Postcovid distant complications in periodontal tissues in individuals after inpatient treatment in the red zone

There are no data in the literature on long-term complications in periodontal tissues due to a coronavirus infection. The aim is to study postcovid complications arising in periodontal tissues in patients with general somatic pathology. Materials and methods. At the first stage, 296 patients were examined who were treated in hospitals for COVID-19 and 128 people — the comparison group — without concomitant pathology, who were divided into 6 age groups. The examination included measuring the microcirculation index (MI) and determining the degree of oxygenation in periodontal tissues according to Laser Doppler Flowmetry (LDF) data. At the second stage, the same indicators were determined in 74 patients with complications after COVID-19 in the form of periodontitis, and an index evaluation of periodontal tissues was also performed: periodontal index (PI). The severity of periodontal pathology and the period of its occurrence were assessed depending on the age of patients, the effect of postcovid vasculitis on the state of the microcirculatory bed and the nature of the course of pathological processes in the periodontal. Dopplerograms revealed predictors of the development of severe periodontal pathology. Results. The integral microcirculation index and the level of oxygenation in the periodontium and on the phalanx of the finger in patients with COVID-19 undergoing inpatient treatment were statistically significantly lower than in patients of control groups. Against the background of improved microcirculation and oxygenation of periodontal tissues by 3 months after coronavirus infection, there is a decrease in PMA and PI indices. By the 6th and even more than the 9th month, the examined patients showed a drop in the indicators of regional blood flow and the level of tissue saturation against the background of an increase in the indices of PMA and PI. Conclusions. The greatest number of pathological processes in periodontal tissues occurred in the period from 6 to 9 months, the most pronounced in the age group of 65—80 years — 43.1%, 55—64 years — 41.3%, 45—54 years — in 31.3% of patients. In patients with severe hemorrhagic vasculitis (1.1%), the most pronounced changes in periodontal tissues were observed. In this category of patients, 3 months after the infection, there was a sharp development of rapidly progressive periodontopathy, and by the 9th month there was a complete loss of teeth. The severe form of hemorrhagic vasculitis was characterized by severe microcirculation disorders in periodontal tissues (PM=16.1±0.9). The indicators of microcirculation (PM) below 17.1 and hemoglobin oxygen saturation (SO2) below 77.9 are predictors of the development of inflammatory changes in periodontal tissues. © 2023 Clinical Dentistry LLC. All rights reserved.

Associated effects of clinical characteristics, risk factors, and comorbidity on disease severity and mortality among patients with COVID-19 in Sulaimani City/ Kurdistan Region of Iraq.

The effects of clinical symptoms, laboratory indicators, and comorbidity status of SARS-CoV-2-infected patients on the severity of disease and the risk of death were investigated. Questionnaires and electronic medical records of 371 hospitalized COVID-19 patients were used for data collection (demographics, clinical manifestation, comorbidities, laboratory data). Association among categorical variables was determined using Kolmogorov-Smirnov test (P-value ≤0.05). Median age of study population (249 males, 122 females) was 65 years. Roc curves analysis found that age ≥64 years and age ≥67 years are significant cut-offs identifying patients with more severe disease and mortality at 30 days. CRP values at cut-off ≥80.7 and ≥95.8 significantly identify patients with more severe disease and mortality. Patients with more severe disease and risk of death were significantly identified with platelet value at the cut-off ≤160,000, hemoglobin value at the cut-off ≤11.7, D-Dimer values ≥1383 and ≥1270, and with values of neutrophil granulocytes (≥8.2 and ≤2) and lymphocytes (≤2 and ≤2.4). Detailed clinical investigation suggests granulocytes together with lymphopenia may be a potential indicator for diagnosis. Older age, several comorbidities (cancer, cardiovascular diseases, hypertension) and more laboratory abnormalities (CRP, D-Dimer, platelets, hemoglobin) were associated with development of more severity and mortality among COVID-19 patients.

Immunologic and Autoimmune-Related Sequelae of Severe Acute Respiratory Syndrome Coronavirus 2 Infection: Clinical Symptoms and Mechanisms of Disease.

