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Bats harbor viruses that can cause severe disease and death in humans including filoviruses (e.g., Ebola virus), henipaviruses (e.g., Hendra virus), and coronaviruses (e.g., SARS-CoV). Bats often tolerate these viruses without noticeable adverse immunological effects or succumbing to disease. Previous studies have largely focused on the role of the bat's innate immune response to control viral pathogenesis, but little is known about bat adaptive immunity. A key component of adaptive immunity is the humoral response, comprised of antibodies that can specifically recognize viral antigens with high affinity. The antibody genes within the 1,400 known bat species are highly diverse, and these genetic differences help shape fundamental aspects of the antibody repertoire, including starting diversity and viral antigen recognition. Whether antibodies in bats protect, mediate viral clearance, and prevent transmission within bat populations is poorly defined. Furthermore, it is unclear how neutralizing activity and Fc-mediated effector functions contribute to bat immunity. Although bats have canonical Fc genes (e.g., mu, gamma, alpha, and epsilon), the copy number and sequences of their Fc genes differ from those of humans and mice. The function of bat antibodies targeting viral antigens has been speculated based on sequencing data and polyclonal sera, but functional and biochemical data of monoclonal antibodies are lacking. In this review, we summarize current knowledge of bat humoral immunity, including variation between species, their potential protective role(s) against viral transmission and replication, and address how these antibodies may contribute to population dynamics within bats communities. A deeper understanding of bat adaptive immunity will provide insight into immune control of transmission and replication for emerging viruses with the potential for zoonotic spillover. [ABSTRACT FROM AUTHOR]

Background: Acute respiratory infections are a leading cause of morbidity and mortality in children. However, studies on the prevalence of respiratory viruses among children with acute respiratory infections in Kunming, China, are lacking. Therefore, we aimed to investigate the epidemiological characteristics of respiratory pathogens among children with acute respiratory infections in Kunming during the coronavirus disease 2019 pandemic. Methods: Nasopharyngeal swab samples were collected from 4956 children with acute respiratory infections at Yunnan Provincial First People's Hospital between January 2020 and December 2022, patients with COVID-19 were excluded from the study. Multiplex reverse transcription polymerase chain reaction was used to detect respiratory pathogens. Results: The frequency of respiratory pathogens among children was significantly lower in 2020 than in 2021 and 2022. The following pathogens had the highest prevalence rates (in descending order) from 2020 to 2022: HRV > RSV > PIV > ADV > MP; HRV > RSV > HADV > PIV > MP and HRV > Mp > HADV > H3N2 > HMPV. The overall frequency of respiratory pathogens exhibited an inverted U-shape with increasing age among the children. Human bocavirus, human parainfluenza virus, and human respiratory syncytial virus were the dominant respiratory viruses in children aged ≤ 3 years, whereas Mycoplasma pneumoniae was the dominant respiratory pathogen in children aged > 3 years. HRV has the highest prevalence and is the main pathogen of mixed infection. The prevalence of the influenza A virus has decreased significantly, whereas HRSV and Mp are found to be seasonal. Conclusions: Our findings offer an objective evaluation of transmission dynamics and epidemiological shifts in respiratory pathogens during the coronavirus disease 2019 pandemic in Kunming, serving as a basis for informed decision-making, prevention, and treatment strategies. [ABSTRACT FROM AUTHOR]

Introduction: Oxysterol-binding protein (OSBP) is known for its crucial role in lipid transport, facilitating cholesterol exchange between the Golgi apparatus and endoplasmic reticulum membranes. Despite its established function in cellular processes, its involvement in coronavirus replication remains unclear. Methods: In this study, we investigated the role of OSBP in coronavirus replication and explored the potential of a novel OSBP-binding compound, ZJ-1, as an antiviral agent against coronaviruses, including SARS-CoV-2. We utilized a combination of biochemical and cellular assays to elucidate the interactions between OSBP and SARS-CoV-2 non-structural proteins (Nsps) and other viral proteins. Results: Our findings demonstrate that OSBP positively regulates coronavirus replication. Moreover, treatment with ZJ-1 resulted in reduced OSBP levels and exhibited potent antiviral effects against multiple coronaviruses. Through our investigation, we identified specific interactions between OSBP and SARS-CoV-2 Nsps, particularly Nsp3, Nsp4, and Nsp6, which are involved in doublemembrane vesicle formation--a crucial step in viral replication. Additionally, we observed that Nsp3 a.a.1-1363, Nsp4, and Nsp6 target vesicle-associated membrane protein (VAMP)-associated protein B (VAP-B), which anchors OSBP to the ER membrane. Interestingly, the interaction between OSBP and VAP-B is disrupted by Nsp3 a.a.1-1363 and partially impaired by Nsp6. Furthermore, we identified SARS-CoV-2 orf7a, orf7b, and orf3a as additional OSBP targets, with OSBP contributing to their stabilization. Conclusion: Our study highlights the significance of OSBP in coronavirus replication and identifies it as a promising target for the development of antiviral therapies against SARS-CoV-2 and other coronaviruses. These findings underscore the potential of OSBP-targeted interventions in combating coronavirus infections. [ABSTRACT FROM AUTHOR]

The prevalence of insomnia has increased in recent years, significantly affecting the lives of many individuals. Coronavirus disease 2019 (COVID-19) infection has been found to have a substantial impact on the human gut microbiota (GM). Clinical studies have shown that the high prevalence, prolonged duration, and refractory treatment of insomnia symptoms following the COVID-19 pandemic may be related to the effect of COVID-19 infection on the GM. Therefore, the GM may be a potential target for the treatment of insomnia following COVID-19 infection. However, relevant studies have not been well-documented, and the GM has not been sufficiently analyzed in the context of insomnia treatment. Herein, we review the interaction between sleep and the GM, summarize the characteristics of COVID-19-induced abnormal changes in the GM and metabolites in patients with insomnia, and discuss potential mechanisms, including metabolic, immune, and neural pathways, by which these abnormal changes in the GM cause insomnia as well as the factors affecting the GM. Finally, we discuss the prospect of modulating the host GM community for the effective treatment of insomnia after COVID-19 infection and the need for further clinical studies. [ABSTRACT FROM AUTHOR]

INTRODUCTION: The aim of this study is to describe the presenting features, genetic factors, and outcomes of 23 adults who developed liver injury after coronavirus disease 2019 (COVID-19) mRNA vaccination. METHODS: Patients with suspected COVID-19 vaccine hepatitis were enrolled into the Drug-Induced Liver Injury Network. Causality was assessed using the Drug-Induced Liver Injury Network expert opinion score. High-resolution HLA sequencing was undertaken using Illumina platform. RESULTS: Amongst the 16 high causality cases, median time to onset was 16 days, median age was 63 years, and 75% were female. The injury was hepatocellular in 75% with a median alanine aminotransferase of 497 U/L, and 37% had jaundice. An antinuclear antibody and smooth muscle antibody were detectable in 27% and 36%, but only 12% had an elevated immunoglobulin G level. During follow-up, 37% received a short course of corticosteroids, and 88% fully recovered by 6 months with no deaths observed. HLA alleles associated with autoimmune hepatitis were not overrepresented compared with controls, but an ERAP-2 variant (rs1263907) and the ERAP-1 Hap6 haplotype were significantly overrepresented in the high causality cases vs controls (P = 0.026 and 5 x 10-5, respectively). DISCUSSION: Acute liver injury may arise within 8 weeks of COVID-19 mRNA vaccination that is generally mild and self-limited in most patients. The absence of an association with the AIH HLA alleles combined with the significant ERAP-2 and ERAP-1 Hap6 haplotype associations implicates a unique but very rare host immune response to vaccine-derived antigens in the pathogenesis of COVID-19 vaccine hepatotoxicity. [ABSTRACT FROM AUTHOR]

Aim: The coronavirus disease 2019 (COVID‐19) pandemic affected cancer service delivery and the feasibility of following the standard treatment guidelines. The present paper describes the use of clinical care guidelines for cancer management in routine practice and the approach adopted towards cancer care during the COVID‐19 pandemic in India. Methods: A web‐based survey was done in 107 hospitals (including public and private health facilities) that hosted Hospital‐Based Cancer Registries under the National Cancer Registry Programme. The participants comprised Principal Investigators of these registries, who were also medical, surgical, and radiation oncology clinicians. The survey was done between May 1, 2021, and July 31, 2021. Participants were provided with a web link for the survey questionnaire, confidential login, and password. Results: The study found high utilization of Clinical Practice Guidelines (CPGs) during practice, with eight out of ten physicians constantly to referring them. The study reported lack of knowledge, skills, and training to administer the treatment based on the guidelines followed by organizational infrastructure and affordability of treatment by the patients as the factors hampering utilization. International clinical guidelines were preferred when compared to national guidelines. The COVID‐19 pandemic decreased the use of CPGs, wherein six out of ten clinicians reported their use. Conclusion: Stakeholders who formulate clinical guidelines must consider the practical aspects and feasibility of implementing such guidelines during a pandemic and similar situations. This should be coupled with adequate changes in care practice to ensure optimal care delivery and a continuum of cancer care in routine and pandemic‐imposed situations. [ABSTRACT FROM AUTHOR]

Purpose: Evaluate maternal and neonatal outcomes in peripartum coronavirus disease 2019 (COVID-19) positive women. Methods: A retrospective cohort study was conducted, comparing outcomes between women with and without peripartum COVID-19. All singleton deliveries from June 2020 to January 2022 were included. Univariate analysis was followed by multivariate analysis. Results: Of 26,827 singleton deliveries, 563 women had peripartum COVID-19, associated with preterm deliveries both near-term and remote from term [adjusted odds ratio (aOR) 1.6 and 2.0, respectively, p = 0.007 and 0.003]. Women with peripartum COVID-19 had a significantly higher rate of disseminated intravascular coagulation (DIC) (aOR 23.0, p < 0.001). Conversely, peripartum COVID-19 peripartum COVID-19 was negatively associated with premature rupture of membranes and prolonged maternal length of stay (aOR 0.7 and 0.5, respectively, p = 0.006 and <0.001). In cesarean delivery (CDs), patients with COVID-19 had higher rate of urgent CDs (75.5 vs. 56.1%, p < 0.001), higher rate of regional anesthesia (74.5 vs. 64.9%, p = 0.049), and longer anesthesia duration (86.1 vs. 53.4 min, p < 0.001). CD rate due to non-reassuring fetal heart rate (NRFHR) was significantly higher in women with COVID-19 (29.6 vs. 17.4%, p = 0.002). Conversely, CDs rate due to history of previous single CD was significantly higher in patients without COVID-19 diagnosis (13.6 vs. 4.1%, p = 0.006). Concerning neonatal outcomes, an association has been observed between COVID-19 and low one-minute APGAR score <5, as well as neonatal COVID-19 infection (aOR 61.8 and 1.7 respectively, p < 0.001 and p = 0.037). Conclusions: Peripartum COVID-19 is associated with preterm deliveries, urgent CDs and DIC, potentially aligning with the infection's pathophysiology and coagulation alterations. [ABSTRACT FROM AUTHOR]

