Management of centralized transition ward in a large general hospital in Shanghai during the epidemic caused by severe acute respiratory syndrome coronavirus 2 omicron variant infection.

The epidemic of coronavirus disease 2019 (COVID-19) has seriously affected people's normal work, life, and medical treatment. Since Mar. 2022, there has been a pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) omicron variant in Shanghai. In order to meet the needs of hospitalization for patients, and at the same time for better control of epidemic and nosocomial infections, a large hospital in Shanghai innovatively set up a centralized transition ward in the hospital, and established scientific rules of medical work, regulations for prevention of nosocomial infections and efficient norms for patient admission. During the operation of the ward, a total of 211 patients were treated and one of the patients was confirmed of COVID-19 recurrence. All work was carried out methodically, and neither hospitalized patients nor medical staff had nosocomial infection of COVID-19. The preparation, operation and management of the central transition ward in our hospital are summarized here to provide guidance and reference for general hospitals to carry out similar work under the epidemic.Copyright © 2022, Second Military Medical University Press. All rights reserved.

Features of liver function in pediatric patients infected with Delta variant versus Omicron variant of severe acute respiratory syndrome coronavirus 2.

Objective To summarize and analyze the features of liver function in pediatric patients infected with Delta variant versus Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS - CoV - 2). Methods In this study,an analysis was performed for the liver function test results of the locally transmitted or imported pediatric patients with SARS - CoV - 2 infection during isolation who were admitted to Guangzhou Eighth People's Hospital,Guangzhou Medical University,since May 21,2021,and the clinical data and the constituent ratio of liver injury were compared between the pediatric patients infected with Delta variant and those infected with Omicron variant. The independent samples t - test or the Mann - Whitney U test was used for comparison of continuous data between two groups,and the chi - square test or the Fisher's exact test was used for comparison of categorical data between two groups. Results A total of 85 pediatric patients infected with SARS - CoV - 2 were enrolled,among whom there were 32 (37. 6%)pediatric patients infected with Delta variant and 53 (62. 4%)pediatric patients infected with Omicron variant,and there were no significant differences between the two groups in age,sex, body height,body weight,and comorbidities (all P > 0. 05). There were no significant differences between the two groups in alanine aminotransferase (ALT),aspartate aminotransferase (AST),alkaline phosphatase (ALP),gamma - glutamyl transpeptidase,total bilirubin,albumin,and cholinesterase (all P > 0. 05),and the pediatric patients infected with Omicron variant had a significantly higher level of total bile acid (TBA)than those infected with Delta variant (Z = - 2. 336,P = 0. 020). However,the median values of TBA were within the normal range and the ratios of abnormal TBA were no significant difference between the two groups (P > 0. 05). Among the 85 pediatric patients,10 (11. 8%)had a mild increase in liver function parameters,among whom 7 had an increase in TBA,1 had an increase in ALT, 1 had increases in ALT and AST,and 1 had an increase in ALP. The analysis of liver injury in the pediatric patients infected with Delta variant or Omicron variant showed that there was no significant difference in the constituent ratio of liver injury caused by the two variants (6. 3% vs 15. 1%,chi2 = 0. 691,P = 0. 406). Conclusion Mild liver injury is observed in pediatric patients infected with Delta and Omicron variants of SARS - CoV - 2,but further studies are needed to evaluate the long - term influence of such infection on liver function.Copyright © 2022 Editorial Board of Jilin University

Traditional Chinese Medicine Syndrome Differentiation of Delta and Omicron Variants of SARS-CoV-2 Carriers in Changsha,Hunan.

