Modelling spatial variations of novel coronavirus disease (COVID-19): evidence from a global perspective.

In late December 2019, strange pneumonia was detected in a seafood market in Wuhan, China which was later termed COVID-19 by the World Health Organization. At present, the virus has spread across 232 countries worldwide killing 2,409,011 as of 17 February 2021 (9:37 CET). Motivated by a recent dataset, knowledge gaps, surge in global cases, and the need to combat the virus spread, this study examined the relationship between COVID-19 confirmed cases and attributable deaths at the global and regional levels. We used a panel of 232 countries (further disaggregated into Africa-49, Americas-54, Eastern Mediterranean-23, Europe-61, Southeast Asia-10, and Western Pacific-35) from 03 January 2020 to 28 November 2020, and the instrumental variable generalized method of moment's model (IV-GMM) for analysing the datasets. The results showed that COVID-19 confirmed cases at both the global and regional levels have a strong positive effect on deaths. Thus, the confirmed cases significantly increase attributable deaths at the global and regional levels. At the global level, a 1% increase in confirmed cases increases attributable deaths by 0.78%. Regionally, a 1% increase in confirmed cases increases attributable deaths by 0.65% in Africa, 0.90% in the Americas, 0.67% in the Eastern Mediterranean, 0.72% in Europe, 0.88% in Southeast Asia, and 0.52% in the Western Pacific. This study expands the understanding of the relationship between COVID-19 cases and deaths by using a global dataset and the instrumental variable generalized method of moment's model (IV-GMM) for the analysis that addresses endogeneity and omitted variable issues.

Therapeutic Options for the Treatment of 2019-Novel Coronavirus in India: A Review

Purpose: As of, from 30th Jan to 31st May, 2020, more than 182,143 confirmed cases were reported in India along with 86,984 recovered cases and 5164 deceased cases of COVID-19. More than 53 countries are also affected with this pandemic virus. However, the lack of specific drugs to prevent/treat this pandemic disease is a major problem in this current scenario. In this re-gard, this systemic review was conducted to identify the therapeutic approaches and researches, which are ongoing in India against COVID-19. Method(s): We had screened Google Scholar database with the keywords nCoV, corona virus in In-dia, effect of SARS-CoV-2 in India, 2019-nCoV, treatment pattern in India for nCoV and therapy used to treat nCoV in India. In the final review, we had included a total of 49 articles. Result(s): As a result we had found that the Indian Council of Medical Research and NIH have giv-en a standard guideline of Hydroxychloroquine and other antiviral drugs for nCoV, and also there are various researches going on related to nCoV treatment like, chemicals from natural products, herbs and spices commonly used in India, combination therapy of lopinavir and ritonavir, ultra-vio-let radiation therapy, molecular dynamic (MD) simulations of molecules for vaccine preparation, Convalescent plasma transfusion (CPT) therapy and many more. Conclusion(s): New drugs and therapy are in the premature stage for this hazardous pandemic. We need more time to gain the detailed knowledge of the life cycle of the nCoV, which can speed up the drug/vaccine development process against nCoV.Copyright © 2022 Bentham Science Publishers.

Critical Insight into the Attributes of Emerging Novel Coronavirus (COVID-19) in India and Across the World

The World Health Organization (WHO) has recently announced the spread of novel coronavi-rus (nCoV) globally and has declared it a pandemic. The probable source of transmission of the virus, which is from animal to human and human to human contact, has been established. As per the statistics reported by the WHO on 11th April 2020, data has shown that more than sixteen lakh confirmed cases have been identified globally. The reported cases related to nCoV in India have been rising substantially. The review article discusses the characteristics of nCoV in detail with the probability of potentially effective old drugs that may inhibit the virus. The research may further emphasize and draw the attention of the world towards the development of an effective vaccine as well as alternative therapies. Moreover, the article will help to bridge the gap between the new researchers since it's the current thrust area of research.Copyright © 2020 Bentham Science Publishers.

