Diagnosis and main types of coronavirus in humans: a narrative review / Uma análise dos principais diagnósticos de Sars-cov-2 disponíveis no Brasil: uma revisão de literatura / Diagnóstico y principales tipos de coronavirus en humanos: una revisión narrativa

Introdução: Com a emergência do SARS-CoV-2 foi disponibilizado uma grande quantidade de ferramentas de diagnóstico. Neste contexto, a falta de vacina, de tratamento e o grande número de casos graves e morte, possibilitou a aprovação emergencial de diversos testes, que ainda necessitam de estudos populacionais para seu registro definitivo. Objetivo: Realizar uma revisão de literatura para avaliar as metodologias de diagnóstico disponíveis no Brasil, de acordo com a realidade local de saúde, explorando o momento epidemiológico a complexidade do teste e a finalidade da sua aplicação. Metodologia: Trata-se de um estudo bibliográfico, descritivo do tipo revisão de literatura. Foram utilizadas as seguintes bases de dados científicos para buscas: PUBMED, MEDLINE, LILACS E COCHRANE LIBRARY, através de descritores selecionados na plataforma DECS. Resultados: O cenário de diversos ensaios, baseados em diferentes metodologias, como os testes baseados em RNA viral, em detecção de antígenos virais ou de anticorpos, associados ao conhecimento da história natural do vírus, possibilita uma análise crítica do melhor diagnóstico de acordo com a clínica do paciente, os epidemiológicos, o objetivo do diagnóstico e a acurácia do ensaio. Atualmente, há mudança no padrão imunológico da população e a descrição de tipos e subtipos de SARS-CoV-2 com mudanças gênicas, que podem levar a mudanças na acurácia diagnóstica ou a re-emergência em surtos de doença grave. Conclusão: Ainda é incerto o caminho evolutivo da história natural da Covid-19 e os ensaios diagnósticos estão em diferentes estágios de desenvolvimento, validação e produção e cada tipo de teste tem suas próprias vantagens e desvantagens distintas inerentes a plataforma tecnológica de origem e uma combinação de tipos de testes usados em momentos diferentes pode ser útil para a condução clínica dos pacientes e no controle da pandemia por SARS-CoV-2.

Introduction: With the emergence of SARS-CoV-2, a large number of diagnostic tools were made available. In this context, the lack of vaccine, treatment and the large number of severe cases and death, allowed the emergency approval of several tests, which still require population studies for their definitive registration. Objective: To carry out a literature review to evaluate the diagnostic methodologies available in Brazil, according to the local health reality, exploring the epidemiological moment, the complexity of the test and the purpose of its application. Methodology: This is a bibliographic, descriptive study of the literature review type. The following scientific databases were used for searches: PUBMED, MEDLINE, LILACS AND COCHRANE LIBRARY, through selected descriptors on the DECS platform. Results: The scenario of several tests, based on different methodologies, such as tests based on viral RNA, on detection of viral antigens or antibodies, associated with knowledge of the natural history of the virus, allows a critical analysis of the best diagnosis according to the patient's clinical, epidemiological, diagnostic objective and assay accuracy. Currently, there is a change in the immune pattern of the population and the description of types and subtypes of SARS-CoV-2 with genetic changes, which can lead to changes in diagnostic accuracy or the re-emergence in outbreaks of severe disease. Conclusion: The evolutionary path of the natural history of Covid-19 is still uncertain and diagnostic assays are at different stages of development, validation and production and each type of test has its own distinct advantages and disadvantages inherent in the technology platform of origin and a combination of types of tests used at different times can be useful for the clinical management of patients and in the control of the SARS-CoV-2 pandemic.

