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1.
J Med Virol ; 95(6): e28863, 2023 06.
Article in English | MEDLINE | ID: covidwho-20238042

ABSTRACT

The ongoing COVID-19 has not only caused millions of deaths worldwide, but it has also led to economic recession and the collapse of public health systems. The vaccines and antivirals developed in response to the pandemic have improved the situation markedly; however, the pandemic is still not under control with recurring surges. Thus, it is still necessary to develop therapeutic agents. In our previous studies, we designed and synthesized a series of novel 2-anilinoquinazolin-4(3H)-one derivatives, and demonstrated inhibitory activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and MERS-CoV in vitro. We then conducted in vivo studies using modified compounds that are suitable for oral administration. These compounds demonstrated no toxicity in rats and inhibited viral entry. Here, we investigated the in vivo efficacy of these drug candidates against SARS-CoV-2. Three candidate drugs, 7-chloro-2-((3,5-dichlorophenyl)amino)quinazolin-4(3H)-one (1), N-(7-chloro-4-oxo-3,4-dihydroquinazolin-2-yl)-N-(3,5-dichlorophenyl)acetamide (2), and N-(7-chloro-4-oxo-3,4-dihydroquinazolin-2-yl)-N-(3,5-difluorophenyl)acetamide (3) were administered orally to hACE2 transgenic mice at a dose of 100 mg/kg. All three drugs improved survival rate and reduced the viral load in the lungs. These results show that the derivatives possess in vivo antiviral efficacy similar to that of molnupiravir, which is currently being used to treat COVID-19. Overall, our data suggest that 2-anilinoquinazolin-4(3H)-one derivatives are promising as potential oral antiviral drug candidates against SARS-CoV-2 infection.


Subject(s)
Angiotensin-Converting Enzyme 2 , COVID-19 , SARS-CoV-2 , Animals , Humans , Mice , Rats , Acetamides , Angiotensin-Converting Enzyme 2/genetics , Antiviral Agents/pharmacology , Antiviral Agents/therapeutic use , COVID-19/genetics , COVID-19/therapy , Disease Models, Animal , Mice, Transgenic , Quinazolines/pharmacology , Quinazolines/therapeutic use , SARS-CoV-2/genetics
2.
Plants (Basel) ; 12(8)2023 Apr 20.
Article in English | MEDLINE | ID: covidwho-2306211

ABSTRACT

In total, four new eudesmane-type sesquiterpene glycosides, askoseosides A-D (1-4), and 18 known compounds (5-22) were isolated from the flowers of Aster koraiensis via chromatographic techniques. Chemical structures of the isolated compounds were identified by spectroscopic/spectrometric methods, including NMR and HRESIMS, and the absolute configuration of the new compounds (1 and 2) was performed by electronic circular dichroism (ECD) studies. Further, the anticancer activities of the isolated compounds (1-22) were evaluated using the epidermal growth factor (EGF)-induced as well as the 12-O-tetradecanoylphorbol 13-acetate (TPA)-induced cell transformation assay. Among the 22 compounds, compounds 4, 9, 11, 13-15, 17, 18, and 22 significantly inhibited both EGF- and TPA-induced colony growth. In particular, askoseoside D (4, EGF: 57.8%; TPA: 67.1%), apigenin (9, EGF: 88.6%; TPA: 80.2%), apigenin-7-O-ß-d-glucuronopyranoside (14, EGF: 79.2%; TPA: 70.7%), and 1-(3',4'-dihydroxycinnamoyl) cyclopentane-2,3-diol (22, EGF: 60.0%; TPA: 72.1%) showed higher potent activities.

