Corona disease anxiety and health related behaviors: What happened to primgravida women post COVID-19?

Background: The COVID-19 pandemic has sparked psychological and behavioural changes among pregnant women across the globe and thereby might have a devastating impact on the fetal and neonatal outcomes. The dearth of information related to this significant topic can contribute to surge feelings of uneasiness and perinatal anxiety of primigravida women. Therefore, assessing and investigating the relationship between corona disease anxiety and health related behaviors among primigravida women post COVID-19, would provide an auxiliary template to the Ministry of health in the Middle East and North Africa (MENA) region to integrate this into their sustainable health agenda. Methods: A descriptive correlational research design was used in this study in which a convenient sample of 200 primigravida women completed a Corona disease anxiety scale (CDAS) and pregnant women's health- related behavior changes post COVID-19. Results: More than four fifth of the study subjects reported mild anxiety level (82%) and nearly three fifth of the studied primigravidas' reported fair level of health-related behaviors (59%). Also, a statistical significant correlation was found between the studied primigravidas' anxiety level and their health-related behavior including; healthy diet regimen, follow up visits, and protective personal measures (r = 0.273, P<0.001, r = 0.188, P<0.008, r = 0.242, P<0.001, r = 0.189, P<0.007, r = 0.407, P<0.001 and r = 0.309, P<0.001, respectively). Conclusion: Corona disease anxiety was proved to be the independent predictor of health- related behavior. Mental health screening of primigravida women at the outset of any public health emergency should be prompted.

Assessment of corneal endothelial cell parameters using specular microscopy in previously infected SARS-CoV-2 patients.

PURPOSE: To examine the long-term effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on the corneal endothelium. METHODS: This was a comparative, cross-sectional study that included subjects who had recovered from SARS-CoV-2 infection for at least 6 months (group 1) and a group of age- and sex-matched controls with no prior symptomatology or documentation of SARS-CoV-2 infection (group 2). After full ophthalmological evaluation, specular microscopy was used to examine the endothelial cell parameters, including endothelial cell density, coefficient of variation, hexagonality, average area, and central corneal thickness. RESULTS: Sixty-four and 53 right eyes were included in groups 1 and 2, respectively. No statistically significant differences were detected in any of the examined specular parameters between the two groups. CONCLUSION: SARS-CoV-2 infection may have no delayed sequel on the corneal endothelium. Future prospective studies with repeated examinations in the same subjects would be useful.

Outcomes of Remote Patient Monitoring in Peritoneal Dialysis: A Meta-Analysis and Review of Practical Implications for COVID-19 Epidemics.

The present study seeks to determine clinical outcomes associated with remote patient monitoring of peritoneal dialysis (RPM-PD), with potential implications during COVID-19 outbreaks. We performed a systematic review in the PubMed, Embase, and Cochrane databases. We combined all study-specific estimates using the inverse-variant weighted averages of logarithmic relative risk (RR) in the random-effects models. Confidence interval (CI) including the value of 1 was used as evidence to produce a statistically significant estimate. Twenty-two studies were included in our meta-analysis. Quantitative analysis demonstrated that RPM-PD patients had lower rates of technique failure (log RR = -0.32; 95% CI, -0.59 to -0.04), lower hospitalization rates (standardized mean difference = -0.84; 95% CI, -1.24 to -0.45), and lower mortality rates (log RR = -0.26; 95% CI, -0.44 to -0.08) compared with traditional PD monitoring. RPM-PD has better outcomes in multiple spheres of outcomes when compared with conventional monitoring and likely increases system resilience during disruptions of healthcare operations.

COVID-19-related acute invasive fungal rhinosinusitis: risk factors associated with mortality