Introducción: Con la aparición del SARS-CoV-2, se dispuso de un gran número de herramientas diagnósticas. En este contexto, la falta de vacuna, tratamiento y el gran número de casos graves y muerte, permitieron la aprobación de urgencia de varias pruebas, que aún requieren estudios poblacionales para su registro definitivo. Objetivo: Realizar una revisión bibliográfica para evaluar las metodologías diagnósticas disponibles en Brasil, de acuerdo con la realidad sanitaria local, explorando el momento epidemiológico, la complejidad de la prueba y la finalidad de su aplicación. Metodología: Se trata de un estudio bibliográfico, descriptivo, del tipo revisión de literatura. Para las búsquedas se utilizaron las siguientes bases de datos científicas PUBMED, MEDLINE, LILACS Y COCHRANE LIBRARY, a través de descriptores seleccionados en la plataforma DECS. Resultados: El escenario de varias pruebas, basadas en diferentes metodologías, como pruebas basadas en el ARN viral, en la detección de antígenos virales o anticuerpos, asociado al conocimiento de la historia natural del virus, permite un análisis crítico del mejor diagnóstico de acuerdo con la clínica del paciente, epidemiológica, objetivo diagnóstico y precisión de la prueba. Actualmente, hay un cambio en el patrón inmunológico de la población y la descripción de tipos y subtipos de SARS-CoV-2 con cambios genéticos, que pueden conducir a cambios en la precisión diagnóstica o la reaparición en brotes de enfermedad grave. Conclusiones: El camino evolutivo de la historia natural del Covid-19 es aún incierto y los ensayos de diagnóstico se encuentran en diferentes etapas de desarrollo, validación y producción y cada tipo de prueba tiene sus propias ventajas y desventajas distintas inherentes a la plataforma tecnológica de origen y una combinación de tipos de pruebas utilizadas en diferentes momentos puede ser útil para el manejo clínico de los pacientes y en el control de la pandemia de SARS- CoV-2.

Efficacy and safety of single-dose ivermectin in mild-to-moderate COVID-19: the double-blind, randomized, placebo-controlled CORVETTE-01 trial.

Background: To investigate whether ivermectin inhibits SARS-CoV-2 proliferation in patients with mild-to-moderate COVID-19 using time to a negative COVID-19 reverse transcription-polymerase chain reaction (RT-PCR) test. Methods: CORVETTE-01 was a double-blind, randomized, placebo-controlled study (August 2020-October 2021) conducted in Japan. Overall, 248 patients diagnosed with COVID-19 using RT-PCR were assessed for eligibility. A single oral dose of ivermectin (200 µg/kg) or placebo was administered under fasting. The primary outcome was time to a negative COVID-19 RT-PCR test result for SARS-CoV-2 nucleic acid, assessed using stratified log-rank test and Cox regression models. Results: Overall, 112 and 109 patients were randomized to ivermectin and placebo, respectively; 106 patients from each group were included in the full analysis set (male [%], mean age: 68.9%, 47.9 years [ivermectin]; 62.3%, 47.5 years [placebo]). No significant difference was observed in the occurrence of negative RT-PCR tests between the groups (hazard ratio, 0.96; 95% confidence interval [CI] 0.70-1.32; p = 0.785). Median (95% CI) time to a negative RT-PCR test was 14.0 (13.0-16.0) and 14.0 (12.0-16.0) days for ivermectin and placebo, respectively; 82.1% and 84% of patients achieved negative RT-PCR tests, respectively. Conclusion: In patients with COVID-19, single-dose ivermectin was ineffective in decreasing the time to a negative RT-PCR test. Clinical Trial Registration: ClinicalTrials.gov, NCT04703205.

COVID-19: Impact, Diagnosis, Management and Phytoremediation

COVID-19, or SARS-CoV-2, is an extremely deadly virus that is responsible for over half a million deaths of people in the world. This virus originated in China in December 2019 and rapidly spread worldwide in 2-3 months, and affected every part of the world. Its life-threatening nature forced governments in all countries to take emergency steps of lockdown that affected the entire world's education, health, social and economic aspects. Due to the implementation of these emergencies, the population is facing psychological, social and financial problems. Additionally, this pandemic has significantly influenced the health care systems as all the resources from governments of all countries were directed to invest funds to discover new diagnostic tests and manage COVID-19 infection. The impact of the COVID-19 pandemic on the education and social life of the population is described in this article. Additionally, the diagnosis, management, and phytoremedia-tion to control the spread of COVID-19 and traditional medicinal plants' role in managing its mild symptoms have been discussed.Copyright © 2023 Bentham Science Publishers.

Pediatric Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): Clinical Characteristics and Cycle Threshold Value (CT value) of Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) of Nasopharyngeal Samples

Introduction: We aimed to characterize epidemiological and clinical characteristics of children and adolescents with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, and to evaluate relationship of cycle threshold value (CT value) of Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) test (As surrogate marker of viral load) with patient age and severity of infection. Method(s): We retrospectively collected data of children and adolescents admitted in our center from April 2020 to July 2020 with positive RT-PCR test for SARS-CoV-2. Result(s): Total 62 children, with median (IQR) of age 96 (54-122) months and 39 adolescents with median (IQR) of age 19.5 (18.2-20) years were included. 56 (90%) children and 34 (87%) adolescents had history of SARS-CoV-2 positive cases in their family. Only nine (14%) children had associated risk factor for severe SARS-CoV-2 infection. Fever was the commonest symptom which was present in 24 (39%) children and 16 (41%) adolescents. Cough was present in 17 (27%) children and 10 (26%) adolescents. Diarrhea was found in 14 (23%) children and three (8%) adolescents. CT values of RT-PCR test were similar in children and adolescence (p = 0.48). However, asymptomatic children had higher CT values than symptomatic children (p = 0.01). Conclusion(s): Majority of children have asymptomatic or mild SARS-CoV-2 infection with similar CT values in children and adolescents.Copyright © 2022 by author(s).

