); with both ARDS classification groups contributing to 25 patients (54.4%) and 11 patients (23.9%) of the non-survival group, respectively. Cumulative fluid balance over 24 h was higher in the non-survival group with significant differences on Day 3 (1,953 vs. 622 ml, p < 0.05) and Day 7 of ICU (3,485 vs. 830 ml, p < 0.05). Patients with high serum creatinine, urea, lactate dehydrogenase, aspartate aminotransferase and d-dimer, and low lymphocyte count throughout the stay also had a higher risk of mortality. The hospital mortality rate was 30.6% in our sample. Conclusion: We report high mortality amongst critically ill patients in intensive care units in Malaysia, at 30.6%, during the March to May 2020 period. High admission SAPS II and SOFA, and severe hypoxemia and high cumulative fluid balance were associated with mortality. Higher creatinine, urea, lactate dehydrogenase, aspartate aminotransferase and d-dimer, and lymphopenia were observed in the non-survival group.

Healthcare providers' attitudes towards delay in cancer treatment during COVID-19 pandemic.

INTRODUCTION: The COVID-19 pandemic has created unprecedented obstacles leading to delays in treatment for older adults with cancer. Due to limited resources at the height of the pandemic, healthcare providers were constantly faced with ethical dilemmas regarding postponing or rescheduling care for their patients. MATERIALS AND METHODS: Two survey-based studies were conducted at different time-points during the pandemic looking at factors affecting oncology care providers' attitudes towards delay in treatment for older adults with cancer. Eligible participants were recruited by email sent through professional organizations' listservs, email blasts, and social media. Change in provider attitude over time was analyzed by comparing responses from the 2020 and 2021 surveys. Data analysis included descriptive statistics and chi-squares. RESULTS: In 2020, 17.5% of respondents were strongly considering/considering postponing cancer treatment for younger patients (age 30 and below), while 46.2% were considering delaying treatment for patients aged >85. These responses were in stark contrast to the results of the 2021 survey, where only 1.4% of respondents strongly considered postponing treatment for younger patients, and 13.5% for patients aged >85. DISCUSSION: All recommendations to postpone treatment for older adults with cancer must be made after mutual discussion with the patient. Throughout the COVID-19 pandemic, oncology care providers had to consider multiple factors while treating patients, frequently making most decisions without appropriate institutional support.

Mapping research on healthcare operations and supply chain management: a topic modelling-based literature review.

The literature on healthcare operations and supply chain management has seen unprecedented growth over the past two decades. This paper seeks to advance the body of knowledge on this topic by utilising a topic modelling-based literature review to identify the core topics, examine their dynamic changes, and identify opportunities for further research in the area. Based on an analysis of 571 articles published until 25 January 2022, we identify numerous popular topics of research in the area, including patient waiting time, COVID-19 pandemic, Industry 4.0 technologies, sustainability, risk and resilience, climate change, circular economy, humanitarian logistics, behavioural operations, service-ecosystem, and knowledge management. We reviewed current literature around each topic and offered insights into what aspects of each topic have been studied and what are the recent developments and opportunities for more impactful future research. Doing so, this review help advance the contemporary scholarship on healthcare operations and supply chain management and offers resonant insights for researchers, research students, journal editors, and policymakers in the field.

Reimagining global food value chains through effective resilience to COVID-19 shocks and similar future events: A dynamic capability perspective.

The restructuring of global value/supply chains gained increasing attention as the unprecedented COVID-19 echoed around the world. Yet, the COVID-19 related theory-driven, large scale quantitative, and empirical studies are relatively scarce. This study advances the extant literature by empirically investigating how do firms in the global food value chains (GFVCs) re-imagine their businesses structure in response to the COVID-19-becoming more resilient and competitive to the current pandemic and similar future events. We leverage a unique data of 231 senior managers of the Australian GFVCs and examine their firms' response strategies. Drawing upon key insights from the dynamic capability view, we find that GFVCs' competitiveness is achieved when exposure to COVID-19 shocks elicits dynamic capabilities-readiness, response, recovery-and these capabilities work jointly and sequentially to cultivate resilience. A key finding of this study is that firms with domestic plus global value chain partners are more resilient than those having only global business partners. This finding implies that excessive reliance on offshoring sometimes becomes lethal, especially amid unexpected and prolonged global shocks and, therefore, companies should strike a balance between domestic and global business partners to remain competitive. These findings offer important contributions to theory, practice, and UN sustainable development goals.