3.
Bioorganic & medicinal chemistry letters ; 2023.
Article in English | EuropePMC | ID: covidwho-2283036

ABSTRACT

The COVID-19 pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) continues to threaten human health and create socioeconomic problems worldwide. A library of 200,000 small molecules from the Korea Chemical Bank (KCB) were evaluated for their inhibitory activities against SARS-CoV-2 in a phenotypic-based screening assay to discover new therapeutics to combat COVID-19. A primary hit of this screen was the quinolone structure-containing compound 1. Based on the structure of compound 1 and enoxacin, which is a quinolone-based antibiotic previously reported to have weak activity against SARS-CoV-2, we designed and synthesized 2-aminoquinolone acid derivatives. Among them, compound 9b exhibited potent antiviral activity against SARS-CoV-2 (EC50 = 1.5 µM) without causing toxicity, while having satisfactory in vitro PK profiles. This study shows that 2-aminoquinolone acid 9b provides a promising new template for developing anti-SARS-CoV-2 entry inhibitors.

4.
Int J Nurs Stud ; 140: 104413, 2023 Apr.
Article in English | MEDLINE | ID: covidwho-2282026

ABSTRACT

BACKGROUND: Cognitive disorders, such as Alzheimer's disease, are a global health problem. Digital healthcare technology is an innovative management tool for delaying the progression of dementia and mild cognitive impairment. Thanks to digital technology, the possibility of safe and effective care for patients at home and in the community is increasing, even in situations that threaten the continuity of care, such as the COVID-19 pandemic. However, it is difficult to select appropriate technology and alternatives due to the lack of comprehensive reviews on the types and characteristics of digital technology for cognitive impairment, including their effects and limitations. OBJECTIVE: This study aims to identify the types of digital healthcare technology for dementia and mild cognitive impairment and comprehensively examine how its outcome measures were constructed in line with each technology's purpose. METHODS: According to the Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews guidelines, a literature search was conducted in August 2021 using Medline (Ovid), EMBASE, and Cochrane library. The search terms were constructed based on Population-Concept-Context mnemonic: 'dementia', 'cognitive impairment', and 'cognitive decline'; digital healthcare technology, such as big data, artificial intelligence, virtual reality, robots, applications, and so on; and the outcomes of digital technology, such as accuracy of diagnosis and physical, mental, and social health. After grasping overall research trends, the literature was classified and analysed in terms of the type of service users and technology. RESULTS: In total, 135 articles were selected. Since 2015, an increase in literature has been observed, and various digital healthcare technologies were identified. For people with mild cognitive impairment, technology for predicting and diagnosing the onset of dementia was studied, and for people with dementia, intervention technology to prevent the deterioration of health and induce significant improvement was considered. Regarding caregivers, many studies were conducted on monitoring and daily living assistive technologies that reduce the burden of care. However, problems such as data collection, storage, safety, and the digital divide persisted at different intensities for each technology type. CONCLUSIONS: This study revealed that appropriate technology options and considerations may differ depending on the characteristics of users. It also emphasises the role of humans in designing and managing technology to apply digital healthcare technology more effectively.


Subject(s)
COVID-19 , Cognitive Dysfunction , Humans , Artificial Intelligence , Cognition , Cognitive Dysfunction/therapy , Cognitive Dysfunction/psychology , Delivery of Health Care , Pandemics
5.
Bioorg Med Chem Lett ; 85: 129214, 2023 04 01.
Article in English | MEDLINE | ID: covidwho-2281197

ABSTRACT

The COVID-19 pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) continues to threaten human health and create socioeconomic problems worldwide. A library of 200,000 small molecules from the Korea Chemical Bank (KCB) were evaluated for their inhibitory activities against SARS-CoV-2 in a phenotypic-based screening assay to discover new therapeutics to combat COVID-19. A primary hit of this screen was the quinolone structure-containing compound 1. Based on the structure of compound 1 and enoxacin, which is a quinolone-based antibiotic previously reported to have weak activity against SARS-CoV-2, we designed and synthesized 2-aminoquinolone acid derivatives. Among them, compound 9b exhibited potent antiviral activity against SARS-CoV-2 (EC50 = 1.5 µM) without causing toxicity, while having satisfactory in vitro PK profiles. This study shows that 2-aminoquinolone acid 9b provides a promising new template for developing anti-SARS-CoV-2 entry inhibitors.


