Background: Polymerase chain reaction (PCR) cycle threshold (Ct) values can be used to estimate the viral burden of Severe Acute Respiratory Syndrome Coronavirus type 2 (SARS-CoV-2) and predict population-level epidemic trends. We investigated the use of machine learning (ML) and epidemic transmission modeling based on Ct value distribution for SARS-CoV-2 incidence prediction during an Omicron-predominant period.
Methods: Using simulated data, we developed a ML model to predict the reproductive number based on Ct value distribution, and validated it on out-of-sample province-level data. We also developed an epidemiological model and fitted it to province-level data to accurately predict incidence.
Results: Based on simulated data, the ML model predicted the reproductive number with highest performance on out-of-sample province-level data. The epidemiological model was validated on outbreak data, and fitted to province-level data, and accurately predicted incidence.
Conclusions: These modeling approaches can complement traditional surveillance, especially when diagnostic testing practices change over time. The models can be tailored to different epidemiological settings and used in real time to guide public health interventions.
Background: SARS-CoV-2, the virus responsible for the COVID-19 pandemic, can be detected in stool samples and subsequently shed in the sewage system. The field of Wastewater-based epidemiology (WBE) aims to use this valuable source of data for epidemiological surveillance, as it has the potential to identify unreported infections and to anticipate the need for diagnostic tests. Objectives: The objectives of this study were to analyze the absolute concentration of genome copies of SARS-CoV-2 shed in Catalonia9s wastewater during the Omicron peak in January 2022, and to develop a mathematical model capable of using wastewater data to estimate the actual number of infections and the temporal relationship between reported and unreported infections. Methods: We collected twenty-four-hour composite 1-liter samples of wastewater from 16 wastewater treatment plants (WWTPs) in Catalonia on a weekly basis. We incorporated this data into a compartmental epidemiological model that distinguishes between reported and unreported infections and uses a convolution process to estimate the genome copies shed in sewage. Results: The 16 WWTPs showed an average correlation of 0.88 ± 0.08 (ranging from 0.96 to 0.71) and an average delay of 8.7 ± 5.4 days (ranging from 0 to 20 days). Our model estimates that about 53% of the population in our study had been infected during the period under investigation, compared to the 19% of cases that were detected. This under-reporting was especially high between November and December 2021, with values up to 10. Our model also allowed us to estimate the maximum quantity of genome copies shed in a gram of feces by an infected individual, which ranged from 4.15 × 10^7 gc/g to 1.33 × 10^8 gc/g. Discussion: Although wastewater data can be affected by uncertainties and may be subject to fluctuations, it can provide useful insights into the current trend of an epidemic. As a complementary tool, WBE can help account for unreported infections and anticipate the need for diagnostic tests, particularly when testing rates are affected by human behavior-related biases.
OBJECTIVE To estimate the reliability and the validity of the single item burnout measure in a sample of nurses in Greece. METHOD We conducted an online cross-sectional study in Greece with 963 nurses. Data were collected during October 2022. We measured demographic and work-related variables of nurses, i.e. gender, age, chronic disease, self-rated health status, years of experience, and working in COVID-19 ward/intensive care unit. We used the single item burnout (SIB) and the Copenhagen Burnout Inventory (CBI) to measure occupational burnout. Moreover, we used the COVID-19 burnout scale (COVID-19-BS) to measure nurses burnout during the pandemic, and the Patient Health Questionnaire-4 (PHQ-4) to measure anxiety and depression among nurses. RESULTS Intraclass correlation coefficient between the two measurements of the SIB during the test-retest study was 0.986 indicating excellent reliability of the SIB. We found a high correlation between CBI factors and SIB (p<0.001), a moderate correlation between PHQ-4 and SIB (p<0.001), and a low to moderate correlation between COVID-19-BS and SIB (p<0.001). Therefore, concurrent validity of SIB was excellent. Moreover, SIB had high discriminant validity. In particular, nurses with a chronic disease, those with a very poor/poor/moderate health status, and those working in COVID-19 ward/intensive care unit had higher levels of burnout according to the SIB (p<0.001 in all cases). Moreover, we found a positive relationship between years of experience and SIB score (r=0.13, p<0.001). CONCLUSIONS The single item burnout measure is a brief, reliable, and valid tool that we can use as a screening measure to identify individuals at high risk of burnout.
