The severe acute respiratory syndrome Coronarovirus-2 associated still causes a significant number of deaths and hospitalizations mainly by the development of respiratory failure. We aim to validate lung ultrasound score in order to predict mortality and the severity of the clinical course related to the need of respiratory support.

In this prospective multicenter hospital-based cohort study, all adult patients with diagnosis of SARS-CoV-2 infection, performed by real-time reverse transcription polymerase chain reaction were included. Upon admission, all patients underwent blood gas analysis and lung ultrasound by expert operators. The acquisition of ultrasound scan was performed on 12 peculiar anatomic landmarks of the chest. Lung ultrasound findings were classified according to a scoring method, ranging 0 to 3: Score 0: normal A-lines. Score 1: multiple separated B-lines. Score 2: coalescent B-lines, alteration of pleural line. Score 3: consolidation area.

One thousand and seven patients were included in statistical analysis (male 62.4 %, mean age 66.3). Oxygen support was needed in 811 (80.5 %) patients. The median ultrasound score was 24 and the risk of having more invasive respiratory support increased in relation to higher values score computed. Lung ultrasound score showed negative strong correlation (rho: -0.71) with the P/F ratio and a significant association with in-hospital mortality (OR 1.11, 95 %CI 1.07-1.14; p < 0.001), even after adjustment with the following variables (age, sex, P/F ratio, SpO2, lactate, hypertension, chronic renal failure, diabetes, and obesity).

The novelty of this research corroborates and validates the 12-field lung ultrasound score as tool for predicting mortality and severity clinical course in COVID-19 patients. Baseline lung ultrasound score was associated with in-hospital mortality and requirement of intensive respiratory support and predict the risk of IOT among COVID-19 patients.

The Spanish Society of Pulmonology and Thoracic Surgery created a registry for hospitalised patients with COVID-19 and the different types of respiratory support used (RECOVID). Objectives. To describe the profile of hospitalised patients with COVID-19, comorbidities, respiratory support treatments and setting. In addition, we aimed to identify varying profiles of patients according to outcomes and the complexity of respiratory support needed.

Multicentre, observational study in 49 Spanish hospitals. A protocol collected demographic data, comorbidities, respiratory support, treatment setting and 1-year follow-up. Patients were described using either frequency and percentages or median and interquartile range, as appropriate. A cluster analysis made it possible to identify different types of profile among the patients.

In total, 2148 of 2454 hospitalised patients (87.5%) received care in the conventional ward, whilst 126 in IRCU and 180 in ICU. In IRCU, 30% required high-flow nasal oxygen whilst 25%, non-invasive mechanical ventilation and 17%, mechanical ventilation. Four clusters of patients were identified. Two clusters were more likely to require IRCU/ICU admission, although primarily Cluster 2: Cluster (C) 1 consisted of patients without comorbidities and C2, those with comorbidities. Both presented higher inflammatory levels and lower lymphocyte count and SpO2/FiO2; however, C2 showed worse values. Two different clusters identified patients requiring less complex respiratory support. C3 presented higher comorbidities and elevated lymphocyte count, SpO2/FiO2 and low C-reactive protein (CRP). C4 included those without comorbidities except for arterial hypertension, lymphopenia and an intermediate CRP. In-hospital mortality and subsequent 1-year mortality were greater for C2 (28.6% and 7.1%) and C1 (11.1%, 8.3%) than for C4 (3.3%, 1.8%) and C3 (0%, 0%).

The cluster analysis identified four clinical phenotypes requiring distinct types of respiratory support, with great differences present per characteristics and outcomes.

With about 6 million visitors, the 2022 Oktoberfest in Germany has been one of the largest in-person social events following the COVID-19 pandemic. Despite high vaccination rates in Germany at that time, health authorities pointed out the high risk of getting infected at such events. Using a unique dataset, we estimate the causal impact of the Oktoberfest on the spread of infection by applying an event study design. Our results imply a significant increase in the infection rates during and after Oktoberfest, especially in the age cohorts 15-34 and 35-59. However, the case rate drops relatively quickly after Oktoberfest. We also find little to no effect of the fair on the infection rates of the remaining age cohorts below 15 and above 60 years of age. A robustness check using the hospitalization rate as dependent variable confirms those results. Our findings have important implications for regulations of large social events in times of COVID-19, when the share of vaccinated people in the population is already high.

