Correlation between Blood Group, Sex Prevalence and Residency with COVID19 Positive Cases in Wasit Province, Iraq

Coronavirus disease 2019 (COVID-19) is one of the updated challenges facing the whole world. To identify the more blood group that positive to COVID19 in male or female. A cross-sectional study was conducted for positively confirmed 265 patients with COVID19 positive in Wasit province at AL-Zahraa Teaching Hospital from the period of March 13th till April 20th. All of them full a question-naire regarded by risk factors and other comorbidities. Data were analyzed by SPSS version 23 using fre-quency tables and percentage. For numerical data, the median, and interquartile range (IQR) were used. Differences between categorical groups were performed by fissure exact test. In this study, the median age of the patients was 43 years old and interquartile range 25-56 years. Majority of the patients were female 60% and 51% of them were from the same region (wasite). The dominant blood group among patients was (O) 40%. The highest percentage of comorbidities among patients was hypertension 40%, and the most presenting symptoms were cough and fever. About 51% of patients were with mild symptoms. Diabetes, coronary heart diseases, and chronic renal diseases were significantly related to disease severity (P-value=0.02, 0.001, 0.01 respectively.Copyright © 2023, Colegio de Farmaceuticos de la Provincia de Buenos Aires. All rights reserved.

The Correlation between Blood Group, Sex Prevalence and Residency with COVID-19 Positive Cases in Waist Province

Coronavirus disease 2019 (COVID-19) is one of the updated challenges facing the whole world. To identify the more blood group that positive to COVID19 in male or female. A cross-sectional study was conducted for positively confirmed 265 patients with COVID19 positive in Waist province at AL-Zahraa Teaching Hospital from the period of March 13th till April 20th. All of them full a questionnaire regarded by risk factors and other comorbidities. Data were analyzed by SPSS version 23 using frequency tables and percentage. For numerical data, the median, and interquartile range (IQR) were used. Differences between categorical groups were performed by fissure exact test. In this study, the median age of the patients was 43 years old and interquartile range 25-56 years. Majority of the patients were female 60% and 51% of them were from the same region (waist). The dominant blood group among patients was (O) 40%. The highest percentage of comorbidities among patients was hypertension 40%, and the most presenting symptoms were cough and fever. About 51% of patients were with mild symptoms. Diabetes, coronary heart diseases, and chronic renal diseases were significantly re-lated to disease severity (p-value = 0.02, 0.001, 0.01 respectively.Copyright © 2023, Colegio de Farmaceuticos de la Provincia de Buenos Aires. All rights reserved.

Characteristics and outcomes of multisystem inflammatory syndrome in children: A multicenter, retrospective, observational cohort study in Mexico.

Introduction: Multisystem inflammatory syndrome in children associated with coronavirus disease 2019 (MIS-C), a novel hyperinflammatory condition secondary to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is associated with severe outcomes such as coronary artery aneurysm and death. Methods: This multicenter, retrospective, observational cohort study including eight centers in Mexico, aimed to describe the clinical characteristics and outcomes of patients with MIS-C. Patient data were evaluated using latent class analysis (LCA) to categorize patients into three phenotypes: toxic shock syndrome-like (TSSL)-MIS-C, Kawasaki disease-like (KDL)-MIS-C, and nonspecific MIS-C (NS-MIS-C). Risk factors for adverse outcomes were estimated using multilevel mixed-effects logistic regression. Results: The study included 239 patients with MIS-C, including 61 (26%), 70 (29%), and 108 (45%) patients in the TSSL-MIS-C, KDL-MIS-C, and NS-MIS-C groups, respectively. Fifty-four percent of the patients were admitted to the intensive care unit, and 42%, 78%, and 41% received intravenous immunoglobulin, systemic glucocorticoids, and anticoagulants, respectively. Coronary artery dilatation and aneurysms were found in 5.7% and 13.2% of the patients in whom coronary artery diameter was measured, respectively. Any cause in-hospital mortality was 5.4%. Hospitalization after ten days of symptoms was associated with coronary artery abnormalities (odds ratio [OR] 1.6, 95% confidence interval [CI] 1.2-2.0). Age ≥10 years (OR: 5.6, 95% CI: 1.4-2.04), severe underlying condition (OR: 9.3, 95% CI: 2.8-31.0), platelet count <150,000 /mm3 (OR: 4.2, 95% CI: 1.2-14.7), international normalized ratio >1.2 (OR: 3.8, 95% CI: 1.05-13.9), and serum ferritin concentration >1,500 mg/dl at admission (OR: 52, 95% CI: 5.9-463) were risk factors for death. Discussion: Mortality in patients with MIS-C was higher than reported in other series, probably because of a high rate of cases with serious underlying diseases.

