Comparison of Delta and Omicron variant of COVID-19 infection cases in Montenegro

Introduction/Objective At the end of 2021, Omicron wave (B.1.1.529) SARS-CoV-2 variant superseded the Delta variant (B.1.617). The main goal of the research is to provide a detailed and comprehensive presentation of data related to people infected with the coronavirus in Montenegro. The specific goal of the research is to determine whether virus mutations influenced the course of the epidemic during its two-year duration. Methods This is a retrospective study. We used data from the Institute of Public Health of Montenegro. Our sample consisted of 127,134 people who tested positive for Delta or Omicron infection aged 0–100 years, who had a positive PCR test for COVID-19 between August 17, 2021 and April 17, 2022. Results The respondents aged 40–49 years were taken as a reference group for age. The results showed that the age group from 20 to 29 years old was affected 1.03 times more than the reference group – per-sons belonging to the age group of 30–39 years were affected 1.07 times more than the reference group. The Central region was taken as the reference group for the region. The results showed that people who live in southern region got sick 1.14 times more often and people who live in northern region got sick 1.20 times less than people from the central region. Conclusion The biggest predictor that a person would get sick is the age group. Also, the predictor is the region, and in our research, it was southern region. © 2023, Serbia Medical Society. All rights reserved.

The arise of SARS-CoV-2 Delta variant in Cape Verde

Since March 2020, we have been living in a pandemic caused by the SARS-CoV-2 virus, responsible for COVID-19 disease. The emergence of new variants and strains of SARS-CoV-2 virus, in particular the Delta variant in October 2020, sparked a new alert for the scientific community, given its high efficiency in replication and transmissibility, as well as its relationship to more serious symptoms, which contribute to the increase of hospitalization and mortality rates, particularly in African countries. In this case report, we explored the arrival of the Delta variant in Cape Verde, an African middle-income country, in August 2021, and analyzed its possible effects on increased notification of new cases and mortality rates in the country, as well as the health system's responsiveness to the new variant. This is particularly relevant given the country's lack of infrastructure for the screening and surveillance of new variants, which, therefore, influence the adoption of new mitigation and control measures for COVID-19 prevention, particularly in this period of flexibilization of the most COVID-19 restrictive measures (i.e. social distance), return of tourism and schools activities in the country. © 2023 Multidisciplinary Science Journal. All rights reserved.

Dynamic chest computed tomography change analysis and prediction of length of stay for delta variant COVID-19 patients

OBJECTIVE: As hospital admission rate is high during the COVID-19 pandemic, hospital length of stay (LOS) is a key indicator of medical resource allocation. This study aimed to elucidate specific dynamic longitudinal computed tomography (CT) imaging changes for patients with COVID-19 over in-hospital and predict individual LOS of COVID-19 patients with Delta variant of SARS-CoV-2 using the machine learning method. MATERIALS AND METHODS: This retrospective study recruited 448 COVID-19 patients with a total of 1761 CT scans from July 14, 2021 to August 20, 2021 with an averaged hospital LOS of 22.5 ± 7.0 days. Imaging features were extracted from each CT scan, including CT morphological characteristics and artificial intelligence (AI) extracted features. Clinical features were obtained from each patient's initial admission. The infection distribution in lung fields and progression pattern tendency was analyzed. Then, to construct a model to predict patient LOS, each CT scan was considered as an independent sample to predict the LOS from the current CT scan time point to hospital discharge combining with the patients' corresponding clinical features. The 1761 follow-up CT data were randomly split into training set and testing set with a ratio of 7:3 at patient-level. A total of 85 most related clinical and imaging features selected by Least Absolute Shrinkage and Selection Operator were used to construct LOS prediction model. RESULTS: Infection-related features were obtained, such as the percentage of the infected region of lung, ground-glass opacity (GGO), consolidation and crazy-paving pattern, and air bronchograms. Their longitudinal changes show that the progression changes significantly in the earlier stages (0–3 days to 4–6 days), and then, changes tend to be statistically subtle, except for the intensity range between (−470 and −70) HU which exhibits a significant increase followed by a continuous significant decrease. Furthermore, the bilateral lower lobes, especially the right lower lobe, present more severe. Compared with other models, combining the clinical, imaging reading, and AI features to build the LOS prediction model achieved the highest R2 of 0.854 and 0.463, Pearson correlation coefficient of 0.939 and 0.696, and lowest mean absolute error of 2.405 and 4.426, and mean squared error of 9.176 and 34.728 on the training and testing set. CONCLUSION: The most obvious progression changes were significantly in the earlier stages (0–3 days to 4–6 days) and the bilateral lower lobes, especially the right lower lobe. GGO, consolidation, and crazy-paving pattern and air bronchograms are the most main CT findings according to the longitudinal changes of infection-related features with LOS (day). The LOS prediction model of combining clinical, imaging reading, and AI features achieved optimum performance.