The global public health is still at risk due to the COVID-19 pandemic, which was caused by SARS-CoV-2. Disease severity varies among patients and is influenced by mutations in the viral genome, particularly within the spike protein's receptor-binding domain (RBD). This study aimed to investigate the association between RBD mutations and disease severity and to shed light on the fundamental molecular mechanisms. Nasopharyngeal and oropharyngeal samples were obtained from 70 COVID-19 patients in Iran, including 35 mild and 35 deceased cases. The RBD region of the spike protein gene underwent amplification through reverse transcription-polymerase chain reaction (RT-PCR) and was subsequently sequenced using Sanger sequencing. The impact of RBD mutations on binding affinity to human ACE2 (hACE2) was assessed by molecular docking analyses. Sequence analysis identified seven nonsynonymous mutations within the RBD region. The N501Y mutation, which was the most prevalent, showed a significant correlation with disease severity. Molecular docking revealed that the N501Y substitution enhanced binding affinity to hACE2 by increasing hydrophobic interactions and altering the interaction patterns of neighboring residues. This study demonstrates that the N501Y mutation has an independent association with increased severity of COVID-19, likely due to its effect on strengthening the RBD-hACE2 interaction. Further studies involving larger cohorts and diverse populations are necessary to confirm these results and to explore their potential implications for disease management and therapeutic strategies.

COVID-19 associated pulmonary aspergillosis (CAPA) has been globally reported to be a life-threatening complication of severe COVID-19. Previous studies primarily focused on an association between secondary Aspergillus infection and elevated mortality risk in COVID-19 patients, while potential confounding factors and alternative pathogenic mechanisms remain insufficiently investigated. The risk factors and outcomes of patients with secondary SARS-CoV-2 infection following invasive pulmonary aspergillosis (IPA) were not been well explored either.

This retrospective monocentric study enrolled 152 hospitalized IPA patients with and without SARS-CoV-2 infection from 1 November 2022 to 31 October 2023. The characteristics of IPA patients and related risk factors were investigated, and the relationship between different SARS-CoV-2 infection status and the prognosis in IPA patients was further evaluated.

Our analysis demonstrated that IPA patients subsequently diagnosed with SARS-CoV-2 infection exhibited significantly elevated mortality risk compared to those without viral coinfection (53.6% vs. 22.9%, P < 0.001). SARS-CoV-2 infection status (OR 3.708; P = 0.001; 95%CI 1.674-8.212), albumin concentration (OR 0.885; P = 0.005; 95%CI 0.813-0.964), and C-reactive protein level (OR 1.007; P = 0.012; 95%CI 1.002-1.013) were statistically significant independent risk factors for prognosis of IPA patients. Subsequent analysis established a multivariate risk prediction model incorporating independent prognostic factors, which exhibited robust discriminative capacity for mortality risk stratification via ROC curve validation (AUC = 0.792, 95%CI 0.721-0.862, P < 0.0001). A statistically significant difference in mortality rate existed between IPA patients with secondary SARS-CoV-2 infection and CAPA patients (63.2% and 33.3%, P = 0.037). Notably, comparative analysis revealed no statistically significant differences in 28-day (22/96, 22.9% vs. 6/18, 33.3%) or 90-day mortality rates (22/96, 22.9% vs. 6/18, 33.3%) between patients with IPA without SARS-CoV-2 infection and IPA patients with secondary SARS-CoV-2 infection.

IPA patients with secondary SARS-CoV-2 coinfection had a lower mortality compared to those with CAPA. Considering the high mortality rate, more medical cares are needed for these patients.

