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.

Clinical and laboratory characteristics of SARS-CoV-2 infection in overweight and obese patients.

Objective. To assess the impact of obesity and overweight on the course of COVID-19. Patients and methods. This prospective study included 218 patients with SARS-CoV-2 infection aged 18 to 94 years hospitalized between June 2020 and March 2021. We evaluated their clinical and laboratory parameters and their association with body weight. All patients were divided into 3 groups depending on their body mass index (BMI). Group 1 included 81 patients with grade 1-3 obesity (BMI >=30);group 2 comprised 71 overweight patients (BMI >=25 and <30);group 3 included 66 patients with normal body weight (BMI >=18.5 and <25). We analyzed clinical symptoms (including shortness of breath, fever, myalgia, headache, fatigue, changes in the oropharynx, cough, rhinorrhea, sore throat, anosmia, and diarrhea), prevalence of concomitant disorders and complications, findings of computed tomography and pulse oximetry, and findings of instrumental and laboratory examinations (complete blood count, urine test, electrocardiography, echo cardiography, biochemical assays, including C-reactive protein, procalcitonin, alanine aminotransferase, aspartate aminotransferase, lactate, lactate dehydrogenase, activated partial thromboplastin time, prothrombin index, D-dimer, ferritin). Data analysis was performed using the Statistica 6.0 software. Results. We found that overweight and obese patients were more likely to have the main COVID-19 symptoms and comorbidities than those with normal weight. Overweight and obese patients also required respiratory support more frequently than patients with normal weight. Obese and overweight patients had more severe systemic inflammation (CRP, procalcitonin), cytolysis (ALT, AST), and thrombosis (D-dimer). Conclusion. Our findings suggest that obesity and overweight are the factors associated with a more severe SARS-CoV-2 infection, which should be considered when planning their treatment and developing resource strategies.Copyright © 2022, Dynasty Publishing House. All rights reserved.

Clinical identification and severity in patients with COVID-19

The clinical evaluation of the patient with COVID-19 allows better care, application of safety criteria and preventive measures. The disease progresses from mild to severe and critical. In this work, is evaluated in patients with COVID-19 clinical format to identify moderate to severe stages of the disease. Following a cohort of male and female patients over 18 years of age admitted to the Infectology Service of the General Hospital of Mexico. Each patient is studied using the"COVID-19 Infectology"clinical format and in the first 24 hours of admission, a real-time RT-PCR molecular test is performed for SARS-CoV-2 infection. 65 patients classified as severe COVID-19 were studied, the RT-PCR was positive in 60 patients and negative in 5, clinical data did not differ from the positive ones and the 5 negative were considered false negative cases of the molecular test. There were no differences between positives and negatives with Fisher's test, and no difference in age, comorbidities, or prognostic evaluation with Student's t test. The conclusion is that the clinical format"COVID-19 Infectology"allows to recognize the cases and identify those that are in a severe evolution.Copyright /© 2021 Sociedad Medica del Hospital General de Mexico. Published by Permanyer.

Managing Severe Acute Asthma Exacerbation in Pregnancy during the COVID-19 Pandemic: A Case Report from a Resource-limited Setting

BACKGROUND: One-third of pregnant women will experience worsening asthma requiring emergency hospitalization. However, no report comprehensively discussed the management of asthma attacks in pregnant women in impoverished settings. We attempt to illuminate what general practitioners can do to stabilize and improve the outcome of severe acute asthma exacerbations in primary care with resource limitations. CASE REPORT: A nulliparous 29-year-old woman in her 21st week of pregnancy presented severe acute asthma exacerbation in moderate persistent asthma with uncontrolled asthma status along with gestational hypertension, uncompensated metabolic acidosis with a high anion gap, anemia, respiratory infection, and asymptomatic bacteriuria, all of which influenced her exacerbations. This patient was admitted to our resource-limited subdistrict hospital in Indonesia during the COVID-19 pandemic for optimal stabilization. Crystalloid infusions, oxygen supplementation, nebulized beta-agonist with anticholinergic agents, inhaled corticosteroids, intravenous methylprednisolone, broad-spectrum antibiotics, subcutaneous terbutaline, mucolytics, magnesium sulphate, oral antihypertensives, and continuous positive airway pressure were used to treat her life-threatening asthma. After she was stabilized, we referred the patient to a higher-level hospital with more advanced pulmonary management under the supervision of a multidisciplinary team to anticipate the worst scenario of pregnancy termination. CONCLUSION(S): Limitations in primary care, including the lack of sophisticated intensive care units and laboratory panels, may complicate challenges in managing severe acute asthma exacerbation during pregnancy. To enhance maternal-fetal outcomes, all multidisciplinary team members should be well-informed about key asthma management strategies during pregnancy using evidence-based guidelines regarding the drug, rationale, and safety profile.Copyright © 2023 Muhammad Habiburrahman, Triya Damayanti, Mohammad Adya Firmansha Dilmy, Hariyono Winarto.

