Background Some refugee and migrant populations have been disproportionately impacted by the COVID-19 pandemic, yet evidence suggests lower uptake of COVID-19 vaccines. They are also an under-immunised group for many routine vaccines. We did a rapid review to explore drivers of under-immunisation and vaccine hesitancy among refugee and migrant populations globally to define strategies to strengthen both COVID-19 and routine vaccination uptake. Methods We collected global literature (01/01/2010 - 05/05/2022) pertaining to drivers of under-immunisation and vaccine hesitancy in refugees and migrants, incorporating all vaccines. We searched MEDLINE, Embase, Global Health PsycINFO and the WHO Global Research on COVID-19 database and grey literature. Qualitative data were analysed thematically to identify drivers of under-immunisation and vaccine hesitancy, then categorised using the Increasing Vaccination Model. Results 63 papers were included in this review, reporting data on diverse population groups, including refugees, asylum seekers, labour and undocumented migrants from 22 countries, with six papers reporting on a regional or global scale. Drivers of under-immunisation and vaccine hesitancy pertaining to a wide range of vaccines were covered, including COVID-19 (n=27), HPV (13), measles or MMR (3), influenza (3), tetanus (1), and vaccination in general. We found a range of factors driving under-immunisation and hesitancy in refugee and migrant groups, including unique awareness and access factors that need to be better considered in policy and service delivery. Acceptability of vaccination was often deeply rooted in social and historical context and influenced by personal risk perception. Conclusions These findings hold direct relevance to current efforts to ensure high levels of global immunisation coverage, key to which is to ensure marginalised refugees and migrant populations are included in national vaccination plans of low- middle- and high-income countries. We found a stark lack of research from low- and middle-income and humanitarian contexts on vaccination in mobile groups, a situation that needs to be urgently rectified to ensure high coverage for COVID-19 and routine vaccinations.
Accurate, reliable, and timely estimates of pathogen variant risk are essential for informing public health responses. Unprecedented rates of genomic sequencing have generated new insights into variant dynamics. However, estimating the fitness advantage of a novel variant shortly after emergence, or its dynamics more generally in data-sparse settings, remains difficult. This challenge is exacerbated in countries where surveillance is limited or intermittent. To stabilize inference in these data-sparse settings, we develop a hierarchical modeling approach to estimate variant fitness advantage and prevalence by pooling data across geographic regions. We demonstrate our method by reconstructing SARS-CoV-2 BA.5 variant emergence, and assess performance using retrospective, out-of-sample validation. We show that stable and robust estimates can be obtained even when sequencing data are sparse. Finally, we discuss how this method can inform risk assessment of novel variants and provide situational awareness on circulating variants for a range of pathogens and use-cases.
Background: The Identification and Treatment of Hypoxemic Respiratory Failure (HRF) and ARDS with Protection, Paralysis, and Proning (TheraPPP) study is a type-1 hybrid stepped-wedge cluster randomized effectiveness-implementation study involving 17 adult Intensive Care Units (ICUs). This study will evaluate the effectiveness and implementation of an evidence-based, stakeholder-informed, multidisciplinary care pathway called Venting Wisely that standardizes the diagnosis and delivery of life-saving therapies for critically ill patients with Hypoxemic Respiratory Failure (HRF) and acute respiratory distress syndrome (ARDS). Objective: To describe a pre-specified statistical analysis plan (SAP) for the TheraPPP study prior to completion of recruitment, electronic data retrieval, and before any analysis has been conducted. Methods and analysis: The Statistical Analysis Plan (SAP) was designed by the principal investigators and senior biostatistician and reviewed in detail by the Venting Wisely Scientific Steering Group before being approved. This statistical analysis plan is reported in accordance with Guidelines for the Content of Statistical Analysis Plans in Clinical Trials. A study specific CONSORT diagram and baseline characteristics table were developed. We estimate a total of 18816 mechanically ventilated patients will be included in this study with 11424 patients pre-implementation and 7392 patients post implementation. Given that ARDS patients are an important subgroup within this study, we estimate that this will generate a sample size of 2688 sustained ARDS patients within our TheraPPP study cohort. The primary clinical outcome is 28-day ventilator free days (VFDs). For the primary analysis, we will compare the mean 28-day VFDs pre-implementation and post-implementation using a mixed effects linear regression model to account for clustering of patients within site. Secondary clinical outcomes will be similarly compared pre-implementation and post-implementation using mixed effects linear or logistic regression models, as appropriate. All models will be adjusted for age, sex, severity of illness (sequential organ failure assessment score on admission) and severity of hypoxemia on admission based on PF ratio, as well as type and size of ICU. Pre-specified subgroups will include patient sex, age, HRF, ARDS, Covid-19 and cardiac surgical status, body mass index (BMI), height, illness acuity, and ICU volume. Ethics and Trial Registration: The study has received ethics approval from the University of Calgary (20-0646) and the University of Alberta (pro00112232). The trial was registered with ClinicalTrials.gov (NCT04744298) prior to the enrollment of any patients on Feb 8, 2021.
