Bilateral Spontaneous Pneumothorax in a Child with Multisystem Inflammatory Syndrome Associated with COVID-19

Introduction: Spontaneous pneumothorax is a rare complication of coronavirus disease 2019 (COVID-19), primarily reported in adults. Pediatric cases with bilateral pneumothorax are much less reported. Case Presentation: We presented the case of a five-year-old previously healthy boy who developed persistent fever, abdominal pain, generalized maculopapular rash, and dyspnea before admission. His chest computed tomography (CT) showed a viral involvement pattern of pneumonia suggestive of COVID-19. Subsequently, he was confirmed with multisystem inflammatory syndrome in children (MIS-C). While he responded well to the therapies, on the fifth day of admission, he developed respiratory distress again. A chest roentgenogram showed bilateral spontaneous pneumothorax. Bilateral chest tubes were inserted, and his condition improved sig-nificantly after five days of admission to the intensive care unit. Two weeks later, he was discharged in good condition. Conclusion(s): Children with MIS-C associated with COVID-19 may develop primary spontaneous pneumothorax. Owing to the clinical picture overlapping with MIS-C associated with COVID-19, the timely diagnosis of pneumothorax may be challenging in such patients.Copyright © 2022, Author(s).

Long-COVID and its Physical and Neurological Symptoms in Adults: A Systematic Review

This review was carried out with the objective to study patterns of neurological, psychological and other physical consequences of COVID-19 in the long term. The guidelines of PRISMA (Preferred Reporting Items for Systematic Reviews and Metaanalyses) had been followed;22 articles, published during January 2020 to September 2021, were selected. Original research, review articles, editorial and viewpoints were included. Google Scholar, Medline, and PubMed were searched through 2020 till 2021.Data collection in selected studies was performed mainly through the online survey, telephone survey, use of medical records, and patient interviews. This systematic review contains the studies conducted in the American, Asian and European countries. The major outcomes identified were the neurological, psychological, and other long-term chronic manifestations of COVID- 19. This review demonstrates that long-COVID has started to bring a huge wave of patients, the count of them being millions now, who can enter a phase of disability due to neurological damages if not treated during the early course of illness. Though more disabling than lethal, long-COVID patients with a neurological deficit is expected to overburden the healthcare system globally which is already been struggling to handle acute COVID-19 patients in this once-in-a-lifetime pandemic.Copyright © 2023 Lahore Medical And Dental College. All rights reserved.

Hematological and biochemical assessment of children infected with measles virus: 2022 outbreak in pakistan

Measles is a contagious disease caused by an RNA virus. Resurgence of measles after Covid-19 and its severity among children has led to many speculations about the Measles vaccination coverage and its efficacy. In this study, the clinical data of children <9 years (n=19) admitted at the Pakistan Institute of Medical Sciences (PIMS) in the measles ward was analyzed. The blood samples were processed for hematology and routine biochemistry tests. The results obtained were statistically analyzed on SPSS-21 software by using One-Way ANOVA for Complete Parameters (CP), Kruskal Wallis, and Mann-Whitney test for Differential leucocyte count (DLC) and Biochemical parameters. A p<0.05 was considered significant. The results suggest no significant difference in Complete blood parameters (CP) among non-vaccinated, partially vaccinated and fully vaccinated patients. Among DLC Basophils level was significantly different (p=0.024), being lower in partially vaccinated than non-vaccinated patients. Biochemical parameters showed that serum urea level was significantly different (p=0.013), showing a decline in fully vaccinated patients as compared to non-vaccinated patients. Moreover, a significantly higher level of Alkaline phosphatase as compared to the normal range was observed in fully vaccinated patients. However, lower levels of MCH, MCV, MCHC, RBC, Hb, eosinophils, and a higher level of RDW-CV were observed overall as compared to the normal range (healthy individuals). The results suggest improvements are needed in vaccination strategies for effectively controlling the disease. Anemic conditions in overall measles patients indicate poor health conditions. This study contains a limited sample size, further research on measles virus (MeV) mutations, and vaccine optimization could be helpful for the complete eradication of measles from Pakistan. © Pakistan Academy of Sciences

Patients' satisfaction with nursing care quality and associated factors: A cross-section study.

