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Transfusion-dependent thalassemia is the most severe form of thalassemia in which patients require a regular blood transfusion to maintain their haemoglobin level. COVID-19 pandemic has disrupted the routine measure in controlling chronic diseases like thalassemia. This study aims to measure the difference in pre-transfusion haemoglobin level and frequency of transfusion before and during pandemics. This retrospective cross-sectional study utilized medical records data of 101 transfusion-dependent thalassemia (TDT) patients treated in Cipto Mangunkusumo Hospital (CMH) from 2019-2021. The dependent variables of this study were pre-transfusion haemoglobin level and transfusion attendance. The pre-pandemic phase was defined from March 30, 2019, to March 29, 2020, whereas the during-pandemic phase was from March 30, 2020, to March 29, 2021. Up to 59.4% of subjects had suboptimal Hb level of < 9.0 g/dL even before the pandemic and it increased to 71.3% during a pandemic. Transfusion frequency of pre-pandemic and during-pandemic phases showed no significant difference (p-value = 0.990). The mean pre-transfusion haemoglobin level before the pandemic was 8.71 g/dL and it decreased to 8.46 g/dL (p-value <0.001). Our study showed poorer control of pre-transfusion Hb levels during the pandemic and decreased transfusion frequency. This puts them at a higher risk of developing many longterm complications.
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Background and purpose: The COVID-19 pandemic have led to some psychological disorders and sleep problems that should be taken into account after recovery. After recovering from COVID-19 people are at risk of sleep disorders, depression, and low quality of life and there is paucity of information about this issue. The present study aimed to compare the effectiveness of mindfulness and aerobic exercise on depressive symptoms, perceived stress, and sleep quality in recovered COVID-19 patients. Material(s) and Method(s): An intervention field research was performed in 60 male and female patients (mean age: 39.52+/-5.82) recovered from COVID-19 in Kermanshah, Iran. Participants were randomly divided into four groups (n=15): 1) attending mindfulness-based stress reduction (MBSR) program, 2) aerobic exercise, 3) combination of MBSR and aerobic exercise, and 4) control group. The study was carried out at four stages: pretest, interventions, post-test, and follow-up test. Dependent variables included depressive symptoms, perceived stress, and sleep quality. Bonferroni Post hoc test in 4*3 mixed ANOVA was used for data analysis. Result(s): In this study, depression and perceived stress reduced in all experimental groups compared to the control group (P= 0.001). Also, sleep quality improved in these groups compared to the control group (P= 0.001). Post hoc tests showed the superiority of combination of MBSR and aerobic exercise compared to other interventions. Conclusion(s): According to current study, combination of MBSR and physical activity shows to be more helpful than mindfulness training and physical activity alone in improving psychological problems and sleep quality after recovering from COVID-19.Copyright © 2023, Mazandaran University of Medical Sciences. All rights reserved.
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Aims: The aim of the present study was to study the prevalence of depression, anxiety, stress, and post-traumatic symptoms in Health-Care Workers (HCWs) of three Health Authorities of Emilia-Romagna, Italy during the COVID pandemic. Material(s) and Method(s): An online questionnaire was spread to the staff of the University Hospital of Modena and the Local Health Agencies of Modena and Romagna, including the Depression Anxiety Stress Scale (DASS-21), the Impact of Event Scale - Revised (IES-R), and the Utrecht Work Engagement Scale - Short Version (UWES-9). The scores at DASS-21 and IES-R were used as dependent variables in multivariate logistic regression models. Result(s): A total of 5868 HCWs were reached (response rate of 22.4%), 76.1% of which were women, mostly aged between 45 and 54 years. Rates of positive scores were: 27.9% DASS-21 Depression;28.4% DASS-21 Anxiety;34.7% DASS-21 Stress;21.9% IES-R. At the multivariate logistic regression, the following were statistically significant risk factors for positive scores: female sex, young age, and working at the front line. An increase in alcohol and tobacco consumption and worsening of eating habits were also strongly associated with symptoms. At UWES-9, the three samples reported lower vigor than dedication and absorption, which are at a medium-high level. Conclusion(s): HCWs have experienced high levels of emotional distress related to the COVID-19 pandemic. Significant improvements are needed not only in terms of organization and distribution of resources, but also in provision of dedicated psycho-social interventions.Copyright © 2023