The Mpox virus, formerly known as Monkeypox, was declared a Public Health Emergency of International Concern in July 2022 due to its rapid global spread. By 2024, the more virulent and fatal Clade Ib variant had reached the United States. While Mpox typically presents with a self-limited rash, severe manifestations requiring surgical intervention have become increasingly prevalent, necessitating heightened awareness and preparedness among surgeons.This narrative review, specifically targeting surgeons, provides a comprehensive summary of the current data on the epidemiology, pathophysiology, perioperative considerations, and surgical management of Mpox-related conditions. It outlines essential hospital protocols and perioperative precautions to mitigate nosocomial spread, drawing useful parallels with measures established for COVID-19. It also addresses Mpox-related surgical pathologies, including colorectal abscesses, cutaneous scarring, facial lesions, and ocular complications, detailing management strategies for each.Our findings emphasize the need for rigorous infection control measures, early recognition of surgical indications, and interdisciplinary coordination to optimize patient outcomes, especially since Mpox is most readily transmitted among immunocompromised individuals, such as those who have undergone solid organ transplants. The virus primarily spreads through sexual transmission and contact with infected skin lesions, necessitating standardized hospital protocols to minimize its spread, particularly in operating rooms. Colorectal manifestations often require surgical drainage, with colostomy being necessary in severe cases, while ophthalmic manifestations demand prompt and aggressive management to preserve vision. Airway management and anesthetic planning are also critical considerations in cases involving oropharyngeal Mpox lesions.This review highlights the urgent need for ongoing documentation and research to refine surgical management protocols for Mpox, enhancing preparedness for future outbreaks. The complexity and severity of Mpox-related surgical pathologies underscore the necessity for further studies to refine management strategies, develop innovative treatments, and improve patient outcomes. Future research should aim to deepen our understanding of Mpox pathophysiology and optimize protocols to ensure safe and effective care for affected patients. This is essential in an era marked by the threat of emerging infectious diseases and the lessons learned from recent global health crises.

Frequent SARS-CoV-2 vaccination in vulnerable populations has raised concerns that this may contribute to T cell exhaustion, which could negatively affect the quality of immune protection. Herein, we examined the impact of repeated SARS-CoV-2 vaccination on T cell phenotypic and functional exhaustion in frail older adults in long-term care (n = 23), individuals on immunosuppressive drugs (n = 10), and healthy adults (n = 43), in Canada. Spike-specific CD4+ and CD8+ T cell levels did not decline in any cohort following repeated SARS-CoV-2 vaccination, nor did the expression of exhaustion markers on spike-specific or total T cells increase. T cell production of multiple cytokines (i.e. polyfunctionality) in response to the spike protein of SARS-CoV-2 did not decline in any cohort following repeated vaccination. None of the cohorts displayed elevated levels of terminally differentiated T cells following multiple SARS-CoV-2 vaccinations. Thus, repeated SARS-CoV-2 vaccination was not associated with increased T cell exhaustion in older frail adults, immunosuppressed individuals, or healthy adults.

NETosis, the process through which neutrophils release neutrophil extracellular traps (NETs), has emerged as a crucial mechanism in host defense and the pathogenesis of autoimmune responses. During the SARS-CoV-2 pandemic, this process received significant attention due to the central role of neutrophil recruitment and activation in infection control. However, elevated neutrophil levels and dysregulated NET formation have been linked to coagulopathy and endothelial damage, correlating with disease severity and poor prognosis in COVID-19. Moreover, it is known that SARS-CoV-2 can induce persistent low-grade systemic inflammation, known as long COVID, although the underlying causes remain unclear. It has been increasingly acknowledged that excessive NETosis and NET generation contribute to further pathophysiological abnormalities following SARS-CoV-2 infection. This review provides an updated overview of the role of NETosis in autoimmune diseases, but also the relationship between COVID-19 and long COVID with autoimmunity (e.g., latent and overt autoimmunity, molecular mimicry, epitope spreading) and NETosis (e.g., immune responses, NET markers). Finally, we discuss potential therapeutic strategies targeting dysregulated NETosis to mitigate the severe complications of COVID-19 and long COVID.