SARS-CoV-2 vaccines from A to Z: A review of the current challenges

COVID-19 pandemic is a major worldwide health disaster firstly reported in December 2019. The Food and Drug Administration (FDA) has offered the public hope of halting it, authorizing vaccinations for emergency use with more than 85% efficacy against serious acute respiratory syndrome (SARS-CoV-2). Recent outbreaks of SARS-CoV-2 variations including spike-protein mutations, the key vaccines viral target for immune response, have prompted a thorough investigation into the vaccine's long-term effectiveness. Consequently, this review assayed the details on SARS-CoV-2 infection mechanism and how to control the infection by different types of SARS-CoV-2 vaccines, and their effectiveness against other mutant strains. Additionally, the review summarized the different complaints which have been recorded after vaccination. In conclusion, these negative effects must be constantly weighed against the predicted advantages in terms of disease prevention. Although COVID-19 vaccination is recommended for everyone aged 5 years and older, SARS-CoV-2 is high likely to continue to be a pandemic infectious as a result of the broadcasting of variants of the virus. Therefore, a booster vaccination, wearing a mask, and social distancing should be maintained. © 2023 Global NEST.

Changing Features of Liver Injury in COVID-19 Patients: Impact of Infection with the SARS-CoV-2 Delta (B.1.617.2) Variants.

BACKGROUND: There is growing evidence that abnormal liver function tests (LFTs) are common in patients with coronavirus disease 2019 (COVID-19). However, it is not known whether viral involvement in the liver differs according to the strain. We investigated the impact on liver injury in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta (B.1.617.2) variants. MATERIALS AND METHODS: We conducted a single-center, retrospective cohort study, including 372 patients admitted during the pre-Delta period (PDP: between February 1 and November 30, 2020) and 137 patients admitted during the Delta period (DP: between August 1 and August 31, 2021). Initial liver injury was defined as alanine aminotransferase (ALT) or aspartate aminotransferase (AST) levels ≥3 × the upper limit of normal (ULN) or alkaline phosphatase (ALP) or total bilirubin ≥2 × the ULN within 3 days from admission. RESULTS: Of 509 patients with COVID-19 included in our study, 38 (7.5%) patients had initial liver injury. The DP group had a significantly higher rate of initial liver injury than the PDP group (PDP: 5.9% vs. DP: 11.7%, P = 0.028). The DP group (adjusted odds ratio [aOR]: 2.737, 95% confidence interval [CI]: 1.322 - 5.666) was independently associated with initial liver injury. During hospitalization, 160 (31.4%) patients had severe COVID-19. The DP group and initial liver injury had higher odds of progressing to severe COVID-19 (aOR: 2.664, 95% CI: 1.526 - 4.648, and aOR: 4.409, 95% CI: 1.816 - 10.707, respectively). The mediation analysis suggested that initial liver injury mediates the relationship between SARS-CoV-2 Delta variant infection and severe COVID-19 (unstandardized beta coefficient = 0.980, Standard error = 0.284, P = 0.001). CONCLUSION: Initial liver injury is more common in COVID-19 patients with Delta variants. Also, Delta variants and initial liver injury are associated with poor clinical outcomes.

Baculoviral COVID-19 Delta DNA vaccine cross-protects against SARS-CoV2 variants in K18-ACE2 transgenic mice.

