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Objective: In the twenty-first century, despite the development in infection management, and improvement of vaccines and therapeutic agents in the field of health, new viral outbreaks that can still be fatal in humans and animals are emerging. The infection of zoonosis COVID-19 from bat origin, the intermediate host of which is still being unclear, has appeared in people who visited animal bazaar in December 2019, in Wuhan, China. The World Health Organization declared this infection a pandemic in February 2020. Millions of people have been affected by this pandemic. The fight against the pandemic has had a great economic cost and continues to do so. Even people have changed their lifestyle. In this context, there have been concerns about companion animals with COVID-19 transmission, from human to animal or animal to human. The purpose of this review was to examine the studies on the presence and transmission of COVID-19 in companion animals such as cats, dogs, hamsters and horses. Result and Discussion: It has been reported in studies that most of the companion animals (cat, dog and hamster) were susceptible to SARS-CoV-2, and humans could be a source of infection for them. However, the potential role of companion animals in transmission to humans is not fully known. It is clear from this pandemic that the necessity of epidemiological investigation of infectious agents, especially zoonotic ones, in one health concept has emerged once again.Copyright © 2022 University of Ankara. All rights reserved.
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Objective: to study the causes and predictors of mental disorders during the COVID-19 epidemic in those who turned to psychiatrist for the first time, as well as in patients with already diagnosed mental illness. Patients and methods. We examined 100 patients who turned to a psychiatrist due to a deterioration in their mental state during the pandemic, 50 patients were newly diagnosed (Group 1) and 50 with previously diagnosed mental disorders (Group 2). The study was carried out by a clinical method using a specially designed map, followed by statistical processing of the obtained data. Results and discussion. Mental disorders caused by the COVID-19 pandemic more often occurred at a young age, in patients with higher and secondary specialized education, and in single patients. In the 1st group, as a result of exposure to psychogenic factors (the influence of the media, quarantine, economic changes), anxiety (36.8%) and depressive (21.1%) disorders occurred more often, and after the coronavirus infection, depressive disorders were in the first place (54.2%). The 2nd group mostly included patients with endogenous disorders (bipolar affective disorder - 24%, recurrent depressive disorder - 20%, schizophrenia - 20%), which were exacerbated more often as a result of COVID-19, to a lesser extent - psychogenic (experiences associated with a change in material status and illness of relatives). Obsessive-compulsive disorder, generalized anxiety disorder, somatoform disorders have been associated with epidemic factors. Conclusion. The results obtained indicate that there are differences between the mental disorders that first appeared during the pandemic and the exacerbations of the condition in mentally ill patients, which relate to the predictors, causes and clinical manifestations of these disorders.Copyright © 2022 Ima-Press Publishing House. All rights reserved.
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The emergence of the rare syndrome called vaccine-induced immune thrombocytopenia and thrombosis (VITT) after adenoviral vector vaccines, including ChAdOx1 nCov-19, raises concern about one's predisposing risk factors. Here we report the case of a 56-year-old white man who developed VITT leading to death within 9 days of symptom onset. He presented with superior sagittal sinus thrombosis, right frontal intraparenchymal hematoma, frontoparietal subarachnoid and massive ventricular hemorrhage, and right lower extremity arterial and venous thrombosis. His laboratory results showed elevated D-dimer, C-reactive protein, tissue factor, P-selectin (CD62p), and positive anti-platelet factor 4. The patient's plasma promoted higher CD62p expression in healthy donors' platelets than the controls. Genetic investigation on coagulation, thrombophilia, inflammation, and type I interferon-related genes was performed. From rare variants in European or African genomic databases, 68 single-nucleotide polymorphisms (SNPs) in one allele and 11 in two alleles from common SNPs were found in the patient genome. This report highlights the possible relationship between VITT and genetic variants. Additional investigations regarding the genetic predisposition of VITT are needed.