Background: There is insufficient data on severe acute respiratory syndrome coronavirus type-2 (SARS-CoV-2) infection in Chinese patients with multiple sclerosis (pwMS). This study aims to explore the manifestation of pwMS during the Coronavirus disease 2019 (COVID-19) pandemic and the effect of SARS-CoV-2 infection on the prognosis of MS in northern China. Methods: In this cross-sectional study, an online self-administered questionnaire and telephone interviews were conducted among pwMS of northern China. Clinical correlation of SARS-CoV-2 infection since the onset of the COVID-19 pandemic in northern China was analyzed. Results: 164 patients with an average age of 38.9 ± 12.2 years were included, of which 57.3% had a disease course ≤ 5 years. 33.5% of the patients were COVID-19 vaccinated. 87.2% received disease-modifying therapy (DMT), and the average immunotherapy duration was 1.9 ± 1.6 years. 83.5% were SARS-CoV-2 infected, 14.6% reported worsening of their original condition after infection, and 5.1% had a relapse of MS. Shorter disease course was independently related to infection risk (P = 0.046), whereas increasing age was related to aggravated behavioral symptoms (P = 0.008). However, gender, vaccination, and DMT were not associated with susceptibility or poor prognosis. Conclusion: A shorter disease course is independently associated with an increased risk of SARS-CoV-2 infection, and age is associated with worsening disability. It seems to be safe and necessary to use DMT during the pandemic, however, the use of B cell-depletion agents should be approached with caution. [ABSTRACT FROM AUTHOR]

Objectives: The main factors associated with coronavirus disease-19 (COVID-19) mortality are age, comorbidities, pattern of inflammatory response, and SARS-CoV-2 lineage involved in infection. However, the clinical course of the disease is extremely heterogeneous, and reliable biomarkers predicting adverse prognosis are lacking. Our aim was to elucidate the prognostic role of a novel marker of coronary artery disease inflammation, peri-coronary adipose tissue attenuation (PCAT), available from high-resolution chest computed tomography (HRCT) in COVID-19 patients with severe disease requiring hospitalization. Methods: Two distinct groups of patients were admitted to Parma University Hospital in Italy with COVID-19 in March 2020 and March 2021 (first- and third-wave peaks of the COVID-19 pandemic in Italy, with the prevalence of wild-type and B.1.1.7 SARS-CoV-2 lineage, respectively) were retrospectively enrolled. The primary endpoint was in-hospital mortality. Demographic, clinical, laboratory, HRCT data, and coronary artery HRCT features (coronary calcium score and PCAT attenuation) were collected to show which variables were associated with mortality. Results: Among the 769 patients enrolled, 555 (72%) were discharged alive, and 214 (28%) died. In multivariable logistic regression analysis age (p < 0.001), number of chronic illnesses (p < 0.001), smoking habit (p = 0.006), P/F ratio (p = 0.001), platelet count (p = 0.002), blood creatinine (p < 0.001), non-invasive mechanical ventilation (p < 0.001), HRCT visual score (p < 0.001), and PCAT (p < 0.001), but not the calcium score, were independently associated with in-hospital mortality. Conclusion: Coronary inflammation, measured with PCAT on non-triggered HRCT, appeared to be independently associated with higher mortality in patients with severe COVID-19, while the pre-existent coronary atherosclerotic burden was not associated with adverse outcomes after adjustment for covariates. Clinical relevance statement: The current study demonstrates that a relatively simple measurement, peri-coronary adipose tissue attenuation (PCAT), available ex-post from standard high-resolution computed tomography, is strongly and independently associated with in-hospital mortality. Key Points: • Coronary inflammation can be measured by the attenuation of peri-coronary adipose tissue (PCAT) on high-resolution CT (HRCT) without contrast media. • PCAT is strongly and independently associated with in-hospital mortality in SARS-CoV-2 patients. • PCAT might be considered an independent prognostic marker in COVID-19 patients if confirmed in other studies. [ABSTRACT FROM AUTHOR]

Although respiratory symptoms are the most prominent manifestations of coronavirus disease 2019 (COVID-19), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and especially the omicron variant, may cause neurological manifestations such as seizures. It remains unclear if specific variants of the virus increase the risk of seizures more than others. This was a retrospective multicenter study of pediatric (zero to 16 years) patients with COVID-19 who attended five pediatric emergency departments in Madrid, Spain, between March 2020 and July 2022. An analysis of demographics, medical history, and seizure characteristics was conducted. The data obtained were correlated with the incidence of the different strains of SARS-CoV-2 in the Community of Madrid. A total of 2411 seizures (infectious and noninfectious) were recorded, and 35 of them (1.4%) were positive for SARS-CoV-2. Of those 35 patients, 18 (51.4%) reported a history of previous seizures. The highest percentage of cases occurred when the omicron variant was the most prevalent (28 [80%] vs 7 [20%] before omicron variant). Typical febrile seizures accounted for 52.9% of the cases. No treatment was required in more than half (57.1%) of the cases. during the emergence of the omicron variant, there has been an increase in the number of COVID-19-associated seizures. These findings highlight the need for SARS-CoV-2 screening in patients with febrile and afebrile seizures, in addition to other microbiological, biochemical, or neuroimaging tests, depending on the patient's age and clinical presentation. [ABSTRACT FROM AUTHOR]

Data on the safety and antibody response of the BNT162b2 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mRNA vaccine in children aged 5–11 years with underlying diseases are limited. Thus, our study aimed to address this gap. This prospective observational study investigated the antibody titers for SARS-CoV-2 spike protein receptor-binding domain (S-IgG) and nucleocapsid protein (N-IgG) in patients aged 5–11 years with chronic underlying diseases following two doses of BNT162b2. Additionally, a questionnaire was used to assess adverse events (AEs) arising within 7 days after each dose. Data on severe AEs arising within 28 days after each dose were extracted from the patients' electronic medical records. Among 122 patients, 24.6% (30/122) were immunocompromised. Furthermore, 79 patients experienced at least one AE following vaccination, but all recovered without sequelae, including one severe case after the first dose. The seropositivity rate after the second dose was 99.1% (116/117). Excluding 19 N-IgG-positive patients, the geometric mean antibody titer (GMT) was significantly higher in immunocompetent patients than in immunocompromised patients (1496 U/mL [95% confidence interval 1199–1862] vs. 472 U/mL [200−1119], p = 0.035). Additionally, the GMT of S-IgG was higher in N-IgG-positive patients than in N-IgG-negative patients (8203 [5847–11482] U/mL vs. 1127 [855–1486] U/mL, p < 0.001). BNT162b2 is acceptably safe and immunogenic for children aged 5–11 years with underlying diseases. Although seroconversion was satisfactory in immunocompromised patients, the titers were lower than in immunocompetent patients. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic significantly affected students studying in higher education (HE) institutions in the UK and international contexts. Black and Asian Minority Ethnic (BAME) university students faced massive pressure during and post COVID-19 pandemic, alongside trying to meet their education goals. Our research project was with postgraduate students from two HE institutions, and this paper highlights participants' lived experiences and perspectives, including emotional stress, the need for greater support to access learning resources, financial issues and physical and mental health issues. Our paper suggests that HE institutions need to provide democratic spaces to encourage all students, including BAME students, to engage in dialogues among themselves and with other key players in HE, such as policymakers, and local and international communities, to address issues of inequality. It is important for HE institutions to listen to students' voices, reflect on the impact of the pandemic on their lives and make strategic planning for mitigating negativities and uplifting quality learning experiences post the pandemic. [ABSTRACT FROM AUTHOR]

Objective: The relationship between the quality of diet and sleep, cognitive function, and fear related to coronavirus disease-2019 (COVID-19) among older adults in Turkey during the pandemic remains unclear. This study aimed to investigate the correlation between diet quality, cognitive function, sleep quality, and levels of coronaphobia in individuals aged 65 and above, to understand the impact of COVID-19. Materials and Methods: Sleep quality, diet quality, coronaphobia, and cognitive status of 72 older individuals were evaluated using the Pittsburgh sleep quality index, healthy eating index 2010, Montreal cognitive assessment scale, and coronavirus-19 phobia scale, respectively. Results: The participants had poor diet quality (54.2%), poor sleep quality (62.5%), obesity (41.7%), higher levels of coronaphobia, and cognitive impairment. There was a moderate negative relationship between sleep quality and coronaphobia and between cognitive status and coronaphobia (p=0.00); and a weak positive relationship between diet quality and cognitive status (p<0.05). However, no relationship was found between sleep quality and diet quality, and between coronaphobia and diet quality (p>0.05). Conclusion: Our study highlights the significant challenges faced by older adults during the COVID-19 pandemic, including poor nutrition quality, sleep disturbances, coronaphobia, and cognitive impairment. Our findings suggest a potential interplay between nutrition quality, sleep patterns, and cognitive function among older adults, with those experiencing coronaphobia exhibiting additional cognitive and sleep-related concerns. We advocate the implementation of targeted interventions aimed at mitigating cognitive impairment, addressing nutritional deficiencies, and improving sleep quality among older adults, irrespective of COVID-19 infection status, to enhance overall well-being during these challenging times. [ABSTRACT FROM AUTHOR]

The poor prognosis observed in elderly individuals infected with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) remains a serious clinical burden and the underlying mechanism is unclear, which necessities detailed investigation of disease characteristics and research for efficient countermeasures. To simulate lethal coronavirus disease 2019 (COVID‐19) in senescent human patients, 80‐week‐old male hamsters are intranasally inoculated with different doses of SARS‐CoV‐2 Omicron BA.5 variant. Exposure to a low dose of the Omicron BA.5 variant results in early activation of the innate immune response, followed by rapid viral clearance and minimal lung damage. However, a high dose of BA.5 results in impaired interferon signaling, cytokine storm, uncontrolled viral replication, and severe lung injury. To decrease viral load and reverse the deterioration of COVID‐19, a new bio‐mimic decoy called CoVR‐MV is used as a preventive or therapeutic agent. Administration of CoVR‐MV as a preventive or therapeutic intervention in the early stages of infection can effectively suppress viral load, regulate the immune response, and rescue animals from death and critical illness. These findings underscore the risk associated with SARS‐CoV‐2 Omicron BA.5 exposure in senescent hamsters and highlight the importance of early intervention to prevent disease progression. [ABSTRACT FROM AUTHOR]