Neuro-Behcet's disease in the setting of active COVID-19 infection

Background: Cases of SARS-COV-2 triggering or exacerbating autoimmune responses has been described in the literature, and it has shown that use of steroids in non-severe COVID-19 may potentially increase mortality. Case presentation: A 22 year-old African-American man presented with headache, weight, loss, and oral/scrotal ulcerations. Case report: Neurological exam revealed somnolence and right hemiplegia. MRI was remarkable multiple enhancing lesions involving the brainstem and left hemisphere. He was found to have a positive SARS-CoV-2 test. Work-up was unrevealing, and he was diagnosed with Neuro-Behcet's disease (NBD) based on the International Criteria for Behcet's Disease (ICBD)ackspaceD)BackspaceBackspacep. The patient was treated with systemic steroids, which resulted in both clinical and radiological improvement of his disease without exacerbation of his SAR-CoV-2 infection. Conclusion(s): This case presentation suggests that IV steroids may be safe in the treatment of NBD in adult patients presenting with SARS-CoV-2 infection.Copyright © 2021

A study on the factors influencing the transfer of COVID-19 severe illness patients out of the ICU based on generalized linear mixed effect model.

The clinical data of 76 severe illness patients with novel coronavirus SARS-CoV-2 from July to August, 2020 admitted to the ICU Intensive Care Unit ward in a hospital in Urumqi were collected in the paper. By using the Laplace approximation parameter estimation method based on maximum likelihood estimation, the generalized linear mixed effect model (GLMM) was established to analyze the characteristics of clinical indicators in critical patients, and to screen the main influencing factors of COVID-19 critical patients' inability to be transferred out of the ICU in a short time: age, C-reactive protein, serum creatinine and lactate dehydrogenase.

High-specificity targets in SARS-CoV-2 N protein for serological detection and distinction from SARS-CoV.

Numerous serological detection kits are being rapidly developed and approved for screening and diagnosing suspected coronavirus disease 2019 (COVID-19) cases. However, cross-reactivity between pre-existing antibodies against other coronaviruses and the captured antigens in these kits can affect detection accuracy, emphasizing the necessity for identifying highly specific antigen fragments for antibody detection. Thus, we performed a conservation and specificity analysis of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) nucleocapsid (N) protein. We also integrated various B-cell epitope prediction methods to obtain possible dominant epitope regions for the N protein, analyzed the differences in serological antibody levels for different epitopes using ELISA, and identified N protein epitopes for IgG and IgM with high-specificity. The SARS-CoV-2 N protein showed low mutation rates and shared the highest amino acid similarity with SARS-CoV; however, it differed substantially from other coronaviruses. Tests targeting the SARS-CoV-2 N protein produce strong positive results in patients recovering from SARS-CoV. The N18-39 and N183-197 epitopes for IgG and IgM detection, respectively, can effectively overcome cross-reactivity, and even exhibit good specificity between SARS-CoV-2 and SARS-CoV. The antibody levels detected with these were consistent with those detected using the complete N protein. These findings provide a basis for serological diagnosis and determining the kinetics of SARS-CoV-2 antibody detection in patients.

A Sever case of of SARS-CoV-2 infection in Gansu.

An outbreak infection with the novel coronavirus (SARS-CoV-2) has developed in Wuhan since December 2019.This paper describes the first critical case in Gansu China.

Headache Attributed to Vaccination Against COVID-19 (Coronavirus SARS-CoV-2) with the ChAdOx1 nCoV-19 (AZD1222) Vaccine: A Multicenter Observational Cohort Study.

INTRODUCTION: The most frequently reported neurological adverse event of ChAdOx1 nCoV-19 (AZD1222) vaccine is headache in 57.5%. Several cases of cerebral venous thrombosis (CVT) have developed after vaccination. Headache is the leading symptom of CVT. For the differential diagnosis of headaches attributed to this vaccine and headaches attributed to CVT, it is of central clinical importance whether and, if so, how the phenotypes and course of these headaches can be differentiated. The study aims to examine in detail the phenotype of headache attributed to this vaccine. METHODS: Data on the clinical features and corresponding variables were recorded using a standardized online questionnaire in this multicenter observational cohort study. The primary outcomes of this study are the clinical features of headaches after vaccination. FINDINGS: A total of 2464 participants reported headaches after vaccination with the ChAdOx1 nCoV-19 (AZD1222) vaccine. On average, headaches occurred 14.5 ± 21.6 h after vaccination and lasted 16.3 ± 30.4 h. A bilateral location was described by 75.8% of participants. This is most often found on the forehead (40.0%) and temples (31.4%); 50.4% reported a pressing and 37.7% a dull pain character. Headache intensity was most often severe (38.7%), moderate (35.2%), or very severe (15.5%). Accompanying symptoms were most commonly fatigue (44.8%), chills (36.1%), exhaustion (34.9%), and fever (30.4%). CONCLUSION: Headaches attributed to COVID-19 vaccination with the ChAdOx1 nCoV-19 (AZD1222) vaccine demonstrate an extensive and characteristic complex of symptoms. The findings have several important clinical implications for the differentiation of post-vaccinal headache and other primary as well as secondary headaches.

