COVID-19-Induced Hypertriglyceridemia Leading to Pancreatitis in a 51-Year-Old Female.

There are increasing reports of the effects of COVID-19 on the pancreas. Pancreatitis, as a result of hypertriglyceridemia, has also been reported. Hypothesized mechanisms include hemophagocytic lymphohistiocytosis (HLH) syndrome and acquired lipoprotein lipase (LPL) inhibitors. We present a 51-year-old female patient who presented with nausea, vomiting, and epigastric abdominal pain radiating to the back. On examination, she had generalized abdominal tenderness without guarding or rebound tenderness. Our workup revealed elevated lipase of 1150 units/L, triglycerides (TG) of 11340 mg/dL, and mild pancreatitis on an abdominal computed tomography (CT) scan. On day 2, she developed a new oxygen requirement and tested positive for COVID-19. She was treated with fluids and opiates for pancreatitis, plasmapheresis, and an insulin infusion to treat her hypertriglyceridemia. She was treated with remdesivir for an acute COVID-19 infection. Triglycerides decreased to <500 mg/dL with treatment, and she was discharged home on oral lipid-lowering agents. By discussing this case, we aim to shed light on the association between COVID-19 and hypertriglyceridemia, which can further lead to life-threatening complications such as acute pancreatitis. Further studies are needed to identify the exact mechanisms, preventive measures, and long-term effects of COVID-19 on triglycerides and the pancreas.

Acquired immune thrombotic thrombocytopenic purpura (TTP) associated with inactivated COVID-19 vaccine CoronaVac.

Corona virus disease 2019 (COVID-19) due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has affected the whole world. Acquired thrombotic thrombocytopenic purpura (TTP) has been reported after administration of mRNA- or adenoviral vector-based COVID-19 vaccines, including Ad26.COV2-S, BNT162b2, mRNA-1273, and ChAdOx1 nCov-19. However, whether inactivated vaccines, such as CoronaVac, could cause TTP and whether the symptoms in TTPs caused by inactivated vaccines are different from previously reported cases are unknown. In this study, two cases were reported. Both cases developed TTP after the second CoronaVac vaccination shot, but not the first. They demonstrated symptoms of fever, neurological abnormalities, renal dysfunction, thrombocytopenia, and hemolysis. Both patients achieved complete remission through several sessions of plasma exchanges and immune suppression. The incidence of TTP in Nanjing area was analyzed. The number of patients with TTP was 12 in 2019, 6 in 2020, 16 in 2021, and 19 in 2022. To the authors' knowledge, this report is the first report of TTP associated with inactivated COVID-19 vaccine (CoronaVac). The rarity and delayed onset may be due to the relatively milder immune response caused by the inactivated vaccines than mRNA-based ones. Timely plasma exchange is a vital treatment for CoronaVac-related TTP, similar to activated vaccine-related TTP.

Risk factors for acute kidney injury in patients hospitalized with COVID-19 / Fatores de risco para lesão renal aguda em pacientes hospitalizados com COVID-19

Abstract Introduction: Acute kidney injury (AKI) occurs frequently in COVID-19 patients and is associated with greater morbidity and mortality. Knowing the risks of AKI allows for identification, prevention, and timely treatment. This study aimed to identify the risk factors associated with AKI in hospitalized patients. Methods: A descriptive, retrospective, cross-sectional, and analytical component study of adult patients hospitalized with COVID-19 from March 1 to December 31, 2020 was carried out. AKI was defined by the creatinine criteria of the KDIGO-AKI guidelines. Information, regarding risk factors, was obtained from electronic medical records. Results: Out of the 934 patients, 42.93% developed AKI, 60.59% KDIGO-1, and 9.9% required renal replacement therapy. Patients with AKI had longer hospital stay, higher mortality, and required more intensive care unit (ICU) admission, mechanical ventilation, and vasopressor support. Multivariate analysis showed that age (OR 1.03; 95% CI 1.02-1.04), male sex (OR 2.13; 95% CI 1.49-3.04), diabetes mellitus (DM) (OR 1.55; 95% CI 1.04-2.32), chronic kidney disease (CKD) (OR 2.07; 95% CI 1.06-4.04), C-reactive protein (CRP) (OR 1.02; 95% CI 1.00-1.03), ICU admission (OR 1.81; 95% CI 1.04-3.16), and vasopressor support (OR 7.46; 95% CI 3.34-16.64) were risk factors for AKI, and that bicarbonate (OR 0.89; 95% CI 0.84-0.94) and partial pressure arterial oxygen/inspired oxygen fraction index (OR 0.99; 95% CI 0.98-0.99) could be protective factors. Conclusions: A high frequency of AKI was documented in COVID-19 patients, with several predictors: age, male sex, DM, CKD, CRP, ICU admission, and vasopressor support. AKI occurred more frequently in patients with higher disease severity and was associated with higher mortality and worse outcomes.

