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1.
Sci Rep ; 12(1): 9510, 2022 Jun 09.
Article in English | MEDLINE | ID: covidwho-1886224

ABSTRACT

Biomarkers to identify ICU COVID-19 patients at high risk for mortality are urgently needed for therapeutic care and management. Here we found plasma levels of the glycolysis byproduct methylglyoxal (MG) were 4.4-fold higher in ICU patients upon admission that later died (n = 33), and 1.7-fold higher in ICU patients that survived (n = 32),compared to uninfected controls (n = 30). The increased MG in patients that died correlated inversely with the levels of the MG-degrading enzyme glyoxalase-1 (r2 = - 0.50), and its co-factor glutathione (r2 = - 0.63), and positively with monocytes (r2 = 0.29). The inflammation markers, SSAO (r2 = 0.52), TNF-α (r2 = 0.41), IL-1ß (r2 = 0.25), CRP (r2 = 0.26) also correlated positively with MG. Logistic regression analysis provides evidence of a significant relationship between the elevated MG upon admission into ICU and death (P < 0.0001), with 42% of the death variability explained. From these data we conclude that elevated plasma MG on admission is a novel independent biomarker that predicts mortality in ICU COVID-19 patients.


Subject(s)
COVID-19 , Intensive Care Units , Biomarkers , Glycolysis , Humans , Pyruvaldehyde
2.
Topics in Antiviral Medicine ; 30(1 SUPPL):62, 2022.
Article in English | EMBASE | ID: covidwho-1880746

ABSTRACT

Background: Lung cell lines to model SARS-CoV-2 replication in vitro are greatly limited hampering the rigorous study of SARS-CoV-2-host interactions. We analyzed a panel of 10 airway cell lines with various levels of ACE2 expression to identify models of SARS-CoV-2 infection. We found that none of the ACE2 expressing cell lines supported replication, whereas the H522 human lung adenocarcinoma cells were naturally permissive to SARS-CoV-2 infection despite detectable expression of ACE2. We confirmed that SARS-CoV-2 replication is indeed completely independent of ACE2 in H522s but dependent on heparan sulfates and the E484D substitution within the Spike. Further, we show that many of the ACE2 positive non-permissive cell lines express high basal levels of interferon-stimulated genes, which can be overcome by inhibition of the JAK/STAT pathway or by ACE2 overexpression. Together, our findings highlight ACE2-independent pathways can control the cellular tropism of SARS-CoV-2. Methods: Conventional molecular virology assays have been conducted to study the permissiveness of a panel of 10 cell lines expressing various levels of ACE2. ACE2 independence of SARS-CoV-2 replication was validated by antibody blocking, Fc-ACE2 decoy peptide and CRISPR-based approaches in H522 cells. RNA sequencing was used to study the basal level of genes in the type-I IFN pathway in the panel of 10 cell lines, which was further validated by western blotting and qRT-PCR. A panel of 5 cell lines, with varying expression levels of ACE2 and TMPRSS2, were pre-treated with Ruxolitinib, a JAK inhibitor, and infected with SARS-CoV-2 strain 2019-nCoV/USA-WA1/2020 and spike variants. Viral replication was detected through analysis of cell associated RNA Results: H522 human lung adenocarcinoma supports SARS-CoV-2 replication in a completely ACE2-independent manner. Transcriptomic analysis revealed basal high level of expression of interferon response pathway genes in some ACE2-positive cells recalcitrant to SARS-CoV-2 infection. Infection of OE21 and SCC25 cells required blocking of the IFN response pathway or ACE2 overexpression to allow SARS-CoV-2 infection. Conclusion: These findings suggest that SARS-CoV-2 replication can proceed in complete absence of ACE2 and that the innate immunity is a key determinant of SARS-CoV-2 cellular tropism. These findings may explain the complex SARS-CoV-2 pathogenesis in vivo as it shows that factors independent of ACE2 can define cellular tropism.

