Covid-19, Pregnancy, and Vaccinations.

Pregnancy in the presence of COVID-19 increases the risk for illness severity. Data suggest that pregnant women with COVID-19 are more likely to be hospitalized, to be admitted to the intensive care unit, and to require life support. Vaccination is currently considered the most effective preventive intervention against COVID-19 in the United States. However, the unsurprising exclusion of pregnant women as participants in initial COVID-19 vaccine clinical trials has led to a gap in the scientific data regarding the safety profile and subsequent use of COVID-19 vaccine for women who are pregnant. Experts believe current COVID-19 vaccines developed using either mRNA or viral vector vaccine technologies and authorized for emergency use by the United States Food and Drug Administration are unlikely to pose obstetrical or neonatal risks. Still, current vaccination recommendations for women who are pregnant have been both mixed and contradictory. The need to expeditiously identify, collate, and disseminate available vaccine-related safety data is critical to preventing severe illness while also advancing the health and wellness of an underserved high-risk population subgroup.

African-Americans Have a Higher Propensity for Death from COVID-19: Rationale and Causation.

The purpose of this article is to provide an understanding about the mechanisms that contribute to the proliferation of COVID-19 morbidity and mortality among high-risk populations, and especially African-Americans. African-Americans are succumbing to novel SARS-CoV-2 (COVID-19) at an alarming rate. Current data indicate that while African-Americans represent less than 13.4% of the United States' population, they account for one-third of more than 4.77 million persons with verified COVID-19 infections. Currently, more than 50,258 African-Americans have succumbed to the disease. African-Americans are disproportionately impacted by COVID-19 to an extent unobserved in other racial/ethnic subgroups. In addition, this article describes the physiological event inflammation-mediation storming (cytokine storming). Social determinants of health such as income, education, and employment are hypothesized to impact cogent health care delivery for African-Americans. Included in this article are data on clinical outcomes that highlight the role of pre-existing (health disparities) conditions like diabetes, hypertension, cardiovascular disease, obesity, and lung disease, as barriers to optimal outcomes among African-Americans who are hospitalized with COVID-19. Also explored in this article is causation for vascular complications. A further aim of this article is to provide insight into cause and effect rationales for COVID-19 and health disparities, from both biosocial and health inequality perspectives. Linkages between these selected health disparities and COVID-19 are examined to determine possible deteriorating effects of COVID-19. Finally, techniques are offered to render culturally competent care to African-Americans diagnosed with COVID-19 who present concomitantly with health disparities.

What Nurses Should Know About COVID-19.

Coronavirus disease 19 (COVID-19) is a highly infectious illness caused by novel SARS-CoV-2 coronavirus. The World Health Organization recently designated SARS-CoV-2 associated COVID-19 to be a global pandemic. The fear or spread of COVID-19 has touched every continent. The importance of understanding the drivers of COVID-19 on community health is amplified by the ability of SARS-CoV-2 to rapidly change genetic structure, our restricted knowledge about the disease, and limited or non-existent vaccines and treatment options. An understanding of basic COVID-19 epidemiology is a prerequisite for curtailing transmission, preventing morbidity and mortality, developing efficacious vaccines, implementing effective infection control protocols, and applying treatment algorithms.

Chloroquine and Hydroxychloroquine for the Treatment of COVID-19: Review and Appraisal of Current Evidence.

Novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and associated coronavirus disease 19 (COVID-19) began ravaging most of the globe in November 2019. In the United States more than 25 million people have been infected with SARS-CoV-2. To date, COVID-19 has killed close to 400,000 U.S. citizens. In the face of limited pharmacotherapies, the current burden of SARS-CoV-2 and COVID-19 signals overwhelming sickness and trillions in healthcare costs ahead. The need to expeditiously identify safe and efficacious prophylaxis and treatment options is critical. Drug repositioning may be a promising strategy toward mitigating the impact of SARS-CoV-2 and COVID-19. This rapid review appraises available evidence on the viability of vintage antimalarial drugs chloroquine (CHQ) and its analog hydroxychloroquine (HCQ) repositioned for SARS-CoV-2 prophylaxis and COVID-19 treatment. Findings suggest neither the use of CHQ nor HCQ singularly, or concomitantly, with azithromycin and/or zinc provide definitive benefits for use against SARS-CoV-2 infection or COVID-19 illness. Moreover, administration of these medications was linked to significant and sometimes fatal complications.

The World Health Organization - Community Empowerment Model in Addressing Food Insecurity in Low-Income African-American Women: A Review of the Literature.

Numerous researchers have examined the serious consequences of food insecurity and food deserts affecting the nutritional health of poor or low-income African-American women and their families. Food insecurity is defined as having limited or uncertain capacityfor acquiring sufficient, safe, and nutritious food at all times to meet one's dietary needs, while food deserts refer to economically and socially-deprived inner city areas with inadequate food supply that are often inhabited by low-income groups. Researchers have found that despite the capacity of community-level resources such as SNAP (Supplemental Nutrition Assistance Program) and WIC (Women, Infants, and Children) supporting healthy nutrition, food insecurity persists among some recipients of both nutritional resources. Both food insecurity and food deserts had a negative effect on the emotional eating, emotional coping, coping strategies, and depressive symptoms in low-income African-American women. Even more concerning is that food deserts have been linked to decreased physical activity in low-income African-American women. Neighborhoods with fewer food supermarkets in which to purchase fresh produce and other healthy nutritious foods also emphasized junk food displays. Thus, neighborhoods with persons that have powerful influences (e.g., local merchants and community liaisons) must bear responsibility to help eliminate food deserts that were linked to obesity, high BMI measures, and Type 2 diabetes in African-American women. Food inse- curity was viewed from the lens of the World Health Organization - Community Empowerment Model (CEM) that incorporates 5 core processes or barometers for change: community coalitions, critical consciousness raising, exerting public pressure, lobbying, advocacy and mediation, and reframing and reorienting health services. Each of the processes plays a powerful role in assisting communities in taking charge of their health and assuming responsibility for improving access to healthy nutritious foods and eliminating food deserts in low-income communities. The implications of change and community involvement rely on all persons with a vested interest in address- ing the disturbing problem offood insecurity and food deserts affecting the nutritional health and well-being of African-American communities.