Effective Health Screening and Prompt Vaccination to Counter the Spread of COVID-19 and Minimize Its Adverse Effects

Precautionary measures are the best conceivable ways to impede the spreading of COVID-19 disease. Initial stage detection, proper analysis, suitable confinement, effective therapy and prompt vaccination are the key consideration to inhibit expedite transmission. Precautions are primarily concentrated on effective health screening, efficient treatment, and vaccination on time for each and every individual. Before the invention of COVID-19 vaccine, proper health checking or explorations are of predominant concern from therapeutic viewpoint as avoidance is superior than healing. At present scenario, impressive health screening through RT-PCR test, rapid antigen test, etc. is very imperative to identify Corona-positive cases in early stages even there is no disorders or symptoms of COVID-19 infection. Faster vaccination of most of the people, irrespective of cast, religion, and economic conditions, is indispensable to prohibit the transportation of such growing disorder and minimize its adverse effects. Recent literature reveals that most of the vaccines are safe and effective against coronavirus. A potent and competent vaccine lessens mild to moderate and serious conditions of COVID-19 patients regardless of comorbidities. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023.

Psychological status of medical staff dedicated to nucleic acid collection in COVID-19 epidemic during closed-loop management: A cross-sectional study.

Background: To investigate the depression, anxiety and somnipathy situation occurred in the nucleic acid collection staff during the closed-loop management period of COVID-19. And try to understand the influencing factors of related psychological status. Methods: A cross-sectional study of 1,014 nucleic acid collection staff from seven Chinese hospitals was conducted. Various investigation methods were involved in the questionnaires to collect data, including 12-items self-made questionnaire survey of basic demographic information, 9-items patient health questionnaire depression scale (PHQ-9), 7-items generalized anxiety disorder scale (GAD-7) and Pittsburgh sleep quality index (PSQI). Data analysis was performed using SPSS version 26.0 and Excel software. Mann-Whitney U-test, Chi-square test, correlation analysis, mono-factor analysis and binary logistic regression were applied accordingly for further analysis. Results: The positive rate of depression, anxiety and sleep disorder of 1,014 nucleic acid collectors under closed-loop management were 33.5, 27.2, and 50.1%, respectively. Depression was significantly positively correlated with anxiety and sleep (P < 0.05). The scores of depression scale were positively correlated with the age and the fear for infection (r = 0.106, 0.218, both P < 0.05); The scores of anxiety scale were also positively correlated with the age and the fear for infection (r = 0.124, 0.225, both P < 0.05); The length of service, collection time and the degree of worry about infection and was positively correlated with the score of sleep scale (r = 0.077, 0.074, 0.195, both P < 0.05); Education level had a significant negative association with PHQ-9, GAD-7 and PSQI (r = -0.167,-0.172, both P < 0.05). Binary logistic regression analysis showed that age, technical title, education level, collection time, collection frequency, collection location, fear for infection and external environment were important influencing factors of depression, anxiety and sleep disorders. Conclusion: The results of this study suggested that when carrying out nucleic acid collection mission, managers should intervene to optimize the collection location, control the duration of each collection mission, replace the collection staff in time and pay close attention to the psychological state of the collection staff.

Oral lesions with immunohistochemical evidence of Sars-CoV-2 in swab-negative post-COVID syndrome.

OBJECTIVES: Growing evidence exists about post-COVID condition/syndrome as sequelae of Sars-CoV-2 infection in healed patients, possibly involving the lungs, brain, kidney, cardiovascular and neuromuscular system, as well the persistency of taste dysfunction. Such symptoms develop during or after infection and continue for more than 12 weeks with pathogenesis related to virus persistency but variable by organs or systems. MATERIALS AND METHODS: We recently observed six patients recovered from COVID-19 and with negative RT-PCR testing, showing oral mucosa lesions (mainly ulcers) overlapping those occurring in the acute phase, persisting up to 20 days and thus needing a biopsy with histological investigation and spike protein evaluation by immunohistochemistry. RESULTS: We found epithelial ulceration, inflammatory infiltrate, vessels with increased diameter and flattened endothelium but no thrombi formation; also, we found a weak epithelial SARS-CoV-2 positivity limited to the basal/spinosum layers, progressively decreasing toward the periphery, and the intraepithelial lymphomonocytes, endothelium, and perivascular pericytes too. CONCLUSIONS: Our findings provide evidence that SARS-CoV-2 can persist, as for other organs/systems, also in the oral epithelium/mucosa after the acute phase and can be responsible for lesions, although by a pathogenetic mechanism that should be better defined but certainly referable as the oral mucosa counterpart of post-COVID syndrome.