3.
BMC Psychiatry ; 22(1): 378, 2022 06 03.
Article in English | MEDLINE | ID: covidwho-1879229

ABSTRACT

BACKGROUND: As the pandemic started, Saudi Arabia applied extreme measures in responses to the pandemic crises, which have adversely affected individuals' mental health. Therefore, the aim of this study is to describe trends in mental health disorder ED visit before and after the pandemic in two medical centers in Saudi Arabia. METHODS: A retrospective cohort study using data from electronic health records in the Ministry of National Guard Health Affairs' (MNG-HA) in Saudi Arabia. Multiple logistic regression model was used to examine the age and sex differences in mental health disorder ED visits before and during the COVID19 pandemic. RESULTS: A total of 1117 ED psychiatric visits, a sharp increase in the number of psychiatric ED visits during the pandemic with an average increase of 25.66% was observed. During the pandemic, psychiatric ED visits were significantly higher in females (adjusted AOR 1.41, 95% CI 1.08, 1.83) than males. During the COVID19 pandemic, generalized anxiety disorder was the most common psychiatric ED disorder with reported increase of visits by 53.34% (p-value 0.005). CONCLUSION: ED psychiatric visits have consistently increased before and during the COVID19 pandemic. Interventions for mental health related disorders are urgently needed for preventing mental health problems among females.


Subject(s)
COVID-19 , COVID-19/epidemiology , Emergency Service, Hospital , Female , Humans , Male , Mental Health , Pandemics , Retrospective Studies
4.
Disaster Med Public Health Prep ; : 1-9, 2022 Jun 07.
Article in English | MEDLINE | ID: covidwho-1878448

ABSTRACT

BACKGROUND: In late 2019, a novel coronavirus was detected in Wuhan, China that caused a pandemic by September 2021, resulting in 224,180,411 cases and more than 4,600,000 deaths worldwide. In response to the pandemic, the Autonomous Kurdistan Regional Government of Iraq (KRG) imposed strict infection control measures at its borders for all travelers from neighboring countries, wherein each traveler was subjected to a mandatory Reverse Transcription Polymerase Chain Reaction (RT-PCR) test on arrival to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected travelers. The aim of this study is to determine the rate of infection with SARS-CoV-2 among the travelers entering Kurdistan region through Ibrahim Al-Khalil crossing point with Turkey as a predictor for the upcoming infection waves. METHODS: The data of RT-PCR tests to detect SARS-CoV-2 in all travelers arriving at the Ibrahim Al-Khalil Border Crossing between Iraq and the Republic of Turkey was reviewed from 21st August 2020 to 21st August 2021. RESULTS: It was found that there were 9,873 cases of SARS-CoV-2 infections among 1,082,074 travelers during the study period. CONCLUSIONS: This study shows the importance of mass testing of travelers at border crossings to control the spread of SARS-CoV-2 infection.

5.
Ain Shams Engineering Journal ; : 101834, 2022.
Article in English | ScienceDirect | ID: covidwho-1866888

ABSTRACT

The coronavirus (COVID-19) pandemic was recognized as a worldwide epidemic and classed as a high risk in early 2020, affecting people's health, economies, and business sectors considerably. This pandemic has had an impact on people's lifestyles and work processes in a multitude of sectors. The construction industry is one such industry that has had a substantial influence on it. However, this influence needs to be measured in different areas. This study aims to measure the effects of the COVID-19 on the 7 core safety elements and their 24 procedures that are derived from the recommended practices for safety and health programs in construction that is issued by OSHA to see whether their priorities have been changed or not. The data were collected and then analyzed using Relative Importance Index (RII) to study the changes in their priorities;and using t-test to study the significance of the changes before and after COVID-19 pandemic.

