Assessment of Vitamin D Level as a Risk Factor and Illness Severity Indicator in COVID 19 Cases

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-COV2) viruses using angiotensin-converting enzyme 2 (ACE2) receptors, to enter human cells, these receptors are highly expressed in the lung alveolar cells, vascular endothelium, cardiac myocytes, and other cells. Inadequate vitamin D levels in the blood have been linked to a higher risk of COVID-19 severity. Objective: To determine the association between Vitamin D level and severity of COVID-19 infection. Materials and Method: A cross sectional study was conducted at Thumbay Hospital, Ajman, UAE. Enrolled 70 COVID-19 positive hospitalized patients with age group ≥ 18 years old of both genders. Patients taking vitamin D supplements were excluded from the study. The biochemical analysis for the collected blood samples was performed on the automated analyzer and assessed for significance analysis. Result: There is a statistically significant correlation between Vitamin D levels and disease severity (p < 0.05) as determined by Pearson's Chi-square test. Independent t-test shown that there is a statistically significant difference with regards to gender, age groups, and co morbidity (p < 0.05). Pearson's correlation revealed a moderate, positive correlation between Vitamin D levels and the severity of COVID-19 infection, which was statistically significant. Conclusion: Vitamin D levels affect COVID-19 severity, with more severe cases showing vitamin D levels lower than normal when compared to severe cases with sufficient vitamin D levels. Furthermore, blood vitamin D levels are linked to age groups in COVID-19 patients. Vitamin D insufficiency and deficiency, on the other hand, was not linked to a higher risk of death prognosis, and co morbidities. © Sabir SM, Ismail MK, Ibrahim EH, Khan ZA.

Five-Year Follow-Up of a Phase 1 Trial of Donor-Derived Modified Immune Cell Infusion in Kidney Transplantation

Background: The administration of modified immune cells (MIC) prior to kidney transplantation led to specific immunosuppression against the allogeneic donor and a significant increase in regulatory B lymphocytes (Breg) (Morath et al., J Clin Invest 2020). We now wanted to investigate how this approach affects the clinical course of treated patients. Method(s): Clinical results of ten patients from a phase I clinical trial who had received MIC infusions before kidney transplantation were compared to results of 15 matched standard-risk recipients. Follow-up was until year five after surgery. Result(s): The 10 MIC patients had an excellent clinical course with stable kidney graft function and showed no donor-specific human leukocyte antigen antibodies (DSA) or acute rejections during follow-up. In contrast, 1 of 15 controls died and 5 of 15 controls developed DSA (log rank P = 0.046) (Figure 1 A, B). While the number of patients with a non-opportunistic infection did not differ significantly between groups (P = 0.36), opportunistic infections were reported more frequently in controls (log rank P = 0.033) (Figure 1 C). Compared to controls, MIC patients were found to have a trend towards a higher COVID-19 anti-S1 IgG index after vaccination with a median of 53 vs. 2 (P = 0.16). Importantly, the four MIC patients who had received the highest MIC cell dose 7 days before surgery and were on low immunosuppression during follow-up, continued to show absent anti-donor T lymphocyte reactivity in vitro and high CD19+CD24hiCD38hi transitional Breg as well as CD19+CD24hiCD27+ memory Breg. Conclusion(s): MIC infusions together with reduced conventional immunosuppression were associated with lower de novo DSA development and lower rates of opportunistic infections. In the future, MIC infusions could contribute to graft protection while reducing the side effects of immunosuppressive therapy. (Figure Presented).

Loneliness and quality of life: Perceived online and offline social support among Sub-Saharan African students in China during the COVID-19 lockdowns