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[Background] The epidemic of coronavirus disease 2019 (COVID-19) seriously affects the psychological status of medical staff who directly face the risk of the disease. [Objective] This study investigates the prevalence and related factors of depression, anxiety, and insomnia among medical staff during the COVID-19 pandemic. [Methods] From February 13 to March 1, 2020, a network questionnaire survey was conducted among 482 medical staff selected by convenience sampling. A self-designed questionnaire was used to investigate the basic demographic information and COVID-19-related questions. The Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Insomnia Severity Index (ISI) were used to estimate the prevalence of depression, anxiety, and insomnia among the medical staff. Stepwise multiple linear regression analysis was performed with PHQ-9 score, GAD-7 score, and ISI score as dependent variables. Multivariate logistic regression analysis (forward-conditional method) on depression, anxiety, and insomnia as dependent variables was performed with basic demographic information and COVID-19-related questions as independent variables. [Results] Among the surveyed medical staff, the prevalence rates of depression, anxiety, and insomnia were 14.3%, 11.2%, and 23.2%, respectively. There were no significant differences in the prevalence rates among different age, gender, local risk level, and occupation groups and those aiding Hubei Province or not. The medical staff who directly contacted fever or diagnosed patients had more serious depression (b=1.73, 95%CI: 0.79-2.66) and insomnia (b=2.43, 95%CI: 1.48-3.39) and a higher risk of insomnia (OR=1.89, 95%CI: 1.21-2.96). The medical staff whose current protective measures cannot prevent infection had more serious depression (b=1.72, 95% CI: 0.65-2.80), anxiety (b=1.75, 95% CI: 0.76-2.75), and insomnia (b=1.73, 95% CI: 0.63-2.82), and had a higher risk of depression (OR=1.97, 95% CI: 1.11-3.49), anxiety (OR=3.00, 95%CI: 1.64-5.46), and insomnia (OR=1.79, 95%CI: 1.08-2.96). [Conclusion] During the COVID-19 epidemic, the risks of depression, anxiety, and insomnia among selected medical staff are increased compared with the non-epidemic period. Occupational exposure to high-risk groups and protective measures would significantly affect mental health of medical staff.Copyright © 2021, Shanghai Municipal Center for Disease Control and Prevention. All rights reserved.
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Background and purpose: The COVID-19 pandemic have led to some psychological disorders and sleep problems that should be taken into account after recovery. After recovering from COVID-19 people are at risk of sleep disorders, depression, and low quality of life and there is paucity of information about this issue. The present study aimed to compare the effectiveness of mindfulness and aerobic exercise on depressive symptoms, perceived stress, and sleep quality in recovered COVID-19 patients. Material(s) and Method(s): An intervention field research was performed in 60 male and female patients (mean age: 39.52+/-5.82) recovered from COVID-19 in Kermanshah, Iran. Participants were randomly divided into four groups (n=15): 1) attending mindfulness-based stress reduction (MBSR) program, 2) aerobic exercise, 3) combination of MBSR and aerobic exercise, and 4) control group. The study was carried out at four stages: pretest, interventions, post-test, and follow-up test. Dependent variables included depressive symptoms, perceived stress, and sleep quality. Bonferroni Post hoc test in 4*3 mixed ANOVA was used for data analysis. Result(s): In this study, depression and perceived stress reduced in all experimental groups compared to the control group (P= 0.001). Also, sleep quality improved in these groups compared to the control group (P= 0.001). Post hoc tests showed the superiority of combination of MBSR and aerobic exercise compared to other interventions. Conclusion(s): According to current study, combination of MBSR and physical activity shows to be more helpful than mindfulness training and physical activity alone in improving psychological problems and sleep quality after recovering from COVID-19.Copyright © 2023, Mazandaran University of Medical Sciences. All rights reserved.
