The use of remote consultations and telemedicine approaches significantly increased over the pandemic. There is evidence that some patients still prefer this mode of care delivery and time saving may also enable additional consultations and help to reduce waiting lists. However, the effectiveness of remote consulting for certain specialities, such as surgery, is unclear. The aim of this review was to investigate the effectiveness of video or telephone consultations, particularly focusing on clinical, patient reported and safety outcomes, in adult secondary surgical outpatient care during the COVID-19 pandemic. 14 studies were identified. These were published in 2021-2022. Evidence is low or very-low quality due to observational study designs, small sample sizes and patient selection. Policy and practice implications: Evidence is of low quality but suggests that for many surgical outpatient consultations, remote consultations are as effective as in-person consultations. There is potential for time and cost savings for remote consultations compared to in-person consultations. High quality research is needed to evaluate the effectiveness of remote consultations to understand which patients and which surgical specialities would benefit most.
Objective: To explore the prevalence and contributing factors of resident burnout in a University Hospital before and during the COVID 19 pandemic. Methods: Thirty Faculty of Medicine departments were included in the survey, where 400 university hospital residents filled out the Maslach Burnout Inventory (MBI) in January 2018 and April 2020. Related scores of emotional exhaustion (EE), decreased accomplishment (DA) and depersonalization (DP) were calculated and compared between the different groups. Correlation between scores and possible contributing factors, including demographics, work-life circumstances, exposure to workplace violence, were investigated. Contributing factors were compared between the time points. Results: The EE and DA scores were significantly higher in junior residents than in senior residents. Both scores were higher among residents who had experienced abuse or violence. The emergency medicine residents had significantly higher DP scores, while the EE scores of radiology residents were lower than others. Thirty percent of all residents smoked cigarettes. This percentage was even higher among the residents of the departments of surgery and emergency medicine (45-50%). A significant correlation was demonstrated between the scores of MBI and smoking, while analysis with other demographics did not yield any relation. According to the study results, basic science residents had significantly increased scores in all MBI subgroups during the pandemic. Conclusion: Resident physician burnout was found to be related to the work environment, smoking cigarettes and exposure to violence at workplace.
Background Varied degrees of lockdown have been imposed for dozens of jurisdictions upon facing the SARS-CoV-2 epidemics during the past two years. Areal lockdown has been demonstrated effective to reduce the morbility and mortality of COVID-19. Even after the strict lockdown the peak of infection will appear around 9-25 days (median 18 days) thereafter. A wave of Omicron variant (BA.2 and BA.2.2) outbreak was seen from March to May 2022, in Shanghai, a megacity in China mainland. Aim To understand the sources of infection cases from outside or inside the isolated locations before and after the strict city lockdown. Methods The attributable addresses of SARS-CoV-2 infection were reported daily as well as the infected cases from March 18th, 2022 on through government website, which was publicly accessible. The address data and infected cases were collected until May 29th, 2022. The location (longitude and latitude) of these addresses were retrieved and the pattern of repeatedly reported addresses were analyzed. A tool of simple and meso-scale point-based (location-based) chronological graph was used to visualize and analyze the interactions of these locations. Results From March 18th to May 29th 2022, 173,350 items representing 35,743 unique addresses and 636,279 infected cases were released. The infection cases peaked 16 days after the city lockdown and were highly clustered in much crowded districts. The proportion of repeatedly reported locations of the previous day increased from around 20% before lockdown to greater than 40% in the plateau and remained at this level for up to one third (20/62) of the lockdown phase. This significantly increased proportion of intra-address infection indicated a pattern shift from inter-addresses to intra-address (D=0.2954, p<0.0001), which might perpetuate to the growth of infection cases. Based upon the day-to-day nearest neighbour transmission assumption the connections between some frequently repeated locations might be complex and heterogeneous. Interpretation During the strict areal isolation the intra-address infection may contribute significantly to infected cases of SARS-CoV-2 Omicron variant, the infection might have easily spilled over the boundary of family(with averaged family size of 2.3-3.1 people and family were required stay-at-home compulsively). This significant inter-addresses to intra-address pattern shift necessitated the understanding of intra-location transmission routes and corresponding interventions. Areal isolation and close off with homogeneous assumption inside and outside the isolated areas should be modified and the quantifing of the elevated risk for previously less exposed but much vulnerable sub-population was in pressing need.