We describe a novel approach to recovering the underlying parameters of the SIR dynamic epidemic model from observed data on case incidence or deaths. We formulate a discrete-time approximation to the original continuous-time model and search for the parameter vector that minimizes the standard least squares criterion function. We show that the gradient vector and matrix of second-order derivatives of the criterion function with respect to the parameters adhere to their own systems of difference equations and thus can be exactly calculated iteratively. Applying our new approach, we estimate four-parameter SIR models on two types of datasets: (1) daily reported cases of COVID-19 during the SARS-CoV-2 Omicron/BA.1 surges of December 2021 - March 2022 in New York City and Los Angeles County; and (2) weekly deaths from a plague outbreak on the Isle of Bombay during December 1905 - July 1906, originally studied by Kermack and McKendrick in their now-classic 1927 paper. The estimated parameters from the COVID-19 data suggest a duration of persistent infectivity beyond that reported in small-scale clinical studies of mostly symptomatic subjects. The estimated parameters from the plague data suggest that the Bombay outbreak was in fact driven by pulmonic rather than bubonic plague.
The COVID-19 pandemic has caused global declines in life expectancy; it is therefore critical to understand risk factors related to mortality and morbidity for this infectious disease. Past work indicates that certain pre-existing medical conditions, behavioral patterns, and sociodemographic factors may increase COVID-19-related negative outcomes. Left unexplored, however, is whether COVID-19 outcomes are influenced by exposure to childhood adversity. This is a notable gap given that childhood adversity is associated with lifelong physical health disparities and early mortality. We leverage data from the UK Biobank cohort (N=151,200) to investigate relations between early childhood adversity and COVID-19 mortality and morbidity. As predicted, we show that childhood adversity is associated with a higher risk of COVID-19 hospitalization and mortality, even after adjusting for potential confounding variables. Such results highlight the importance of considering early-life experiences and their impact on COVID-19 outcomes to guide public health intervention and prevention strategies.
Background: This study has assessed the protective effect of a new Anti-COVID-19 SA58 Nasal Spray (SA58 Nasal Spray) against SARS-CoV-2 infection under continuous exposure. Methods: This is an exploratory open-label, single-arm trial. To evaluate the safety and effectiveness of SA58 against SARS-CoV-2 family transmission, SA58 was administered to all enrolled family contacts at 3~6-hour intervals. The frequency of administration and adverse events (AEs) were self-reported by online questionnaire, and RT-PCR tests were used to diagnose SARS-CoV-2 infection. The effectiveness was assessed in comparison to a contemporaneous control group whose information was collected through three follow-up visits. Total effectiveness and single-day effectiveness were calculated. Results: The incidence of SARS-CoV-2 infection was 62.9% (44/70) in the experimental group and 94.8% (343/362) in the control group. Using SA58 nasal spray at least three times per day could possibly reduce the risk of household transmission of SARS-CoV-2 by 46.7%~56.5%. The incidence of AEs was 41.4% and the severity of all AEs was mild. Conclusion: Even under the scenario of continuous exposure to SARS-CoV-2, SA58 nasal spray remained effective in blocking viral transmission and was well tolerated.
The global devastation of the COVID-19 pandemic has led to calls for a revolution in heating, ventilation, and air conditioning (HVAC) systems to improve indoor air quality (IAQ), due to the dominant role of airborne transmission in disease spread. While simple guidelines have recently been suggested to improve IAQ mainly by increasing ventilation and filtration, this goal must be achieved in an energy-efficient and economical manner and include all air cleaning mechanisms. Here, we develop a simple protocol to directly, quantitatively, and optimally control transmission risk while minimizing energy cost. We collect a large dataset of HVAC and IAQ measurements in buildings and show how models of infectious aerosol dynamics and HVAC operation can be combined with sensor data to predict transmission risk and energy consumption. Using this data, we also verify that a simple safety guideline is able to limit transmission risk in full data-driven simulations and thus may be used to guide public health policy. Our results provide a comprehensive framework for quantitative control of transmission risk using all available air cleaning mechanisms in an indoor space while minimizing energy costs to aid in the design and automated operation of healthy, energy-efficient buildings.