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Objective: To study the clinical characteristics of diabetes mellitus with Coronavirus disease 2019 (COVID-19) and explore the possible mechanism of diabetes predisposition. Method(s): A single center, retrospective and observational study was used to collect 48 inpatients diagnosed with COVID-19 who were admitted to the first ward of the third department of infection, Raytheon hospital, Wuhan from February 23, 2020 to March 30, 2020. Demographic data, symptoms, laboratory tests, comorbidities, treatments and clinical outcomes have been collected. The patients were divided into non-diabetic group and diabetic group according to the combination of diabetes. The clinical data and laboratory test results of the two groups were observed, and the t test, non-parametric test and Chi square test were used for comparison. Result(s): All the 5 patients with COVID-19 diabetes mellitus had fever and respiratory symptoms, chest CT was consistent with typical COVID-19 imaging features, and novel coronavirus nucleic acid test results were positive. There were no statistically significant differences in age, gender composition, co-existing diseases, clinical symptoms, clinical typing, disease course and treatment plan between the diabetic group and the non-diabetic group (P>0.05).There was a statistically significant difference in fasting blood glucose between the non-diabetic group and the diabetic group (P<0.05).The difference of fasting blood glucose at discharge from the diabetes group compared with that at admission was also statistically significant (P<0.05).There was no statistically significant difference between the two groups in other laboratory examination indexes (P>0.05). Conclusion(s): COVID-19 patients with diabetes are mainly manifested by fever and respiratory symptoms.Chest CT shows typical COVID-19 imaging features.Copyright © 2020 by the Chinese Medical Association.
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Atrial fibrillation (AF) is the most frequent form of cardiac arrhythmia in COVID-19 infected patients. The occurrence of AF paroxysms is often associated with the acute period of infection in time. At the same time, the pathophysiological mechanisms of the occurrence of AF associated with COVID-19 remain insufficiently studied. The review considers the available literature data on the influence of factors such as reduced availability of angiotensin-converting enzyme 2 receptors, interaction of the virus with the cluster of differentiation 147 and sialic acid, increased inflammatory signaling, "cytokine storm", direct viral damage to the endothelium, electrolyte and acid-alkaline balance in the acute phase of severe illness and increased sympathetic activity.Copyright © Autors 2023.
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Background: The emergence of autoinflammatory/autoimmune disorders in COVID-19 patients has necessitated the development of new strategies for the management of these phenomena. Several viruses have been shown to cause autoimmunity by boosting the production of autoreactive lymphocytes, resulting in a lack of tolerance in the host's immune response. The SARS-CoV- 2 virus and/or its proteins can cause autoimmunity by molecular mimicry, superantigen activity, and disruption of type I IFN production. Method(s): The data of three patients who applied to the outpatient clinics of pediatric immunology and rheumatology at Uludag University Hospital between March 2020 and December 2021 and were followed up with autoimmune/autoinflammatory disease following CCovid-19- 19 infection were analyzed retrospectively. Result(s): All patients were female and aged between 2-17 years. They had SARS-COV- 2 infection which was mild a few months ago. Before the Covid-19 infection, all of the patients were in good health. The patients had no history of frequent infections or familial predisposition to rheumatic diseases. Following the Covid-19- infection, all of our patients showed fever, rash, joint discomfort, and muscle soreness. Despite the fact that myalgia affects the whole body, arthralgia was present on the wrists and knees of patients. CRP, sedimentation rate, and acute phase reactants increased in all of them. According to the American College of Rheumatology's diagnostic criteria, our first patient was diagnosed with systemic lupus erythematosus (SLE) and was treated with hydroxychloroquine, intravenous immunoglobulin treatment and anakinra. Two of three were diagnosed with systemic juvenile idiopathic arthritis (sJIA) according to the League of Associations for Rheumatology (ILAR) criteria. Only one patient had low IgG and IgA levels (Table 1). Two patients showed a decrease in CD19+ naive cells percent and numbers. Conclusion(s): Following SARS-CoV- 2 infection, autoimmune and autoinflammatory disorders such as rheumatoid arthritis, psoriatic arthritis, type 1 diabetes and Still disease have been documented in adult cases. There are limited pediatric cases on this issue. It has been suggested that the persistence of the latent immune response after COVID-19 infection happens by sensitizing the immune system to viral particles long after they have been eliminated from organisms. Is the autoimmune process the effect of a viral infection or mis-targeted immune system? These questions need deep research and discussion.