Subject(s)
COVID-19 , SARS-CoV-2 , Humans , Pandemics , Antiviral Agents/pharmacology , Antiviral Agents/chemistry , Molecular Docking Simulation , Protease Inhibitors
6.
J Am Heart Assoc ; 12(4): e028713, 2023 02 21.
Article in English | MEDLINE | ID: covidwho-2242562

ABSTRACT

Background The COVID-19 pandemic affected outpatient care delivery and patients' access to health care. However, no prior studies have documented telehealth use among patients with cardiovascular disease. Methods and Results We documented the number of telehealth and in-person outpatient encounters per 100 patients with cardiovascular disease and the percentage of telehealth encounters from January 2019 to June 2021, and the average payments per telehealth and in-person encounters across a 12-month period (July 2020-June 2021) using the MarketScan commercial database. From February 2020 to April 2020, the number of in-person encounters per 100 patients with cardiovascular disease decreased from 304.2 to 147.7, whereas that of telehealth encounters increased from 0.29 to 25.3. The number of in-person outpatient encounters then increased to 280.7 in June 2020, fluctuated between 268.1 and 346.4 afterward, and ended at 268.1 in June 2021, lower than the prepandemic levels. The number of telehealth encounters dropped to 16.8 in June 2020, fluctuated between 8.8 and 16.6 afterward, and ended at 8.8 in June 2021, higher than the prepandemic levels. Patients who were aged 18 to 35 years, women, and living in urban areas had higher percentages of telehealth encounters than those who were aged 35 to 64 years, men, and living in rural areas, respectively. The mean (95% CI) telehealth and in-person outpatient encounter costs per visit were $112.8 (95% CI, $112.4-$113.2) and $161.4 (95% CI, $160.4- $162.4), respectively. Conclusions There were large fluctuations in telehealth and in-person outpatient encounters during the pandemic. Our results provide insight into increased telehealth use among patients with cardiovascular disease after telehealth policy changes were implemented during the pandemic.


Subject(s)
COVID-19 , Cardiovascular Diseases , Telemedicine , Male , Humans , Female , COVID-19/epidemiology , Pandemics , Cardiovascular Diseases/epidemiology , Cardiovascular Diseases/therapy , Telemedicine/methods , Delivery of Health Care
7.
Am J Emerg Med ; 38(7): 1548.e5-1548.e7, 2020 07.
Article in English | MEDLINE | ID: covidwho-2220380

ABSTRACT

OBJECTIVE: To present guidance for clinicians caring for adult patients with acuteischemic stroke with confirmed or suspected COVID-19 infection. METHODS: The summary was prepared after review of systematic literature reviews,reference to previously published stroke guidelines, personal files, and expert opinionby members from 18 countries. RESULTS: The document includes practice implications for evaluation of stroke patientswith caution for stroke team members to avoid COVID-19 exposure, during clinicalevaluation and conduction of imaging and laboratory procedures with specialconsiderations of intravenous thrombolysis and mechanical thrombectomy in strokepatients with suspected or confirmed COVID-19 infection. RESULTS: Conclusions-The summary is expected to guide clinicians caring for adult patientswith acute ischemic stroke who are suspected of, or confirmed, with COVID-19infection.