Laboratory science evidence suggests possibility of immune imprinting, a negative impact for vaccination on subsequent protective immunity against SARS-CoV-2 infection. We investigated differences in incidence of SARS-CoV-2 reinfection in the cohort of persons who had a primary omicron infection, but different vaccination histories using matched, national, retrospective, cohort studies. Adjusted hazard ratio (AHR) for incidence of reinfection, factoring also adjustment for differences in testing rate, was 0.43 (95% CI: 0.39-0.49) comparing history of two-dose vaccination to no vaccination, 1.47 (95% CI: 1.23-1.76) comparing history of three-dose vaccination to two-dose vaccination, and 0.57 (95% CI: 0.48-0.68) comparing history of three-dose vaccination to no vaccination. Divergence in cumulative incidence curves increased markedly when incidence was dominated by BA.4/BA.5 and BA.2.75* omicron subvariant. History of primary-series vaccination enhanced immune protection against omicron reinfection, but history of booster vaccination compromised protection against omicron reinfection. These findings do not undermine the short-term public health utility of booster vaccination.
Clinical Performance Evaluation of the CareSuperb™ COVID-19 Antigen Home Test - Condition: COVID-19
Intervention: Device: CareSuperb COVID-19 Antigen Home Test Kit
Sponsor: AccessBio, Inc.
Recruiting
Use of E-health Based Exercise Intervention After COVID-19 - Condition: COVID-19
Intervention: Behavioral: Exercise training using an e-health tool
Sponsors: Norwegian University of Science and Technology; University of Oslo
Recruiting
Effect Of Calcitriol On Neutrophil To Lymphocytes Ratio And High Sensitivity C-Reactive Protein Covid-19 Patients - Condition: COVID-19
Interventions: Drug: Calcitriol; Other: Placebo
Sponsor: Universitas Sebelas Maret
Completed
Clinical Study for the Efficacy and Safety of Ropeginterferon Alfa-2b in Moderate COVID19. - Condition: COVID-19
Interventions: Drug: P1101 (Ropeginterferon alfa-2b); Procedure: SOC
Sponsor: National Taiwan University Hospital
Active, not recruiting
Phase I Clinical Trial of Recombinant Variant COVID-19 Vaccine (Sf9 Cell) (WSK-V102) - Condition: COVID-19
Intervention: Biological: Recombinant variant COVID-19 vaccine(Sf9 cell)
Sponsor: WestVac Biopharma Co., Ltd.
Not yet recruiting
A Phase II Clinical Trial of Recombinant Variant COVID-19 Vaccine (Sf9 Cell) (WSK-V102) - Condition: COVID-19
Interventions: Biological: Recombinant variant COVID-19 vaccine (Sf9 cell); Biological: Recombinant COVID-19 vaccine (CHO cell); Biological: Recombinant COVID-19 vaccine (Sf9 cell)
Sponsor: WestVac Biopharma Co., Ltd.
Not yet recruiting
A Study to Compare QLS1128 With Placebo in Symptomatic Participants With Mild to Moderate COVID-19 - Condition: COVID-19
Interventions: Drug: QLS1128; Drug: Placebo
Sponsor: Qilu Pharmaceutical Co., Ltd.
Not yet recruiting
Short-term Effects of Transdermal Estradiol on Female COVID-19 Patients - Conditions: COVID-19; Hormone Replacement Therapy
Interventions: Drug: Climara 0.1Mg/24Hr Transdermal System; Other: Hydrogel patch
Sponsors: Istanbul University - Cerrahpasa (IUC); Turkish Menopause and Osteoporosis Society; Karakoy Rotary Club; Rebul Pharmacy
Completed
Effect of Kinesio Tape Versus Diaphragmatic Breathing Exercise In Post COVID-19 - Condition: Post COVID-19 Condition
Interventions: Other: Pursed lip breathing; Other: Cognitive Behavior Therapy; Other: Diaphragmatic breathing exercise; Other: Kinesio tape
Sponsor: Cairo University
Not yet recruiting
Hydrogen-Oxygen Generator With Nebulizer for Adjuvant Treatment of Novel Coronavirus Disease 2019 (COVID-19) - Conditions: Covid19; Hydrogen-oxygen Gas; AMS-H-03
Interventions: Device: Hydrogen-Oxygen Generator with Nebulizer, AMS-H-03; Device: OLO-1 Medical Molecular Sieve Oxygen Generator
Sponsor: Guangzhou Institute of Respiratory Disease
Not yet recruiting
Oxygen Atomizing Inhalation of EGCG in the Treatment COVID-19 Pneumonia in Cancer Patients - Conditions: COVID-19 Pneumonia; Neoplasms Malignant
Interventions: Drug: EGCG; Drug: Placebo
Sponsor: Shandong Cancer Hospital and Institute
Recruiting
The Use of Photobiomodulation in the Treatment of Oral Complaints of Long COVID-19.A Randomized Controlled Trial. - Conditions: Xerostomia; COVID-19; Long COVID; Persistent COVID-19
Interventions: Combination Product: Institutional standard treatment for xerostomia and Long Covid; Radiation: Photobiomodulation Therapy; Radiation: Placebo Photobiomodulation Therapy
Sponsor: University of Nove de Julho
Recruiting
Balneotherapy for Patients With Post-acute Coronavirus Disease (COVID) Syndrome - Condition: Post-COVID-19 Syndrome