RESUMO Introdução: Lesão renal aguda (LRA) ocorre frequentemente em pacientes com COVID-19 e associa-se a maior morbidade e mortalidade. Conhecer riscos da LRA permite a identificação, prevenção e tratamento oportuno. Este estudo teve como objetivo identificar fatores de risco associados à LRA em pacientes hospitalizados. Métodos: Realizou-se estudo descritivo, retrospectivo, transversal e de componente analítico de pacientes adultos hospitalizados com COVID-19 de 1º de março a 31 de dezembro, 2020. Definiu-se a LRA pelos critérios de creatinina das diretrizes KDIGO-LRA. Informações sobre fatores de risco foram obtidas de prontuários eletrônicos. Resultados: Dos 934 pacientes, 42,93% desenvolveram LRA, 60,59% KDIGO-1 e 9,9% necessitaram de terapia renal substitutiva. Pacientes com LRA apresentaram maior tempo de internação, maior mortalidade e necessitaram de mais internações em UTIs, ventilação mecânica e suporte vasopressor. A análise multivariada mostrou que idade (OR 1,03; IC 95% 1,02-1,04), sexo masculino (OR 2,13; IC 95% 1,49-3,04), diabetes mellitus (DM) (OR 1,55; IC 95% 1,04-2,32), doença renal crônica (DRC) (OR 2,07; IC 95% 1,06-4,04), proteína C reativa (PCR) (OR 1,02; IC 95% 1,00-1,03), admissão em UTI (OR 1,81; IC 95% 1,04-3,16) e suporte vasopressor (OR 7,46; IC 95% 3,34-16,64) foram fatores de risco para LRA, e que bicarbonato (OR 0,89; IC 95% 0,84-0,94) e índice de pressão parcial de oxigênio arterial/fração inspirada de oxigênio (OR 0,99; IC 95% 0,98-0,99) poderiam ser fatores de proteção. Conclusões: Documentou-se alta frequência de LRA em pacientes com COVID-19, com diversos preditores: idade, sexo masculino, DM, DRC, PCR, admissão em UTI e suporte vasopressor. LRA ocorreu mais frequentemente em pacientes com maior gravidade da doença e associou-se a maior mortalidade e piores desfechos.

Cardiac Damage After SARS-CoV2 Infection.

COVID-19 is a viral disease that can manifest acutely in the respiratory tract and other organs. In this study, we aimed to investigate potential long-term damage to the heart from COVID-19. For this study, we divided 97 consecutive unselected COVID-19 patients aged 18-80 years at a cardiology practice in Cologne, Germany, into two groups based on the severity of their infection. We performed a resting ECG and a resting transthoracic echocardiography three and six months after SARS-CoV2 infection. The key discriminator determining disease severity was bed confinement or hospital admission. Group 1 included patients with less severe COVID-19, whereas group 2 contained more severe cases. Heart rate as the primary ECG endpoint was lower by a statistically significant amount for the entire study population (p=0.024), subdivided by gender (pwomen <0.001, pmen <0.001) and in group 1 p =0.003 compared to three months. QTc time and repolarization disturbances as primary ECG endpoints and the echocardiographic primary endpoints, left ventricular ejection fraction, and left ventricular end-diastolic diameter (LVEDD), showed no relevant difference between the subgroups at three and six months or between the measurements taken at each point. In contrast, LVEDD normalized to body surface area was statistically significantly lower at six months in women in group 1 compared to group 2 (p=0.048) and in the overall study population at six months compared with the data after three months (p=0.034). E/E' was statistically lower at six months than at three months in the whole population (p=0.004) and in women (p=0.031). All measured echocardiographic and electrocardiographic mean values were within the normal range in all groups and follow-up controls. Overall, the prospective study conducted showed no significant evidence of long-term cardiac damage from COVID-19 disease, as evidenced by electrocardiographic and echocardiographic examinations at three and six months after infection.

