An African perspective on the ethics and politics of foreign medical aid in a pandemic

This chapter attempts an interrogation of the political and ethical dimensions of foreign medical aid during a pandemic. One of the moral conundrums that the coronavirus (COVID-19) pandemic presents to governments of developing countries in the Global South with poor health infrastructure is seeking much needed foreign medical aid without compromising sovereignty, safety, and national integrity, especially from the Global North. In the context of COVID-19 pandemic in Nigeria, medical supplies and personnel were offered by China as emergency philanthropy. This chapter provides a novel ethical evaluation of foreign medical aid in a pandemic, using principles of the African ethic of communion. It exposes the values both at play and absent in choosing foreign medics as a complementary strategy, as opposed to full reliance on the competence and initiatives of local medical personnel in tackling the challenges of COVID-19 in Nigeria. The chapter argues that while the values of transparency, consultation, dialogue, and trust building are lacking in the decision-making process that brought the Chinese foreign medics' aid to Nigeria, the act is morally justified by virtue of its potentials to save lives that would otherwise be lost without it. This chapter posits further, however, that China's politicization of its philanthropy undercuts the moral justification of the gesture. It concludes by explicating how the principles of relationality, equity, and harmony embedded within an African moral worldview can provide moral validation for medical philanthropy at a time of pandemic without compromising China's responsibility and Nigeria's national integrity. © The Author(s), under exclusive license to Springer Nature Switzerland AG 2023. All rights reserved.

Identification and characterization of 7-azaindole derivatives as inhibitors of the SARS-CoV-2 spike-hACE2 protein interaction.

The COVID-19 pandemic, caused by SARS-CoV-2, has become a global public health crisis. The entry of SARS-CoV-2 into host cells is facilitated by the binding of its spike protein (S1-RBD) to the host receptor hACE2. Small molecule compounds targeting S1-RBD-hACE2 interaction could provide an alternative therapeutic strategy sensitive to viral mutations. In this study, we identified G7a as a hit compound that targets the S1-RBD-hACE2 interaction, using high-throughput screening in the SARS2-S pseudovirus model. To enhance the antiviral activity of G7a, we designed and synthesized a series of novel 7-azaindole derivatives that bind to the S1-RBD-hACE2 interface. Surprisingly, ASM-7 showed excellent antiviral activity and low cytotoxicity, as confirmed by pseudovirus and native virus assays. Molecular docking and molecular dynamics simulations revealed that ASM-7 could stably bind to the binding interface of S1-RBD-hACE2, forming strong non-covalent interactions with key residues. Furthermore, the binding of ASM-7 caused alterations in the structural dynamics of both S1-RBD and hACE2, resulting in a decrease in their binding affinity and ultimately impeding the viral invasion of host cells. Our findings demonstrate that ASM-7 is a promising lead compound for developing novel therapeutics against SARS-CoV-2.

Clinical outcomes of COVID-19 treated with remdesivir across the continuum of care.

Introduction: During the early phase of the coronavirus disease 2019 (COVID-19), remdesivir was only approved for hospitalized patients. Our institution developed hospital-based, outpatient infusion centers for selected hospitalized patients with COVID-19 who had clinical improvement to allow for early dismissal. The outcomes of patients who transitioned to complete remdesivir in the outpatient setting were examined. Methods: Retrospective study of all hospitalized adult patients with COVID-19 who received at least one dose of remdesivir from November 6, 2020, to November 5, 2021, at one of the Mayo Clinic hospitals. Results: Among 3029 hospitalized patients who received treatment with remdesivir for COVID-19, the majority (89.5%) completed the recommended 5-day course. Among them, 2169 (80%) patients completed treatment during hospitalization, whereas 542 (20.0%) patients were dismissed to complete remdesivir in outpatient infusion centers. Patients who completed the treatment in the outpatient setting had lower odds of death within 28 days (aOR 0.14, 95% CI 0.06-0.32, p < 0.001). However, their rate of subsequent hospital encounters within 30 days was higher (aHR 1.88, 95% CI 1.27-2.79, p = 0.002). Among patients treated with remdesivir only in the inpatient setting, the adjusted odds of death within 28 days were significantly higher among those who did not complete the 5-day course of remdesivir (aOR 2.07, 95% CI 1.45-2.95, p < 0.001). Conclusions: This study describes the clinical outcomes of a strategy of transitioning remdesivir therapy from inpatient to outpatient among selected patients. Mortality was lower among patients who completed the 5-day course of remdesivir.