The surveillance of live births in Brazil has been carried out since 1990 by the Information System on Live Births (SINASC), which was implemented by the Ministry of Health aiming at standardized registration on a national level. The state of Para is part of the Brazilian Amazon, northern Brazil, which has several unique characteristics. Thus, the purpose of this study was to identify the epidemiological pattern of live births before and during the pandemic of COVID-19 in the state of Para, 2016 to 2020. This is an ecological epidemiological time-series study, using epidemiological surveillance data from DATASUS, referring to the Live Births Information System (SINASC). These are data that have been treated by surveillance and are in aggregate format. The study population is the live births residing in the state of Para, in the period from 2016 to 2020. The data collection instrument was the Declaration of Live Births (DLB). There were 689,454 live births, and the highest rates of births were and continued to remain in the Marajo II, Baixo Amazonas, Xingu, and Tapajos regions. The Metropolitan I and Araguaia regions were and continue to be the lowest rates in the state. Age of the mother 15 to 19 years old 22.29%, 20 to 24 years old 30.05% and 25 to 29 years old 22.58%, most of the single pregnancy type 98.32%, prenatal consultations, performed 7 or more 48.10%, followed by 4 to 6 consultations 33.98%, most presented 7 or more years of the study 48.10%, followed by 3 to 6 years 33.98%. Represented 51.21% male and 48.77% female. The occurrence of congenital anomalies represented 0.52% of live births. Another congenital malformation and deformity were the most prevalent at 25.53%, followed by Congenital deformities of the feet 14.90%, Other congenital malformations of the nervous system 14.84%, and Other congenital malformations 10.77%, Cleft lip, and cleft palate 8.88%, Other congenital malformations digestive tract 8.10%. The demographic transition has already occurred for several decades, including the reduction of fertility and birth rate, so our study showed that the reduction in the number of live births was already a reality in the country, but we emphasize that this reduction was enhanced by the pandemic. We observed greater adherence to prenatal care and a lower prevalence of low birth weight compared to other studies, but the limitation was the absence of studies in the same place of the research. Regarding data incompleteness, we emphasize the ignored fields that reflect the fragility in the surveillance of live births, which was reinforced by the literature.
COVID-19 has affected at the global scale. However, its impacts are not evenly distributed. The article aims to explore the spatial determination of the COVID-19 related death. The data for the analysis has been accessed from the World Health Organization (WHO). Both descriptive and statistical analysis has been done to assess the COVID-19 related death and spatial explanation. The regression models suggested the explanatory power of spatial difference in the COVID-19 related death. However, further addition of various COVID-19 vaccine did not produce expected result.
Background: T cells are important in preventing severe disease from SARS-CoV-2, but scalable and field-adaptable alternatives to expert T cell assays are needed. The interferon-gamma release assay QuantiFERON platform was developed to detect T cell responses to SARS-CoV-2 from whole blood with relatively basic equipment and flexibility of processing timelines. Methods: 48 participants with different infection and vaccination backgrounds were recruited. Whole blood samples were analysed using the QuantiFERON SARS-CoV-2 assay in parallel with the well-established Protective Immunity from T Cells in Healthcare workers (PITCH) ELISpot, which can evaluate spike-specific T cell responses. Aims: The primary aims of this cross-sectional observational cohort study were to establish if the QuantiFERON SARS-Co-V-2 assay could discern differences between specified groups and to assess the sensitivity of the assay compared to the PITCH ELISpot. Findings: The QuantiFERON SARS-CoV-2 distinguished acutely infected individuals (12-21 days post positive PCR) from naive individuals (p< 0.0001) with 100% sensitivity and specificity for SARS-CoV-2 T cells, whilst the PITCH ELISpot had reduced sensitivity (62.5%) for the acute infection group. Sensitivity with QuantiFERON for previous infection was 12.5% (172-444 days post positive test) and was inferior to the PITCH ELISpot (75%). Although the QuantiFERON assay could discern differences between unvaccinated and vaccinated individuals (55-166 days since second vaccination), the latter also had reduced sensitivity (55.5%) compared to the PITCH ELISpot (66.6%). Conclusion: The QuantiFERON SARS-CoV-2 assay showed potential as a T cell evaluation tool soon after SARS-CoV-2 infection but has lower sensitivity for use in reliable evaluation of vaccination or more distant infection.