Background Acute invasive fungal rhinosinusitis (AIFRS) is a rare aggressive life-threatening infection that affects immunocompromised individuals. Recently, an increase in the incidence of this infection has been reported in patients who have SARS-CoV-2 infection or recently recovered. This study was to assess the outcome and define risk factors that might affect the outcome in SARS-CoV-2-related AIFRS. A prospective observational study included 54 patients diagnosed with SARS-CoV-2-related AIFRS. Controlling the predisposing factors, systemic antifungal, and early surgical debridement was performed. The mortality rate was calculated. Age, sex, underlying risk factors, the extent of the disease, debridement technique, and other biochemical variables were evaluated regarding their impact on survival. Patients were followed up for 3 months. Results Fifty-four patients with a mean age of 48.1 years. Diabetes mellitus was the most common comorbidity affecting 52 patients (96.3%). Intracranial and intraorbital extension had a predictive value for mortality (P value 0.050 and 0.049 respectively). However, only intracranial extension was the independent predictor of mortality. Biochemical variables were higher than the normal range, but only serum ferritin level above 165 ng/ml was an independent predictor of mortality in patients with AIFR. The mortality rate was 38.9%. Conclusion The extent of the disease has a major impact on survival, so early diagnosis of AIFRS within patients infected with SARS-CoV-2 or recently recovered is essential to reduce mortality.

Is It Safe to Receive Kidneys from Deceased Kidney Donors Who Tested Positive for Covid-19 Infection?

BACKGROUND AND AIMS Our modern world is facing extraordinary circumstances while passing through a serious pandemic caused by the novel coronavirus (COVID-19) which may lead to multi-organ system failure and death. COVID-19 deaths may provide a potential source for kidneys available for transplantation. In our study, we are discussing the safety of receiving kidneys from donors who tested positive for the novel coronavirus. METHOD All renal transplant recipients registered in UNOS database who had their transplants between 1 March 2020 and 1 June 2021 were retrospectively reviewed. Patients who received kidney transplants from a deceased donor with positive PCR of COVID-19 test were included in our study. Patients were followed up till 1 July 2021. Data about recipient factors (age, sex, ethnicity, diabetes and date of renal transplant), transplant factors (type of induction therapy, maintenance immunosuppressive therapy, delayed graft functions, early post-operative rejection episodes, HLA mismatch, PRA level and cold ischemia time) and donor factors (age, sex, ethnicity, diabetes, hypertension, date of COVID-19 test and type of COVID-19 test) were collected. Outcome measured were post-transplant hospitalisation, acute rejection, delayed graft function, patient, and graft survival till the end of the follow-up. RESULTS Eighty-six transplant patients received kidneys from deceased donors who tested positive for COVID-19 infection using PCR test. Sixty patients received kidneys from deceased patients who tested positive for COVID-19 within 30 days pre-transplant. Twenty-six patients received kidneys from deceased patients who tested positive for COVID-19 between 30 and 90 days pre-transplant. Number of post-transplant hospitalisation and acute rejection episodes were nil. 19.76% of the patients had delayed graft functions. Graft loss occurred in one patient due to graft vein thrombosis. Patient survival was 100%. CONCLUSION Receiving kidneys from deceased donors who tested positive for COVID-19 infection seems safe and does not affect hospitalisation, acute rejection rates, graft or patient survival. Longer follow-up is needed to confirm our results.

Environmentally azithromycin pharmaceutical wastewater management and synergetic biocompatible approaches of loaded azithromycin@hematite nanoparticles.

Pharmaceutical wastewater contamination via azithromycin antibiotic and the continuous emergence of some strains of bacteria, cancer, and the Covid-19 virus. Azithromycin wastewater treatment using the biosynthesized Hematite nanoparticles (α-HNPs) and the biocompatible activities of the resulted nanosystem were reported. Biofabrication of α-HNPs using Echinacea purpurea liquid extract as a previously reported approach was implemented. An evaluation of the adsorption technique via the biofabricated α-HNPs for the removal of the Azr drug contaminant from the pharmaceutical wastewater was conducted. Adsorption isotherm, kinetics, and thermodynamic parameters of the Azr on the α-HNPs surface have been investigated as a batch mode of equilibrium experiments. Antibacterial, anticancer, and antiviral activities were conducted as Azr@α-HNPs. The optimum conditions for the adsorption study were conducted as solution pH = 10, 150 mg dose of α-HNPs, and Azr concentration 400 mg/L at 293 K. The most fitted isothermal model was described according to the Langmuir model at adsorption capacity 114.05 mg/g in a pseudo-second-order kinetic mechanistic at R2 0.9999. Thermodynamic study manifested that the adsorption behavior is a spontaneous endothermic chemisorption process. Subsequently, studying the biocompatible applications of the Azr@α-HNPs. Azr@α-HNPs antibacterial activity revealed a synergistic effect in the case of Gram-positive more than Gram-negative bacteria. IC50 of Azr@α-HNPs cytotoxicity against MCF7, HepG2, and HCT116 cell lines was investigated and it was found to be 78.1, 81.7, and 93.4 µg/mL respectively. As the first investigation of the antiviral use of Azr@α-HNPs against SARS-CoV-2, it was achieved a safety therapeutic index equal to 25.4 revealing a promising antiviral activity. An admirable impact of the use of the biosynthesized α-HNPs and its removal nanosystem product Azr@α-HNPs was manifested and it may be used soon as a platform of the drug delivery nanosystem for the biomedical applications.