Objective/background:The COVID-19 pandemic disrupted education globally, triggering fear and uncertainties for students. However, there is currently no research evidence to document the loneliness experience of Sub-Saharan African (SSA) students in China and how social support influenced their quality of life (QoL). This study explored the effect of COVID-19-induced loneliness and social support on the QoL of SSA students in China. Method: The study adopted an institutional-based cross-sectional survey through an online questionnaire on social media platforms to investigate the QoL of SSA students in Chinese universities. Pearson correlation matrix and regression analysis were conducted to validate the association of loneliness, social support (online and offline), and socio-demographic attributes on the student’s QoL. Result: In the population of 358 SSA students appraised in the study, loneliness experience was negatively associated with QoL. Online social support and offline social support were positively associated with QoL. The linear regression shows that loneliness, social support, and socio-demographic attributes explain 25.7% (psychological health), 26.6% (physical health), 24.9% (environmental health), and 30.3% (social relation) of the variance in the QoL domains. By evaluating the EUROHIS subjective QoL, loneliness independently accounts for 24.5% of the variance in the subjective QoL of the SSA students examined in the study (model 1). In comparison, the added effects of social supports and socio-demographic attributes on model 3 explained 32% of the subjective QoL. Conclusion: It is strongly recommended that loneliness eradication programs be implemented in these universities among SSA students who experience loneliness that negates their QoL. Interventions should focus on how these students can integrate and build social networks (online and offline) to improve social interaction and support for better QoL. © 2022 by Author/s and Licensed by Modestum.

SARS-COV-2 ENDOTHELIAL DYSFUNCTION CAN CAUSE ERECTILE DYSFUNCTION: HISTOPATHOLOGICAL, IMMUNOHISTOCHEMICAL AND ULTRASTRUCTURAL STUDY OF THE HUMAN PENIS

OBJECTIVE: To describe the histopathological features of penile tissue of patients who recovered from symptomatic COVID-19 infection and subsequently developed severe erectile dysfunction (ED). MATERIALS AND METHODS: After providing informed consent, penile tissue was collected from patients undergoing surgery for inflatable penile prosthesis due to severe ED under an IRB approved protocol. Two specimens were obtained from men with a history of COVID-19 infection and two specimens were obtained from men with no history of infection (all men tested negative immediately before surgery). Tissue from COVID-19 (+) and COVID-19 (-) specimens were imaged with transmission electron microscopy (TEM). The tissue was analyzed for viral RNA using polymerase chain reaction (PCR) and viral spike protein. Formalin-fixed paraffinembedded tissues were stained with hematoxylin and eosin (H&E) and subjected to immunohistochemical analysis for endothelial Nitric Oxide Synthase (eNOS) expression (marker of endothelial function). Endothelial progenitor cells (EPC) function was assessed ex vivo by determination of endothelial colony forming units from blood samples collected from the COVID-19 (+) and COVID (-) men with severe ED. RESULTS: TEM revealed extracellular viral particles ∼100 nm in diameter, with prominent peplomers (spikes), and electron-dense dots of the nucleocapsid inside the particles near penile vascular endothelial cells of the COVID-19 (+) patients. Notably, viral particles were not detected in tissue obtained from COVID-19 (-) men. COVID-19 RNA was detected in both the penis biopsy samples from men with a history of COVID, but not in the samples from COVID-19 (-) men. There were no significant differences in H&E staining between COVID-19 (+) and COVID-19 (-) men and viral spike protein was not detected. Immunohistochemistry showed decreased eNOS expression in the corpus cavernosum of COVID-19 (+) men compared to COVID-19 (-) men, consistent with endothelial dysfunction. COVID-19 spike protein-positive cells could not be detected by immunofluorescence despite positive COVID-19 PCR. EPC levels from the COVID-19 (+) men were 0 cell/well and 1.167 cell/well respectively compared to mean EPCs from 34 COVID-19 (-) men with severe ED (4.04 cells/well), suggesting impaired endothelial function. CONCLUSIONS: Our study is the first to demonstrate the presence of COVID-19 virus in the penis long after the initial infection in humans. Our study also suggests that widespread endothelial cell dysfunction from COVID-19 infection can contribute to resultant erectile dysfunction. Future studies will evaluate novel molecular mechanisms of how COVID-19 infection leads to ED. IMPACT STATEMENT: COVID-19 can linger in the penis long after initial infection and can contribute to erectile dysfunction.