Nirmatrelvir-Ritonavir (NR) has proven effective for mild to moderate COVID-19 patients at risk of disease progression. Following its emergency use authorization in Taiwan in January 2022, this study aims to evaluate its impact on severe COVID-19 outcomes across different patient demographics in Taiwan.

We performed a retrospective analysis of a database that includes data from three hospitals in Northern Taiwan. Patients with COVID-19 in 2022 were paired by propensity score matching based on NR prescription. Cox proportional hazard regression analysis calculated hazard ratios (HR), adjusting for confounding factors. Subgroup analysis determined HRs across patient characteristics.

Among 95,096 patients, 3329 were in the NR group, and 12,807 in the non-NR group. NR users demonstrated significantly better prevention of severe outcomes: intubation (HR=0.296 [95 % CI: 0.187-0.469], p = 0.0482); ICU admission (HR=0.327[0.108-0.991], p < 0.001); mortality (HR=0.195 [0.101-0.378], p < 0.001). Subgroup analysis revealed significantly lower intubation risks for NR users among both sexes, aged 18-65 or ≥ 65 years, BMI < 30, and patients with diabetes mellitus (DM), cardiovascular disease (CVD), or chronic obstructive pulmonary disease (COPD). ICU admission risk was lower for NR users among males, aged ≥ 65 years, and BMI < 30. Mortality risk was lower for NR users among both sexes, aged ≥ 65 years, BMI < 30, and patients with DM, CVD, or COPD.

NR significantly reduces the risk of severe COVID-19, particularly among older adults and those with pre-existing conditions, supporting NR as an essential treatment for high-risk COVID-19 patients.

This study aims to evaluate the effectiveness of various COVID-19 response policies in the United Sates that facilitated rapid virus transmission suppression and promoted quick return to normalcy during the first three years of the pandemic.

We constructed comprehensive and unique time-to-event panel data that tracks the timeline of all policy implementations, and transmission waves, specifically measuring the duration from peak transmission to the desired suppression level, over 157 weeks. We then conducted a survival analysis to estimate the effectiveness of COVID-19 response policies in relation to the virus transmission dynamics. Our analysis focuses on the ten most populous U.S. states, representing diverse geographic, cultural, and political landscapes across the country. The survival analysis leverages the extensive time-to-event panel data collected from multiple sources.

Our findings indicate that not all policies were equally effective in facilitating rapid transmission and promoting swift suppression return to normalcy. Containment or closure policies, such as school closures and stay-at-home orders, are associated with a shorter duration for returning to normalcy, highlighting their effectiveness in curbing COVID-19 transmission. In contrast, health system policies and vaccine policies showed mixed results.

The findings from our survival analysis of the novel data set provide practical insights for prioritizing policy measures among various options to effectively and timely suppress the transmission of highly contagious diseases. These insights can also enhance resource utilization and allocation within and across public health systems, while minimizing restrictions on people's daily lives.

Otitis media (OM) is a prevalent and serious condition in childhood, but comprehensive global studies assessing its burden are lacking.

Using data from the 2021 Global Burden of Disease (GBD) study, we analyzed OM incidence cases and disability-adjusted life years (DALYs) in children aged 0-14 from 1990 to 2021. Trends were analyzed across regions, age groups, sexes, and socio-demographic index (SDI) using estimated annual percentage changes (EAPC). Predictive models were used to forecast trends to 2050.

The global number of OM incidence cases in children increased from 256 million in 1990 to 297 million in 2021, a 15.97% rise. The age-standardized incidence rate (ASIR) showed a slight increase (EAPC: 0.12). Despite some variations across age, sex, and regions, the age-standardized DALY rate (ASDR) declined. ASIR and ASDR were highest in children aged < 1 year and gradually decreased with age. The largest burden was observed in low- and middle-low-SDI regions, although these regions showed the greatest declines in EAPC. Correlation analysis indicated that ASDR decreases as the SDI increases. By 2050, the number of global OM incidence cases in children is projected to reach 334 million, with most of the increase concentrated in low-SDI regions, while ASIR is expected to remain stable.