Subject(s)
Brain Ischemia/therapy , Coronavirus Infections/complications , Infection Control , Pneumonia, Viral/complications , Stroke/therapy , Betacoronavirus , Brain Ischemia/diagnostic imaging , COVID-19 , Disease Management , Humans , Pandemics , SARS-CoV-2 , Stroke/diagnostic imaging
8.
Part Fibre Toxicol ; 20(1): 2, 2023 01 10.
Article in English | MEDLINE | ID: covidwho-2196355

ABSTRACT

BACKGROUND: Polypropylene (PP) is used in various products such as disposable containers, spoons, and automobile parts. The disposable masks used for COVID-19 prevention mainly comprise PP, and the disposal of such masks is concerning because of the potential environmental pollution. Recent reports have suggested that weathered PP microparticles can be inhaled, however, the inhalation toxicology of PP microparticles is poorly understood. RESULTS: Inflammatory cell numbers, reactive oxygen species (ROS) production, and the levels of inflammatory cytokines and chemokines in PP-instilled mice (2.5 or 5 mg/kg) increased significantly compared to with those in the control. Histopathological analysis of the lung tissue of PP-stimulated mice revealed lung injuries, including the infiltration of inflammatory cells into the perivascular/parenchymal space, alveolar epithelial hyperplasia, and foamy macrophage aggregates. The in vitro study indicated that PP stimulation causes mitochondrial dysfunction including mitochondrial depolarization and decreased adenosine triphosphate (ATP) levels. PP stimulation led to cytotoxicity, ROS production, increase of inflammatory cytokines, and cell deaths in A549 cells. The results showed that PP stimulation increased the p-p38 and p-NF-κB protein levels both in vivo and in vitro, while p-ERK and p-JNK remained unchanged. Interestingly, the cytotoxicity that was induced by PP exposure was regulated by p38 and ROS inhibition in A549 cells. CONCLUSIONS: These results suggest that PP stimulation may contribute to inflammation pathogenesis via the p38 phosphorylation-mediated NF-κB pathway as a result of mitochondrial damage.


Subject(s)
Microplastics , Pneumonia , Polypropylenes , Animals , Mice , Cytokines/metabolism , Inflammation/chemically induced , Inflammation/metabolism , Microplastics/toxicity , NF-kappa B/metabolism , Pneumonia/chemically induced , Polypropylenes/toxicity , Reactive Oxygen Species/metabolism
9.
Acta Otolaryngol ; : 1-7, 2022 Nov 17.
Article in English | MEDLINE | ID: covidwho-2120966

ABSTRACT

BACKGROUND: Although dizziness is a common symptom after vaccination, the mechanism, and prognosis are not well understood. AIMS/OBJECTIVES: This study aimed to investigate patients with dizziness after COVID-19 vaccination by analyzing objective information. METHODS: A retrospective study of patients who visited the outpatient clinics of two institutes with a complaint of dizziness occurring within 72 h after a COVID-19 vaccination. RESULTS: In most cases, patients experienced only a single event of dizziness, and the subjective symptom was relieved after a few weeks. All patients decreased gain of vestibular ocular reflex (VOR). The vestibular function test results showed signs of central vestibulopathy in some cases. We separated patients into two groups; the direction-fixed nystagmus (DFN) group and the direction-changing nystagmus (DCN) group. All patients showed decreased gain on the rotational chair test (RCT). The DFN group showed an 80% decrease in video head impulse test (vHIT) gain, whereas the DCN group only showed a decrease of 25%. In RCT, 66% of the DFN group showed asymmetry compared to 20% showing asymmetry in the DCN group. CONCLUSION AND SIGNIFICANCE: The patients who suffered from dizziness after the COVID-19 vaccination exhibited decreased VOR gain and in some cases signs of central vestibulopathy.

10.
Infect Chemother ; 54(3): 559-562, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-2055540

ABSTRACT

Thrombocytopenia is one of the rare signs of both the coronavirus disease 2019 (COVID-19) and COVID-19 vaccination. An 85-year-old man was diagnosed with immune thrombocytopenia and COVID-19, 7 days after COVID-19 vaccination. The patient was successfully treated with a short course of intravenous immunoglobulin and oral corticosteroids.