Objective: To summarize and compare the main traditional Chinese medicineTCMsyndromes of Delta and Omicron variants of severe acute respiratory syndrome coronavirus 2SARS-CoV-2 carriers to provide references for the syndrome evolution and syndrome differentiation of SARS-CoV-2 infection. Method(s):The TCM medical records of imported and local cases of infection with Delta and Omicron variants of SARS-CoV-2 in Changsha since September 23,2021 to March 27,2022 were collected,including 18 Delta variant cases and 36 Omicron variant cases. Their TCM diagnosis information and TCM pathogenesis were analyzed and compared. Result(s): The common manifestations in Delta variant cases were cough,fever,chest distress/shortness of breath,sore muscles,nausea,dry mouth,dry or sore throat,thick and greasy tongue coating,and rapid and slippery pulse. The predominant pathogenesis was dampness-heat in the upper-energizer and heat stagnation in the lesser Yang combined with dampness. The occurrence of chest distress/shortness of breath,greasy tongue coating,slippery pulse,and the proportion of dampness-heat in the upper-energizer syndrome were higher in Delta variant cases than in Omicron variant cases P<0.05. The common manifestations in Omicron variant cases were itchy and sore throat,nasal congestion,running nose,fever,mild aversion to cold,dry mouth,dizziness,slightly reddish tongue with thin white coating,and rapid or wiry pulse. The predominant pathogenesis was wind-dryness invading defensive exterior,and heat stagnation in the lesser Yang. The occurrence of white-coated tongue and the proportion of wind-dryness invading defensive exterior syndrome were higher in Omicron variant cases than in Delta variant casesP<0.05. Conclusion(s): There are certain differences in TCM syndromes and the corresponding pathogenesis between Delta variant and Omicron variant cases in Changsha,Hunan. The Delta variant of SARS-COV-2 tends to induce dampness-heat syndrome, whereas Omicron variant infection tends to elicit wind-dampness syndrome,which is expected to provide a reference for the pathogenesis evolution of SARS-COV-2 infection.Copyright © 2022, China Academy of Chinese Medical Sciences Institute of Chinese Materia Medica. All rights reserved.

Evaluation of COVID-19 Vaccines in Primary Prevention Against Infections and Reduction in Severity of Illness Following the Outbreak of Sars-Cov-2 Omicron Variant in Shanghai

Objectives: To evaluate COVID-19 vaccines in primary prevention against infections and lessening the severity of illness following the most recent outbreak of the SARS-CoV-2 Omicron variant in Shanghai. Method(s): To investigate whether inactivated vaccines were effective in protecting against COVID-19 infections, we estimated the odds ratio (OR) of the vaccination in COVID-19 cases vs. matched community-based healthy controls. To evaluate the potential benefits of vaccination in lowering the risk of symptomatic infection (vs. asymptomatic), we estimated the relative risk (RR) of symptomatic infections among diagnosed patients. We also applied the multivariate stepwise Logistic regression analyses to measure the risk of disease severity (symptomatic vs. asymptomatic and moderate/severe vs. mild) in COVID-19 patient cohort with vaccination status as an independent variable while controlling for potential confounding factors. Result(s): Out of the 153,544 COVID-19 patients included in the analysis, 118,124 (76.9%) patients had been vaccinated and 143,225(93.3%) were asymptomatic patients. Of the 10,319 symptomatic patients, 10,031(97.2%), 281(2.7%) and 7(0.1%) experienced mild, moderate, and severe infections, respectively. There is no evidence that the vaccination helped protect from infections (OR=0.82, p=0.613). The vaccination, however, offered a small but significant protection against symptomatic infections (RR=0.92, p < 0.001) and halved the risk of moderate/severe infections (OR=0.48, 95% CI: 0.37 - 0.61). Older age (> 60 years) and malignant tumors were significantly associated with moderate/severe infections. Gender also appeared to be a risk factor for symptomatic infections, with females being associated with a lower risk for moderate/severe illness. Conclusion(s): Inactivated COVID-19 vaccines helped provide a small but significant protection against symptomatic infections and halved risk of moderate/severe illness among symptomatic patients. The vaccination was not effective in blocking COVID-19 Omicron variant community spread.Copyright © 2023

Clinical Characteristics of Patients with Sars-Cov-2 Omicron Variant and COVID-19 Vaccination with Clinical Outcome Findings in Shanghai, China: A Single Center, Retrospective, Observational Study