EFFECT OF COVID-19 mRNA VACCINES ON SPERM QUALITY

OBJECTIVE: Fertility related safety data was neither reported in the clinical trials nor evaluated in animal models prior to emergency use authorization (EUA) for two novel mRNA vaccines, BNT162b2 and mRNA-127.1,2 Despite excellent safety profiles for both vaccines, 44% of Americans are hesitant in receiving the vaccine. Although the specific reasons for COVID-19 vaccine hesitancy are unknown, concerns over fertility has previously decreased other vaccine uptake. As COVID-19 vaccination in the United States opens to children and adolescents, evaluating any potential impact of the vaccine on male reproduction is imperative for public reassurance. We hypothesized that since both vaccines only contain mRNA encoding the SARS-CoV-2 spike protein without biologic ability to replicate live virus, the vaccines would not decrease semen parameters. MATERIALS AND METHODS: We conducted a single-center prospective cohort study after IRB approval from the University of Miami (#20201451). Healthy men aged 18-50 scheduled for mRNA COVID-19 vaccination in Miami, Florida were recruited.Participants provided a semen sample after 2-7 days of abstinence, prior to receiving the first dose of either vaccine and about 72 days after the second dose. Specimens were self-collected into a wide-mouth sterile container and semen analysis (SA) performed by HCLD trained andrology clinicians examined semen volume, concentration, motility, and total motile sperm count (TMSC). RESULTS: 45 men provided a semen sample. Neither median sperm concentration nor total motile sperm count (TMSC) declined post vaccination (Figure 1). There was no clinically significant change in TMSC. Only 12 (26.6%) men had a marginal decrease in TMSC. In fact, the remaining 33 (73.3%) men demonstrated normal sperm parameters. Importantly, 8 (17%) men with oligospermia prior to vaccination did not experience a decrease in spermatogenesis. Only one subject had an abnormal TMSC (TMSC ≤ 9) after vaccination. CONCLUSIONS: After receiving the two doses of the vaccines, we did not observe a clinically significant sperm parameter decline within the cohort, suggesting the vaccines do not negatively impact male fertility potential. IMPACT STATEMENT: This is the first male fertility evaluation of the COVID-19 mRNA vaccines, in which we found that the vaccines do not negatively impact semen parameters. (Table Presented).

Social Determinants of Health (SDOH) barriers as predictors of intent to vaccinate for COVID-19 in a vulnerable population

Purpose: Determine the role of social determinants of health (SDOH), including socioeconomic status (SES) (education, income in predicting intent to vaccinate for COVID-19 among a diverse community-based population, over sampled for cancer survivors in Connecticut (CT). Background: Race, ethnicity, and the SDOH (e.g., food insecurity, housing instability, trouble paying utilities bills) have a known impact on COVID-19 incidence, morbidity, and mortality. Although the impact on cancer survivors is not as well understood, this population may also face disproportionately severe outcomes. To our knowledge, there are no published studies that address intention to vaccinate in community based populations that are predominantly African American/Black (AA) or Hispanic/Latinx (H/L), nor in the cancer survivors who live in these communities. Prior studies have suggested that some vulnerable populations have lowered willingness to vaccinate (e.g., for influenza) than other groups. This study will explore the role of the high burden of SDOH barriers and selected socio-cultural factors such as perceived risk, medical mistrust, and source of health information. Methods: Data for this study are from 252 CT residents, collected from August - December, 2020 using Qualtrics, an online survey platform. Using an extensive network of community partners, we recruited through list serves and social media, targeting communities known to be most impacted by the pandemic. The intent was to enroll a population that was similar to the racial/ethnic sociodemographic profile of the city of New Haven, while oversampling cancer survivors. Using SAS 9.4, we conducted descriptive and multivariate analyses to identify the role of SDOH in willingness to vaccinate. Results: The study population was disproportionately African American/Black (23.5%) and Hispanic/Latinx (17.5%) and included 83 (32.9%) cancer survivors. In this high-risk population, 38.9% of the sample were unwilling or uncertain whether they would vaccinate against Covid-19 in the future. In multivariate adjusted model, individuals reporting at least one SDOH barrier (food insecurity, trouble paying utilities bills, or housing instability) were significantly less likely to vaccinate (odds ratio=2.26;95% Confidence Interval 1.17-4.36). Other significant predicators included low perceived risk and lacking confidence in information provided through the health care system. Conclusion: Social determinants of health play a critical role in predicting intent to vaccinate for COVID-19. Special efforts are needed to ensure that vulnerable populations understand their individual risk, the benefits and risks of getting the COVID-19 vaccine, with interventions aimed at enlisting trusted entities that may not be recognized as traditional sources of health information.