After severe acute respiratory syndrome coronavirus-2 (SARS-CoV2) made the world tremble with a global pandemic, SARS-CoV2 vaccines were developed. However, due to the coronavirus's intrinsic nature, new variants emerged, such as Delta and Omicron, refractory to the vaccines derived using the original Wuhan strain. We developed an HERV-enveloped recombinant baculoviral DNA vaccine against SARS-CoV2 (AcHERV-COVID19S). A non-replicating recombinant baculovirus that delivers the SARS-CoV2 spike gene showed a protective effect against the homologous challenge in a K18-hACE2 Tg mice model; however, it offered only a 50 % survival rate against the SARS-CoV2 Delta variant. Therefore, we further developed the AcHERV-COVID19 Delta vaccine (AcHERV-COVID19D). The AcHERV-COVID19D induced higher neutralizing antibodies against the Delta variant than the prototype or Omicron variant. On the other hand, cellular immunity was similarly high for all three SARS-CoV2 viruses. Cross-protection experiments revealed that mice vaccinated with the AcHERV-COVID19D showed 100 % survival upon challenge with Delta and Omicron variants and 71.4 % survival against prototype SARS-CoV2. These results support the potential of the viral vector vaccine, AcHERV-COVID19D, in preventing the spread of coronavirus variants such as Omicron and SARS-CoV2 variants.

Ethical Issues Involving the Development of COVID-19 Vaccines: Role of Vaccine Development, Clinical Trials, and Speed of Peer Review in Dissuading Public Vaccine Hesitancy

Over 60% of the population in the United States received the SARS-Co-V type 2 messenger RNA (mRNA) vaccine, manufactured by Pfizer-BioNTech and by Moderna. The pace at which these mRNA vaccines have been developed may be alarming to the public when compared with timelines for the development of traditional vaccines for other diseases, eliciting issues of mistrust. Ethical issues arise regarding the pace of vaccine development and have been described and highlighted by the media. In addition, testing and validation of basic science and clinical findings, combined with potential side effects of the mRNA vaccines have contributed to public mistrust of this particular vaccine platform. Here, we focus on the current ethical concerns involved with vaccine development, identify the ethical concerns that mitigate the role of public vaccine hesitancy and efforts to minimize the role of such issues, and address some of the scientific concerns cited by the public in their hesitancy to obtain the mRNA vaccine. Copyright © 2021 by Begell House, Inc.

An anti-inflammatory and anti-fibrotic proprietary Chinese medicine nasal spray designated as Allergic Rhinitis Nose Drops (ARND) with potential to prevent SARS-CoV-2 coronavirus infection by targeting RBD (Delta)- angiotensin converting enzyme 2 (ACE2) binding.

BACKGROUND: Since the outbreak of COVID-19 has resulted in over 313,000,000 confirmed cases of infection and over 5,500,000 deaths, substantial research work has been conducted to discover agents/ vaccines against COVID-19. Undesired adverse effects were observed in clinical practice and common vaccines do not protect the nasal tissue. An increasing volume of direct evidence based on clinical studies of traditional Chinese medicines (TCM) in the treatment of COVID-19 has been reported. However, the safe anti-inflammatory and anti-fibrotic proprietary Chinese medicines nasal spray, designated as Allergic Rhinitis Nose Drops (ARND), and its potential of re-purposing for suppressing viral infection via SARS-CoV-2 RBD (Delta)- angiotensin converting enzyme 2 (ACE2) binding have not been elucidated. PURPOSE: To characterize ARND as a potential SARS-CoV-2 entry inhibitor for its possible preventive application in anti-virus hygienic agent. METHODS: Network pharmacology analysis of ARND was adopted to asacertain gene targets which were commonly affected by COVID-19. The inhibitory effect of ARND on viral infection was determined by an in vitro pseudovirus assay. Furthermore, ARND was confirmed to have a strong binding affinity with ACE2 and SARS-CoV-2 spike-RBD (Delta) by ELISA. Finally, inflammatory and fibrotic cell models were used in conjunction in this study. RESULTS: The results suggested ARND not only inhibited pseudovirus infection and undermined the binding affinity between ACE2 and the Spike protein (Delta), but also attenuated the inflammatory response upon infection and may lead to a better prognosis with a lower risk of pulmonary fibrosis. The data in this study also provide a basis for further development of ARND as an antiviral hygienic product and further investigations on ARND in the live virus, in vivo and COVID-19 patients. ARND holds promise for use in the current COVID-19 outbreak as well as in future pandemics. CONCLUSION: ARND could be considered as a safe anti-SARS-CoV-2 agent with potential to prevent SARS-CoV-2 coronavirus infection.