Objective: We aimed to investigate the effect of oral anticoagulant (OA) use during coronavirus disease-2019 (COVID-19) on early admission laboratory parameters and/or length of hospital stay in patients receiving chronic OA medication. Materials and Methods: This retrospective study included two groups; group 1 (n=62) consisted of OA users, and group 2 (n=75) of age and sexmatched OA non-users at the time of COVID-19 diagnosis. Early admission laboratory measures, numbers of comorbidities, length of hospital stay, and outcomes of patients were recorded and analyzed. Results: Despite higher comorbidities in group 1, serum C-reactive protein (CRP) and D-dimer levels were significantly lower than group 2 (p<0.05, all). The mortality rate was higher in group 2 but did not reach statistical significance (p>0.05). Regression analysis showed that OA users (compared to OA non-users) had 0.980 and 0.520 times lower serum CRP and D-dimer levels, respectively. Conclusion: This study showed a beneficial effect of OA use on early admission serum CRP, and D-dimer levels, which are important prognostic predictors of COVID-19. Additionally, OA use is associated with fewer hospital stays for COVID-19 patients. These beneficial effects of OA use might help improve the management of this infection after further studies in this field. [ABSTRACT FROM AUTHOR]

Central nervous system histoplasmosis is a serious complication of a common endemic mycosis, but it is rare in immunocompetent hosts. SARS-CoV-2 has introduced significant challenges into the healthcare setting with overlapping clinical presentations that may delay the diagnosis of alternative conditions. Additionally, it may lead to immune dysregulation and increase the risk for secondary infections, including invasive fungal diseases. Limited reports have described disseminated histoplasmosis in adults associated with COVID-19, but none have described central nervous system infection or complications in pediatric patients. We report a case of disseminated histoplasmosis involving the central nervous system in a previously healthy 13-year-old male with SARS-CoV-2 infection. An extensive immunological evaluation did not identify an underlying immunodeficiency. We highlight the potential of COVID-19 immune dys-regulation to contribute to the development or progression of invasive fungal disease. [Pediatr Ann. 2024;53(8):e305–e309.] [ABSTRACT FROM AUTHOR]

This article examines the public communication of COVID-19-related 'preprints' (unreviewed research studies) in a digital media environment. To understand how preprint research flows from preprint server, to media story, to social media audience, we analysed engagement with 'second-order citations' – social media posts linking to media coverage of research – using a sample of 41 media stories published by the research amplifier platform The Conversation (TC) that mentioned preprint research during the early months of the pandemic. We applied content analyses to the Facebook and Twitter accounts sharing these stories and analysed the engagement that the posts received. We found that TC stories mentioning preprints were shared among a diverse collection of Facebook and Twitter accounts, providing a second layer of social media amplification of preprint research. Still, posts by a small proportion of 'elite' actors – people with prominent roles in media and communications, politics or academia – tended to generate more engagement. [ABSTRACT FROM AUTHOR]

This paper discusses findings from a commissioned evaluation of an Australian government COVID-19 health campaign that utilised third-party influencers to increase the reach of health communication messages among culturally and linguistically diverse young people. Although the campaign was successful, interviews with select influencers and target audience members indicated that the 'serious' tone of the health messaging was less effective and less likely to be shared and that messages should be more 'entertaining'. Analyses of data indicated three themes providing insights into how future campaigns may benefit from a focus that draws together health information and entertainment using models already constructed in the entertainment–education field: (1) Entertaining health messages have a stronger fit with influencers who are known for their entertainment value; (2) Entertaining messages are more memorable and more likely to be shared; (3) A balance between entertainment and the signifiers of trust and credibility such as government health authority logos overcomes trust issues in the context of current health disinformation and misinformation. [ABSTRACT FROM AUTHOR]

This study explores communication strategies and techniques in the political discourse of the Australian Prime Minister, Scott Morrison, during crisis. Twelve public speeches and statements made during media conferences, from April 2019 to May 2020, are analysed as sample data. These consist of three contexts, starting from the election campaign, followed by the bushfires that ravaged the nation and the first wave of COVID-19 pandemic. The study identifies the prominent themes and most frequently occurring features in the data set. The election campaign communications and COVID-19 crisis communications are observed to have similar use of discourse features and emphasis of themes. Comparatively, the bushfire crisis communications showed low levels of technique usage and a low significance of themes. The speeches are grouped into four political discourse clusters for further analysis using actantial modelling. The models provide a visual representation of various actants to draw comparative insights. The study highlights that communication needs to be viewed as a discursive activity that can have variations to the contexts, and the need to attribute sufficient significance for public issues using discourse features is critical. [ABSTRACT FROM AUTHOR]

This article critically interrogates the promissory discourse underpinning the cultural sectors' 'digital pivot' in the wake of COVID-19 restrictions in 2020 and 2021; namely, that artistic and creative work could be done lucratively online, offer equal opportunities for all, and assure ongoing audience consumption. Drawing on empirical data from two research projects with arts and culture workers in Australia during COVID-19 restrictions, we investigate the intersection of this promissory discourse with individual and institutional practices of digital disengagement. We contend that, rather than a panacea to lost work and income and the assurance of continued cultural consumption, digital disengagement meant that the pivot prohibited, multiplied, and negated artistic and cultural labour. By considering disengagement that was imposed upon, resourcing contingent, and that actively pushed back, this article complicates our understanding of digitalised arts and cultural labour. [ABSTRACT FROM AUTHOR]

Recombinant human granulocyte colony‐stimulating factor (G‐CSF) administration in patients with cancer and coronavirus disease (COVID‐19) remains controversial. Concerns exist that it may worsen COVID‐19 outcomes by triggering an inflammatory cytokine storm, despite its common use for managing chemotherapy‐induced neutropenia (CIN) or febrile neutropenia post‐chemotherapy. Here, we determined whether prophylactic or therapeutic G‐CSF administration following chemotherapy exacerbates COVID‐19 progression to severe/critical conditions in breast cancer patients with COVID‐19. Between December 2022 and February 2023, all 503 enrolled breast cancer patients had concurrent COVID‐19 and received G‐CSF post‐chemotherapy, with most being vaccinated pre‐chemotherapy. We prospectively observed COVID‐19‐related adverse outcomes, conducted association analyses, and subsequently performed Mendelian randomization (MR) analyses to validate the causal effect of genetically predicted G‐CSF or its associated granulocyte traits on COVID‐19 adverse outcomes. Only 0.99% (5/503) of breast cancer patients experienced COVID‐19‐related hospitalization following prophylactic or therapeutic G‐CSF administration after chemotherapy. No mortality or progression to severe/critical COVID‐19 occurred after G‐CSF administration. Notably, no significant associations were observed between the application, dosage, or response to G‐CSF and COVID‐19‐related hospitalization (all p >.05). Similarly, the MR analyses showed no evidence of causality of genetically predicted G‐CSF or related granulocyte traits on COVID‐19‐related hospitalization or COVID‐19 severity (all p >.05). There is insufficient evidence to substantiate the notion that the prophylactic or therapeutic administration of G‐CSF after chemotherapy for managing CIN in patients with breast cancer and COVID‐19 would worsen COVID‐19 outcomes, leading to severe or critical conditions, or even death, especially considering the context of COVID‐19 vaccination. [ABSTRACT FROM AUTHOR]

Introduction: Severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) causes coronavirus disease 2019 (COVID‐19) and produced a worldwide pandemic in 2020. There have been 770,875,433 confirmed cases and 6,959,316 attributed deaths worldwide until September 19, 2023. The virus can also affect the lower urinary tract (LUT) leading to bladder inflammation and producing lower urinary tract symptoms (LUTS) in both the acute and chronic phases of disease. Methods: At the 2023 meeting of the International Consultation on Incontinence‐Research Society (ICI‐RS), the literature relating to COVID‐19 and bladder dysfunction was reviewed. The LUTS reported, as well as the pathophysiology of these bladder symptoms, were the subject of considerable discussion. A number of different topics were discussed including lower LUTS reported in COVID‐19, how SARS‐CoV‐2 may infect and affect the urinary tract, and proposed mechanisms for how viral infection result in new, worsened, and in some persisting LUTS. Conclusions: The workshop discussed the interaction between the virus and the immune system, covering current evidence supporting theories underlying the causes of acute and chronic LUTS related to COVID‐19 infection. Research questions for further investigation were suggested and identified. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) is highly contagious and causes a series of health problems, particularly in Yemen, which has a fragile healthcare system and cannot handle public health emergencies. Aims: This analysis aimed to determine the epidemiological status of COVID-19 in the Taiz governorate between April 2020 and December 2023. Methods: A retrospective study based on surveillance data from the Taiz governorate was used. The required data were gathered from the Ministry of Health and Population in Aden and analyzed using SPSS. Results: Out of 5826 suspected of COVID-19 cases, 1933 (33.18%) cases were positive for COVID-19 infection. The high rates of COVID-19 cases were reported at 35.40% in males, 37.80% in people aged 35–44 years, 47.20% in 2020, 72.73% in Dhubab district, and 27.78% in March 2021. The overall incidence rate of cases was reported at 6.2 per 10,000 people in Taiz governorate (8.85 in males and 3.80 in females). In addition, the high incidence rate of COVID-19 was observed among age groups ≥ 65 years, in 2021, and in Al-Mukha districts. In total, the rate of fatality cases was 14.12%, the higher rate of fatality cases was 15.46% among males and 32.23% among individuals aged ≥ 65 years, and 26.97% in 2020. Conclusion: In this finding, the incidence rate of COVID-19 is high. It is necessary to increase the public's awareness of the transmission and prevention methods of COVID-19, as well as implement appropriate strategies to protect populations from infectious diseases. [ABSTRACT FROM AUTHOR]