Kawasaki Disease in the Time of COVID-19 and MIS-C - The International Kawasaki Disease Registry.

BACKGROUND: Patients with Multisystem Inflammatory Syndrome in Children (MIS-C) and Kawasaki disease (KD) have overlapping clinical features. We compared demographics/clinical presentation, management, and outcomes of patients by evidence of prior SARS-CoV-2 infection. METHODS: The International KD Registry (IKDR) enrolled KD and MIS-C patients from sites from North, Central and South America, Europe, Asia and Middle East. Evidence of prior infection was defined as: Positive (+ve household contact or positive PCR/serology), Possible (suggestive clinical features of MIS-C and/or KD with negative PCR or serology but not both), Negative (negative PCR and serology and no known exposure), and Unknown (incomplete testing and no known exposure). RESULTS: Of 2345 enrolled patients SARS-CoV-2 status was Positive for 1541 (66%) patients, Possible 89 (4%), Negative 404 (17%) and Unknown for 311 (13%) patients. Clinical outcomes varied significantly between the groups, with more patients in the Positive/Possible groups presenting with shock, having admission to Intensive Care, receiving inotropic support, and having longer hospital stays. Regarding cardiac abnormalities, patients in the Positive/Possible groups had a higher prevalence of left ventricular dysfunction, while patients in the Negative and Unknown groups had more severe coronary artery abnormalities. results CONCLUSION: : There appears to be a spectrum of clinical features from MIS-C to KD with a great deal of heterogeneity, and one primary differentiating factor is evidence for prior acute SARS CoV2 infection/exposure. SARS-CoV-2 Positive/Possible patients had more severe presentations and required more intensive management, with a greater likelihood of ventricular dysfunction but less severe coronary artery adverse outcomes, in keeping with MIS-C.

Treatment of Long-Haul COVID Patients With Off-Label Acyclovir.

The SARS-CoV-2 virus (COVID-19) became a global pandemic in March 2020. This novel, highly infectious virus caused millions of infections and deaths around the world. Currently, there are few medications that are available for the treatment of COVID-19. Those affected are most commonly given supportive care, with some experiencing symptoms for months. We report a series of four cases depicting the successful use of acyclovir in the treatment of the virus SARS-CoV-2 in patients with long-haul symptoms, especially those in the realm of encephalopathy and neurological problems. Treatment with acyclovir in these patients resolved their symptoms and lowered their IgG and IgM titers, supporting the use of acyclovir as a safe and effective treatment for COVID-19 neurologic symptoms. We suggest the use of the antiviral medication, acyclovir, as a treatment for patients with long-term symptoms and unusual presentations of the virus, such as encephalopathy or coagulopathy.

Adapting the ethical review process for COVID-19 research: reviewers’ perspectives from Pakistan

Background:Research ethics committees (RECs) globally have adapted their responses to provide timely reviews of research proposals in the wake of the COVID-19 pandemic. The REC of the National Bioethics Committee (NBC) of Pakistan has followed suit.Aims:To explore perceptions of NBC-REC reviewers who reviewed COVID-19 research proposals while describing the newly instituted Rapid Turnaround Review (RTR) system.Methods:This cross-sectional study used 3 methods of data collection: a demographic questionnaire filled in by permanent members and co-opted reviewers; qualitative in-depth interviews conducted with both groups; and document review related to COVID-19 research proposals.Results:Eight permanent members and 3 co-opted members participated. Under the RTR system, the time for review was established as 72 hours after receipt of the proposal. The Committee reviewed 55 projects over 10 months. Participants described numerous strengths of the new system, including introduction of online discussions via Zoom as well as presence of co-opted members leading to learning opportunities, particularly for junior members. The RTR system also allowed NBC-REC to gain recognition it had not enjoyed previously. Challenges identified by respondents included initial difficulty in initiating the system and tighter deadlines that may have compromised review quality. Poor scientific quality of proposals, compounded by external pressures to provide rapid approval, added to reviewers’ frustrations. While fruitful, the RTR system was considered unsustainable beyond a public health emergency.Conclusion:Adaptation of ethical review processes is essential in emergencies; however, existing guidelines have to be modified to suit contextual needs.