6.
Lung India ; 39(SUPPL 1):S148-S149, 2022.
Article in English | EMBASE | ID: covidwho-1856983

ABSTRACT

Background: Mortality and morbidity are highest in severe and critically ill patients with COVID -19 pneumonia. Recently corticosteroids have shown a definite mortality benefit in these patients. In this study we used interleukin-6 inhibitor, tocilizumab in patients who failed to show any clinical improvement after initial treatment with steroids. Patients and Methods: This is a retrospective observational study in Severe and critical COVID 19 patients, who got admitted to intensive care unit and subsequently received tocilizumab were included. Patients who worsened clinically or had no change in oxygen requirement even after 24hrs of receiving Intravenous methylprednisolone at a dose of 1-2mg/kg/day had received tocilizumab (maximum total dose of 800mg) intravenously. All-cause mortality and progression to mechanical ventilation at day 28 were the primary outcome measures. Clinical improvement and oxygen requirements after tocilizumab administration along with trends in inflammatory markers were secondary outcome. Secondary infections rates and other drug related side effects were also noted. Results: A total of 51 patients who did not show clinical improvement even after 24 hours of intravenous steroids and received tocilizumab were included. In these patients, there was a significant decrease in oxygen requirement by day 3 and clinical improvement by day 7 of tocilizumab administration. Among the inflammatory markers, we observed elevated median baseline values of CRP (114.2 mg/L) , IL-6 (55.4 pg/ml) and Neutrophil to Lymphocyte Ratio (12.4). Out of these only CRP showed a significant decrease after the drug administration. 13 (26.5%) of the 49 patients who were on non-invasive or conventional oxygen support progressed to mechanical ventilation. The day 28 all-cause mortality rate was 10/51(19.6%). 10(19.6%) of the 51 patients had life threatening infections, 1 patient had colonic perforation and 1 patient had transaminitis following tocilizumab administration. Conclusion: Early and timely administration of tocilizumab is a viable option in selected severe and critical covid 19 patients who do not respond to initial steroids. When given along with steroids?, incidence of life threatening infections seems to increase, hence a high suspicion of secondary infection should be kept.

7.
Drug Metab Pers Ther ; 37(1): 35-40, 2021 07 08.
Article in English | MEDLINE | ID: covidwho-1855056

ABSTRACT

OBJECTIVES: To mitigate the incidence of recurrent stroke in patients, dual antiplatelet therapy comprising aspirin and clopidogrel is usually administered. Clopidogrel is a prodrug and its bioactivation is catalyzed by cytochrome P450 (CYP)2C19. The main objective of this work was to determine the prevalence of CYP2C19*2 carriers in Saudi ischemic stroke patients and assess the suitability of using genotyping to guide antiplatelet therapy in a university hospital setup. METHODS: This prospective (2018-2019) study was conducted on 256 patients (age 61 ± 12.5) clinically diagnosed with ischemic stroke who were genotyped using Spartan RX CYP2C19 assay. RESULTS: From the total patient group (256), upon admission, 210 patients were prescribed either aspirin, clopidogrel or dual antiplatelet therapy. Of the 27 patients with the CYP2C19*2 allele who were prescribed clopidogrel (18) or dual antiplatelet therapy (9), only 21 patients could be followed up for a period of six months post stroke event, in addition to 21 age- and sex-matched patients with the normal allele. The CYP2C19*2 allele carriers had a statistically significant increased risk of recurrent stroke compared to patients carrying the normal allele. CONCLUSIONS: This study shows the suitability of using genotyping to guide antiplatelet therapy in ischemic stroke patients in a clinical setting.


Subject(s)
Ischemic Stroke , Platelet Aggregation Inhibitors , Aged , Aspirin/therapeutic use , Clopidogrel/therapeutic use , Cytochrome P-450 CYP2C19/genetics , Genotype , Hospitals , Humans , Middle Aged , Prevalence , Prospective Studies , Saudi Arabia/epidemiology
8.
PLoS Global Public Health ; 2(3), 2022.
Article in English | CAB Abstracts | ID: covidwho-1854963