Novel coronavirus (COVID-19) and its potential G.I. manifestation: A review.

The outbreak of the new coronavirus in Wuhan, Chinese Hubei City (COV-2) was also known as COVID-19 and has spread to more than 213 countries, zones or territories worldwide, and is an emergency of international public health with no antiviral drugs or vaccines; and, also, the presencouragement of the disease has become a global public health emergency. This novel coronavirus is now the seventh member of the coronaviridae family, known for infecting humans and showing evidence of causing gastric symptoms, and has the potential to be transmitted through the fecal-oral route according to a new report published online by physicians at Shanghai Jiao Tong University (Gastroenterology. 2020 March 3. doi: 10.1053/j.gastro. 2020.02.054). Here we identify the efforts to compile and disseminate the COVID-19 epidemiological information on Its potential G.I. Demonstration of news media and social networks, and few newspapers recently published. Physicians should know, how GI manifestation discussed in different publications to suspect CORONA virus infection in that patients who does not have any upper and lower respiratory tract symptom and intervein to discuss the disease severity and duration. It will increase the threshold of suspicion of physician toward Covid-19 disease.

Red cell distribution width (RDW): a prognostic indicator of severe COVID-19.

BACKGROUND: The global mortality rate for coronavirus disease 2019 (COVID-19) is 3.68%, but the mortality rate for critically ill patients is as high as 50%. Therefore, the exploration of prognostic predictors for patients with COVID-19 is vital for prompt clinical intervention. Our study aims to explore the predictive value of hematological parameters in the prognosis of patients with severe COVID-19. METHODS: Ninety-eight patients who were diagnosed with COVID-19 at Jingzhou Central Hospital and Central Hospital of Wuhan, Hubei Province, were included in this study. RESULTS: The median age of the patients was 59 [28-80] years; the median age of patients with a good prognosis was 56 [28-79] years, and the median age of patients with a poor outcome was 67 [35-80] years. The patients in the poor outcome group were older than the patients in the good outcome group (P<0.05). The comparison of hematological parameters showed that lymphocyte count (Lym#), red blood cells (RBCs), hemoglobin (HGB), hematocrit (HCT), mean corpuscular volume (MCV), and mean corpuscular hemoglobin (MCH) were significantly lower in the poor outcome group than in the good outcome group (P<0.05). Further, the red cell volume distribution width-CV (RDW-CV) and red cell volume distribution width-SD (RDW-SD) were significantly higher in the poor outcome group than in the good outcome group (P<0.0001). Receiver operating characteristic (ROC) curves showed RDW-SD, with an area under the ROC curve (AUC) of 0.870 [95% confidence interval (CI) 0.796-0.943], was the most significant single parameter for predicting the prognosis of severe patients. When the cut-off value was 42.15, the sensitivity and specificity of RDW-SD for predicting the prognosis of severe patients were 73.1% and 80.2%, respectively. Reticulocyte (RET) channel results showed the RET level was significantly higher in critical patients than in moderate patients and severe patients (P<0.05), which may be one cause of the elevated RDW in patients with a poor outcome. CONCLUSIONS: In this study, the hematological parameters of COVID-19 patients were statistically analyzed. RDW was found to be a prognostic predictor for patients with severe COVID-19, and the increase in RET may contribute to elevated RDW.

Field grand challenge with emerging superbugs and the novel coronavirus (SARS-CoV-2) on plastics and in water.

