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1.
Expert Rev Vaccines ; 21(10): 1377-1394, 2022 10.
Article in English | MEDLINE | ID: covidwho-1997004

ABSTRACT

INTRODUCTION: Since its emergence, there have been huge efforts to design vaccines against coronavirus disease 2019 (COVID-19) to inhibit its interpersonal spread. Global vaccine development is the most promising cost-effective method for overcoming the epidemic. However, following reports of post-vaccination thromboembolic adverse effects, there have been raising concerns about the safety profile of the COVID-19 vaccine. AREAS COVERED: We aimed to review the recent Food and Drug Administration (FDA)-approved vaccines and identify the organ-based major complications of COVID-19 vaccines based on reliable published studies. To find high-quality and large-scale observational, clinical trial, and cohort studies, PubMED, Scholar, Embase, and Web of Science were searched using keywords: COVID-19, SARS-CoV-2, vaccine, Pfizer (BNT162b2), Johnson and Johnson (Ad26.COV2), Moderna (mRNA-1273), Oxford AstraZeneca (ChAdOx1nCoV19), Coronavac (Sinovac), BBIBP-CorV (Sinopharm), adverse effect, and complication. To include all relevant articles, backward searching was also done on similar article citations. Case reports, studies including less than 10 participants, and biased articles were excluded. EXPERT OPINION: Based on data from high-quality and population-based studies, major adverse effects are divided into four major organ-specific groups, including cardiovascular, neurologic, hematologic, and immune-allergic side effects. The incidence of most of these side effects is not different between vaccinated and normal populations, and currently, the benefits of vaccination against COVID-19 are greater than the mortality and morbidity risks of COVID-19 infection. However, further studies, specifically systematic review and meta-analysis, are still indicated to investigate further unknown side effects of these vaccines and the existence of causality between the vaccine and reported adverse events.


Subject(s)
COVID-19 Vaccines , COVID-19 , BNT162 Vaccine , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Humans , SARS-CoV-2 , United States , Vaccination
2.
Health Sci Rep ; 5(5): e751, 2022 Sep.
Article in English | MEDLINE | ID: covidwho-1976719

ABSTRACT

Background and Aims: Coronary artery disease is high-risk comorbidity of COVID-19 infection. Nonelective coronary artery revascularization in COVID-19 patients carries substantial risk. Therefore, it is essential to understand the risk factors and outcomes fully. This study aims to evaluate the prognosis of coronary artery bypass grafting (CABG) surgery in patients with COVID-19. Methods: This retrospective cohort study assesses 171 patients who underwent urgent and emergent CABG in Tehran Heart Center from March 2020 to September 2021. The patients were allocated to cases and controls based on COVID-19 infection status. Demographic and clinical features, alongside the complications and outcomes, were compared between the two groups. Results: According to diagnostic criteria, 62 patients were diagnosed with COVID-19 (Case) and 109 patients had no COVID diagnosis (Control). Regarding the demographics and risk factors, hypertension was more prevalent among patients with COVID-19 (64.5% compared to 43.1% p= 0.007). Length of hospital stay, ventilation time, and intensive care unit (ICU) stay time were significantly higher in patients infected with COVID-19. Postoperative complications, including stroke, atrial fibrillation, pleural effusion, blood transfusion, and Inotrope use, were significantly higher in the case group. Mortality rates were also higher in COVID-19 patients with an odds ratio of 1.53; however, this difference is not statistically significant (p: 0.44, 95% CI = 0.50-4.01). Conclusion: COVID-19 is associated with a significantly higher hospital stay, ventilation time, and ICU stay. Mortality rates are also higher, albeit insignificantly. Various postoperative complications are also higher with COVID-19.

3.
Journal of Intensive Medicine ; 2022.
Article in English | ScienceDirect | ID: covidwho-1665214

ABSTRACT

Background The coronavirus disease 2019 (COVID-19) is an ongoing pandemic since December 2019. Invasive mechanical ventilation (IMV) is essential for the management of COVID-19 with acute respiratory distress syndrome (ARDS). We aimed to assess the impact of compliance with a respiratory decision support system on the outcomes of patients with COVID-19-associated ARDS who required IMV. Methods In this retrospective, single-center, case series, 46 patients with COVID-19-associated ARDS who required IMV at Zhongnan Hospital of Wuhan University, China, from January 8, 2020, to March 24, 2020, with the final follow-up date of April 20, 2020, were included. Demographic, clinical, laboratory, imaging, and management information were collected and analyzed. Compliance with the respiratory support decision system was documented, and its relationship with 28-day mortality was evaluated. Results The median age of the 46 patients with COVID-19-associated ARDS requiring IMV was 68.5 years, and 31 were men. The partial pressure of arterial oxygen (PaO2)/fraction of inspired oxygen (FiO2) ratio at intensive care unit (ICU) admission was 104 mmHg. The median total length of IMV was 12.0 (interquartile range [IQR], 6.0–27.3) days, and the median respiratory support decision score was 11.0 (IQR, 7.8–16.0). To 28 days after ICU admission, 18 (39.1%) patients died. Survivors had a significantly higher respiratory support decision score than non-survivors (15.0 [10.3–17.0] vs. 8.5 (6.0–10.3), P = 0.001). Using receiver operating characteristic (ROC) curve to assess the discrimination of respiratory support decision score to 28-day mortality, the area under the curve (AUC) was 0.796 (95% confidence interval [CI]: 0.657–0.934, P = 0.001) and the cut-off was 11.5 (sensitivity = 0.679, specificity = 0.889). Patients with a higher score (>11.5) were more likely to survive at 28 days after ICU admission (log-rank test, P < 0.001). Conclusions For severe COVID-19-associated ARDS with IMV, following the respiratory support decision and assessing completion would improve the progress of ventilation. With a decision score of >11.5, the mortality at 28 days after ICU admission showed an obvious decrease.