Intervention: Other: Balneotherapy and aquatic exercises
Sponsors: Parc de Salut Mar; Caldes de Montbui’s City Council; Consorcio Centro de Investigación Biomédica en Red (CIBER); European Regional Development Fund
Completed
A Study to Assess the Efficacy of HH-120 Nasal Spray for Prevention of SARS-CoV-2 Infection in Adult Close Contacts of Individuals Infected With SARS-CoV-2 - Condition: SARS-CoV-2 Infection
Interventions: Drug: HH-120 nasal spray 1; Drug: HH-120 nasal spray 2; Drug: Placebo Comparator 1; Drug: Placebo Comparator 2
Sponsor: Beijing Ditan Hospital
Completed
A FIRST IN HUMAN TO EVALUATE THE SAFETY AND IMMUNOGENICITY OF SARS-CoV-2 UQSC2 VACCINE IN HEALTHY ADULTS. - Condition: COVID-19
Interventions: Biological: UQSC2 Vaccine; Biological: NVX-CoV2373 vaccine
Sponsors: The University of Queensland; Coalition for Epidemic Preparedness Innovations
Not yet recruiting
New bi-phosphonate derivative: Synthesis, characterization, antioxidant activity in vitro and via cyclic voltammetry mode and evaluation of its inhibition of SARS-CoV-2 main protease - In this study, we have synthesized a new molecule labeled HBPA. Its molecular structure was determined by spectroscopic methods such as: FT-IR, NMR (¹H, ^(13)C and ^(31)P); our compound is subjected to two antioxidant activities assays: DPPH scavenging and ferric reducing antioxidant power (FRAP); in the results, HBPA was expanded remarkable inhibition when compared especially to standard BHT with values of 14.936±0.808 and 7.1486±0.0645 μg/ml, respectively; in addition to the scavenging test of…
Co-pyrolysis of medical protective clothing and oil palm wastes for biofuel: Experimental, techno-economic, and environmental analyses - The ongoing global pandemic of COVID-19 has devastatingly influenced the environment, society, and economy around the world. Numerous medical resources are used to inhibit the infectious transmission of the virus, resulting in massive medical waste. This study proposes a sustainable and environment-friendly method to convert hazardous medical waste into valuable fuel products through pyrolysis. Medical protective clothing (MPC), a typical medical waste from COVID-19, was utilized for…
An in-solution snapshot of SARS-COV-2 main protease maturation process and inhibition - The main protease from SARS-CoV-2 (M^(pro)) is responsible for cleavage of the viral polyprotein. M^(pro) self-processing is called maturation, and it is crucial for enzyme dimerization and activity. Here we use C145S M^(pro) to study the structure and dynamics of N-terminal cleavage in solution. Native mass spectroscopy analysis shows that mixed oligomeric states are composed of cleaved and uncleaved particles, indicating that N-terminal processing is not critical for dimerization. A 3.5 Å…
Bioactive Compositions of Cinnamon (Cinnamomum verum J. Presl) Extracts and Their Capacities in Suppressing SARS-CoV-2 Spike Protein Binding to ACE2, Inhibiting ACE2, and Scavenging Free Radicals - Cinnamon (Cinnamomum verum J. Presl) bark and its extracts are popular ingredients added to food and supplement products. It has various health effects, including potentially reducing the risk of coronavirus disease-2019 (COVID-19). In our study, the bioactives in cinnamon water and ethanol extracts were chemically identified, and their potential in suppressing SARS-CoV-2 spike protein-angiotensin-converting enzyme 2 (ACE2) binding, reducing ACE2 availability, and scavenging free radicals was…
Structure-based design of a SARS-CoV-2 Omicron-specific inhibitor - The Omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) introduced a relatively large number of mutations, including three mutations in the highly conserved heptad repeat 1 (HR1) region of the spike glycoprotein (S) critical for its membrane fusion activity. We show that one of these mutations, N969K induces a substantial displacement in the structure of the heptad repeat 2 (HR2) backbone in the HR1HR2 postfusion bundle. Due to this mutation, fusion-entry peptide…
Omicron-induced interferon signalling prevents influenza A H1N1 and H5N1 virus infection - Recent findings in permanent cell lines suggested that SARS-CoV-2 Omicron BA.1 induces a stronger interferon response than Delta. Here, we show that BA.1 and BA.5 but not Delta induce an antiviral state in air-liquid interface (ALI) cultures of primary human bronchial epithelial (HBE) cells and primary human monocytes. Both Omicron subvariants caused the production of biologically active type I (α/β) and III (λ) interferons and protected cells from super-infection with influenza A viruses….