Respiratory syncytial virus: desperately seeking solutions

Respiratory syncytial virus (RSV) infection remains a major public health problem, especially in younger children and the elderly. But several monoclonal antibodies, antivirals and vaccines, either recently launched or in development, offer new hope for RSV prevention and treatment.Copyright © 2023 Wiley Interface Ltd.

Sars cov-2 infection in a neonate in ghana: A case report

Backgrounds: The clinical and socioeconomic effects of COVID-19 are still being felt through-out the world. The disease affects people of all age groups, but it is known to have a milder clinical course in children including neonates. There is paucity of data from Sub-Saharan Africa on neonatal COVID-19 infection, and no such case has been reported in the literature in Ghana. Case presentation: This study presented a case report of a neonate who was found to be positive for COVID-19 infection after presenting symptoms such as respiratory distress, rhinorrhoea, and cough. This neonate was managed with in-hospital standard protocol for sepsis with a focus on pneumonia. Conclusion(s): The national guidelines on COVID-19 management were used for the neonate who was recovered and discharged.Copyright © 2021, TMU Press.

COVID-19 in Ultramarathon Runners: Findings of The Ultrarunner Longitudinal TRAcking Study

Purpose: Ultramarathon runners are a unique patient population who have been shown to be free of nearly all severe chronic medical conditions. The effect that COVID-19 infection has on this population and their running behavior is unknown. Method(s): The Ultrarunner Longitudinal TRACking Study (ULTRA Study) is the largest known longitudinal study of ultramarathon runners. Questions on general health status, running behavior, performance, and COVID-19 infection were included. Result(s): Six hundred sixty-two ultramarathon runners participated in the study. This group exercised an average of 10.0 hours per week, including running an average of 26.8 miles per week;52.1% of ultramarathon runners reported ever being symptomatic from a COVID-19 infection with 6.3% testing positive multiple times. Severe infection occurred in 0.3% (2 patients) requiring a total of 3 days of hospitalization. Of those who were infected, 84% were fully vaccinated at the time of their infection;67% of infections effected running for a mean of 33.1 days. The most common other symptoms included fever (73.3%), fatigue (68.7%), sore throat (67.5%), runny nose (67.0%), and cough (66.7%). Cardiovascular symptoms, which are of particular interest in the running population, included shortness of breath (46.4%), increased heart rate (45.2%), chest pain (34.2%), and wheezing (32.5%). Of 662, 48 (7.3%) of ultrarunners reported Long COVID (symptoms lasting more than 12 weeks). Conclusion(s): Severe COVID-19 infection is rare in ultramarathon runners, although symptomatic infection that affects running is common. These rates, along with Long COVID, are lower than is reported in the literature for the population on average. Significance: Ultrarunners are at very low risk of COVID- 19 symptoms requiring hospital care but significant risk of infection that effects running. Cardiovascular symptoms are common, and the long-term significance of these symptoms in runners is unknown.

Smell disorders associated with COVID-19 infection

Background: We performed a search in the PubMed databases, Web of Science, LILACS, MEDLINE, SciELO, and Cochrane Library using the keywords COVID-19, Novel coronavirus, corona, 2019-nCoV, SARS-CoV-2, ENT, nose, anosmia, hyposmia, smell, olfactory, ORL, different ENT related symptoms. We reviewed published and peer-reviewed studies that reported the ENT manifestations in COVID-19 laboratory-confirmed positive patients. Main text: Within the included 2549 COVID-19 laboratory-confirmed positive patients, smell affection was reported in 1453 patients (57%). The other reported ENT manifestations were taste disorder (49.2%), headache (42.8%), nasal blockage (26.3%), sore throat (25.7%), runny nose or rhinorrhea (21.3%), upper respiratory tract infection (URTI) (7.9%), and frequent sneezing (3.6%). Conclusion(s): Smell affection in COVID-19 is common and could be one of the red flag signs in COVID-19 infection. With a sensitivity of utilized questionnaire in smell identification, a homogenous universal well-defined COVID-19 questionnaire is needed to make the COVID-19 data collection more sensible.Copyright © 2021, The Author(s).