ABSTRACT

Diagnostic assays for various infectious diseases, including COVID-19, have been challenged for their utility as standalone point-of-care diagnostic tests due to suboptimal accuracy, complexity, high cost or long turnaround times for results. It is therefore critical to optimise their use to meet the needs of users. We used a simulation approach to estimate diagnostic outcomes, number of tests required and average turnaround time of using two-test algorithms compared with singular testing;the two tests were reverse transcription polymerase chain reaction (RT-PCR) and an antigen-based rapid diagnostic test (Ag-RDT). A web-based application of the model was developed to visualise and compare diagnostic outcomes for different disease prevalence and test performance characteristics (sensitivity and specificity). We tested the model using hypothetical prevalence data for COVID-19, representing low- and high-prevalence contexts and performance characteristics of RT-PCR and Ag-RDTs. The two-test algorithm when RT-PCR was applied to samples negative by Ag-RDT predicted gains in sensitivity of 27% and 7%, respectively, compared with Ag-RDT and RT-PCR alone. Similarly, when RT-PCR was applied to samples positive by Ag-RDT, specificity gains of 2.9% and 1.9%, respectively, were predicted. The algorithm using Ag-RDT followed by RT-PCR as a confirmatory test for positive patients limited the requirement of RT-PCR testing resources to 16,400 and 3,034 tests when testing a population of 100,000 with an infection prevalence of 20% and 0.05%, respectively. A two-test algorithm comprising a rapid screening test followed by confirmatory laboratory testing can reduce false positive rate, produce rapid results and conserve laboratory resources, but can lead to large number of missed cases in high prevalence setting. The web application of the model can identify the best testing strategies, tailored to specific use cases and we also present some examples how it was used as part of the Access to Covid-19 Tools (ACT) Accelerator Diagnostics Pillar.

9.
Leadership & Organization Development Journal ; : 15, 2022.
Article in English | Web of Science | ID: covidwho-1853395

ABSTRACT

Purpose - The purpose of this paper is to examine how the spiritual leadership (SL) of the leader is perceived by workers in the public health sector in the Assiut region of Egypt. In other words, this study investigates the work-related workplace spirituality (WPS) of public health workers in this context. Design/methodology/approach - An online survey was conducted among a sample of 333 employees working in the public health sector in Assiut. Findings - The empirical results indicate that the SL of the leader (especially altruism and vision), as evaluated by employees, positively influence work-related WPS. The results confirm that strengthening SL is a promising pathway to improve WPS, which may ultimately have some benefits, such as helping to improve individual and institutional performance in the public health sector. Originality/value - The authors hope that the theoretical insights gained through the findings of this study will encourage researchers to explore how and when to enhance SL and WPS for employees.

10.
Inform Med Unlocked ; 30: 100937, 2022.
Article in English | MEDLINE | ID: covidwho-1851297

ABSTRACT

The COVID-19 virus has spread rapidally throughout the world. Managing resources is one of the biggest challenges that healthcare providers around the world face during the pandemic. Allocating the Intensive Care Unit (ICU) beds' capacity is important since COVID-19 is a respiratory disease and some patients need to be admitted to the hospital with an urgent need for oxygen support, ventilation, and/or intensive medical care. In the battle against COVID-19, many governments utilized technology, especially Artificial Intelligence (AI), to contain the pandemic and limit its hazardous effects. In this paper, Machine Learning models (ML) were developed to help in detecting the COVID-19 patients' need for the ICU and the estimated duration of their stay. Four ML algorithms were utilized: Random Forest (RF), Gradient Boosting (GB), Extreme Gradient Boosting (XGBoost), and Ensemble models were trained and validated on a dataset of 895 COVID-19 patients admitted to King Fahad University hospital in the eastern province of Saudi Arabia. The conducted experiments show that the Length of Stay (LoS) in the ICU can be predicted with the highest accuracy by applying the RF model for prediction, as the achieved accuracy was 94.16%. In terms of the contributor factors to the length of stay in the ICU, correlation results showed that age, C-Reactive Protein (CRP), nasal oxygen support days are the top related factors. By searching the literature, there is no published work that used the Saudi Arabia dataset to predict the need for ICU with the number of days needed. This contribution is hoped to pave the path for hospitals and healthcare providers to manage their resources more efficiently and to help in saving lives.