The COVID-19 pandemic has resulted in a significant number of people developing long-term health effects of postacute sequelae SARS-CoV-2 infection (PASC). Both acute COVID-19 and PASC are now recognized as multiorgan diseases with multiple symptoms and disease causes. The development of immune dysregulation during acute COVID-19 and PASC is of high epidemiologic concern. Both conditions may also be influenced by comorbid conditions such as pulmonary dysfunction, cardiovascular disease, neuropsychiatric conditions, prior autoimmune conditions and cancer. This review discusses the clinical symptoms, pathophysiology, and risk factors that affect both acute COVID-19 and PASC.

Diabetes Mellitus And Covid-19

Background and Purpose: according to the studies that have been conducted so far, the corona virus has more severe clinical consequences in diabetic patients than in non-diabetic cases;Therefore, the present study was conducted with the aim of investigating the severity of the disease and mortality in patients infected with the Coronavirus between these 2 groups. Materials and Methods: In this cross-sectional-analytical study, the clinical records of 185 hospitalized patients with a positive laboratory diagnosis of Covid-19 were reviewed from February 14 to February 26, 2020. The patients were divided into 2 non-diabetic (95 people) and diabetic (90 people) groups, and their clinical symptoms and blood biochemical parameters were compared. Results: Based on the results, most of the patients were male and compared to non-diabetic patients, the diabetic group was significantly older (P=0.01). In this study, the disturbance in paraclinical factors such as d-dimer, BUN, VBG and lymphopenia in diabetic patients was significantly higher than in the control group, which indicates the need for more care in diabetic patients. Conclusion: it is suggested to follow health protocols for people with land diseases, be more careful., therefore, more extensive research with larger sample sizes is needed to achieve more accurate results. [ FROM AUTHOR] Copyright of Journal of Pharmaceutical Negative Results is the property of ResearchTrentz and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Importance of herpes viruses in children with post-COVID conditions

Aim: to assess the prevalence of detection of confirmed herpes virus infections (HVI) in children who had a previous COVID-19 infection, characterize specific clinical manifestations of the disease under the new conditions (post-COVID syndrome), and to provide a rationale for the administration of drug therapy. Patients and Methods: of 456 patients who received medical consultations from September 2021 to July 2022, the authors selected 72 (15.8%) children (42 boys and 30 girls) who had a previous SARS-CoV-2 infection confirmed by serological tests or polymerase chain reaction and in whom herpes viruses were found during serological evaluation. Results: most of the children (81.4%) visited the polyclinic within the first six months after the COVID-19 infection. Epstein-Barr virus (EBV) was the most prevalent finding among herpesviruses detected in children with post-COVID-19 sequela — it was detected in 44 (61.1%) cases. Human herpesvirus (HHV) 6 and cytomegalovirus (CMV) were less common in this group and found in 41 (56.9%) and 30 (41.7%) children, respectively. HHV-1 and HHV-2 were detected more rarely — in 11 (15.3%) children. Monoinfection was diagnosed in 41 (56.9%) cases and a combination of viruses was found in 31 children, in 22 (71.0%) of them it comprised two viruses, in 6 (19.3%) — three viruses, and in 3 (9.7%) — four viruses. The presence of herpesvirus infections underpinned the main reasons why parents of the ill children were seeking for outpatient care, in particular: a prolonged subfebrile condition (18.0%), fatigue and sleep disorders (27.7%), rashes (16.6%), lymphadenopathy (16.7%), ENT diseases (33.3%), more frequently occurring respiratory diseases (33.3%), and the increase in seizure activity in children with epilepsy (8.3%). In addition to herpes viruses, pathogenic agents were detected in 18% of patients, including intracellular pathogens, which were found in 13.9% of 72 children. Taking into consideration the obtained results and established clinical diagnoses, the authors conducted a review and provided a rationale for the administered drug therapy, including medications for herpes treatment. Conclusion: a prior COVID-19 infection induces immunosuppression and, as a result, the activation of herpesvirus infections as long-term effects of COVID-19 (post-COVID conditions). The presence of mixed viral and bacterial pathogens is an indication for administering antivirals, immunomodulators, antibacterial agents, and probiotics. © 2023, Meditsina-Inform LLC. All rights reserved.