Background: Causes of non-malarial fevers in sub-Saharan Africa remain understudied. We hypothesized that metagenomic next-generation sequencing (mNGS), which allows for broad genomic-level detection of infectious agents in a biological sample, can systematically identify potential causes of non-malarial fevers. Methods and Findings: The 212 participants in this study were of all ages and were enrolled in a longitudinal malaria cohort in eastern Uganda. Between December 2020 and August 2021, respiratory swabs and plasma samples were collected at 313 study visits where participants presented with fever and were negative for malaria by microscopy. Samples were analyzed using CZ ID, a web-based platform for microbial detection in mNGS data. Overall, viral pathogens were detected at 123 of 313 visits (39%). SARS-CoV-2 was detected at 11 visits, from which full viral genomes were recovered from nine. Other prevalent viruses included Influenza A (14 visits), RSV (12 visits), and three of the four strains of seasonal coronaviruses (6 visits). Notably, 11 influenza cases occurred between May and July 2021, coinciding with when the Delta variant of SARS-CoV-2 was circulating in this population. The primary limitation of this study is that we were unable to estimate the contribution of bacterial microbes to non-malarial fevers, due to the difficulty of distinguishing bacterial microbes that were pathogenic from those that were commensal or contaminants. Conclusions: These results revealed the co-circulation of multiple viral pathogens likely associated with fever in the cohort during this time period. This study illustrates the utility of mNGS in elucidating the multiple causes of non-malarial febrile illness. A better understanding of the pathogen landscape in different settings and age groups could aid in informing diagnostics, case management, and public health surveillance systems.
Booster Study of COVID-19 Protein Subunit Recombinant Vaccine - Condition: COVID-19
Interventions: Biological: SARS-CoV-2 subunit protein recombinant vaccine; Biological: Active Comparator
Sponsors: PT Bio Farma; Faculty of Medicine Universitas Padjadjaran; Faculty of Medicine Universitas Udayana
Recruiting
A Study to Evaluate the Immunogenicity and Safety of a Recombinant Protein COVID-19 Vaccine SCTV01E-1 in Population Aged Above 18 Years - Conditions: COVID-19; SARS-CoV-2 Infection
Interventions: Biological: SCTV01E-1 on D0; Biological: SCTV01E-1 on D28; Biological: SCTV01E-1 on D150; Biological: SCTV01E on D0; Biological: SCTV01E on D28; Biological: SCTV01E on D150; Biological: SCTV01E-1 on D120; Biological: SCTV01E on D120
Sponsor: Sinocelltech Ltd.
Not yet recruiting
A Novel Parameter LIT/N That Predicts Survival in COVID-19 ICU Patients - Condition: COVID-19 Pneumonia
Intervention: Diagnostic Test: the LIT test
Sponsors: Gazi University; Oxford MediStress
Completed
Efficacy and Safety of ES16001 in Patients With COVID-19 - Condition: COVID-19
Interventions: Drug: ES16001 40 mg; Drug: ES16001 80 mg; Drug: ES16001 160 mg; Drug: Placebo
Sponsor: Genencell Co. Ltd.