Needs assessment for health service design for people with back pain in a hospital setting: A qualitative study.

BACKGROUND: There is a need for effective health service solutions to provide greater structure and support for implementing evidence-based practice in back pain care. Patient involvement in developing these solutions is crucial to increase relevance, acceptability and uptake. OBJECTIVES: To determine patients' perceived needs and barriers to best-practice back pain care, and potential solutions to better address care needs. The study is the third in a series of needs assessment studies feeding into the 'idea generation' for service design in a large teaching hospital in a culturally and linguistically diverse community in metropolitan Sydney, Australia. DESIGN: We conducted a combination of focus groups and in-depth interviews using an interpretive description approach. We used inductive thematic analysis to identify the main themes. SETTING AND PARTICIPANTS: We purposively sampled patients with diverse characteristics from the neurosurgery and physiotherapy outpatient clinics, in particular those whose primary language was English, Arabic, Persian or Mandarin. Non-English audio recordings were translated and transcribed by bilingual researchers. RESULTS: There were 24 participants (focus groups = 9; individual interviews = 15) when data saturation was reached. The analysis identified three key themes with several subthemes around what service designers needed to understand in helping people with back pain in this setting: (1) This is who I am; (2) It's not working for me; and (3) What I think I need. DISCUSSION AND CONCLUSION: This study highlights that perceived unmet needs of patients are underpinned by unhelpful beliefs about the causes of and solutions for back pain, misaligned care expectations, unclear expectations of the hospital role and fragmentations in the health system. To design and implement a service that can deliver better back pain care, several solutions need to be integrated around: developing new resources that challenge unhelpful beliefs and set realistic expectations; improving access to education and self-management resources; focusing on individualized care; using a collaborative multidisciplinary approach within the hospital; and better connecting with and directing primary health care services. PATIENT OR PUBLIC CONTRIBUTION: A consumer representative of the Western Sydney Local Health District provided input during study conceptualisation and is duly recognized in the Acknowledgements section.

Cefixime wastewater management via bioengineered Hematite nanoparticles and the in-vitro synergetic potential multifunction activities of Cefixime@Hematite nanosystem

The current paper evaluates the adsorption performance of the biofabrication of Alpha Hematite nanoparticles (α-HNPs) for the removal of the Cefixime (Cfx) drug from the pharmaceutical wastewater. Adsorption isotherms, kinetics, and thermodynamic studies have been investigated using batch mode procedures. The optimum conditions were conducted as solution pH 4, α-HNPs dose 100 mg, Cfx concentration 100 mg/L, and absolute temperature 298 K. Cfx adsorption found to follow the Langmuir isothermal model via maximum monolayer adsorption capacities of 147.1 mg/g, and equilibrium kinetic as pseudo-second-order. Thermodynamic parameters were derived as spontaneous chemisorption endothermic processes. The capability of the process for the adsorbent regeneration study revealed the utility of the α-HNPs efficiency up to 5 successive times. Antibacterial activity of the adsorbed Cfx at the surface of α-HNPs (Cfx@α-HNPs) was investigated manifesting highly potent against each of Gram-negative bacteria & Gram-positive. The synergistic impact of Cfx@α-HNPs as an anticancer agent against MCF7, HepG2, and HCT116 cell lines was conducted at IC50 108.5, 117.7, and 156.4 µg/mL respectively revealing a promising efficacy comparing use of the α-HNPs alone. α-HNPs and Cfx@α-HNPs could be suggested as a novel multidrug bacteria-resistant alternative approach in case of treatment for chronic wound infections. As the first investigation of antiviral use of Cfx@α-HNPs against SARS-CoV-2, it was achieved a safety therapeutic index equal to 2.6 revealing a promising antiviral activity.