AIM: This research aimed to evaluate patients' satisfaction with the nursing care quality during their hospitalization. DESIGN: Quantitative cross-sectional descriptive design. METHODS: A convenience sample of 238 patients were recruited from hospitals in two provinces in Saudi Arabia. Patient satisfaction was measured by the Arabic version of the Patients' Satisfaction with Nursing Care Quality Questionnaire (PSNCQQ-Ar). RESULTS: Significant differences were found between Saudi provinces regarding the overall quality of nursing care (M = 4.65, p < 0.001). The study revealed mean significant variations between patient satisfaction with nursing care and sociodemographic factors, including age (p = 0.002), education level (p = 0.047), marital status (p = 0.017), employment status (p = 0.038), urban vs. suburban residence (p = 0.006), length of hospitalization (p = 0.001), and accompaniment by a family member (p = 0.014). Improving patients' experience during their hospitalization requires regular examination of the quality of nursing care services. PATIENT CONTRIBUTION: This research enhances our understanding of patients satisfaction toward the quality of nursing care received during hospitalization.

The Impact of Event Scale-Revised: Examining Its Cutoff Scores among Arab Psychiatric Patients and Healthy Adults within the Context of COVID-19 as a Collective Traumatic Event.

The Impact of Event Scale-Revised (IES-R) is the most popular measure of post-traumatic stress disorder (PTSD). It has been recently validated in Arabic. This instrumental study aimed to determine optimal cutoff scores of the IES-R and its determined six subscales in Arab samples of psychiatric patients (N = 168, 70.8% females) and healthy adults (N = 992, 62.7% females) from Saudi Arabia during the COVID-19 pandemic as a probable ongoing collective traumatic event. Based on a cutoff score of 14 of the Depression Anxiety Stress Scale 8-items (DASS-8), receiver operator curve (ROC) analysis revealed two optimal points of 39.5 and 30.5 for the IES-R in the samples (area under the curve (AUC) = 0.86 & 0.91, p values = 0.001, 95% CI: 0.80-0.92 & 0.87-0.94, sensitivity = 0.85 & 0.87, specificity = 0.73 & 0.83, Youden index = 0.58 & 0.70, respectively). Different cutoffs were detected for the six subscales of the IES-R, with numbing and avoidance expressing the lowest predictivity for distress. Meanwhile, hyperarousal followed by pandemic-related irritability expressed a stronger predictive capacity for distress than all subscales in both samples. In path analysis, pandemic-related irritability/dysphoric mood evolved as a direct and indirect effect of key PTSD symptoms (intrusion, hyperarousal, and numbing). The irritability dimension of the IES-R directly predicted the traumatic symptoms of sleep disturbance in both samples while sleep disturbance did not predict irritability. The findings suggest the usefulness of the IES-R at a score of 30.5 for detecting adults prone to trauma related distress, with higher scores needed for screening in psychiatric patients. Various PTSD symptoms may induce dysphoric mood, which represents a considerable burden that may induce circadian misalignment and more noxious psychiatric problems/co-morbidities (e.g., sleep disturbance) in both healthy and diseased groups.

COVID-19 pandemic roles on consumer behaviour towards sustainable transitions: a retail industry survey

In this paper, we offer some initial examination on how Covid-19 pandemic impacted the consumer behaviour towards retail sector in India. We argue that Covid-19 pandemic offers a great opportunity for businesses. We also discuss some potential directions of how consumer sustainable decision making will be shifted to due to the pandemic. In this paper the data is collected from various Indian consumers from different cities who made purchases from organised retail store. In our discussion of consumer behaviour we outline how COVID-19 has impacted retail sector and also the behaviour of the consumers towards sustainable transitions. It has been seen that consumers interest have been shifted towards retailing, online payments, sustainable food habits, and sustainable lifestyle. This study will help the businesses as well the academicians in determining what consumers prefer during this pandemic.