Effectiveness of COVID-19 Vaccines against SARS-CoV-2 Infection among Persons Attending the RT-PCR center at a Medical College Hospital in Telangana: A Case- Control Study.

Background: In January 2021, India's drug regulator issued restricted emergency approval for COVISHIELD and COVAXIN, which were manufactured in India. In mid-January 2021, in India, there were 10.5 million confirmed cases and 0.15 million deaths. The objectives were to evaluate vaccine effectiveness (VE) of coronavirus disease 2019 (COVID-19) vaccines made in India against severe acute respiratory syndrome coronavirus disease 2 (SARS-CoV-2) infection. Materials and Methods: A test-negative case-control study was conducted from May 2021 to December 2021 for a duration of 8 months among people attending a reverse transcriptase polymerase chain reaction (RT-PCR) center at a medical college hospital for RT-PCR test for SARS-CoV-2. The baseline characteristics and RT-PCR report were collected from the RT-PCR center. The exposure to COVID-19 vaccines was enquired via phone call or was checked with data available with the health authorities. Results: After applying inclusion and exclusion criteria and case and control definitions, a total of 380 participants (95 cases and 285 controls) were included. The adjusted VE of two doses of COVISHIED vaccine against symptomatic SARS-CoV-2 infection was 52.2% (41.7 to 62.1), and that of a single dose was 40.88% (31.26 to 51.29). The adjusted VE of two doses of COVAXIN vaccine against SARS-CoV-2 infection was 39% (29.40 to 49.27). The overall VE was 48.20% (37.90 to 58.22) for two doses of any vaccines. Conclusions: Vaccines made in India were nearly 50% effective. Further new studies should be conducted as new variants of SARS-CoV-2 are emerging. We do not know the VE against the variants, and whether booster doses are required or not is not yet established.

The COVID-19 Pandemic and Health Inequities in the State of Sergipe / A Pandemia de COVID-19 e Iniquidades em Saúde no Estado de Sergipe

O estudo analisa a associação das taxas de incidência e mortalidade por COVID-19 nos municípios do estado de Sergipe ­ Brasil com indicadores de vulnerabilidade social e desenvolvimento humano utilizados no país; e com a taxa de realização de exames RT PCR para diagnóstico da doença realizados por município. Trata-se de estudo ecológico dos casos e óbitos por COVID-19 acumulados de março de 2020 a março de 2021, ocorridos no Estado de Sergipe por município; e sua correlação com o Índice de Vulnerabilidade Social (IVS), Índice de Desenvolvimento Humano Municipal (IDHM) e quantidade de testes RT PCR realizados para diagnóstico da doença, utilizando a correlação de Spearman (ρ). Contrariando nossas hipóteses e a literatura científica, os municípios com maiores índices de vulnerabilidade social e menor desenvolvimento humano tiveram menos casos da doença e óbitos por habitante, ao mesmo tempo que testaram menos para o diagnóstico da COVID-19. O estudo aponta a iniquidade como fator a ser superado no enfrentamento da pandemia, por prejudicar um diagnóstico de cenário mais próximo da realidade, comprometendo o planejamento e implementação de medidas de saúde coletiva.

This study analyzes the association of incidence and mortality rates by COVID-19 in the municipalities of the state of Sergipe, Brazil with indicators of social vulnerability and human development used in the country, as well as with the rate of RT-PCR exams for the diagnosis of the disease performed by each municipality. This is an ecological study of COVID-19 cases and deaths accumulated from March 2020 to March 2021, which occurred in the State of Sergipe by municipality; and its correlation with the Social Vulnerability Index (SVI), Municipal Human Development Index (MHDI), and number of RT-PCR tests performed to diagnose the disease, using Spearman's correlation (ρ). Contrary to our hypotheses and the scientific literature, municipalities with higher rates of social vulnerability and lower human development had fewer cases of the disease and deaths per inhabitant, while testing less for the diagnosis of COVID-19. The study points to inequity as a factor to be overcome in the face of the pandemic, as it impairs a proper diagnosis of the scenario closer to reality, compromising the planning and implementation of collective health measures.