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Background: SARS-CoV-2 Omicron sublineages exhibit evolving escape to in vitro neutralization by monoclonal antibodies (mAbs), with an unclear impact on in vivo treatment response. Our aim is to assess the impact of SARS-Cov-2 variants on the decline of viral load (VL) after treatment with 3 different drugs approved in EU for the early treatment of patients with mild-moderate COVID-19. Method(s): Post-hoc analysis from MONET (EudraCT: 2021-004188-28), phase 4 open-label RCT to assess efficacy of 500 mg intravenous sotrovimab (SOT), 600 mg intramuscular tixagevimab/cilgavimab (TIX/CIL) and oral 5-days course of NMV/r 300/100 mg BID, in non-hospitalized high-risk patients (pts) with early COVID-19. Pts' features were analyzed as binary variables by Chi-squared test. SARS-Cov-2 VL in nasopharyngeal swabs was carried out at randomization (1d) and at day 7 (7d) by cycle threshold value (Ct). Variant sequencing was performed at 1d. Ct variation was assessed by mixed effect log-linear model including random intercept at pts' level, log of Ct as independent variable, time, arm, viral variant as dependent variables, and interaction between time and arm. Multiple comparisons were adjusted by Bonferroni. Result(s): Among the 320 pts included between 4 Mar and 16 Nov, 2022, 108 (33.75%) received NMV/r, 103 (32.19%) TIX/CIL, and 109 (34.06%) SOT. Main characteristics were balanced across arms. Most of the pts were infected either with BA.2 (N=194;60.63%) or BA.4/BA.5 (N=100;31.25%) (Fig1A). VL at 1d was similar across the arms. In contrast, mean 7d VL was significantly lower in pts receiving NMV/r than in those receiving TIX/ CIL or SOT (P< 0.001) No significant VL variation was observed between the mAb arms (Fig1B). The analysis of the impact of viral variants suggests that while VL was significantly affected by variants (P=0.034), the superior effect of NMV/r over mAbs was homogeneous across all variant groups (P=0.290 for interaction) (Fig1C). Conclusion(s): Our study provides for the first time strong in vivo evidence that, when used against Omicron lineages, NMV/r exerts a stronger antiviral effect than mAbs. These results confirm previous in vitro evidence suggesting that mAbs may not retain neutralizing activity against all Omicron sublineages and provide preliminary information on how to use VL variation as a surrogate marker of efficacy. Further studies are needed to investigate whether the superior virologic activity of NMV/r over mAbs is confirmed for newly emerging variants, including BQ.1.1 or XBB.
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Vocational education plays a strategic role in the creation of a skilled workforce who is ready to enter the world of work. In order to achieve the standard competency level, the proportion of practice is required to be 60% and large financing is required. During the Covid-19 pandemic there were many changes in the world of education, PBM had to be done online or online, children's education costs were not fulfilled due to layoffs, the economy slumped and had an impact on entrepreneurship and the influence of student personal costs. The cost of education has changed a lot. A study of changes in financing is needed for planning learning in covid conditions and demands for changes in learning patterns in the 4.0 era. The design used in this research is an explanatory mixed method research, quantitative data is taken together with qualitative data collection. The independent variable is the influence of the pandemic, the dependent variable is the cost of education (education budget and student personal costs). Online survey using googleform. The sample of level II and III students who have been exposed to face-to-face and online learning is 143 students. The education budget & costs are presented with the percentage of reduction and increase. Individual operational costs before and during the pandemic were used the Mann Whitney test at 95% confidence level. The recurrent cost budget that is used to finance the operational activities of PBM for D3 Nutrition Study Program for one budget year, with the predicate BLU should have financial management flexibility, so that student advice to provide tuition fee relief, complete facilities (campus wifi, practical equipment, air conditioning class), providing adequate quotas and spending for practical purposes as well as sufficient costs for student activities can be facilitated. All budget items decreased during the epidemic, except for the cost of providing goods and services for competency and IT compliance. The results of the survey on individual personal costs showed that the significance of all items in question, parents' income, living costs and transport costs decreased before and during the pandemic, while Quota and refreshing costs / personal needs increased on average. A deeper study is needed on the education budget and changes in individual operational costs during the Covid-19 pandemic and facing the challenges ahead in the 4.0 era.Copyright © 2020 Ubiquity Press. All rights reserved.
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Objectives: the aim of the study was description of the association between the number of hours spent on the internet and symptomatology of Internet addiction, corrected by sociodemographic data, mental instability, alcohol and cannabis use, gambling, and subjective estimation of physical and mental health using responses from a representative sample of Czech respondents during COVID-19 pandemic. Sample and setting: The group consisted of 2 602 people (1 206 men, 1 396 women), average age 44,61 years, SD = 15,8223, range 15-85 years randomly selected by quota selection based on age, gender, education and region. Data were processed by hierarchical multivariate linear regression analysis (OLS). The dependent variable was data from the Excessive Internet Use test. Independent variables were age, gender, net income, marital status, education, subjective estimation of mental and physical health, data from MHI-5, CAGE, cast and PGsi tools. Result(s): the results are in line with previous research, which indicates that the development of internet addiction is mainly due to time spent on the Internet, the risk is inversely related to age and slightly higher in men. The influence of other variables measuring substance use, gambling and mental health supports hypotheses about common etiology of various types of addiction and their association with mental health. Study limitation: the study is based on self-referential data, has a heuristic, empirical character and does not rely on a pre-formulated theory.Copyright © 2022 TIGIS Spol. s.r.o.. All rights reserved.