Clinical Outcome of Systemic Lupus Erythematosus during the Covid-19 Omicron Variantwave Compared to Previous Periods: Results from a Single Center Cohort of Puerto Rico

Objectives: Variant-related differences of SARS-CoV-2 have been reported such as higher transmissibility but less disease severity in omicron sublineages when compared to other variants. Although some studies have examined the outcomes of COVID-19 in systemic lupus erythematosus (SLE), most were conducted during the initial waves. Thus, we sought to compare the clinical outcomes of SLE patients with COVID-19 during the omicron and pre-delta/delta periods. Method(s): A cohort of adults with SLE from a single center in Puerto Rico was studied. SARS CoV-2 infection was confirmed by polymerase chain reaction or antigen tests. The pre-delta/delta variants period was defined as March 2020 to November 2021 and the omicron period as December 2021 to October 2022. Demographic parameters, cumulative SLE manifestations, disease activity, disease damage, lupus treatments, comorbidities, COVID-19 symptoms, SLE exacerbations, and hospitalizations were compared between the study periods using bivariate and multivariate analyses. Result(s): Of the entire SLE cohort (n = 347), 151 patients (43.5%) had COVID-19. In those with COVID-19, the mean (SD) age was 46.7 (12.5) years and 96.0% were women. Overall, clinical outcomes were favorable with low rates of hospitalizations (2.6%), lupus flares (3.3%), and mortality (0.7%). In 14.6% of cases, COVID-19 occurred during the pre-delta/delta period and in 85.4% during the omicron wave. Patients that had COVID-19 during the predelta/ delta period were younger and had a significantly higher proportion of oral ulcers, psychosis, anti-Smith antibodies, coronary artery disease, and chronic kidney disease compared to those during the omicron wave. Among COVID-19 symptoms, runny nose, cough, and sore throat were more common in the omicron period, whereas anosmia and anorexia were more frequent in the pre-delta/delta period. In the multivariable analyses adjusted by age, all variables retained significance except for psychosis, anti-Smith antibodies, and coronary artery disease. No significant differences were observed for other variables. Conclusion(s): In this group of Puerto Ricans with SLE, a higher proportion had COVID-19 during the omicron wave compared to previous periods. No differences were seen for severe outcomes such as hospitalizations, lupus flares, and mortality. Furthermore, COVID-19 did not appear to have a negative impact on the short-term clinical outcomes of these patients, regardless of the variant period examined.

Clinical manifestations and emotional disorders in patients with new coronavirus infection (COVID-19)

The Novel Coronavirus Disease (COVID-19) is characterized by a variety of clinical manifestations, including a predominant lesion of the respiratory system with the possible development of distress syndrome, the development of multiple organ failure. COVID-19 can cause depression, anxiety, and other emotional disorders, which may interfere with subsequent physical recovery. The aim - clinical analysis of emotional disorders in patients with the Novel Coronavirus Infection (COVID-19). Material and methods. A retrospective analysis of electronic medical records of 124 patients admitted to the infectious diseases department of Chelyabinsk City Clinical Hospital No. 8 in 2020-2021 was carried out. The methods of clinical and psychological research (including clinical conversation, observation and testing using the "Hospital Scale of Anxiety and Depression" HADS and the "Symptom Check List" SCL-90-R) were used to identify the features of the emotional states of patients with COVID-19. Statistical analysis was performed using the statistical package <<Statistica 6.0>>. The Spearman rank correlation coefficient was used. Results. Typical complaints upon admission to the hospital are fever, cough, general weakness, loss of smell and taste, runny nose. The majority of patients showed elevated levels of C-reactive protein and protein of the acute phase of inflammation - ferritin, an increase in the D-dimer by more than 2.5 times compared with the average standard values, a decrease in the value of the prothrombin index (mean value 88.7+/-6.4%) indicate coagulopathy as a manifestation of hyperinflammation that develops in COVID-19. More than half of patients (52.08+/-9.42%) experienced psychological distress of moderate and high severity: an increased level of distress was recorded in 42.78+/-9.33% of the examined patients, a high level of distress was found in 9.30+/-5.48% of patients. Direct correlations of varying degrees of strength between general somatic distress and indicators of anxiety, depression, psychopathological manifestations (obsessive-compulsiveness and interpersonal sensitivity) and mental distress were identified. Revealed negative emotional experiences in patients with COVID-19 can cause adverse effects on the course and prognosis of the disease, reduce adherence to treatment, negatively affect the social functioning and quality of life of patients.Copyright © Infectious Diseases: News, Opinions, Training 2022.