Recruiting
Phase 2a Trial to Evaluate Safety and Immunogenicity of COVID-19 Vaccine Strategies in HIV-infected/Uninfected Adults. - Condition: COVID-19
Intervention: Drug: Ad26.COV2.S (VAC31518, JNJ-78436735) Vaccine, SARS-CoV-2 rS (CovovaxTM), BNT162b2 (Pfizer)
Sponsors: The Aurum Institute NPC; Coalition for Epidemic Preparedness Innovations
Recruiting
COVID Protection After Transplant - Sanofi GSK (CPAT-SG) Study - Conditions: COVID-19; Kidney Transplant
Intervention: Biological: Sanofi-GSK monovalent (B.1.351) CoV2 preS dTM-AS03 COVID-19 vaccine
Sponsors: National Institute of Allergy and Infectious Diseases (NIAID); PPD; Johns Hopkins University; Sanofi Pasteur, a Sanofi Company
Not yet recruiting
Safety and Immunogenicity of COVID-19 Vaccine, AdCLD-CoV19-1 - Conditions: COVID-19; Vaccines
Intervention: Biological: AdCLD-CoV19-1
Sponsors: International Vaccine Institute; Cellid Co., Ltd.
Not yet recruiting
Smartphone Intervention for Overdose and COVID-19 - Conditions: Substance Use Disorders; Overdose; COVID-19
Intervention: Device: iThrive WI Intervention
Sponsors: University of Wisconsin, Madison; National Institute on Drug Abuse (NIDA)
Not yet recruiting
A Study to Evaluate the Safety and Immunogenicity of COVID-19 and Influenza Combination Vaccine - Conditions: COVID-19; Influenza
Interventions: Drug: CIC Vaccine; Drug: qNIV Vaccine; Drug: SARS-CoV-2 rS Vaccine; Drug: Influenza Vaccine
Sponsor: Novavax
Not yet recruiting
Study to Assess Efficacy and Safety of Treamid for Patients With Reduced Exercise Tolerance After COVID-19 - Conditions: SARS-CoV-2 Infection; Lung Fibrosis
Interventions: Drug: Treamid; Drug: Treamid twice a day; Drug: Treamid once a day; Drug: Placebo
Sponsor: PHARMENTERPRISES LLC
Not yet recruiting
Self-proning and Repositioning in COVID-19 Outpatients at Risk of Complicated Illness - Conditions: COVID-19; COVID-19 Pneumonia; Proning; Hospitalization; Death; Outpatient; Complication
Intervention: Other: Self-proning
Sponsors: Unity Health Toronto; Applied Health Research Centre
Recruiting
Effects of Immulina TM Supplements With PASC Patients - Condition: Post Acute COVID-19 Syndrome
Interventions: Dietary Supplement: Immulina TM; Dietary Supplement: Placebo
Sponsors: University of Mississippi Medical Center; National Institute of General Medical Sciences (NIGMS)
Not yet recruiting
Evaluation of Clinical Performance and Usability of iStatis COVID-19 Ag Rapid Test at POC - Conditions: COVID-19 Virus Infection; COVID-19; Coronavirus Disease-19; COVID-19 Pandemic; SARS-CoV-2 Infection
Interventions: Diagnostic Test: iStatis COVID-19 Ag Rapid Test; Diagnostic Test: “COVID-19 RT-PCR Test EUA Number: EUA200011, Company: Laboratory Corporation of America (”Labcorp")
Sponsor: bioLytical Laboratories
Completed
Resilience Intervention for Health Professionals COVID-19 - Condition: Mental Health Wellness 1
Intervention: Other: Mindfulness-based Intervention
Sponsor: Universidad de Monterrey
Completed
Addressing Post-COVID-19 Musculoskeletal Symptoms - Conditions: Telemedicine; Musculoskeletal Disease; SARS-CoV-2; Pain; COVID-19; Exercise
Interventions: Other: Multicomponent exercise program; Other: Tele-health primary care rehabilitation program
Sponsor: Universidad Europea de Madrid
Not yet recruiting
Screening, molecular simulation and in silico kinetics of virtually designed Covid main protease inhibitors - Coronavirus (covid-19) infection is considered to deadliest ever pandemic experienced by the human being. It has very badly affected the socio-economic health of human and stuck the scientific community to think and rethink about its complete eradication. But due to no effective treatment or unavailability of vaccine the health professional could not show any significant improvement to control the pandemic. The situation needs newer molecule, vaccine or effective treatment to control covid-19…