Current status of hydroxychloroquine and azithromycin for the treatment of COVID-19: an observational review

Though the effect of the coronavirus has known to be a catastrophic pandemic since a 100 years ago, severe acute respiratory syndrome-2 coronavirus (SARS2-CoV) was first claimed to be emerged in December 2019 at the city of Wuhan, China. Abruptly, the virus dominated more than 218 countries with 157,566,607 confirmed cases and the death figure has reached nearly 3,284,551 till time. Recently the pandemic is getting worse day-by-day, people are suffering from hypoxia and severe respiratory problems despite the continuous services provided by the healthcare sector. Prior concern behind this emergency is that, till date, researchers and scientists failed to invent any productive pharmaceutical treatment to weed out the infection completely. Although vaccination is publicly available, it is applicable only for precautionary purposes and not evident of preventive measures. This review focuses on the therapeutic status to control the severity of SAS2-CoV agent. The approach aims at implicating a low toxic metabolite anti-malarial drug, hydroxychloroquine combined with an antibiotic called azithromycin for the treatment of acute respiratory disturbance and hypoxia. This article briefly demonstrates the phramaco-potential of both these medications, their effects on patients based on a clinical observation and ongoing status of dosage to validate its implication.

Macrophage targeted delivery systems: Basic concepts and therapeutic applications

The proposed book is envisioned for the nascent and entry-level researchers who are interested to work in the field of drug delivery and its applications specifically for macrophage targeting. Macrophages have gained substantial attention as therapeutic targets for drug delivery considering their major role in health and regulation of diseases. Macrophage-targeted therapeutics have now added significant value to the lives and quality of life of patients, without undue adverse effects in multiple disease settings. We anticipate examining and integrating the role of macrophages in the instigation and advancement of various diseases. The major focus of the book is on recent advancements in various targeting strategies using delivery systems or nanocarriers followed by application of these nanocarriers for the treatment of macrophage associated disorders. Macrophage Targeted Delivery Systems is primarily targeted to Pharmaceutical Industry & Academia, Medical & Pharmaceutical Professionals, Undergraduate & Post graduate students and Research Scholars, Ph.D, post docs working in the field of medical and pharmaceutical sciences. © The Editor(s) (if applicable) and The Author(s), 2022. All rights reserved.

Detecting COVID-19 Through Lung X-Ray Imaging: An Alternative Using Modified CNN Architecture

The arrival of COVID-19 took the very existence of human race for a toss. In countries like India, where the majority of the population is concentrated in the rural areas and are subject to an affordability and infrastructural constraint, cannot afford sophisticated COVID-19 tests. But, X-Ray is widely obtainable across both the rural and urban belts of our country and comes at an affordable cost, even free at the government hospitals. In the present research paper, we put forward a fusion-based DCGAN and CNN based neural net architecture which will generate synthetic COVID-19 infected lung X-Ray images from our fed data. Here we consider mainly two (2) output classes namely, malignant and benign. The novelty in this paper is that from the original X-Ray Image our model will generate a "predicted” image instantaneously using the DCGAN structure to understand the process of mutation. Also, the model predicts the class of the newly generated "predicted” image, whether it is COVID-19 positive or negative through the proposed CNN architecture. However, the paper that the success of deploying our model depends on the availability of the 5G network as the "predicted” X-Ray image along with the original X-Ray image of a patient needs to be transmitted to a central server from where it needs to be analyzed for further course of treatment as already specified. We have made an attempt to achieve the state of the art accuracy in our CNN model. © 2022 Scrivener Publishing LLC.

METABOLIC SUPPORT FOR PATIENTS WITH MILD COGNITIVE (DODECAMENTAL) IMPAIRMENT IN THE OUTCOME OF COVID-19.