Bronchopleural Fistula as a Complication in a COVID-19 Patient Managed With Endobronchial Valves.

Bronchopleural fistula (BPF) is associated with high morbidity if left untreated. Although rare, the frequency of BPF in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is becoming recognized in medical literature. We present a case of a 64-year-old male with BPF with persistent air leak due to SARS-CoV-2 pneumonia treated with Spiration Valve System endobronchial valve (EBV). An EBV was placed in the right middle lobe with successful cessation of air leak. In conclusion, the use of EBVs for BPF with persistent air leaks in SARS-CoV-2 patients who are poor surgical candidates is effective and safe.

Antiviral Strategies Using Natural Source-Derived Sulfated Polysaccharides in the Light of the COVID-19 Pandemic and Major Human Pathogenic Viruses.

Only a mere fraction of the huge variety of human pathogenic viruses can be targeted by the currently available spectrum of antiviral drugs. The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak has highlighted the urgent need for molecules that can be deployed quickly to treat novel, developing or re-emerging viral infections. Sulfated polysaccharides are found on the surfaces of both the susceptible host cells and the majority of human viruses, and thus can play an important role during viral infection. Such polysaccharides widely occurring in natural sources, specifically those converted into sulfated varieties, have already proved to possess a high level and sometimes also broad-spectrum antiviral activity. This antiviral potency can be determined through multifold molecular pathways, which in many cases have low profiles of cytotoxicity. Consequently, several new polysaccharide-derived drugs are currently being investigated in clinical settings. We reviewed the present status of research on sulfated polysaccharide-based antiviral agents, their structural characteristics, structure-activity relationships, and the potential of clinical application. Furthermore, the molecular mechanisms of sulfated polysaccharides involved in viral infection or in antiviral activity, respectively, are discussed, together with a focus on the emerging methodology contributing to polysaccharide-based drug development.

Effect of viral infection on brain functions and Psychological Impact of the COVID-19 on our thinking and mood (preprint)

Background: Viral infections such as measles virus (MV), herpes virus, and human immunodeficiency virus (HIV) can lead to transient or permanent neurological or psychiatric dysfunction. However, respiratory system affecting viruses have appeared as an unbeatable challenge to the modern world. They include the human respiratory syncytial virus (hRSV), the influenza virus (IV), and the coronavirus (CoV). They cause acute respiratory infections mainly children under 5 years old and also the elderly. The most frequent clinical manifestations are febrile or afebrile seizures, status epilepticus, encephalopathies, and encephalitis. Objective: The objective of this review is to assess the effect of COVID-19 on our mood and thinking during this pandemic. Method: We reviewed the literature using different databases e.g., Google Scholar, PubMed, and Science direct etc. Results: Viral Infections badly affect the nervous system functions and ultimate can lead to the onset of neurological and psychological illnesses. Conclusion: COVID-19 is somehow causing depression, anxiety, panic attacks, and stress. As a consequence, social distancing has increased that has ultimately modified our thinking style, mood and has lead to the psychological, emotional and behavioral changes. Review Criteria We reviewed the literature using different databases e.g., Google Scholar, PubMed, etc. from 1997 to 2021 without language limitations. Message for the clinic It is clear that COVID-19 causes cardiac, respiratory, renal, and gastrointestinal dysfunctions and has also a direct effect on brain functioning resulting in psychological and behavioral changes. Along with other dysfunctions, it has severely affected the living style of people and brought depression, anxiety, panic attacks, loneliness, and self-deprecation. It is highly recommended that while treating such patients, all these aspects should be kept in mind. Hence, not only medication can ameliorate the side impacts of this infection but counseling is another tool to bring positive impact in those respondents.