In-silico approach to identify antiviral potent inhibitors against nsp4 of SARS-COV-2

In the absence of effective therapy till now millions of people are dying due to severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). To combat with this highly pathogenic virus, potent and less toxic therapeutic drugs are needed. onstructural protein (NSP4) responsible for cytoplasmic rearrangements necessary for optimal SARS-CoV- 2 replication has been identified as one of the potential drug targets in the development of antiviral agents. To identify promising therapeutic compounds against the imminent danger of COVID-19, present study was designed to predict a 3D-model of NSP4 protein and recognize selective inhibitors, followed by molecular docking with reported antiviral photochemical compounds. Homology modeling was done by using deposited sequence of NSP4 in NCBI database. SWISS MODEL was used to identify best PDB template 3vcb with a sequence similarity of 61.36 percent. To validate 200 reported antiviral photochemical compounds were docked against developed3D-NSP4 model by using MoE software. Lowest binding energy candidates were chosen and screened for pharmacokinetics using the Admits server. NSP4 3D homology model showed potential binding interactions with all reported drugs. However, seven inhibitors were discovered with strongest binding energies ranging from - 9.4838 to -15.7308 Kcal/Mol. In conclusion, this study presents a 3D model of NSP4 and helps understanding the molecular interactions at atomic level. Hence, this model could be suggested as an antiviral target for the development of novel anti-viral agents against COVID-19.

Prevalence of post-COVID symptoms of obsessive-compulsive disorder in Saudi Arabia.

OBJECTIVES: To determine the prevalence of Obsessive-Compulsive Disorder (OCD) symptoms in patients who have survived COVID-19. METHODS: The study used an observational cross-sectional design between July and October 2021. The target population was adult patients who had confirmed COVID-19 infection prior to joining the study, OCD symptoms were assessed using the Arabic OCD scale created by Abohendy and colleagues, which included 83 questions covering 12 different domains and was administired online. RESULTS: A total of 356 patients were included in the analysis. Approximately 9.0% and 1.7% of the patients had a history of psychiatric disease and OCD diagnosis (respectively). The total symptom score was 32.8%. The most frequently reported domains were rumination of ideas (55.5%), re-checking compulsions (37.0%), and slowness (34.0%), while the least frequently reported domains included obsessive impulses (26.3%), obsessive images (26.5%), and religious compulsions (26.8%). Unlike other domains, the purity and cleanliness compulsions scores were significantly higher than the scale reference population. A higher total symptom score was observed in psychiatric patients (p=0.004) and, to a lesser extent, in OCD patients (p=0.250). CONCLUSION: Overall, OCD symptoms, including cleanliness and fear of disease obsessions, tend to be higher in psychiatric and OCD patients, these findings are valuable for future studies.

Chronic Kidney Disease Patients: Collateral Damage Due to Suspension of Vascular Access Services

This study was conducted at the Department of Vascular Surgery at Combined Military Hospital Lahore from December 2019 to June 2020. The mortality of patients on the waiting list for vascular access in our institution three months after implementing strict policies for elective surgeries (30th March 2020 to 29th June 2020) was compared with the preceding three months. The mortality of patients in the pre-COVID-19 periods on the waiting list for HD was 11 (7.9%) in the pre-COVID-19 period, while this increased to 5 (12.5%) in the post-COVID-19 period. COVID-19 related suspension of vascular access services negatively influences CKD patients waiting for permanent vascular access. © 2022, Army Medical College. All rights reserved.

Evaluation the Role of CD4 and CD8 Reducing the Deterioration of COVID-19 Iraqi Patients

Since its start spreed "Severe acute respiratory syndrome coronavirus 2" was discovered in Wuhan, China.that is chargeable COVID-19, a pandemic virus, has end up a widespread fitness hassle everywhere in the global Over 2.1 million people have been affected. We analyze serum concentration of CD4 marker and CD8 marker depend in COVID-19 sufferers, and to make clear a relationship between these variables and disorder Progression and severity For those purpose, (158) sufferers with COVID-19 (showed with the aid of using polymerase chain reaction) and (22) seemingly wholesome human beings have been protected withinside the present day examine and taken into consideration as a manipulate group. All examine population (sufferers and manipulate) have been subjected to the assessment of serum awareness of CD4 marker and CD8 marker. COVID-19 sufferers displayed a huge elevation withinside the tiers of parameters protected on this examine while in comparison with wholesome controls. We additionally observed that concentration of CD4 and CD8 high in sever (CD4 5.68 +/- 0.16-CD8 961.74149.48 ) than critical (CD4 4.7610.14- CD8 880.19 +/- 52.03 )and moderate (CD43.83 +/- 0.09 - CD8 647.52 +/- 44.54) groups with high significant different (P <= 0.01(.