COVID-19-related thrombotic complications experience before and during delta wave.

OBJECTIVE: Hypercoagulability and thrombotic complications seen in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), as well as the associated pathophysiology, have been reported extensively. However, there is limited information regarding the factors related to this phenomenon and its association with the Coronavirus disease 2019 (COVID-19) Delta variant. METHODS: A retrospective review including patients admitted to a tertiary center with a COVID-19 positive test and at least one acute thrombotic event confirmed by imaging between June 2020 and August 2021 was performed. We compared the rates of thrombotic events in patients with COVID-19 before and during the Delta peak. We also analyzed the association of the thrombotic complications with demographic characteristics, comorbidities, anticoagulation strategies, and prothrombotic markers while describing other complications secondary to COVID-19 infection. RESULTS: Of 964 patients admitted with COVID-19 diagnosis, 26.5% (n = 256) had a thrombotic event evidenced by ultrasound or computed tomography scan. Venous thromboembolism was found in 60% (n = 153), arterial thrombosis in 23% (n = 60), and both venous and arterial thromboses in 17% (n = 17) of the study cohort. Of all patients, 94% were not vaccinated. Delta variant wave (DW) patients had thrombotic episodes in 34.7% (n = 50/144) of cases compared with 25% (n = 206/820) of non-Delta wave (NDW) patients, posing an estimated risk 1.36 times higher in patients infected with COVID-19 during the DW than NDW. Overall, DW subjects were significantly younger (P < .001) with lower body mass index (P = .021) compared with NDW patients. Statistical analyses showed African American patients were more likely to have arterial thrombosis compared with the other groups when testing positive for COVID-19 (odds ratio [OR], 1.78; 95% confidence interval [CI], 1.04-3.05; P = .035, whereas immunosuppressed patients had less risk of arterial thrombosis (OR, 0.38; 95% CI, 0.15-0.96; P = .042). Female gender (OR, 2.15; 95% CI, 1.20-3.85; P = .009) and patients with active malignancy (OR, 5.99; 95% CI, 2.14-16.78; P = .001) had an increased risk of having multiple thrombotic events at different locations secondary to COVID-19. CONCLUSIONS: COVID-19 infection is associated with elevated rates of thrombotic complications and an especially higher risk in patients infected during the Delta variant peak. We highlight the importance of vaccination and the development of new anticoagulation strategies for patients with COVID-19 with additional hypercoagulable risk factors to prevent thrombotic complications caused by this disease.

Mental health in COVID-19 Delta variant survivors and healthcare workers during the 2021 outbreak in Nanjing, China: a cross-sectional study.

Since the coronavirus disease 2019 (COVID-19) Delta variant was discovered in India in October 2020, it has rapidly triggered a second outbreak globally. However, the effects of the COVID-19 Delta variant on mental health in survivors and healthcare workers are unclear. The aim of this study is to assess mental health among the COVID-19 Delta variant survivors and healthcare workers, and analyze the possible impact factors. This survey-based, cross-sectional study used the Symptom Check List-90 Revised questionnaire to evaluate psychological status among 60 COVID-19 Delta variant survivors, 162 nurses, and 72 hygienists in Nanjing, China. Three indices and nine dimensions were compared for job, education level, gender, age, and marriage classification. Data were analyzed using SPSS 25.0. Mental distress among participants was not very serious in general. The survivors presented the highest score, followed by the hygienists, and the lowest score was in nurses. Low-educated individuals and women showed significant increase. No significant difference was noted in age and marriage classification. In this survey study of COVID-19 Delta variant survivors and healthcare workers in Nanjing, China, the survivors needed psychological support immediately. Meanwhile, healthcare workers warranted more attention, especially the lower education levels and women. A comprehensive emergency response plan was warranted.

Suburban Road Networks to Explore COVID-19 Vulnerability and Severity.