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Polypectomy is the most common therapeutic endoscopic intervention in children. Management of sporadic juvenile polyps is limited to polypectomy to resolve symptoms, whereas polyposis syndromes pose a multidisciplinary challenge with broader ramifications. In preparation for polypectomy, there are key patient, polyp, endoscopy unit, and provider characteristics that factor into the likelihood of success. Younger age and multiple medical comorbidities increase the risk of adverse outcomes, classified as intraoperative, immediate postoperative, and delayed postoperative complications. Novel techniques, including cold snare polypectomy, can significantly decrease adverse events but a more structured training process for polypectomy in pediatric gastroenterology is needed.
Subject(s)
Colonic Polyps , Colorectal Neoplasms , Humans , Child , Intestinal Polyposis/surgery , Colonic Polyps/surgery , Colonoscopy , Colorectal Neoplasms/surgeryABSTRACT
BACKGROUND: Our study aimed to establish 'real-world' performance and cost-effectiveness of ovarian cancer (OC) surveillance in women with pathogenic germline BRCA1/2 variants who defer risk-reducing bilateral salpingo-oophorectomy (RRSO). METHODS: Our study recruited 875 female BRCA1/2-heterozygotes at 13 UK centres and via an online media campaign, with 767 undergoing at least one 4-monthly surveillance test with the Risk of Ovarian Cancer Algorithm (ROCA) test. Surveillance performance was calculated with modelling of occult cancers detected at RRSO. The incremental cost-effectiveness ratio (ICER) was calculated using Markov population cohort simulation. RESULTS: Our study identified 8 OCs during 1277 women screen years: 2 occult OCs at RRSO (both stage 1a), and 6 screen-detected; 3 of 6 (50%) were ≤stage 3a and 5 of 6 (83%) were completely surgically cytoreduced. Modelled sensitivity, specificity, Positive Predictive Value (PPV) and Negative Predictive Value (NPV) for OC were 87.5% (95% CI, 47.3 to 99.7), 99.9% (99.9-100), 75% (34.9-96.8) and 99.9% (99.9-100), respectively. The predicted number of quality-adjusted life years (QALY) gained by surveillance was 0.179 with an ICER cost-saving of -£102,496/QALY. CONCLUSION: OC surveillance for women deferring RRSO in a 'real-world' setting is feasible and demonstrates similar performance to research trials; it down-stages OC, leading to a high complete cytoreduction rate and is cost-saving in the UK National Health Service (NHS) setting. While RRSO remains recommended management, ROCA-based surveillance may be considered for female BRCA-heterozygotes who are deferring such surgery.
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Objective: Postinfectious irritable bowel syndrome (IBS) is a known entity. We evaluated the incidence of post-COVID-19 IBS in patients discharged from the hospital and analyzed its correlation with the clinical and laboratory parameters, and treatment during the hospital stay. Methods: Three hundred three COVID-19 hospitalized patients without prior history of IBS were prospectively followed after their discharge and were evaluated as per Rome-IV criteria for IBS. Results: One hundred seventy-eight patients were males (58.7%). The age range was 17-95 years (mean +or- SD, 55.9 +or- 15.8). A total of 194 (64%) had mild COVID-19, 74 (24.4%) had moderate COVID-19, whereas 35 (11.6%) had severe COVID-19 infection. Sixteen (5.3%) patients had concomitant GI symptoms during COVID-19 infection. IBS symptoms were found to be present in 32 (10.6%) patients, out of which 17 (53.13%) had diarrhea-predominant, 10 (31.25%) had constipation-predominant, and five (15.62%) had mixed-type IBS. Post-COVID-19 IBS was more common in the female sex (P < 0.001), concomitant GI symptoms with COVID-19 (P < 0.001), oxygen requirement (P = 0.015), deranged liver function tests at the time of admission (P = 0.002), high procalcitonin (P = 0.013), high C-reactive protein levels (P = 0.035);whereas negative correlation was found with remdesivir treatment (P = 0.047). After performing regression analysis, female sex (P < 0.001), oxygen requirement during hospital stay (P = 0.016), GI symptoms during COVID-19 infection (P < 0.001), and high procalcitonin levels (P = 0.017) were independently associated with post-COVID-19 IBS. Conclusion: GI symptoms during active COVID-19 infection increase the chances of developing post-COVID-19 IBS. The risk of developing post-COVID-19 IBS increases in female patients, those requiring oxygen and having high procalcitonin levels during COVID-19 infection.