Making Assembly Line in Supply Chain Robust and Secure Using UHF RFID and Blockchain (preprint)

This paper presents a block-chain enabled inkjet-printed ultrahigh frequency radiofrequency identification (UHF RFID) system for the supply chain management, traceability and authentication of hard to tag bottled consumer products containing fluids such as water, oil, juice, and wine. In this context, we propose a novel low-cost, compact inkjet-printed UHF RFID tag antenna design for liquid bottles, with 2.5 m read range improvement over existing designs along with robust performance on different liquid bottle products. The tag antenna is based on a nested slot-based configuration that achieves good impedance matching around high permittivity surfaces. The tag was designed and optimized using the characteristic mode analysis. Moreover, the proposed RFID tag was commercially tested for tagging and billing of liquid bottle products in a conveyer belt and smart refrigerator for automatic billing applications. With the help of block-chain based product tracking and a mobile application, we demonstrate a real-time, secure and smart supply chain process in which items can be monitored using the proposed RFID technology. We believe the standalone system presented in this paper can be deployed to create smart contracts that benefit both the suppliers and consumers through the development of trust. Furthermore, the proposed system will paves the way towards authentic and contact-less delivery of food, drinks and medicine in recent Corona virus pandemic.

A presumed case of new-onset focal seizures as a delayed complication of COVID-19 infection.

Previously seizures have been reported as presenting neurological manifestation with COVID-19 infection. There is a growing literature on the delayed neurologic effects of COVID-19 infection. Here, we report a case with insidious onset of focal impaired awareness seizures associated with left temporal epileptiform interictal and ictal discharges consistent with focal epilepsy; occurring within a short time frame of the diagnosis of COVID-19 infection. This may be possibly a post COVID-19 inflammatory syndrome manifesting as new onset focal epilepsy with focal non-motor seizures with impaired awareness. As implicated by presentation with seizure as in our case, longterm follow-up studies are warranted to further investigate if the patients who acquire COVID-19 infection are at increased risk of developing epilepsy as a delayed manifestation.

Neurological Predictors of Clinical Outcomes in Hospitalized Patients With COVID-19.

Introduction: Multiple risk factors of mortality have been identified in patients with COVID-19. Here, we sought to determine the effect of a history of neurological disorder and development of neurological manifestations on mortality in hospitalized patients with COVID-19. Methods: From March 20 to May 20, 2020, hospitalized patients with laboratory confirmed or highly suspected COVID-19 were identified at four hospitals in Ohio. Previous history of neurological disease was classified by severity (major or minor). Neurological manifestations during disease course were also grouped into major and minor manifestations. Encephalopathy, ischemic or hemorrhagic stroke, and seizures were defined as major manifestations, whereas minor neurological manifestations included headache, anosmia, dysgeusia, dizziness or vertigo, and myalgias. Multivariate logistic regression models were used to determine significant predictors of mortality in patients with COVID-19 infection. Results: 574/626 hospitalized patients were eligible for inclusion. Mean age of the 574 patients included in the analysis was 62.8 (SD 17.6), with 298 (51.9%) women. Of the cohort, 240(41.8%) patients had a prior history of neurological disease (HND), of which 204 (35.5%) had a major history of neurological disease (HND). Mortality rates were higher in patients with a major HND (30.9 vs. 15.4%; p = 0.00002), although this was not a significant predictor of death. Major neurological manifestations were recorded in 203/574 (35.4%) patients during disease course. The mortality rate in patients who had major neurological manifestations was 37.4% compared to 11.9% (p = 2 × 10-12) in those who did not. In multivariate analysis, major neurological manifestation (OR 2.1, CI 1.3-3.4; p = 0.002) was a predictor of death. Conclusions: In this retrospective study, history of pre-existing neurological disease in hospitalized COVID-19 patients did not impact mortality; however, development of major neurological manifestations during disease course was found to be an independent predictor of death. Larger studies are needed to validate our findings.