Clinical and laboratory characteristics of SARS-CoV-2 infection in overweight and obese patients.

Objective. To assess the impact of obesity and overweight on the course of COVID-19. Patients and methods. This prospective study included 218 patients with SARS-CoV-2 infection aged 18 to 94 years hospitalized between June 2020 and March 2021. We evaluated their clinical and laboratory parameters and their association with body weight. All patients were divided into 3 groups depending on their body mass index (BMI). Group 1 included 81 patients with grade 1-3 obesity (BMI >=30);group 2 comprised 71 overweight patients (BMI >=25 and <30);group 3 included 66 patients with normal body weight (BMI >=18.5 and <25). We analyzed clinical symptoms (including shortness of breath, fever, myalgia, headache, fatigue, changes in the oropharynx, cough, rhinorrhea, sore throat, anosmia, and diarrhea), prevalence of concomitant disorders and complications, findings of computed tomography and pulse oximetry, and findings of instrumental and laboratory examinations (complete blood count, urine test, electrocardiography, echo cardiography, biochemical assays, including C-reactive protein, procalcitonin, alanine aminotransferase, aspartate aminotransferase, lactate, lactate dehydrogenase, activated partial thromboplastin time, prothrombin index, D-dimer, ferritin). Data analysis was performed using the Statistica 6.0 software. Results. We found that overweight and obese patients were more likely to have the main COVID-19 symptoms and comorbidities than those with normal weight. Overweight and obese patients also required respiratory support more frequently than patients with normal weight. Obese and overweight patients had more severe systemic inflammation (CRP, procalcitonin), cytolysis (ALT, AST), and thrombosis (D-dimer). Conclusion. Our findings suggest that obesity and overweight are the factors associated with a more severe SARS-CoV-2 infection, which should be considered when planning their treatment and developing resource strategies.Copyright © 2022, Dynasty Publishing House. All rights reserved.

Comprehensive evaluation of otorhinolaryngological symptoms in COVID-19 patients

Introduction: The aim of this study is to comprehensively evaluate the incidence and natural course of otorhinolaryngological symptoms of COVID-19 infection and its relations to each other and patient's demographics. Method(s): This is a prospective study conducted on symptomatic adult patients proven to be infected with COVID-19. Detailed history was taken from each patient including onset of symptoms. Symptoms were followed up tightly. We focus on otorhinolaryngological (ORL) symptoms and their duration and onset in relation to other symptoms. Data were collected and analyzed in detail. Result(s): Six-hundred eighty-six patients were included in the study, their age ranged from 19-75 years old, and of them 55.1% were males. Cough was found in 53.1% of cases followed by sore throat in 45.8%, anosmia/ hyposmia in 42.3%, headache in 42%, rhinorrhea in 19.5%, dry mouth in 7.6%, globus in 6.1%, epistaxis in 4.4%, and hearing loss in 0.6%. In non-ORL symptoms, fever was found in 54.2%, malaise in 55.1%, dyspnea in 49.3%, and diarrhea in 27.2%. The first symptom was anosmia in 15.7% of cases, sore throat in 6.1 %, cough in 7.9%, and headache in 13.4% of cases. Fever was the first symptom in 22.7%, malaise in 25.1%, and diarrhea in 6.4%. Headache occurred for 5.5 +/- 2 days, anosmia/hyposmia 3 to > 30 days, sore throat 4.1 +/- 1.2 days, rhinorrhea 4.3 +/- 1.1, cough 7.4 +/- 2.5 days, fever 4.7 +/- 2 days, and malaise 6.5 +/- 2.4 days. The cluster of COVID-19-related symptoms showed nine principal components. Conclusion(s): Otorhinolaryngological symptoms are main symptoms in COVID-19 infection, and they should be frequently evaluated to detect suspected cases especially in pauci-symptomatic patients and to properly manage infected patients.Copyright © 2022, The Author(s).

