Predictors of severity in COVID-19

Background: In the context of home monitoring of severe acute respiratory syndrome coronavirus-2 disease (COVID-19) patients, it is imperative to evaluate the accuracy of finger pulse oximetry oxygen saturation (SpO2) in the assessment of hypoxia. Methods: Retrospective data analysis was performed on (n = 132) hospitalised COVID-19 patients with various levels of severity, in whom SpO2, haematological, biochemical and arterial blood gas (ABG) parameters were measured within 48 h after admission. Discrepancy between SpO2 and arterial blood oxygen saturation SaO2 was compared between mild, moderate and severe COVID-19 to assess the accuracy of finger pulse oximetry. Results: We found that total white blood cell count, neutrophil %, neutrophil-lymphocyte ratio, platelet-lymphocyte ratio, ferritin, C-reactive protein and lactate dehydrogenase (LDH) were significantly increased in severe COVID-19, while lymphocyte % was significantly less when compared to mild and moderate cases. Multivariable analysis suggested that red cell distribution width (RDW) and LDH together account for significant variance in the severity of disease. The SpO2 and SaO2 were significantly less in the severe group. The difference between SpO2 and SaO2 has a clinically meaningful albeit statistically nonsignificant trend with the discrepancy greater in severe COVID-19 cases when compared to mild and moderate cases. Conclusions: Finger pulse oximetry has the potential to underestimate the severity of hypoxia in severe COVID-19 and this has implications in the decision to start oxygen therapy. RDW and LDH constitute the best parsimonious set of variables to predict severity.

CORONAVIRUS DISEASE SURVIVAL TIME MODEL FOR FORECASTING

The term "survival analysis" refers to statistical techniques for data analysis where the time until the occurrence of the desired event serves as the outcome variable. Time to event analysis is another name for survival analysis. Applications for survival analysis are fairly broad and include things like calculating a population's survival rate or contrasting the survival of two or more groups. Cox regression analysis is a highly well-liked and frequently applied technique among them. Data on disease states are typically obtained at random epochs or at periodic epochs during follow-up in research looking at biological changes between states of Coronavirus infection and the start of COVID-19 in the human immune system. For instance, after the COVID enters a person's bloodstream by a route of transmission, it progresses through numerous stages that are linked to the depletion of B cells before becoming COVID-19. This study presents the Cox's approach for simulating the link between variables influencing the development of two disease states, namely I= the time epoch of COVID infection and P= the time epoch of COVID-19. Incubation period (IP) or survival time is the precise interval of time between "P and I." It is shown how Cox's model works with several personal infective factors and how well it can estimate the percentage of COVID-19 victims with the same completed length of IP. Such forecast values are then established for a synthetically simulated data set. [ FROM AUTHOR] Copyright of Journal of Pharmaceutical Negative Results is the property of ResearchTrentz and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Impact of endothelial function on the prognosis of COVID19 patients

Introduction: The pathophysiological mechanisms related to the severity of the clinical picture of Sars-Cov-2 infection remain questions that the medical community seeks to resolve and whose knowledge will allow the design of therapeutic strategies. Purpose(s): To evaluate the association between endothelial function and mortality in patients with COVID-19. Material(s) and Method(s): Prospective cohort study. Patients with confirmed diagnosis of COVID-19, who required hospitalization, oxygen saturation <60% and laboratory data of endothelial function markers were included;all those with incomplete data were excluded. Result(s): The age of the population was 57.06 +/- 13.405, 69% were intubated, those who died had poorer ventilatory parameters;peak pressure (30.06 +/- 6.13 vs 24.82 +/- 6.06, p<0.001), Fi02 (57.5 [40 - 80] vs 45 [40 -80], p <0.001) and PaO2/FiO2 calculation (127.84 +/- 50.08 vs 163.36 +/- 45.47, p<0.001). In addition, they had greater laboratory alterations: procalcitonin (0.49 [0.16 - 4] vs. 18 [0.07 - 0.52], p=0.03) and CRP (13.34[7.67 - 19.03] vs 6.69 [2.4 - 15 89], p=0.05), higher levels of clotting times, PT(14.8 [14 - 16.6] vs 14.4 [13.7 -15.6], p=0.5) and INR (1.04 [0.98 - 1.17] vs 1.01 [.95 - 1.1], p=0.05). In blood biometry, higher numbers of leukocytes of (11.3 [8.65 - 14.4] vs. 9.9 [6.7 - 13], p=0.041), neutrophils (8.8 [7.4 - 12.5] vs. 8.1 [4.74 - 11.1], p=0.01) and lower numbers of lymphocytes (. 7 [.40 - 1.1] vs 1.1 [.7 - 1.5], p<0.001) and with significant statistical trend, hemoglobin(11.26 +/- 2.55 vs 12.42 +/- 2.4, p=0.07) compared to surviving subjects. Conclusion(s): Hematological and liver alterations are markers of higher mortality in patients with COVID-19 as an expression of multiorgan disease.