This opinion paper reports field grand challenges associated with plastic and water contaminated with the novel coronavirus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) and superbugs, given the emergency of public health and environmental protection from the presence of lethal viruses and bacteria. Two primary focuses of detection and treatment methods for superbugs and the novel coronavirus (SARS-CoV-2) are investigated, and the future outlook is provided based on grand challenges identified in the water field. Applying conventional treatment technologies to treat superbugs or the novel coronavirus (SARS-CoV-2) has brought negative results, including ineffective treatment, formation of toxic byproducts, and limitation of long-term performance. Existing detection methods are not feasible to apply in terms of sensitivity, difficulty of applications in field samples, speed, and accuracy at the time of sample collection. Few studies are found on superbugs or adsorption of the novel coronavirus (SARS-CoV-2) on plastic, as well as effects of superbugs or the novel coronavirus (SARS-CoV-2) on treatment of plastic waste and wastewater. With the need for and directions of further research and challenges discussed in this paper, we believe that this opinion paper offers information useful to a wide audience, including scientists, policy makers, consultants, public health workers, and field engineers in the water sector.

Novel coronavirus pneumonia (COVID-19) after pulmonary surgery: A case report / 中国胸心血管外科临床杂志

@#There was a male novel coronavirus (2019-nCoV, SARS-CoV-2) pneumonia (COVID-19) patient after pulmonary surgery at age of 61 years. The patient had no clear history of contact COVID-19 patient before surgery. He developed transient fever on the 4th day after surgery. The body temperature returned to normal on the 5th day after antibiotic adjustment. The patient developed fever and fatigue again on the 6th day after surgery. A chest CT scan revealed postoperative pneumonia. The patient was treated by ganciclovir and moxifloxacin hydrochloride. The patient's temperature gradually decreased on the 7th to 9th days after the operation. CT scan on the 10th day after surgery showed viral pneumonia, so we immediately raised the level of protection. The novel coronavirus nucleic acid test was positive. The patient was immediately transferred to the designated hospital for treatment. The patient was treated by arbidol, moxifloxacin, human immunoglobulin (PH4), ambroxol and other nutritional symptomatic and supportive treatment. The patient's condition is currently stable. Ten people in close contact with the patient developed symptoms, and their CT scans showed viral pneumonia. Six of them were positive in nucleic acid tests, and the others were still under quarantine observation. This shows that it is easy to confuse the imaging manifestations of pneumonia with novel coronavirus pneumonia after lung surgery. We should perform nucleic acid detection as soon as possible in the early diagnosis of CT and reformulate the treatment protocol.

Challenges and countermeasures of thoracic surgery in the epidemic of novel coronavirus pneumonia / 中国胸心血管外科临床杂志

@#Since December 2019, a novel coronavirus (2019-nCoV, SARS-CoV-2) pneumonia (COVID-19) outbreak has occurred in Wuhan, Hubei Province, and the epidemic situation has continued to spread. Such cases have also been found in other parts of the country. The spread of the novel coronavirus pneumonia epidemic has brought great challenges to the clinical practice of thoracic surgery. Outpatient clinics need to strengthen the differential diagnosis of ground glass opacity and pulmonary plaque shadows. During the epidemic, surgical indications are strictly controlled, and selective surgery is postponed. Patients planning to undergo a limited period of surgery should be quarantined for 2 weeks and have a nucleic acid test when necessary before surgery. For patients who are planning to undergo emergency surgery, nucleic acid testing should be carried out before surgery, and three-level protection should be performed during surgery. Patients who are planning to undergo emergency surgery in the epidemic area should be confirmed with or without novel coronavirus pneumonia before operation, and perform nucleic acid test if necessary. Surgical disinfection and isolation measures should be strictly carried out. Among postoperative patients, cases with new coronavirus infection were actively investigated. For the rescue of patients with novel coronavirus infection, attention needs to be paid to prevention and treatment and related complications, including mechanical ventilation-related pneumothorax or mediastinal emphysema, and injury after tracheal intubation.