The impact of a prior SARS-CoV-2 infection on the progression of subsequent infections has been unclear. Using a convenience sample of 94,812 longitudinal RT-qPCR measurements from anterior nares and oropharyngeal swabs, we compared the SARS-CoV-2 viral kinetics of first vs. second infections, adjusting for viral variant, vaccination status, and age. Relative to first infections, second infections usually featured a lower peak viral concentration and faster clearance time, especially in individuals who received a vaccine dose between their first and second infection. Furthermore, a person9s relative (rank-order) viral clearance time, compared to others infected with the same variant, was similar across first and second infections; that is, individuals who had a relatively fast clearance time in their first infection tended to also have a relatively fast clearance time in their second infection. These findings provide evidence that, like vaccination, immunity from a prior SARS-CoV-2 infection shortens the duration of subsequent acute SARS-CoV-2 infections principally by reducing viral clearance time. Additionally, there appears to be an inherent element of the immune response, or some other host factor, that shapes a person9s relative ability to clear SARS-CoV-2 infection that persists across sequential infections.
Background: Respiratory disease is a major cause of morbidity and mortality; however, current surveillance for circulating respiratory viruses is passive and biased. Seasonal circulation of respiratory viruses changed dramatically during the COVID-19 pandemic. More active methods for understanding respiratory disease dynamics are needed to better inform public health response and to guide clinical decision making. Wastewater-based epidemiology has been used to understand COVID-19, influenza A, and RSV infection rates at a community level, but has not been used to investigate other respiratory viruses. Methods: We measured concentrations of influenza A and B, RSV A and B, human parainfluenza (1-4), rhinovirus, seasonal human coronaviruses, and human metapneumovirus RNA in wastewater solids three times per week for 17 months spanning the COVID-19 pandemic at a wastewater treatment plant in California, USA. Novel probe-based assays were developed and validated for non-influenza viral targets. We compared viral concentrations to positivity rates for viral infections from clinical specimens submitted to sentinel laboratories. Findings: We detected RNA from all target viruses in wastewater solids. Human rhinovirus and seasonal coronaviruses were found at highest concentrations. Concentrations of viruses correlated significantly and positively with positivity rates of associated viral diseases from sentinel laboratories. Measurements from wastewater indicated limited circulation of RSV A and influenza B, and human coronavirus OC43 dominated the seasonal human coronavirus infections while human parainfluenza 1 and 4A dominated among parainfluenza infections. Interpretation: Wastewater-based epidemiology can be used to obtain information on circulation of respiratory viruses at a community level without the need to test many individuals because a single sample of wastewater represents the entire contributing community. Results from wastewater can be available within 24 hours of sample collection, allowing real time information to inform public health response, clinical decision making, and individual behavior modifications.
The wastewater-based epidemiology (WBE) of SARS-CoV-2 is a quick and cost-effective method of tracking virus transmission. However, few studies reported on campus or in academic or residential settings worldwide. In this study, we demonstrated the WBE approach to detect, monitor, and evaluate genomic variants of SARS-CoV-2 fragments in a sewage treatment plant (STP) located on the campus of CSIR National Chemical Laboratory, Pune, India. Herein we describe the early warning capability of WBE, with viral load rise in campus sewage water up to 14 days before its clinical detection. This was supported further by a significant correlation between SARS-CoV-2 RNA concentration and clinically reported COVID-19 cases on campus. Additionally, we comprehended the probable targets missed by the quantitative qRT-PCR using amplicon-based sequencing due to low viral load. The analysis revealed the presence of signature mutations of the Omicron (S:N679K, S:N764K, S:D796Y, N:P13L, ORF1a:T3255I, ORF1a:K856R, ORF1a:P3395H, and N:S413R) before the lineage was first detected globally. Further, we used Lineage decomposition (LCS) tool to detect the Variant of Concern (VOC)/Variant of Interest (VOI) signals upto a month earlier in sewage water samples. The analysis also indicated the transition of lineage from Delta to Omicron in late Decemeber,2021. This is the first study in India highlighting the use of on-campus STP to evaluate the local spread of SARS-CoV-2, which could aid in preventing COVID-19 in academic institutes/universities. This study proves the usefulness of WBE as an early warning system for detecting, tracking and tracing VOCs using the sequencing approach. The current study could aid in taking critical decisions to tackle the pandemic scenario on campus.