Automatic Covid-19 Face Mask and Body Temperature Detection Using Raspberry Pi

The first step in diagnosing COVID is checking for fever. Also, we need to check everyone's masks. Although manual temperature scanning has significant drawbacks, temperature checking technology exists to scan each entry. Employees who are not adequately trained in the use of temperature scanners. There is human error in reading the values. People are often allowed in despite high temperatures or not wearing masks. Staff will not scan if supervisors are not present. Manual scanning methods are not ideal for large groups. Here we propose an entry-level vendor and fully automated temperature scanner system to solve this problem. It is a flexible system with a wide range of applications. The technology uses a mask monitor and non-contact temperature measurement. If high temperature or mask absence is detected, an immediate human barrier is added to the scanner to prevent entry. No one will be allowed without temperature and mask scan. Immediate admission is granted only to those who meet both the criteria. The temperature sensor, camera and other components of the system are all controlled by the Raspberry Pi computer. A temperature sensor and camera are used to search for masks and measure forehead temperature. Raspberry evaluates the sensor data to determine whether the user is granted access. In this case, the system triggers a motor to open the barrier to allow the person to enter the building. The device flashes a red light and denies entry if it detects high temperature or the absence of a mask. As a result, the technology provides a fully automated approach to stopping the spread of COVID. Copyright © 2022, Anka Publishers. All rights reserved.

Fetal Biometry and Doppler Assessment of Pregnant Women with COVID-19

Background: The world has changed radically because of the worldwide COVID-19 pandemic. SARS-CoV-2, a unique strain of large, enveloped single-stranded RNA viruses, that has spread around the world. The primary objective of this research was to assess the fetal growth velocity in pregnancies complicated by SARS-CoV-2 infection and those that were not. The secondary objective was to determine if SARS-CoV-2 infection may affect maternal and fetal Doppler readings. Methods and Results: A total of 250 pregnant women diagnosed with SARS-CoV-2 (Case group) were compared to 300 healthy pregnant women (Control group) in a prospective case-control study in Mosul from February 20 to October 20, 2021. Infections during pregnancy were detected and verified using the real-time reverse transcriptase-polymerase chain reaction (RT-PCR). All ultrasound exams were done from 24 to 40 weeks. Measuring parameters using Doppler ultrasonography included plasticity and resistive indices (PI, RI), as well as cerebroplacental ratio computed according to gestational age. Fetal development in utero was assessed by measuring biometric markers, such as parietal diameter, head size, belly circumference, leg length, and estimated fetal weight every four weeks. The US scans in the second and third trimester of pregnancy showed no evidence of congenital abnormalities (P=0.7047). There was a significant incidence of cesarean delivery (P=0.0000) and lower fetal activity at birth (P=0.0000) in the Case group, compared to the Control group. Anticoagulant treatment during pregnancy was not associated with an increased risk of postpartum hemorrhage in women of the Case group. Also, there were no significant differences in fetal biparietal diameter and femur length between groups in the second and third trimesters, and both fetal and maternal Doppler studies throughout the second and third trimesters of pregnancy yielded no significant differences in the PI and RI indices. © 2022, International Medical Research and Development Corporation. All rights reserved.

COVID-19 vaccine delivery: an opportunity to set up systems for the future [version 1, peer review: 2 approved with reservations]

The race to develop safe and effective SARS-COV-2 vaccines has moved with unprecedented speed. There are now multiple promising candidates seeking emergency use authorization from the United States Food and Drug Administration and a host of candidates positioned for approval worldwide. Attention has now turned to allocation, distribution and verification of these vaccines, yet this focus exposes that the underlying infrastructure for global delivery and monitoring is threadbare and unevenly distributed. This presents both a barrier and an opportunity to deploy sustainable infrastructure. Major global stakeholders must convene quickly, collaborate, and collectively invest in global standards, legal models, common vocabularies and interoperable biometric-supported digital health technologies. As the COVID-19 vaccine effort scales, governments, private sector and NGOs have the chance to place lasting resources needed for equitable and effective delivery that can pay dividends into the future. Copyright © 2020. Weintraub R et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Optical biometric measurements in patients with previous COVID-19 treatment.