An open comparative study was conducted to assess the efficacy and safety of cytoflavin in the treatment of 50 patients who underwent SARS-CoV-2 infection, with subsequently developed mild cognitive impairment after leaving an infectious disease hospital. The survey was carried out using the Montreal Cognitive Assessment Scale (MoCA test) for the study of cognitive status, as well as the SF-36 questionnaire to determine parameters of the quality of life of patients and to assess the level of asthenia, anxiety and depression during follow-up (at the beginning of study and after 10 days of fluid therapy). Patients of the main group received intravenous infusion of cytoflavin for 10 days at a dose of 10 mL per 100 mL of 0.9% sodium chloride solution, while the comparison group received "active placebo" (100.0 mL of 0.9 sodium chloride solution) also for 10 days. During observation, the main test group patients showed significant discrepancies in the amount of complaints such as dizziness, headache, and decreased cognitive performance versus placebo group. According to the MoCA test results, patients of the main group showed higher total score on the background of improved cognitive functions: attention improved by 13.2%, p < 0.05 (subtest "repetition" of the number series in forward and reverse order and the "cotton" subtest with letter "A");regulatory skills improved by 9.8%, p < 0.05 (speaking "fluency" subtest);visual-constructive skills improved by 11.4%, p < 0.05 ("clock drawing" subtest);phrase repetition improved by 11.3%, p < 0.05, and literature associations improved by 11.3%, p < 0,05. Based on the results of the SF-36 questionnaire, the life quality was also significantly improved, by 19.5%, p < 0.05 on the average (including physical functioning and condition, pain intensity, general condition, vitality and mental health indicators). The tolerance of cytoflavin in all patients was good and there were no side effects related to the drug. Thus, the use of cytoflavin in the complex treatment of SARS-CoV-2 patients, who suffered from the infection with encephalopathy/mild cognitive impairment developed as part of the postvoid syndrome, reduces neurological deficit and helps to restore neurocognitive functions.Copyright © 2021 Eieeaeoea aaoiia

Statistics and Management COVID-19 in Kosovo-Case Study Hospital of Ferizaj

Infectious diseases are disorders caused by microorganisms such as bacteria, viruses, parasites or fungi. According to the World Health Organization, infectious diseases cause about 26% of the world's deaths and are the leading cause of death in people younger than 50 years old. Infectious diseases are classified into new infectious diseases, which include SARS-1, SARS-2, bird flu, etc., and recurrent diseases, which include pre-existing infections with known incidence and geographical spread. Coronaviruses are a family of viruses widely found in animals and humans, responsible for a variety of diseases, ranging from common cold to much more severe diseases which often lead to pneumonia. The group of new diseases also includes Coronavirus 2019 (COVID-19), which initially causes a respiratory infection with the continuation of other complications. This virus is a new type of beta-coronavirus, which first appeared in China and later spread very fast all over the world leading to a global pandemic. Disease monitoring should primarily include erythrocyte sedimentation rate, leukocyte count, leukocyte formula, C-reactive protein (CRP), determination of Troponin I (hsTnI) and T (cTnT), pro-B Type N-terminal natriuretic peptide (NT-proBNP), fibrinogen and D-dimer levels. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

Structural patterns of SARS-CoV-2 variants of concern (alpha, beta, gamma, delta) spike protein are influenced by variant-specific amino acid mutations: A computational study with implications on viral evolution.

SARS-CoV-2 (SARS2) regularly mutates resulting to variants of concern (VOC) which have higher virulence and transmissibility rates while concurrently evading available therapeutic strategies. This highlights the importance of amino acid mutations occurring in the SARS2 spike protein structure since it may affect virus biology. However, this was never fully elucidated. Here, network analysis was performed based on the COVID-19 genomic epidemiology network between December, 2019-July, 2021. Representative SARS2 VOC spike protein models were generated and quality checked, protein model superimposition was done, and common contact based on contact mapping was established. Throughout this study, we found that: (1) certain individual variant-specific amino acid mutations can affect the spike protein structural pattern; (2) certain individual variant-specific amino acid mutations had no affect on the spike protein structural pattern; and (3) certain combination of variant-specific amino acids are putatively epistatic mutations that can potentially influence the VOC spike protein structural pattern. This manuscript was submitted as part of a theme issue on "Modelling COVID-19 and Preparedness for Future Pandemics".