4.
Front Public Health ; 9: 770985, 2021.
Article in English | MEDLINE | ID: covidwho-1566667

ABSTRACT

Vaccine hesitancy in the US throughout the pandemic has revealed inconsistent results. This systematic review has compared COVID-19 vaccine uptake across US and investigated predictors of vaccine hesitancy and acceptance across different groups. A search of PUBMED database was conducted till 17th July, 2021. Articles that met the inclusion criteria were screened and 65 studies were selected for a quantitative analysis. The overall vaccine acceptance rate ranged from 12 to 91.4%, the willingness of studies using the 10-point scale ranged from 3.58 to 5.12. Increased unwillingness toward COVID-19 vaccine and Black/African Americans were found to be correlated. Sex, race, age, education level, and income status were identified as determining factors of having a low or high COVID-19 vaccine uptake. A change in vaccine acceptance in the US population was observed in two studies, an increase of 10.8 and 7.4%, respectively, between 2020 and 2021. Our results confirm that hesitancy exists in the US population, highest in Black/African Americans, pregnant or breastfeeding women, and low in the male sex. It is imperative for regulatory bodies to acknowledge these statistics and consequently, exert efforts to mitigate the burden of unvaccinated individuals and revise vaccine delivery plans, according to different vulnerable subgroups, across the country.


Subject(s)
COVID-19 Vaccines , COVID-19 , Female , Humans , Male , SARS-CoV-2 , United States/epidemiology , Vaccination
5.
Int Dent J ; 71(5): 358-368, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-987965

ABSTRACT

INTRODUCTION: Infection prevention in dental practice is a principle of utmost importance aiming to protect patients, the dental team, and ultimately, public health. The recent pandemic of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has instigated worldwide public concern. This highly contagious disease has called for profound changes in patient care around the world. The goal of this article is to review the current literature and introduce essential knowledge about COVID-19, recommend management protocols and adequate protection for dental professionals during the outbreak. MATERIAL AND METHODS: The literature search was conducted from April to June 2020. After full-text screening a total of 85 studies were included. RESULTS: Given the novelty of SARS-CoV-2, some characteristics of the virus remain yet unknown. The virus is aerosol-transmissible and, because of the nature of dental procedures, this puts dental professionals and patients at a high risk of contamination by this pathogen. Adequate management protocols and specific protective approaches are essential to minimise the spread of COVID-19 in dental settings during the outbreak. DISCUSSION: The overall impact of COVID-19 in health care worldwide is yet to be determined. This constitutes a significant limitation to this review because the information obtained risks being outdated as the pandemic progresses. The prudent practitioner will use this review as a starting point and continue to proactively update themselves as the outbreak continues. Further studies are required to investigate the potential impact of infections with SARS-CoV-2 within dental settings.


Subject(s)
COVID-19 , Dentistry , Disease Outbreaks/prevention & control , Humans , Pandemics , SARS-CoV-2
6.
Front Endocrinol (Lausanne) ; 11: 525, 2020.
Article in English | MEDLINE | ID: covidwho-690147

ABSTRACT

Background: Diabetes correlates with poor prognosis in patients with COVID-19, but very few studies have evaluated whether impaired fasting glucose (IFG) is also a risk factor for the poor outcomes of patients with COVID-19. Here we aimed to examine the associations between IFG and diabetes at admission with risks of complications and mortality among patients with COVID-19. Methods: In this multicenter retrospective cohort study, we enrolled 312 hospitalized patients with COVID-19 from 5 hospitals in Wuhan from Jan 1 to Mar 17, 2020. Clinical information, laboratory findings, complications, treatment regimens, and mortality status were collected. The associations between hyperglycemia and diabetes status at admission with primary composite end-point events (including mechanical ventilation, admission to intensive care unit, or death) were analyzed by Cox proportional hazards regression models. Results: The median age of the patients was 57 years (interquartile range 38-66), and 172 (55%) were women. At the time of hospital admission, 84 (27%) had diabetes (and 36 were new-diagnosed), 62 (20%) had IFG, and 166 (53%) had normal fasting glucose (NFG) levels. Compared to patients with NFG, patients with IFG and diabetes developed more primary composite end-point events (9 [5%], 11 [18%], 26 [31%]), including receiving mechanical ventilation (5 [3%], 6 [10%], 21 [25%]), and death (4 [2%], 9 [15%], 20 [24%]). Multivariable Cox regression analyses showed diabetes was associated increased risks of primary composite end-point events (hazard ratio 3.53; 95% confidence interval 1.48-8.40) and mortality (6.25; 1.91-20.45), and IFG was associated with an increased risk of mortality (4.11; 1.15-14.74), after adjusting for age, sex, hospitals and comorbidities. Conclusion: IFG and diabetes at admission were associated with higher risks of adverse outcomes among patients with COVID-19.