Impact of health navigation program on healthy lifestyle and cancer screening in population with significant social determinants of health (SDOH) barriers

Objective: Assess consumer experience and health impact among under-resourced individuals who were enrolled into longitudinal navigation to address social determinants of health (SDOH) needs and health goals related to cancer primary and secondary prevention. Background: The Yale Cancer Disparities Firewall Project is a multi-tiered initiative to address the social determinants of health (SDOH) and other challenges that prevent at-risk communities from receiving the full benefit of the many available cancer prevention and cancer screening options. A communityfacing health navigation program, staffed by community members who have received extensive multidisciplinary training is a central component of this program. Methods: Of the 61 currently enrolled individuals (all of whom are either African American/Black or Hispanic/Latinx), we collected questionnaire data from 24 individuals (39% response rate). In general, participants are enrolled for a minimum of 1 year, but most have been followed for 2 years. Respondents were similar to non-respondents with respect to race (60% were Black/African American vs 61.2%, respectively) and age (mean = 44.8 vs 47.2 years, respectively). Respondents were more likely to be female (85% vs 71.4%, p =.009), Hispanic/Latinx (35% vs 42%), but significantly less likely to be foreign-born (15% vs 26.5 %, p = .021). We assessed satisfaction with assigned navigator(s), uptake of referred services, knowledge gained, health behavior change, and self-rated health (SRH). Results: Per self-report, 79.2% of participants agreed and a further 12.5% somewhat agreed that they were overall satisfied with their experience with the health navigation program. Importantly, two-thirds (66.7%) agreed and a further 20.8% somewhat agreed that they changed their behavior to improve their health and well-being because of the program. Of the 5 health focused services offered, the most commonly reported uptake was physical activity (87.5%), followed by learning how to eat healthier and losing weight. Additionally, one third (33.3%) of participants received assistance with reducing or stopping smoking. In terms of secondary prevention, 62.5% of clients received assistance with cancer screening. Of the 5 SDOH focused services offered, the most common was assistance with finding food to eat (66.7%) followed by assistance with paying utilities (45.8%), a shift from the priority needs at baseline (40% needing food assistance, and 35% with housing concerns), presumably reflecting the additional strains associated with the COVID-19 pandemic. Conclusions: Against the backdrop of COVID-19, these findings suggest that addressing SDOH barriers through individual navigation is an important add-on service when facilitating access to services to maintain healthy lifestyle and adhere to cancer screening guidelines. Although this was a pilot program, we foresee the opportunity to utilize trained non-clinical navigators and/or community health workers and to promote cancer prevention in at risk communities.

User Interface Design for Counseling Guidance Applications of Vocational High School Through a User-Centered Design Approach

Guidance and counseling services have an important role in moral assistance and directing students' talents and interests. The Covid-19 pandemic has hampered Counseling Guidance services because learning activities are carried out online. This study aims to conduct a UI and UX assessment of the counseling application based on the Cased Based Reasoning algorithm called B-Talk. This application was developed with a mobile platform design. Infernalities than the approach used is the User-Centered Design (UCD). The UCD approach is an approach that uses factors human, knowledge of usability techniques, and an interactive approach to developing design and systems. The UI(User Interface) and UX(User Experience) designs that have been produced will be tested with an expert assessment of Counseling Guidance which includes two aspects, namely usability testing and User Experience Question (UEQ). The media validation assessment was obtained from an average value of 89.2% of the standard feasibility without revision. In this case, it can be concluded that the B-Talk application design can be used as its function for Counseling Guidance media for adolescents. © 2021 IEEE.

Prevalence and Risk Factors of Occupational Health Hazards among Health Care Workers of Northern Saudi Arabia: A Multicenter Study.