Ensitrelvir for Mild-to-Moderate Covid-19: Phase 3 Part of Phase 2/3 Study

Background: Ensitrelvir is a SARS-CoV-2 3CL protease inhibitor approved in Japan under emergency regulatory approval system as an oral treatment for COVID-19. Here we report the key analysis results of 125 mg group of phase3 part (SCORPIO-SR). Method(s): This study was a multicenter, randomized, double-blind, placebocontrolled study. Regardless of SARS-CoV-2 vaccination status and presence of risk factors for severe disease, patients with mild-to-moderate COVID-19 within 120 hours from onset were randomized to oral administration of ensitrelvir 125 mg (375 mg loading dose on Day1), ensitrelvir 250 mg (750 mg loading dose on Day1), and placebo once daily, for 5 days. The primary endpoint was time to resolution of 5 symptoms of COVID-19 (stuffy or runny nose, sore throat, cough, feeling hot or feverish, and low energy or tiredness), and the key secondary endpoints include change from baseline on Day4 in the amount of SARS-CoV-2 viral RNA and time to first negative of viral titer. The primary population for the primary and key secondary endpoints was patients with <72 hours from onset to randomization. Result(s): Median time to resolution of 5 symptoms was significantly shorter in 125 mg group (n=336, 167.9 hours) than placebo group (n=321, 192.2 hours) (p=0.0407). Mean change of viral RNA levels from baseline (log10 copies/mL) on Day4 was significantly greater in 125 mg group (-2.48) than in placebo group (-1.01) (p< 0.0001). The time to first negative of viral titer was significantly shorter in 125 mg group (n=199, 36.2 hours) compared to placebo group (n=211, 65.3 hours) (p< 0.0001). Mean changes from baseline in viral titers [log10(TCID50)/mL] were significantly greater in 125mg group on Day2 (-0.807, n=196) and Day4 (-1.108, n=197) than in the placebo group (-0.395, n=208 and -0.850, n=207, respectively) (p< 0.0001). (Table Presented) In the patients randomized within 120 hours of onset, median time to resolution of 5 symptoms was 189.7 hours in 125 mg group (n=582) and 200.3 hours in placebo group (n=572) (p=0.4352). No deaths or serious adverse drug reactions were reported in either group, and the incidence of serious adverse events between the two groups was comparable. Conclusion(s): Ensitrelvir demonstrated a significant reduction in the time to resolution of 5 typical symptoms of COVID-19, robust antiviral effects and good tolerability.

Outcomes of chronic spontaneous urticaria in a patient with non-Hodgkin's lymphoma and SARS-Cov- 2 infection: Efficacy of treatment with omalizumab

Case report Background: Association of chronic spontaneous urticaria (CSU) with malignancies and worsening of urticaria during COVID-19 have been reported. The efficacy of treatment of CSU with omalizumab in the context of malignancies or COVID-19 is not well established. Method(s): Case report of a patient followed for 9 years with CSU. Data collected from Medical Records and interviews during consultations. Result(s): Female, 29 years-old, came to clinic in 2013 for investigation, diagnosed with CSU. She also presented mild asthma, allergic rhinitis and history of urticaria after taking amoxicillin. She had a positive autologous serum skin test, and positive skin tests to dust mite, cat, cockroach, peanut and milk. Her total IgE was 227IU/ mL. Anti-nuclear and anti-thyroid antibodies were negative;ERS 13mm, blood eosinophils 300/mm3, and stool exam negative for parasites. She showed no response to second generation antihistamines up to fourfold doses, with UCT < 6 and CU-QoL = 89. After 6 months, omalizumab was added at 300 mg subcutaneously, every 4 weeks. The patient showed immediate reactions after the two applications of omalizumab: first, diffuse pruritus and throat tightness;second, worsening of urticaria and pruritus, requiring iv medications. Treatment with omalizumab was stopped, she was kept on fourfold dose of bilastine with partial control of symptoms. In 2016, she presented worsening of urticaria (UCT = 1), weight loss of 6kg/2 months, daily fever and enlarged cervical lymph nodes, and was diagnosed with diffuse large B-cell non-Hodgkin's lymphoma. Following chemotherapy with cyclophosphamide, doxorubicin, vincristine, prednisone and rituximab, she presented complete resolution of urticaria. Two years after remission of the lymphoma, in 2019, she presented recurrence of urticaria, and treatment with fourfold dose of bilastine was reinitiated with control of symptoms (UCT = 16). Investigation ruled out recurrence of lymphoma. In May 2021, she was diagnosed with SARS-CoV- 2 infection. Symptoms of COVID-19 were runny nose and low grade fever, however urticaria got worse and no longer responsive to bilastine. Treatment with omalizumab was attempted, with no reactions and good efficacy after the first dose, with an UCT = 15, and urticaria remains controlled on treatment with omalizumab to present. Conclusion(s): In this report, we highlight the efficacy and safety of using omalizumab in a patient with refractory CSU associated with neoplasia and SARS-CoV- 2 infection.