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One of the conformational issues by the explosion Of pet ownership throughout the COVID 19 pandemic is the Ming number dunes of brachycephalic obstructive envay syndrome (BOAS), which is a condition prevalent in some of the UK's most copular dog breeds The challenges the veterinary profession is not only to identify and treat affected individuals from within the population of dogs presenting to primary care clinicians, using surgical and non-surgical options but also to educate clients on how to recognise clinical signs of the disease as early as possible.
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Objective: In the twenty-first century, despite the development in infection management, and improvement of vaccines and therapeutic agents in the field of health, new viral outbreaks that can still be fatal in humans and animals are emerging. The infection of zoonosis COVID-19 from bat origin, the intermediate host of which is still being unclear, has appeared in people who visited animal bazaar in December 2019, in Wuhan, China. The World Health Organization declared this infection a pandemic in February 2020. Millions of people have been affected by this pandemic. The fight against the pandemic has had a great economic cost and continues to do so. Even people have changed their lifestyle. In this context, there have been concerns about companion animals with COVID-19 transmission, from human to animal or animal to human. The purpose of this review was to examine the studies on the presence and transmission of COVID-19 in companion animals such as cats, dogs, hamsters and horses. Result and Discussion: It has been reported in studies that most of the companion animals (cat, dog and hamster) were susceptible to SARS-CoV-2, and humans could be a source of infection for them. However, the potential role of companion animals in transmission to humans is not fully known. It is clear from this pandemic that the necessity of epidemiological investigation of infectious agents, especially zoonotic ones, in one health concept has emerged once again.Copyright © 2022 University of Ankara. All rights reserved.
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Objective: In the twenty-first century, despite the development in infection management, and improvement of vaccines and therapeutic agents in the field of health, new viral outbreaks that can still be fatal in humans and animals are emerging. The infection of zoonosis COVID-19 from bat origin, the intermediate host of which is still being unclear, has appeared in people who visited animal bazaar in December 2019, in Wuhan, China. The World Health Organization declared this infection a pandemic in February 2020. Millions of people have been affected by this pandemic. The fight against the pandemic has had a great economic cost and continues to do so. Even people have changed their lifestyle. In this context, there have been concerns about companion animals with COVID-19 transmission, from human to animal or animal to human. The purpose of this review was to examine the studies on the presence and transmission of COVID-19 in companion animals such as cats, dogs, hamsters and horses. Result and Discussion: It has been reported in studies that most of the companion animals (cat, dog and hamster) were susceptible to SARS-CoV-2, and humans could be a source of infection for them. However, the potential role of companion animals in transmission to humans is not fully known. It is clear from this pandemic that the necessity of epidemiological investigation of infectious agents, especially zoonotic ones, in one health concept has emerged once again.Copyright © 2022 University of Ankara. All rights reserved.
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Objective: To study the clinical characteristics of diabetes mellitus with Coronavirus disease 2019 (COVID-19) and explore the possible mechanism of diabetes predisposition. Method(s): A single center, retrospective and observational study was used to collect 48 inpatients diagnosed with COVID-19 who were admitted to the first ward of the third department of infection, Raytheon hospital, Wuhan from February 23, 2020 to March 30, 2020. Demographic data, symptoms, laboratory tests, comorbidities, treatments and clinical outcomes have been collected. The patients were divided into non-diabetic group and diabetic group according to the combination of diabetes. The clinical data and laboratory test results of the two groups were observed, and the t test, non-parametric test and Chi square test were used for comparison. Result(s): All the 5 patients with COVID-19 diabetes mellitus had fever and respiratory symptoms, chest CT was consistent with typical COVID-19 imaging features, and novel coronavirus nucleic acid test results were positive. There were no statistically significant differences in age, gender composition, co-existing diseases, clinical symptoms, clinical typing, disease course and treatment plan between the diabetic group and the non-diabetic group (P>0.05).There was a statistically significant difference in fasting blood glucose between the non-diabetic group and the diabetic group (P<0.05).The difference of fasting blood glucose at discharge from the diabetes group compared with that at admission was also statistically significant (P<0.05).There was no statistically significant difference between the two groups in other laboratory examination indexes (P>0.05). Conclusion(s): COVID-19 patients with diabetes are mainly manifested by fever and respiratory symptoms.Chest CT shows typical COVID-19 imaging features.Copyright © 2020 by the Chinese Medical Association.