Chest CT comparison of ground glass opacity-like 2019 novel coronavirus pneumonia and early-stage lung carcinoma / 中国胸心血管外科临床杂志

@#Objective    To investigate CT image features of ground glass opacity (GGO)-like 2019 novel coronavirus (2019-nCoV, SARS-CoV-2) pneumonia (COVID-19) and early-stage lung carcinoma for control and therapy of this acute severe respiratory disease. Methods    We retrospectively analyzed the clinical data of 71 GGO-like COVID-19 patients who received therapy in Tongji Hospital of Huazhong University of Science and Technology between January 17th and February 13th, 2020. These 71 GGO-like COVID-19 patients were as a COVID-19 group. And 80 GGO-like early-stage lung carcinoma patients who underwent resection were as a lung carcinoma group. Clinical features such as sex, age, symptoms including fever, cough, fatigue, myalgia and dyspnea, detailed exposure history, confirmatory test (SARS-CoV-2 quantitative RT-PCR) and pathologic diagnosis were analyzed. Results    Significantly different symptoms and exposure history between the two groups were detected (P<0.001). More lesions (61 patients at percentage of 85.92%, P<0.001), relative peripheral locations (69 patients at percentage of 97.18%, P<0.001) and larger opacities (65 patients at percentage of 91.55%, P<0.001) were found in chest radiographs of GGO-like COVID-19 compared with GGO-like early-stage lung carcinoma. Similar features appeared in early-stage of COVID-19 and lung carcinoma, while pneumonia developed into more extensive and basal predominant lung consolidation. Coexistence of GGO-like COVID-19 and early-stage lung carcinoma might occur. Conclusion    Considering these similar and unique features of GGO-like COVID-19 and early-stage lung carcinoma, it is necessary to understand short time re-examination of chest radiographs and other diagnostic methods of these two diseases. We believe that the findings reported here are important for diagnosis and control of COVID-19 in China.

Survey on perceived work stress and its influencing factors among hospital staff during the COVID-19 pandemic in Taiwan.

This study aimed to investigate the perceived work stress and its influencing factors among hospital staff during the novel coronavirus (COVID-19) pandemic in Taiwan. A web-based survey was conducted at one medical center and two regional hospitals in southern Taiwan, targeting physicians, nurses, medical examiners, and administrators. The questionnaire included items on the demographic characteristics of hospital staff and a scale to assess stress among healthcare workers caring for patients with a highly infectious disease. A total of 752 valid questionnaires were collected. The hospital staff reported a moderate level of stress and nurses had a highest level of stress compared to staff in the other three occupational categories. The five highest stress scores were observed for the items "rough and cracked hands due to frequent hand washing and disinfectant use," "inconvenience in using the toilet at work," "restrictions on eating and drinking at work," "fear of transmitting the disease to relatives and friends," and "fear of being infected with COVID-19." Discomfort caused by protective equipment was the major stressor for the participants, followed by burden of caring for patients. Among participants who experienced severe stress (n = 129), work stress was higher among those with rather than without minor children. The present findings may serve as a reference for future monitoring of hospital staff's workload, and may aid the provision of support and interventions.

Temporal signal and the phylodynamic threshold of SARS-CoV-2.

The ongoing SARS-CoV-2 outbreak marks the first time that large amounts of genome sequence data have been generated and made publicly available in near real time. Early analyses of these data revealed low sequence variation, a finding that is consistent with a recently emerging outbreak, but which raises the question of whether such data are sufficiently informative for phylogenetic inferences of evolutionary rates and time scales. The phylodynamic threshold is a key concept that refers to the point in time at which sufficient molecular evolutionary change has accumulated in available genome samples to obtain robust phylodynamic estimates. For example, before the phylodynamic threshold is reached, genomic variation is so low that even large amounts of genome sequences may be insufficient to estimate the virus's evolutionary rate and the time scale of an outbreak. We collected genome sequences of SARS-CoV-2 from public databases at eight different points in time and conducted a range of tests of temporal signal to determine if and when the phylodynamic threshold was reached, and the range of inferences that could be reliably drawn from these data. Our results indicate that by 2 February 2020, estimates of evolutionary rates and time scales had become possible. Analyses of subsequent data sets, that included between 47 and 122 genomes, converged at an evolutionary rate of about 1.1 × 10-3 subs/site/year and a time of origin of around late November 2019. Our study provides guidelines to assess the phylodynamic threshold and demonstrates that establishing this threshold constitutes a fundamental step for understanding the power and limitations of early data in outbreak genome surveillance.

