Current Practices and Recommendations for Prioritizing Patients Mimicking Upper Respiratory Tract Symptoms in Period of Covid 19 Pandemic: A Strategic Perspective.

Upper respiratory tract symptoms can be caused by many diseases like Covid 19 disease, common cold, seasonal flu or allergy. This present a diagnostic dilemma in OPD to clinically identify which patient is suspected of Covid 19 disease and which is not. Which patient needs immediate Covid 19 testing, as not all patients presenting with these symptoms have Covid 19 disease. To develop a criteria which can help clinician in OPD while dealing with cases of upper respiratory tract symptoms and to highlight this grey area which needs further research. 107 patients with upper respiratory tract symptom over a period of 1 month, fulfilling the inclusion and exclusion criteria were evaluated and analysed. Patients were divided into 2 groups. Group I is High suspicion group having 43 cases, Group II Low Suspicion group having 64 cases. In group I there were 29 Covid 19 positive cases (67.44%). In group II there were 3 Covid 19 positive cases (4.6%). By dividing the patients of upper respiratory tract symptoms into three groups (I & II) a system can be made for proper, timely and efficient treatment of such cases.

Residential mobility predicts COVID-19 and seasonal flu vaccination behaviors in the United States.

Aim: Vaccination is one of the most effective strategies to contain the transmission of infectious diseases; however, people's intentions and behavior for vaccination vary across different regions and countries around the world. It is not clear how socioecological factors such as residential mobility influence people's vaccination behaviors for infectious diseases. Methods: We analyzed public data on residential mobility and vaccination rates for COVID-19 and seasonal flu in the United States and explored how residential mobility in the previous year influenced vaccination rates for COVID-19 and seasonal flu (2011-2018) across 50 states of the US. The data were accessed and analyzed in 2021. Results: Study 1 demonstrated that collective-level residential mobility predicted COVID-19 vaccination rates across the United States (B = -168.162, 95% CI [-307.097, -29.227], adjusted R 2 = 0.091, p = 0.019). Study 2 corroborated this finding by documenting that collective-level residential mobility predicted vaccination rates for seasonal flu from 2011 to 2018 across the United States (B = -0.789, 95% CI = [-1.018, -0.56], adjusted R 2 = 0.222, p < 0.001). The link between residential mobility and vaccination behavior was robust after controlling relevant variables, including collectivism, cultural tightness-looseness, and sociodemographic variables. Conclusions: Our research demonstrated that residential mobility is an important socioecological factor that influences people's vaccination behaviors for COVID-19 and seasonal flu. The results enrich our understanding of the socioecological factors that influence vaccination behaviors and have implications for developing tailored interventions to promote vaccination during pandemics of infectious diseases.

A New Drug Formula for Pneumonia and Severe Seasonal Flu; a Promising Drug for Eradicate COVID19.

World Health Organization (WHO) well-known pleiotropic antiviral compounds.This study was designed to evaluate the effects of herbal drug combination in treatment of pneumonia, severe respiratory distress, and severe flu and recently for COVID19.The treatment phase includes 12 days period of herbal drug mixture (X) . Results showed the activity of herbal drug in eradication of COVID19, pneumonia and severe seasonalful.

Mitigating co-circulation of seasonal influenza and COVID-19 pandemic in the presence of vaccination: A mathematical modeling approach.