Health care workers (HCWs) working in different health care facilities are exposed to many hazards, especially during the COVID-19 pandemic. This questionnaire-based cross-sectional study aimed to assess the prevalence, pattern, and risk factors of occupational health hazards faced by 438 randomly selected HCWs from northern Saudi Arabia. The HCWs are commonly exposed to needle stick injuries (34.5%) under the biological hazards category; and work-related stress (69.6%) under the non-biological hazards categories. The significant associated factors were work setting (ref: Primary Health Center: Adjusted OR (AOR) = 2.81, 95%CI = 1.21-4.59, p = 0.017), smoking status (ref.: non-smoker: AOR = 1.73, 95%CI = 1.03-2.91, p = 0.039), and mean sleeping duration per day (AOR = 1.22, 95%CI = 1.04-1.43, p = 0.014) for biological, and smoking status (ref: non-smoker: AOR = 2.16, 95%CI = 1.09-3.29, p = 0.028), and mean sleeping duration per day (AOR = 1.35, 95%CI = 1.07-1.70, p = 0.013) for non-biological categories. This study revealed several risk factors and occupational health hazards that HCWs are exposed to during their work time. Periodic training and follow-up assessments regarding bio-safety measures for the HCWs should be implemented. Finally, future explorative studies are warranted on the feasibility of implementing rotation-based postings for the HCWs in different health care settings.

SARS-CoV-2 endothelial dysfunction can cause erectile dysfunction: Histopathological, immunohistochemical and ultrastructural study of the human penis

INTRODUCTION AND OBJECTIVE: To describe the histopathological features of penile tissue of patients who recovered from symptomatic COVID-19 infection and subsequently developed severe erectile dysfunction (ED). METHODS: After providing informed consent, penile tissue was collected from patients undergoing surgery for inflatable penile prosthesis due to severe ED under an IRB approved protocol. Two specimens were obtained from men with a history of COVID-19 infection and two specimens were obtained from men with no history of infection (all men tested negative immediately before surgery). Formalin-fixed paraffin-embedded tissues were stained with hematoxylin and eosin (H&E) and subjected to immunohistochemical analysis for endothelial Nitric Oxide Synthase (eNOS) expression (marker of endothelial function). Tissue from COVID-19 (+) and COVID-19 (-) specimens were imaged with transmission electron microscopy (TEM). Endothelial progenitor cells (EPC) function was assessed ex vivo by determination of endothelial colony forming units from blood samples collected from the COVID-19 (+) and COVID (-) men with severe ED. RESULTS: TEM showed extracellular viral particles w100 nm in diameter with prominent peplomers (spikes) near penile vascular endothelial cells of the COVID-19 (+) patient (Figure 1A + 1B) and the absence of viral particles in control tissue. Immunohistochemistry showed eNOS expression in the corpus cavernosum of COVID (+) men was significantly decreased compared to COVID (-) men suggesting endothelial dysfunction (Figure 1C). Mean EPC levels from the COVID-19 (+) patients were lower (0.72 cells/well) compared to mean EPCs from men with severe ED and no history of COVID-19 (4.04 cells/well) suggesting impaired endothelial function. CONCLUSIONS: Our study is the first to demonstrate the presence of COVID-19 virus in the penis long after the initial infection in humans. Our study also suggests that widespread endothelial cell dysfunction from COVID19 infection can contribute to resultant erectile dysfunction. Our future studies will evaluate novel molecular mechanisms of how COVID-19 infection leads to ED. (Figure Presented).

Evaluation of SARS-CoV-2 in humansemen and effecton total sperm number: A prospective observational study

INTRODUCTION AND OBJECTIVE: The severe acuterespiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has created a surge of research to help better understand the breadth of possible sequelae. However, little is known regarding the impact on semen parameters and fertility potential. Our study sought to evaluate the impact of SARS-CoV-2 on male reproduction among American men. We collected semen samples from men who recovered from SARS-CoV-2 infection to evaluate for the presence of SARS-CoV-2. We also assessed the impact of SARS-CoV-2 infection on total sperm number (TSN) in ejaculate both during the acute phase after testing positive and a smaller cohort of men at follow-up. METHODS: We prospectively recruited thirty men diagnosed with acute SARS-CoV-2 infection using real-time reverse transcriptasepolymerase chain reaction (RT-PCR) of pharyngeal swab specimens. Semen samples were collected from each individual using mailed kits. Follow-up semen samples were done with mailed kits or inperson in office setting. Semen analysis and PCR was performed after samples were received. RESULTS: Thirty semen samples from recovered men were obtained 11-64 days after testing positive for SAR-CoV-2 infection. The median duration between positive SAR-CoV-2 test and semen collection was 37 days (IQR=23). The median total sperm number (TSN) in ejaculate was 12.5 million (IQR=53.1). When compared with age-matched SARS-CoV-2(-) men, TSN was lower among SARS-CoV-2(+) men (p=0.0024). Five men completed a follow-up sperm analysis (median 3 months) and had a median TSN of 18 million (IQR=21.6). No RNA was detected by means of RT-PCR in the semen in 16 samples tested. CONCLUSIONS: SARS-CoV-2 infection, though not detected in semen of recovered men, can affect TSN in ejaculate in the acute setting. Whether SARS-CoV-2 can affect spermatogenic function longterm remains to be evaluated.