Exercise Training Six-Months After Discharge in Post-COVID-19 Syndrome - Condition: COVID-19 Pneumonia
Intervention: Other: Aerobic exercise and strength training
Sponsor: Ukbe Sirayder
Completed
ACTIV-6: COVID-19 Study of Repurposed Medications - Arm C (Fluticasone) - Condition: Covid19
Interventions: Drug: Fluticasone; Other: Placebo
Sponsors: Susanna Naggie, MD; National Center for Advancing Translational Sciences (NCATS); Vanderbilt University Medical Center
Completed
ACTIV-6: COVID-19 Study of Repurposed Medications - Arm A (Ivmermectin 400) - Condition: Covid19
Interventions: Drug: Ivermectin; Other: Placebo
Sponsors: Susanna Naggie, MD; National Center for Advancing Translational Sciences (NCATS); Vanderbilt University Medical Center
Completed
Counter-Regulatory Hormonal and Stress Systems in Patients With COVID-19 - Condition: COVID-19
Intervention: Diagnostic Test: Blood sampling
Sponsor: Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Completed
Exploratory Efficacy of N-Acetylcysteine in Patients With History of COVID-19 - Condition: COVID-19
Interventions: Drug: N-Acetylcysteine; Drug: Placebo
Sponsor: Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Active, not recruiting
Effect of Selected Types of Breathing Exercises on Different Outcome Measures in Covid-19 Patients - Condition: COVID-19
Intervention: Other: breathing exercise
Sponsor: Basma Mosaad Abd-elrahman Abushady
Completed
A Specific miRNA Encoded by SARS-CoV-2 as a Diagnostic Tool to Predict Disease Severity in COVID-19 Patients - Condition: COVID-19
Intervention: Diagnostic Test: miRNA analysis in plasma
Sponsor: Fondazione Policlinico Universitario Agostino Gemelli IRCCS
Completed
Telerehabilitation in the Post-COVID-19 Patient (TRIALS) - Condition: Post-COVID-19 Syndrome
Intervention: Other: Telerehabilitation program
Sponsor: Istituto Auxologico Italiano
Recruiting
Application and Research of Mesenchymal Stem Cells in Alleviating Severe Development of COVID-19 Infection - Condition: COVID-19
Interventions: Biological: Umbilical cord mesenchymal stem cells implantation; Other: Comparator
Sponsor: Hebei Medical University
Recruiting
Immunogenicity and Reactogenicity of the Beta-variant Recombinant Protein Booster Vaccine (VidPrevtyn Beta, Sanofi) Compared to a Bivalent mRNA Vaccine (Comirnaty Original/Omicron BA.4-5, BioNTech-Pfizer) in Adults Previously Vaccinated With at Least 3 Doses of COVID-19 mRNA Vaccine - Conditions: Vaccine Reaction; COVID-19
Interventions: Biological: Comirnaty® BNT162b2 /Omicron BA.4-5 vaccine (Pfizer-BioNTech); Biological: VidPrevtyn® Beta vaccine (Sanofi/GSK)
Sponsors: Assistance Publique - Hôpitaux de Paris; IREIVAC/COVIREIVAC Network
Not yet recruiting
Study of WPV01 Compared With Placebo in Patients With Mild/Moderate COVID-19 Infection - Condition: COVID-19 Infection
Interventions: Drug: WPV01; Drug: Placebo
Sponsor: Westlake Pharmaceuticals (Hangzhou) Co., Ltd.
Not yet recruiting
ARVAC-A New Recombinant Coronavirus Disease 2019 (COVID-19) - Condition: COVID-19 Vaccine
Interventions: Biological: Gamma Variant RBD-based ARVAC-CG vaccine; Biological: Omicron Variant RBD-based ARVAC-CG vaccine; Biological: Bivalent RBD-based ARVAC-CG vaccine; Other: Placebo
Sponsors: Mónica Edith Lombardo; Universidad Nacional de San Martín (UNSAM); National Council of Scientific and Technical Research, Argentina; Laboratorio Pablo Cassará S.R.L.