[Impact of Mild SARS-CoV-2 Infection on Hematological Parameters and Suitability of Apheresis Platelets Donation in Blood Donors].

OBJECTIVE: To investigate the effects of mild SARS-CoV-2 infection on hematological parameters of adult blood donors and the suitability of apheresis platelet donation, the changes of the hematological parameters in blood donors with mild infection of the SARS-CoV-2 Omicron variant strain were evaluated. METHODS: Seventy-two blood donors with mild COVID-19 symptoms who donated consecutive apheresis platelets for 3 times from December 2022 to January 2023, 42 cases among which were included in the infection-positive group, and 30 cases in the suspected infection group. Forty-two donors un-vaccinated against SARS-CoV-2, un-infected, and donated three consecutive apheresis platelets from October to November 2022 were included in the control group. The changes of blood routine testing in the positive group and the suspected infection group were retrospectively compared before (Time1) and after (Time2 and Time3) the onset of symptoms, three consecutive times (Time1, Time2, Time3) in the control group by repeated measures analysis of variance. The Bayesian discriminant method was used to establish a discriminant equation to determine whether the recent infection of SARS-CoV-2 occurred or not. RESULTS: Simple effect of the number times of tests in the positive and suspected infection groups was significant（ Finfection-positive group=6.98, P < 0.001, partial η2=0.79, Fsuspected infection group=4.31, P < 0.001, partial η2=0.70）. The positive group and the suspected infection group had lower RBC, HCT, and HGB, and higher PLT and PCT at Time2 compared to Time1 and Time3(P < 0.05). The positive group and the suspected infection group showes RDW-CV and RDW-SD at Time3 higher than Time1 and Time2 (P < 0.001). The simple effect of the number times of tests in the control group was not significant ( F=0.96, P =0.55, partial η2=0.34). The difference of the whole blood count parameters in the control group for three times was not statistically significant (P >0.05). We established a discriminant equation to determine whether the recent infection of SARS-CoV-2 occurred or not. The equation had an eigenvalue of 0.22, a canonical correlation of 0.43 (χ2=27.81, P < 0.001), and an analysis accuracy of 72.9%. CONCLUSION: The hematological indicators of RBC, HCT, HGB, PLT, PCT, RDW-CV and RDW-SD in blood donors who had infected with mild COVID-19 showed dynamic changes. The discriminant equation for whether they are infected recently with COVID-19 has a high accuracy rate.

A case of Hemophagocytic syndrome due to reactivation of Epstein-Barr virus after novel coronavirus infection.

Background: Reactivation of EBV after novel coronavirus infection is common, and co-infection with EBV in patients with novel coronavirus pneumonia may lead to more severe clinical manifestations, prolong the duration of the underlying disease, or precipitate the progression of post novel coronavirus syndrome. EBV-induced hemophagocytic syndrome is a rare and life-threatening condition, and there are no reports of EBV reactivation leading to hemophagocytic syndrome after novel coronavirus infection. Case presentation: Here, we report a case of a 73-year-old man with EBV reactivation after novel coronavirus infection, who was diagnosed with hemophagocytic syndrome after bone marrow aspiration and died after being treated with acyclovir, dexamethasone. Conclusions: the aim of this report is to increase clinical awareness of this type of disease for early recognition and treatment.

Influence of COVID-19 infection on early pregnancy outcomes in different periods around frozen embryo transfer.