The Extent of Lung Involvement Based on CT-Scores, Compared to Clinical Symptoms and Laboratory Findings in COVID-19 Patients

Novel coronavirus disease 2019 (COVID-19) has become a public health concern with over 6.5 million cases and 390,000 deaths around the world. This research aimed to find an association between computed tomography (CT) scores and clinical and laboratory findings to estimate the extent of lung infection in patients with COVID-19. The study sample enrolled 129 patients diagnosed with COVID-19 from January to February 2020. The chest CT images and clinical data were reviewed, images were segmented and scored by the degree of involvement from 0 to 4, and the relationship between them and clinical and laboratory findings were analyzed statistically. This study included 74 men and 59 women with a mean age of 55.08 years. Different abnormalities were observed;the mean CT score was 8.52 (7.83 to 9.21) and the most frequent lesions were GGO and consolidation. Our results revealed significant differences between groups categorized by dyspnea, sore throat, and low oxygen saturation concerning CT scores. There was also a significant correlation between CT scores and WBC counts and CRP levels (P<0.05). The evidence from this study implies that clinical and laboratory data, such as CRP, dyspnea, lymphopenia, and symptom onset closely correspond to chest CT scores and may be employed as initial tools to estimate the extent of lung involvement in COVID-19 patients.Copyright © 2023 Tehran University of Medical Sciences.

A simple diagnostic scoring system for COVID-19 screening

Background: The COVID-19 pandemic has prompted the world to make various efforts to control its spread by finding ways to diagnose COVID-19 quickly and accurately. Early identification of COVID-19 infection is essential, especially in hospitals with limited resources. We aimed to generate two scores based upon clinical and laboratory findings in patients screen for COVID-19 infection. Methodology: This study used a retrospective cohort design that involved 705 adults (>= 18 y old) admitted in Dr. Sardjito Hospital and Dr. S. Hardjolukito Hospital. The patients' data collected included demographic characteristics, anamnesis on signs and symptoms, history of contact with COVID-19 patients, history of staying or visiting an endemic area, comorbidities, and laboratory and radiologic indicators. All variables with a P < 0.25 on the bivariate test were included in a univariable logistic regression. If the P < 0.05, the variable was included in the multivariable logistic regression with a P < 0.05 considered significant. Receiver Operating Characteristic (ROC) producing an area under the curve (AUC) with 95% confidence intervals (CIs) was used to assess discrimination power. Results: Two scores were generated;score in Model 1 consisted of clinical signs, basic laboratory indicators, and chest X-ray, and in Model 2 consisted of clinical signs, chest X-ray, basic and advanced laboratory indicators, including C-reactive protein (CRP), lactate dehydrogenase (LDH), albumin, and D-dimer. The ROC score of Model 1 was 0.801 (0.764-0. 838), which is considered good discrimination, and of Model 2 had excellent discrimination with a ROC of 0.858 (0.826-0. 891);the differences in the ROC of the two models was statistically significant (P = 0.03). The score of Model 1 more than 5 had 85% sensitivity and 61% specificity of positive COVID-19. A score of Model 2 more than 4 had 83% sensitivity and 72% specificity for diagnosing positive COVID-19. Conclusions: A simple score consisting of clinical symptoms and signs, and simple laboratory indicators can be used to screen for COVID-19 infection.

Moral Injury Among Frontline Long-Term Care Staff and Management During the COVID-19 Pandemic.

Background: A growing body of research highlights the experiences of moral injury among healthcare professionals during the COVID-19 pandemic. Moral injury (i.e., participating in or witnessing acts that violate one's central moral values), is associated with a host of psychological sequelae and corresponding negative psychosocial impacts. There is a lack of research examining the experiences of moral injury among those working in long-term care settings during the COVID-19 pandemic. Given the drastic impact that the COVID-19 pandemic has had on long-term care facilities in Canada, it is important to understand the experiences of moral injury among those working in long-term care settings to inform the development of effective prevention and intervention strategies. Objectives & Method: The objectives of this study were to understand the experiences and impact of moral injury among Canadian frontline long-term care workers (staff and management) during the COVID-19 pandemic. Participants (N = 32 long-term care staff and management working in Ottawa and Manitoba) completed in-depth, semi-structured qualitative interviews and clinical diagnostic assessments (Mini International Neuropsychiatric Interviews; MINI; Version 7.0.2) between March 2021-June 2021. Findings: The core category of our qualitative grounded theory model of moral injury in long-term care exemplified four shared types of morally injurious experiences, paired with cognitive, affective, and physiological symptom domains. Seven associated main themes emerged, contributing to the experiences and impact of moral injury in long-term care: 1) Beliefs about older adults and long-term care; 2) Interpretation of morally injurious experiences; 3) Management of morally injurious experiences; 4) Long-term care pandemic impacts; 5) Personal pandemic impacts; 6) Structural impacts in long-term care; and 7) Mental health needs and supports. Clinical assessments demonstrated anxiety disorders (n = 4) and feeding and eating disorders (n = 3) were among the most frequently classified current psychiatric disorders among long-term care workers. Conclusions: This is the first Canadian study to examine the experiences and impact of moral injury in long-term care during the COVID-19 pandemic using qualitative and clinical diagnostic methodologies. Implications and insights for screening and intervention are offered.

