Evaluation of Short-Term Side Effects Following the First Dose of COVID-19 Vaccines Among Physicians and Dentists: A Cross-Sectional Study from India.

Background: Efficacy and safety are fundamental for the development of successful COVID-19 vaccines. Vaccine-associated side effects influence vaccine hesitancy. This study investigated the prevalence, severity, and onset of side effects following the first dose of COVID-19 vaccines among physicians and dentists working in various healthcare settings across India. Methods: A cross-sectional survey collected self-report data from April to June 2021 on side effects following the first dose of the vaccine. An online validated questionnaire using the Google Docs® platform was circulated via email and social media platforms. Results: More than 40% of participants experienced at least one side effect after the first dose of vaccination; the most common were mild and resolved within three days after vaccination. More than 91% of respondents received the Covishield (AstraZeneca) vaccine; the most prevalent adverse effects were soreness of the injected arm (78.9%), tiredness (71.1%), and fever (54.9%). Logistic regression showed that women were almost 60% less likely to report side effects. Conclusion: Findings supported the safety of the first dose of the COVID-19 vaccine based on relatively few self-limiting side effects, mainly soreness of the injected arm and tiredness. Further research is needed to determine the long-term safety of COVID-19 vaccines, especially after booster doses.

Prevalence of COVID-19 vaccine reactogenicity among Bangladeshi physicians.

Increased COVID-19 vaccine hesitancy presents a major hurdle in global efforts to contain the COVID-19 pandemic. This study was designed to estimate the prevalence of adverse events after the first dose of the Covishield (AstraZeneca) vaccine among physicians in Bangladesh. A cross-sectional study was conducted using an online questionnaire for physicians (n = 916) in Bangladesh. Physicians who received at least one dose of the COVID-19 vaccine were included. The study was carried out from April 12 to May 31, 2021. More than 58% of respondents (n = 533) reported one or more adverse events. Soreness of the injected arm (71.9%), tiredness (56.1%), fever (54.4%), soreness of muscles (48.4%), headache (41.5%) and sleeping more than usual (26.8%) were the most commonly reported adverse events. Most vaccine-related reactogenicities were reported by the younger cohorts (<45 years). The majority of respondents reported severity of reactogenicity as "mild," experienced on the day of vaccination, and lasting for 1-3 days. The most common reactogenicity was pain at the injection site; the second most common was tiredness. Almost half (49.2%) of the physicians took acetaminophen (paracetamol) to minimize the effects of vaccine reactogenicity. Multivariate logistic regression analyses showed that physicians with diabetes and hypertension (OR = 2.729 95% CI: 1.282-5.089) and asthma with other comorbidities (OR = 1.885 95% CI: 1.001-3.551) had a significantly higher risk of vaccine-related reactogenicities than physicians without comorbidities. Further safety studies with larger cohorts are required to monitor vaccine safety and provide assurance to potential vaccine recipients.

Therapeutic potential of 5-aminolevulinic acid and sodium-ferrous citrate for viral insults: relevance to the COVID-19 crisis.

INTRODUCTION: : 5-Aminolevulinic acid (5-ALA) is a naturally synthesized amino acid present in most plants as well as animals, and it is routinely consumed by humans. This brief report sought to describe the potential of 5-ALA and sodium-ferrous citrate (5-ALA/SFC) to ameliorate the course of coronavirus disease 2019 (COVID-19). AREAS COVERED: : Studies have shown that 5-ALA is converted to protoporphyrin IX (PPIX), then to heme. Recent studies have demonstrated that PPIX has antiviral effects against several viruses, including Zika virus, dengue virus, and influenza A virus. The anti-inflammatory effects of 5-ALA have also been reported in humans. Preliminary in vitro and clinical studies have shown that the combination of 5-ALA/SFC could reduce severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-mediated insults. The SARS-CoV-2 genome contains guanine-quadruplex sequences, and the administration of 5-ALA/SFC can lead to the generation of porphyrins that have the ability to bind to guanine-quadruplexes and reduce the replication of SARS-CoV-2. Furthermore, 5-ALA is a metabolic precursor of heme, which is a potent inducer of the enzyme heme oxygenase-1, the levels of which are decreased in patients with severe COVID-19. Oral administration of 5-ALA/SFC induced heme oxygenase-1 in the peripheral blood of uninfected healthy individuals. EXPERT OPINION: : Based on the available information, it appears likely that 5-ALA/SFC has therapeutic value in clinically controlling SARS-CoV-2-mediated insults in COVID-19 patients. Multicenter randomized controlled trials are needed for determining the long-term clinical utility of 5-ALA/SFC.

Vitamin D-independent benefits of safe sunlight exposure.

This review examines the beneficial effects of ultraviolet radiation on systemic autoimmune diseases, including multiple sclerosis and type I diabetes, where the epidemiological evidence for the vitamin D-independent effects of sunlight is most apparent. Ultraviolet radiation, in addition to its role in the synthesis of vitamin D, stimulates anti-inflammatory pathways, alters the composition of dendritic cells, T cells, and T regulatory cells, and induces nitric oxide synthase and heme oxygenase metabolic pathways, which may directly or indirectly mitigate disease progression and susceptibility. Recent work has also explored how the immune-modulating functions of ultraviolet radiation affect type II diabetes, cancer, and the current global pandemic caused by SARS-CoV-2. These diseases are particularly important amidst global changes in lifestyle that result in unhealthy eating, increased sedentary habits, and alcohol and tobacco consumption. Compelling epidemiological data shows increased ultraviolet radiation associated with reduced rates of certain cancers, such as colorectal cancer, breast cancer, non-Hodgkins lymphoma, and ultraviolet radiation exposure correlated with susceptibility and mortality rates of COVID-19. Therefore, understanding the effects of ultraviolet radiation on both vitamin D-dependent and -independent pathways is necessary to understand how they influence the course of many human diseases.