Recruiting
A Study of HH-120 Nasal Spray in Close Contacts of Those Diagnosed With COVID-19 - Conditions: COVID-19; SARS-CoV-2 Infection
Intervention: Drug: HH-120 Nasal Spray
Sponsor: Beijing Ditan Hospital
Completed
Mitigating Mental and Social Health Outcomes of COVID-19: A Counseling Approach - Conditions: Social Determinants of Health; Mental Health Issue; COVID-19
Interventions: Other: Individual Counseling; Other: Group Counseling; Other: Resources
Sponsors: New Mexico State University; National Institutes of Health (NIH)
Not yet recruiting
A Phase 2 Trial of the Immunogenicity and Safety of CVXGA1 Intranasal COVID Vaccine in Healthy Adults - Condition: COVID-19
Intervention: Biological: CVXGA1
Sponsor: CyanVac LLC
Not yet recruiting
Inhibitory activity of a sulfated oligo-porphyran from Pyropia yezoensis against SARS-CoV-2 - COVID-19 caused by SARS-CoV-2 has spread around the world at an unprecedented rate. A more homogeneous oligo-porphyran with mean molecular weight of 2.1 kD, named OP145, was separated from Pyropia yezoensis. NMR analysis showed OP145 was mainly composed of →3)-β-d-Gal-(1 → 4)-α-l-Gal (6S) repeating units with few replacement of 3,6-anhydride, and the molar ratio was 1:0.85:0.11. MALDI-TOF MS revealed OP145 contained mainly tetrasulfate-oligogalactan with Dp range from 4 to 10 and with no more…
The diverse role of heparan sulfate and other GAGs in SARS-CoV-2 infections and therapeutics - In December 2019, the global coronavirus disease 2019 (COVID-19) pandemic began in Wuhan, China. COVID-19 is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which infects host cells primarily through the angiotensin-converting enzyme 2 (ACE2) receptor. In addition to ACE2, several studies have shown the importance of heparan sulfate (HS) on the host cell surface as a co-receptor for SARS-CoV-2-binding. This insight has driven research into antiviral therapies, aimed…
Work-related experiences of consultant psychiatrists during the COVID-19 response: qualitative analysis - CONCLUSIONS: The challenges of leading mental health services were evident in the increased complexity involved in caring for vulnerable patients during the pandemic, contributing to uncertainty, loss of control and moral distress among participants. These dynamics worked synergistically with pre-existing system-level failures, eroding capacity to mount an effective response. The longer-term psychological well-being of consultant psychiatrists - as well as the pandemic preparedness of healthcare…
Vitamin C promotes ACE2 degradation and protects against SARS-CoV-2 infection - ACE2 is a major receptor for cellular entry of SARS-CoV-2. Despite advances in targeting ACE2 to inhibit SARS-CoV-2 binding, strategies to flexibly and sufficiently reduce ACE2 levels for the prevention of SARS-CoV-2 infection have not been explored. Here, we reveal vitamin C (VitC) administration as a potent strategy to prevent SARS-CoV-2 infection. VitC reduces ACE2 protein levels in a dose-dependent manner, while even a partial reduction in ACE2 levels can greatly inhibit SARS-CoV-2…
Low hanging fruit for combatting SARS-CoV-2? - Entry of SARS-CoV-2 into human respiratory cells, mediated by the spike protein, is absolutely dependent on the cellular receptor ACE2 (angiotensin-converting enzyme-2). This makes ACE2 an attractive target for therapeutic intervention in COVID-19. In this issue, Zuo et al. discover that vitamin C, an essential nutrient and common dietary supplement, can target ACE2 for ubiquitin-dependent degradation, resulting in the inhibition of SARS-CoV-2 infection (Zuo et al, 2023). The study identifies…
Comparison of Anakinra and Tocilizumab in Anticytokine Therapy in the Treatment of Coronavirus Disease-2019 - CONCLUSION: We observed the positive effects of the use of tocilizumab on clinical improvement in the early period; mechanical ventilation requirement was delayed and at a lower rate. Anakinra treatment did not change mortality and PaO(2)/FiO(2) rates. Mechanical ventilation requirements occurred earlier in the patients who were not receiving any anticytokine therapy. Studies with larger patient populations are needed to demonstrate the potential efficacy of anticytokine therapy.
Transcriptome and metabolome profiling unveils the mechanisms of naphthalene acetic acid in promoting cordycepin synthesis in Cordyceps militaris - Cordycepin, an important active substance in Cordyceps militaris, possesses antiviral and other beneficial activities. In addition, it has been reported to effectively promote the comprehensive treatment of COVID-19 and thus has become a research hotspot. The addition of naphthalene acetic acid (NAA) is known to significantly improve the yield of cordycepin; however, its related molecular mechanism remains unclear. We conducted a preliminary study on C. militaris with different concentrations of…
Determining the Optimal SARS-CoV-2 mRNA Vaccine Dosing Interval for Maximum Immunogenicity - CONCLUSION: Increased mRNA vaccine dosing intervals longer than 38 days result in higher levels of anti-spike antibodies and ACE-2 inhibition when assessed six months after the first COVID-19 vaccine.