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Aim: This study aims to determine the effects of play activities for COVID-19 positive and MIS-C pediatric patients on the anxiety and fear of children and their parents. Method(s): This is an experimental study that was prepared through STROBE. The study population consisted of 38 children treated in a university hospital COVID-19 unit. The Children's Anxiety Meter-State and the Children's Fear Scale were administered before and after the play activities. The parents' fear and anxiety were assessed using the COVID-19 Phobia Scale and the Beck Anxiety Inventory. The book and coloring set was prepared in advance and delivered to the experimental group in a package. After the sets were given to the parents, the parents read the book to their children the same day. Afterward, they were asked to color pictures of coronavirus precautions together with the children. SPSS 22.00 package program was used to analyze the study data. The Mann-Whitney U test was used to compare independent groups, and Wilcoxon analysis was used to analyze dependent variables before and after the play activities. Result(s): Based on the children's anxiety and fear scores in the experimental group, significant differences were found before and after the play activities and significant differences between the anxiety scores (<0.05) of parents and children. However, no significant difference was found between post-play anxiety and fear scores of children in the experimental group and the scores of the control group. Discussion(s): The experimental group had low mean anxiety and fear scores after the play activities. Play activities should be used to reduce the anxiety and fear of children who are treated in isolation in hospitals during the COVID-19 pandemic. Even if children are restricted to isolation rooms, their daily routines should be maintained, and their parents should be supported.Copyright © 2021 Croatian Paediatric Society. All rights reserved.
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Introduction: To describe the incidence and outcomes of SARS-CoV-2 infection, to evaluate its impact (mortality), and the factors associated with infection and mortality in dialysis patients in Argentina. Method(s): All prevalent dialysis patients were included from the period from April 2020 to February 2022. The positive COVID diagnosis was always made with swab and PCR. Signs and symptoms at disease onset were included, as well as the evolution of the patient that included the requirement of hospitalization, hospitalization in a care unit (ICU) and the need for invasive respiratory assistance. Continuous variables are expressed as mean +/- standard deviation or median and range, whether or not they are parametric, continuous variables are expressed as frequency and prevalence. According to the pandemic in the general population, 3 periods were considered: period 1 (Jan2020-Feb2021), period 2 (Mar2021-Nov2021), period 3 (Dec2021-Feb2022). Univariate analysis was performed for infection and mortality as dependent variables, using the T Test, Wilcoxon or Chi2 as appropriate. Multivariate analysis was performed for the dependent variable mortality. A p<0.05 was considered significant. The analysis was performed with the software MedCalc 20113. Result(s): 27,548 cases were recorded (12,221, 10,241, and 5,086 in periods 1, 2, and 3, respectively). The median age was 60.8 years (52% > 60 years) and 58% were male. The most frequent antecedents were community transmission and close contact with a suspected or confirmed case. The most frequent symptoms were malaise (16%), headaches (13%), odynophagia (10%) and myalgia (11%). The most frequent clinical signs were: cough (28%9, Tdegree >= 38degreeC (20%), dyspnoea (12%) and tachypnoea (6%). Mean time between the onset of symptoms and the PCR result of 3.8 days. Of the positive cases, 31% required hospitalization, and of these 26% were in the ICU. Of those admitted to the ICU, 50% required MV. Overall mortality was 23.4%. Mortality was higher during the first period and consequently reduced during 2nd and 3rd period (27, 2%;19, 8%;2, 9% respectively).The most frequent CKD aetiologies were DBT, unknown and nephroangiosclerosis. Most of the patients had less than 3 years on dialysis, but the highest mortality was seen in the group with more than 3 years of dialysis. COVID-19 cases were more prevalent in HD patients compared to PD patients, however the type of modality did not show differences in terms of mortality. Table 1 shows those variables associated with mortality. [Formula presented] Conclusion(s): Throughout the three periods of the COVID pandemic, a decrease in hospitalization and mortality was observed. These variables as well as the infection rate were higher than in the general population. Vaccination, a priority in this population, was associated with lower mortality. Joint actions between Public Health entities and Scientific Societies in pandemic situations ensure an adequate diagnosis of the situation and the bases for timely actions. No conflict of interestCopyright © 2023
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Introduction: For detecting myocardial injury in severe and critical COVID-19, the electrocardiogram (ECG) is neither sensitive nor specific;but in a resource-poor environment, it remains relevant. Changes in the ECG can be a potential marker of severe and critical COVID-19 to be used for predicting not only disease severity but also the prognosis for recovery. Method(s): The admitting and interval ECGs of 1,333 COVID-19 patients were reviewed in a two-year, single-center, retrospective cohort study. Each was evaluated for 29 pre-defined ECG patterns under the categories of rhythm, rate, McGinn-White and RV overload patterns, axis and QRS abnormalities, ischemia/infarct patterns, and AV blocks before univariate and multivariate regression analyses for correlation with disease severity;need for advanced ventilatory support;and in-hospital mortality. Result(s): Of the 29 ECG patterns, 18 showed a significant association with the dependent variables on univariate analysis. Multivariate analysis revealed that atrial fibrillation, HR >100 bpm, low QRS voltage, QTc >500msec, diffuse nonspecific T-wave changes, and 'any AMI' ECG patterns correlate with disease severity;need for advanced ventilatory support and in-hospital mortality. S1Q3 and S1Q3T3 increased the odds of critical disease and need for high oxygen requirement by 2.5-3 fold. Fractionated QRS increased odds of advanced ventilatory support. Conclusion(s): The ECG can be useful for predicting the severity and outcome of more than moderate COVID-19. Their use can facilitate rapid triage, predict disease trajectory, and prompt a decision to intensify therapy early in the disease to make a positive impact on clinical outcomes.