A pharmacokinetic drug-drug interaction study between rosuvastatin and emvododstat, a potent anti-SARS-CoV-2 (COVID-19) DHODH (dihydroorotate dehydrogenase) inhibitor - A therapeutic agent that targets both viral replication and the hyper-reactive immune response would offer a highly desirable treatment for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; COVID-19) management. Emvododstat (PTC299) was found to be a potent inhibitor of immunomodulatory and inflammation-related processes by the inhibition of dihydroorotate dehydrogenase (DHODH) to reduce SARS-CoV-2 replication. DHODH is the rate-limiting enzyme of the de novo pyrimidine nucleotide…
Innovative, rapid, high-throughput method for drug repurposing in a pandemic-A case study of SARS-CoV-2 and COVID-19 - Several efforts to repurpose drugs for COVID-19 treatment have largely either failed to identify a suitable agent or agents identified did not translate to clinical use. Reasons that have been suggested to explain the failures include use of inappropriate doses, that are not clinically achievable, in the screening experiments, and the use of inappropriate pre-clinical laboratory surrogates to predict efficacy. In this study, we used an innovative algorithm, that incorporates dissemination and…
Therapeutic developments for SARS-CoV-2 infection-Molecular mechanisms of action of antivirals and strategies for mitigating resistance in emerging variants in clinical practice - This article systematically presents the current clinically significant therapeutic developments for the treatment of COVID-19 by providing an in-depth review of molecular mechanisms of action for SARS-CoV-2 antivirals and critically analyzing the potential targets that may allow the selection of resistant viral variants. Two main categories of agents can display antiviral activity: direct-acting antivirals, which act by inhibiting viral enzymes, and host-directed antivirals, which target host…
Multiple functions of stress granules in viral infection at a glance - Stress granules (SGs) are distinct RNA granules induced by various stresses, which are evolutionarily conserved across species. In general, SGs act as a conservative and essential self-protection mechanism during stress responses. Viruses have a long evolutionary history and viral infections can trigger a series of cellular stress responses, which may interact with SG formation. Targeting SGs is believed as one of the critical and conservative measures for viruses to tackle the inhibition of…
Erastin inhibits porcine epidemic diarrhea virus replication in Vero cells - CONCLUSIONS: Since NRF2, ACSL4 and GPX4 are classical Ferroptosis genes, this study speculates that erastin may inhibit the replication of PEDV in Vero cells in part through the regulation of ferroptosis pathway, and erastin may be a potential drug for the treatment of PEDV infection.
Treatment of severe covid-19 with interleukin 6 receptor inhibition - No abstract
Wearing N95 masks decreases the odor discrimination ability of healthcare workers: a self-controlled before-after study - CONCLUSION: Wearing N95 masks decreases the odor discrimination ability of healthcare workers. Therefore, we suggest that healthcare workers seek other clues when diagnosing disease with a characteristic odor.
Structure-based computational screening of 470 natural quercetin derivatives for identification of SARS-CoV-2 Mpro inhibitor - Coronavirus disease 2019 (COVID-19) is a global pandemic infecting the respiratory system through a notorious virus known as the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Due to viral mutations and the risk of drug resistance, it is crucial to identify new molecules having potential prophylactic or therapeutic effect against SARS-CoV-2 infection. In the present study, we aimed to identify a potential inhibitor of SARS-CoV-2 through virtual screening of a compound library of…
In-silico studies of Momordica charantia extracts as potential candidates against SARS-CoV-2 targeting human main protease enzyme (Mpro) - Momordica charintia, a well-known plant called bitter melon, has been shown to have antibacterial, anti-diabetic, and antiviral properties against HIV infection. The goal of this work was to investigate the inhibitory effect of phytocompounds found in Momordica charintia leaf extracts on SARS-CoV-2 3CL protease (also known as the Main protease, M^(pro)) utilizing GC-MS analysis and molecular docking studies. The Crystal Structure of the SARS-CoV-2 3CL protease in complex with an inhibitor N3 was…