Persistent allergic respiratory symptoms induced by food allergy: Report of two cases

Case report Dust is a known mixture and carrier of multiple allergens and an epidemiologic study demonstrated the presence of peanut proteins in school cafeterias and classrooms, suggesting that schools may play an important role in exposure to environmental food allergens. While inhalation of food allergens is a known trigger of IgE-mediate acute respiratory reaction as rhinitis and wheezing, little is known about persistent allergic asthma and/or rhinitis induced by chronic inhalation of food allergens. Here we report two cases of teenagers with nuts allergy presenting with persistent respiratory symptoms when exposed to closed and dusty environments. The first case concerns a 12-year-old boy allergic to walnut and hazelnut (specific IgE > 100 and 81.70 kU/l, respectively). For some years he has had a persistent mild asthma, frequent nasal occlusion and rhinorrhea, without any allergic sensitization to aeroallergens. Symptoms occurred exclusively during school period when he required maintenance therapy with inhaled and nasal steroids. He was asymptomatic and did not need any treatment during summer. During the lockdown period due to Covid-19 pandemic, he did not attend school for several months and he was able to discontinue inhaled corticosteroid therapy without recurrence of asthma and rhinitis symptoms. Asthma recurred after he returned to school, but with only mild intermittent symptoms, probably thanks to the use of masks and the frequent airing of the classrooms. On a single occasion he experienced nasal occlusion and rhinorrhea after that a parent had eaten hazelnut cream in the same room where he was. The second case deals with a 17-year-old boy with a history of several food allergies (milk, egg, wheat, banana, nuts, hazelnuts) and mild persistent asthma in absence of sensitization to aeroallergens. He successfully underwent oral desensitization for milk, egg and wheat in previous years. Asthma symptoms improved over the years together with progressive development of oral tolerance to food allergens for which oral immunotherapy had been done. On the other hand, he referred persistence of allergic rhinitis especially during the school year and his symptoms got worse in classroom. Exhaled nitric oxide was quite increased with evidence of eosinophils in nasal smears. In-vitro and in-vivo tests only detected food allergens sensitizations, in particolar to walnuts and hazelnuts (specific IgE were 61.00 and 55.50 kU/l respectively). These two clinical cases suggest that food allergens might be causative agents of allergic persistent asthma and/or rhinitis as aeroallergens do.