Background: We aimed to compare optical biometric measurements using optical biometry in patients with previously received COVID-19 treatment and a control group. Methods: In this cross-sectional study, patients with previously received COVID-19 treatment formed the COVID-19 group and age- and sex-matched healthy participants formed the control group. Optical biometric measurements including keratometry, corneal astigmatism, astigmatic axis, central corneal thickness, anterior chamber depth, and axial length were made using a Nidek optical biometer (AL-Scan; Nidek Co., Ltd., Japan). Results: Measurements of keratometry (p = 0.79), corneal astigmatism (p = 0.41), axial length (p = 0.96), anterior chamber depth (p = 0.59), and central corneal thickness (p = 0.37) were similar between the COVID-19 and control groups. The astigmatic axis type taken from 2.4 mm of the cornea showed significant difference between the two groups (p = 0.02, χ2), while the measurements taken from 3.3 mm of the cornea were similar (p = 0.10, χ2). In the subgroup analysis, axial length, anterior chamber depth, and central corneal thickness measurements were found to be statistically significantly higher in male patients of the COVID-19 group (p = 0.02; p = 0.001; p = 0.02, t test). Conclusion: The changes in optical biometric measurements found in our study were due to the fact that COVID-19 is more frequent and severe in males, SARS-CoV­2 can attach to the cornea via ACE­2 receptors, and favipiravir can reach the aqueous humor. To our knowledge, there is no study on this subject to date, and therefore more research is needed to shed light on this topic.

DO WOMEN GET WHAT THEY WANT? A SERVICE REVIEW OF ONLINE CONTRACEPTION OFFERED BY AN NHS INTEGRATED SEXUAL HEALTH SERVICE

Introduction Responding to COVID-19 restrictions and increasing demand, we introduced an online contraception service. Patients complete a comprehensive web-questionnaire which is subsequently assessed by a nurse who supplies a suitable method. This service is 'wholly-online' (excludes real-time interactions) however, some patients submit insufficient or ambiguous information and follow-up consultations are required. Aims - to determine the profile of patients using this service, their contraception choices and whether they achieved a wholly-online-service. to determine what factors prevented the wholly-onlineservice and what could be done to improve this. Methods Retrospective notes review of 100 consecutive patients in November 2021, noting: age, contraception requested, had they;watched our online video for chosen method, declared adequate blood pressure, height and weight measurements. Outcomes noted: patients receiving chosen method with a wholly-online-service, if not, what intervention followed (telephone/face-to-face) and reasons. Results Table-1 shows patient profiles. Table-2 shows outcomes of online requests. P89 Table 1 Method of contraception requested via online service P89 Table 2 Outcomes of online request Discussions 'Wholly-online' contraception was achieved in 26% of patients. An extra 6% required a clarification phone call before receiving contraception. An extra 27% attended for biometrics(height, weight, blood-pressure) before receiving contraception. 16% were ineligible, requiring face-to-face consultations for clinical or safeguarding reasons. This suggests - our 'wholly-online' service is meeting a demand, presumably because patients prefer going online in their own time, rather than scheduling an appointment. - a significant appetite for combined-oral-contraception online for those without biometric recordings. We will explore a hybrid service involving online requests and drop-in access for biometrics that could meet this demand, without challenging the capacity of our appointments services (Table Presented).

Beijing Pinggu Childhood Eye Study: The Baseline Refractive Characteristics in 6- to 12-Year-Old Chinese Primary School Students.