Noncommunicable disease, clinical course and COVID-19 prognosis: results based on I-core registry

Background:There are no data on the association between clinical course and comorbidity in Iranian patients with COVID-19.Aims:To determine noncommunicable disease (NCD), clinical characteristics and prognosis of patients hospitalized with COVID-19 in Isfahan, Islamic Republic of Iran.Methods:This multicentric retrospective observational study was performed on all patients hospitalized with COVID-19 in Isfahan from 17 February to 6 April 2020. We recruited 5055 patients. Data on clinical course and comorbid NCDs such as hypertension, coronary heart disease (CHD), diabetes mellitus (DM), cancer, chronic kidney disease (CKD) and chronic respiratory disease (CRD) were collected. Statistical analyses were done by Mann–Whitney U, χ2 and logistic regression tests using Stata version 14.Results:DM and hypertension were the most prevalent comorbidities in patients with positive and negative reverse transcription polymerase chain reaction (RT-PCR). Odds ratio (95% confidence interval) of mortality-associated factors was significant for DM [1.35 (1.07–1.70)], CHD [1.58 (1.26–1.96)], CRD [2.18 (1.58–3.0)], and cancer [3.55 (2.42–5.21)]. These results remained significant for cancer after adjustment for age, sex and clinical factors. Among patients with positive RT-PCR, death was significantly associated with CRD and cancer, while this association disappeared after adjustment for all potential confounders. There was a significant association between NCDs and higher occurrence of low oxygen saturation, mechanical ventilation requirement and intensive care unit admission after adjustment for age and sex.Conclusion:The presence of NCDs alone did not increase mortality in patients with COVID-19, after adjustment for all potential confounders including clinical factors.

Vaccine hesitancy in the Gulf Cooperation Council countries

Background: Vaccination has a tremendous impact on health at the regional and global levels, however, the tendency for people to hesitate on vaccination has been increasing in the past few decades. Aims: We assessed vaccine hesitancy and its determinants in the Gulf Cooperation Council countries. Methods: We conducted a literature review to assess peer-reviewed articles published up to March 2021 on vaccine hesitancy in the Gulf Cooperation Council countries using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses approach. A search was conducted via PubMed and 29 articles were identified. After the removal of duplicates and irrelevant articles, 14 studies remained relevant and were used for the review. Results: Vaccine hesitancy in the Gulf Cooperation Council countries ranged from 11% to 71%. Differences in rates were noted for vaccine type, with COVID-19 vaccine having the highest reported hesitancy (70.6%). The likelihood of accepting vaccination was associated with previous individual acceptance of vaccine, specifically the seasonal influenza vaccine. The most common determinants of vaccine hesitancy were distrust in vaccine safety and concerns about side-effects. Healthcare workers were among the main sources of information and recommendations about vaccination, but 17–68% of them were vaccine-hesitant. The majority of the healthcare workers had never received any training on addressing vaccine hesitancy among patients. Conclusions: Vaccine hesitancy is prevalent among the publics and healthcare workers in the Gulf Cooperation Council countries. There is a need to continually monitor perceptions and knowledge about vaccines and vaccination in these countries to better inform interventions to improve vaccine uptake in the sub-region.

Acceptability of COVID-19 vaccination among healthcare workers in Sudan

Introduction: Several studies have investigated COVID-19 vaccine acceptability and hesitancy, especially among healthcare workers (HCWs). However, acceptability of the vaccine by HCWs in Sudan remains unclear. Aims: We investigated acceptability of the COVID-19 vaccine and its determinants among HCWs in Sudan. Methods: Using a semi-structured questionnaire, we conducted a web-based cross-sectional study of COVID-19 vaccine hesitancy and its associated determinants among healthcare workers in Sudan during March–April 2021. Results: A total of 576 HCWs responded to the survey. Mean age was 35 years. Females (53.3%), medical doctors (55.4%) and being located in Khartoum State (76.0%) each accounted for more than half of the participants. Absolute refusal of the COVID-19 vaccine was expressed by 16.0% of the respondents. Males were more than twice as likely to accept the vaccine as females. Lower acceptability was statistically significantly associated with the nurses (OR = 0.35, 95% CI: 0.15–0.82, P < 0.001), increased perceived harm from the vaccine (OR = 0.11, 95% CI: 0.05–0.23, P < 0.001), lack of confidence in the source of the vaccine (OR = 0.16, 95% CI: 0.08–0.31, P < 0.001) and lack of confidence in organizations or government sectors supervising the vaccination process (OR = 0.31, 95% CI: 0.17–0.58, P < 0.001). Conclusion: This study highlights a moderate level of COVID-19 vaccine acceptability among HCWs in Sudan. Special consideration should be given to addressing vaccine hesitancy among female HCWs and nurses.