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Coronavirus disease 2019 (COVID-19) is a lethal disease caused by the coronavirus SARS-CoV-2, which can result in a broad clinical spectrum of respiratory symptoms. While many clinical risk factors such as concomitant chronic diseases play roles in the pathophysiology of COVID-19, genetic predisposition factors have not been widely studied. The aim of this study was, therefore, to evaluate the relationship between some singlenucleotide polymorphisms (SNPs) of the human genes TYK2 and ACE2 and the severity of SARS-CoV-2 infection. Genomic DNA was isolated from 200 SARS-CoV-2-infected individuals with severe (n = 100) or mild (n = 100) disease. Owing to the importance of ACE2 and TYK2 genes in regulating the immune response to SARS-CoV-2 infection, TYK2 gene SNPs, i.e. rs2304255, rs2304256, rs12720270, and rs12720354 and ACE2 rs382746 variants, were genotyped in the samples. To confirm the results, the expression of different TYK2 genotypes was investigated using real-time PCR. The presence of the nucleotide T at the locus rs2304255 was shown to be a risk factor linked to disease severity (OR [95% CI] = 3.2485 [2.1554-4.8961]). Similarly, the presence of A at the locus rs12720354 increased the risk of severity (OR [95% CI]) = 3.9721 [2.6075-6.0509]). In contrast, the presence of A at the loci rs2304256 and rs12720270 was observed to reduce the severity risk (OR [95% CI] = 0.2495 [0.1642-0.3793] and 0.1668 [0.1083-0.2569], respectively). Real-time PCR results also demonstrated that the expression level of TYK2 in samples with the TT genotype of rs2304255 and the AA genotype of rs12720354 and in samples with the GG genotype of rs12720207 was significantly lower than in those with other genotypes. The results of this study suggest that TYK2 SNPs might be utilized to identify individuals who are at risk for severe COVID-19, in order to better manage their health care. It is predicted that the presence of some alleles (T in rs2304255, A in rs12720354, and G in rs12720207) of TYK2 can affect COVID-19 severity by reducing TYK2 expression and thereby affecting the regulatory role of TYK2 in the immune response.
Subject(s)
Angiotensin-Converting Enzyme 2 , COVID-19 , Humans , Angiotensin-Converting Enzyme 2/genetics , TYK2 Kinase/genetics , TYK2 Kinase/metabolism , COVID-19/genetics , SARS-CoV-2/genetics , SARS-CoV-2/metabolism , Genotype , Genetic Predisposition to Disease , Polymorphism, Single NucleotideABSTRACT
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children is characterized by a wide variety of expressions ranging from asymptomatic to, rarely, critical illness. The basis of this variability is not yet fully understood. The aim of this study was to identify clinical and genetic risk factors predisposing to disease susceptibility and progression in children. Methods: We enrolled 181 consecutive children aged less than 18 years hospitalized with or for SARS-CoV-2 infection during a period of 24 months. Demographic, clinical, laboratory, and microbiological data were collected. The development of coronavirus disease 2019 (COVID-19)-related complications and their specific therapies were assessed. In a subset of 79 children, a genetic analysis was carried out to evaluate the role of common COVID-19 genetic risk factors (chromosome 3 cluster; ABO-blood group system; FUT2, IFNAR2, OAS1/2/3, and DPP9 loci). Results: The mean age of hospitalized children was 5.7 years, 30.9% of them being under 1 year of age. The majority of children (63%) were hospitalized for reasons different than COVID-19 and incidentally tested positive for SARS-CoV-2, while 37% were admitted for SARS-CoV-2 infection. Chronic underlying diseases were reported in 29.8% of children. The majority of children were asymptomatic or mildly symptomatic; only 12.7% developed a moderate to critical disease. A concomitant pathogen, mainly respiratory viruses, was isolated in 53.3%. Complications were reported in 7% of children admitted for other reasons and in 28.3% of those hospitalized for COVID-19. The respiratory system was most frequently involved, and the C-reactive protein was the laboratory test most related to the development of critical clinical complications. The main risk factors for complication development were prematurity [relative risk (RR) 3.8, 95% confidence interval (CI) 2.4-6.1], comorbidities (RR 4.5, 95% CI 3.3-5.6), and the presence of coinfections (RR 2.5, 95% CI 1.1-5.75). The OAS1/2/3 risk variant was the main genetic risk factor for pneumonia development [Odds ratio (OR) 3.28, 95% CI 1-10.7; p value 0.049]. Conclusion: Our study confirmed that COVID-19 is generally less severe in children, although complications can develop, especially in those with comorbidities (chronic diseases or prematurity) and coinfections. Variation at the OAS1/2/3 genes cluster is the main genetic risk factor predisposing to COVID-19 pneumonia in children.