Background: This study aimed to assess the impact of coronavirus disease 2019 (COVID-19) on hospital service utilization and revenue in Chinese tertiary hospitals and develop an optimal pandemic control strategy (OPCS) for the peak period of the Omicron wave. Methods: Retrospective data from three Chinese tertiary hospitals (provincial, city, and county level) were analyzed for three phases: pre-outbreak (Jan-Apr 2019), outbreak (Jan-Apr 2020), and post-outbreak (Jan-Apr 2021). OPCS was developed under the guidance of the China government pandemic control policy during post-break phase of COVID-19. A decision-tree model was constructed to compare OPCS to strict pandemic control strategy during outbreak phase for the hospital service utilization and hospital revenue in a provincial tertiary hospital during the Omicron wave. Results: Outpatient, emergency room (ER) visits, hospitalizations, and intensive care admissions dropped by 33.8–53.4% during the outbreak, with the provincial hospital being the most affected. Hospital revenue also declined, especially for the provincial hospital (40.1%). Post-outbreak, most services recovered, but ER visits remained lower (11.6% decrease for provincial hospital, 46.5% for county hospital). Total income and expenditure decreased, with the provincial hospital experiencing the most significant revenue reduction (45.7%). OPCS showed greater utilization of medical services (31.6 times more outpatient visits; 1.7 times more inpatient days; 3.4% more surgery volume) and higher revenue (¥220.8 million more) compared to the strict pandemic control strategy. Conclusions: COVID-19 measures were associated with less hospital service utilization and revenue in Chinese tertiary hospitals. The developed OPCS in Chinese tertiary hospitals, focusing on isolating infected inpatients but not shutting down the hospital facilities exposed to virus, could be effective in optimizing hospital service utilization and hospital revenue during the Omicron wave. [ABSTRACT FROM AUTHOR]

BACKGROUND Clinical trials of treatments for coronavirus disease 2019 (Covid-19) have not shown a significant benefit of postexposure prophylaxis. METHODS We conducted a phase 2-3 double-blind trial to assess the efficacy and safety of nirmatrelvir-ritonavir in asymptomatic, rapid antigen test-negative adults who had been exposed to a household contact with Covid-19 within 96 hours before randomization. The participants were randomly assigned in a 1:1:1 ratio to receive nirmatrelvir-ritonavir (300 mg of nirmatrelvir and 100 mg of ritonavir) every 12 hours for 5 days or for 10 days or matching placebo for 5 or 10 days. The primary end point was the development of symptomatic SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) infection, confirmed on reverse-transcriptase-polymerase-chain-reaction (RT-PCR) or rapid antigen testing, through 14 days in participants who had a negative RT-PCR test at baseline. RESULTS A total of 2736 participants were randomly assigned to a trial group -- 921 to the 5-day nirmatrelvir-ritonavir group, 917 to the 10-day nirmatrelvir-ritonavir group, and 898 to the placebo group. Symptomatic, confirmed SARS-CoV-2 infection developed by day 14 in 2.6% of the participants in the 5-day nirmatrelvir-ritonavir group, 2.4% of those in the 10-day nirmatrelvir-ritonavir group, and 3.9% of those in the placebo group. In each nirmatrelvir-ritonavir group, the percentage of participants in whom symptomatic, confirmed SARS-CoV-2 infection developed did not differ significantly from that in the placebo group, with risk reductions relative to placebo of 29.8% (95% confidence interval [CI], -16.7 to 57.8; P=0.17) in the 5-day nirmatrelvir-ritonavir group and 35.5% (95% CI, -11.5 to 62.7; P=0.12) in the 10-day nirmatrelvir-ritonavir group. The incidence of adverse events was similar across the trial groups, with dysgeusia being the most frequently reported adverse event (in 5.9% and 6.8% of the participants in the 5-day and 10-day nirmatrelvir-ritonavir groups, respectively, and in 0.7% of those in the placebo group). CONCLUSIONS In this placebo-controlled trial, postexposure prophylaxis with nirmatrelvir-ritonavir for 5 or 10 days did not significantly reduce the risk of symptomatic SARS-CoV-2 infection. [ABSTRACT FROM AUTHOR]

Background: Rapid diagnostic tests (RDTs) for coronavirus disease (COVID) are used in low- and middle-income countries (LMICs) to inform treatment decisions. However, to date, it is unclear when this use is cost-effective. Existing analyses are limited to a narrow set of countries and uses. The aim of this study is to assess the cost-effectiveness of COVID RDTs to inform the treatment of patients with severe illness in LMICs, considering real world practice. Methods and findings: We assessed the cost-effectiveness of COVID testing across LMICs using a decision tree model, differentiating results by country income level, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) prevalence, and testing scenario (none, RDTs, polymerase chain reaction tests—PCRs and combinations). LMIC experts defined realistic care pathways and treatment options. Using a healthcare provider perspective and net monetary benefit approach, we assessed both intended (COVID symptom alleviation) and unintended (treatment side effects) health and economic impacts for each testing scenario. We included the side effects of corticosteroids, which are often the only available treatment for COVID. Because side effects depend both on the treatment and the patient's underlying illness (COVID or COVID-like illnesses, such as influenza), we considered the prevalence of COVID-like illnesses in our analyses. We found that SARS-CoV-2 testing of patients with severe COVID-like illness can be cost-effective in all LMICs, though only in some circumstances. High influenza prevalence among suspected COVID cases improves cost-effectiveness, since incorrectly provided corticosteroids may worsen influenza outcomes. In low- and some lower-middle-income countries, only patients with a high index of suspicion for COVID should be tested with RDTs, while other patients should be presumed to not have COVID. In some lower-middle-income and upper-middle-income countries, suspected severe COVID cases should almost always be tested. Further, in these settings, negative test results in patients with a high initial index of suspicion should be confirmed through PCR and, during influenza outbreaks, positive results in patients with a low initial index of suspicion should also be confirmed with a PCR. The use of interleukin-6 receptor blockers, when supported by testing, may also be cost-effective in higher-income LMICs. The cost at which they would be cost-effective in low-income countries ($162 to $406 per treatment course) is below current prices. The primary limitation of our analysis is substantial uncertainty around some of the parameters in our model due to limited data, most notably on current COVID mortality with standard of care, and insufficient evidence on the impact of corticosteroids on patients with severe influenza. Conclusions: COVID testing can be cost-effective to inform treatment of LMIC patients with severe COVID-like disease. The optimal algorithm is driven by country income level and health budgets, the level of suspicion that the patient may have COVID, and influenza prevalence. Further research to better characterize the unintended effects of corticosteroids, particularly on influenza cases, could improve decision making around the treatment of those with COVID-like symptoms in LMICs. Gabrielle Bonnet and team assess the cost-effectiveness of COVID testing across low-and-middle-income countries, differentiating results by country income level, SARS-CoV-2 prevalence and different testing scenarios. Author summary: Why was this study done?: The main role of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) testing has evolved from transmission reduction to informing the treatment of patients with most vulnerability or most severe illness. SARS-CoV-2 testing availability and use remains inconsistent in some low- and middle-income countries (LMICs), and understanding the cost-effectiveness of testing in such contexts may help guide priority setting and inform guidelines for health professionals. Research on the cost-effectiveness of SARS-CoV-2 testing in LMICs is limited. To our knowledge, no paper has considered both presumptive and symptomatic coronavirus disease (COVID) treatment as alternatives to testing, or has considered a range of treatment options reflective of LMIC contexts. What did the researchers do and find?: We used a decision tree model, health payer provider perspective and net monetary benefit approach to assess the cost-effectiveness of testing to support treatment for patients with severe/critical COVID-like illness in 129 LMICs, based on treatment pathways reported by experts working in LMICs. In low-income and the poorest of lower-middle-income countries, only patients with a high index of suspicion for COVID should be tested with rapid diagnostic tests. In the wealthiest among lower-middle-income countries and in upper-middle-income countries, testing of suspected severe COVID cases is almost always recommended. Polymerase chain reaction (PCR) confirmation of negative test results in patients with a high index of suspicion and, during influenza epidemics/outbreaks, of positive test results in patients with a low index of suspicion, is recommended. What do these findings mean?: COVID testing of patients with severe, COVID-like symptoms in LMICs can be cost-effective, provided sufficiently specific clinical screening algorithms can be used. Policymakers should consider both our study's results regarding variability between countries at a similar income level and its sensitivity analysis, particularly regarding country-specific factors, alongside other considerations such as local feasibility and equity, to inform national level decision-making. The main limitation of the study is uncertainty on some parameters, including current COVID case fatality risks and the impact of corticosteroids on patients with influenza. [ABSTRACT FROM AUTHOR]

Aim Methods Results Conclusion The effectiveness of the coronavirus disease (COVID‐19) vaccine in Japanese patients undergoing haemodialysis has previously not been evaluated on a large scale. We analyzed data from the Japanese Society for Dialysis Therapy Renal Data Registry (JRDR), covering nearly all Japanese patients undergoing dialysis (~95% coverage), to examine the association between COVID‐19 vaccination and infection or mortality.We used data from the JRDR end‐of‐year surveys conducted in 2020 and 2021, including information on the COVID‐19 vaccination and infection months. COVID‐19 infection incidence and its associated mortality rates based on vaccination status (time updated) and odds ratio (OR) (vaccinated vs. unvaccinated) were estimated monthly from April 2021, when vaccination commenced in Japan.COVID‐19 infection analysis included 228 865 patients (215 941 vaccinated and 12 924 unvaccinated patients at the end of 2021). The age‐ and sex‐adjusted ORs (aORs) were significantly lower in August, September, October and November 2021, especially in September (aOR [95% confidence interval (CI)]: 0.25 [0.18–0.36]). Additional adjustments for past medical history and laboratory results rarely affected these results. Similarly, in the COVID‐19‐related mortality analysis with 228 731 patients, including 216 781 vaccinated and 11 950 unvaccinated at the end of 2021, COVID‐19‐related mortality risk was significantly lower in the vaccinated group in August, September, October and November (aOR [95% CI]: August, 0.32 [0.12–0.84], September, 0.04 [0.01–0.11]; October, 0.10 [0.01–0.81]; November, 0.05 [0.00–0.79]).In Japanese patients undergoing haemodialysis, the first or second COVID‐19 vaccine dose was significantly associated with decreased COVID‐19 infection and mortality rates, suggesting its effectiveness in this population. [ABSTRACT FROM AUTHOR]