COVID-19 vaccine acceptance and COVID-19-induced income disruption among migrant workers in Saudi Arabia

Background: Neither COVID-19 vaccine acceptance nor income changes among migrant workers during the pandemic has been assessed in Saudi Arabia. Aims: To assess the correlates of willingness to take the COVID-19 vaccine and a decrease in income during the pandemic among migrant workers in Saudi Arabia. Methods: An electronic questionnaire was administered to 2403 migrant workers from the Middle East and South Asia employed in agriculture, auto repair, construction, food service (restaurants), municipality, and poultry farms in Al-Qassim Province, Saudi Arabia. The interviews were conducted in the native languages of the workers in 2021. Chi-square was used to assess the associations, and a multiple logistic regression was used to generate the odds ratio. Data analysis was conducted using SPSS version 27. Results: South Asian workers were 2.30 [95% confidence interval (CI): 1.60–3.32] times more likely to accept the COVID-19 vaccine than those from the Middle East (reference group). Restaurant, agriculture and poultry workers were respectively 2.36 (95% CI: 1.41–3.95), 2.13 (95% CI: 1.29–3.51) and 14.56 (95% CI: 5.64–37.59) times more likely to accept the vaccine than construction workers (reference group). Older (≥ 56 years, reference group ≤ 25 years) workers were 2.23 (95% CI: 0.99–5.03) times, auto repair 6.75 (95% CI: 4.33–10.53) times, and restaurant workers 4.04 (95% CI: 2.61–6.25) times more likely to experience a reduction in income than construction workers. Conclusions: Workers from South Asia were more likely to accept the COVID-19 vaccine and less likely to experience an income reduction than those from the Middle East.

Indirect effects of COVID-19 pandemic on reproductive, maternal, newborn and child health services in Pakistan

Background: COVID-19 is having many impacts on health, economy and social life; some due to the indirect effects of closure of health facilities to curb the spread. Closures were implemented in Pakistan from March 2020, affecting provision of reproductive, maternal, newborn and child health (RMNCH) services. Aim: To appraise the effects of containment and lockdown policies on RMNCH service utilization in order to develop an early response to avoid the catastrophic impact of COVID-19 on RMNCH in Pakistan. Methods: Routine monitoring data were analysed for indicators utilization of RMNCH care. The analysis was based on Period 1 (January–May 2020, first wave of COVID-19); Period 2 (June–September 2020, declining number of cases of COVID-19); and Period 3 (October–December 2020, second wave of COVID-19). We also compared data from May and December 2020 with corresponding months in 2019, to ascertain whether changes were due to COVID-19. Results: Reduced utilization was noted for all RMNCH indicators during Periods 1 and 3. There was a greater decline in service utilization during the first wave, and the highest reduction (~82%) was among children aged < 5 years, who were treated for pneumonia. The number of caesarean sections dropped by 57%, followed by institutional deliveries and first postnatal visit (37% each). Service utilization increased from June to September, but the second wave of COVID-19 led to another decrease. Conclusion: To reinstate routine services, priority actions and key areas include continued provision of family planning services along with uninterrupted immunization campaigns and routine maternal and child services.

Epidemiological and clinical characteristics of patients with COVID-19 in Islamic Republic of Iran

Background: Coronavirus disease 2019 (COVID-19) is a worldwide public health emergency. Aims: This study aimed to investigate the epidemiological and clinical characteristics of patients with COVID-19 in Saveh city, Islamic Republic of Iran in 2020. Methods: In this descriptive analytical research, 3181 patients suspected of having COVID-19 who visited Saveh med- ical centres were investigated. Patients were confirmed with COVID-19 using polymerase chain reaction testing. Data on sociodemographic, epidemiological and clinical characteristics of the patients were collected using a validated form through interviews and medical records. The chi-squared, t and Fisher exact tests were used to assess differences in socio- demographic, epidemiological and clinical characteristics between patients with positive and negative polymerase chain reaction results. Logistic regression analysis was used to examine the association between independent variables and death from COVID-19. Results: About half the patients (48.3%) had a history of chronic disease. Diabetes (16.2%), high blood pressure (14.8%) and cardiovascular disease (12.4%) were the most prevalent chronic diseases among patients who were confirmed positive for COVID-19. Risk factors for death among confirmed COVID-19 patients were: intubation (odds ratio (OR) = 8.97; 95% con- fidence interval (CI): 5.15–15.63), age ≥ 80 years (OR = 5.81; 95% CI: 1.91–17.60), oxygen saturation < 93% (OR = 2.48; 95% CI: 1.51–4.08), diabetes (OR = 1.88; 95% CI: 1.00–3.54) and shortness of breath (OR = 1.70; 95% CI: 1.02–2.82). Conclusion: Given the greater risks of contracting and dying from COVID-19 in certain groups of patients, health educa- tion programmes targeting these groups are recommended.