Laughter therapy: A humor-induced hormonal intervention to reduce stress and anxiety.

Prolonged pharmacological interventions have detrimental health consequences by developing drug tolerance or drug resistance, in addition to adverse drug events. The ongoing COVID-19 pandemic-related stress has adversely affected the emotional and mental health aspects around the globe. Consequently, depression is growing during the COVID-19 pandemic. Besides specific pharmacological interventions, which if prolonged have detrimental health consequences, non-pharmacological interventions are needed to minimize the emotional burden related to the COVID-19 pandemic. Laughter therapy is a universal non-pharmacologic approach to reduce stress and anxiety. Therapeutic laughter is a non-invasive, cost-effective, and easily implementable intervention that can be used during this pandemic as a useful supplementary therapy to reduce the mental health burden. Laughter therapy can physiologically lessen the pro-stress factors and increase the mood-elevating anti-stress factors to reduce anxiety and depression. In this ongoing stressful period of the COVID-19 pandemic, keeping necessary social distancing, it is important to create a cheerful environment that will facilitate laughter among the family, neighbor, and community to cope with the stresses of the COVID-19 pandemic.

Disproportionate COVID-19 vaccine acceptance rate among healthcare professionals on the eve of nationwide vaccine distribution in Bangladesh.

BACKGROUND: Acceptance of the COVID-19 vaccine by the target groups would play a crucial role in stemming the pandemic. Healthcare professionals (HCPs) are the priority group for vaccination due to them having the highest risk of exposure to infection. This survey aimed to assess their acceptance of COVID-19 vaccines in Bangladesh. RESEARCH DESIGN AND METHODS: A cross-sectional survey using an online questionnaire was conducted between January 3 to 25, 2021, among HCPs (n = 834) in Bangladesh. RESULTS: Less than 50% of HCPs would receive the vaccine against COVID-19 if available and 54% were willing to take the vaccine at some stage in the future. Female participants (OR:1.64;95%CI:1.172-2.297), respondents between 18-34 years old (OR:2.42; 95% CI:1.314-4.463), HCPs in the public sector (OR:2.09; 95% CI:1.521-2.878), and those who did not receive a flu vaccine in the previous year (OR:3.1; 95% CI:1.552-6.001) were more likely to delay vaccination. CONCLUSIONS: The study revealed that, if available, less than half of the HCPs would accept a COVID-19 vaccine in Bangladesh. To ensure the broader success of the vaccination drive, tailored strategies and vaccine promotion campaigns targeting HCPs and the general population are needed.

COVID-19 pandemic: Can zinc supplementation provide an additional shield against the infection?

Coronavirus disease-19 (COVID-19)-induced severe acute respiratory syndrome is a global pandemic. As a preventive measure, human movement is restricted in most of the world. The Centers for Disease Control and Prevention (CDC), the National Institutes of Health (NIH), along with the World Health Organization (WHO) have laid out some therapeutic guidelines for the infected patients. However, other than handwashing and vigilance surrounding commonly encountered oronasal symptoms and fever, no universally available prophylactic measure has yet been established. In a pandemic, the accessibility of a prophylactic biologically active substance is crucial. Ideally, it would be something readily available at a low price to a larger percentage of the population with minimal risk. Studies have demonstrated that zinc may reduce viral replication and increase immune responses. While consuming zinc (within the recommended upper safety limits), as a prophylactic might provide an additional shield against the initiation and progression of COVID-19 would need clinical studies, the potential clearly exists. Even after vaccination, low zinc status may affect the vaccination responses.

Exacerbation of antimicrobial resistance: another casualty of the COVID-19 pandemic?

Introduction: The widespread use of antimicrobial drugs during the ongoing coronavirus disease 2019 (COVID-19) pandemic and the likely emergence of antibiotic-resistant microorganisms is a global health concern. Even before the COVID-19 pandemic, several antimicrobial drugs have lost their efficacy and are no longer useful to treat life-threatening infections. Since the exacerbation of antimicrobial resistance is likely to be another casualty of the COVID-19 pandemic, there is a pressing need to develop innovative strategies to minimize the risk of antimicrobial resistance.Areas covered: Focusing on the COVID-19 pandemic, I have briefly summarized the current knowledge and challenges in our understanding of antimicrobial resistance, emphasizing quorum sensing and quorum quenching. Our understanding of bacterial communication by quorum sensing to acquire virulence has paved the way to reduce bacterial pathogenicity through quorum quenching. Availability of clinically viable quorum quenching agents would likely to diminish bacterial virulence to create a microenvironment for the host phagocytic cells to reduce bacterial infection.Expert opinion: Future studies that aim to generate clinically useful quorum quenching agents need to be considered. An important benefit of such agents may be a diminished risk of antimicrobial resistance.

COVID-19 Pandemic: Can Maintaining Optimal Zinc Balance Enhance Host Resistance?

The novel coronavirus disease 2019 (COVID-19) is now officially declared as a pandemic by the World Health Organization (WHO), and most parts of the world are taking drastic measures to restrict human movements to contain the infection. Millions around the world are wondering, if there is anything that could be done, other than maintaining high personal hygiene, and be vigilant of the symptoms, to reduce the spread of the disease and chances of getting infected, or at least to lessen the burden of the disease, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The National and International health agencies, including the National Institutes of Health (NIH), the Centers for Disease Control and Prevention (CDC), and the WHO have provided clear guidelines for both preventive and treatment suggestions. In this article, I will briefly discuss, why keeping adequate zinc balance might enhance the host response and be protective of viral infections.