The Delta variant of COVID-19 has been found to be extremely difficult to contain worldwide. The complex dynamics of human mobility and the variable intensity of local outbreaks make measuring the factors of COVID-19 transmission a challenge. The inter-suburb road connection details provide a reliable proxy of the moving options for people between suburbs for a given region. By using such data from Greater Sydney, Australia, this study explored the impact of suburban road networks on two COVID-19-related outcomes measures. The first measure is COVID-19 vulnerability, which gives a low score to a more vulnerable suburb. A suburb is more vulnerable if it has the first COVID-19 case earlier and vice versa. The second measure is COVID-19 severity, which is proportionate to the number of COVID-19-positive cases for a suburb. To analyze the suburban road network, we considered four centrality measures (degree, closeness, betweenness and eigenvector) and core-periphery structure. We found that the degree centrality measure of the suburban road network was a strong and statistically significant predictor for both COVID-19 vulnerability and severity. Closeness centrality and eigenvector centrality were also statistically significant predictors for COVID-19 vulnerability and severity, respectively. The findings of this study could provide practical insights to stakeholders and policymakers to develop timely strategies and policies to prevent and contain any highly infectious pandemics, including the Delta variant of COVID-19.

COVID-19 Delta Variant: Perceptions, Worries, and Vaccine-Booster Acceptability among Healthcare Workers.

Background: As the COVID-19 Delta variant has spread across the globe, healthcare workers' (HCWs) knowledge, worries, and vaccine booster acceptance should be assessed. Methods: Online questionnaires aimed at HCWs in Saudi Arabia were distributed between 9 and 12 August 2021, aiming to evaluate HCWs' perceptions and worries about the Delta variant as well as their feelings about receiving a booster-vaccine. Results: A total of 1279 HCWs participated, with 51.1% being physicians and 41.7% nurses. 92.5% were aware of the emergence of the Delta variant. Still, only 28.7% were found to have sufficient knowledge of the variant, and their level of worry about it was higher than their level of worry about the Alpha variant (2.32/5 versus 1.79/5). The main information sources cited by the participants were social media (50.5%), while 30.5% used scientific journals. Overall, 55.3% were willing to receive a vaccine booster, while one third would have preferred to receive a new mRNA vaccine specifically developed for the Delta variant. Factors associated with vaccine booster acceptance were receiving both vaccination doses (p = 0.008), believing that the Pfizer-BioNTech BNT162b2 vaccine is effective against variants (p < 0.001), and agreement that mixing/matching vaccines is effective against variants (p < 0.001). Conclusions: A high percentage of HCWs were aware of the Delta variant, but only a small fraction had decent quality of knowledge about it. The participants exhibited high worry levels and showed a modest acceptance of receiving a vaccine booster dose. These results should encourage public health officials to scale up educational efforts to disseminate reliable information about the different variants and provide recommendations about receiving a vaccine booster. Further research on methods to alleviate HCWs' worries about emerging variants is warranted.

SARS-CoV-2 Delta (B.1.617.2) Variant: A Unique T478K Mutation in Receptor Binding Motif (RBM) of Spike Gene.

Over two hundred twenty-eight million cases of coronavirus disease 2019 (COVID-19) in the world have been reported until the 21st of September 2021 after the first rise in December 2019. The virus caused the disease called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Over 4 million deaths blame COVID-19 during the last one year and 8 months in the world. Currently, four SARS-CoV-2 variants of concern are mainly focused by pandemic studies with limited experiments to translate the infectivity and pathogenicity of each variant. The SARS-CoV-2 α, ß, γ, and δ variant of concern was originated from United Kingdom, South Africa, Brazil/Japan, and India, respectively. The classification of SARS-CoV-2 variant is based on the mutation in spike (S) gene on the envelop of SARS-CoV-2. This review describes four SARS-CoV-2 α, ß, γ, and δ variants of concern including SARS-CoV-2 ε, ζ, η, ι, κ, and B.1.617.3 variants of interest and alert. Recently, SARS-CoV-2 δ variant prevails over different countries that have 3 unique mutation sites: E156del/R158G in the N-terminal domain and T478K in a crucial receptor binding domain. A particular mutation in the functional domain of the S gene is probably associated with the infectivity and pathogenesis of the SARS-CoV-2 variant.