Clinical and epidemiological characteristics of the first 150 patients with COVID-19 in Lebanon: a prospective descriptive study

Background: Clinical features of confirmed COVID-19 cases cover a wide spectrum. Aims: To study the clinical, radiological and virological features of the first 150 patients with COVID-19 in Lebanon. Methods: Our university hospital was designated as the primary COVID-19 care centre in Lebanon. Between 21 February 2020, the date of the first confirmed case of COVID-19 in Lebanon, and 3 April 2020, our team treated 150 patients diagnosed with COVID-19. In this prospective descriptive study, we present our experience in treating these patients, specifically the diagnostic criteria, outcome, and demographic, clinical, radiological and biological characteristics. Results: Ninety-five (63.33%) of the patients were male and 55 (36.67%) were female. Most patients (58%) were aged > 50 years, and 8 (5.33%) were healthcare workers. Diagnosis was based on reverse transcription polymerase chain reaction, and patients were classified as mild, moderate or critical. Fifteen (10%) patients had a critical presentation and fever was the most prominent symptom at presentation. One hundred and thirty-eight (92%) patients underwent radiological evaluation. The most common laboratory findings were lymphocytopenia (34.38%), followed by neutropenia (28.13%), but leukocytosis was not prevalent (1.56%). Old age and comorbidity were significant indicators in patient risk stratification. Chest computed tomography was an invaluable method of diagnosis and management. Our radiological findings were consistent with the published literature. Conclusion: Our study underlines the variable presentation of COVID-19, the difference in severity, and the diverse methods of diagnosis. This suggests the need for a tailored approach, taking into consideration the wide spectrum of presentation.

Knowledge, attitudes, and practices of Sudanese residents towards COVID-19

Background: Coronavirus disease 2019 (COVID-19) is a severe acute respiratory infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Sufficient knowledge, positive attitudes, and correct practices are crucial for the prevention of COVID-19. Aims: This study aimed at assessing the knowledge, attitudes and practices of a sample of Sudanese residents towards COVID-19. Methods: A cross-sectional community-based survey was conducted on 812 participants, including both sexes and aged 18 years and above, with the exclusion of health care workers. Considerable care was taken to include people with different education levels. Results: Among the survey respondents (n=812), 45.8% were women, 40.4% held a bachelor’s degree, 5.7% were uneducated, and 51.1% were aged 18-25 years. The overall correct rate of the knowledge questionnaire was 78.2%; 66.9% agreed that religious gatherings and events should be cancelled to prevent the spread of COVID-19; 34.1% of respondents wore medical masks; and 57.9% avoided shaking hands in recent days. Conclusion: This study showed that sampled Sudanese residents have incomplete knowledge and poor practices towards COVID-19. However, we found that women and people aged 18–25 years were more knowledgeable and had more positive attitudes towards COVID-19. We hope that concerned authorities will establish awareness programmes to improve the ability to combat this disease.

Current situation of COVID-19 in northern Cyprus

Background: The public health burden of the novel coronavirus disease 2019 (COVID-19) is expected to increase and urgent strict measures by decision-makers is critical for the containment of the novel coronavirus (SARS-CoV-2) outbreak worldwide. Aims: This study aimed to give a real-time analysis of COVID-19 presence in northern Cyprus. Methods: All official SARS-CoV-2 positive cases were tracked and reported in terms of the origin, nationality, and transmission routes. Preventive measures taken after the first reported case were analyzed for their effectiveness as control strategies. Results: The index case of SARS-CoV-2 in northern Cyprus was identified as a female German tourist. First local case had travel history from the United Kingdom after which local transmission occurred. Rapid and strict containment measures have currently delayed a peak in observed cases. Conclusions: Rapid implementation of social-distancing measures, good hygiene measures and travel/gathering bans in northern Cyprus has been effective in controlling the outbreak.