ADJUNCTIVE USE OF DISPOSABLE 1.1-MM CRYOPROBE WITH ROBOTIC-ASSISTED BRONCHOSCOPY

SESSION TITLE: Tales in Bronchoscopy SESSION TYPE: Rapid Fire Case Reports PRESENTED ON: 10/19/2022 12:45 pm - 1:45 pm INTRODUCTION: Peripheral pulmonary nodule biopsy can be challenging based on its location and size. Robotic bronchoscopy is augmenting peripheral navigation, allowing for approximation of peripheral nodules. The diagnostic yield is variable and is primarily dependent upon operator experience, selection of biopsy equipment and nodule texture. Hard pulmonary nodules are difficult to biopsy with a needle, brush and forceps. We report a case of utilizing combined disposable 1.1 mm cryoprobe and robotic bronchoscopy to diagnose a right lower lobe nodule. CASE PRESENTATION: A 83-year-old woman with a remote history of non-Hodgkin's lymphoma presented with dyspnea and fatigue. 18F-FDG PET/CT revealed a 2.7 cm hypermetabolic nodule with central photopenia in the right lower lobe (RLL) along with patchy bilateral ground-glass opacities related to COVID-19 infection. After a few weeks, robotic navigation was used for approximation of the RLL superior segment nodule. Under fluoroscopic and radial guidance with circumferential signal, 6 forcep biopsies and 5 fine needle aspirations with 21-gauge needle yielded a non-diagnostic sample. A decision was made to utilize a 1.1 mm disposable cryoprobe, which was inserted through the opening made by the forceps into the target lesion. Six cryo biopsies were obtained with 4-6 seconds freeze time. Minimal bleeding was encountered and no pneumothorax occurred. Histopathological examination revealed necrotizing granulomatous inflammation. DISCUSSION: To the best of our knowledge, this is the first reported case of combination 1.1 mm disposable cryoprobe biopsy with robotic bronchoscopy. Interventional pulmonologists are primarily using cryo probe for mechanical tumor debulking and peripheral lung biopsy for diagnosis of interstitial lung disease. The use of a 1.1 mm cryoprobe under robotic guidance allows for well-preserved tissue samples and possibly boosting diagnostic yield. The advantage of the 1.1 mm cryoprobe lies with its size and excellent flexibility. The robotic platform also corrects for any unwanted deflection. One limitation of using a flexible cryoprobe is its blunt tip, requiring an additional step in gaining access to nodules located outside the airway with either the biopsy needle or forceps. Future improvements in cryoprobe design with a sharp tip may address this limitation. CONCLUSIONS: Combining 1.1 mm disposable cryoprobe with robotic bronchoscopy is safe and can be considered as an adjunct to conventional biopsy, allowing for well-preserved tissue. Further prospective studies to evaluate its performance and safety is warranted. Reference #1: Kho SS, Chai CS, Nyanti LE, et al. Combination of 1.1 mm flexible cryoprobe with conventional guide sheath and therapeutic bronchoscope in biopsy of apical upper lobe solitary pulmonary nodule. BMC Pulm Med. 2020. 158(20). doi.org/10.1186/s12890-020-01199-3 Reference #2: Chen AC, Pastis NJ Jr, Mahajan AK, et al. Robotic Bronchoscopy for Peripheral Pulmonary Lesions: A Multicenter Pilot and Feasibility Study (BENEFIT). Chest. 2021;159(2):845-852. doi:10.1016/j.chest.2020.08.2047 Reference #3: Sahajal Dhooria, Inderpaul Singh Sehgal, Ashutosh NA Digambar Behera, Ritesh Agarwal. Diagnostic Yield and Safety of Cryoprobe Transbronchial Lung Biopsy in Diffuse Parenchymal Lung Diseases: Systematic Review and Meta-Analysis. Respiratory Care. 2016. 61(5):700-712. doi.org/10.4187/respcare.04488 DISCLOSURES: No relevant relationships by Sailendra Chundu No relevant relationships by Moiz Javed No relevant relationships by Abid Khokar No relevant relationships by Ali Saeed No relevant relationships by Andrew Talon No relevant relationships by Melinda Wang

Investigating the effect of antimicrobial treatment on silk fabric by herbal extract