Background: Acute myocardial injury, cytokine storms, hypoxemia and pathogen-mediated damage were the major causes responsible for mortality induced by coronavirus disease 2019 (COVID-19)-related myocarditis. These need ECMO treatment. We investigated differentially expressed genes (DEGs) in patients with COVID-19-related myocarditis and ECMO prognosis. Methods: GSE150392 and GSE93101 were analyzed to identify DEGs. A Venn diagram was used to obtain the same transcripts between myocarditis-related and ECMO-related DEGs. Enrichment pathway analysis was performed and hub genes were identified. Pivotal miRNAs, transcription factors, and chemicals with the screened gene interactions were identified. The GSE167028 dataset and single-cell sequencing data were used to validate the screened genes. Results: Using a Venn diagram, 229 overlapping DEGs were identified between myocarditis-related and ECMO-related DEGs, which were mainly involved in T cell activation, contractile actin filament bundle, actomyosin, cyclic nucleotide phosphodiesterase activity, and cytokine-cytokine receptor interaction. 15 hub genes and 15 neighboring DEGs were screened, which were mainly involved in the positive regulation of T cell activation, integrin complex, integrin binding, the PI3K-Akt signaling pathway, and the TNF signaling pathway. Data in GSE167028 and single-cell sequencing data were used to validate the screened genes, and this demonstrated that the screened genes CCL2, APOE, ITGB8, LAMC2, COL6A3 and TNC were mainly expressed in fibroblast cells; IL6, ITGA1, PTK2, ITGB5, IL15, LAMA4, CAV1, SNCA, BDNF, ACTA2, CD70, MYL9, DPP4, ENO2 and VEGFC were expressed in cardiomyocytes; IL6, PTK2, ITGB5, IL15, APOE, JUN, SNCA, CD83, DPP4 and ENO2 were expressed in macrophages; and IL6, ITGA1, PTK2, ITGB5, IL15, VCAM1, LAMA4, CAV1, ACTA2, MYL9, CD83, DPP4, ENO2, VEGFC and IL32 were expressed in vascular endothelial cells. Conclusion: The screened hub genes, IL6, ITGA1, PTK2, ITGB3, ITGB5, CCL2, IL15, VCAM1, GZMB, APOE, ITGB8, LAMA4, LAMC2, COL6A3 and TNFRSF9, were validated using GEO dataset and single-cell sequencing data, which may be therapeutic targets patients with myocarditis to prevent MI progression and adverse cardiovascular events. [ABSTRACT FROM AUTHOR]

Postacute sequelae of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (PASC) represent an urgent public health challenge and are estimated to affect more than 60 million individuals globally. Although a growing body of evidence suggests that dysregulated immune reactions may be linked with PASC symptoms, most investigations have primarily centered around blood-based studies, with few focusing on samples derived from affected tissues. Furthermore, clinical studies alone often provide correlative insights rather than causal mechanisms. Thus, it is essential to compare clinical samples with relevant animal models and conduct functional experiments to understand the etiology of PASC. In this study, we comprehensively compared bronchoalveolar lavage fluid single-cell RNA sequencing data derived from clinical PASC samples and a mouse model of PASC. This revealed a pro-fibrotic monocyte-derived macrophage response in respiratory PASC, as well as abnormal interactions between pulmonary macrophages and respiratory resident T cells, in both humans and mice. Interferon-γ (IFN-γ) emerged as a key node mediating the immune anomalies in respiratory PASC. Neutralizing IFN-γ after the resolution of acute SARS-CoV-2 infection reduced lung inflammation and tissue fibrosis in mice. Together, our study underscores the importance of performing comparative analysis to understand the cause of PASC and suggests that the IFN-γ signaling axis might represent a therapeutic target. Editor's summary: The term "Long Covid" covers a myriad of symptoms that a person may experience after an acute infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is also referred to as postacute sequelae of SARS-CoV-2 (PASC). The specific drivers of these symptoms are unclear, complicating the development of therapeutics for those suffering from this condition. Here, Li et al. used comparative analysis to interrogate a potential driver of respiratory PASC, one of the most debilitating types of PASC. The authors found that humans with respiratory PASC had evidence of an enhanced monocyte-derived macrophage response in their bronchoalveolar lavage fluid. A similar phenotype was observed in aged C57BL/6 mice infected with mouse-adapted SARS-CoV-2. This phenotype in mice could be reduced by anti–interferon-γ (anti–IFN-γ) treatment initiated after the resolution of acute disease, suggesting that the IFN-γ signaling pathway may represent a potential therapeutic target for humans. —Courtney Malo [ABSTRACT FROM AUTHOR]

Background While inflammatory and immune responses to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in peripheral blood are extensively described, responses at the upper respiratory mucosal site of initial infection are relatively poorly defined. We sought to identify mucosal cytokine/chemokine signatures that distinguished coronavirus disease 2019 (COVID-19) severity categories, and relate these to disease progression and peripheral inflammation. Methods We measured 35 cytokines and chemokines in nasal samples from 274 patients hospitalized with COVID-19. Analysis considered the timing of sampling during disease, as either the early (0–5 days after symptom onset) or late (6–20 days after symptom onset) phase. Results Patients that survived severe COVID-19 showed interferon (IFN)-dominated mucosal immune responses (IFN-γ, CXCL10, and CXCL13) early in infection. These early mucosal responses were absent in patients who would progress to fatal disease despite equivalent SARS-CoV-2 viral load. Mucosal inflammation in later disease was dominated by interleukin 2 (IL-2), IL-10, IFN-γ, and IL-12p70, which scaled with severity but did not differentiate patients who would survive or succumb to disease. Cytokines and chemokines in the mucosa showed distinctions from responses evident in the peripheral blood, particularly during fatal disease. Conclusions Defective early mucosal antiviral responses anticipate fatal COVID-19 but are not associated with viral load. Early mucosal immune responses may define the trajectory of severe COVID-19. [ABSTRACT FROM AUTHOR]

Background: Evidence suggests reduced survival rates following Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection in people with preexisting mental disorders, especially psychotic disorders, before the broad introduction of vaccines. It remains unknown whether this elevated mortality risk persisted at later phases of the pandemic and when accounting for the confounding effect of vaccination uptake and clinically recorded physical comorbidities. Methods and findings: We used data from Czech national health registers to identify first-ever serologically confirmed SARS-CoV-2 infections in 5 epochs related to different phases of the pandemic: 1st March 2020 to 30th September 2020, 1st October 2020 to 26th December 2020, 27th December 2020 to 31st March 2021, 1st April 2021 to 31st October 2021, and 1st November 2021 to 29th February 2022. In these people, we ascertained cases of mental disorders using 2 approaches: (1) per the International Classification of Diseases 10th Revision (ICD-10) diagnostic codes for substance use, psychotic, affective, and anxiety disorders; and (2) per ICD-10 diagnostic codes for the above mental disorders coupled with a prescription for anxiolytics/hypnotics/sedatives, antidepressants, antipsychotics, or stimulants per the Anatomical Therapeutic Chemical (ATC) classification codes. We matched individuals with preexisting mental disorders with counterparts who had no recorded mental disorders on age, sex, month and year of infection, vaccination status, and the Charlson Comorbidity Index (CCI). We assessed deaths with Coronavirus Disease 2019 (COVID-19) and from all-causes in the time period of 28 and 60 days following the infection using stratified Cox proportional hazards models, adjusting for matching variables and additional confounders. The number of individuals in matched-cohorts ranged from 1,328 in epoch 1 to 854,079 in epoch 5. The proportion of females ranged from 34.98% in people diagnosed with substance use disorders in epoch 3 to 71.16% in individuals diagnosed and treated with anxiety disorders in epoch 5. The mean age ranged from 40.97 years (standard deviation [SD] = 15.69 years) in individuals with substance use disorders in epoch 5 to 56.04 years (SD = 18.37 years) in people with psychotic disorders in epoch 2. People diagnosed with or diagnosed and treated for psychotic disorders had a consistently elevated risk of dying with COVID-19 in epochs 2, 3, 4, and 5, with adjusted hazard ratios (aHRs) ranging from 1.46 [95% confidence intervals (CIs), 1.18, 1.79] to 1.93 [95% CIs, 1.12, 3.32]. This patient group demonstrated also a consistently elevated risk of all-cause mortality in epochs 2, 3, 4, and 5 (aHR from 1.43 [95% CIs, 1.23, 1.66] to 1.99 [95% CIs, 1.25, 3.16]). The models could not be reliably fit for psychotic disorders in epoch 1. People diagnosed with substance use disorders had an increased risk of all-cause mortality 28 days postinfection in epoch 3, 4, and 5 (aHR from 1.30 [95% CIs, 1.14, 1.47] to 1.59 [95% CIs, 1.19, 2.12]) and 60 days postinfection in epoch 2, 3, 4, and 5 (aHR from 1.22 [95% CIs, 1.08, 1.38] to 1.52 [95% CIs, 1.16, 1.98]). Cases ascertained based on diagnosis of substance use disorders and treatment had increased risk of all-cause mortality in epoch 2, 3, 4, and 5 (aHR from 1.22 [95% CIs, 1.03, 1.43] to 1.91 [95% CIs, 1.25, 2.91]). The models could not be reliably fit for substance use disorders in epoch 1. In contrast to these, people diagnosed with anxiety disorders had a decreased risk of death with COVID-19 in epoch 2, 3, and 5 (aHR from 0.78 [95% CIs, 0.69, 0.88] to 0.89 [95% CIs, 0.81, 0.98]) and all-cause mortality in epoch 2, 3, 4, and 5 (aHR from 0.83 [95% CIs, 0.77, 0.90] to 0.88 [95% CIs, 0.83, 0.93]). People diagnosed and treated for affective disorders had a decreased risk of both death with COVID-19 and from all-causes in epoch 3 (aHR from 0.87 [95% CIs, 0.79, 0.96] to 0.90 [95% CIs, 0.83, 0.99]), but demonstrated broadly null effects in other epochs. Given the unavailability of data on a number of potentially influential confounders, particularly body mass index, tobacco smoking status, and socioeconomic status, part of the detected associations might be due to residual confounding. Conclusions: People with preexisting psychotic, and, less robustly, substance use disorders demonstrated a persistently elevated risk of death following SARS-CoV-2 infection throughout the pandemic. While it cannot be ruled out that part of the detected associations is due to residual confounding, this excess mortality cannot be fully explained by lower vaccination uptake and more clinically recorded physical comorbidities in these patient groups. Using data from Czech national health registers, Tomáš Formánek and team examine the risk of death from COVID-19 and from all causes after the first laboratory-confirmed SARS-CoV-2 infection in individuals with pre-existing mental disorders during five different phases of the pandemic. Twitter/X version: Tomáš Formánek and team examine the risk of death from COVID-19 and from all causes after the first laboratory-confirmed SARS-CoV-2 infection in individuals with pre-existing mental disorders during five different phases of the pandemic. Author summary: Why was this study done?: Existing research has demonstrated consistently elevated risk of death with Coronavirus Disease 2019 (COVID-19) or all-cause mortality in people with preexisting psychotic and substance use disorders following a Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection. The evidence on people with preexisting affective and anxiety disorders is broadly consistent with increased mortality risk; however, multiple studies demonstrated null effects. To the best of our knowledge, no study has used national data covering almost all inpatient and outpatient settings, including primary care, and laboratory-confirmed SARS-CoV-2 infections to investigate whether this elevated mortality risk was present throughout the pandemic, including its later phases, and when robustly accounting for the confounding effect of vaccination uptake and clinically recorded physical comorbidities. What did the researchers do and find?: Using Czech national, whole population, all healthcare encompassing register-based data, individuals with preexisting psychotic and, less consistently, substance use disorders had increased risk of death with COVID-19 and all-cause mortality, including at the later phases of the pandemic. People with preexisting anxiety disorders had decreased risk of death with COVID-19 and all-cause mortality in multiple epochs, whereas people with preexisting affective disorders demonstrated broadly null effects throughout the pandemic. These associations could not be fully explained by differences in vaccination uptake or clinically recorded physical comorbidities. What do these findings mean?: The consistently lower survival in people with preexisting psychotic and substance use disorders aligns with existing evidence on fatal health inequalities in these patient groups. Systemic efforts are needed to fully reverse the risk attributable to long-term, structural processes affecting health of people with psychotic and substance use disorders. The main limitation of the present study was its inability to fully control for a number of characteristics, particularly body mass index, tobacco smoking status, and socioeconomic status, that might confound the associations between mental disorders and mortality: future studies should explore these associations while accounting for these confounders. [ABSTRACT FROM AUTHOR]