Objectives: This study aimed to determine disease severity, clinical features, clinical outcome in hospitalized patients with the Omicron variant and evaluate the effectiveness of one-dose, two-dose, and three-dose inactivated vaccines in reducing viral loads, disease course, ICU admissions and severe diseases. Method(s): Retrospective cohort analysis was performed on 5,170 adult patients (>=18 years) identified as severe acute respiratory syndrome coronavirus 2 positive with Reverse Transcription Polymerase Chain Reaction admitted at Shanghai Medical Center for Gerontology between March 2022 and June 2022. COVID-19 vaccination effectiveness was assessed using logistic regression models evaluating the association between the risk of vaccination and clinical outcomes, adjusting for confounders. Result(s): Among 5,170 enrolled patients, the median age was 53 years, and 2,861 (55.3%) were male. 71.0% were mild COVID-19 cases, and cough (1,137 [22.0%]), fever (592 [11.5%]), sore throat (510 [9.9%]), and fatigue (334 [6.5%]) were the most common symptoms on the patient's first admission. Ct values increased generally over time and 27.1% patients experienced a high viral load (Ct value< 20) during their stay. 105(2.0%) of these patients were transferred to the intensive care unit after admission. 97.1% patients were cured or showed an improvement in symptoms and 0.9% died in hospital. The median length of hospital stay was 8.7+/-4.5 days. In multivariate logistic analysis, booster vaccination can significantly reduce ICU admissions and decrease the severity of COVID-19 outcome when compared with less doses of vaccine (OR=0.75, 95%CI, 0.62-0.91, P<=0.005;OR=0.99, 95%CI, 0.99-1.00, p<0.001). Conclusion(s): In summary, the most of patients who contracted SARSCoV-2 omicron variant had mild clinical features and patients with vaccination took less time to lower viral loads. As the COVID-19 pandemic progressed, an older and less vaccinated population was associated with higher risk for ICU admission and severe disease.Copyright © 2023

Thoughts on diagnosis and treatment plan of patients infected with severe acute respiratory syndrome coronavirus 2 omicron variant in large shelter hospitals in Shanghai.

The epidemic caused by the infection of severe acute respiratory syndrome coronavirus 2 omicron variant broke out in Shanghai in Mar. 2022. Omicron variant has characteristics such as strong concealment and rapid transmission, resulting in significant differences between the current round of epidemic and that in Wuhan. The number of infected patients (mainly asymptomatic infected patients) increased rapidly in a short term. Based on dynamic zero policy, shelter hospitals were set up in time in Shanghai to treat the patients. It is suggested that medical resources and patient characteristics should be taken into account in the independent cabin of a shelter hospital with more than 10 000 beds, and the clinical medical practice should be divided to 5 modes (universal education and management, community outpatient clinic, ward duty, emergency rescue, and temporary observation and transport) to optimize the allocation of medical resources, so as to further enhance the treatment capacity and efficiency of shelter hospitals.Copyright © 2022, Second Military Medical University Press. All rights reserved.

Myocardium damage and electrocardiogram characteristics of patients infected with SARS-CoV-2 Omicron variant in Zhuhai

Aim To explore the myocardial damage, abnormal electrocardiogram characteristics of patients infected with SARS-CoV-2 Omicron variant in Zhuhai. Methods 84 patients with SARS-CoV-2 Omicron variant (Omicron variant group) admitted to the Fifth Affiliated Hospital of Sun Yat-sen University from January 13 to March 20, 2022 were included, and 88 patients with non SARS-CoV-2 Omicron variant (non-Omicron variant group) from January 17 to February 17, 2020 were included. A retrospective study was conducted to compare myocardial damage, abnormal electrocardiogram and clinical characteristics between the two groups. Results The mean age of patients in Omicron variant group was smaller than that in non-Omicron variant group [(36. 6±15. 6) years vs. (49. 8±14. 3) years, P<0. 01], and the proportion of patients with body temperature, systolic blood pressure and fever at admission was lower than that of non-Omicron variant group (P<0. 05). The neutrophil / lymphocyte ratio [(2. 93 (3. 03, 5. 81) vs. 7. 06 (2. 32, 11. 27), P<0. 001], interleukin-2 (IL-2) and interleukin-6 (IL-6) levels in Omicron variant group were significantly lower than those in non-Omicron variant group (P<0. 01). Cardiac troponin I (cTnI) was negative in Omicron variant group, and the concentrations of cTnI, creatine kinase-MB isozyme (CK-MB) and N-terminal pro-brain natriuretic peptide (NT-proB-NP) and the proportion of patients with elevated levels were significantly lower than those of non-Omicron variant group (P<0. 01). The incidence of abnormal electrocardiogram in Omicron variant group was also significantly lower than that in non-Omicron variant group (25. 0% vs. 42. 0%, P = 0. 001), sinus tachycardia, atrial premature beats and T wave changes were the main symptoms. Atrial premature beats, T wave changes, ST segment depression and bundle branch block were the main symptoms in non-Omicron variant group. Conclusions The patients infected with SARS-CoV-2 Omicron variant in Zhuhai may not have obvious myocardial damage because most of the patients have been vaccinated with COVID-19 vaccine. The incidence of abnormal electrocardiogram is also significantly lower than that of non-Omicron variant group, mainly sinus tachycardia, atrial premature beats and T wave changes. © 2022, Editorial Office of Chinese Journal of Arteriosclerosis. All rights reserved.