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Objective: Healthcare professionals (HP) play a role in vaccine acceptance as they influence people's decisions by sharing their personal experiences. The study was aimed to determine the coronavirus disease-2019 (COVID-19) vaccine literacy (VL) and vaccine hesitancy (VH) level among HP in Turkiye, their relationship and influencing factors. Material(s) and Method(s): This cross-sectional online study was applied to 1,111 HP between 15.02.2022-15.03.2022. The sociodemographic data form, COVID-19 Vaccine Literacy Scale (CVLS), and Vaccine Hesitancy Scale-long form (VHS) were used. Sociodemographic characteristics, questions about COVID-19 and COVID-19 vaccines were considered as independent variables, while VL and VH were considered as dependent variables. Result(s): Of the participants, 33.8% (n=376) were physicians, 25.2% (n=280) were nurses/midwives and 41.0% (n=455) were other HP. The CVLS functional mean score of HP was 2.6+/-0.7 and the interactivecritical mean score was 3.0+/-0.6. The VHS mean score was 44.6+/-16.3. Being a physician (p<0.001 for functional, p=0.002 for interactive-critical) and thinking that the origin of the coronavirus is a natural source from animals (p=0.029 for functional, p<0.001 for interactive-critical) were the factors that increased VL. Being a physician (p<0.001) and having high CVLS mean scores (p<0.001 for functional and interactive-critical) were the factors that decreased the VH. There was a weak negative correlation between VL and VH levels (r=-0.223 for functional, r=-0.323 for interactive-critical) (p<0.001). Conclusion(s): Considering that high VL level decreased VH level, it is obvious that the knowledge level of HP about COVID-19 vaccines should be increased.Copyright © 2023 by Turkiye Klinikleri.
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Introduction: The aim of the study is to determine the patient's outcome and mortality rate of COVID-19 patients requiring hemodialysis in Anwar Khan Modern Medical College & Hospital. Method(s): Retrospective cohort study of medical record of patients with COVID-19 hospitalized at Anwar Khan Modern Medical College & Hospital during the months of September 2020 to January 2021. The dependent variable was in patient's outcome and mortality rate and independent variables included clinical conditions, physical examination results, oxygen requirements, diagnosis, clinical features, and complications. Result(s): Total 98 patients were included. Among them 97 patients were treated with hemodialysis and 1 was pre-dialysis patient. Median age was 59 years and 52 (53.06%) were male and 46 (46.94%) were female. The most frequent comorbidities were chronic kidney disease (CKD), hypertension (HTN), and diabetes mellitus (DM). Patients were diagnosed with different clinical manifestation when they arrived at hospital. Major manifestations were cough, breathlessness, fatigue, fever and body ache. The patients showed some other complications including fluctuated blood pressure (50.1%), vomiting (19.38%), shivering (37.76%), chest pain (16.33%).Treatment was given according to WHO and Bangladesh Government Covid-19 treatment guideline. We observed lower mortality rate. 11 (11.23%) patients died during this observation period. Mortality rate of male patients were 7(7.14%) and female patient were 4(4.08%). Another 87(88.79%) patients were alive according to the observations. Conclusion(s): We found low mortality rate in our cohort study. Dead patients had severe clinical manifestations and complications i.e. DM, HTN, CKD with cough, breathlessness and fatigue. Close monitoring, guideline medication and patient care reduces mortality. No conflict of interestCopyright © 2023
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Background: In 2020, due to the COVID-19 pandemic, most group therapists moved their practice to online platforms. Surveys of psychotherapists indicate that many intend to maintain at least part of their practices online after the pandemic. This survey-based study aimed to identify therapist experiences with doing group therapy online, and to examine factors that are associated with therapist-rated outcomes. Method(s): 307 group therapists were surveyed about their ratings of the ease or difficulty in conducting group therapy online versus in-person, and indicators of patient outcomes in online groups. A confirmatory factor analysis resulted in a good fitting three latent factor solution: group therapeutic process factor (therapist ratings of ease to foster therapeutic alliance, group cohesion, and patient self-disclosure), group therapist factor (therapist presence, empathy, and focus in online therapy), and group therapeutic challenges factors in online work (related to the difficulty of working through conflict, managing avoidance, observing nonverbal communication, and discomfort during the online session). An online group therapy outcome factor was the dependent variable modeled as a latent factor of therapists' perception of patient outcomes and their own satisfaction with online groups. Results showed that higher levels of the group therapeutic processes and group therapist factors, and lower group challenges were associated with higher online group therapy outcomes. Conclusion(s): The present study suggests that online groups operate based on many of the same factors that have been supported in in-person group treatment. These factors were associated with the therapist's perceptions of online group effectiveness. However, difficulties in managing relationships in the online session may represent a barrier to enacting group therapeutic factors.