Assessment of Corneal Endothelial Cell Parameters Using Specular Microscopy in Previously Infected SARS-CoV-2 Patients (preprint)

Purpose: To examine the long-term effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on the corneal endothelium. Methods: A comparative, cross-sectional study that included subjects who had recovered from SARS-CoV-2 infection for at least 6 months (group 1) and a group of age- and sex-matched controls with no prior symptomatology or documentation of SARS-CoV-2 infection (group 2). After full ophthalmological evaluation, specular microscopy was used to examine the endothelial cell parameters, including endothelial cell density, coefficient of variation, hexagonality, average area, and central corneal thickness.Results: sixty-four and 53 right eyes were included in groups 1 and 2, respectively. No statistically significant differences were  detected in any of the examined specular parameters between the two groups.Conclusion: SARS-CoV-2 infection appears to have no delayed sequel on the corneal endothelium. Future prospective studies with repeated examinations in the same subjects would be useful.

Deep Learning Algorithms Achieved Satisfactory Predictions When Trained on a Novel Collection of Anticoronavirus Molecules.

Drug discovery and repurposing against COVID-19 is a highly relevant topic with huge efforts dedicated to delivering novel therapeutics targeting SARS-CoV-2. In this context, computer-aided drug discovery is of interest in orienting the early high throughput screenings and in optimizing the hit identification rate. We herein propose a pipeline for Ligand-Based Drug Discovery (LBDD) against SARS-CoV-2. Through an extensive search of the literature and multiple steps of filtering, we integrated information on 2,610 molecules having a validated effect against SARS-CoV and/or SARS-CoV-2. The chemical structures of these molecules were encoded through multiple systems to be readily useful as input to conventional machine learning (ML) algorithms or deep learning (DL) architectures. We assessed the performances of seven ML algorithms and four DL algorithms in achieving molecule classification into two classes: active and inactive. The Random Forests (RF), Graph Convolutional Network (GCN), and Directed Acyclic Graph (DAG) models achieved the best performances. These models were further optimized through hyperparameter tuning and achieved ROC-AUC scores through cross-validation of 85, 83, and 79% for RF, GCN, and DAG models, respectively. An external validation step on the FDA-approved drugs collection revealed a superior potential of DL algorithms to achieve drug repurposing against SARS-CoV-2 based on the dataset herein presented. Namely, GCN and DAG achieved more than 50% of the true positive rate assessed on the confirmed hits of a PubChem bioassay.

[Serological tests for SARS-CoV-2 in a health workers population in Nouakchott-Mauritania]. / Dépistage sérologique de SARS-CoV-2 chez une population de personnel de santé à Nouakchott-Mauritanie.

The first outbreak of epidemic respiratory disease due to unknown etiology was reported in the Chinese city of Wuhan December 2019. The World Health Organization (WHO) firstly used the term "new coronavirus 2019" on December 29, 2019. This pandemic, which is currently called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a disease caused by SARS-CoV-2. It was subsequently called coronavirus disease 2019 (COVID-19) by the WHO. The purpose of this study was to determine the prevalence of antibodies against SARS-CoV-2 in all employees of the Nouakchott National Hospital Center (CHN). The study was conducted during the week 20/05/2020 to 27/05/2020. It involved 853 employees of all ranks (doctors, pharmacists, nurses, secretaries, security personnel, administrators...) of whom 504 were male and 331 were female, with a sex ratio of 1,52 with an average age of 39 years, ranging from 20 to 60 years. The screening for IgG and IgM antibodies to SARS-CoV-2 was performed using Biotime (Xiamen Biotime Biotechnology Co., Ltd.) immunochromatographic technique. Out of 835 employees included in our study, 14 were positive (1.67%) of whom 12 had IgM and IgG anti-SARS-CoV-2 antibodies and 2 had isolated IgM. Nasopharyngeal swab polymerase chain reaction (PCR) was performed in these 14 patients and was positive in six. While PCR is the gold standard for the diagnosis of SARS-CoV-2, serological tests for SARS-CoV-2 antibodies, in particular rapid tests (RDTs) are a diagnostic complement to COVID-19. They have the advantage of being easy to realize, of being safe both in the laboratories and outside the laboratories. RDTs enabled us to detect asymptomatic SARS-CoV-2 carriers within CHN employees. This allowed for patients management and isolation to protect patients and their environments.