11.
Healthcare (Basel) ; 10(10)2022 Sep 22.
Article in English | MEDLINE | ID: covidwho-2043667

ABSTRACT

Long-term sequelae refer to persistent symptoms or signs for >6 months after SARS-CoV-2 infection. The most common symptoms of sequelae are fatigue and neuropsychiatric symptoms (concentration difficulty, amnesia, cognitive dysfunction, anxiety, and depression). However, approved treatments have not been fully established. Herbal medicines are administered for 12 weeks to patients who continuously complain of fatigue or cognitive dysfunction for >4 weeks that only occurred after COVID-19 diagnoses. Based on the Korean Medicine syndrome differentiation diagnosis, patients with fatigue will be administered Bojungikgi-tang or Kyungok-go, whereas those with cognitive dysfunction will be administered Cheonwangbosim-dan. Results could support evidence that herbal medicines may mitigate fatigue and cognitive dysfunction caused by COVID-19. Furthermore, by investigating the effects of herbal medicines on changes in metabolite and immune response due to COVID-19, which may be responsible for sequelae, the potential of herbal medicines as one of the therapeutic interventions for post-acute sequelae of SARS-CoV-2 infection can be evaluated. Therefore, the effects of herbal medicine on fatigue and cognitive dysfunction sequelae due to COVID-19 will be elucidated in this study to provide an insight into the preparation of medical management for the post-acute sequelae of SARS-CoV-2 infection.

12.
Int J Environ Res Public Health ; 19(18)2022 Sep 13.
Article in English | MEDLINE | ID: covidwho-2032962

ABSTRACT

The management paradigm of SMEs is changing due to the recent Fourth Industrial Revolution and the changing COVID-19 environment. To respond to these changes, companies are focusing on protean career attitude (PCA) and psychological well-being (PWB) of employees to improve corporate performance. Under these circumstances, this study investigated the structural relationship of the dual mediation effects of career commitment and career satisfaction in the relationship between PCA and PWB. To this end, this study targeted 307 employees of Korean small and medium-sized enterprises (SMEs), and the results are as follows. First, PCA was found to have a positive effect on career satisfaction and PCA was found to have a positive effect on career commitment. Second, PCA was found to have a significant effect on PWB. Third, career satisfaction, a parameter of this study, was found to have a positive impact on career commitment; in the relationship between PCA and PWB, the dual mediation effects of career satisfaction and career commitment were found to be significant. Finally, this study provided discussions and theoretical and practical implications based on those results, as well as directions for future research.


Subject(s)
COVID-19 , Workplace , COVID-19/epidemiology , Humans , Job Satisfaction , Personal Satisfaction , Surveys and Questionnaires , Workplace/psychology
13.
Int J Environ Res Public Health ; 19(17)2022 Aug 25.
Article in English | MEDLINE | ID: covidwho-2006005

ABSTRACT

This study investigated the efficacy and safety of convalescent plasma (CP) transfusion against the coronavirus disease 2019 (COVID-19) via a systematic review and meta-analysis of randomized controlled trials (RCTs). A total of 5467 articles obtained from electronic databases were assessed; however, only 34 RCTs were eligible after manually screening and eliminating unnecessary studies. The beneficial effect was addressed by assessing the risk ratio (RR) and standardized mean differences (SMDs) of the meta-analysis. It was demonstrated that CP therapy is not effective in improving clinical outcomes, including reducing mortality with an RR of 0.88 [0.76; 1.03] (I2 = 68% and p = 0.10) and length of hospitalization with SMD of -0.47 [-0.95; 0.00] (I2 = 99% and p = 0.05). Subgroup analysis provided strong evidence that CP transfusion does not significantly reduce all-cause mortality compared to standard of care (SOC) with an RR of 1.01 [0.99; 1.03] (I2 = 70% and p = 0.33). In addition, CP was found to be safe for and well-tolerated by COVID-19 patients as was the SOC in healthcare settings. Overall, the results suggest that CP should not be applied outside of randomized trials because of less benefit in improving clinical outcomes for COVID-19 treatment.