Nano-antivirals: A comprehensive review

Nanoparticles can be used as inhibitory agents against various microorganisms, including bacteria, algae, archaea, fungi, and a huge class of viruses. The mechanism of action includes inhibiting the function of the cell membrane/stopping the synthesis of the cell membrane, disturbing the transduction of energy, producing toxic reactive oxygen species (ROS), and inhibiting or reducing RNA and DNA production. Various nanomaterials, including different metallic, silicon, and carbon-based nanomaterials and nanoarchitectures, have been successfully used against different viruses. Recent research strongly agrees that these nanoarchitecture-based virucidal materials (nano-antivirals) have shown activity in the solid state. Therefore, they are very useful in the development of several products, such as fabric and high-touch surfaces. This review thoroughly and critically identifies recently developed nano-antivirals and their products, nano-antiviral deposition methods on various substrates, and possible mechanisms of action. By considering the commercial viability of nano-antivirals, recommendations are made to develop scalable and sustainable nano-antiviral products with contact-killing properties. Copyright © 2022 Hussain, Abro, Ahmed, Memon and Memon.

In silico study to find a potent inhibitor, Vilazodone, to cure COVID-19 using molecular docking

The pandemic caused by the coronavirus SARS-COVID-2 has had devastating impact on the world. It has caused a significant number of deaths across the world. Fast spread and lack of vaccine prompted academia to adopt new, fast and reliable methodologies to design new drugs. A combined approach of direct drug design and indirect drug design has been used for molecular docking. In the study, we found a compound, Vilazodone, with a binding energy of -8.40 kcal/mol. The druglikeness properties of this compound are investigated through SWISS ADMET analysis. In this in-silico study, we confirmed this compound is a potential drug candidate against SARS-CoV-2.However, in-vitro and in-vivo studies are required to prove its efficacy. © 2022 IEEE.

Network analysis of the autophagy biochemical network in relation to various autophagy-targeted proteins found among SARS-CoV-2 variants of concern.

Autophagy is an important cellular process that triggers a coordinated action involving multiple individual proteins and protein complexes while SARS-CoV-2 (SARS2) was found to both hinder autophagy to evade host defense and utilize autophagy for viral replication. Interestingly, the possible significant stages of the autophagy biochemical network in relation to the corresponding autophagy-targeted SARS2 proteins from the different variants of concern (VOC) were never established. In this study, we performed the following: autophagy biochemical network design and centrality analyses; generated autophagy-targeted SARS2 protein models; and superimposed protein models for structural comparison. We identified 2 significant biochemical pathways (one starts from the ULK complex and the other starts from the PI3P complex) within the autophagy biochemical network. Similarly, we determined that the autophagy-targeted SARS2 proteins (Nsp15, M, ORF7a, ORF3a, and E) are structurally conserved throughout the different SARS2 VOC suggesting that the function of each protein is preserved during SARS2 evolution. Interestingly, among the autophagy-targeted SARS2 proteins, the M protein coincides with the 2 significant biochemical pathways we identified within the autophagy biochemical network. In this regard, we propose that the SARS2 M protein is the main determinant that would influence autophagy outcome in regard to SARS2 infection.

Tryptophan Metabolism 'Hub' Gene Expression Associates with Increased Inflammation and Severe Disease Outcomes in COVID-19 Infection and Inflammatory Bowel Disease.

The epithelial barrier's primary role is to protect against entry of foreign and pathogenic elements. Both COVID-19 and Inflammatory Bowel Disease (IBD) show commonalities in symptoms and treatment with sensitization of the epithelial barrier inviting an immune response. In this study we use a multi-omics strategy to identify a common signature of immune disease that may be able to predict for more severe patient outcomes. Global proteomic approaches were applied to transcriptome and proteome. Further semi- and relative- quantitative targeted mass spectrometry methods were developed to substantiate the proteomic and metabolomics changes in nasal swabs from healthy, COVID-19 (24 h and 3 weeks post infection); serums from Crohn's disease patients (scored for epithelial leak), terminal ileum tissue biopsies (patient matched inflamed and non-inflamed regions, and controls). We found that the tryptophan/kynurenine metabolism pathway is a 'hub' regulator of canonical and non-canonical transcription, macrophage release of cytokines and significant changes in the immune and metabolic status with increasing severity and disease course. Significantly modified pathways include stress response regulator EIF2 signaling (p = 1 × 10-3); energy metabolism, KYNU (p = 4 × 10-4), WARS (p = 1 × 10-7); inflammation, and IDO activity (p = 1 × 10-6). Heightened levels of PARP1, WARS and KYNU are predictive at the acute stage of infection for resilience, while in contrast, levels remained high and are predictive of persistent and more severe outcomes in COVID disease. Generation of a targeted marker profile showed these changes in immune disease underlay resolution of epithelial barrier function and have the potential to define disease trajectory and more severe patient outcomes.