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In our study, we aimed to evaluate the significance of specific cytokines in blood plasma as predictive markers of COVID-associated mortality. Materials and methods. In plasma samples of 29 patients with PCR-confirmed COVID-19 we measured the concentrations of 47 molecules. These molecules included: interleukins and selected pro-inflammatory cytokines (IL-1alpha, IL-1beta, IL-2, IL-3, IL-4, IL-5, IL-6, IL-7, IL-9, IL-12 (p40), IL-12 (p70), IL-13, IL-15, IL-17A/CTLA8, IL-17-E/IL-25, IL-17F, IL-18, IL-22, IL-27, IFNalpha2, IFNgamma, TNFalpha, TNFbeta/Lymphotoxin-alpha(LTA));chemokines (CCL2/MCP-1, CCL3/MIP-1alpha, CCL4/MIP-1beta, CCL7/MCP-3, CCL11/Eotaxin, CCL22/MDC, CXCL1/GROalpha, CXCL8/IL-8, CXCL9/MIG, CXCL10/IP-10, CX3CL1/Fractalkine);anti-inflammatory cytokines (IL-1Ra, IL-10);growth factors (EGF, FGF-2/FGF-basic, Flt-3 Ligand, G-CSF, M-CSF, GM-CSF, PDGF-AA, PDGFAB/BB, TGFalpha, VEGF-A);and sCD40L. We used multiplex analysis based on xMAP technology (Luminex, USA) using Luminex MagPix. As controls, we used plasma samples of 20 healthy individuals. Based on the results, we applied Receiver Operating Characteristic (ROC) analysis and Area Under Curve (AUC) values to compare two different predictive tests and to choose the optimal division point for disease outcome (survivors/non-survivors). To find optimal biomarker combinations, we as used cytokines concentrations as dependent variables to grow a regression tree using JMP 16 Software.Results. Out of 47 studied cytokines/chemokines/growth factors, we picked four pro-inflammatory cytokines as having high significance in evaluation of COVID-19 outcome: IL-6, IL-8, IL-15, and IL-18. Based on the results received, we assume that the highest significance in terms of predicting the outcome of acute COVID-19 belongs to IL-6 and IL-18. Conclusion. Analyzing concentrations of IL-6 and IL-18 before administering treatment may prove valuable in terms of outcome prognosis. Copyright © Arsentieva N.A. et al., 2022.
