Scientific Assessment and Sorting of Topological Parameters Affecting Time in Recovering from COVID-19

Coronavirus disease 2019 is a new infectious respiratory disease as named by the World Health Organization. This virus is affecting different individuals in diverse manners. Consequently, studies are going on to identify the factors and parameters disturbing predominantly. According to various studies, the immunity of a person determines the effect of the virus on that individual's health. Thus, immunity is determined by multiple factors like climate, population, geographical location, sanitation facilities. In existing studies, the effect of various climatic factors, such as temperature, relative humidity of diverse countries and areas, on COVID-19 spread is taken. To extend these studies, this paper is an effort to consider almost all the topological parameters of significant countries and different states of India for analysing their effects on the recovery rate due to COVID-19. Finally, these parameters are ranked/sorted as per their impact on recovery rates. © 2023 The authors.

PSYCHOLOGICAL DAMAGE TO MEDICAL STAFF DUE TO SARS - COV-2 VIRUS

Based on the evidence showing the psychological impairment of medical staff in pandemic periods is useful to introduce large-scale support programs and psychological education of medical staff. These measures, adapted to age and sex, can help increase the quality of work in the health fields and can also prevent medical leave for employees due to psychiatric pathologies caused by poorly managed stress and burnout.

Coronavirus infection in children

A review of the literature of foreign and Russian studies on the course of a new coronavirus infection in children ( SARS - CoV -2) is presented. The studies conducted over the past two years have shown a difference in the course of COVID -19 in children. The clinical picture of coronavirus infection in children is very diverse: from symptoms of a respiratory infection to multisystem inflammatory syndrome. It has been established that among children there is lower frequency of severe course of coronavirus infection. For complete understanding of features and treatment of the new coronavirus infection, large-scale epidemiological studies are required.

In-silico genomic landscape characterization and evolution of SARS-CoV-2 variants isolated in India shows significant drift with high frequency of mutations.

In-silico studies on SARS-CoV-2 genome are considered important to identify the significant pattern of variations and its possible effects on the structural and functional characteristics of the virus. The current study determined such genetic variations and their possible impact among SARS-CoV-2 variants isolated in India. A total of 546 SARS-CoV-2 genomic sequences (India) were retrieved from the gene bank (NCBI) and subjected to alignment against the Wuhan variant (NC_045512.2), the corresponding amino acid changes were analyzed using NCBI Protein-BLAST. These 546 variants revealed 841 mutations; most of these were non-synonymous 464/841 (55.1%), there was no identical variant compared to the original strain. All genes; coding and non-coding showed nucleotide changes, most of the structural genes showed frequent nonsynonymous mutations. The most affected genes were ORF1a/b followed by the S gene which showed 515/841 (61.2%) and 120/841 (14.3%) mutations, respectively. The most frequent non-synonymous mutation 486/546 (89.01%) occurred in the S gene (structural gene) at position 23,403 where A changed to G leading to the replacement of aspartic acid by glycine in position (D614G). Interestingly, four variants also showed deletion. The variants MT800923 and MT800925 showed 12 consecutive nucleotide deletion in position 21982-21993 resulting in 4 consecutive amino acid deletions that were leucine, glycine, valine, and tyrosine in positions 141, 142, 143, and 144 respectively. The present study exhibited a higher mutations rate per variant compared to other studies carried out in India.

Corrigendum: Antifibrotics in COVID-19 Lung Disease: Let Us Stay Focused.

[This corrects the article DOI: 10.3389/fmed.2020.00539.].

Inferring True COVID19 Infection Rates From Deaths.

The novel coronavirus, SARS-CoV-2, commonly known as COVID19 has become a global pandemic in early 2020. The world has mounted a global social distancing intervention on a scale thought unimaginable prior to this outbreak; however, the economic impact and sustainability limits of this policy create significant challenges for government leaders around the world. Understanding the future spread and growth of COVID19 is further complicated by data quality issues due to high numbers of asymptomatic patients who may transmit the disease yet show no symptoms; lack of testing resources; failure of recovered patients to be counted; delays in reporting hospitalizations and deaths; and the co-morbidity of other life-threatening illnesses. We propose a Monte Carlo method for inferring true case counts from observed deaths using clinical estimates of Infection Fatality Ratios and Time to Death. Findings indicate that current COVID19 confirmed positive counts represent a small fraction of actual cases, and that even relatively effective surveillance regimes fail to identify all infectious individuals. We further demonstrate that the miscount also distorts officials' ability to discern the peak of an epidemic, confounding efforts to assess the efficacy of various interventions.

Room to Breathe: The Impact of Oxygen Rationing on Health Outcomes in SARS-CoV2.

As the primary surge of coronavirus disease 2019 (COVID-19) wanes in many countries, it is important to reconsider best practice. More cases, probably the majority of cases, are yet to come. Hopefully, during this next phase, we will have more time, more resources, and more experience from which to affect better outcomes. Here, we examine the compromised oxygen strategy that many nations followed. We explore the evidence related to such strategies and discuss the potential mortality impact of delaying oxygen treatment in COVID-19 pneumonia.

Effects of COVID-19 Pandemic Confinement in Patients With Cognitive Impairment.