Stakeholders analysis of COVID-19 management and control: a case of Iran.

BACKGROUND: The COVID-19 pandemic is a multi-faceted phenomenon with many political, economic and social consequences. Success in managing and controlling this pandemic depends on the coordinated efforts of many organizations and institutions. Therefore, this study aimed to identify and analyze the actors and stakeholders related to managing and controlling this pandemic in Iran. METHODS: This mix-method stakeholder analysis was conducted in 2021 nationwide as retrospectively. The purposive sampling method was applied when inviting eligible participants to participate in the study. Our study was conducted in two phases. In the qualitative phase, data were collected using a semi-structured interview. An interview guide was developed based on the WHO stakeholder analysis framework. In the quantitative phase, we used a questionnaire developed based on the study framework. Each question was scored on a 5-point Likert scale, with a score greater than 4 was considered as high, 3-4 was considered as moderate, and 1-3 was considered as low. Data were analyzed using framework analysis, WHO stakeholders' analysis framework and MENDELOW matrix. MAXQDA qualitative data analysis software Version 11 and Policy Maker software (Version. 4) were used for data analysis. RESULTS: A total of 48 stakeholders were identified. Ministry of Health (MoH), National Headquarters for Coronavirus Control (NHCC) had the highest participation level, high supportive position, and knowledge of the subject. The Parliament of Iran (PoI), Islamic Revolutionary Guard Corps (IRGC), and Islamic Republic of Iran Broadcasting (IRIB) had the highest power/influence during the Covid-19 epidemic. Only two stakeholders (6.06%) had high participation, and 18.18% had moderate participation. All stakeholders except for the NHCC and the MoH lacked appropriate knowledge of the subject. Furthermore, only three stakeholders (9.09%) had high power/influence. CONCLUSION: Given the multidimensional nature of Covid-19, most institutions and organizations were involved in managing this pandemic. Stakeholders with high power/authority and resources had a low/moderate participation level and a moderate supportive position. Moreover, organizations with a high supportive position and participation had low power/authority and resources to cope with COVID-19.

Antibiotic Resistance during COVID-19: A Systematic Review.

One of the public health issues faced worldwide is antibiotic resistance (AR). During the novel coronavirus (COVID-19) pandemic, AR has increased. Since some studies have stated AR has increased during the COVID-19 pandemic, and others have stated otherwise, this study aimed to explore this impact. Seven databases-PubMed, MEDLINE, EMBASE, Scopus, Cochrane, Web of Science, and CINAHL-were searched using related keywords to identify studies relevant to AR during COVID-19 published from December 2019 to May 2022, according to PRISMA guidelines. Twenty-three studies were included in this review, and the evidence showed that AR has increased during the COVID-19 pandemic. The most commonly reported resistant Gram-negative bacteria was Acinetobacterbaumannii, followed by Klebsiella pneumonia, Escherichia coli, and Pseudomonas aeruginosa. A. baumannii and K. pneumonia were highly resistant to tested antibiotics compared with E. coli and P. aeruginosa. Moreover, K. pneumonia showed high resistance to colistin. Commonly reported Gram-positive bacteria were Staphylococcus aureus and Enterococcus faecium. The resistance of E. faecium to ampicillin, erythromycin, and Ciprofloxacin was high. Self-antibiotic medication, empirical antibiotic administration, and antibiotics prescribed by general practitioners were the risk factors of high levels of AR during COVID-19. Antibiotics' prescription should be strictly implemented, relying on the Antimicrobial Stewardship Program (ASP) and guidelines from the World Health Organization (WHO) or Ministry of Health (MOH).