In this study eco-friendly antimicrobial finish was developed by Azadirachata indica, Butea monosperma and Litchi chinensis and then applied on 100% silk fabric. The effectiveness of antimicrobial finish was checked up to 25 washes. The antimicrobial finish was extracted from leaves of these plants and applied on silk fabric by using pad dry cure method. It is true experimental study with pre-test and post-test control group design. FTIR and SEM tests were used to observe the presence of antimicrobial finish on silk fabric. The antimicrobial finish was fixed on silk fabric by the use of poly urethane binder. The antimicrobial activity of treated and untreated fabric and durability to successive washes were assessed by using ASTEM E2149 shake flask method. The treated fabric with A. indica and B.monosperme showed 100% reduction in microorganism presence while L. chinensis revealed 60% reduction against microorganisms. The antimicrobial finish showed 100% reduction after successive laundring up to 25 washes. This fabric is beneficial for home furnishing, sportswear and footwear industry as well as in apparel sector such as in formal wear and making matching face mask against COVID-19 pandemic.

Bringing experimental therapeutics clinical trials network (ETCTN) to underrepresented population

Background: Access to health care including clinical trials (CT) leading to paradigm-changing cancer treatments are critical for high quality cancer care and equity in society. In this report, we highlight methods in accruing to ETCTN wherein underrepresented rural, low-income, and racial minorities comprise >50% of enrollment. Methods: University of Kansas Cancer Center (KUCC) is one of eight National Cancer Institute (NCI) designated cancer centers awarded CATCH-UP.2020 (CATCH-UP), a congressionally mandated P30 supplement to enhance access for minority/underserved populations to ETCTN precision medicine CT. KUCC catchment area is 23% rural by Rural Urban Continuum Codes (RUCC);almost 90 % of counties are designated primary care HPSA's (Health Professional Shortage Areas). KUCC Early Phase and Masonic Cancer Alliance (rural outreach network) partnered to operationalize CATCH-UP. We engaged disease-focused champion investigators in disease working groups and MCA physicians who selected scientifically sound CT that fit catchment area needs. Patient and Investigator Voices Organizing Together, a patient research advocacy group provided practical feedback. MCA navigator coordinated recruitment. Telehealth was used for rural patients that would have a significant distance to travel just to be screened. Results: CATCH-UP was initiated in September 2020. Twenty-eight CT were activated, many in community sites. Average activation time was 81 days. Delays were mainly from CT amendments. KUCC enrolled the first patient in the CATCH-UP program. In 6 months, we met accrual requirements (24/year, 50% minorities). During first year, we enrolled 47 (>50% minorities), an increase of 680% from our average accrual of 6/year (>50% minorities) in ETCTN through Early Drug Development Opportunity Program (2016-2020). To date, we have enrolled 61, 54% from rural, HPSA, race and other minorities. Although the proportion of minorities did not change but remained high, this funding allowed us to substantially increase the number of patients from a catchment area with high proportion of geographically and socioeconomically underserved minorities given access to early phase CT through ETCTN. Conclusions: Amid COVID-19 pandemic, the NCI CATCH-UP program and methods we used allowed access to novel therapies for rural, medically underserved, and other minority groups.

Factors influencing hospital anxiety and depression among emergency department nurses during the COVID-19 pandemic: A multi-center cross-sectional study

Introduction The emergency department (ED) is a highly stressful environment, which exposes nurses to infection. ED nurses handle life-threatening conditions, endure long working hours, and deal with anxious patients and their families. Aim This study aimed to examine factors, which may influence anxiety and depression levels among ED nurses during the coronavirus disease 2019 (COVID-19) pandemic. Methods A cross-sectional design was used with 251 participants from six hospitals in Saudi Arabia (mean age = 32.7 ± 6.59, range = 21–54 years, 70.5% females). Data were collected using the Hospital Anxiety and Depression Scale (HADS), and the analysis was conducted using structural equation modeling (SEM). Results Based on the HADS scores, 29.1 and 25.5% of ED nurses were identified as doubtful cases for depression and anxiety, respectively. Additionally, 34.7 and 43.3% of ED nurses were identified as definite cases for depression and anxiety, respectively. Higher anxiety levels were observed among female nurses, nurses with lower physical activity levels, and nurses who worked in urban areas. Low physical activity levels and more than 6 years of work experience correlated with a higher level of depression. None of the hypothesized paths in the anxiety and depression models were significant, except for two observed variables—namely, work location and physical exercise in the anxiety model and physical exercise in the depression model. Conclusion Emergency department nurses expressed high levels of anxiety and depression during the COVID-19 pandemic, which may negatively affect their performance and reduce care quality. Therefore, health care leaders should implement specialized mental health education programs focused on nursing occupational safety and support to improve ED nurses’ psychological well-being. Specific attention should be paid to ED female nurses who work in urban areas, especially those with more than 6 years of experience.