In the realm of acute respiratory infections, coronavirus disease-19 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), poses a global public health challenge. The application of corticosteroids (CSs) in COVID-19 remains a contentious topic among researchers. Accordingly, our team performed a comprehensive meta-analysis of randomized controlled trials (RCTs) to meticulously evaluate the safety and efficacy of CSs in hospitalized COVID-19 patients. To explore efficacy of CSs in the treatment of COVID-19 patients, we meticulously screened RCTs across key databases, including PubMed, Web of Science, Embase, Cochrane Library, ClinicalTrials.gov, as well as China's CNKI and Wanfang Data. We focused on assessing the 28 days mortality rates. We evaluated the data heterogeneity using the Chi-square test and I2 values, setting significance at 0.1 and 50%. Data from 21 RCTs involving 5721 participants were analyzed. The analysis did not demonstrate a significant association between CSs intervention and the 28 days mortality risk in hospitalized COVID-19 patients (relative risk [RR] = 0.93; 95% confidence interval [95% CI]: 0.84–1.03; P = 0.15). However, subgroup analysis revealed a significant reduction in 28 days mortality among patients with moderate-to-severe COVID-19 (RR at 0.85; 95% CI: 0.76–0.95; P = 0.004). Specifically, short-term CS administration (≤ 3 days) was associated with a substantial improvement in clinical outcomes (RR = 0.24; 95% CI: 0.09–0.63; P = 0.004), as was longer-term use (≥ 8 days) (RR = 0.88; 95% CI: 0.77–0.99; P = 0.04). Additionally, in patients with moderate-to-severe COVID-19, the administration of dexamethasone increased the number of 28 days ventilator-free days (Mean Difference = 1.92; 95% CI: 0.44–3.40; P = 0.01). Methylprednisolone also demonstrated significant benefits in improving clinical outcomes (RR = 0.24; 95% CI: 0.09–0.63; P = 0.004). Our meta-analysis demonstrated that although there is no significant difference in 28 days mortality rates among hospitalized COVID-19 patients, the use of CSs may be beneficial in improving clinical outcomes in moderate or severe COVID-19 patients. There was no significant increase in the occurrence of adverse events associated with the use of CSs. Our meta-analysis provides evidence that while CSs may not be suitable for all COVID-19 patients, they could be effective and safe in severely ill COVID-19 patients. Consequently, it is recommended to administer CSs for personalized treatments in COVID-19 cases to improve the clinical outcomes while minimizing adverse events. [ABSTRACT FROM AUTHOR]

Background: Cold agglutination syndrome is a subtype of autoimmune hemolytic anemia. The condition is referred to as "cold" because the antibodies become active and induce hemolysis at cold temperatures, typically 3–4 °C, which is not always the case in other kinds of autoimmune hemolytic anemia. Whereas primary cold agglutination syndrome may occur in the absence of underlying conditions, secondary cold agglutination syndrome is associated with the presence of underlying infections, including coronavirus disease 2019. Case presentation: We report the case of a 69-year-old Japanese woman with periodontitis who was referred to our hospital with complaints of brown-colored urine and chest pain. Her hemoglobin level was 6.1 g/dL. Computed tomography revealed multiple lung abscesses. Her direct antibody test results were positive (2+) for anti-complement direct antiglobulin and negative for immunoglobulin G, and her cold agglutinin titer was elevated at 1:4096. Workup for anemia revealed a positive result for cold agglutination syndrome. The patient had received the fourth dose of coronavirus disease 2019 vaccination. Nasopharyngeal swab test for detecting severe acute respiratory syndrome coronavirus 2 using a real-time reverse-transcription polymerase chain reaction gave a cycle threshold value of 42.3, and the level of virus-specific immunoglobulin G was elevated at 7.71 S/C (normal range −1.4 S/C). Conclusion: A decrease in hemoglobin in patients with coronavirus disease 2019 may be associated with secondary cold agglutination syndrome. The patient was hypothesized to have developed multiple lung abscesses with secondary cold agglutination syndrome following coronavirus disease 2019. Thus, following coronavirus disease 2019, patients can develop secondary cold agglutination syndrome, which could worsen owing to associated bloodstream bacterial infections. [ABSTRACT FROM AUTHOR]

Background: Corona virus disease 2019 (COVID-19) is an extremely contagious viral infection caused by the severe acute respiratory syndrome coronavirus 2. Understanding the willingness of the community to receive the COVID-19 vaccine will help in the development and implementation of effective COVID-19 vaccination promotion programs. Therefore, we aimed to assess the level of COVID-19 vaccine acceptance and associated factors among residents of Dire Dawa Administration, Eastern Ethiopia. Methods: A community-based cross-sectional study was conducted among 840 residents in Dire Dawa Administration from May 18th to June 18th, 2021. Multistage cluster sampling followed by systematic random sampling was used to select respondents. A pretested interviewer-administered structured questionnaire was used to collect the data from respondents. Bivariable and multivariable logistic regression were used to identify predictors of COVID-19 vaccine acceptance. The odds ratio (OR), along with a 95% confidence interval (CI), was used to estimate the strength of the association. Results: Out of 840 respondents recruited, the proportion of COVID-19 vaccine acceptance was found to be 54.4% (457/840); (95% CI: 51.0%, 57.7%) Being male [AOR = 1.85, 95% CI: (1.35, 2.54), P < 0.001], not having a current habit of substance use [AOR = 2.38, 95% CI: (1.73, 3.26), P < 0.001], having a monthly income of less than 51.31 USD [AOR = 0.19, 95% CI: (0.04, 0.88), P = 0.001]; and not having a prior history of vaccination experience [AOR = 0.40, 95% CI: (0.29, 0.54), P < 0.001] were significantly associated with COVID-19 vaccine acceptance. Conclusion: This study reveals that the proportion of COVID-19 vaccine acceptance among residents of Dire Dawa Administration, Eastern Ethiopia, was 54.4%. Factors like being male and not having a current habit of substance use were positively associated, whereas having a monthly income of less than 51.31 USD and not having a prior history of vaccination experience were negatively associated with COVID-19 vaccine acceptance. Health information dissemination and economic empowerment are crucial to improving COVID-19 vaccine acceptance among the community. This study provides valuable data for policymakers to plan early vaccination programs and tackle the challenges identified in the study. [ABSTRACT FROM AUTHOR]

Background Methods Results Conclusions While coronavirus disease 2019 (COVID‐19) is no longer a public health emergency, certain patients remain at risk of severe outcomes. To better understand changing risk profiles, we studied the risk factors for patients with and without solid organ transplantation (SOT) through the various waves of the pandemic.Using the National COVID Cohort Collaborative we studied a cohort of adult patients testing positive for COVID‐19 between January 1, 2020, and May 2, 2022. We separated the data into waves of COVID‐19 as defined by the Centers for Disease Control. In our primary outcome, we used multivariable survival analysis to look at various risk factors for hospitalization in those with and without SOT.A total of 3,570,032 patients were captured. We found an overall risk attenuation of adverse COVID‐19‐associated outcomes over time. In both non‐SOT and SOT populations, diabetes, chronic kidney disease, and congestive heart failure were risk factors for hospitalization. For SOT specifically, longer time periods between transplant and COVID‐19 were protective and age was a risk factor. Notably, asthma was not a risk factor for major adverse renal cardiovascular events, hospitalization, or mortality in either group.Our study provides a longitudinal view of the risks associated with adverse COVID‐related outcomes amongst SOT and non‐SOT patients, and how these risk factors evolved over time. Our work will help inform providers and policymakers to better target high‐risk patients. [ABSTRACT FROM AUTHOR]

Background Case Presentation Conclusions Bickerstaff brainstem encephalitis (BBE) is an autoimmune disease affecting the brainstem, typically caused by a prior infection. However, BBE after coronavirus disease 2019 (COVID‐19) infection is rare. Here, we present a severe case of BBE after COVID‐19 infection, highlighted by increased levels of CXCL‐10.A 28‐year‐old woman presented with symptoms of cold and fever lasting 5 days, accompanied by numbness, weakness and unsteadiness in the distal parts of her limbs before being admitted. Upon admission, her condition was classified with a Glasgow Coma Scale score of E1V1M4, absence of bilateral ocular cephalic reflexes, eyes fixed in the midline position and pathological reflex in lower limbs. COVID‐19 antigen tests were positive, and cerebrospinal fluid CXCL‐10 levels were elevated. Positive serum anti‐GQ1b antibodies, along with other clinical findings, confirmed the diagnosis of BBE. Initial treatment with high‐dose intravenous immunoglobulin was ineffective, leading to mechanical ventilation on day 2 from admission. Additional steroid pulse therapy and plasmapheresis were initiated on day 7. Communication abilities were restored by day 19, and the patient was extubated on day 21. Continuous alleviation of symptoms was observed, with no sequelae at discharge on day 42.BBE related to COVID‐19 with high CXCL‐10 levels can become severe. However, early intensive immunotherapy, including plasmapheresis, might result in favorable prognosis. [ABSTRACT FROM AUTHOR]