In vitro metabolic characterization of the SARS-CoV-2 papain-like protease inhibitors GRL0617 and HY-17542 - The SARS-CoV-2 pandemic requires a new therapeutic target for viral infection, and papain-like protease (Plpro) has been suggested as a druggable target. This in-vitro study was conducted to examine the drug metabolism of the GRL0617 and HY-17542, Plpro inhibitors. Metabolism of these inhibitors was studied to predict the pharmacokinetics in human liver microsomes. The hepatic cytochrome P450 (CYP) isoforms responsible for their metabolism were identified using recombinant enzymes. The drug-drug…
Polypropylene Modified with Ag-Based Semiconductors as a Potential Material against SARS-CoV-2 and Other Pathogens - The worldwide outbreak of the coronavirus pandemic (COVID-19) and other emerging infections are difficult and sometimes impossible to treat, making them one of the major public health problems of our time. It is noteworthy that Ag-based semiconductors can help orchestrate several strategies to fight this serious societal issue. In this work, we present the synthesis of α-Ag(2)WO(4), β-Ag(2)MoO(4), and Ag(2)CrO(4) and their immobilization in polypropylene in the amounts of 0.5, 1.0, and 3.0 wt %,…
Hemolytic uremic syndrome in the setting of COVID-19 successfully treated with complement inhibition therapy: An instructive case report of a previously healthy toddler and review of literature - CONCLUSION: Although reports of HUS in the setting of COVID-19 continue to pour in, the questions of exact mechanism and similarities to MIS-C remain. Our case for the first time accentuates the use of complement blockade as a valuable treatment option in this scenario. We sincerely believe that reporting on HUS as a complication of COVID-19 in children will give rise to improved diagnosis and treatment, as well as better understanding of both of these intricating diseases.
Pharmacokinetics and Pharmacodynamics of Imatinib for Optimal Drug Repurposing from Cancer to COVID-19 - CONCLUSION: COVID-19 patients exhibit higher total imatinib exposure compared to cancer patients, attributed to differences in plasma protein concentrations. Higher imatinib exposure in COVID-19 patients did not associate with improved clinical outcomes. Total C(trough) and AUC(ave) inversely associated with some PD-outcomes, which may be biased by disease course, variability in metabolic rate and protein binding. Therefore, additional PKPD analyses into unbound imatinib and its main metabolite…
Establishment of angiotensin-converting enzyme 2 and cluster of differentiation 147 dual target cell membrane chromatography based on SNAP-tag technology for screening anti severe acute respiratory syndrome coronavirus 2 active components - Patients have different responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and these may be life-threatening for critically ill patients. Screening components that act on host cell receptors, especially multi-receptor components, is challenging. The in-line combination of dual-targeted cell membrane chromatography and a liquid chromatography-mass spectroscopy (LC-MS) system for analyzing angiotensin-converting enzyme 2 (ACE2) and cluster of differentiation 147…
Design and characterization of novel SARS-CoV-2 fusion inhibitors with N-terminally extended HR2 peptides - Development of potent and broad-spectrum antivirals against SARS-CoV-2 remains one of top priorities, especially in the case of that current vaccines cannot effectively prevent viral transmission. We previously generated a group of fusion-inhibitory lipopeptides, with one formulation being evaluated under clinical trials. In this study, we dedicated to characterize the extended N-terminal motif (residues 1161-1168) of the so-called spike (S) heptad repeat 2 (HR2) region. Alanine scanning…
Pinosrtobin from plants and propolis against human coronavirus HCoV-OC43 by modulating host AHR/CYP1A1 pathway and lipid metabolism - Coronaviruses, as enveloped positive-strand RNA viruses, manipulate host lipid compositions to enable robust viral replication. Temporal modulation of the host lipid metabolism is a potential novel strategy against coronaviruses. Here, the dihydroxyflavone pinostrobin (PSB) was identified through bioassay that inhibited the increment of human coronavirus OC43 (HCoV-OC43) in human ileocecal colorectal adenocarcinoma cells. Lipid metabolomic studies showed that PSB interfered with linoleic acid…