Survival analysis of all critically ill patients with COVID-19 admitted to the main hospital in Mogadishu, Somalia, 30 March-12 June 2020: which interventions are proving effective in fragile states?

OBJECTIVES: To determine risk factors for death in patients with coronavirus disease 2019 (COVID-19) admitted to the main hospital in Somalia, and identify interventions contributing to improved clinical outcome in a low-resource and fragile setting. METHODS: A survival analysis was conducted of all patients with COVID-19 admitted to the main hospital in Somalia from 30 March to 12 June 2020. RESULTS: Of the 131 patients admitted to the hospital with COVID-19, 52 (40%) died and 79 (60%) survived. The main factors associated with the risk of in-hospital death were age ≥60 years {survival probability on day 21 was 0.789 [95% confidence interval (CI) 0.658-0.874] in patients aged <60 years vs 0.339 (95% CI 0.205-0.478) in patients aged ≥60 years}, cardiovascular disease [survival probability 0.478 (95% CI 0.332-0.610) in patients with cardiovascular disease vs 0.719 (95% CI 0.601-0.807) in patients without cardiovascular disease] and non-invasive ventilation on admission (patients who were not ventilated but received oxygen were significantly more likely to survive than patients who were ventilated; P<0.001). CONCLUSION: Considering the risk factors (age ≥60 years, presence of cardiovascular disease and use of non-invasive ventilation) is critical when managing patients with severe COVID-19, especially in low-resource settings where availability of skilled healthcare workers for critical care units is limited. These findings also highlight the importance of use of medical oxygen for severely ill patients, and the critical aspect of deciding whether or not to ventilate critical patients with COVID-19 in order to improve clinical outcome.

Coronavirus disease 2019 and renal transplantation.

Ever since the severe acute respiratory syndrome virus causing coronavirus disease 2019 (COVID-19) struck the world, global health strategies have changed significantly. According to the Centers for Disease Control and Prevention, kidney transplant recipients are stratified as being high risk of developing fatal illness from COVID-19 infection. Kidney transplant is the gold-standard treatment for end-stage kidney disease subjects. During the pandemic, significant concerns have emerged regarding continuation of kidney transplant surgeries and management of kidney transplant recipients post-transplant. The added risk of immunosuppression in this cohort was and remains a theoretical concern, posing a potential risk of transplantation rather than benefit. This comprehensive review aims to cover most of the faced challenges in kidney transplantation in different stages of the pandemic. In addition, it will elucidate the epidemiology, nature, course of the disease, surgical consideration in donors and recipients as well as role of immunosuppression and management of COVID-19 infected kidney transplant recipients during these extraordinary circumstances.

COVID-19 outbreak in Mauritania: epidemiology and health system response.

INTRODUCTION: In Africa, the first case of COVID-19 was reported in February 2020. Mauritania's first case was confirmed in March 2020. METHODOLOGY: We provide an update of the COVID-19 epidemic in Mauritania as of December 2020, and describe the country's Health System Response. RESULTS: In total, 133,749 diagnostic tests were performed, 14,364 (10.7%) were positive (309 cases/100,000 inhabitants). Case fatality rate was 2.4%. The 20-39 year-olds (41%) and males (59.1%) were most commonly affected. Comorbidities among fatal cases included cardiovascular diseases (44.8%) and diabetes (37.1%). Clinical symptoms included fever (57%), cough (52%), running nose (47%) and headache (26%). After the first case, prevention measures were progressively tightened, and quarantine implemented for all suspected cases. Schools and universities were closed, and flights to Mauritania suspended. Restaurants and cafeterias were closed, and night curfews installed. Friday prayers were suspended nationwide, and movements between regions restricted. These measures helped to contain the spread of SARS-CoV-2 during the first pandemic wave, which peaked in June 2020 with low rates. However, the number of daily cases reached high levels in December 2020, during the second wave (40.1% of all cases and 48.9% of deaths). During the first wave, there were 38 ICU beds nationwide, but the ICU's capacity increased in short time. CONCLUSIONS: Mauritania has passed through the first pandemic wave with relatively low case fatality rates, currently being at the end of the second wave. As the country's health system is very vulnerable, there is a need for strict public health measures during epidemics.