Characterization of Adaptive Immune Responses to SARS-CoV-2 Updated Bivalent Booster

Bivalent COVID-19 vaccines that contain two mRNAs encoding Wuhan-1 and Omicron BA.4/5 spike proteins are successful in preventing infection from the original strain and Omicron variants, but the quality of adaptive immune responses is still not well documented. This study aims at characterizing adaptive immune responses to the bivalent booster vaccination in 46 healthy participants. Plasma and PBMC were collected prior and three weeks after bivalent booster. We measured anti-N, anti-S, and RBD IgM, IgA, IgG plasma titers against original, Omicron BA.1, and BA.5 variants (pending) as well as total anti-S IgG titers and surrogate Virus Neutralization capacity against the Alpha, Delta, and BA.1 variant. With spectral flow-cytometry we identified peripheral blood B-cells specific for the RBD of the S-protein of the original and BA.1 variants. T-cell-specific responses were assessed by cytokine release assay after stimulation with SARS-CoV-2 peptides from the original, BA.1, BA.4, and BA.5 variants (pending). Finally, we performed TRB and IGH repertoire studies on sorted CD4+, CD8+, CD19+ lymphocytes, to study breadth of SARS-CoV-2 specific clonotypes (pending). 27/46 participants were analyzed;9 had SARS-CoV-2 infection (COVID+), while 18 are infection naive (COVID-). In both groups, median time since last dose of SARS-CoV-2 vaccine (3rd or 4th) was 11 months. All subjects were positive for anti-S IgG prior to bivalent booster. The COVID + group displayed anti-S IgG pre-booster levels and neutralization against BA.1 higher than the COVID- group. Significant increase post-boost of total anti-S IgG and BA.1 neutralizing activity was detected in the COVID- but not in the COVID+ group;however, no difference in neutralization activity post-boost was detected between the two groups. Furthermore, the COVIDgroup showed significant increase in the frequency of CD19+ and CD27+ switched memory B-cells specific for BA.1 RBD in post-boost compared to pre-boost samples. However, post-boost frequencies of the same B-cells were higher in the COVID+ compared to the COVID- group. These preliminary findings confirm that among individual immunized with the original COVID-19 mRNAvaccine, prior COVID infection provides increased protection against SARS-CoV-2 variants. They also demonstrate that booster immunization with the bivalent vaccine induces robust adaptive immune responses against Omicron variant.[Formula presented][Formula presented]Copyright © 2023 Elsevier Inc.

Analysis of the Solution of a Model of SARS-CoV-2 Variants and Its Approximation Using Two-Step Lagrange Polynomial and Euler Techniques

In this paper, a vaccination model for SARS-CoV-2 variants is proposed and is studied using fractional differential operators involving a non-singular kernel. It is worth mentioning that variability in transmission rates occurs because of the particular population that is vaccinated, and hence, the asymptomatic infected classes are classified on the basis of their vaccination history. Using the Banach contraction principle and the Arzela–Ascoli theorem, existence and uniqueness results for the proposed model are presented. Two different numerical approaches, the fractional Euler and Lagrange polynomial methods, are employed to approximate the model's solution. The model is then fitted to data associated with COVID-19 deaths in Pakistan between 1 January 2022 and 10 April 2022. It is concluded that our model is much aligned with the data when the order of the fractional derivative (Formula presented.). The two different approaches are then compared with different step sizes. It is observed that they behave alike for small step sizes and exhibit different behaviour for larger step sizes. Based on the numerical assessment of the model presented herein, the impact of vaccination and the fractional order are highlighted. It is also noted that vaccination could remarkably decrease the spikes of different emerging variants of SARS-CoV-2 within the population. © 2023 by the authors.