Subject(s)
Blood Glucose/metabolism , Coronavirus Infections/mortality , Diabetes Complications/mortality , Diabetes Mellitus/physiopathology , Glucose Intolerance/complications , Hyperglycemia/complications , Pneumonia, Viral/mortality , Adult , Aged , Betacoronavirus/isolation & purification , COVID-19 , China/epidemiology , Coronavirus Infections/complications , Coronavirus Infections/epidemiology , Coronavirus Infections/virology , Diabetes Complications/epidemiology , Diabetes Complications/virology , Diabetes Mellitus/virology , Fasting , Female , Follow-Up Studies , Glucose Intolerance/virology , Hospital Mortality , Hospitalization , Humans , Hyperglycemia/virology , Male , Middle Aged , Pandemics , Pneumonia, Viral/complications , Pneumonia, Viral/epidemiology , Pneumonia, Viral/virology , Prognosis , Retrospective Studies , Risk Factors , SARS-CoV-2 , Severity of Illness Index , Survival Rate
7.
J Biol Chem ; 295(33): 11742-11753, 2020 08 14.
Article in English | MEDLINE | ID: covidwho-615997

ABSTRACT

The pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has challenged the speed at which laboratories can discover the viral composition and study health outcomes. The small ∼30-kb ssRNA genome of coronaviruses makes them adept at cross-species spread while enabling a robust understanding of all of the proteins the viral genome encodes. We have employed protein modeling, molecular dynamics simulations, evolutionary mapping, and 3D printing to gain a full proteome- and dynamicome-level understanding of SARS-CoV-2. We established the Viral Integrated Structural Evolution Dynamic Database (VIStEDD at RRID:SCR_018793) to facilitate future discoveries and educational use. Here, we highlight the use of VIStEDD for nsp6, nucleocapsid (N), and spike (S) surface glycoprotein. For both nsp6 and N, we found highly conserved surface amino acids that likely drive protein-protein interactions. In characterizing viral S protein, we developed a quantitative dynamics cross-correlation matrix to gain insights into its interactions with the angiotensin I-converting enzyme 2 (ACE2)-solute carrier family 6 member 19 (SLC6A19) dimer. Using this quantitative matrix, we elucidated 47 potential functional missense variants from genomic databases within ACE2/SLC6A19/transmembrane serine protease 2 (TMPRSS2), warranting genomic enrichment analyses in SARS-CoV-2 patients. These variants had ultralow frequency but existed in males hemizygous for ACE2. Two ACE2 noncoding variants (rs4646118 and rs143185769) present in ∼9% of individuals of African descent may regulate ACE2 expression and may be associated with increased susceptibility of African Americans to SARS-CoV-2. We propose that this SARS-CoV-2 database may aid research into the ongoing pandemic.


Subject(s)
Betacoronavirus/chemistry , Betacoronavirus/genetics , Coronavirus Infections/metabolism , Databases, Protein , Molecular Dynamics Simulation , Pneumonia, Viral/metabolism , Proteome , Amino Acid Transport Systems, Neutral/chemistry , Amino Acid Transport Systems, Neutral/genetics , Amino Acid Transport Systems, Neutral/metabolism , Angiotensin-Converting Enzyme 2 , COVID-19 , Coronavirus Infections/virology , Coronavirus Nucleocapsid Proteins , Genetic Predisposition to Disease , Genetic Variation , Host-Pathogen Interactions , Humans , Male , Nucleocapsid Proteins/chemistry , Nucleocapsid Proteins/metabolism , Pandemics , Peptidyl-Dipeptidase A/chemistry , Peptidyl-Dipeptidase A/genetics , Peptidyl-Dipeptidase A/metabolism , Phosphoproteins , Pneumonia, Viral/virology , Protein Interaction Maps , Protein Processing, Post-Translational , SARS-CoV-2 , Sequence Homology, Amino Acid , Serine Endopeptidases/chemistry , Serine Endopeptidases/genetics , Serine Endopeptidases/metabolism , Spike Glycoprotein, Coronavirus/chemistry , Spike Glycoprotein, Coronavirus/metabolism
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