Covid Prediction and Covid Detection via X-Ray Images

The situation of the novel coronavirus is deteriorating day by day. There are more than 373 million cases recorded across the globe to date. The first incident of the disease was reported in China's Wuhan province in the month of December 2019. The virus is called COVID-19 which is an abbreviation for Corona Virus Disease 2019 or 2019-nCoV. The covid virus belongs to the same virus family as SARS, which stands for the severe acute respiratory syndrome. To date, approx. 5.5 million people have died due to the virus. The worst affected countries are the USA, India, Brazil, France, and Turkey. Most countries face the Second Wave of the coronavirus, which is more dangerous than the previous wave. India is currently passing through a rough phase, registering more than 50,000 positive cases daily for the past few weeks. Around 1000 people are dying every day as per the official data issued by government bodies. With a population of 1.4 billion people, it is challenging to break the chains of the spread of the disease. The country is facing serious medical shortages which include Oxygen support, medicines, ICUs, and Ventilators. A sudden surge of the cases created a panic situation across the country. It is nearly impossible to calculate the actual cases and the number of deaths. The conventional Rapid Antigen tests and RT-PCR tests (i.e., real-time polymerase chain reaction) are not completely efficient and quick. The Rapid Antigen tests have just 50 -60% accuracy, and the RT-PCR test takes 24 to 48 hours to declare whether a person is Covid positive or negative. Time plays an important role during covid. The early the infection can be detected, the early that person can start his/her medications, consult a doctor, and isolate himself/herself to prevent further spreading of the virus. So, in this study, X-Ray scans are used to ascertain whether a person is covid positive or not in few seconds. A Machine Learning model is also included in the study to forecast the number of instances in the next few days. © 2022 IEEE.

Diagnostic Performance of Standard and Inverted Grey-Scale CXR in Detection of Lung Lesions in COVID-19 Patients: A Single Institute Study in the Region of Abu Dhabi

Purpose: This study aimed at evaluating the diagnostic performance of standard greyscale and inverted greyscale Chest X-ray (CXR) using Computed Tomography (CT) scan as a gold standard. Methods: In this retrospective study, electronic medical records of 120 patients who had valid CXR and High-resolution CT (HRCT) within less than 24 hours after having a positive COVID-19 RT-PCR test during the period from May 19th to May 23rd, 2020, in a single tertiary care center were reviewed. PA chest radiographs were presented on 2 occasions to 5 radiologists to evaluate the role and appropriateness of standard greyscale and inverted greyscale chest radiographs (CXR) when images are viewed on high-specification viewing systems using a primary display monitor and compared to computed tomography (CT) findings for screening and management of suspected or confirmed COVID-19 patients. Results: Ninety-six (80%) patients had positive CT findings, 81 (67.5%) had positive grey scale CXR lesions, and 25 (20.8%) had better detection in the inverted grey scale CXR. The CXR sensitivity for COVID-19 pneumonia was 93.8% (95% CI (86.2% - 98.0%) and the specificity was 48.7% (95% CI (32.4% - 65.2%). The CXR sensitivity of detecting lung lesions was slightly higher in male (95.1% (95% CI (86.3% - 99.0%)) than female (90.0% (95% CI (68.3% - 98.8%)), while the specificity was 48.0% (95% CI (27.8% - 68.7%) and 50.0% (95% CI (23.0% - 77.0%) in males and females, respectively. However, no significant difference was detected in ROC area between men and women. Conclusion: The sensitivity of detecting lung lesions of CXR was relatively high, particularly in men. The results of the study support the idea of considering conventional radiographs as an important diagnostic tool in suspected COVID-19 patients, especially in healthcare facilities where there is no access to HRCT scans. CXR shows high sensitivity for detecting lung lesions in HRCT confirmed COVID-19 patients. Better detection of lesions was noted in the inverted greyscale CXR in 20.8% of cases, with positive findings in standard greyscale CXR. Conventional radiographs can be used as diagnostic tools in suspected COVID-19 patients, especially in healthcare facilities where there is no access to HRCT scans. © 2022 Al Helali et al.

Clinical Characteristics of Patients Returning to Emergency Department With Initial False-Negative Reverse Transcriptase Polymerase Chain Reaction (RT-PCR)-Based COVID-19 Test.