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In our study, we aimed to evaluate the significance of specific cytokines in blood plasma as predictive markers of COVID-associated mortality. Materials and methods. In plasma samples of 29 patients with PCR-confirmed COVID-19 we measured the concentrations of 47 molecules. These molecules included: interleukins and selected pro-inflammatory cytokines (IL-1alpha, IL-1beta, IL-2, IL-3, IL-4, IL-5, IL-6, IL-7, IL-9, IL-12 (p40), IL-12 (p70), IL-13, IL-15, IL-17A/CTLA8, IL-17-E/IL-25, IL-17F, IL-18, IL-22, IL-27, IFNalpha2, IFNgamma, TNFalpha, TNFbeta/Lymphotoxin-alpha(LTA));chemokines (CCL2/MCP-1, CCL3/MIP-1alpha, CCL4/MIP-1beta, CCL7/MCP-3, CCL11/Eotaxin, CCL22/MDC, CXCL1/GROalpha, CXCL8/IL-8, CXCL9/MIG, CXCL10/IP-10, CX3CL1/Fractalkine);anti-inflammatory cytokines (IL-1Ra, IL-10);growth factors (EGF, FGF-2/FGF-basic, Flt-3 Ligand, G-CSF, M-CSF, GM-CSF, PDGF-AA, PDGFAB/BB, TGFalpha, VEGF-A);and sCD40L. We used multiplex analysis based on xMAP technology (Luminex, USA) using Luminex MagPix. As controls, we used plasma samples of 20 healthy individuals. Based on the results, we applied Receiver Operating Characteristic (ROC) analysis and Area Under Curve (AUC) values to compare two different predictive tests and to choose the optimal division point for disease outcome (survivors/non-survivors). To find optimal biomarker combinations, we as used cytokines concentrations as dependent variables to grow a regression tree using JMP 16 Software.Results. Out of 47 studied cytokines/chemokines/growth factors, we picked four pro-inflammatory cytokines as having high significance in evaluation of COVID-19 outcome: IL-6, IL-8, IL-15, and IL-18. Based on the results received, we assume that the highest significance in terms of predicting the outcome of acute COVID-19 belongs to IL-6 and IL-18. Conclusion. Analyzing concentrations of IL-6 and IL-18 before administering treatment may prove valuable in terms of outcome prognosis. Copyright © Arsentieva N.A. et al., 2022.
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Introduction: Severe COVID-19 infection in a subset of patients is associated with hyperinflammation similar to hemophagocytic lymphohistiocytosis (HLH) however it may not fulfill the required diagnostic criteria (HLH 2004 criteria or H score). We compared clinical, laboratory parameters, bone marrow findings and disease outcome of severe COVID-19 infection related HLH with HLH secondary to causes other than severe COVID-19 to describe features specific to severe COVID-19 associated HLH and limitations of currently available diagnostic criteria of HLH in context to severe COVID -19 infection induced hyperinflammation. Method(s): We analyzed 69 patients diagnosed as HLH of which 47 had severe COVID-19 and 22 had HLH secondary to causes other than COVID-19. Clinical, hematological and biochemical parameters were compared using Mann-Whitney U test. Bone marrow examination (BME) was done in all for presence of hemophagocytosis. Immunohistochemical staining for CD68 and CD163 were done for identification of histiocytes. Occurrence of COVID-19 related HLH was taken as the dependent variable to determine predictors of COVID-19 HLH. Result(s): Organomegaly was seen in only 4.3% (2/47) cases with COVID-19 related HLH as compared to 54.5% (12/22) with non-COVID HLH (p< 0.001). Amongst the quantitative variables, a significant difference in COVID-19 related and non-COVID-19 related HLH was found in the following parameters: Age (p< 0.001), Triglyceride (p=0.009), Fibrinogen (p< 0.001), Ferritin (p< 0.001), Hemoglobin (p< 0.001), Total leukocyte count (p=0.003), Absolute neutrophil count (p< 0.001), Neutrophil lymphocyte ratio (p< 0.001) and H score (p< 0.001). BME of all patients showed presence of hemophagocytes. Only 6.4% (3/47) cases with COVID related HLH had 5/8 HLH 2004 criteria as compared to 63.6% (14/22) cases with non-COVID related HLH (p< 0.001). H-Score >=169 was also significantly less common in COVID HLH as compared to non-COVID HLH (40.42% vs 86.36%, p=0.001). Conclusion(s): Organomegaly, cytopenias, hypofibrinogenemia and hypertriglyceridemia which are part of HLH diagnostic criteria are rare in severe COVID-19 making it difficult to diagnose. Demonstration of hemophagocytes in bone marrow should be recommended in suspicious cases for initiation of early immunosuppressive therapy. (Figure Presented).
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The main purpose of this research study is determining the robotic and artificial intelligence in the health care during the COVID-19 pandemic. This research study presents that secondary data analysis related to the artificial intelligence and robotic. This research study depends upon questions for gathering the data used closed ended and open-ended question related to the variables. The robotic and artificial intelligence is main in independent variable and the COVID-19 is considered as dependent variables. For determine the research study used E-views software and generate different results included descriptive statistical analysis, correlation coefficient, the unit root test analysis, the normality test analysis also that explain the ganger causality test between dependent and independent variables. The overall result founded that there are direct effect and relation of robotic and artificial intelligence in health care during COVID-19 pandemic. Copyright © 2022 Authors. All rights reserved.