Pharmaceutical services department strategies and patient perception to maintain healthcare services during COVID-19 crisis.

Background: In March 2020, the World Health Organization (WHO) declared Severe Acute Respiratory Syndrome Coronavirus 2 (SARS2-CoV-2) as global pandemic. This health crisis has overwhelmed the healthcare system, leading to unprecedented morbidity and mortality rates. During this pandemic, pharmacies tried to maintain their services either through remote services or face-to-face dispensing and consultation. Objectives: This study aimed to share the strategies and plans adopted by the pharmaceutical services department to maintain the healthcare services during the SARS2-CoV-2 crisis and evaluate the patient's perspective. Methods: A cross-sectional analytical survey was conducted among patients/patient relatives who attended King Hamad University Hospital (KHUH) outpatient pharmacies in the Kingdom of Bahrain between February 2021 and May 2021. Patients have two options: either to submit the survey online through barcode scanning or to fill it as a physical paper and submit it to the pharmacy staff (Online-based and paper-based). A total of 641 responses were received. Hospital applied safety logistics to ensure staff and patient safety. Results: Post-hoc analysis revealed that patients aged between 20 and 39 years had less agreement than patients ≤ 19 years old in terms of preferring to continue the same services after the pandemic (p = 0.009). More level of understanding of pharmacy services was seen among patients with higher educational levels compared to elementary and secondary levels in cases of services related to adverse events (p = 0.038) and wrong/missed medication rectification (p = 0.018). Unemployed patients were more in agreement than employed ones regarding continuing the same procedure after the pandemic, services related to wrong/missed medication rectification, and safety while staying in the pharmacy waiting area. Conclusion: Most patients were satisfied with the face-to-face counseling, pharmacy-adapted strategies, and services during the SARS2-CoV-2 pandemic. Face-to-face service during the pandemic was equally comfortable across all age groups and gender.

Tracing Some Salivary Immune Elements in Iraqi SARS-2 Patients.

Saliva is one of the most significant components in maintaining oral homeostasis and symbiosis. It contains antimicrobial proteins and peptides, such as mucins, lactoferrin, lysozyme, lactoperoxidase, Catherine, statins, and antibodies (secretory immunoglobin A [sIgA]). Early defenses against respiratory infections rely heavily on mucosal immunity, especially secretory sIgA, which has several features and functions that make it suitable for mucosal defense. Salivary testing has been utilized to define mucosal immune responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Lysozyme has muramidase, with antimicrobial activity, and high concentrations in body fluids, such as saliva and tear. This research aimed to offer an update on how saliva components suppress viral infection and sustain health. A total of 50 individuals, including 30 SARS-2 patients and 20 non-infected subjects, in the age range of 32-54 years were enrolled in this study. Saliva specimens were obtained from polymerase chain reaction (PCR)-confirmed coronavirus disease 2019 (COVID-19) patients and non-infected participants. To collect saliva, the subjects were advised to swirl water over their lips three times, and 5.0 ml of saliva was collected. Samples were centrifuged at 800 x g for 10 min. Saliva was diluted at 1:2,000 with 1 × Diluent N. The immunoglobulin A (IgA) titer in saliva was detected. A spectrophotometer was used to measure the solution's change in absorbance at 550 nm. Measurements (salivary IgA and lysozyme) were made after 7, 30, and 60 days of confirmatory PCR COVID-19 test. The mean scores of salivary IgA levels were obtained at 17.85, 15.26, and 10.73 mg/dl in patients and 9.53, 10.33, and 9.21 mg/dl in healthy individuals after 7, 30, and 60 days, respectively. The salivary lysozyme activity levels in SARS-2 patients compared to controls were 9.7, 7.3, and 4.2 mg/dl versus 2.9, 3.4, and 3.77 mg/dl, respectively. The salivary IgA level was significantly higher in patients of a confirmatory test for COVID-19 compared to healthy individuals.

Epidemiology, clinical characteristics and risk factors of COVID-19 among children in Saudi Arabia: a multicenter chart review study.