Background: The coronavirus disease 2019 (COVID-19) outbreak is an international public health emergency. Early identification of COVID-19 patients with false-negative RT-PCR tests is paramount in the ED to prevent both nosocomial and community transmission. This study aimed to compare clinical characteristics of repeat emergency department (ED) visits among coronavirus disease 2019 (COVID-19) patients with initial false-negative reverse transcriptase-polymerase chain reaction (RT-PCR)-based COVID-19 test. Methods: This is a retrospective, multi-center, cohort study conducted at 12 hospitals affiliated with Baylor Scott & White Health system. Patients visiting the EDs of these hospitals between June and August 2020 were screened. Patients tested negative for viral RNA by quantitative RT-PCR in the first ED visit and positive in the second ED visit were included. The primary outcome was the comparison of clinical characteristics between two consecutive ED visits including the clinical symptoms, triage vital signs, laboratory, and chest X-ray (CXR) results. Results: A total of 88 confirmed COVID-19 patients with initial false-negative RT-PCR COVID-19 test in the ED were included in the final analyses. The mean duration of symptoms in the second ED visit was significantly higher (3.6 ± 0.4 vs. 2.6 ± 0.3 days, p = 0.020). In the first ED visit, lymphocytopenia (35.2%), fever (32.6%), nausea (29.5%), and dyspnea (27.9%) are the most common signs of COVID-19 infection during the window period. There were significant increases in the rate of hypoxia (13.6% vs. 4.6%, p = 0.005), abnormal infiltrate on CXR (59.7% vs. 25.9%, p < 0.001), and aspartate aminotransferase (AST) elevation (26.1% vs. 9.1%, p < 0.001) in the second ED visit. Conclusions: Early COVID-19 testing (less than 3 days of symptom duration) could be associated with a false-negative result. In this window period, lymphocytopenia, fever, nausea, and dyspnea are the most common early signs that can potentially be clinical hints for COVID-19 diagnosis.

Evaluation of Cost-Benefit and Measures During the COVID-19 Pandemic for Incoming Travelers Through Tests in Origin in Spain.

Background: The World Health Organization has promoted preventive measures for reducing the impact of the pandemic. One of these measures was tests in origin for travelers. Testing strategies for COVID-19 facilitate the overall public health response to the pandemic and contributes to minimize the infection among the population COVID-19. Goal: In this work, we assess the efficiency of diagnostic testing of incoming travelers in the Canary Islands, Spain, during a period of 4 months, with a focus on the economic impact for the regional government. We study the cost-benefit of this measure as well as the potential influence on the number of positive cases in the population. Methods: We processed the real data in the Canary Islands of pre-flight PCR and antigen tests that were required to the residents when traveling back to the Canaries from anywhere in Spain in a period of 4 months, from 14 December, 2020 to 4 April, 2021. As a result, we calculated the economic impact of doing those tests and compare them with the estimated costs of passengers under the hypothesis of entering the islands without testing. The cost-benefit was obtained for different scenarios, where the incoming passengers generated hospitalization and intensive care unit (ICU) costs directly and via transmissions. Results: The incoming testing funded by the government, if applied during the bad evolution of the pandemic with 1.2 ratio of transmission, clearly saved money to the public health system. In addition to the economic impact of this measure, we estimated the potential influence on the number of positive cases in the population according to different scenarios of the propagation of the pandemic. At the beginning of February 2021, the savings were about €130.551,47, with a 95% confidence interval (CI) of €24.677,94-236.425,00. By the end of April 2021, the savings were above €2,000,000 (€2.284.788,50 on average and 95% CI of €2.092.914,84-2.476.662,16) and the savings increased as the pandemic evolved. At the end of the period, the savings were twice the expenses. Conclusions: Testing in origin has proved to be a good measure that helped to mitigate COVID-19 spread among regions. Our results confirm that the free PCR or rapid antigen tests produce relevant savings to the public budget. We studied 61.990 reported data during 2020 and 2021 from the travelers from national flights, against 346.449 of total incoming travelers to the Canary Islands in this period. The measure pursued by the Government of the Canary Islands of providing free tests for residents showed a clear benefit for both, limiting the propagation of COVID-19 and reducing the costs of the hospitalizations and ICU admissions. It should be noted that the free testing measure in this period was before starting the vaccination campaigns. As measure of public health in the airports, testing helped to control and make the mobility of travelers secure.

Evaluation of SARS-CoV-2 transmission in COVID-19 isolation wards: On-site sampling and numerical analysis.