Imaging trend and disease course in admitted COVID-19 patients.

OBJECTIVES: To describe radiographic imaging findings and disease course in admitted Coronavirus disease 2019 (COVID-19) patients. METHODS: This retrospective study was carried in the Radiology Department, King Fahad Military Medical Complex, Dhahran between March to August 2020 (6 months). All laboratory confirmed COVID-19 admitted cases were evaluated for their symptoms, duration of hospital stays (in a ward or intensive care unit [ICU]), and imaging findings (ground-glass opacity [GGO], air-space shadowing/consolidation, and others such as atelectasis, reticulation, peribronchovascular thickening, lymphadenopathy and pleural effusion) on chest radiograph (CXR) and computed tomography (CT) studies. Cavitation, nodularity, bronchiectasis, and embolism detected on CT scans were considered as complications. Disease course in terms of recovery (radiographic regression or resolution of findings), worsening (shifting from ward to ICU), and unfavorable outcome (persistent ICU stay or death) were recorded. Imaging findings were interpreted by 2 experienced radiologists and consensus reporting was made. Chi-square test was used to determine association. Results: Out of 106 patients, majority were males (n=82, 77.4%). Forty-six patients (43.3%) had abnormal imaging with mostly peripheral GGO (56.5%), followed by consolidations (34.7%), and others (26%). Complications were detected in 6 ICU patients. All patients with unfavorable outcomes were above 60 years having comorbidities or complications (p less than 0.0005). Fatality rate was calculated as 2.8. Conclusion: Coronavirus disease 2019 is seen mostly affecting males, with peripheral opacities as common imaging findings. Elderly patients with co-morbidities may show unfavorable outcomes.

COVID-19 in Older Individuals with Cancer: Problem and Potential Solutions.

The ongoing coronavirus disease-2019 (COVID-19) pandemic has radically affected medical practice and healthcare delivery in the United States and beyond. Its impact on vulnerable populations especially older adults battling cancer is striking. Older adults with baseline immunosenescence compounded with multimorbidity and reduced physiological reserves are at even higher risk of succumbing to infection. When it comes to older adults with cancer mortality, it often multifactorial with modifiable risk factors. A specific approach with attention to advance care planning and how cancer care is delivered coupled with a comprehensive geriatric assessment may ultimately be the key to improve overall survival.

A Review on the State of the Art in Non Contact Sensing for COVID-19 (preprint)

COVID-19 disease, caused by SARS-CoV-2, has resulted in a global pandemic recently. With no approved vaccination or treatment, governments around the world have issued guidance to their citizens to remain at home in efforts to control the spread of the disease. The goal of controlling the spread of the virus is to prevent strain on hospital. In this paper, we have focus on how non-invasive methods are being used to detect the COVID-19 and assist healthcare workers in caring for COVID-19 patients. Early detection of the COVID-19 virus can allow for early isolation to prevent further spread. This study outlines the advantages and disadvantages and a breakdown of the methods applied in the current state-of-the-art approaches. In addition, the paper highlights some future research directions, which are required to be explored further to come up with innovative technologies to control this pandemic.

BeepTrace: Blockchain-enabled Privacy-preserving Contact Tracing for COVID-19 Pandemic and Beyond (preprint)

The outbreak of COVID-19 pandemic has exposed an urgent need for effective contact tracing solutions through mobile phone applications to prevent the infection from spreading further. However, due to the nature of contact tracing, public concern on privacy issues has been a bottleneck to the existing solutions, which is significantly affecting the uptake of contact tracing applications across the globe. In this paper, we present a blockchain-enabled privacy-preserving contact tracing scheme: BeepTrace, where we propose to adopt blockchain bridging the user/patient and the authorized solvers to desensitize the user ID and location information. Compared with recently proposed contract tracing solutions, our approach shows higher security and privacy with the additional advantages of being battery friendly and globally accessible. Results show viability in terms of the required resource at both server and mobile phone perspectives. Through breaking the privacy concerns of the public, the proposed BeepTrace solution can provide a timely framework for authorities, companies, software developers and researchers to fast develop and deploy effective digital contact tracing applications, to conquer COVID-19 pandemic soon. Meanwhile, the open initiative of BeepTrace allows worldwide collaborations, integrate existing tracing and positioning solutions with the help of blockchain technology.