Vaccinated, What Next? An Efficient Contact and Social Distance Tracing Based on Heterogeneous Telco Data

The demand for safety-boosting systems is always increasing, especially to limit the rapid spread of COVID-19. Real-time social distance preserving is an essential application towards containing the pandemic outbreak. Few systems have been proposed which require infrastructure setup and high-end phones. Therefore, they have limited ubiquitous adoption. Cellular technology enjoys widespread availability and their support by commodity cellphones which suggest leveraging it for social distance tracking. However, users sharing the same environment may be connected to different teleco providers of different network configurations. Traditional cellular-based localization systems usually build a separate model for each provider, leading to a drop in social distance performance. In this paper, we propose CellTrace, a deep learning-based social distance preserving system. Specifically, CellTrace finds a cross-provider representation using a deep learning version of Canonical Correlation Analysis. Different providers’data are highly correlated in this representation and used to train a localization model for estimating the social distances. Additionally, CellTrace incorporates different modules that improve the deep model’s generalization against overtraining and noise. We have implemented and evaluated CellTrace in two different environments with a side-by-side comparison with the state-of-the-art cellular localization and contact tracing techniques. The results show that CellTrace can accurately localize users and estimate the contact occurrence, regardless of the connected providers, with a sub-meter median error and 97% accuracy, respectively. In addition, we show that CellTrace has robust performance in various challenging scenarios. Author

Unveiling the multitargeted potential of N-(4-Aminobutanoyl)-S-(4-methoxybenzyl)-L-cysteinylglycine (NSL-CG) against SARS CoV-2: a virtual screening and molecular dynamics simulation study.

The coronaviridae family has caused the most destruction among all the viral families in modern sciences. It is one of the recently discovered and added members of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which has caused the global pandemic and significant destruction worldwide. However, scientists worldwide have developed vaccines, which are being given to humans. The mutated strain of the virus has caused various uncertainties about whether the discovered drug and vaccines affect it. Even after the World Health Organization's approval for the vaccines, their effectiveness and protection ratio are still a major concern. At the community level, to this date, there is no medicine available to cure the patients. In this study, we have screened the vast library from Drug Bank and identified N-(4-Aminobutanoyl)-S-(4-methoxybenzyl)-L-cysteinylglycine (NSL-CG) that can work against two major targets of SARS CoV-2, replication-transcription and RNA dependent polymerase. Further, we have performed the Molecular Mechanics/Generalized Born Surface Area (MM/GBSA) and molecular dynamics simulation of the compound with both proteins individually, giving us enough evidence that the said drugs can work against the two targets together. Inhibiting the action of any of both proteins may lead to retaining the virus, and having a dual-targeted drug can be an extra precise measure for this process. The NSL-CG is an experimental drug belonging to the peptidomimetics class included in the small group of drugs with a docking score of -9.079 kcal/mol with replication-transcription -7.885 kcal/mol with RNA-dependent polymerase. Hence, through the complete flowed study, the NSL-CG can be further experimentally validated in in-vitro and in-vivo conditions before human utilisation.Communicated by Ramaswamy H. Sarma.

High Seroprevalence of SARS-CoV-2 IgG and RNA among Asymptomatic Blood Donors in Makkah Region, Saudi Arabia.