BACKGROUND: The Coronavirus Disease 2019 (COVID-19) has affected over 100 million cases worldwide. Children accounted for 1-5% of all cases with less reported symptoms and better prognosis compared to adults. This study aimed to describe the epidemiological characteristics and outcomes of pediatric COVID-19 cases in Saudi Arabia in addition to identifying risk factors associated with disease severity. METHODS: This was a multicenter, cross-sectional retrospective study that included confirmed SARS-CoV-2 infection among pediatric patients (< 14 years) from the time of initial identification in March 2020 to the end of July 2020 in 6 centers across the country. Patients were classified based on clinical severity. Study outcomes included time to recovery, need for invasive ventilation, and mortality. Multivariate logistic regression analysis was conducted to explore factors associated with increased disease severity. RESULTS: The study enrolled 567 children with (51.5%) were males, and (44.6%) aged from 6 to 14 years old. Asymptomatic patients accounted for 38.98% of the cases: while 319 patients (56%) had mild disease, and 27 patients (4.76%) had moderate-to-severe disease. Only 10 patients (1.76%) required Pediatric Intensive Care Unit admission. The calculated case-fatality was 0.7%. After performing multivariate regression analysis, chronic lung conditions [adjusted OR = 12.73, 95% CI (2.05-79.12)] and decreased red blood cells (RBCs) count [adjusted OR = 2.43, 95% CI (1.09-5.41] were found to be significant predictors for moderate-to-severe disease (p = 0.006 and 0.030, respectively). CONCLUSION: Most COVID-19 cases in the current study had a benign course of illness and carried an excellent prognosis. Children with chronic lung conditions or low RBCs count are at higher risk to develop moderate-to-severe COVID-19 disease.

Application of thermography to estimate respiratory rate in the emergency room: The journal Temperature toolbox.

Among the vital signs collected during hospital triage, respiratory rate is an important parameter associated with physiological, pathophysiological, and emotional changes. In recent years, the importance of its verification in emergency centers due to the severe acute respiratory syndrome 2 (SARS2) pandemic has become very clear, although it is still one of the least evaluated and collected vital signs. In this context, infrared imaging has been shown to be a reliable estimator of respiratory rate, with the advantage of not requiring physical contact with patients. The objective of this study was to evaluate the potential of analyzing a sequence of thermal images as an estimator of respiratory rate in the clinical routine of an emergency room. We used an infrared thermal camera (T540, Flir Systems) to obtain the respiratory rate data of 136 patients, based on nostrils' temperature fluctuation, during the peak of the COVID-19 pandemic in Brazil and compared it with the chest incursion count method, commonly employed in the emergency screening procedures. We found a good agreement between both methods, with Bland-Altman limits of agreement ranging from -4 to 4 min-1, no proportional bias (R2 = 0.021, p = 0.095), and a strong correlation between them (r = 0.95, p < 0.001). Our results suggest that infrared thermography has potential to be a good estimator of respiratory rate in the routine of an emergency room.

Covid-19 detection from X-ray images using Customized Convolutional Neural Network

COVID-19 continues to have a devastating impact on the lives of people all over the world. Various new technologies arose in the research environment to assist mankind in surviving and living a better life. It is important to screen the infected patients in a timely and cost-effective manner to combat this disease and avoid its transmission. To achieve this aim, detection of Covid-19 from radiological evaluation of chest x-ray images using deep learning algorithms is less expensive and easily available option as it ensures fast and efficient diagnosis of the disease. Therefore, this paper presents a novel customized convolutional neural network (CNN) approach for the detection of COVID-19 from chest x-ray images. The performance of the proposed model is evaluated on three different size datasets, created from publicly available datasets. Experimental results show that the proposed model has better performance on Dataset 2. A very large increase or decrease of the number of samples in the dataset degrades the performance of the proposed model. The performance of the CNN model is compared with traditional pretrained networks namely VGG-16, VGG-19, ResNet-50 and Inception-V3. All the models show promising performance on dataset 2 which shows that optimum amount of data is enough for the model to lean features from the input data. Overall, the best validation accuracy of 97.78 was achieved by the proposed model on dataset 2. © 2022 IEEE.