Simulation of COVID-19 symptoms in a genetically engineered mouse model: implications for the long haulers.

The ongoing pandemic (also known as coronavirus disease-19; COVID-19) by a constantly emerging viral agent commonly referred as the severe acute respiratory syndrome corona virus 2 or SARS-CoV-2 has revealed unique pathological findings from infected human beings, and the postmortem observations. The list of disease symptoms, and postmortem observations is too long to mention; however, SARS-CoV-2 has brought with it a whole new clinical syndrome in "long haulers" including dyspnea, chest pain, tachycardia, brain fog, exercise intolerance, and extreme fatigue. We opine that further improvement in delivering effective treatment, and preventive strategies would be benefited from validated animal disease models. In this context, we designed a study, and show that a genetically engineered mouse expressing the human angiotensin converting enzyme 2; ACE-2 (the receptor used by SARS-CoV-2 agent to enter host cells) represents an excellent investigative resource in simulating important clinical features of the COVID-19. The ACE-2 mouse model (which is susceptible to SARS-CoV-2) when administered with a recombinant SARS-CoV-2 spike protein (SP) intranasally exhibited a profound cytokine storm capable of altering the physiological parameters including significant changes in cardiac function along with multi-organ damage that was further confirmed via histological findings. More importantly, visceral organs from SP treated mice revealed thrombotic blood clots as seen during postmortem examination. Thus, the ACE-2 engineered mouse appears to be a suitable model for studying intimate viral pathogenesis thus paving the way for identification, and characterization of appropriate prophylactics as well as therapeutics for COVID-19 management.

Mountain spa rehabilitation improved health of patients with post-COVID-19 syndrome: pilot study.

European Association of Spa Rehabilitation (ESPA) recommends spa rehabilitation for patients with post-COVID-19 syndrome. We tested the hypothesis that a high-altitude environment with clean air and targeted spa rehabilitation (MR - mountain spa rehabilitation) can contribute to the improving platelet mitochondrial bioenergetics, to accelerating patient health and to the reducing socioeconomic problems. Fifteen healthy volunteers and fourteen patients with post-COVID-19 syndrome were included in the study. All parameters were determined before MR (MR1) and 16-18 days after MR (MR2). Platelet mitochondrial respiration and OXPHOS were evaluated using high resolution respirometry method, coenzyme Q10 level was determined by HPLC, and concentration of thiobarbituric acid reactive substances (TBARS) as a parameter of lipid peroxidation was determined spectrophotometrically. This pilot study showed significant improvement of clinical symptoms, lungs function, and regeneration of reduced CI-linked platelet mitochondrial respiration after MR in patients with post-COVID-19 syndrome. High-altitude environment with spa rehabilitation can be recommended for the acceleration of recovery of patients with post-COVID-19 syndrome.

Estimating Methods of the Undetected Infections in the COVID-19 Outbreak: A Systematic Review.