Nasal photodisinfection in an industrial workplace for COVID-19 suppression

Antimicrobial photodynamic therapy (aPDT) [1] has been deployed in tens of thousands of patients in Canada for preoperative intranasal bacterial suppression to reduce the prevalence rate of surgical site infections [2]. This treatment has proven safe and effective, with infection rate reductions of 40-80% in tertiary care systems despite only requiring 4 minutes of therapy [2]. We previously demonstrated that aPDT eliminates the RNA signature of wild-type SARS-CoV-2 in vitro, with reduction of RT-qPCR threshold counts (DELTACt = 22) in a light-dose dependent manner (C = 320 muM, lambda = 664 nm, F = 36 J/cm2) [3]. Photodynamic targets were found to include the receptor binding domain, spike protein and nucleocapsid domain, consistent with a broad spectrum peroxidative effect on anionic moieties throughout the virion [3]. This work describes the benefits of using regular aPDT treatments in the industrial workplace for the purpose of employee COVID-19 prevention. From July 2020 to August 2021, aPDT was deployed at a large Canadian food processing plant. Meat processing facilities face distinctive challenges in control of infectious diseases, including SARS-CoV-2. Factors that increase processing workers' risk for exposure to SARS-CoV-2 include close contact for 8-12 hour shifts, shared transportation, and congregate housing [4,5]. The presence of a slaughtering plant in a community is associated with a 51 to 75% increase in COVID-19 cases per thousand over the baseline community rate, and a 37 to 50% increase in death rate over the baseline community rate [5]. Methylene blue-mediated aPDT (SteriwaveTM Nasal Photodisinfection System, Ondine Biomedical Inc., Vancouver, BC) was added to the standard infection control bundle at the plant, along with employee education. Treatments were administered free of charge to approximately 1,500 employees on a voluntary basis during paid work hours. Compliance levels of employees requesting aPDT were 85%. To determine intervention efficacy, the rate of qPCR-positive COVID-19 tests over the treatment time period was compared to the same rate in the surrounding province. Results demonstrated a reduction of COVID-19 rate of over 3 times (p<.0001, Fisher's Exact Test) in the treated population compared to the untreated population, with the largest adverse event being mild (self-limiting) rhinorrhea in < 1% of cases. The plant continued production and distribution of products without disruption. Important outcomes from this quality improvement initiative included (a) aPDT proved to be a rapid, lightweight intervention that could be deployed at high compliance levels in a commercial high-throughput food processing operation, (b) significant impact (>3X reduction) on the COVID-19 rates was observed and (c) COVID-19-related comorbidities including acute and long-term illness, disability, and death were proportionately avoided.Copyright © 2023

Clinical and paraclinical manifestation COVID-19 in different age children

Purpose - to establish the clinical and paraclinical manifestations of the course of COVID-19 in children, depending on age to predict the severity of the disease's manifestation. Materials and methods. The 60 children aged from 3 months to 17 years old with laboratory-confirmed SARS-CoV-2 were examined. All patients underwent general clinical, laboratory, and instrumental examinations and received therapy according to Ukrainian National protocol. SARS-CoV-2 infection was confirmed by real-time PCR. Results. Thus, in young children COVID-19 begins acutely (90.0%) with intoxication (75.0%), fever (65.0%), nasal congestion (25.0%), rhinorrhea (20.0%), dry cough (60.0%), increased ESR and C-reactive protein (55.0%). The course of COVID-19 in children 4-6 years is accompanied by acute onset (85.71%), fever (85.71%), pharyngitis (85.71%), lymphopenia (28.56%), and no CT signs of lesions (71.43%). In children 7-12 years old, COVID-19 causes intoxication (88.89%), fever (83.33%), pharyngitis (55.56%), dry cough (77.78%), lymphocytosis (16.67%) with accelerated ESR (38.89%) and pneumonia (38.89%). The course of COVID-19 in children was older than 13 years old characterized by fever (73.33%), pharyngitis (66.67%), dry cough (73.33%), olfactory loss (20.0%), leukopenia (20.0%), ESR acceleration (20.0%), and a decrease in prothrombin (13.33%) without pulmonary lesions (73.33%). Conclusions. These data suggest that the severity and duration of clinical and laboratory manifestations of COVID-19 depend on the child's age. The course of COVID-19 in children of all age groups is mostly of moderate severity with a favorable prognosis ((56.67%) hospitalized children did not have any complications). Only children from 7 to 12 years old need additional attention due to the severe manifestations of intoxication (88.89%) and the risk of complications with pneumonia (38.89%). The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.Copyright © 2022 Modern Pediatrics. Ukraine. All rights reserved.