PURPOSE: The study aimed to investigate the potential influence of COVID-19 infection on embryo implantation and early development in women undergoing frozen embryo transfer (FET), with a specific focus on infections occurring at different periods around FET. METHODS: A retrospective analysis was performed on women who had undergone FET during a period marked by a significant surge in COVID-19 infection in Shanghai. All enrolled women experienced their first documented COVID-19 infection around the time of FET, ensuring that infections did not occur prior to oocyte retrieval. Participants were categorized into six groups based on the timing of infection: uninfected, ≥ 60 days, < 60 days before FET, 0-14 days, 15-28 days, and 29-70 days after FET. Clinical outcomes were compared across these groups. RESULTS: The infection rate among the total of 709 cases was 78.28%. Infected individuals exhibited either asymptomatic or mild symptoms. The ongoing pregnancy rates for the first four groups were 40.7%, 44.4%, 40.5%, and 34.2% (P = 0.709) respectively, biochemical pregnancy rates (59.1% vs. 61.1% vs. 67.6% vs. 55.7%, P = 0.471) and clinical pregnancy rates (49.6% vs. 55.6% vs. 55.4% vs. 48.1%, P = 0.749), all showed no significant differences. Early spontaneous abortion rates across all six groups were 18.3%, 20.0%, 25.0%, 28.9%, 5.4%, and 19.0% respectively, with no significant differences (P = 0.113). Multivariable logistic analysis revealed no significant correlation between the infection and ongoing pregnancy. CONCLUSION: Asymptomatic or mild COVID-19 infections occurring around FET do not appear to have a significant adverse impact on early pregnancy outcomes.

Bioinformatics Study of Flavonoids From Genus Erythrina As Ace2 inhibitor Candidates For Covid-19 Treatment.

Purpose: This study aimed to screen potential drug candidates from the flavonoids of the genus Erythrina for the Corona Virus Disease 2019 (COVID-19) treatment. Patients and Methods: A comprehensive screening was conducted on the structures of 473 flavonoids derived from the genus Erythrina, focusing on their potential toxicity and pharmacokinetic profiles. Subsequently, flavonoids that were non-toxic and possessed favorable pharmacokinetic properties underwent further analysis to explore their interactions with the angiotensin-converting enzyme 2 (ACE2) receptor, employing molecular docking and molecular dynamics simulations. Results: Among 473 flavonoids, 104 were predicted to be safe from being mutagenic, hepatotoxic, and inhibitors of the human ether-a-go-go-related gene (hERG). Among these 104 flavonoids, 18 compounds were predicted not to be substrates of P-glycoprotein (P-gp). Among these 18 flavonoids, gangetinin (471) and erybraedin D (310) exhibit low binding affinities and root mean square deviation (RMSD) values, indicating stable binding to the ACE2 receptor. The physicochemical attributes of compounds 310 and 471 suggest that they possess drug-like properties. Conclusion: Gangetinin (471) and erybraedin D (310) may serve as promising candidates for COVID-19 treatment due to their potential to inhibit the ACE2-RBD interaction. This warrants further investigation into their inhibitory effects on ACE2-RBD binding through in vitro experiments.

Effectiveness of Vitamin D and Alpha-Lipoic Acid in COVID-19 Infection: A Literature Review.