INTRODUCTION: The accurate number of COVID-19 cases is essential knowledge to control an epidemic. Currently, one of the most important obstacles in estimating the exact number of COVID-19 patients is the absence of typical clinical symptoms in a large number of people, called asymptomatic infections. In this systematic review, we included and evaluated the studies mainly focusing on the prediction of undetected COVID-19 incidence and mortality rates as well as the reproduction numbers, utilizing various mathematical models. METHODS: This systematic review aims to investigate the estimating methods of undetected infections in the COVID-19 outbreak. Databases of PubMed, Web of Science, Scopus, Cochrane, and Embase, were searched for a combination of keywords. Applying the inclusion/exclusion criteria, all retrieved English literature by April 7, 2022, were reviewed for data extraction through a two-step screening process; first, titles/abstracts, and then full-text. This study is consistent with the PRISMA checklist. RESULTS: In this study, 61 documents were retrieved using a systematic search strategy. After an initial review of retrieved articles, 6 articles were excluded and the remaining 55 articles met the inclusion criteria and were included in the final review. Most of the studies used mathematical models to estimate the number of underreported asymptomatic infected cases, assessing incidence and prevalence rates more precisely. The spread of COVID-19 has been investigated using various mathematical models. The output statistics were compared with official statistics obtained from different countries. Although the number of reported patients was lower than the estimated numbers, it appeared that the mathematical calculations could be a useful measure to predict pandemics and proper planning. CONCLUSION: In conclusion, our study demonstrates the effectiveness of mathematical models in unraveling the true burden of the COVID-19 pandemic in terms of more precise, and accurate infection and mortality rates, and reproduction numbers, thus, statistical mathematical modeling could be an effective tool for measuring the detrimental global burden of pandemic infections. Additionally, they could be a really useful method for future pandemics and would assist the healthcare and public health systems with more accurate and valid information.

A simple diagnostic scoring system for COVID-19 screening

Background: The COVID-19 pandemic has prompted the world to make various efforts to control its spread by finding ways to diagnose COVID-19 quickly and accurately. Early identification of COVID-19 infection is essential, especially in hospitals with limited resources. We aimed to generate two scores based upon clinical and laboratory findings in patients screen for COVID-19 infection. Methodology: This study used a retrospective cohort design that involved 705 adults (>= 18 y old) admitted in Dr. Sardjito Hospital and Dr. S. Hardjolukito Hospital. The patients' data collected included demographic characteristics, anamnesis on signs and symptoms, history of contact with COVID-19 patients, history of staying or visiting an endemic area, comorbidities, and laboratory and radiologic indicators. All variables with a P < 0.25 on the bivariate test were included in a univariable logistic regression. If the P < 0.05, the variable was included in the multivariable logistic regression with a P < 0.05 considered significant. Receiver Operating Characteristic (ROC) producing an area under the curve (AUC) with 95% confidence intervals (CIs) was used to assess discrimination power. Result(s): Two scores were generated;score in Model 1 consisted of clinical signs, basic laboratory indicators, and chest X-ray, and in Model 2 consisted of clinical signs, chest X-ray, basic and advanced laboratory indicators, including C-reactive protein (CRP), lactate dehydrogenase (LDH), albumin, and D-dimer. The ROC score of Model 1 was 0.801 (0.764-0. 838), which is considered good discrimination, and of Model 2 had excellent discrimination with a ROC of 0.858 (0.826-0. 891);the differences in the ROC of the two models was statistically significant (P = 0.03). The score of Model 1 more than 5 had 85% sensitivity and 61% specificity of positive COVID-19. A score of Model 2 more than 4 had 83% sensitivity and 72% specificity for diagnosing positive COVID-19. Conclusion(s): A simple score consisting of clinical symptoms and signs, and simple laboratory indicators can be used to screen for COVID-19 infection. Copyright © 2022 Faculty of Anaesthesia, Pain and Intensive Care, AFMS. All rights reserved.

Association of Clinical Features with Spike Glycoprotein Mutations in Iranian COVID-19 Patients.

BACKGROUND: Mutations in spike glycoprotein, a critical protein of SARS-CoV-2, could directly impact pathogenicity and virulence. The D614G mutation, a non-synonymous mutation at position 614 of the spike glycoprotein, is a predominant variant circulating worldwide. This study investigated the occurrence of mutations in the crucial zone of the spike gene and the association of clinical symptoms with spike mutations in isolated viruses from Iranian patients infected with SARS-CoV-2 during the second and third waves of the COVID-19 epidemic in Isfahan, the third-largest city in Iran. METHODS: The extracted RNA from 60 nasopharyngeal samples of COVID-19 patients were subjected to cDNA synthesis and RT-PCR (in three overlapping fragments). Each patient's reverse transcriptase polymerase chain reaction (RT-PCR) products were assembled and sequenced. Information and clinical features of all sixty patients were collected, summarized, and analyzed using the GENMOD procedure of SAS 9.4. RESULTS: Analysis of 60 assembled sequences identified nine nonsynonymous mutations. The D614G mutation has the highest frequency among the amino acid changes. In our study, in 31 patients (51.66%), D614G mutation was determined. For all the studied symptoms, no significant relationship was observed with the incidence of D614G mutation. CONCLUSIONS: D614G, a common mutation among several of the variants of SARS-CoV-2, had the highest frequency among the studied sequences and its frequency increased significantly in the samples of the third wave compared to the samples of the second wave of the disease.