ZnO-chlorogenic acid nanostructured complex inhibits Covid-19 pathogenesis and increases hydroxychloroquine efficacy - The study purpose was to compare the anti- the novel coronavirus disease 2019 (COVID-19) property of chlorogenic acid (CGA) and Zinc oxide nanoparticles (ZnO-NP) with the new valid synthesized complex of ZnO /CGA-NPs. Methods The facile mixing method was utilized to prepare ZnO/CGA-NPs. The in vitro effect of different ZnO/CGA-NPs concentrations on papain-like protease (PL^(pro)) and spike protein- receptor-binding domain (RBD) was measured by ELISA technique. The compounds effects on SARS-CoV2…
Emodin from Aloe inhibits Swine acute diarrhea syndrome coronavirus in cell culture - Swine acute diarrhea syndrome coronavirus (SADS-CoV) is an emerging swine enteropathogenic coronavirus that causes severe diarrhea in neonatal piglets, leading to serious economic losses to the pig industries. At present, there are no effective control measures for SADS, making an urgent need to exploit effective antiviral therapies. Here, we confirmed that Aloe extract (Ae) can strongly inhibit SADS-CoV in Vero and IPI-FX cells in vitro. Furthermore, we detected that Emodin from Ae had…
Folic acid restricts SARS-CoV-2 invasion by methylating ACE2 - The current COVID-19 pandemic is motivating us to elucidate the molecular mechanism of SARS-CoV-2 invasion and find methods for decreasing its transmissibility. We found that SARS-CoV-2 could increase the protein level of ACE2 in mice. Folic acid and 5-10-methylenetetrahydrofolate reductase (MTHFR) could promote the methylation of the ACE2 promoter and inhibit ACE2 expression. Folic acid treatment decreased the binding ability of Spike protein, pseudovirus and inactivated authentic SARS-CoV-2 to…
SARS-CoV-2 Infection-Associated Aortic Thrombosis Treated with Oral Factor Xa Inhibition - Coronavirus disease 2019 (COVID-19) is an acute complex systemic disorder caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).While SARS-CoV-2 is known to cause significant pulmonary disease, various extrapulmonary manifestations of COVID-19 have also been reported. Growing evidence suggests that COVID-19 is associated with coagulopathy leading to micro and macrovascular complications. Although in patients with COVID-19, venous thromboembolic events are more frequent,…
Investigation into the in vivo mechanism of diosmetin in patients with breast cancer and COVID-19 using bioinformatics - Patients with breast cancer are prone to SARS-CoV-2 infection [the causative virus of coronavirus disease (COVID-19)] due to their lack of immunity. In the current study, we examined the mechanism of action of Diosmetin, a flavonoid with anti-inflammatory properties, in patients with BRCA infected with SARS-CoV-2.We used bioinformatics technology to analyze the binding ability, biological function, and other biological characteristics of Diosmetin in vivo and examine the core target and…
Ruxolitinib inhibits cytokine production by human lung macrophages without impairing phagocytic ability - Background: The Janus kinase (JAK) 1/2 inhibitor ruxolitinib has been approved in an indication of myelofibrosis and is a candidate for the treatment of a number of inflammatory or autoimmune diseases. We assessed the effects of ruxolitinib on lipopolysaccharide (LPS)- and poly (I:C)-induced cytokine production by human lung macrophages (LMs) and on the LMs’ phagocytic activity. Methods: Human LMs were isolated from patients operated on for lung carcinoma. The LMs were cultured with ruxolitinib…
Nutraceutical prospects of Houttuynia cordata against the infectious viruses - The novel enveloped β-coronavirus SARS-CoV-2 (COVID-19) has offered a surprising health challenge all over the world. It develops severe pneumonia leading to acute respiratory distress syndrome (ARDS). Like SARS-COV-2, other encapsulated viruses like HIV, HSV, and influenza have also offered a similar challenge in the past. In this regard, many antiviral drugs are being explored with varying degrees of success to combat the associated pathological conditions. Therefore, upon scientific…