Diabetes Mellitus and COVID-19: Review Article.

BACKGROUND AND AIMS: We aim to cover most of the current evidence on the mutual effect of diabetes & COVID-19 infection on each other and the management of the COVID-19 patients with diabetes. METHODS: We utilized databases to review the current evidence related to diabetes mellitus and COVID-19. RESULTS: We discussed the most recent evidence of diabetes milieus and COVID-19 regarding risk factors, management, complications, and telemedicine. CONCLUSION: Diabetes mellitus is associated with a significant risk of complications, extended hospital stays, and mortality in COVID-19 infected patients.

Current systematic reviews and meta-analyses of COVID-19.

BACKGROUND: Coronavirus disease 2019 (COVID-19) has left a significant impact on the world's health, economic and political systems; as of November 20, 2020, more than 57 million people have been infected worldwide, with over 1.3 million deaths. While the global spotlight is currently focused on combating this pandemic through means ranging from finding a treatment among existing therapeutic agents to inventing a vaccine that can aid in halting the further loss of life. AIM: To collect all systematic reviews and meta-analyses published related to COVID-19 to better identify available evidence, highlight gaps in knowledge, and elucidate further meta-analyses and umbrella reviews that are yet to be performed. METHODS: We explored studies based on systematic reviews and meta-analyses with the key-terms, including severe acute respiratory syndrome (SARS), SARS virus, coronavirus disease, COVID-19, and SARS coronavirus-2. The included studies were extracted from Embase, Medline, and Cochrane databases. The publication timeframe of included studies ranged between January 01, 2020, to October 30, 2020. Studies that were published in languages other than English were not considered for this systematic review. The finalized full-text articles are freely accessible in the public domain. RESULTS: Searching Embase, Medline, and Cochrane databases resulted in 1906, 669, and 19 results, respectively, that comprised 2594 studies. 515 duplicates were subsequently removed, leaving 2079 studies. The inclusion criteria were systematic reviews or meta-analyses. 860 results were excluded for being a review article, scope review, rapid review, panel review, or guideline that produced a total of 1219 studies. After screening articles were categorized, the included articles were put into main groups of clinical presentation, epidemiology, screening and diagnosis, severity assessment, special populations, and treatment. Subsequently, there was a second subclassification into the following groups: gastrointestinal, cardiovascular, neurological, stroke, thrombosis, anosmia and dysgeusia, ocular manifestations, nephrology, cutaneous manifestations, D-dimer, lymphocyte, anticoagulation, antivirals, convalescent plasma, immunosuppressants, corticosteroids, hydroxychloroquine, renin-angiotensin-aldosterone system, technology, diabetes mellitus, obesity, pregnancy, children, mental health, smoking, cancer, and transplant. CONCLUSION: Among the included articles, it is clear that further research is needed regarding treatment options and vaccines. With more studies, data will be less heterogeneous, and statistical analysis can be better applied to provide more robust clinical evidence. This study was not designed to give recommendations regarding the management of COVID-19.

New-onset Type 1 Diabetes Mellitus with Diabetic Ketoacidosis and Pancreatitis in a Patient with COVID-19.

Coronavirus Disease 2019 (COVID-19) had struck the world with health and economic catastrophes and recently with unusual autoimmune presentations, including new-onset Type 1 Diabetes. Herein we present a 17-year-old male patient who presented to the outptient clinic with fever, palpitation, and cough of four-week duration; he was referred to the emergency room and was found to have DKA. CT of the chest showed ground-glass opacities suggestive of COVID-19 pneumonia, and abdominal cuts showed dilated intrahepatic biliary radicles with pancreatic loculations suggestive of pancreatitis. The patient was admitted to the ICU, started on intravenous fluids and insulin infusion then COVID-19 PCR returned positive. We hypothesize that SARS-CoV-2 has a vital role in eliciting an autoimmune response triggering type 1 diabetes, and further studies are needed to confirm this hypothesis. SARS-CoV-2 may cause pancreatitis, and the first presentation could be high blood sugar or DKA.