Over three years since the World Health Organization (WHO) declared COVID-19 a pandemic, it is still a global burden. Vaccines against COVID-19, caused by SARS-CoV-2, are available and effective for preventing disease. However, their protective effects are not 100%. Currently, the U.S. Food and Drug Administration (FDA) has only approved a limited number of inpatient treatments for COVID-19, such as remdesivir, baricitinib, and tocilizumab. These medications have indications and contraindications applicable to a select patient population. Finding additional effective therapies that are widely available with limited risk could be vital in optimizing treatment strategies for this viral illness. Some vitamins and supplements have been identified as potential options for managing COVID-19. Vitamin D (VD) deficiency has been associated with respiratory tract infections. Moreover, alpha-lipoic acid (ALA) is a powerful antioxidant and helps reduce inflammatory responses in many pathologic conditions. This review aims to analyze the current evidence regarding the effectiveness of VD and alpha-lipoic acid in COVID-19 infection in both outpatient and hospitalized patients. Relevant randomized controlled trials (RCTs) were identified via the PubMed database from January 1, 2021, to December 31, 2023. Inclusion criteria were as follows: the study design was a randomized controlled trial (RCT), the usage of a constant dose during the intervention period without any additional boluses, and a research ethics committee approved it. Exclusion criteria included a lack of an outcome or apparent intervention, additional boluses, or a single-dose regimen in all the interventional groups. There were 11 studies with a total sample size of 35,717 patients that met the criteria for this review. A total of 10 RCTs examined the efficacy of VD, and one RCT that reviewed the efficacy of ALA was identified. All of the articles investigated the use of VD or ALA during the treatment of COVID-19. The endpoints of each study varied, including length of stay in hospital, viral load, SARS-CoV-2 infection rate, mechanical ventilation, inflammatory markers, clinical symptoms, Sequential Organ Failure Assessment (SOFA) score, and mortality. In 8/10 VD supplementation trials, significant differences were identified between the interventional and placebo groups in the aforementioned parameters. In 2/10 VD supplementation trials, no significant differences were identified. The ALA supplementation RCT found no differences between the interventional and placebo groups in the SOFA score and 30-day all-cause mortality rate. The current literature suggests that VD can potentially reduce the SARS-CoV-2 infection rate, oxygen requirements, inflammatory markers, clinical symptoms, and mortality. Regarding ALA, although there was a suggestion of benefit, it was not statistically significant. Common limitations among the different studies included relatively small sample sizes, different geographical patient locations among studies, and differences in dosages. Trials investigating the effects of higher doses of VD supplementation on SARS-CoV-2 infection should be conducted. More research is needed to define best practices and optimal dosing protocols for the use of VD in COVID-19.

Prevalence of co-existent COVID-19-associated pulmonary aspergillosis (CAPA) and its impact on early mortality in patients with COVID-19-associated pulmonary mucormycosis (CAPM).

BACKGROUND: Data on mixed mould infection with COVID-19-associated pulmonary aspergillosis (CAPA) and COVID-19-associated pulmonary mucormycosis (CAPM) are sparse. OBJECTIVES: To ascertain the prevalence of co-existent CAPA in CAPM (mixed mould infection) and whether mixed mould infection is associated with early mortality (≤7 days of diagnosis). METHODS: We retrospectively analysed the data collected from 25 centres across India on COVID-19-associated mucormycosis. We included only CAPM and excluded subjects with disseminated or rhino-orbital mucormycosis. We defined co-existent CAPA if a respiratory specimen showed septate hyphae on smear, histopathology or culture grew Aspergillus spp. We also compare the demography, predisposing factors, severity of COVID-19, and management of CAPM patients with and without CAPA. Using a case-control design, we assess whether mixed mould infection (primary exposure) were associated with early mortality in CAPM. RESULTS: We included 105 patients with CAPM. The prevalence of mixed mould infection was 20% (21/105). Patients with mixed mould infection experienced early mortality (9/21 [42.9%] vs. 15/84 [17.9%]; p = 0.02) and poorer survival at 6 weeks (7/21 [33.3] vs. 46/77 [59.7%]; p = 0.03) than CAPM alone. On imaging, consolidation was more commonly encountered with mixed mould infections than CAPM. Co-existent CAPA (odds ratio [95% confidence interval], 19.1 [2.62-139.1]) was independently associated with early mortality in CAPM after adjusting for hypoxemia during COVID-19 and other factors. CONCLUSION: Coinfection of CAPA and CAPM was not uncommon in our CAPM patients and portends a worse prognosis. Prospective studies from different countries are required to know the impact of mixed mould infection.

Does the SARS-CoV-2 mRNA vaccine and its serum IgG levels affect fertility treatments and obstetric outcomes? An observational cohort study.