Transcutaneous Auricular Vagus Nerve Stimulation Improves Inflammation but Does Not Interfere with Cardiac Modulation and Clinical Symptoms of Individuals with COVID-19: A Randomized Clinical Trial.

Transcranial auricular vagus nerve stimulation (taVNS) has shown effectiveness in reducing inflammation and depression. Thus, this study evaluated its effect on inflammation, cardiac autonomic modulation, and clinical symptoms in individuals affected by COVID-19. Methods: There were 52 randomized participants hospitalized with COVID-19 diagnosis who were to receive active (a-taVNS) or sham taVNS (s-taVNS) for 90 min twice a day for seven consecutive days. Interleukin 6 (IL-6), 10 (IL-10), cortisol, C-reactive protein (CRP), heart rate variability (HRV), and clinical symptoms were assessed before and after seven days of treatment. There were also seven- and fourteen-day follow-ups for clinical symptoms, including anxiety and depression levels, as well as a six-month follow-up for memory and attention levels. Results: There was significant reduction in CRP -23.9%, (95% CI -46.3 to -1.4) and IL-6 -37.7%, (95% CI -57.6 to -17.7) for the a-taVNS group. There were no changes in IL-10, cortisol levels, or in HRV results (p > 0.05) in both groups. There were no changes regarding clinical symptoms, except for a significant decrease in depression level (-2.85, 95% CI -5.44 to -0.27) in the a-taVNS group. Conclusion: taVNS showed effects on CRP, IL-6, and depression levels; however, it did not affect other clinical symptoms.

Clinical and Laboratory Characteristics of Patients with Paediatric Inflammatory Multisystem Syndrome Temporally Associated with COVID-19 (PIMS-TS)

Introduction. Paediatric Inflammatory Multisystem Syndrome Temporally Associated with COVID-19 (PIMS-TS) is a rare complication of SARS-CoV-2 infection in children. There are also problems with the digestive system (vomiting, diarrhea, abdominal pain), conjunctivitis, headaches, swelling of the hands and feet, and others. Aim. The aim of the study is the clinical and laboratory evaluation of patients meeting the PIMS-TS criteria according to the RCPCH. This study aimed to determine the clinical and laboratory characteristics of patients meeting criteria for PIMS-TS. Material and methods. The study was a retrospective analysis of hospital records of 29 PIMS-TS patients of the Provincial Paediatric Hospital in Bydgoszcz hospitalised between November 2020 and August 2021. Results. Fever was found in 100% of the patients. Other symptoms re-ported were gastrointestinal problems, headache, apathy, oral inflammation, and more. Every fourth patient was diagnosed with pulmonary interstitial lesions in the form of smudgy or fine patchy thickening. Echocardiographic tests showed decreased left ventricular contractility in 10 patients. Reduced left ventricular fractional shortening below 28% was found in four patients and ejection fraction below 55% in five patients. In every second child, abdominal ultrasound imaging showed lesions such as enlarged mesenteric lymph nodes, peritoneal effusion, or enlarged liver. Changes were also confirmed by laboratory tests. Conclusions. Patients with PIMS-TS showed increased levels of inflammatory and myocardial dysfunction markers. The long-term prognosis for PIMS-TS is still uncertain. Further research and observation are needed to determine long-term complications and the actual pathomechanisms of the disease.

USE OF MOUTHWASH AND DENTIFRICE CONTAINING AN ANTIMICROBIAL PHTHALOCYANINE DERIVATIVE FOR THE REDUCTION OF CLINICAL SYMPTOMS OF COVID-19: A RANDOMIZED TRIPLE-BLIND CLINICAL TRIAL.