The co-circulation of two respiratory infections with similar symptoms in a population can significantly overburden a healthcare system by slowing the testing and treatment. The persistent emergence of contagious variants of SARS-CoV-2, along with imperfect vaccines and their waning protections, have increased the likelihood of new COVID-19 outbreaks taking place during a typical flu season. Here, we developed a mathematical model for the co-circulation dynamics of COVID-19 and influenza, under different scenarios of influenza vaccine coverage, COVID-19 vaccine booster coverage and efficacy, and testing capacity. We investigated the required minimal and optimal coverage of COVID-19 booster (third) and fourth doses, in conjunction with the influenza vaccine, to avoid the coincidence of infection peaks for both diseases in a single season. We show that the testing delay brought on by the high number of influenza cases impacts the dynamics of influenza and COVID-19 transmission. The earlier the peak of the flu season and the greater the number of infections with flu-like symptoms, the greater the risk of flu transmission, which slows down COVID-19 testing, resulting in the delay of complete isolation of patients with COVID-19 who have not been isolated before the clinical presentation of symptoms and have been continuing their normal daily activities. Furthermore, our simulations stress the importance of vaccine uptake for preventing infection, severe illness, and hospitalization at the individual level and for disease outbreak control at the population level to avoid putting strain on already weak and overwhelmed healthcare systems. As such, ensuring optimal vaccine coverage for COVID-19 and influenza to reduce the burden of these infections is paramount. We showed that by keeping the influenza vaccine coverage about 35% and increasing the coverage of booster or fourth dose of COVID-19 not only reduces the infections with COVID-19 but also can delay its peak time. If the influenza vaccine coverage is increased to 55%, unexpectedly, it increases the peak size of influenza infections slightly, while it reduces the peak size of COVID-19 as well as significantly delays the peaks of both of these diseases. Mask-wearing coupled with a moderate increase in the vaccine uptake may mitigate COVID-19 and prevent an influenza outbreak.

Second Wave of Covid-19 with Seasonal Influenza (Flu) in Uttar Pradesh, Northern India: A Cohort Study

Background: Coronavirus disease 2019 (Covid-19) is caused by a novel coronavirus (SARS-CoV-2) infection, while influenza viruses cause the flu. SARS-CoV-2 and influenza virus co-infection seems to be a real and serious concern. Objective(s): This study aims to evaluate the clinical features, laboratory investigations, computed tomography scans, and interventions of Covid-19 patients during seasonal influenza. Method(s): This was a multi-center prospective cohort study that collected data from hospitals, clinics, and laboratories on measurements, treatments, and outcomes from Covid-19 patients admitted to temporary Covid-19 care centers. Result(s): A total of 480 individuals (female, 231 [48.12%];male, 249 [51.88%]) were recruited from March 31st to May 14th, 2021 at five hospitals/clinics in Uttar Pradesh, North India. The patients were divided into six groups based on their age (65+ years [25.41% of cases] being the most affected age) and five groups based on their conditions (asymptomatic 65 [13.54%], mild 94 [19.58%], moderate 206 [42.91%], severe 84 [17.50%] and critical 31 [6.45%]). Patients' outcomes were documented as death (19 [3.95%]), recovery (421 [87.71%]) and under-treatment (40 [8.34%]). Conclusion(s): The most common clinical symptoms reported were fever, sore throat, and dyspnea. The severity was linked to hypoxemia, lymphocytopenia, thrombocytopenia, elevated erythrocyte sedimentation rate (ESR), and high blood urea nitrogen (BUN). The vast majority of patients were given symptomatic treatment. Any onset of fever should be suspected and examined for the viral strain to distinguish between Covid-19 and the seasonal flu. Copyright © 2022 Bentham Science Publishers.

FIFA Arab Cup tournament with full capacity of spectators during the COVID-19 pandemic: a cross-sectional study.