BACKGROUND: Although there are some data regarding the COVID-19 vaccine and in in vitro fertilization (IVF) treatments, its potential impact in terms of serum immunoglobulin G (IgG) levels has not been evaluated prospectively. This study aimed to assess the effect of COVID-19 vaccine and IgG levels on IVF outcomes. METHODS: This observational, cohort study was conducted at a referral IVF unit. Couples undergoing IVF treatment during the COVID-19 vaccination period were recruited from March-April 2021. The study compared 38 women who had received the Pfizer mRNA COVID-19 vaccination to 10 women who had not and were not infected by the virus. We also compared pre- and post-vaccination IVF treatments for 24 women. The relation between serologic titers and IVF treatment outcomes was also assessed. RESULTS: No significant difference was found between the vaccinated and unvaccinated/uninfected groups regarding the main outcome measures. However, there was a trend toward a higher pregnancy rate for the unvaccinated group (57% vs. 23%, p = 0.078) but no difference in delivery rate (p = 0.236), gestational week (p = 0.537) or birth rate (p = 0.671). CONCLUSION: We cautiously state that the COVID-19 mRNA vaccine does not affect fertility outcomes, including fertilization, pregnancy and delivery rates, obstetric outcomes, and semen parameters, regardless of measured IgG levels.

Saudi Healthcare Students' General Practices Applied to Protect Against COVID-19 and Their Beliefs Regarding the Use of Herbal Supplements as a Protection Method.

BACKGROUND: At the beginning of the COVID-19 pandemic, the absence of treatment increased the Saudi population's inquietude regarding the virus. Therefore, people were seeking alternative methods to protect themselves from disease's fast transmission, such as hand hygiene, social isolation, and the use of natural and dietary products. AIM: The main objective of this study is to assess healthcare students' general practices applied to protect against COVID-19 and their beliefs regarding the use of herbal supplements as a protection method. METHODOLOGY: All undergraduate healthcare students were eligible to participate, except pre-professional students. The estimated sample size was 371, which was calculated using Raosoft® software (Raosoft Inc., Seattle, WA). A cross-sectional online survey was distributed among the targeted population. The data were entered in Microsoft Excel (Microsoft Corporation, Redmond, WA) and transferred to be analyzed by JMP software (SAS Institute Inc., Cary, NC). RESULTS: A total of 441 healthcare students, who met the inclusion criteria, participated in this study. About 81.41% of the participants reported that they were completely committed to Saudi guidelines regarding preventive measures against COVID-19 transmission. Most of the participants were not using herbal supplements, while 17.1% of them used herbal products or dietary supplements during the COVID-19 pandemic. The participants who used herbal and dietary products commonly consumed ginger and vitamins C and D. In addition, a chi-square showed significant differences in gender and specialties regarding the usage of herbal supplements as a protective method against COVID-19 (P<0.05). CONCLUSION: The findings of our study exhibit the general practice of herbal products during the COVID-19 pandemic among Saudi healthcare students was low in comparison with their beliefs. In addition, the using of herbal supplements should be evidence-based to guarantee safe consumption.

Recent advances in application of computer-aided drug design in anti-COVID-19 Virials Drug Discovery.

Corona Virus Disease 2019 (COVID-19) is a global pandemic epidemic caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), which poses a serious threat to human health worldwide and results in significant economic losses. With the continuous emergence of new virus strains, small molecule drugs remain the most effective treatment for COVID-19. The traditional drug development process usually requires several years; however, the development of computer-aided drug design (CADD) offers the opportunity to develop innovative drugs quickly and efficiently. The literature review describes the general process of CADD, the viral proteins that play essential roles in the life cycle of SARS-CoV-2 and can serve as therapeutic targets, and examples of drug screening of viral target proteins by applying CADD methods. Finally, the potential of CADD in COVID-19 therapy, the deficiency, and the possible future development direction are discussed.

COVID-19 vaccine hesitancy among the Chinese elderly: A multi-stakeholder qualitative study.

The United Nations reported that the mortality risk of Corona Virus Disease 2019 (COVID-19) is five times higher in the elderly than the global average. Although the COVID-19 vaccine effectively prevents infections and reduce mortality among the elderly, vaccine hesitancy among the Chinese elderly poses a significant threat. This study, utilizing the "Confidence, Convenience and Complacency (3 Cs)" vaccine hesitancy model, aimed to explore factors contributing to vaccine hesitancy among the Chinese elderly and assess national countermeasures and potential improvement approaches. Thirteen elderly with vaccine hesitancy and eleven vaccine-related staff participated in semi-structured interviews. Thematic analysis revealed three key determinants of vaccine hesitancy among the elderly: perceived low threat of COVID-19, lack of confidence in COVID-19 vaccine, and poor accessibility to vaccination. China has implemented strategies, including advocacy through diverse channels, joint multi-sectoral promotion vaccination, and enhancing ongoing vaccination services. Recommendations from the vaccine-related staff emphasize improving vaccine awareness among the elderly, and prioritizing the vaccination environment and process. The study underscores the importance of targeted vaccination promotion programs addressing hesitation reasons to improve vaccination rates. Furthermore, existing countermeasures can serve as a foundation for enhancing vaccination strategies, including improved publicity, administration, and management approaches.