Although airborne transmission has been considered as a possible route for the spread of SARS-CoV-2, the role that aerosols play in SARS-CoV-2 transmission is still controversial. This study evaluated the airborne transmission of SARS-CoV-2 in COVID-19 isolation wards at Prince of Wales Hospital in Hong Kong by both on-site sampling and numerical analysis. A total of 838 air samples and 1176 surface samples were collected, and SARS-CoV-2 RNA was detected using the RT-PCR method. Testing revealed that 2.3% of the air samples and 9.3% of the surface samples were positive, indicating that the isolation wards were contaminated with the virus. The dispersion and deposition of exhaled particles in the wards were calculated by computational fluid dynamics (CFD) simulations. The calculated accumulated number of particles collected at the air sampling points was closely correlated with the SARS-CoV-2 positive rates from the field sampling, which confirmed the possibility of airborne transmission. Furthermore, three potential intervention strategies, i.e., the use of curtains, ceiling-mounted air cleaners, and periodic ventilation, were numerically investigated to explore effective control measures in isolation wards. According to the results, the use of ceiling-mounted air cleaners is effective in reducing the airborne transmission of SARS-CoV-2 in such wards.

Clinical Presentations of Suspected and Confirmed COVID-19 Cases in Shahroud, Iran

Background & Objective: COVID-19 is a serious disease with different symptoms and risk factors infecting and killing many people around the world. This study was performed to investigate the demographic and clinical characteristics of COVID-19 suspects referred to the hospitals and coronavirus treatment centers of Shahroud, Iran. Materials & Methods: Upon the outbreak of the COVID-19 epidemic in Shahroud, Shahroud University of Medical Sciences launched a project to systematically record the demographic, clinical, and medical data of all suspects referred to the Corona Center. In this study, the data of 3945 suspected people collected during 5 months were analyzed. The RT-PCR test was used as the criterion for diagnosing the disease. Results: Among 3945 suspected cases, 24.4% had positive RT-PCR test. The mean age of confirmed cases was 52.16 years. Dry cough and fever in addition to anorexia were reported as the most common symptoms. The results of logistic regression analysis showed that people over 60 years with heart disease reduce the risk, while people over 60 years, diabetics, and obese people increase the risk of infection. Conclusion: These results necessitate further lines of research into different symptoms and risk factors to help identify COVID-19 cases earlier and start faster treatment. © 2022, Zanjan University of Medical Sciences and Health Services. All rights reserved.

Quarantine and testing strategies to ameliorate transmission due to travel during the COVID-19 pandemic: a modelling study.

BACKGROUND: Numerous countries have imposed strict travel restrictions during the COVID-19 pandemic, contributing to a large socioeconomic burden. The long quarantines that have been applied to contacts of cases may be excessive for travel policy. METHODS: We developed an approach to evaluate imminent countrywide COVID-19 infections after 0-14-day quarantine and testing. We identified the minimum travel quarantine duration such that the infection rate within the destination country did not increase compared to a travel ban, defining this minimum quarantine as "sufficient." FINDINGS: We present a generalised analytical framework and a specific case study of the epidemic situation on November 21, 2021, for application to 26 European countries. For most origin-destination country pairs, a three-day or shorter quarantine with RT-PCR or antigen testing on exit suffices. Adaptation to the European Union traffic-light risk stratification provided a simplified policy tool. Our analytical approach provides guidance for travel policy during all phases of pandemic diseases. INTERPRETATION: For nearly half of origin-destination country pairs analysed, travel can be permitted in the absence of quarantine and testing. For the majority of pairs requiring controls, a short quarantine with testing could be as effective as a complete travel ban. The estimated travel quarantine durations are substantially shorter than those specified for traced contacts. FUNDING: EasyJet (JPT and APG), the Elihu endowment (JPT), the Burnett and Stender families' endowment (APG), the Notsew Orm Sands Foundation (JPT and APG), the National Institutes of Health (MCF), Canadian Institutes of Health Research (SMM) and Natural Sciences and Engineering Research Council of Canada EIDM-MfPH (SMM).

Hearing loss in patients with and without COVID-19 before and alter recovery from positive cases

Introduction and objective: There are still few studies on the damage of COVID-19 in hearing, so initial evaluations and their follow-up are recommended, the objective of this study was to compare the degree and type of hearing loss in subjects with and without COVID-19 at the beginning of the disease and after their recovery of whom their positivity was confirmed. Method: prospective, comparative non-experimental study. After signing the informed consent to a voluntary sample of 105 subjects who came to confirm positivity for COVID-19, they underwent tonal audiometry and a reassessment after their recovery of the positives. Results: Sensory superficial hearing loss was more frequent in the group aged 35 to 50 years, in the group negative to SARS-Cov-2, the results before-after the recovery of the positive ones was significant in the average of 7 frequencies and medium frequencies. Discussion: The results of this study coincide with what has been published in relation to the type and degree of hearing loss, age and non-perception of it, the diversity of COVID-19 symptoms without differences between the groups with and without COVID-19. Differences in the averages of pure tones at 7 frequencies and mid-frequencies not reported for contrast. Conclusions: the type and degree of hearing loss was as expected with respect to age, the differences in the averages before and after were better in the second evaluation, probably due to the resolution of the inflammatory condition. It is recommended to increase the sample and add an objective evaluation of the ear half.