A DNA-based non-infectious replicon system to study SARS-CoV-2 RNA synthesis - The COVID-19 pandemic caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has seriously affected public health around the world. In-depth studies on the pathogenic mechanisms of SARS-CoV-2 is urgently necessary for pandemic prevention. However, most laboratory studies on SARS-CoV-2 have to be carried out in BSL-3 laboratories, greatly restricting the progress of relevant experiments. In this study, we used a bacterial artificial chromosome (BAC) method to assemble a…
The mechanism of metal-based antibacterial materials and the progress of food packaging applications: A review - Food packages have been detected carrying novel coronavirus in multi-locations since the outbreak of COVID-19, causing major concern in the field of food safety. Metal-based supported materials are widely used for sterilization due to their excellent antibacterial properties as well as low biological resistance. As the principal part of antibacterial materials, the active component, commonly referred to Ag, Cu, Zn, etc., plays the main role in inhibiting and killing pathogenic microorganisms by…
Heterologous Prime-boost of SARS-CoV-2 Inactivated Vaccine and mRNA BNT162b2 among Healthy Thai Adolescents - CONCLUSIONS: Heterologous prime-boost vaccination with CoronaVac followed by BNT162b2 induced high neutralizing titer against SARS-CoV-2 Delta strain. After 5-month interval, booster with BNT162b2 induced high neutralizing titer against Omicron strain.Thai Clinical Trials Registry (thaiclinicaltrials.org): TCTR20210923012.
Mechanism of selenomethionine inhibiting of PDCoV replication in LLC-PK1 cells based on STAT3/miR-125b-5p-1/HK2 signaling - There are no licensed therapeutics or vaccines available against porcine delta coronavirus (PDCoV) to eliminate its potential for congenital disease. In the absence of effective treatments, it has led to significant economic losses in the swine industry worldwide. Similar to the current coronavirus disease 2019 (COVID-19) pandemic, PDCoV is trans-species transmissible and there is still a large desert for scientific exploration. We have reported that selenomethionine (SeMet) has potent antiviral…
Semi-selective plasma filtration applied to the treatment of acquired thrombotic thrombocytopenic purpura following bnt162b2 administration - Following the widespread use of anti SARS-CoV-2 vaccines, there have been reports of thrombocytopenia developing after the administration of different types of vaccine. We report a case of a 63-year-old male who developed neurological symptoms after receiving the second dose of the bnt162b2 vaccine. Blood tests performed upon admission to the Emergency Department revealed severe thrombocytopenia and microangiopathic hemolytic anemia. ADAMTS13 activity was undetectable and antibody titer was…
Native and activated antithrombin inhibits TMPRSS2 activity and SARS-CoV-2 infection - Host cell proteases such as TMPRSS2 are critical determinants of SARS-CoV-2 tropism and pathogenesis. Here, we show that antithrombin (AT), an endogenous serine protease inhibitor regulating coagulation, is a broad-spectrum inhibitor of coronavirus infection. Molecular docking and enzyme activity assays demonstrate that AT binds and inhibits TMPRSS2, a serine protease that primes the Spike proteins of coronaviruses for subsequent fusion. Consequently, AT blocks entry driven by the Spikes of…
Dipeptidylpeptidase (DPP)-4 inhibitor therapy increases circulating levels of anti-inflammatory soluble frizzle receptor protein (sFRP)-5 which is decreased in severe COVID-19 disease - Obesity and type 2 diabetes (T2D) show an increased risk for a severe COVID-19 disease. Treatment with DPP4 inhibitor (DPP4i) results in reduced mortality and better clinical outcome. Here, we aimed to identify potential mechanisms for the observed DPP4i effect in COVID-19. Comparing T2D subjects with and without DPP4i treatment, we identified a significant increase of the anti-inflammatory adipokine sFRP5 in relation to DPP4 inhibition. sFRP5 is a specific antagonist to Wnt5a, a glycopeptide…