The Trend of C-Reactive Protein After Corticosteroid Therapy in COVID-19 Patients Admitted to IGIMS, Patna.

BACKGROUND: C-reactive protein (CRP) is a routine inflammation biomarker. Increased CRP levels are correlated with COVID-19. We found a marked reduction in CRP concentration on corticosteroid therapy, which in turn led to reduced mortality and duration of hospital stay. METHODS: In this retrospective cohort study, CRP levels were measured on admission and at 72 hours and compared between two groups of patients, with and without corticosteroid therapy. The study sample consisted of 105 RT-PCR-confirmed patients admitted to the ICU of the COVID ward. Out of the total patients, 57 received one or more doses of dexamethasone in addition to usual treatment, and 48 were given only usual care. RESULT: CRP at the time of admission was comparable for both groups. Also, a significant decrease in the CRP was noted in both groups 72 hours post-admission. Moreover, the decline was more marked in the steroid-administered group (CRP-baseline: 34.3mg/dL (+/-8.44), CRP at 72 hours 18.5mg/dL(+/-7.95) (p <0.00) compared to non-steroid group (CRP_baseline: 34.04mg/dL (+/-10.06), CRP at 72. Those with comorbidities were administered steroids (n=38, 66.7%) compared to those who were not (n=08, 16.7%). The average duration of hospital stay was less (5 to 7 days) in the corticosteroid-administered group compared to the other group (7 to 10 days). CONCLUSION: Routine CRP tests can predict the outcome and treatment of severe coronavirus disease. Corticosteroid treatment in COVID-19 patients is associated with reduced CRP levels within 72 hours after therapy.

Corona virus anxiety and Chinese students' cognitive, affective, and behavioral engagement, and academic resilience: correlations and perceptions.

BACKGROUND: This study delves into the correlation between Corona Virus Anxiety (CVA) and the engagement as well as academic resilience of Chinese students. The context is set against the backdrop of the global pandemic, highlighting the potential psychological impact of COVID-19 on students' well-being and academic performance. OBJECTIVES: The primary objectives of this research are to investigate the relationship between CVA and various dimensions of student engagement, including affective, behavioral, and cognitive aspects. Additionally, the study aims to explore how CVA influences academic resilience, with a focus on persistence and self-regulation. The dual-objective approach employs both quantitative and qualitative methods to provide a comprehensive understanding of the subject matter. METHODOLOGY: A mixed-methods approach is employed, combining quantitative data from scales measuring CVA, engagement, and academic resilience with qualitative insights obtained through interviews. The research sample consists of 390 students from Mudanjiang Medical University. Quantitative data are analyzed using Pearson correlation tests, while thematic analysis is applied to interpret the qualitative findings from interviews. RESULTS: Quantitative data analysis reveals significant negative correlations between CVA and multiple dimensions of student engagement, indicating that higher CVA levels are associated with lower engagement levels. Academic resilience, though relatively high among participants, also exhibits negative correlations with CVA, particularly in terms of persistence and self-regulation. The qualitative findings uncover six main themes elucidating the impact of CVA on students, ranging from emotional and cognitive engagement to the social and technological challenges posed by the pandemic. CONCLUSIONS AND IMPLICATIONS: The research concludes that CVA significantly influences students' engagement and academic resilience. The qualitative insights contribute to a nuanced understanding of the diverse challenges students face during the pandemic. These findings have broad implications for students, university administrators, educators, and educational psychologists, highlighting the importance of addressing mental health concerns and providing adequate support systems in the context of global crises.

The outcomes of COVID-19 and acute pancreatitis: a systematic review and meta-analysis.