Background: Since the Coronavirus disease 2019 (COVID-19) pandemic began, the number of individuals recovering from COVID-19 infection have increased. Post-COVID Syndrome, or PCS, which is defined as signs and symptoms that develop during or after infection in line with COVID-19, continue beyond 12 weeks, and are not explained by an alternative diagnosis, has also gained attention. We systematically reviewed and determined the pooled prevalence estimate of PCS worldwide based on published literature. Methods: Relevant articles from the Web of Science, Scopus, PubMed, Cochrane Library, and Ovid MEDLINE databases were screened using a Preferred Reporting Items for Systematic Reviews and Meta-Analyses-guided systematic search process. The included studies were in English, published from January 2020 to April 2024, had overall PCS prevalence as one of the outcomes studied, involved a human population with confirmed COVID-19 diagnosis and undergone assessment at 12 weeks post-COVID infection or beyond. As the primary outcome measured, the pooled prevalence of PCS was estimated from a meta-analysis of the PCS prevalence data extracted from individual studies, which was conducted via the random-effects model. This study has been registered on PROSPERO (CRD42023435280). Results: Forty eight studies met the eligibility criteria and were included in this review. 16 were accepted for meta-analysis to estimate the pooled prevalence for PCS worldwide, which was 41.79% (95% confidence interval [CI] 39.70–43.88%, I2 = 51%, p = 0.03). Based on different assessment or follow-up timepoints after acute COVID-19 infection, PCS prevalence estimated at ≥ 3rd, ≥ 6th, and ≥ 12th months timepoints were each 45.06% (95% CI: 41.25–48.87%), 41.30% (95% CI: 34.37–48.24%), and 41.32% (95% CI: 39.27–43.37%), respectively. Sex-stratified PCS prevalence was estimated at 47.23% (95% CI: 44.03–50.42%) in male and 52.77% (95% CI: 49.58–55.97%) in female. Based on continental regions, pooled PCS prevalence was estimated at 46.28% (95% CI: 39.53%-53.03%) in Europe, 46.29% (95% CI: 35.82%-56.77%) in America, 49.79% (95% CI: 30.05%-69.54%) in Asia, and 42.41% (95% CI: 0.00%-90.06%) in Australia. Conclusion: The prevalence estimates in this meta-analysis could be used in further comprehensive studies on PCS, which might enable the development of better PCS management plans to reduce the effect of PCS on population health and the related economic burden. [ABSTRACT FROM AUTHOR]

Objective Materials and Methods Results Conclusions To analyse the litigation trends and the reasons for claims within the specialty of Urology, within the UK National Health Service (NHS), over a 16‐year period.Data were requested from NHS Resolution under the Freedom of Information Act 2000. This included the total number of claims in Urology, the number of these that were successful (settled or closed), and the costs in damages paid out per financial year between 2006 and 2022. A breakdown of the successful claims by their primary cause was also collected. These were coded into the categories: ‘non‐operative’, ‘intraoperative’, ‘postoperative’, and ‘other’.A total of 4124 litigation claims were made between 2006 and 2022 and 60.9% (2511/4124) of these claims were successful. In all, £145 million (British pounds) was paid out in damages. The number of successful claims increased 2.9‐fold from the start to end of this 16‐year period, and the costs in damages paid out increased 10‐fold. Regarding primary causes for the successful claims, failure or delay in treatment (20.9%, 525/2511), failure or delay in diagnosis (14.5%, 364/2511), and intraoperative problems (9.1%, 229/2511) accounted for the highest proportion. Overall, non‐operative causes for successful claims accounted for 73.3% (1840/2511), intraoperative for 20.1% (504/2511), and postoperative for 3.9% (98/2511).The number of successful urological litigation claims, and their associated costs is rising. The majority are due to non‐operative causes, which may be partially explained by NHS waiting lists alongside the effects of the coronavirus disease 2019 (COVID‐19) pandemic. [ABSTRACT FROM AUTHOR]

The rapid development of the COVID-19 pandemic resulted in a closer analysis of cell functioning during β-coronavirus infection. This review will describe evidence for COVID-19 as a syndrome with a strong, albeit still underestimated, mitochondrial component. Due to the sensitivity of host mitochondria to coronavirus infection, SARS-CoV-2 affects mitochondrial signaling, modulates the immune response, modifies cellular energy metabolism, induces apoptosis and ageing, worsening COVID-19 symptoms which can sometimes be fatal. Various aberrations across human systems and tissues and their relationships with mitochondria were reported. In this review, particular attention is given to characterization of multiple alterations in gene expression pattern and mitochondrial metabolism in COVID-19; the complexity of interactions between SARS-CoV-2 and mitochondrial proteins is presented. The participation of mitogenome fragments in cell signaling and the occurrence of SARS-CoV-2 subgenomic RNA within membranous compartments, including mitochondria is widely discussed. As SARS-CoV-2 severely affects the quality system of mitochondria, the cellular background for aberrations in mitochondrial dynamics in COVID-19 is additionally characterized. Finally, perspectives on the mitigation of COVID-19 symptoms by affecting mitochondrial biogenesis by numerous compounds and therapeutic treatments are briefly outlined. [ABSTRACT FROM AUTHOR]

Introduction: India has experienced many phases of the rise and fall of Coronavirus Disease-2019 (COVID-19) cases from the first quarter of 2020 to the present date. It is important to periodically assess the clinicoepidemiology and local factors affecting the pandemic in each geographical area. Emerging Severe Acute Respiratory Syndrome Coronavirus 2 (SARSCoV-2) variants {Variants of Concern (VOC) and Variants of Interest (VOI)} are contributing to ongoing unprecedented outbreaks, posing new challenges. Continuous surveillance is essential to keep track of currently circulating lineages. Aim: To study the clinicoepidemiological trends of COVID-19 disease in patients. Materials and Methods: A cross-sectional descriptive study was conducted on 53,311 suspected COVID-19 patients attending Jaipur National University of Medical Sciences and Research (JNUIMSRC), Jaipur, Rajasthan, India. Sociodemographic variables, clinical signs and symptoms, details of hospitalisation, and mortality data were collected between May 2020 and April 2022. All patients with Influenza-like illness and suspected COVID-19 were included in the study. Ribonucleic Acid (RNA) extraction and Polymerase Chain Reaction (PCR) were performed using Indian Council of Medical Research (ICMR) approved kits. Mean, median, and “p-values” were calculated using Microsoft Excel and Statistical Package for Social Sciences (SPSS) version 21.0 software. Results: A total of 15.77% (8410/53,311) of patients tested positive for SARS-CoV-2 by Reverse Transcriptase Polymerase Chain Reaction (RT-PCR). The median age of the patient population was 43±18.44 years, with a male-to-female ratio of 1.86, 33.21% (2793/8410) of patients were asymptomatic. Cough (56.74%; 4772/8410) was the most common symptom, followed by fever (56.48%; 4750/8410) and sore throat (50.31%; 4231/8410). The surge in the number of COVID-19 positive cases varied month-wise during the study period. The case fatality rate was 3.19%. Conclusion: Asymptomatic cases have contributed to the widespread distribution of COVID-19 disease. Periodic remodeling of testing and mitigation strategies is required, given the early detection of asymptomatic infections in comorbid and elderly patients for the management of the COVID19 pandemic. [ABSTRACT FROM AUTHOR]

Aim: Multisystem Inflammatory Syndrome in Children (MIS-C) is a disease developed after about eight weeks of the new coronavirus disease (COVID-19) infection in children. The underlying reason for MIS-C is still unknown. This study aims to assess the nasopharyngeal expressions of Angiotensin-converting enzyme 2 (ACE2), the differentiation 147 receptor cluster (CD147), and the transmembrane serine protease 2 (TMPRSS2) receptors in the MIS-C population. Since these receptors are related to COVID-19 infection, children with previous COVID-19 history were included as a control group. This study is essential for future studies to see if there is any significant expression difference between these receptors in control and MIS-C populations. Materials and Methods: The prospective cohort study took place at Ondokuz Mayıs University. The participants of this study consisted of patients aged 0-18 years who were diagnosed with MIS-C due to COVID-19 infection or patients with only previous COVID- 19 pneumonia but without MIS-C development. A total of 79 cases were registered in this study. Nasopharyngeal samples of children were collected. Total RNA was isolated from all samples. The expression of ACE2, CD147, and TMPRSS2 genes was accessed by real-time quantitative PCR (RT-qPCR). Results: Nasopharyngeal expression of CD147 and TMPRSS2 were not changed in COVID-19 (n=42) and MIS-C (n=37) cases. Expression of ACE2 was increased in the under 10-year-old MIS-C group (n=23) (p=0.004381). Conclusion: Future studies may exclude the nasopharyngeal expression of CD147 and TMPRSS2 to develop MIS-C. Further investigations are required to learn how ACE2 expression contributes to MIS-C development. [ABSTRACT FROM AUTHOR]

Introduction: Immunization is the most effective form of prevention against coronavirus disease-2019 (COVID-19) related complications during pregnancy. This study was done to see the prevalence of the COVID-19 immunization status in pregnant women delivering in a tertiary level Government Hospital in New Delhi, India, and associated side effects of COVID vaccine in pregnancy. Materials and methods: A prospective cross-sectional study was conducted from 1st July 2022 to 31st December 2022 in a tertiary level, Government Hospital in New Delhi, India. The Institutional Ethical Committee provided approval for the study. A written questionnaire was given to all consecutive pregnant women delivering in the hospital, after taking written consent and details of COVID vaccine, number of doses, time of immunization (antenatal/postpartum), COVID infection status (antenatal/postnatal period) and adverse reactions encountered. Observation and results: Women (842) were included in the study, out of which 87% (605/842) were vaccinated and 12.6% (218/842) were unvaccinated. The majority (70.4%) received Covishield while 29.6% received Covaxin. Adverse effect following vaccination was experienced by 9.2% (68/842) women and was mild. Conclusion: The total vaccine coverage among the women enrolled in the study was 87%. There was no statistically significant difference (p-value = 0.095) in the side effects profile of the Covaxin and Covishield vaccines. Among the hesitancy factors observed in the unvaccinated group, safety concern regarding vaccines was the most dominant factor. [ABSTRACT FROM AUTHOR]