Absent immune response to SARS-CoV-2 in a 3-month recurrence of coronavirus disease 2019 (COVID-19) case.

BACKGROUND: The viral persistence in patients with Coronavirus Disease 2019 (COVID-19) remains to be investigated. METHODS: We investigated the viral loads, therapies, clinical features, and immune responses in a 70-year patient tested positive for SARS-CoV-2 for 3 months. FINDINGS: The patient exhibited the highest prevalence of abnormal indices of clinical features and immune responses at the first admission, including fever (38.3 â„ƒ), decreased lymphocytes (0.83 × 109/L) and serum potassium (3.1 mmol/L), as well as elevated serum creatinine (115 µmol/L), urea (8.6 mmol/L), and C-reactive protein (80 mg/L). By contrast, at the second and the third admission, these indices were all normal. Through three admissions, IL-2 increased from 0.14 pg/mL, 0.69 pg/mL, to 0.91 pg/mL, while IL-6 decreased from 11.78 pg/mL, 1.52 pg/mL, to 0.69 pg/mL, so did IL-10 from 5.13 pg/mL, 1.85 pg/mL, to 1.75 pg/mL. The steady declining trend was also found in TNF-α (1.49, 1.15, and 0.85 pg/mL) and IFN-γ (0.64, 0.42, and 0.27 pg/mL). The threshold cycle values of RT-PCR were 26.1, 30.5, and 23.5 for ORFlab gene, and 26.2, 30.6, and 22.7 for N gene, showing the patient had higher viral loads at the first and the third admission than during the middle term of the disease. The patient also showed substantially improved acute exudative lesions on the chest CT scanning images. CONCLUSIONS: The patient displayed declining immune responses in spite of the viral shedding for 3 months. We inferred the declining immune responses might result from the segregation of the virus from the immune system.

Clinical and hematological characteristics of 88 patients with COVID-19.

INTRODUCTION: To retrospectively analyze epidemiological, clinical and hematological characteristics of COVID-19 patients. METHODS: The demographic, symptoms, and physiological parameters of 88 patients were collected and analyzed. The performance of complete blood count (CBC) indexes for monitoring and predicting the severity of COVID-19 in patients was evaluated by analyzing and comparing CBC results among different COVID-19 patient groups. RESULTS: White blood cells (WBCs), the neutrophil percentage (Neu%), absolute neutrophil count (Neu#), and neutrophil-to-lymphocyte ratio (NLR) were significantly higher in the critical group than in the other three groups (P < .05), while the lymphocyte percentage (Lym%), monocyte percentage (Mon%), lymphocyte count (Lym#), and lymphocyte-to-monocyte ratio (LMR) were significantly lower in the critical group than in the other three groups (P < .05). WBCs, the Neu%, Neu#, NLR, and neutrophil-to-monocyte ratio (NMR) were significantly higher in the severe group than in the mild and moderate groups (P < .05), while the Lym% was significantly lower in the severe group than in the mild and moderate groups (P < .05). The Mon%, Lym#, and LMR were significantly lower in the severe group than in the moderate group (P < .05). Using receiver operating characteristic (ROC) curve analysis to differentiate severe and nonsevere patients, the areas under the curve (AUCs) for the NLR, Neu%, and Lym% were 0.733, 0.732, and 0.730, respectively. When differentiating critical patients from noncritical patients, the AUCs for the NLR, Neu%, and Lym% were 0.832, 0.831, and 0.831. CONCLUSIONS: The NLR is valuable for differentiating and predicting patients who will become critical within 4 weeks after the onset of COVID-19.

Lockdown is an effective 'vaccine' against COVID-19: A message from India.

This communication stresses the importance of the complete lockdown of a developing nation as a powerful tool against COVID-19 acting as a 'vaccine'. India has been under complete lockdown since 24th March 2020 in addition to other measures emphasized by the Indian Government such as promoting hand washing, social distancing, and use of face masks. A strict lockdown is suggested as an effective measure for containing the novel Corona virus infection transmission worldwide.