11.
Antioxidants (Basel) ; 11(5)2022 May 09.
Article in English | MEDLINE | ID: covidwho-1847262

ABSTRACT

Foodborne infections and antibiotic resistance pose a serious threat to public health and must be addressed urgently. Pistacia lentiscus is a wild-growing shrub and has been utilized for medicinal applications as well as for culinary purposes. The antibacterial and antioxidant activities of P. lentiscus bark in vitro, as well as the phytochemical composition, are the focus of this inquiry. The bark extract of P. lentiscus showed significant antimicrobial activity in experiments on bacteria and yeast isolated from human and food sources. The exposure time for the complete inhibition of cell viability of P. aeruginosa in the extracts was found to be 5% at 15 min. Phytochemical inquiry of the methanol extract demonstrates the existence of carbohydrates, flavonoids, tannins, coumarins, triterpenes, and alkaloids. Deep phytochemical exploration led to the identification of methyl gallate, gallic acid, kaempferol, quercetin, kaempferol 3-O-α-rhamnoside, kaempferol 3-O-ß-glucoside, and Quercetin-3-O-ß-glucoside. When tested using the DPPH assay, the methanol extracts of P. lentiscus bark demonstrated a high free radical scavenging efficiency. Further, we have performed a molecular modelling study which revealed that the extract of P. lentiscus bark could be a beneficial source for novel flavonoid glycosides inhibitors against SARS-CoV-2 infection. Taken together, this study highlights the Pistacia lentiscus bark methanol extract as a promising antimicrobial and antiviral agent.

12.
Journal of Medical Artificial Intelligence ; 5, 2022.
Article in English | Scopus | ID: covidwho-1841764
13.
J Infect Public Health ; 15(6): 615-620, 2022 May 04.
Article in English | MEDLINE | ID: covidwho-1819541

ABSTRACT

BACKGROUND: Even with the widespread availability of vaccines for the COVID-19 disease, there is no sign of decline in the rate of spread of the disease. Based on findings of different studies across the globe, the disease is characterized by poor outcomes in specific sociodemographic categories such as age, gender and presence of symptoms. METHODS: In this study, we carried out a multivariable logistic regression analysis on a national database (HESN+) of confirmed COVID-19 cases in Saudi Arabia to determine predictors of hospitalization and mortality for these patients. RESULTS: Data was extracted for 328,301 confirmed COVID- 19 patients (mean age (SD) = 37.79 (1.68)) with 34.92% females and 65.08% males. Of these, 59.87% were Saudi Arabian citizens and 40.13% were non-Saudi. 68.91% of cases were discovered in Riyadh (n = 67,384), Makkah (n = 72,590) and the Eastern Province (n = 79,666). 72.2% of all cases were diagnosed and treated by the Ministry of Health (MOH). Of all confirmed cases, 95.28% showed one or more symptoms associated with COVID-19. 5.48% of these were hospitalized and 1.11% died. Predictors of mortality and hospitalization, respectively, included age (OR; 1.088 and 1.03), being male (OR; 1.443 and 1.138), nationality (OR; 2.11 and 1.993), presence of symptoms (OR; 1.816 and 4.386), and the health care sector in which patients received treatment (MOH OR; 1.352 and 4.731). CONCLUSION: We found that COVID-19-related hospitalization or mortality was higher among males, older adults, and patients showing one or more symptoms, and mortality likelihood was more than fourfold for patients treated by the MOH. Immigrants were also more likely to be hospitalized or die from COVID-19 infection compared to Saudi nationals.

14.
Pakistan Journal of Medical and Health Sciences ; 16(3):476-478, 2022.
Article in English | EMBASE | ID: covidwho-1819187

ABSTRACT

During the Covid-19 epidemic, many variables affected the severity of infection, including age, gender, and chronic conditions. In this study, we compared the levels of some immunological parameters (IL6, IFNγ) in Covid 19 patients and diabetic patients with Covid 19 across age groups and gender. Where the levels of interleukin-6 are higher than the normal range when infected with COVID-19 in all age groups and increased in patients without diabetes, where their levels are (210.04 ± 135.44). An increase in the level of IL6 indicates a severe infection with the COVID-19 virus, and this indicates transmission from moderate to severe or severe, as the results of the study did not show any significant differences at P>0.5, and IL6 levels increase in females than in males. Where it reaches (146.105±149.75) The high rate of IFNγ production also indicates support for immunity against infection with the Covid-19 virus, and the equation of its production indicates a low survival rate for patients, as it is produced by helper T cells. JPY 0.009 Where the levels of IFNγ increase significantly in middle ages, reaching (157.64 ± 158.54), and the levels of IFNγ are close between females and males, as they are (102.7 ± 130.27) (102.2 ± 93.12), respectively.