Subject(s)
COVID-19 Drug Treatment , COVID-19 , COVID-19/therapy , Humans , Immunization, Passive/methods , Randomized Controlled Trials as Topic , COVID-19 Serotherapy
14.
PLoS One ; 17(3): e0266317, 2022.
Article in English | MEDLINE | ID: covidwho-1974296

ABSTRACT

BACKGROUND: The association between renal function and all-cause mortality in patients with hypertensive crisis remains unclear. We aimed to identify the impact of estimated glomerular filtration rate (eGFR) on all-cause mortality in patients with hypertensive crisis visiting the emergency department (ED). METHODS: This retrospective study included patients aged ≥18 years admitted to the ED between 2016 and 2019 for hypertensive crisis (systolic blood pressure ≥180 mmHg and/or diastolic blood pressure ≥110 mmHg). They were classified into four groups according to the eGFR at admission to the ED: ≥90, 60-89, 30-59, and <30 mL/min/1.73 m2. RESULTS: Among the 4,821 patients, 46.7% and 5.8% had an eGFR of ≥90 and <30 mL/min/1.73 m2, respectively. Patients with lower eGFR were older and more likely to have comorbidities. The 3-year all-cause mortality rates were 7.7% and 41.9% in those with an eGFR ≥90 and <30 mL/min/1.73 m2, respectively. After adjusting for confounding variables, those with an eGFR of 30-59 (hazard ratio [HR], 1.93; 95% confidence interval [CI], 1.47-2.54) and <30 mL/min/1.73 m2 (HR, 2.35; 95% CI, 1.71-3.24) had significantly higher 3-year all-cause mortality risks than those with an eGFR of ≥90 mL/min/1.73 m2. Patients with an eGFR of 60-89 mL/min/1.73 m2 had a higher mortality (21.1%) than those with an eGFR of ≥90 mL/min/1.73 m2 (7.7%); however, the difference was not significant (HR, 1.21; 95% CI, 0.94-1.56). CONCLUSIONS: Renal impairment is common in patients with hypertensive crisis who visit the ED. A strong independent association was observed between decreased eGFR and all-cause mortality in these patients. eGFR provides useful prognostic information and permits the early identification of patients with hypertensive crisis with an increased mortality risk. Intensive treatment and follow-up strategies are needed for patients with a decreased eGFR who visit the ED.


Subject(s)
Emergency Service, Hospital , Adolescent , Adult , Blood Pressure , Glomerular Filtration Rate/physiology , Humans , Retrospective Studies , Risk Assessment
15.
Pharmaceuticals (Basel) ; 15(7)2022 Jul 04.
Article in English | MEDLINE | ID: covidwho-1917682

ABSTRACT

We previously reported the potent antiviral effect of the 2-aminoquinazolin-4-(3H)-one 1, which shows significant activity (IC50 = 0.23 µM) against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with no cytotoxicity. However, it is necessary to improve the in vivo pharmacokinetics of compound 1 because its area under the curve (AUC) and maximum plasma concentration are low. Here, we designed and synthesized N-substituted quinazolinone derivatives that had good pharmacokinetics and that retained their inhibitory activity against SARS-CoV-2. These compounds were conveniently prepared on a large scale through a one-pot reaction using Dimroth rearrangement as a key step. The synthesized compounds showed potent inhibitory activity, low binding to hERG channels, and good microsomal stability. In vivo pharmacokinetic studies showed that compound 2b had the highest exposure (AUC24h = 41.57 µg∙h/mL) of the synthesized compounds. An in vivo single-dose toxicity evaluation of compound 2b at 250 and 500 mg/kg in rats resulted in no deaths and an approximate lethal dose greater than 500 mg/kg. This study shows that N-acetyl 2-aminoquinazolin-4-(3H)-one 2b is a promising lead compound for developing anti-SARS-CoV-2 agents.