Cross Infection Control Awareness During 5th Wave of Covid 19 Pandemic, Omicron Variant Amongst the Dental Health Care Professionals of Government Sector University in Karachi, Pakistan

Objective: The objective of this study is to evaluate the awareness of cross-infection control measures followed by DHCPs during the 5th wave of Covid-19 pandemic, Omicron variant in a government sector university of Karachi, Pakistan. Method(s): A Cross-sectional study was conducted from June till September 2022 at Sindh Institute of Oral Health Science during the 5th wave of Covid 19 pandemic, Omicron variant. Data was collected from 153 DHCPs from government sector university using a self-administered questionnaire, comprising of 20 closed ended question to assess the awareness and practice of cross infection protocols by DHCPs. Result(s): 98.7% of the participants were vaccinated against Covid 19. 96% of the participants used surgical gowns, face shields, and face masks as part of PPE during examining patients and while performing procedure. After treatment 99.3% of participants washed hands with hand wash, soap or used antiseptic solution. 77.1% of participants asked for Covid 19 test report and 68.6% of participants asked for proof of vaccination against covid 19 before treating patients. 96.1% of participants recommended disinfection of dental unit after every patient. 98% of participants changed glove after every patient. 88.2% of the participants said they would carry all elective and emergency procedures. Conclusion(s): The results of this study show that DHCPs practicing at government sector university have adequate knowledge regarding prevention of cross infection protocols and their importance to limit spread of infections. But their practice of prevention of cross infection during Covid 19 pandemic is not ideal as percentage of DHCPs requiring proof of vaccination or negative reports for Covid 19 were rather low and the percentage of DHCPs willing to carry elective procedures along with emergency ones was rather high.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.

Omicron driven ECMO in a vaccinated critically ill patient

Objectives: Reporting a case of a COVID-19 vaccinated patient admitted to our intensive care unit with severe acute respiratory failure due to SARSCoV2 - Omicron variant, rapidly deteriorating requiring intubation, prone ventilation, and ECMO support. Method(s): A 62 years old Caucasian male was admitted in ICU for rapidly deranging respiratory failure and fever which occurred over the previous 24h. The patient received two doses of SARS-CoV2 vaccine (Oxford, AstraZeneca), the last one over five months before onset of symptoms. The patient was admitted to the intensive care unit (ICU) with tachypnea, low peripheral saturation (80%), elevated serum creatinine (2.4 mg/dl), and mild obesity (BMI 34,6). Pressure support ventilation trial (2 hours) failed carryng out to orotracheal intubation and protective ventilation. Worsening of respiratory exchanges (5 th day from the admission) required a rescue prone ventilation cycle, in the meantime an indication was given to the placement of veno-venous ECMO. The cannulation site was femoro-femoral and the configuration used was Vivc25- Va21, according to the current ELSO nomenclature;ECMO flow was progressively increased until a peripheral saturation of 95% was obtained. Result(s): The patient passed out after 2 month of extracorporeal support with no sign of recovery of pulmonary and renal function. Conclusion(s): Unlike evidences showing a lower symptomatic engagement of the Omicron variant SARSCoV2 positive patients, we have witnessed a rapid and massive pulmonary involvement. The short time that passed from the onset of symptoms and the rapid decay of respiratory function required rapid escalation of the intensity of care up to extracorporeal support. The patient showed previous pathologies that can lead to suspicion of a loss of immune coverage given by the vaccine, in addition to the long time elapsed since the last dose. (Figure Presented).

Hematological features of patients with type 2 diabetes depending on the variant of SARS-COV-2

The aim of our work was to investigate the peculiarities of hematological indicators in patients with COVID-19 depending on the variant of SARS-CoV-2. A retrospective study of the electronic medical records of 19 patients with the delta variant (7 patients had comorbidity with type 2 diabetes (T2D);12 patients without T2D - control group) and 46 patients with the omicron variant (26 patients had comorbidity with T2D;20 patients without T2D - control group). No statistically significant differences were found in gender, the number of leukocytes, lymphocytes, and granulocytes in peripheral blood, C-reactive protein, and D-dimer. The results also showed a significant difference in procalcitonin level and monocyte count in patients with delta variant and T2D. A predictive model was developed using binary logistic regression to determine the SARS-CoV-2 variant based on hematological parameters (sensitivity - 76.5%, specificity - 84.8%). Thus, the peculiarities of hematological indicators of patients with T2D depending on the variant of SARS-CoV-2 (delta or omicron) were established. © P. Petakh, K. Loshak, A. Kamyshnyi.