15.
Expert Rev Vaccines ; : 1-4, 2022 May 03.
Article in English | MEDLINE | ID: covidwho-1815850
18.
Frontiers in endocrinology ; 13, 2022.
Article in English | EuropePMC | ID: covidwho-1787164
19.
Cureus ; 14(3), 2022.
Article in English | EuropePMC | ID: covidwho-1781762

ABSTRACT

Background: Angiotensin-converting enzyme 2 (ACE2) receptor serves as a receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus causing COVID-19, to enter the lungs. Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) may increase the expression of ACE2, resulting in concerns that patients with COVID-19 who are receiving these agents may be at increased risk of severe disease. This study was conducted to further investigate the effects of ACEIs and ARBs on the severity of COVID-19 in hospitalized hypertensive patients. Methods: The study was a retrospective observational study. The medical records of all adult hypertensive patients who were hospitalized at Dammam Medical Complex (DMC) between March 1, 2020, and December 31, 2020, due to COVID-19 were reviewed. The hypertensive patients who were receiving ACEIs or ARBs were compared with the other hypertensive patients who were not on ACEIs or ARBs. Results: A total of 148 hypertensive patients were included in the analysis. They consisted of 106 male and 42 female patients (72% and 28%, respectively). Nearly half of the patients were Saudi (75 patients, 50%). A total of 81 patients were in the ACEI/ARB group, and 67 patients were in the control group. There were no differences between the two groups in age, diabetic status, history of chronic kidney disease, initial blood pressure measurements, and initial oxygen requirements, but the control group contained fewer female patients (18% versus 37%) and Saudi patients (36% versus 63%) than the ACEI/ARB group (p-values = 0.017 and 0.002, respectively). The use of ACEIs or ARBs was associated with significant reductions in ICU admission (9% versus 31%, p-value = 0.001), need for intubation (7% versus 28%, p-value = 0.002), and death (2% versus 24%, p-value = 0.000). A significant negative association between the use ACEIs or ARBs and mortality was also observed in the multivariate analysis after the adjustment for the possible confounders, with an odds ratio (OR) of 0.087 and a 95% confidence interval (CI) of 0.017-0.449. Conclusions: ACEIs and ARBs have no adverse effects on the clinical prognosis of COVID-19 patients with hypertension. Their use might be even beneficial and protective, but future larger studies are needed to confirm these effects. In the meanwhile, they should be continued in COVID-19 hypertensive patients unless their use is contraindicated for other reasons (e.g., hypotension, hyperkalemia, or acute kidney injury (AKI)).

20.
J Epidemiol Glob Health ; 12(2): 188-195, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1783064

ABSTRACT

BACKGROUND: Coinfection at various sites can complicate the clinical course of coronavirus disease of 2019 (COVID-19) patients leading to worse prognosis and increased mortality. We aimed to investigate the occurrence of coinfection in critically ill COVID-19 cases, and the predictive role of routinely tested biomarkers on admission for mortality. METHODS: This is a retrospective study of all SARS-CoV-2-infected cases, who were admitted to King Fahad Hospital of the University between March 2020 and December 2020. We reviewed the data in the electronic charts in the healthcare information management system including initial presentation, clinical course, radiological and laboratory findings and reported all significant microbiological cultures that indicated antimicrobial therapy. The mortality data were reviewed for severely ill patients who were admitted to critical care units. RESULTS: Of 1091 admitted patients, there were 70 fatalities (6.4%). 182 COVID-19 persons were admitted to the critical care service, of whom 114 patients (62.6%) survived. The in-hospital mortality was 13.4%. Coinfection was noted in 67/68 non-survivors, and Gram-negative pathogens (Enterobacterales, Pseudomonas aeruginosa, and Acinetobacter baumanni) represented more than 50% of the etiological agents. We noted that the serum procalcitonin on admission was higher for non-survivors (Median = 1.6 ng/mL ± 4.7) than in survivors (Median = 0.2 ng/mL ± 4.2) (p ≤ 0.05). CONCLUSION: Coinfection is a serious complication for COVID-19 especially in the presence of co-morbidities. High levels of procalcitonin on admission may predict non-survival in critically ill cases in whom bacterial or fungal co-infection is likely.


Subject(s)
COVID-19 , Coinfection , COVID-19/epidemiology , COVID-19/therapy , Coinfection/epidemiology , Critical Illness , Humans , Procalcitonin , Retrospective Studies , SARS-CoV-2
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