16.
Ann Occup Environ Med ; 34: e11, 2022.
Article in English | MEDLINE | ID: covidwho-1912707

ABSTRACT

Background: Although coronavirus disease 2019 is causing a variety of psychological problems for workers, there are few longitudinal studies on changes in workers' mental health by workplace intervention. This study aimed to evaluate the change in the prevalence of depression and anxiety according to the active involvement of the workplace. Methods: This study was conducted on 1,978 workers at a workplace who underwent a health screening from January 2019 to August 2020, and classified depression and anxiety disorders using a self-report questionnaire. After the first pandemic, the company stopped health screening, took paid leave and telecommuting, and conducted interventions such as operating its own screening clinic. To see if this workplace intervention affects workers' mental health, we conducted generalized estimating equations to compare odds ratio (OR). Results: In the pre-intervention group, 384 people (16.86%) had depression, and 507 people (22.26%) had anxiety disorder. Based on the OR before intervention, the OR of depression decreased to 0.76 (0.66-0.87) and the OR of anxiety disorder decreased to 0.73 (0.65-0.82). Conclusions: As a result of this study, it was confirmed that workplace intervention was related to a decrease in depression and anxiety. This study provides basic data to improve workers' mental health according to workplace intervention, and further research is needed according to workplace intervention in the future.

17.
Front Med (Lausanne) ; 9: 919159, 2022.
Article in English | MEDLINE | ID: covidwho-1903046

ABSTRACT

Patients with sickle cell disease (SCD) are at higher risk of getting severe COVID-19 infection. This systematic review and meta-analysis aimed to determine the role of serum ferritin in predicting ICU admission and mortality among patients with SCD following COVID-19 infection. A systematic search was conducted in PubMed, Scopus, Web of Science, Embase, WHO COVID-19 database, ProQuest, and Cochrane Library for articles published between 1st December 2019 to 31st November 2021. Methodological quality was assessed using the Joanna Briggs Institute (JBI) critical appraisal checklists. Eleven articles (7 cohorts and 4 case series) were included in this review. Pooled mean serum ferritin level on admission was 1581.62 ng/mL while pooled proportion of ICU admission and mortality were 0.10 (95% CI 0.06; 0.16, prediction interval 0.04; 0.23, p = 0.29, I 2 = 17%) and 0.07 (95% CI 0.05; 0.11, prediction interval 0.04; 0.12, p = 0.68, I 2 = 0%) respectively. Meta-regression showed that serum ferritin did not predict for both ICU admission (regression coefficient = 0.0001, p = 0.3523) and mortality (regression coefficient = 0.0001, p = 0.4029). Our analyses showed that serum ferritin may not be a useful marker to predict the outcomes of COVID-19 infection among patients with SCD. More data are required to identify a reliable tool to identify patients with SCD who are at risk of getting severe COVID-19 infection. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=287792, PROSPERO Registration: CRD42021287792.