Long-term prediction of the COVID-19 epidemics induced by Omicron-virus in China based on a novel non-autonomous delayed SIR model

Since the outbreak of COVID-19, the severe acute respiratory syndrome coronavirus 2 genome is still mutating. Omicron, a recently emerging virus with a shorter incubation period, faster transmission speed, and stronger immune escape ability, is soaring worldwide and becoming the mainstream virus in the COVID-19 pandemic. It is especially critical for the governments, healthcare systems, and economic sectors to have an accurate estimate of the trend of this disaster. By using different mathematical approaches, including the classical susceptible-infected-recovered (SIR) model and its extensions, many investigators have tried to predict the outbreaks of COVID-19. In this study, we employed a novel model which is based upon the well-known susceptible-infected-removed (SIR) model with the time-delay and time-varying coefficients in our previous works. We aim to predict the evolution of the epidemics effectively in nine cities and provinces of China, including A City, B City, C City, D City, E City, F City, G City, H City and I Province. The results show it is effective to model the spread of the large-scale and sporadic COVID-19 induced by Omicron virus by the novel non-autonomous delayed SIR compartment model. The significance of this study is that it can provide the management department of epidemic control with theoretical references and subsequent evaluation of the prevention, control measures, and effects.

Survival Analysis of Delta versus Omicron Variants in COVID-19 Intensive Care Unit (ICU)

Objective: COVID-19 has presented numerous epidemiological and clinical pictures from its beginning and much effort has been paid to detect the behavior of disease and its new types. Therefore, in this study, we aimed to compare the in-hospital survival time of Delta and Omicron variant patients admitted to the intensive care unit. Methods: This was a secondary data analysis of the QCOVICU data registry of 200 COVID-19 patients admitted to the ICU of Shahid Beheshti-Amir Al-Momenin Hospital of Qom City, in 2021. Likewise, time to event data, demographics, and baseline laboratory data was collected. Time of transfer to ICU, survivals, and possible predictors of hazards of death was compared within the variants of Omicron and delta. Results: Two hundred patients (62.98±19.94 years old, 94 females/106 males;100 Delta and 100 Omicron variant) participated in this study. Fifty percent of the population had died. Cross-tabulation showed comparable death rates among variants of delta and omicron (50.5% vs. 51%;p=0.999). There was a statistically significant higher time to ICU admission in Delta variant victims than in Omicron variant victims. The mean survival time of delta variant patients was 21.52 days (95% CI: 17.96 – 25.09) which was statistically higher than the mean survival of omicron patients (17.15 days, 95% CI: 13.65-20.64, p=0.018). The mean survival time of delta variant patients was statistically higher than omicron patients (21.52 vs. 17.15 days, p=0.018). Gender, age (years), and lymphocyte count were significant predictors of mortality based on the Cox regression analysis (P>0.05). There was a 5.9 times higher risk of mortality in females compared with males' gender after adjusting for other variables and a 5.6% increase in death risk with a 1-year increase in age, and a 31.8% decrease in death risk with a 1% lymphocyte percentage increase. Conclusion: Critically patients with Delta variant are getting ICU admitted later and withstand more days at ICU than Omicron patients. It seems that Omicron variant causes sudden deterioration of the patient's condition. © 2023 by SPC (Sami Publishing Company).

The Evolution of the Covid-19 Pandemic in Pediatric Patients with Sickle Cell Disease: From Alpha to Omicron