Although progress has been made in controlling OM in children over the past 30 years, the ASIR remains high. The sustained high burden and incidence of OM in low-SDI regions, and among young children, pose a significant challenge to children's health.

Background/Objectives: The present study aimed to analyze changes in symptom intensity during the recovery period of COVID-19 survivors and patients with post-COVID syndrome. Methods: Initially, we described a new remote patient monitoring system to track the intensity of specific symptoms in individuals' home environments. Remote patient monitoring (RPM) was implemented over 15 days in a cohort of 133 individuals aged 20 to 78 years, divided into four groups: mild (MG, n = 40), Hospital Discharge Without Invasive Mechanical Ventilation (WIMV, n = 40), Hospital Discharge With Invasive Mechanical Ventilation (IMV, n = 13), and reinfected (RG, n = 40). Results: The most prevalent symptoms reported across all groups, based on average intensity, were shortness of breath, fatigue, cough, headache, and body pain. The WIMV group exhibited the highest average intensities in six symptoms (p < 0.01), while the IMV group reported the highest averages in four symptoms (p < 0.05). Fatigue was the symptom with the highest overall intensity, followed by memory lapses. The hospitalized groups demonstrated the highest intensities and most persistent symptoms (p < 0.05). Blood pressure was significantly higher in the MG group compared to the RG group (p < 0.0001), although all values remained within the normal range. Conclusions: These results provide novel insights, revealing distinct differences in the symptom profiles among the studied groups. These findings hold significant implications for developing more personalized care strategies and informing future pandemic preparedness and response efforts.

Background/Objectives: The World Health Organization (WHO) declared a global pandemic of COVID-19 caused by SARS-CoV-2 in March 2020. May 2023 was the month that ended the global pandemic. Pregnant females with COVID-19 are less likely to be symptomatic than non-pregnant patients, with nearly three-quarters being without symptoms. According to previous studies, even if somebody develops symptoms, they are usually mild, most commonly coughing (41%), fever (40%), and dyspnea (21%). Our study aims to search the literature systematically, especially case series and case reports published in Europe, and to summarize results about the kind of COVID-19 therapy in pregnant women and about outcomes in mothers and newborns. Methods: Our systematic review was registered at the International Prospective Register of Systematic Reviews (PROSPERO) with CRD42024566838. We searched PubMed/MEDLINE, Google Scholar, Web of Science, Scopus, and Serbian Citation Index (SCIndeks). In this study, case reports or case series with open, complete text that included full clinical records of the individuals identified with infection in pregnancy, thought to be caused by COVID-19, were used. Case series or case reports were eliminated if they (1) did not contain a full clinical report for every patient, or (2) included an individual who suffered from another viral infection other than COVID-19, so the clinical course and the outcome could not be precisely defined. We evaluated reporting bias and attrition bias. Results: Our study included 32 published studies (eight case series and 24 case reports) that included 56 individual cases. The oldest patient was 50 years old, and the youngest was 19 years old. The most common symptom initially was dry cough (n = 23; 41%), followed by fever (n = 21; 37%) and dyspnea (n = 10; 17%). In three patients, a lower level of thrombocytes was reported, with the lowest level of 86 × 109. The most frequently used drugs in pregnant women with COVID-19 infection were azithromycin, lopinavir/ritonavir, hydroxychloroquine, as well as corticosteroids. Twenty-two patients were on mechanical ventilation. After all this reported therapy, ten women died, as well as seven newborns. Conclusions: From our results, we can conclude that mechanical ventilation correlates with cesarean section performed more frequently, as well as with a higher mortality rate of neonates. There are no significant data related to transplacental transmission of the virus. Generally, mortality in our group of patients (mothers) was 17%, which is similar to the general population death from COVID-19 infection.