Background: Coronavirus disease 2019 (COVID-19) was first reported in China at the end of 2019. Several case studies have documented a probable association between infection with severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) and acute pancreatitis (AP). The objective of this study was to provide a complete analysis of existing literature that compares the clinical outcomes of AP in patients with COVID-19 and those without COVID-19. The intention was to further our understanding of the involvement of SARS-CoV-2 in the development of pancreatitis. Methods: Between January 2019 and December 2022, we searched PubMed, Embase, Cochrane Library, Web of Science, and Scopus. Nine studies (3,160 patients) were included. In this meta-analysis, Stata 12.0. was utilized. The information provided in this study is presented following the MOOSE reporting checklist. Results: Mortality [odds ratio (OR) =3.95, 95% confidence interval (CI): 2.87, 5.43, P<0.001], intensive care unit (ICU) administration (OR =3.74, 95% CI: 2.26, 6.20, P<0.001), mechanical ventilation (OR =4.84, 95% CI: 2.14, 10.96, P<0.001), severe pancreatitis (OR =2.71, 95% CI: 1.04, 7.04, P=0.042), etiology of idiopathic and unknown (OR =4.75, 95% CI: 1.80, 12.56, P=0.002), necrotizing pancreatitis (OR =1.88, 95% CI: 1.28, 2.76, P=0.001), and length of hospital stay [weighted mean difference (WMD) =5.10, 95% CI: 2.79, 7.41, P<0.001] were more significantly increased in AP cases with COVID-19 than those without it. Conclusions: In conclusion, the findings of this study indicate a potential worsening of AP outcomes in patients affected by COVID-19.

Calibration of Prediction Models of In-hospital Mortality in SARS-CoV-2 Patients Depends also on Data Quality.

How to cite this article: Finsterer J, Scorza FA. Calibration of Prediction Models of In-hospital Mortality in SARS-CoV-2 Patients Depends also on Data Quality. Indian J Crit Care Med 2024;28(2):181-182.

Epidemiology and Scenario Simulations of the Middle East Respiratory Syndrome Corona Virus (MERS-CoV) Disease Spread and Control for Dromedary Camels in United Arab Emirates (UAE).

Middle East Respiratory Syndrome (MERS-CoV) is a coronavirus-caused viral respiratory infection initially detected in Saudi Arabia in 2012. In UAE, high seroprevalence (97.1) of MERS-CoV in camels was reported in several Emirate of Abu Dhabi studies, including camels in zoos, public escorts, and slaughterhouses. The objectives of this research include simulation of MERS-CoV spread using a customized animal disease spread model (i.e., customized stochastic model for the UAE; analyzing the MERS-CoV spread and prevalence based on camels age groups and identifying the optimum control MERS-CoV strategy. This study found that controlling animal mobility is the best management technique for minimizing epidemic length and the number of affected farms. This study also found that disease dissemination differs amongst camels of three ages: camel kids under the age of one, young camels aged one to four, and adult camels aged four and up; because of their immunological state, kids, as well as adults, had greater infection rates. To save immunization costs, it is advised that certain age groups be targeted and that intense ad hoc unexpected vaccinations be avoided. According to the study, choosing the best technique must consider both efficacy and cost.

A review on the effective natural compounds of medicinal plants on the COVID-19.

In this review out of 300 selected articles 70 articles were evaluated, and the most significant compounds impacting COVID-19 and their mechanism of action were introduced. The compounds belong to four categories as follow: Phenolic, Flavonoid, Terpenoid, and Alkaloid compounds. In the phenol groups, the most effective compounds are scutellarin (suppressor of COVID-19 virus), thymol and carvacrol (the most inhibitory effect on COVID-19 virus), in the flavonoid groups, hesperdin (a strong inhibitor on COVID-19), in the terpenoids, methyl tanshinonate and sojil COVID-19 inhibitory effect) and 1,8-cineol (COVID-19 inhibitory effect) and in the last group, niglidine and quinoline alkaloid compounds (COVID-19 inhibitory effect) have been identified and introduced. These compounds have shown promising results due to their structure and effective mechanisms on COVID-19, so it can be an idea for researchers in this field to try to produce drugs by using natural compounds against the COVID-19 and Corona viruses.