Background: Approximately two years ago, COVID-19 was declared a global pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and through genomic surveillance, we have seen the emergence of variants of SARS-CoV-2. In the United States, over 78 million cases and >900,000 deaths attributable to COVID-19 have been reported. SCD was identified as a risk factor for severe COVID-19 disease in adults and pediatric patients. The emergence of novel SARs- CoV-2 variants has led to challenges in diagnosis, treatment, and prediction of long-term sequelae in individuals with SCD and COVID-19. Aim(s): We compare the overall seasonal variation of COVID-19 variants and patterns of healthcare utilization and clinical presentation over time in pediatric patients with SCD and COVID-19 at Children's National Hospital (CNH). Method(s): Our single-center, observational cohort study included 193 pediatric patients with SCD (0-21 years) with PCR-confirmed SARSCoV- 2 infection between March 31, 2020, and January 31, 2022. Per the SECURE SCD Registry definitions, clinical severity was classified as asymptomatic, mild, moderate, and severe. Result(s): A total of 193 unique patients with SCD and positive SARS-CoV-2 PCRs between March 2020-January 2022 were included in our registry. Most patients were female (51.8%), and the mean age was 11.2 years (SD 6.5 years). Most of the cohort resides in Maryland (N=135), and HbSS was the dominant genotype (69.4%). During the alpha dominant variant of the COVID-19 pandemic (March 2020- June 2021) there were 70 cases, followed by 40 cases during the Delta variant (July 2021- December 19, 2021), and 83 cases during the Omicron variant dominance (from December 20, 2021-January 31,2022). There were 149 patients (77%) that presented to the emergency department (ED) or were hospitalized. There were a total of 80 hospitalizations (41.5%), and a relative comparison showed that the percentage of hospitalizations was highest during the delta wave (47.5%) and lowest during the omicron wave (36.1%) (p= 0.407). ED-only utilization was highest in the era of omicron (43.4%, N=36), followed by delta (32.5%, N=13), and then alpha (30%, N=21)(p=0.197). The most common SCD-related complication was vaso-occlusive (VOC) pain (33%, N=64) which accounted for half of all hospital admissions (51%, N=41 of 80). Acute chest syndrome (ACS) was reported in 40% (N=32) of admitted patients and was highest in the alpha era (54.8%, N=17). The use of blood transfusion therapy was highest in the alpha (N=17) and delta (N=14) variants, while Remdesivir use was highest in omicron (N=15). A total of 6 patients received monoclonal antibodies (Delta, N=4;omicron, N=2). Throughout all the variants, there was a significant difference in COVID-19 clinical severity (p>0.005). Of the patients classified as asymptomatic (13%, N=25), seventy-two percent (n=18) were diagnosed during the alpha variant. Mild severity was the most prevalent (69%, N=134), with the omicron variant having the highest cases (51.5%, N=69). Severe cases were observed in all variants (6.7%, N=13) but were most prevalent during the alpha variant (46.2%, N=6). Summary - Conclusion(s): Interestingly, while the relative percentage of hospitalizations was lowest during the omicron wave, it saw the highest percentages of ER utilization. Overall, COVID-19 remains mild in pediatric patients with SCD, and notably, there was higher health care utilization in the omicron era.

A phenoxy-bridged trinuclear Ni(ii) complex: synthesis, structural elucidation and molecular docking with viral proteins

A novel phenoxy-bridged trinuclear nickel(ii) complex [Ni3(mu-L)2(bipy)3](1) (where H3L= (E)-2-hydroxy-N-(2-hydroxy-3,5-diiodophenyl)-3,5-diiodobenzohydrazonic acid, bipy = 2,2'-bipyridyl) has been designed and synthesized as a potential antivirus drug candidate. The trinuclear Ni(ii) complex [Ni3(mu-L)2(bipy)3](1) was fully characterized via single crystal X-ray crystallography. The unique structure of the trinuclear nickel(ii) complex crystallized in a trigonal crystal system with P3221 space group and revealed distorted octahedral coordination geometry around each Ni(ii) ion. The X-ray diffraction analysis established the existence of a new kind of trinuclear metal system containing nickel(ii)-nickel(ii) interactions with an overall octahedral-like geometry about the nickel(ii) atoms. The non-bonded Ni-Ni distance seems to be 3.067 and 4.455 A from the nearest nickel atoms. The detailed structural analysis and non-covalent supramolecular interactions are also investigated by single crystal structure analysis and computational approaches. Hirshfeld surfaces (HSs) and 2D fingerprint plots (FPs) have been explored in the crystal structure to investigate the intermolecular interactions. The preliminary analysis of redox and magnetic characterization was conducted using cyclic voltammetry measurements and a vibrating sample magnetometer (VSM), respectively. This unique structure shows good inhibition performance for SARS-CoV-2, Omicron and HIV viruses. For insight into the potential application of the Ni(ii) coordination complex as an effective antivirus drug, we have examined the molecular docking of the trinuclear Ni(ii) complex [Ni3(mu-L)2(bipy)3](1) with the receptor binding domain (RBD) from SARS-CoV-2 (PDB ID: 7MZF), Omicron BA.3 variant spike (PDB ID: 7XIZ), and HIV protease (PDB ID: 7WCQ) viruses. This structure shows good inhibition performance for SARS-CoV-2, Omicron S protein and HIV protease viruses;the binding energies (DELTAG) and the respective Ki/Kd (inhibition/dissociation constants) correlation values are -8.9 (2.373 muM or 2373 nM), -8.1 (1.218 muM or 1218 nM) and -7.9 (0.874 muM or 874 nM), respectively. The results could be used for rational drug design against SARS-CoV-2 Omicron variant and HIV protease viruses.Copyright © 2023 The Royal Society of Chemistry.