COVID-19: Disease, management, treatment, and social impact.

COVID-19 was originated from Wuhan city of Hubei Province in China in December 2019. Since then it has spread in more than 210 countries and territories. It is a viral disease due to the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) virus. The patients show flu-like symptoms with a dry cough, sore throat, high fever, and breathing problems. The disease due to SARS-CoV-2 was named as COVID-19. About 2.2 million people have been infected with more than 0.15 million deaths globally. The United States of America is the most affected country with the highest patients of about 0.7 million. Despite great efforts, there is no treatment of this disease. However, prevention and management are the best options. This article describes SARS-CoV-2, disease, prevention and management, treatment and social impact on society. It was analyzed that a combination of antiviral drugs with hydroxyl-chloroquine and azithromycin (with the consultation of a medical practitioner) may be the best option to treat the patients, depending on the patient's conditions and symptoms. However, Unani therapy may be useful along with allopathic treatment. It is urgently advised and requested that all the persons should follow the preventive measures, managements and quarantine strictly without any religious discrepancy otherwise the situation may be the worst. Also, there is an urgent requirement to educate our new generation for science and technology to fight against any such disaster in future; if any. There is no need to be panic and proper prevention and management are essential to combat this disease. This article may be useful to create awareness among the public, to prevent, manage and treat COVID-19.

Correlation between weather and Covid-19 pandemic in Jakarta, Indonesia.

This study aims to analyze the correlation between weather and covid-19 pandemic in Jakarta Indonesia. This study employed a secondary data analysis of surveillance data of covid-19 from the Ministry of Health of the Republic of Indonesia and weather from the Meteorological Department of the Republic of Indonesia. The components of weather include minimum temperature (°C), maximum temperature (°C), temperature average (°C), humidity (%), and amount of rainfall (mm). Spearman-rank correlation test was used for data analysis. Among the components of the weather, only temperature average (°C) was significantly correlated with covid-19 pandemic (r = 0.392; p < .01). The finding serves as an input to reduce the incidence rate of covid-19 in Indonesia.

AI4COVID-19: AI Enabled Preliminary Diagnosis for COVID-19 from Cough Samples via an App (preprint)

Background: The inability to test at scale has become humanity's Achille's heel in the ongoing war against the COVID-19 pandemic. A scalable screening tool would be a game changer. Building on the prior work on cough-based diagnosis of respiratory diseases, we propose, develop and test an Artificial Intelligence (AI)-powered screening solution for COVID-19 infection that is deployable via a smartphone app. The app, named AI4COVID-19 records and sends three 3-second cough sounds to an AI engine running in the cloud, and returns a result within two minutes. Methods: Cough is a symptom of over thirty non-COVID-19 related medical conditions. This makes the diagnosis of a COVID-19 infection by cough alone an extremely challenging multidisciplinary problem. We address this problem by investigating the distinctness of pathomorphological alterations in the respiratory system induced by COVID-19 infection when compared to other respiratory infections. To overcome the COVID-19 cough training data shortage we exploit transfer learning. To reduce the misdiagnosis risk stemming from the complex dimensionality of the problem, we leverage a multi-pronged mediator centered risk-averse AI architecture. Results: Results show AI4COVID-19 can distinguish among COVID-19 coughs and several types of non-COVID-19 coughs. The accuracy is promising enough to encourage a large-scale collection of labeled cough data to gauge the generalization capability of AI4COVID-19. AI4COVID-19 is not a clinical grade testing tool. Instead, it offers a screening tool deployable anytime, anywhere, by anyone. It can also be a clinical decision assistance tool used to channel clinical-testing and treatment to those who need it the most, thereby saving more lives.