18.
J Perianesth Nurs ; 2022 Jun 10.
Article in English | MEDLINE | ID: covidwho-1885943

ABSTRACT

PURPOSE: Health care workers (HCWs), and in particular anesthesia providers, often must perform aerosol-generating medical procedures (AGMPs). However, no studies have analyzed droplet distributions on the bodies of HCWs during AGMPs. Therefore, the purpose of this study was to assess and analyze droplet distributions on the bodies of HCWs during suction of oral cavities with and without oral airways and during extubations. DESIGN: Using a quasi-experiemental design, we assumed the HCWs perform suction and extubation on intubated patients, and we prepared an intubated mannequin mimicking a patient. This study performed the oral suction and extubation on the intubated mannequin (with or without oral airways in place) and analyzed the droplet distributions. METHODS: We prepared a mannequin intubated with an 8.0 mm endotracheal tube, assuming the situation of general anesthesia. We designed the body mapping gown, and divided it into 10 areas including the head, neck, chest, abdomen, upper arms, forearms, and hands. We classified experiments into group O when suctions were performed on the mannequin with an oral airway, and into group X when the suctions were performed on the mannequin without an oral airway. An experienced board-certified anesthesiologist performed 10 oral suctions on each mannequin, and 10 extubations. We counted the droplets on the anesthesiologist's gown according to the divided areas after each procedure. FINDINGS: The mean droplet count after suction was 6.20 ± 2.201 in group O and 13.6 ± 4.300 in group X, with a significant difference between the two groups (P < .001). The right and left hands were the most contaminated areas in group O (2.8 ± 1.033 droplets and 2.0 ± 0.943 droplets, respectively). The abdomen, right hand, left forearm, and left hand showed many droplets in group X. (1.3 ± 1.337 droplets, 3.1 ± 1.792 droplets, 3.2 ± 3.910 droplets, and 4.3 ± 2.214 droplets, respectively). The chest, abdomen, and left hand presented significantly more droplets in group X than in group O. The trunk area (chest and abdomen) was exposed to more droplets during extubations than during suctions. CONCLUSIONS: During suctions, more droplets are splattered from mannequins without oral airways than from those with oral airways. The right and left hands were the most contaminated areas in group O. Moreover, the abdomen, right hand, left forearm, and left hand presented a lot of droplets in group X. In addition, extubations contaminate wider areas (the head, neck, chest and abdomen) of an HCW than suctions.

19.
PLoS One ; 17(6): e0268023, 2022.
Article in English | MEDLINE | ID: covidwho-1883705

ABSTRACT

Understanding the underlying and unpredictable dynamics of the COVID-19 pandemic is important. We supplemented the findings of Jones and Strigul (2020) and described the chaotic behavior of COVID-19 using state space plots which depicted the changes in asymptotic behavior and trajectory brought about by the increase or decrease in the number of cases which resulted from the easing or tightening of restrictions and other non-pharmaceutical interventions instituted by governments as represented by the country's stringency index (SI). We used COVID-19 country-wide case count data and analyzed it using convergent cross-mapping (CCM) and found that the SI influence on COVID-19 case counts is high in almost all the countries considered. When we utilized finer granular geographical data ('barangay' or village level COVID-19 case counts in the Philippines), the effects of SI were reduced as the population density increased. The authors believe that the knowledge of the chaotic behavior of COVID-19 and the effects of population density as applied to finer granular geographical data has the potential to generate more accurate COVID-19 non-linear prediction models. This could be used at the local government level to guide strategic and highly targeted COVID-19 policies which are favorable to public health systems but with limited impact to the economy.


Subject(s)
COVID-19 , COVID-19/epidemiology , Government , Humans , Pandemics , Philippines , Population Density
20.
Sustainability ; 14(8):4497, 2022.
Article in English | MDPI | ID: covidwho-1785967

ABSTRACT

Open distance learning has become a new norm in medical education since the COVID-19 pandemic. The abrupt shift from conventional medical education to fully virtual learning deserves a reflection on how it affected the learning motivation among medical students. Hence, this study aimed to investigate the effect of open distance learning on their learning motivation during this pandemic period, with suggestions to improve through reflections and recommendations. This qualitative study involved 152 medical students undertaking the Doctor of Medicine program in Universiti Kebangsaan Malaysia, Malaysia, during the COVID-19 pandemic. All data were collected through a validated questionnaire. We found that medical students portrayed intrinsic motivation-mainly self-motivation, self-discipline, and self-adaptation-in open distance learning during the pandemic period. Feedback from medical students also showed that they advocated a better internet connection, innovative teaching, and learning, as well as new appropriate assessment methods and strengthening of the learning management system for a sustainable open distance learning outcome. Hence, medical educators should be creative in making use of open distance learning as an attractive complementary platform in medical education to ensure life-long learning.

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