PURPOSE: This clinical trial aimed to evaluate the use of mouthwash and dentifrice containing an antimicrobial phthalocyanine derivative (APD) to reduce the clinical symptoms in patients with COVID-19. METHODS: This randomized, triple-blind clinical trial enrolled 134 patients aged 18 years or older who underwent COVID-19 testing through the use of nasopharyngeal swab RT-qPCR in a reference center for the diagnosis of COVID-19, had no clinical contraindications to mouthwash and gargle, and had access to cell phones with communication applications. According to the use of a mouthwash and dentifrice containing antimicrobial phthalocyanine derivatives (APD), patients were randomly assigned (1:1) to the APD or non-APD (control) group. All participants were instructed to floss twice a day, brush teeth for 2 minutes 3 times a day, and gargle/rinse (5 mL) for 1 min/3 times a day for 7 days. An online questionnaire was sent to collect data on the clinical symptoms of COVID-19 3 times: T0 (baseline before using the oral hygiene products), T3 (3 days after), and T7 (7 days after). The investigators, patients, and outcome assessors were blinded to group assignment. The Mann-Whitney, Chi-Square, Fisher's exact, and Cochran's tests were used according to the nature of the variables studied, with the level of significance set at P < .05. RESULTS: No statistically significant difference was found in the prevalence of symptoms between groups at baseline. A statistically significant reduction in clinical symptoms was found in the control group (fatigue, shortness of breath, hoarse voice, sore throat, nasal congestion, and chest pain) and APD group (cough, fatigue, shortness of breath, hyposmia/anosmia, dysgeusia, hoarse voice, sore throat, nasal congestion, chest pain, diarrhea, and irritability/confusion) during the follow-up period. There were statistically significant differences, with a higher prevalence of symptoms in the control group at T3 and T7. Dysgeusia, sore throat, and irritability/confusion were less prevalent in the APD group at T3, and shortness of breath, hyposmia/anosmia, dysgeusia, hoarse voice, sore throat, diarrhea, and irritability/confusion were more prevalent in the control group at T7. CONCLUSIONS: Based on this methodology, the results demonstrated that the regular use of mouthwash and dentifrice-containing APD had a positive impact on the clinical symptoms, as reported by patients with COVID-19.

The Evaluation of Diagnostic Values of Clinical Symptoms for COVID-19 Hospitalized Patients in Northern Iran: The Syndromic Surveillance System Data

Background: A novel coronavirus led to a rapidly spreading outbreak of COVID-19, which caused morbidity and mortality world-wide. Appropriate case definitions can help diagnose COVID-19. Objectives: This study aimed to evaluate the COVID-19 clinical symptoms and their potential patterns using latent class analysis (LCA) for identifying confirmed COVID-19 cases among hospitalized patients in northern Iran according to the syndromic surveil-lance system data. Methods: This cross-sectional study was conducted on patients with COVID-19 admitted to hospitals in Mazandaran Province, Iran. Respiratory specimens were collected by nasopharyngeal swabs from the patients and tested for COVID-19 using reverse transcrip-tion polymerase chain reaction (RT-PCR). Latent class analysis was used to identify patterns of the symptoms. The sensitivity, speci-ficity, and area under the receiver operating characteristic (ROC) curve (AUC) of each symptom pattern were compared and plotted. Also, multiple logistic regression was used to determine the odds ratio for each symptom pattern for predicting COVID-19 infection by adjusting for gender and age groups. Results: Among 13,724 hospitalized patients tested for COVID-19 and included in the analyses, 4,836 (35, 2%) had RT-PCR confirmed COVID-19. The symptoms of fever, chills, cough, shortness of breath, fatigue, myalgia, sore throat, diarrhea, nausea or vomiting, headache, and arthralgia were significantly more common in patients positive for COVID-19 than in other patients and were used in LCA. Latent class analysis suggested six classes (patterns) of clinical symptoms. The AUC of symptom patterns was poor, being 0.43 for class 5, comprising patients without any symptoms, and 0.53 for class 3, comprising patients with fever, chills, and cough. Also, multiple logistic regression showed that class 1, comprising patients with fever, chills, cough, shortness of breath, sore throat, and arthralgia, had an odds ratio of 2.87 (1.39, 3.43) relative to class 5 (patients without any symptoms) for positive COVID-19. Conclusions: This study showed that the clinical symptoms might help diagnose COVID-19. However, the defined clinical symptoms suggested in the surveillance system of COVID-19 in Iran during this time were not appropriate for identifying COVID-19 cases.