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Arterial thrombosis encountered during sars-cov2 infections is a rare complication with a poor prognosis compared to venous ones. They generally occur in severe and critical clinical forms of covid19 [1,2]. The physiopathology of arterial thrombosis, even if not completely understood highlights hypercoagulability and excessive inflammation as risk factors with a major role of the endothelial lesions in their occurrence. The presence of cardiovascular risk factors in patients infected with covid19 is also discussed as a predisposing factor for arterial thrombosis [2,3]. We report the case of a North African male patient hospitalized for acute respiratory distress syndrome (ARDS) secondary to covid19 pneumonia, complicated by the occurrence of multiple arterial thrombosis of the aorto-iliac axis with the rare finding of two free floating thrombus in the aorta and the right common iliac artery. Clinically, the patient had developed acute bilateral lower limb ischemia and multi-organ failure and the evolution was dramatic with rapid worsening of the patient…s health and eventually his death. Thromboembolic complications are frequent during covid19 infection but the aortic localization is very rare. Its diagnosis is difficult and it has a poor prognosis. Our objective through this case report is to increase knowledge about arterial thromboembolic events while discussing their link to the sars-cov2 viral infection. © 2022
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Background COVID-19 started in China and has spread throughout the world since December 2019. The pandemic has not only brought the risk of morbidity and mortality from infection but also psychological burden. Objective To find out the psychological impacts of COVID-19 on students from high schools, colleges and universities in Nepal, along with examining the association between socio-demographic and other related variables and level of anxiety in the students. Method This study sampled students from Nepal using convenience sampling and responded to a quantitative questionnaire that included the 7-item Generalized Anxiety Disorder Scale (GAD-7) and other basic information. Finally, 105 respondents were included in the final analysis (100% response rate). Convenient sampling technique was used to gather the sample. Result The results indicated that 18.1% of the respondents were experiencing severe anxiety, 22.9% moderate anxiety, and 25.7% mild anxiety. Moreover, females were more prone to anxiety as compared to males. The results of correlation analysis indicated that economic effects, and delays in academic activities, were positively associated with anxiety symptoms (p < .05). However, social support was negatively correlated with the level of anxiety (p < .001). Conclusion It is recommended that the mental health of students should be monitored during public health emergencies, such as this one. This study examines the psychological impacts of COVID-19 among the college students in Nepal. Copyright © 2020, Kathmandu University. All rights reserved.
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BACKGROUND: Social isolation and loneliness have emerged as important risk factors for cardiovascular diseases, particularly during the coronavirus disease pandemic. However, it is unclear whether social isolation and loneliness had independent and joint associations with incident heart failure (HF). OBJECTIVES: This study sought to examine the association of social isolation, loneliness, and their combination with incident HF. METHODS: The UK Biobank study is a population-based cohort study. Social isolation and loneliness were assessed using self-reported questionnaires. HF cases were identified by linking hospital records and death registries. The weighted polygenic risk score associated with HF was calculated. RESULTS: Among the 464,773 participants (mean age: 56.5 ± 8.1 years, 45.3% male), 12,898 incident HF cases were documented during a median follow-up of 12.3 years. Social isolation (most vs least: adjusted HR: 1.17; 95% CI:1.11-1.23) and loneliness (yes vs no: adjusted HR: 1.19; 95% CI: 1.11-1.27) were significantly associated with an increased risk of incident HF. The association between an elevated risk of HF and social isolation was modified by loneliness (Pinteraction = 0.034). A gradient of association between social isolation and the risk of incident HF was found only among individuals without loneliness (Ptrend < 0.001), but not among those with loneliness (Ptrend = 0.829). These associations were independent of the genetic risk of HF. CONCLUSIONS: Social isolation and loneliness were independently associated with a higher likelihood of incident HF regardless of genetic risk. The association between social isolation and incident HF was potentially modified by loneliness status.