Pathogenesis and Immune Status in COVID-19 Pneumonia-A Minireview

The novel coronavirus (SARS-CoV-2), which was isolated in January 2020, emerged as a result of natural evolution and has already infected millions of people around the world due to its extensive human-to-human transmission capacity. Highlighting the clinical manifestations, pathology and immune response against the SARS-CoV-2 infection process, this review study was con-ducted through a comprehensive bibliographic search of academic papers that are available online at the following databases Science Direct, Pub Med, ACS Publications, Nature, BioRxiv and Me-dRxiv. According to the analyzed works, people infected with SARS-CoV-2 may display fever and dry cough as the main clinical symptoms and they may also present breathing difficulty, muscle pain (myalgia), chills, lack of appetite, fatigue, sore throat, altered consciousness, diarrhea, vomit-ing, nasal discharge and syncope. When considering the immune status of patients with COVID-19, it is highlighted that hypercytokinemia contributes to the severity that can even result in death. Lymphopenia is the most frequent prognosis described in cases of COVID-19. Thus, a de-tailed understanding of the specific inflammatory pathways that result in the pathology of COVID-19 is crucial for the immediate development of clinical therapeutic approaches.Copyright © 2021 Bentham Science Publishers.

Oro-Facial manifestations of COVID-19 infection in a sample of Iraqi people

Public health officials are gravely concerned about the harm that viral illnesses continue to pose to humanity, various viral outbreaks, including the Middle East Respiratory Syndrome Corona-Virus (MERS-CoV), H1N1 influenza, the severe acute respiratory syndrome coronavirus (SARS-CoV-2) and SARS CoV-2 or COVID-19 that struck the globe in December 2019. A wide range of COVID-19 oral symptoms, such as ulceration, blisters, enanthems, hemorrhagic sores and cheilitis. Aim(s): to investigate the prevalence of oral symptoms amongst COVID-19 patients due to the disease's aggressive nature and diverse symptomatology and to assess the impact of oral health conditions on COVID-19 disease severity in a sample of Iraqi people. Material(s) and Method(s): a cross-sectional study was conducted on (200) patients in total, (81) male and (119) female, who were identified as SARS-COV2 patients. Result(s): COVID confirmed patients were involved in the present study with mean age (36.69+/-17.22) years & age range of (16-78) years. at least one of the oral manifestations was present in 72.5% of the patients, while about 27.5% did not experience any oro-facial symptoms. The oral symptom with the highest prevalence was dry mouth 50% followed by gustatory dysfunction 37% then burning mouth sensation 22.5% after that the oral pain 17%;myofacial pain 15.5 %;stomatitis\mucositis 14.5%;the prevalence of aphthous lesions, fissural cheilitis and tongue depapillation were at the same percentage which was 9.5%;then candidiasis 7.5%;the least prevalent oral symptoms was gingival bleeding at percentage of 2.5%. Conclusion(s): COVID-19 has a noticeable effect on oral cavity, there was a correlations between some general and orofacial manifestations of COVID-19.Copyright © 2023, Codon Publications. All rights reserved.

COVID-19 in patients diagnosed with persistent tachypnea of infancy

Objective: Novel coronavirus has raised substantial concern for patients with chronic lung diseases. The aim of this study was to evaluate the clinical characteristics and outcome of COVID-19 in children with persistent tachypnea of infancy (PTI). Method(s): Children who were previously diagnosed with PTI and admitted for regular follow-up visits were assessed. Data on the history of having SARS-CoV-2 infection was collected. Result(s): Between January 1, 2021, and February 28, 2022, 62 patients with PTI (median age 3.7 years) were evaluated. Thirty-eight patients (61.3%) were diagnosed with COVID-19. Fourteen (36.8%) of them had a positive SARS-CoV-2 PCR test, and 24 (63.2%) were diagnosed by a positive serology test for specific antibodies connected with a history of close contact. Sixteen patients (42.1%) were asymptomatic, and 22 (57.9%) symptomatic. The most common symptoms were rhinorrhea or nasal congestion (77.3%), cough (72.7%), and sore throat (45.5%). According to NIH guidelines, 16 (42.1%) patients were classified as having mild disease, and in 3 (7.9%) children who had dyspnea, the moderate disease was recognized. Three children (7.9%) with increased dyspnea and oxygen demand required admission to the hospital. Follow-up performed in a median time of 6 months revealed that nearly all PTI patients after COVID-19 returned to their baseline status (78.9%);4 children (10.5%) suffered from exacerbating symptoms of the chILD for one month. Surprisingly two (5.3%) children became completely asymptomatic after COVID-19. Conclusion(s): SARS-CoV-2 infection in children with PTI is usually associated with a mild illness with a low risk of hospitalization.