The gold-standard approach for diagnosing and confirming Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) infection is reverse transcription-polymerase chain reaction (RT-PCR). This method, however, is inefficient in detecting previous or dormant viral infections. The presence of antigen-specific antibodies is the fingerprint and cardinal sign for diagnosis and determination of exposure to infectious agents including Corona virus disease-2019 (COVID-19). This cross-sectional study examined the presence of SARS-CoV-2 spike-specific immunoglobulin G (IgG) among asymptomatic blood donors in Makkah region. A total of 4368 asymptomatic blood donors were enrolled. They were screened for spike-specific IgG using ELISA and COVID-19 RNA by real-time PCR. COVID-19 IgG was detected among 2248 subjects (51.5%) while COVID-19-RNA was detected among 473 (10.8%) subjects. The IgG frequency was significantly higher among males and non-Saudi residents (p < 0.001 each) with no significant variation in IgG positivity among blood donors with different blood groups. In addition, COVID-19 RNA frequency was significantly higher among donors below 40-years old (p = 0.047, χ2 = 3.95), and non-Saudi residents (p = 0.001, χ2 = 304.5). The COVID-19 IgG levels were significantly higher among the RNA-positive donors (p = 001), and non-Saudi residents (p = 0.041), with no variations with age or blood group (p > 0.05). This study reveals a very high prevalence of COVID-19 IgG and RNA among asymptomatic blood donors in Makkah, Saudi Arabia indicating a high exposure rate of the general population to COVID-19; particularly foreign residents. It sheds light on the spread on COVID-19 among apparently healthy individuals at the beginning of the pandemic and could help in designing various control measures to minimize viral spread.

Liver function test abnormality in paediatric patients with Covid-19 – a single-centre study in the south of Iran

Introduction: From the beginning of the Covid-19 outbreak, liver involvement has been reported in some adult studies and some possible mechanisms have been proposed for this. However, there are few studies in the paediatric age group. In this study, we aimed to determine the incidence rate of liver damage in paediatric patients with Covid-19 and their impact on the outcome. Methods: All Covid-19 RT-PCR positive children admitted to the Namazi Hospital in Shiraz, Iran, from March 2020 to April 2021 were enrolled. Clinical data, especially gastrointestinal signs and symptoms, and paraclinical data, including liver function tests, C-reactive protein (CRP) and lactate dehydrogenase (LDH) were gathered and all the patients were monitored during their hospital stay. Results: One hundred and ten patients were enrolled in this study and of them 67 patients (69%) were admitted to the PICU. Gastrointestinal symptoms were seen in 47 patients (42.7%) upon admission. Abnormally high AST and ALT were seen in 83 (75.4%) and 49 (44.5%) patients, respectively. In the patients admitted to the PICU (n = 67), 56 (83.6%) had abnormal AST and 34 (50.7%) had high ALT. Twenty-seven (62.8%) and 15 (34.9%) of the 43 patients who were not admitted to the PICU had high AST and ALT, respectively. The patients admitted to the PICU had significantly higher CRP and LDH and lower albumin levels. Logistic Regression analysis revealed that CRP, LDH and albumin are predictors of mortality. Conclusion: Abnormal liver function tests in children with Covid-19 are common and we can consider hypoalbuminaemia in addition to high LDH and CRP as poor prognostic factors.

Comparison of the RSNA chest CT classification system and CO-RADS system in reporting COVID-19 pneumonia in symptomatic and asymptomatic patients

Background: Coronavirus disease (COVID-19) is a new infection with three pandemic waves up till now. CT plays an important role in diagnosis with multiple reporting systems that can be used during CT analysis. We aimed to compare reporting using the recommendations of the radiological society of North America (RSNA) versus the coronavirus disease reporting and data system (CO-RADS) and to assess the performance of CT if used in asymptomatic patients as a screening. Two hundred and fifty-one patients who underwent chest CT scanning either due to clinical suspicion or as screening before hospital admission were included in this retrospective observational cross-sectional study. This was followed by RT-PCR for confirmation. Three radiologists with different years of experience interpreted the CT findings using the RSNA recommendations and the CO-RADS reporting. The data were collected and compared. Results: There was no statistically significant difference noted in the diagnostic accuracy obtained while using the RSNA recommendations and the CO-RADS reporting system. Also, a good inter-rater agreement was noticed while using the two reporting systems. The CT showed a highly significant value while used in the assessment of symptomatic patients in controversy to the screening of asymptomatic patients. Conclusion: Both reporting systems show similar diagnostic accuracy with a good almost similar inter-rater agreement. Both can be used while interpreting the CT images of cases with suspected COVID-19 infection. CT can be used effectively in the detection of COVID-19 infection between symptomatic patients while it is of a lower value in the screening of asymptomatic patients.