Qtc interval prolongation and ecg features during hospitalization in patients with covid-19. results from a cohort of 586 patients in a multi-center prospective international registry

Background: Prolonged QTc interval and life-threatening arrhythmias (LTA) are potential drug induced complications previously reported with antimalarial, antivirals and antibiotics. Objectives: To evaluate prevalence of QTc interval prolongation and ECG features during hospitalization for COVID-19. Methods: 586 consecutive patients were enrolled in a multicenter international registry. 12-lead ECG was performed at admission, after 7 and 14 days;QTc values were analyzed. Results: Mean age was 62±10 years, 352 (60%) pts were male, 44,5% had hypertension, 24% diabetes and 14% were obese. Admission QTc interval was 419±40 msec, after 7 days mean QTc was 430±21 msec and after 14 days 427±46 msec. 89 (15%) pts presented at admission with prolonged QTc interval meanwhile 120 (20,4%) pts had this feature after 7 days. 46 (7%) pts presented at admission T negative waves and 36 (6.1%) pts after 7 days. During hospitalization the following therapy was provided: 274 (46%) pts received corticoids, 221(37%) pts chloroquine, 167 (28,4%) pts antivirals, 485 (82%) pts antibiotics. Conclusions: In a large international cohort of covid-19 patients prolonged QTc interval is interval is common at admission and during hospitalization. Careful evaluation of admission QTc interval is a cornerstone for a tailored therapeutic management.

Placental chronic histiocytic intervillositis correlates with severity of maternal disease in sars-cov-2 infection

Background: Chronic histiocytic intervillositis (CHIV) is a rare placental lesion that has recently been described as a risk factor for transplacental transmission of SARS-CoV-2. Our objectives were to identify a possible correlation between severity of maternal disease and the finding of CHIV in placentas from mothers with SARS-CoV-2 infection, and to determine the prevalence of CHIV in our population of COVID-19 positive mothers. Methods: All placentas from COVID-19 positive mothers sent to the Pathology Departments of our healthcare system hospitals between April 8, 2020 and January 4, 2021, were examined grossly and microscopically. Retrospective review of the maternal and neonatal clinical histories, and correlation with placental histological findings were performed. Results: CHIV was identified in three out of 18 placentas from COVID-19 positive mothers (3/18;16%). Retrospective review of maternal clinical histories from these three mothers revealed severe disease in two of them, including abnormal liver function tests, low platelets and coagulopathy requiring intensive care. Both were third trimester pregnancies, and delivered liveborn infants by Csection. One infant was COVID-19 positive and one was COVID-19 negative. The third mother presented during the second trimester with fever, bleeding and intrauterine fetal demise, and delivered vaginally. The COVID-19 positive mothers without placental CHIV (15/18) were asymptomatic or showed mild symptoms. In this group, there were 15 liveborn infants and one stillbirth (twin). All the liveborn infants were COVID-19 negative. Conclusion: In our series, the presence of placental CHIV was associated with severe maternal disease, but not necessarily with transplacental transmission of SARS-CoV-2. This observation would support host microbiological or immunological factors, such as viral load or presence of maternal cytokine storm, as possible explanations for the placental findings. Larger studies are necessary to fully understand the maternal and fetal response to COVID-19 infection occurring during pregnancy.

Inspiratory muscle training for recovered COVID-19 patients after weaning from mechanical ventilation: A pilot control clinical study.