The Ocular Surface

This is a study of patients who were diagnosed with COVID-19 between December 30 and February 7, 2020 with a clinical diagnosis of COVID-19, a total of 102 patients (48 males and 47 percent and 54 are female 53 percent) were diagnosed with clinical symptoms, Respiratory therapy and chest computer Tomography (CT) abnormalities. Patient's gestational age is 57.63 [14.90] year on average [SD].A total of 102 patients were recognize, with 72 of them being men (50%) and women (50%) respectively. Only two patients (2.78 percent) were found to have conjunctivitis out of 62 patients with laboratory confirmed COVID-19. SARS-COV2 RT-PCR detected ocular discharges in only one of two patients, SARS-COV-2 fragments. Covid-19 infected about 80,000 people in just three months, according to estimates with the help of 300 medical personal. It attacks the respiratory tract first and foremost, although it also affects extra-pulmonary locations, the gastrointestinal tract, as well as other organs. Fever, tiredness, and cough are the early symptoms of SARS-COV-2 infection,. Which rapidly develops into pneumonia. A large number of patients experience symptoms such as headaches, diarrhea, nausea, and vomiting at the start of their disease, and some patients also experience nausea and vomiting some patients occur with asymptomatic infection. Despite the fact that SARS-COV2 infection via the ocular surface is rare was shown to be astonishingly low in this investigation SARS-COV2 infection transmitted through the eyes as a nosocomial illness following occupation exposure is a viable route. the reduced positive rate of SARS-COV-2 conjunctival swab samples could be due to an ineffective diagnosis technique and a sampling time lag. © The Electrochemical Society

Evaluation of the prevalence and clinical and laboratory features of acute viral myositis in children with influenza referred to the emergency department of Ali Asghar Tehran Hospital in 2019 and 2020.

Introduction: Influenza-related viral myositis is observed mostly in children with influenza, and the disease is more common in influenza type B. The aim of the present study was to evaluate the prevalence, and clinical and laboratory features of acute viral myositis in children with influenza in 2019 and 2020. Methods: This retrospective cross-sectional study was performed in Ali Asghar Hospital, from December 2019 to February 2020. Children aged 2-14 years with symptoms of acute onset of fever, along with the symptoms of influenza with or without muscle pain who referred to the emergency department of Hazrat Ali Asghar Children's Hospital, were included in the study. The data were collected and analyzed by Statistical Package for the Social Sciences (SPSS) version 22. Results: Out of the 105 participants in this study, 62 (59%) were male and the rest were female. The average age of the patients was 5.34 years (SD = 2.63). Clinical signs of lower limb pain, myalgia, lameness, weakness, and lethargy were significantly more common in patients with myositis (P-value < 0.05). In-vitro examination demonstrated that creatine phosphokinase (CPK), aspartate aminotransferase (AST), and aAlanine aminotransferease (ALT) levels were significantly higher in patients with myositis. Conclusion: Based on the present results, the clinical symptoms in patients are quite clear, and based on the symptoms, it is possible to diagnose and treat myositis without relying on laboratory findings; due to the self-limitation of this complication and lack of the need for complex treatments in case of early diagnosis, physicians can diagnose and treat many cases, depending on the clinical symptoms and the accuracy of the examination.

A Supervised Multi-tree XGBoost Model for an Earlier COVID-19 Diagnosis Based on Clinical Symptoms

Efficient screening of Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) enables quick and efficient diagnosis of SARS-CoV-2 and can mitigate the burden on healthcare systems. The aim was to assist the medical team globally in triaging incoming patients, especially in countries with limited healthcare infrastructure. In this context, the features with imminent infection risk (Test Indication, Fever, and Headache) were obtained using a multi-tree XGBoost algorithm. Based on their feature importance, the top three clinically relevant earlier clinical symptoms (attributes) were employed to create a Multi-tree XGBoost-based model for an earlier prediction of SARS-CoV-2. Overall, our Multi-tree XGBoost model predicted SARS-CoV-2 infection status with a high F1-score (0.9920 +/- 0.008) and AUC value (0.9974 +/- 0.0026) only by assessing the primary three clinical symptoms related to COVID-19 infection. Thus our multi-tree XGBoost - based model suggests a simple and accurate method for earlier detection of SARS-CoV-2 cases and initiating proper treatment protocol for SARS-CoV-2 positive patients. Therefore, we can conclude that our model will allow the health organizations to potentially reduce the infection rate and mortality in masses with COVID-19 infection and fatality due to SARS-CoV-2.