Rapid detection of the widely circulating B.1.617.2 (Delta) SARS-CoV-2 variant.

The emergence of the B.1.617.2 (Delta) variant of the severe acute syndrome coronavirus (SARS-CoV-2) that emerged in 2019 (COVID-19), resulted in a surge of cases in India and has expanded and been detected across the world, including in the United States. The B.1.617.2 (Delta) variant has been seen to be twice more transmissible coupled with potential increases in disease severity and immune escape. As a result, case numbers and hospitalisations are once again on the rise in the USA. On 16 July 2021, the Centers for Disease Control and Prevention (CDC) reported a 7-day average 69.3% increase in new cases and a 35% increase in hospitalisations. Although the gold standard for SARS-CoV-2 variants identification remains genomic sequencing, this approach is not accessible to many clinical laboratories. The main goal of this study was to validate and implement the detection of the B.1.617.2 (Delta) variant utilising an open reverse transcription polymerase chain reaction (RT-PCR) platform by explicitly detecting the S-gene target failure (SGTF) corresponding to the deletion of two amino acids (ΔE156/ΔF157) characteristic of B.1.617.2 (Delta) variant. This approach was conceived as a rapid screening of B.1.617.2 (Delta) variant in conjunction with CDC's recommended N1 (nucleocapsid gene), N2, and RP (human RNase P) genes, as a pre-screening tool prior to viral genomic sequencing. We assessed 4,937 samples from 5 July to 5 September 2021. We identified the B.1.617.2 (Delta) variant in 435 of 495 positive samples (87.8%); the additional positive samples (7 samples, 1.4%) were found to belong to the B.1.1.7 (Alpha, UK) lineage and the remaining 53 samples (10.7%) were reported as 'other' lineages. Whole genome sequencing of 46 randomly selected samples validated the strains identified as positive and negative for the B.1.617.2 (Delta) variant and confirmed the S gene deletion in addition to B.1.617.2 characteristic mutations including L452R, T478K, P681R and D950N located in the spike protein. This modality has been used as routine testing at the Riverside University System Health (RUHS) Medical Center as a method for detection of B.1.617.2 (Delta) to pre-screen samples before genome sequencing. The assay can be easily implemented in clinical laboratories, most notably those with limited economic resources and access to genomic platforms.

MobEVID: A Smartphone-based RT-PCR Testing Record Capturing Application for COVID-19 Cases

The pandemic due to coronavirus is responsible for serious illness and deaths among individuals. Lately, Reverse transcription polymerase chain reaction testing is considered a benchmark to identify severe acute respiratory syndrome-Associated coronavirus around the world. Along with the test, various necessary information such as clinical characteristics as well as the pre-existing medical history of the patients is needed to analyze the risk of them. In Bangladesh, these records are usually collected by health workers from different test centers in a manual way which may be erroneous. To perform this task more efficiently, we have developed a smartphone-based RT-PCR testing app named mobEVID to aid the health workers as well as patients. Finally, we have taken some reviews from different agents and patients to evaluate the functionality and effectiveness of this app. Their feedback confirms that this promising application is very effective in terms of user-friendliness as well as providing required services. © 2021 IEEE.

COVID-19 screening in a Portuguese pediatric population.

OBJECTIVE: To assess the characteristics of suspected coronavirus disease 19 (COVID-19) and the rate of confirmed COVID-19 in a pediatric population at the beginning of the pandemic in Portugal. STUDY DESIGN: Suspected COVID-19 pediatric cases that were tested in a Portuguese hospital between March 17 and April 2 2020 were included in this descriptive retrospective study. The analyzed data included socio-demographic parameters, characteristics of the household, underlying medical conditions and symptoms. RESULTS: Ninety-four patients were included and all of them were symptomatic and treated without hospitalization. The most common symptoms were cough (80%;n=75), rhinorrhea (72%;n=68) and fever (60%;n=56). There was only one positive for SARS-CoV-2 in a five-year-old child with mild illness without epidemiologic linkage. CONCLUSION: This study showed a low rate of confirmed COVID-19 in children. The causes for this low rate can be multifactorial and illustrates how differently this virus spreads in the pediatric population.