BACKGROUND: We sought to assess the risk of COVID-19 and seasonal flu including respiratory syncytial (RSV) and influenza viruses during the FIFA Arab Cup 2021 in Qatar with full capacity of spectators. We also, evaluated the post-event attitude toward resumption of mass football events. METHODS: This was a cross-sectional study in which spectators (age ≥ 18 years) were invited for reverse-transcription PCR testing for COVID-19 and seasonal flu. At the same time, between 7 and 14 days after the event, the participants completed a self-administered questionnaire regarding their concerns during the tournament. RESULTS: The tournament included 16 international football teams from the Arab countries. As per the study protocol, 10,000 spectators were approached and 6,475 participated. Among the participants, 4,195 (65.1%), 2,253 (34.9%) and 27 (0.4%) were vaccinated with 2 doses, vaccinated with 3 doses, and recovered from SARS-Cov-2 infection, respectively. There were 61 (0.9%), 41(0.6%) and 11(0.2%) participants who tested positive for COVID-19, RSV and influenza (A/B), respectively. The average cycle threshold (Ct) value for COVID-19 positive cases was 26.1±7.3. Among those who were electronically approached, 6,102 completed the survey whereas 373 had incomplete survey. Overall, 2069 (33.9%) participants reported symptoms that theoretically could be related to COVID-19, of them 39 had positive PCR test (1.9%). Spectators (94.3%) were optimistic about returning sport events to the pre-pandemic status. CONCLUSIONS: There was no significant increase in the daily COVID-19 cases during FIFA Arab Cup 2021 with a full capacity of spectators. Therefore, upcoming mass football events can be held safely.

Increasing Seasonal Influenza Vaccination among University Students: A Systematic Review of Programs Using a Social Marketing Perspective.

The health and economic consequences of seasonal influenza present great costs to communities. Promoting voluntary uptake of the seasonal influenza vaccine among university students, particularly during the COVID-19 pandemic, can deliver protective effects for both individuals and the wider community. Vaccine uptake will be greatest when more of the social marketing benchmarks are applied. This systematic review summarizes evidence from programs aiming to increase seasonal influenza vaccination among university students. Six major electronic databases for health promotion studies (PubMed, EBSCO, ProQuest, Ovid, Web of Science, and ScienceDirect) were searched in November 2021 to capture peer-reviewed studies reporting field trials that have sought to increase seasonal influenza vaccination in university student populations, without any restrictions regarding the publication period. Following PRISMA guidelines, this paper identified 12 peer-reviewed studies that were conducted in the field in the United States, Australia, and Spain. Three studies were targeted at healthcare students and the rest focused on wider university student populations. Studies were narratively summarized, evidence of social marketing principles were identified, and quantitative outcomes were meta-analyzed. The findings indicate that none of the field studies, even a self-classified social marketing study, had adopted all eight of the social marketing benchmarks in program design and implementation. The two studies that only used promotion, but not other marketing-mix and social marketing principles, reported increases in students' intention to be vaccinated but not actual behavior. Given that change is more likely when more social benchmarks are applied, this paper identifies activities that can be included in flu vaccine programs to improve flu vaccine uptake rates. The analysis highlights a lack of field studies focusing on increasing rates of vaccination behavior as research outcomes in countries beyond the United States.

Interplay of Influenza A/B Subtypes and COVID-19

Influenza, or most commonly termed the flu, is a common respiratory illness caused by viral infection. The circulation of this virus is found year-round but is more common during the flu season: fall and winter. In the United States, the number of reported cases begins to rise in October, reaches a peak in December, and returns to normal in April. Even though there are four subtypes of the Influenza virus, the seasonal flu outbreaks in humans are caused by type A and B viruses. eVision utilizes influenza data provided by the United States Center for Disease Control and Prevention (CDC) and the World Health Organization (WHO) to analyze influenza A and B cases throughout the flu season. During the 2019-20 flu season, the positive influenza cases reported in the US were between 36 and 56 million, which is the highest over the past six years. However, during the 2020-21 flu season which is the first complete flu season within the COVID-19 pandemic, the reported flu cases reduced drastically to 1,899;of which 713 were caused by influenza A viruses, and 1,186 by influenza B viruses. This indicates that the number of flu B cases was higher than that of flu A which was not normally the case prior to the COVID-19 pandemic. It was further observed that flu B reached its peak either at the same time or earlier than flu A which is also unusual compared to the flu trends prior to the onset of the COVID-19 pandemic. This peculiar trend is also noted during the Severe Acute Respiratory Syndrome (SARS) outbreak in 2003. This paper reports the findings on deviation in the Influenza type A and type B trends during the circulation of Coronavirus in the US and Canada and provides possible reasons for these changes. © 2021 IEEE.