Severe acute respiratory syndrome coronavirus 2 non-structural protein 8 (SARS-CoV-2 nsp8) is a multifunctional protein essential for viral replication and immune evasion. However, the host factors that regulate nsp8 stability and function remain unclear. In this study, we identify HECT and RCC-like domain-containing protein 5 (HERC5) as an essential E3 ligase that regulates nsp8 stability through ISGylation, a ubiquitin-like post-translational modification that facilitates proteasome-dependent degradation. HERC5 overexpression significantly enhances nsp8 degradation in an enzymatic activity-dependent manner, whereas SARS-CoV-2 papain-like protease (PLpro) counteracts this process by deconjugating interferon-stimulated gene 15 (ISG15) from nsp8-thereby preventing its degradation and facilitating viral replication. Mass spectrometry and mutational analyses revealed that the N2 domain of nsp8 is indispensable for ISGylation, with multiple lysine residues acting as primary modification sites. Additionally, we demonstrated that the ISGylation system, including HERC5, ubiquitin-like modifier activating enzyme 7 (UBA7), and ISG15, effectively suppresses SARS-CoV-2 replication across multiple variants, including Omicron BA.5 and XBB.1.5.15. These findings provide novel insights into the role of ISGylation in host antiviral defense and highlight the interplay between HERC5 and PLpro in modulating viral replication. This study establishes a foundation for developing therapeutic strategies targeting HERC5 or PLpro to inhibit SARS-CoV-2 replication.

Disease presentation and progression can vary greatly in heterogeneous diseases, such as COVID-19, with variability in patient outcomes, even within the hospital setting. This variability underscores the need for tailored treatment approaches based on distinct clinical subgroups.

This study aimed to identify COVID-19 patient subgroups with unique clinical characteristics using real-world data (RWD) from electronic health records (EHRs) to inform individualized treatment plans.

A Factor Analysis of Mixed Data (FAMD)-based agglomerative hierarchical clustering approach was employed to analyze the real-world data, enabling the identification of distinct patient subgroups. Statistical tests evaluated cluster differences, and machine learning models classified the identified subgroups.

Three clusters of COVID-19 in patients with unique clinical characteristics were identified. The analysis revealed significant differences in hospital stay durations and survival rates among the clusters, with more severe clinical features correlating with worse prognoses and machine learning classifiers achieving high accuracy in subgroup identification.

By leveraging RWD and advanced clustering techniques, the study provides insights into the heterogeneity of COVID-19 presentations. The findings support the development of classification models that can inform more individualized and effective treatment plans, improving patient outcomes in the future.

COVID-19 disease has been a deadly pandemic in different waves in the Democratic Republic of Congo. However, knowledge of the clinical characteristics of COVID-19 patients and the factors associated with death during different waves is important.

We conducted a retrospective cohort of 410 patients hospitalized during 4 waves of COVID-19, from March 20, 2020, to January 2, 2022, at the Ngaliema clinic in DR Congo. We included any patient hospitalized for COVID-19 with biological confirmation by RT-PCR. Factors associated with death were investigated using logistic regression.

During the 4 waves of the COVID-19 pandemic at Clinique Ngaliema, complaints on admission were most often fever, cough and physical asthenia. Death was most common in the elderly, hypertensive and diabetic patients, those with elevated CRP and hyper leukocytosis. Mortality was highest in the 1st wave (28%), followed by the 3rd wave (27%), then the 2nd (22%) and 4th waves (21%). Factors associated with death were hyper leukocytosis (ORa: 2.76; CI 95%: 1.25-6.1), severe disease stage (ORa 21.24; CI 95%: 1.87-24). Vitamin C 500 mg twice a day use was protective (ORa: 0.24; CI 95%: 0.08-0.72).

COVID-19 disease poses a real public health problem, with non-negligible mortality. Factors associated with death were degree of disease severity, hyper leukocytosis and non-use of vitamin C. Taking these factors into account will help clinicians and decision-makers to anticipate future waves of the pandemic.