BACKGROUND: To the best of our knowledge, no studies have evaluated the effects of inspiratory muscle training (IMT) on recovered COVID-19 patients after weaning from mechanical ventilation. Therefore, this study assessed the efficacy of IMT on recovered COVID-19 patients following mechanical ventilation. METHODS: Forty-two recovered COVID-19 patients (33 men and 9 women) weaned from mechanical ventilation with a mean age of 48.05 ±â€Š8.85 years were enrolled in this pilot control clinical study. Twenty-one patients were equipped to 2-week IMT (IMT group) and 21 matched peers were recruited as a control (control group). Forced vital capacity (FVC%), forced expiratory volume in 1 second (FEV1%), dyspnea severity index (DSI), quality of life (QOL), and six-minute walk test (6-MWT) were assessed initially before starting the study intervention and immediately after intervention. RESULTS: Significant interaction effects were observed in the IMT when compared to control group, FVC% (F = 5.31, P = .041, ηP2 = 0.13), FEV1% (F = 4.91, P = .043, ηP2 = 0.12), DSI (F = 4.56, P = .032, ηP2 = 0.15), QOL (F = 6.14, P = .021, ηP2 = 0.17), and 6-MWT (F = 9.34, P = .028, ηP2 = 0.16). Within-group analysis showed a significant improvement in the IMT group (FVC%, P = .047, FEV1%, P = .039, DSI, P = .001, QOL, P < .001, and 6-MWT, P < .001), whereas the control group displayed nonsignificant changes (P > .05). CONCLUSIONS: A 2-week IMT improves pulmonary functions, dyspnea, functional performance, and QOL in recovered intensive care unit (ICU) COVID-19 patients after consecutive weaning from mechanical ventilation. IMT program should be encouraged in the COVID-19 management protocol, specifically with ICU patients.

High-throughput virtual screening of drug databanks for potential inhibitors of SARS-CoV-2 spike glycoprotein.

COVID-19, which is caused by a novel coronavirus known as SARS-CoV-2, has spread rapidly around the world, and it has infected more than 29 million individuals as recorded on 16 September 2020. Much effort has been made to stop the virus from spreading, and there are currently no approved pharmaceutical products to treat COVID-19. Here, we apply an in silico approach to investigate more than 3800 FDA approved drugs on the viral RBD S1-ACE2 interface as a target. The compounds were investigated through flexible ligand docking, ADME property calculations and protein-ligand interaction maps. Molecular dynamics (MD) simulations were also performed on eleven compounds to study the stability and the interactions of the protein-ligand complexes. The MD simulations show that bagrosin, chidamide, ebastine, indacaterol, regorafenib, salazosulfadimidine, silodosin and tasosartan are relatively stable near the C terminal domain (CTD1) of the S1 subunit of the viral S protein. The relative MMGBSA binding energies show that silodosin has the best binding to the target. The constant velocity steered molecular dynamics (SMD) simulations show that silodosin preferentially interacts with the RBD S1 and has potential to act as an interfering compound between viral spike-host ACE2 interactions. Communicated by Ramaswamy H. Sarma.

AN EVALUATION OF SEMEN PARAMETERS IN MEN WITH CONFIRMED COVID-19 INFECTION

Objective: Our aim was to evaluate the semen parameters of men with COVID-19 infection. Design: A prospective study was performed to evaluate the gross semen parameters in men with COVID-19 infection. Samples of saliva and semen were collected and analyzed. Materials and Methods: We included men age 18-70 years old who tested positive for COVID-19. Subjects were contacted about willingness to participate. Packages with sterile specimen containers were mailed to the subject’s house with a preaddressed package included to return to our lab. The semen then underwent gross semen analysis for volume, concentration, pH and motility. Results: A total of 12 men were enrolled in the study with a median age of 35.5 (IQR = 19.5) (Table 1). The median duration of infection was 37 days (IQR = 21) and 2/12 (16.7%) had associated orchitis symptoms during the infective period. For the 11/12 men who returned a semen specimen, median volume was 1.6cc (IQR = 1.65), median pH was 7.2 (IQR = 0.2), median concentration was 14 million/cc (IQR = 30.25), and median motility of 0% (IQR = 12.5). Conclusions: We evaluated 11 men’s gross semen parameters after confirmed infection with COVID-19. The median concentration for these men is abnormally low compared to World Health Organization guidelines, and further evaluation is needed to determine the impact that COVID-19 infection can have on the testis and for what duration. [Formula presented]