Purpose: To report the design and baseline data of a 3-year cohort study in Beijing Pinggu District primary school students in China after COVID-19. Methods: Noncycloplegic and cycloplegic spherical equivalent refraction (SER) were measured, ocular biometry, including the axial length (AL), anterior chamber depth (ACD) and corneal power (CP), were collected before cycloplegia. Corneal radius (CR), AL-to-CR ratio, and lens power (LP) were calculated. Results: Among the 4,806 (89.1%) eligible students (51.5% male), the prevalence of emmetropia, myopia, mild hyperopia, and mild-to-high hyperopia was 12.8, 30.8, 53.0, and 3.3% after cycloplegia, respectively. Myopia increased from 2.5% in 6- to 71.6% in 12-year-old students, with 9- and 10-year-olds showing the most prominent increases. The median of cycloplegic SER was 0.50 (IQR = 1.63), and the noncycloplegic SER was -0.38 D (IQR = 1.50), which is more negative than the cycloplegic refraction. The mean AL increased with age, from 22.46 ± 0.70 mm to 24.26 ± 1.07 mm. The ACD increased from 3.38 ± 0.28 mm to 3.70 ± 0.30 mm, and the AL-to-CR ratio increased from 2.91 ± 0.08 to 3.12 ± 0.13 between 6- and 12-year-old students. AL, CR and LP explained the SER variance with R2 of 86.4% after adjusting the age and gender. Conclusions and Relevance: The myopia prevalence since emergence of COVID-19 rapidly increased from 6- to 12-year primary school Chinese children, especially after 7 years of age. The non-cycloplegia SER overestimated the prevalence of myopia, and the cycloplegic SER is a more accurate and reliable method to assess the prevalence of refractive status.

Application of artificial intelligence in cataract management: current and future directions.

The rise of artificial intelligence (AI) has brought breakthroughs in many areas of medicine. In ophthalmology, AI has delivered robust results in the screening and detection of diabetic retinopathy, age-related macular degeneration, glaucoma, and retinopathy of prematurity. Cataract management is another field that can benefit from greater AI application. Cataract  is the leading cause of reversible visual impairment with a rising global clinical burden. Improved diagnosis, monitoring, and surgical management are necessary to address this challenge. In addition, patients in large developing countries often suffer from limited access to tertiary care, a problem further exacerbated by the ongoing COVID-19 pandemic. AI on the other hand, can help transform cataract management by improving automation, efficacy and overcoming geographical barriers. First, AI can be applied as a telediagnostic platform to screen and diagnose patients with cataract using slit-lamp and fundus photographs. This utilizes a deep-learning, convolutional neural network (CNN) to detect and classify referable cataracts appropriately. Second, some of the latest intraocular lens formulas have used AI to enhance prediction accuracy, achieving superior postoperative refractive results compared to traditional formulas. Third, AI can be used to augment cataract surgical skill training by identifying different phases of cataract surgery on video and to optimize operating theater workflows by accurately predicting the duration of surgical procedures. Fourth, some AI CNN models are able to effectively predict the progression of posterior capsule opacification and eventual need for YAG laser capsulotomy. These advances in AI could transform cataract management and enable delivery of efficient ophthalmic services. The key challenges include ethical management of data, ensuring data security and privacy, demonstrating clinically acceptable performance, improving the generalizability of AI models across heterogeneous populations, and improving the trust of end-users.

Factors Affecting Learning Satisfaction in Face-to-Face and Non-Face-to-Face Flipped Learning among Nursing Students.

Factors influencing students' learning satisfaction may differ between face-to-face and non-face-to-face flipped learning. For non-face-to-face flipped learning, which was widely employed during the COVID-19 pandemic, it is necessary to examine the impacts on learning satisfaction, which may vary depending on professor-student interaction rather than individual competencies, such as SDL readiness. This descriptive study, conducted 2 March 2019 to 24 June 2020, included 89 s-year, flipped-learning nursing students (28 face-to-face, 61 non-face-to-face). Students completed questionnaires about learning satisfaction, SDL readiness, and professor-student interaction. The data, collected using e-surveys, were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation, and multiple stepwise regression with IBM's SPSS Statistics 25.0 program. The total average score of learning satisfaction (38.19 ± 6.04) was positively correlated with SDL readiness (r = 0.56, p < 0.001) and professor-student interaction (r = 0.36, p = 0.001), although total learning satisfaction was significantly different between the face-to-face and the non-face-to-face groups (t = 5.28, p = 0.024). They were also significant influencing factors, along with face-to-face flipped learning, for total learning satisfaction (F = 18.00, p < 0.001, explanatory power = 36.7%), suggesting flipped learners in non-face-to-face contexts must increase engagement beyond professor-student interaction.

The Association of Structural Inequities and Race With Out-of-Hospital Sudden Death During the COVID-19 Pandemic.

[Figure: see text].