Introduction: State of emergency caused by COVID-19 pandemic and subsequent lockdown hit Spain on 14th March 2020 and lasted until 21st June 2020. Social isolation measures were applied. Medical attention was focused on COVID-19. Primary and social care were mainly performed by telephone. This exceptional situation may affect especially vulnerable patients such as people living with dementia. Our aim was to describe the influence of restrictive measures on patients living with mild cognitive decline and dementia evaluating SARS-CoV2 infection, changes in routines, cognitive decline stage, neuropsychiatric symptoms, delirium, falls, caregiver stress, and access to sanitary care. Materials and Methods: We gathered MCI and dementia patients with clinical follow-up before and after confinement from DegMar registry (Hospital del Mar). A telephone ad-hoc questionnaire was administered. Global status was assessed using CDR scale. Changes in neuropsychiatric symptoms were assessed by Neuropsychiatric Inventory (NPI) and retrospective interview for pre-confinement base characteristics. Results: We contacted a total of 60 patients, age 75.4 years ± 5,192. 53.3% were women. Alzheimer's Disease (41.7%) and Mild Cognitive Impairment (25%) were the most prevalent diagnosis. Remaining cases included different dementia disorders. A total of 10% of patients had been diagnosed with SARS-CoV-2. During confinement 70% of patients abandoned previous daily activities, 60% had cognitive worsening reported by relatives/caretakers, 15% presented delirium episodes, and 13% suffered increased incidence of falls. Caregivers reported an increased burden in 41% cases and burnout in 11% cases. 16% reported difficulties accessing medical care, 33% received medical phone assistance, 20% needed emergency care and 21% had changes in psychopharmacological therapies. Neuropsychiatric profile globally worsened (p < 0.000), also in particular items like agitation (p = 0.003), depression (p < 0.000), anxiety (p < 0.000) and changes in appetite (p = 0.004). Conclusion: SARS-CoV2-related lockdown resulted in an important effect over social and cognitive spheres and worsening of neuropsychiatric traits in patients living with mild cognitive decline and dementia. Although the uncertainty regarding the evolution of the pandemic makes strategy difficult, we need to reach patients and caregivers and develop adequate strategies to reinforce and adapt social and health care.

Antifibrotics in COVID-19 Lung Disease: Let Us Stay Focused.

After decades of research, two therapies for chronic fibrotic lung disease are now approved by the FDA, with dozens more anti-fibrotic therapies in the pipeline. A great deal of enthusiasm has been generated for the use of these drugs, which are by no means curative but clearly have a favorable impact on lung function decline over time. Amidst a flurry of newly developed and repurposed drugs to treat the coronavirus disease 2019 (COVID-19) and its accompanying acute respiratory distress syndrome (ARDS), few have emerged as effective. Historically, survivors of severe viral pneumonia and related acute lung injury with ARDS often have near full recovery of lung function. While the pathological findings of the lungs of patients with COVID-19 can be diverse, current reports have shown significant lung fibrosis predominantly in autopsy studies. There is growing enthusiasm to study anti-fibrotic therapy for inevitable lung fibrosis, and clinical trials are underway using currently FDA-approved anti-fibrotic therapies. Given the relatively favorable outcomes of survivors of virus-mediated ARDS and the low prevalence of clinically meaningful lung fibrosis in survivors, this perspective examines if there is a rationale for testing these repurposed antifibrotic agents in COVID-19-associated lung disease.

Cell-Mediated Immune Responses to COVID-19 Infection.

An unprecedented outbreak of pneumonia caused by a novel coronavirus (CoV), subsequently termed COVID-19 by the World Health Organization, emerged in Wuhan City (China) in December 2019. Despite rigorous containment and quarantine efforts, the incidence of COVID-19 continues to expand, causing explosive outbreaks in more than 160 countries with waves of morbidity and fatality, leading to significant public health problems. In the past 20 years, two additional epidemics caused by CoVs have occurred: severe acute respiratory syndrome-CoV, which has caused a large-scale epidemic in China and 24 other countries; and respiratory syndrome-CoV of the Middle East in Saudi Arabia, which continues to cause sporadic cases. All of these viruses affect the lower respiratory tract and manifest as pneumonia in humans, but the novel SARS-Cov-2 appears to be more contagious and has spread more rapidly worldwide. This mini-review focuses on the cellular immune response to COVID-19 in human subjects, compared to other clinically relevant coronaviruses to evaluate its role in the control of infection and pathogenesis and accelerate the development of a preventive vaccine or immune therapies.

Nutritional Considerations in Frail Older Patients with COVID-19.

The COVID-19 pandemic is posing an unprecedented challenge to healthcare systems worldwide. Older adults, which frequently present multiple chronic comorbidities, are more susceptible to COVID-19 and experience more likely negative outcomes, in terms of disease severity and mortality. However, chronological age per se may not entirely explain the dramatic scenario described among the frailest and oldest persons. Comorbidities and functional status may indeed play a relevant role. Patients at high risk of adverse clinical outcomes in COVID-19 infection are the same at risk of malnutrition, namely older adults and multimorbid individuals. In fact, COVID-19 can negatively impact on nutritional status, both in patients admitted to the hospital with the most severe manifestations of the infection, as well as in those who experience milder/asymptomatic forms of the disease. Despite being quite difficult in these emergency circumstances, nutritional status needs to be assessed in all COVID-19 patients upon admission and during hospital stay. Early nutritional support should be guaranteed in order to improve several malnutrition-related adverse outcomes. The evaluation of the nutritional status is today even more crucial than in normal times given the delicate status of older patients with COVID-19.