In Sicily (Italy), respiratory syncytial virus (RSV), rhinovirus (HRV), and influenza virus triggered epidemics among children, resulting in an increase in acute respiratory tract infections (ARTIs). Our objective was to capture the epidemiology of respiratory infections in children, determining which pathogens were associated with respiratory infections following the lockdown and whether there were changes in the epidemiological landscape during the post-SARS-CoV-2 pandemic era. Materials and Methods: We analyzed multiplex respiratory viral PCR data (BioFire® FilmArray® Respiratory Panel 2.1 Plus) from 204 children presenting with respiratory symptoms and/or fever to our Unit of Pediatrics and Pediatric Emergency. Results: Viruses were predominantly responsible for ARTIs (99%), with RSV emerging as the most common agent involved in respiratory infections, followed by human rhinovirus/enterovirus and influenza A. RSV and rhinovirus were also the primary agents in coinfections. RSV predominated during winter months, while HRV/EV exhibited greater prevalence than RSV during the fall. Some viruses spread exclusively in coinfections (human coronavirus NL63, adenovirus, metapneumovirus, and parainfluenza viruses 1–3), while others primarily caused mono-infections (influenza A and B). SARS-CoV-2 was detected equally in both mono-infections (41%) and coinfections (59%). Conclusions: Our analysis underlines the predominance of RSV and the importance of implementing preventive strategies for RSV. [ABSTRACT FROM AUTHOR]

Objective: To describe the frequency of neuropsychiatric complications among hospitalized patients with coronavirus disease 2019 (COVID-19) and their association with pre-existing comorbidities and clinical outcomes. Methods: We retrospectively identified all patients hospitalized with COVID-19 within a large multicenter New York City health system between March 15, 2020 and May 17, 2021 and randomly selected a representative cohort for detailed chart review. Clinical data, including the occurrence of neuropsychiatric complications (categorized as either altered mental status [AMS] or other neuropsychiatric complications) and in-hospital mortality, were extracted using an electronic medical record database and individual chart review. Associations between neuropsychiatric complications, comorbidities, laboratory findings, and in-hospital mortality were assessed using multivariate logistic regression. Results: Our study cohort consisted of 974 patients, the majority were admitted during the first wave of the pandemic. Patients were treated with anticoagulation (88.4%), glucocorticoids (24.8%), and remdesivir (10.5%); 18.6% experienced severe COVID-19 pneumonia (evidenced by ventilator requirement). Neuropsychiatric complications occurred in 58.8% of patients; 39.8% experienced AMS; and 19.0% experienced at least one other complication (seizures in 1.4%, ischemic stroke in 1.6%, hemorrhagic stroke in 1.0%) or symptom (headache in 11.4%, anxiety in 6.8%, ataxia in 6.3%). Higher odds of mortality, which occurred in 22.0%, were associated with AMS, ventilator support, increasing age, and higher serum inflammatory marker levels. Anticoagulant therapy was associated with lower odds of mortality and AMS. Conclusion: Neuropsychiatric complications of COVID-19, especially AMS, were common, varied, and associated with in-hospital mortality in a diverse multicenter cohort at an epicenter of the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Purpose: Since late 2019, coronavirus disease 2019 (COVID-19) has rapidly spread worldwide. Some children with COVID-19 present with seizures; in particular, studies have reported an increase in seizure episodes during the Omicron wave of the pandemic. This study was performed to describe the clinical characteristics of seizures among children hospitalized with COVID-19 before and during the Omicron wave. Methods: A retrospective cross-sectional study was conducted on all pediatric admissions for COVID-19 at Hospital Tunku Azizah from June 2021 to May 2022. Results: During this period, 1,586 children were admitted with COVID-19, of whom 111 (7.0%) experienced seizures. Patients with seizures were more likely to have a history of seizure (odds ratio [OR], 71.4; 95% confidence interval [CI], 23.7 to 215.2; P<0.001) and prior antiseizure medication use (OR, 55.1; 95% CI, 6.1 to 497.4; P<0.001). Most seizures (55.0%) occurred on the first day of illness, with 86.5% lasting less than 5 minutes. None of the children required intubation or admission to the pediatric intensive care unit, and all were discharged without complications. Between June 2021 and January 2022, the seizure rate varied from 1.3% to 3.4%; however, it increased to 18% in April 2022, coinciding with the period of Omicron variant predominance in Malaysia. Children admitted during the Omicron wave had significantly higher odds of experiencing seizures (OR, 7.89; 95% CI, 2.07 to 13.07; P<0.001) than children hospitalized prior to this wave. Conclusion: In conclusion, the study revealed a marked increase in seizures associated with pediatric COVID-19 cases during the Omicron wave. [ABSTRACT FROM AUTHOR]

Purpose: Coronavirus disease 2019 (COVID-19) can be associated with neurological complications. This study investigated the impact of COVID-19 outbreaks on seizure incidence and duration in children in Korea. Methods: We retrospectively analyzed medical records from Kyungpook National University Children’s Hospital, including 768 children with seizures during the peak COVID-19 outbreaks in March and August 2022, and compared patterns with the same periods in 2021. We examined demographic and clinical characteristics, causes of seizures, underlying conditions, seizure durations, and COVID-19 test results. Results: Out of 16,373,836 COVID-19 cases during the first peak, 25.6% were children (4,184,383), and during the second peak, 20.5% of 6,400,244 cases were children (1,314,331). No significant age differences were observed between either peak and the previous year. However, when compared to the previous year, febrile seizures (FS) were more common during both peaks (25.9% vs. 65.1% in the first peak; 34.3% vs. 59.2% in the second peak). The prevalence of FS was significantly higher in the COVID-19-positive group (84.1%) than in the COVID-19-negative group (51.9%). The incidence of new-onset seizures or breakthrough seizures showed no significant difference. Seizure duration and the incidence of status epilepticus (SE) showed no significant changes, but SE was more common in the COVID-19-negative group (17.1% vs. 6.2%). The clinical features of FS were similar in both groups. Conclusion: COVID-19 appeared to increase the risk of FS in children, but there was no significant impact on the risk of breakthrough seizures or SE in children with epilepsy. Nevertheless, larger-scale studies are necessary. [ABSTRACT FROM AUTHOR]

Determining the frequency and outcomes of neurological disorders associated with coronavirus disease 2019 (COVID-19) is imperative for understanding risks and for recognition of emerging neurological disorders. We investigated the susceptibility and impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among persons with premorbid neurological disorders, in addition to the post-infection incidence of neurological sequelae, in a case–control population-based cohort. Using health service data collected between 1 March 2020 and 30 June 2021, we constructed a cohort of SARS-CoV-2 RNA-positive (n = 177 892) and -negative (n = 177 800) adults who were age, sex and comorbidity matched and underwent RT-PCR testing at similar times. COVID-19-associated mortality rates were examined within the cohort. Neurological sequelae were analysed during the acute (<3 months) and the post-acute (3–9 months) phases post-infection. The risk of death was significantly greater in the SARS-CoV-2 RNA-positive (2140 per 100 000 person years) compared with RNA-negative (922 per 100 000 person years) over a follow-up of 9 months, particularly amongst those with premorbid neurological disorders: adjusted odds ratios (95% confidence interval) in persons with a prior history of parkinsonism, 1.65 (1.15–2.37); dementia, 1.30 (1.11–1.52); seizures, 1.91 (1.26–2.87); encephalopathy, 1.82 (1.02–3.23); and stroke, 1.74 (1.05–2.86). There was also a significantly increased risk for diagnosis of new neurological sequelae during the acute time phase after COVID-19, including encephalopathy, 2.0 (1.10–3.64); dementia, 1.36 (1.07–1.73); seizure, 1.77 (1.22–2.56); and brain fog, 1.96 (1.20–3.20). These risks persisted into the post-acute phase after COVID-19, during which inflammatory myopathy (2.57, 1.07–6.15) and coma (1.87, 1.22–2.87) also became significantly increased. Thus, persons with SARS-CoV-2 infection and premorbid neurological disorders are at greater risk of death, and SARS-CoV-2 infection was complicated by increased risk of new-onset neurological disorders in both the acute and post-acute phases of COVID-19. [ABSTRACT FROM AUTHOR]

Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the greatest pandemic in the world. This virus involves the respiratory system, causes pulmonary dysfunction, and causes coronavirus disease (COVID-19). Pulmonary dysfunction due to COVID-19 may be asymptomatic, mild, moderate, and severe/critical. COVID-19 may involve other organs, and its sequelae may be persistent for a long time. The pulmonary function test is a method for evaluating the lungs in people. In this study, we reviewed the results of pulmonary function test (PFT) in patients with a history of COVID-19 involvement based on previous studies. Materials and Methods: The present review was conducted in 2024 using the keywords COVID-19, pulmonary function test, recovery, and pulmonary involvement in English. Eligible articles (articles containing the mentioned keywords) published during the years 2019 to 2023 were searched in Scopus, Pubmed, Wiley, and Google Scholar international databases. Relevant articles were identified, and after review, the most important and valuable points were presented. Results: PTF should not be done during COVID-19 involvement because it increases the rate of disease transmission. Small airway dysfunction, restrictive ventilatory dysfunction, and pulmonary diffusion impairment patterns are the most common findings in the PFTs of patients with a history of COVID-19. PFT improves gradually after the recovery of pulmonary involvement of COVID-19 for two years, even in patients with severe or critical forms of COVID-19. Conclusion: In this review, we summarized the results of studies about pulmonary function tests after COVID-19 involvement in survivors. Small airway dysfunction, restrictive ventilatory dysfunction, and pulmonary diffusion impairment are the most common findings in the PFT of survivors of COVID-19. These patterns are more prevalent among patients with severe or critical forms of COVID-19, and they are associated with the risk factors of COVID-19 severity, such as age, underlying disease, and pulmonary disorders. Forced vital capacity and diffusion capacity of lungs for carbon monoxide decreased in patients with COVID-19, and forced expiratory volume in 1 second (FEV1)/FVC and residual volume (RV) increased in these patients and they were associated with COVID-19 severity. The pulmonary involvement of COVID-19 recovers over time, and after two years, patients return to their baseline PFTs. [ABSTRACT FROM AUTHOR]

Background: To assess pregnancy outcomes in women with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reinfection. Methods: This was a retrospective cohort study that included pregnant women who contracted coronavirus disease 2019 (COVID-19) once or twice during pregnancy and who gave birth between 1 October 2022 and 15 August 2023 in Shanghai First Maternity and Infant Hospital (Shanghai, China). We collected their clinical data and compared the frequency of adverse pregnancy outcomes between the reinfection group and the primary infection group, such as preterm birth, fetal growth restriction (FGR), hypertensive disorders of pregnancy (HDP), common pregnancy-related conditions, birth weight, and neonatal unit admission. Results: We observed a 7.7% reinfection rate among the 1,405 women who contracted COVID-19 during pregnancy. There were no significant differences in the frequency of preterm birth, FGR, HDP, other common pregnancy-related conditions, birth weight, or rate of neonatal unit admission between the reinfection and single infection groups. All our participants were unvaccinated, and all had mild symptoms. Conclusion: Our study showed no significant association between SARS-CoV-2 reinfection and adverse pregnancy outcomes. [ABSTRACT FROM AUTHOR]