Parents' Willingness to Vaccinate Their Children Against Seasonal Influenza After the COVID-19 Pandemic in Saudi Arabia: A Retrospective Cross-Sectional Survey.

PURPOSE: To explore the impact of the novel coronavirus (COVID-19) pandemic on caregivers' willingness to vaccinate their children against influenza in 2021 in Saudi Arabia and the factors influencing this decision. PATIENTS AND METHODS: An online survey of 2501 caregivers in Saudi Arabia with children aged 6 months-18 years was conducted between July 15, 2021, and August 2, 2021. A convenience sample of participants that met the inclusion criteria was used as the study sample. Social Science Package Statistical (SPSS) was used for the statistical analysis. Categorical variables were reported as frequencies and percentages. The Chi-square test was used for categorical variables to assess the difference between the variables and the parents' willingness to vaccinate their children against seasonal influenza after the COVID-19 pandemic. RESULTS: Of the 2501 respondents to the survey, 1185 (47.3%) parents plan to give their children the influenza vaccine next year, which is an increase from 745 (29.8%) in the previous year. The following were the main reasons for not giving children the vaccine: children were less likely to get seasonal flu (617, 24.7%), fear of side effects (491, 19.6%), and fear of needles and syringes (484, 19.4%). Among the parents, 1222 (48.9%) were more likely to receive the seasonal flu vaccine themselves the following year, and 1361 (54.4%), which is more than half, were concerned about their children contracting seasonal influenza. CONCLUSION: Parents' decision-making to vaccinate their children against seasonal influenza has been influenced by the COVID-19 pandemic. Numerous factors including a caregiver who had received the seasonal influenza vaccine themselves, who had vaccinated or planned to vaccinate their children during the previous or current seasonal influenza season, and/or who had a higher education level were associated with increased willingness to receive the flu vaccine.

What Is the Willingness to Receive Vaccination Against COVID-19 Among the Elderly in Italy? Data From the PASSI d'Argento Surveillance System.

Introduction: Italy was one of the earliest countries to experience a severe COVID-19 epidemic and vaccinating the elderly, who constitute 23% of the population and have experienced the highest mortality rates, is a top priority. Estimating prevalences and understanding risk factors for COVID-19 vaccine hesitancy or refusal are important for development of targeted interventions. Methods: We used data from a specially developed COVID-19 module of PASSI D'Argento, an ongoing surveillance system of residents 65+ years of age to measure the prevalence and identify risk factors for hesitancy and refusal to receive the COVID-19 vaccine. We calculated multinomial regression relative risk ratios to examine the association between demographic characteristics, health status, COVID-19 attitudes and experiences and likely vaccine hesitancy and refusal. Results: Of the 1876 respondents, 55% reported they would accept vaccination and 16% would likely refuse; the remaining 29% were categorized as hesitant. Compared with the acceptance group, we identified several risk factors in common between the hesitancy group and the refusal group, including not having received vaccination against influenza during the previous flu season (hesitancy: RRR = 2.0; 95% CI 1.4-2.9; refusal: RRR = 12.1; 95%CI 7.6-19.4) and lower risk of having had a death from COVID-19 among family or friends (hesitancy: RRR = 4.8; 95%CI 2.0-11.4; refusal: RRR = 15.4; 95%CI 3.7-64.5). The hesitancy group was significantly more likely being worried and they did not know if consequences of the disease would be serious for them. Conclusion: Our findings show the importance of establishing and maintaining active contact between the preventive services, primary care providers and the population because trust is difficult to establish during an emergency like the COVID-19 pandemic. Italian public health is based on a capillary network of general practitioners and having them reach out to their patients who have not previously received influenza vaccine may be a useful strategy for targeting efforts to further encourage uptake of COVID-19 vaccination.

COVID-19 Symptoms Can Prolong Seasonal Flu Infection Symptoms and Recovery Times Among Obese African American Female Population.