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Background: Fatigue is a common problem in pregnancy and is associated with negative outcomes. Objective(s): This study aimed to determine the predictors of fatigue in pregnant women. Method(s): This cross-sectional study was conducted on 150 pregnant women with a gestational age of 12-18 weeks visiting the healthcare centers in Mahabad-Iran, 2021. Fatigue was assessed via the modified Multidimensional Assessment of Fatigue (MAF) checklist, depression via the Edinburgh Postnatal Depression Scale (EPDS), stress and anxiety via Depression, Anxiety and Stress Scale-21 (DASS-21), well-being via WHO-5, and positive and negative affect via International Positive and Negative Affect Schedule-Short Form (I-PANAS-SF). The general linear model was used to esti-mate the degree of the effect of each independent variable (sociodemographic characteristics, de-pression, stress, anxiety, positive and negative affect, and well-being) on the dependent variable (early pregnancy fatigue). Result(s): The mean (SD) fatigue score was 21.91 (7.07), within the 0-50 possible range. The majori-ty of pregnant women (87.3%) suffered from fatigue. Based on the Pearson or Spearman correlation analysis, a significant correlation was observed between fatigue and depression (r= 0.334, P<0.001), anxiety (r= 0.327, P<0.001), stress (r=0.329, P< 0.001), well-being (r=-0.279, P<0.001), and negative affect (r= 0.308, P<0.001). Based on the adjusted general linear model, the education, stress and negative affect variables were predictors of fatigue. Conclusion(s): The education, stress and negative affect predict fatigue in pregnant women, and their identification contributes to the designation of interventions to mitigate fatigue in this group. More studies are required to identify the causes of fatigue during pregnancy. Copyright © 2023 Bentham Science Publishers.
ABSTRACT
Background. Transplacental and milk antibodies following maternal SARS-CoV-2 vaccination could offer infants protection against SARS-CoV-2 infection as there are no approved vaccines for this age-group. Our objective was to assess maternal and infant factors to determine if they are protective against infant SARS-CoV-2 infection. Methods. Prospective cohort starting April 2021 of lactating women immunized with first SARS-CoV-2 vaccine during pregnancy or lactation and their infants. Participants have longitudinal milk and optional blood samples collected. The primary outcome was parent-reported infant SARS-CoV-2 infection between December 1, 2021 and February 20, 2022 during the local Omicron variant wave. Infants with infection before this window were excluded. We measured anti-receptor binding domain (RBD) IgG in milk and maternal and infant blood collected from October to December 2021. For women who received SARS-CoV-2 booster vaccine, the mother and infant samples that were collected 2-4 weeks after vaccine were used in this analysis. Geometric mean titers (GMTs) were log-transformed for analysis. Factors were evaluated with univariate and multivariable logistic regression. Results. Of the 101 mother-infant pairs enrolled, 89 had clinical data during this time period;73 women had milk titers;58 mother-infant pairs had blood titers. All women received SARS-CoV-2 vaccine while pregnant (44%) or lactating (56%). 83% received a SARS-CoV-2 booster vaccine. 81% were still lactating at time of analysis. 23% (N=21) of infants had infection. On univariate analysis, no daycare (Odds ratio (OR: 0.2;95% confidence interval (CI): 0.1-0.6), maternal IgG in blood >= 900 (OR:0.1;95%CI:0.02-0.5);and IgG in milk >= 8 (OR:0.3;95%CI: 0.1-0.9) were significantly protective against infant infection (Figure 1). On multivariable analysis, point estimates for milk IgG, infant blood IgG, maternal receipt of booster vaccine and no daycare were highly protective against infant infection, although only milk IgG and no daycare reached level of significance (Figure 2). Estimates are likely limited by small sample size. No daycare attendance (Odds ratio (OR:0.2;95% confidence interval (CI): 0.1-0.6), maternal IgG in blood >/=900 (OR:0.1;95%CI:0.02-0.5);and IgG in milk >/=8 (OR:0.3;95%CI: 0.1-0.9) were significantly protective against infant infection. Data analyzed with univariate logistic regression with infant SARS-CoV-2 infection as the dependent variable. Milk IgG >/=8, infant blood IgG >/=900, maternal receipt of booster vaccine, and no daycare were highly protective against infant infection, although only milk IgG >/=8 (OR: 0.2;95%CI:0.05-1.0) and no daycare (OR: 0.2;95%CI: 0.1-1.0) reached the level of significance. Data analyzed with multivariable logistic regression with infant SARS-CoV-2 infection as the dependent variable. Conclusion. These data identify factors significantly associated with protection against infant SARS-CoV-2 infection, which could influence parent vaccine decision-making. (Figure Presented).