The objective of this study was to conduct a systematic review on the effect of coronavirus disease 2019 (COVID-19) on the incidence, mortality, and prognosis of ischemic stroke. The systematic review also ascertained the relationship between COVID-19 and the Trial of Org 10,172 in Acute Stroke Treatment (TOAST) typing of ischemic stroke, as well as the risk factors for ischemic stroke in patients with COVID-19.

The relevant literature between COVID-19 and ischemic stroke incidence, mortality, and prognosis up to January 2024 were systematically reviewed. Searches were carried out PubMed, Embase, Web of Science, and Cochrane databases. Utilizing the Meta-analysis of observational studies in epidemiology (MOOSE) declaration list, a systematic review and meta-analysis were carried out. Heterogeneity and publication bias were assessed.

Twenty-one studies encompassed 505,864 participants across 13 countries. In total, 1.1% of patients with COVID-19 infection had an ischemic stroke (odds ratio [OR], 0.011; 95% confidence interval [CI], 0.007-0.017; p < 0.001). COVID-19 was related to in-hospital mortality (OR, 2.76; 95% CI, 1.90-4.02; p < 0.001), mortality 3 months following the beginning of an ischemic stroke (OR, 2.54; 95% CI, 1.80-3.58; p < 0.001), and modified Rankin scale (mRS) score ≤2 at hospital discharge (OR, 0.62; 95% CI, 0.54-0.72; p < 0.001). mRS ≤ 2 at 3 months after the onset of ischemic stroke did not show any correlation significantly with COVID-19 (OR, 0.67; 95% CI, 0.43-1.06; p = 0.086). Longer hospital stays (OR, 0.13; 95% CI, 0.06-0.20; p < 0.001) and increased incidence of large-artery atherosclerosis and small-vessel disease phenotypes of ischemic stroke were observed in patients with both COVID-19 and ischemic stroke (p < 0.05). In patients with COVID-19, ischemic stroke was substantially linked with hypertension, diabetes, hyperlipidemia, smoking, atrial fibrillation, coronary artery disease, chronic kidney disease, and chronic obstructive pulmonary disease (p < 0.05).

COVID-19 is linked with increased incidence and mortality rates for ischemic stroke, as well as a worsening prognosis for the condition. With the data obtained from this study, targeted strategies to prevent and treat ischemic stroke in the context of the COVID-19 can be developed.

https://www.crd.york.ac.uk/PROSPERO/view/CRD42024524016, identifier: CRD42024524016.

A previous questionnaire survey on infection control measures and infection status among practicing dentists during the 1st-5th surge of coronavirus disease 2019 (COVID-19) cases in Japan indicated a low risk of COVID-19 infection spreading through dental care. However, the low number of infected patients during the survey period may have been a contributing factor, and a sharp increase in the number of infected patients was subsequently observed. We re-examined the spread of infections in dental care settings and compared the results with those of previous reports.

An online questionnaire-based survey was administered in March 2023 to examine the situation from February 2022 to March 2023, when the 6th-8th surge of COVID-19 infection was observed in Japan. The survey was conducted via an online platform (Google Forms; San Mateo, California, USA). The call for participation was publicized to members of the Nagano Dental Association. The survey consisted of questions on clinical activities, infection control measures, and confirmed or probable COVID-19 cases among patients and clinical staff.

The number of COVID-19-positive patients increased approximately 50-fold between the study periods. There was a 3.5-fold increase in the rate of dental treatment for infected patients.

Even with the increased likelihood of contact with COVID-19 patients, no cases of infection during dental treatment were observed. The results of this study indicate that even with the possibility of contact with COVID-19 during dental treatment, the likelihood of COVID-19 clusters occurring in dental practices is low if appropriate infection prevention measures are in place.

The COVID-19 pandemic has increased morbidity and mortality, along with substantial economic repercussions for healthcare systems and communities worldwide. This study describes the costs incurred by one of the biggest university hospitals in Finland during the first three years of the pandemic, from 2020 to 2022.