According to several studies, obesity increases rates of metabolic syndrome plus other comorbidities like diabetes and cardiovascular diseases. However, little evidence exists as to whether obesity assists in the prolongation of COVID-19 and seasonal flu-like symptoms especially among African American 55-74-year age groups. The purpose of this study is to show that COVID-19 symptoms can prolong recovery times and symptoms of seasonal flu-infected obese African Americans. The aim of the study is to investigate risk factors which include modifiable (i.e., obesity) and non-modifiable (i.e., age, race) effect on prolongation and recovery times for some inpatient COVID-19 and seasonal flu-infected African American from a single hospital in Detroit, MI.

Association between seasonal flu vaccination and COVID-19 among healthcare workers.

BACKGROUND: In next fall and winter, SARS-CoV-2 could circulate in parallel with seasonal influenza. The dual epidemics will result in considerable morbidity and mortality; therefore, influenza vaccination may be essential. Recent studies found increased risk of coronavirus in individuals receiving influenza vaccination. AIMS: Our aim is to analyse the association between influenza vaccination and COVID-19 in a population of healthcare workers (HCWs). METHODS: IgG antibodies against SARS-CoV-2 were detected in 3520 HCWs at a large hospital in Northern Italy. For each participant, we collected data on flu immunization status for the last five flu seasons. Logistic regression was used to test associations between seasonal flu vaccination status and a positive serology tests for COVID-19. RESULTS: During the last five flu seasons, 2492 vaccinations were administered. Serology tests were negative for 3196 (91%) HCWs and residents and only 21 (1%) people had an equivocal test (12.0-15.0 AU/mL). Only 128 (4%) people received a diagnosis of COVID-19, with a positive swab test. No flu vaccinations for the last five flu seasons were specifically associated with diagnosis of COVID-19 or with positive results of serology tests. CONCLUSIONS: Flu vaccinations did not appear to be associated with SARS-CoV-2 infection. Influenza vaccination should continue to be recommended for HCWs and for individuals at increased risk for severe illness from respiratory infection.

Rationale and design of the pragmatic randomized trial of icosapent ethyl for high cardiovascular risk adults (MITIGATE).

OBJECTIVE: The MITIGATE study aims to evaluate the real-world clinical effectiveness of pre-treatment with icosapent ethyl (IPE), compared with usual care, on laboratory-confirmed viral upper respiratory infection (URI)-related morbidity and mortality in adults with established atherosclerotic cardiovascular disease (ASCVD). BACKGROUND: IPE is a highly purified and stable omega-3 fatty acid prescription medication that is approved for cardiovascular risk reduction in high-risk adults on statin therapy with elevated triglycerides. Preclinical data and clinical observations suggest that IPE may have pleiotropic effects including antiviral and anti-inflammatory properties that may prevent or reduce the downstream sequelae and cardiopulmonary consequences of viral URIs. METHODS: MITIGATE is a virtual, electronic health record-based, open-label, randomized, pragmatic clinical trial enrolling ∼16,500 participants within Kaiser Permanente Northern California - a fully integrated and learning health care delivery system with 21 hospitals and >255 ambulatory clinics serving ∼4.5 million members. Adults ≥50 years with established ASCVD and no prior history of coronavirus disease 2019 (COVID-19) will be prospectively identified and pre-randomized in a 1:10 allocation ratio (∼ 1,500 IPE: ∼15,000 usual care) stratified by age and previous respiratory health status to the intervention (IPE 2 grams by mouth twice daily with meals) vs the control group (usual care) for a minimum follow-up duration of 6 months. The co-primary endpoints are moderate-to-severe laboratory-confirmed viral URI and worst clinical status due to a viral URI at any point in time. CONCLUSION: The MITIGATE study will inform clinical practice by providing evidence on the real-world clinical effectiveness of pretreatment with IPE to prevent and/or reduce the sequelae of laboratory-confirmed viral URIs in a high-risk cohort of patients with established ASCVD.