Descriptive analysis of the incidence rate of postacute COVID-19 syndrome in the Republic of Korea Army.

Background: This study aimed to identify the incidence rate of post-coronavirus disease-2019 (COVID-19) conditions in the Republic of Korea (ROK) Army and to investigate the trend of the incidence rate according to changes in dominant variants. Method(s): We used the results of a 19-item, self-completed survey of those who had recovered from COVID-19 in the ROK Army between March 24, 2020, and April 30, 2022. We used both descriptive and multiple logistic regression analyses to identify factors associated with the incidence rate of post-COVID-19 conditions. Result(s): Among the total of 48,623 COVID-19 episodes in the ROK Army, the overall incidence rate of post-COVID-19 conditions was 32.9%. Based on the survey, the incidence of cough was the highest at 15.4%, followed by fatigue (15.1%) and sputum (13.8%). The delta variant had the highest incidence rate of post-COVID-19 conditions at 50.7%, whereas the omicron variant had the lowest at 19.7%. Concerning the type of post-COVID-19 condition, the neuropsychiatric symptoms had the highest incidence at 27.4% when the delta variant was dominant, and the respiratory symptoms were highest at 37.3% when the omicron variant was dominant. In the case of smell and taste symptoms, the incidence rate was high at 21.1% only when the delta variant was predominant. Conclusion(s): The overall incidence rate of post-COVID-19 conditions in the ROK Army was 32.9%. When the delta variant was dominant, the overall incidence as well as the proportion of neuropsychiatric symptoms were high. However, as the omicron variant became dominant, the overall incidence decreased, but the proportion of respiratory symptoms increased.Copyright © Korean Medical Association.

IN-HOSPITAL CLINICAL COURSE, OUTCOME AND COMPLICATIONS AMONG PATIENTS VACCINATED AGAINST COVID-19.

This retrospective case-series analysis evaluated 403 fully vaccinated with Vero Cell or Sputnik V vaccines patients hospitalized in the 6th City Clinical Hospital of Minsk in the period between January 01 and February 28, 2022 with the main diagnosis of "coronavirus infection (COVID-19)". The diagnosis was confirmed by PCR or SARS-CoV-2 virus antigen tests, as well as chest computed tomography data. The study revealed higher prevalence of older patients (over 65 years) infected with the SARS-CoV-2 virus and hospitalized in early 2022, at the height of the wave of the pandemic due to the spread of the Omicron variant. Most patients (91.8 %) had moderate symptoms. More than half of them received oxygen support. A relatively small number of inpatient, only 8 persons (1.9 %), were hospitalized in the intensive care unit (ICU) and four of them needed mechanical ventilation. Comor-bid conditions and high incidence of mortality (63.5 %) were common in ICU patients. Hypertension and obesity prevailed in the structure of comorbid pathology of all inpatient persons (74.2 and 24.3 %, respectively). Patients of therapeutic departments had relatively short length of stay in the hospital, as well as low in-hospital mortality (0.5 %) and low incidence of complications (5.3 %).Copyright © 2023 The authors.

Management and standardization of hemodialysis centers in lockdown areas under the epidemic of coronavirus disease 2019.

Maintenance hemodialysis patients need to return to hospital 3 times a week for routine hemodialysis treatment. In the case of coronavirus disease 2019 (COVID-19) and regional lockdown, a set of management systems and standardizations has been established in our hemodialysis center, including forward movement of the critical nodes of treatment, specialists pooling program for hemodialysis technology, and dynamic bubble personnel management, to implement dynamic prevention and control strategies, precise management of inpatient wards and closed-loop management of outbreaks. While improving the management of our own hemodialysis center, it is recommended to strengthen multi-center collaboration to build a municipal grid management system for hemodialysis and explore different dialysis strategies for end-stage renal disease to meet the treatment needs and safety management of maintenance hemodialysis patients in lockdown areas under the epidemic.Copyright © 2022, Second Military Medical University Press. All rights reserved.