A retrospective analysis was conducted at a 950-bed tertiary care hospital, encompassing data from 2020 to 2022. Hospitalized COVID-19 cases were identified from an automated surveillance program that integrated microbiological and administrative data. Patient-level data, including hospitalization demographics, vaccination status, and outcomes, were collected. Billing costs, indirect costs, and operational data were obtained to assess hospital costs comprehensively.

During 2020-2022, 2 555 COVID-19-positive patients were treated at the hospital. Of them, 57% were hospitalized primarily for COVID-19 with the hospital billing costs of 14 492 399 € (median 4 137 €/ patient), and 47% of these costs were due to intensive care. Including ER visits of COVID-19 outpatients, admission screening and isolation costs of COVID-19 positive patients hospitalized for other reasons and indirect expenses, the total costs reached 28 899 298 € over three years. Additionally, the hospital incurred losses of income due to postponed elective surgeries.

The economic burden of COVID-19 at the considered university hospital was substantial. Intensive care costs were a significant driver. This study provides a comprehensive overview of the economic and disease burden of COVID-19 at a tertiary care hospital, highlighting the need for strategic planning and financial readiness to address the costs associated with pandemics.

On 7 December 2022, China lifted most of the restrictions under the so-called zero-COVID policy due to factors like less toxicity of the new variants of the virus, leading to widespread infections throughout China.

This study aims to assess the stockpiling behavior of COVID-19 medicines by the general population in Zhejiang at the early stage after China's zero-COVID policy cancellation and its impact on people's anxiety.

A cross-sectional, internet-based survey was conducted to collect information on COVID-19 drug purchasing behavior, sociodemographic characteristics, anxiety levels, etc. Chi-square tests and univariate analyses were used to explore the association between COVID-19 medicines purchasing behavior and sociodemographic characteristics. Multivariate analyses were employed to explore the impact of COVID-19 drug purchasing behavior on anxiety status.

Among 38,480 participants, stockpiling behavior of COVID-19 medicines was reported by 35.74% of them and was most common among participants from Huzhou area, female, those who aged< 20 years, those with postgraduate education level, health workers. A total of 20,986 (54.54%) participants claimed that they were unable to access any COVID-19 medicines, while 3,742 (9.72%) participants felt it unnecessary to stockpile medicines. The majority of the participants (82.3%) experienced anxiety. Multivariate analyses found that compared to those with severe anxiety, those with moderate anxiety were 1.76 times more likely to have stockpiled COVID-19 medicine (aOR 1.76, 95% CI 1.64-1.89); those with mild anxiety were 2.11 times (aOR 2.11, 95% CI 1.98-2.24) more likely to have stockpiled COVID-19 medicine; those with no anxiety were 2.48 times (aOR 2.48, 95% CI 2.31-2.67) more likely to have stockpiled COVID-19 medicine.

At the early stage after China's zero-COVID policy cancellation, drug stockpiling among the public and the subsequent drug shortage was observed. There exists inequity in distribution between regions and among different groups of people. Many people experienced anxiety, especially those without access to COVID-19 medications. Measures for equitable drug distribution and public education on safe self-medication should be taken for future public health events.

During the initial phase of a pandemic outbreak, the rapid increase in the number of infected patients leads to shortages of medical resources for both pandemic-related and non-pandemic (ordinary) patients. It is crucial to efficiently utilize limited existing resources and strike a balance between controlling the pandemic and sustaining regular healthcare system operations. To tackle this challenge, we introduce and investigate the problem of optimizing the location of designated hospitals, reallocating beds within these hospitals, and assigning different types of patients to these hospitals. Designated hospitals isolate pandemic-related patients from ordinary patients to prevent cross-infection. Moreover, isolation beds can be converted into ordinary beds and vice versa. Considering the stochasticity and evolving nature of the pandemic, we formulate this problem as a multi-stage stochastic programming model, integrating a compartmental model with time-varying random parameters to enable dynamic resource allocation as the pandemic progresses. The model is then solved by a data-driven rolling horizon solution approach. We illustrate the effectiveness of our model using real data from the COVID-19 pandemic. Compared with two other approaches, our model demonstrates superior performance in controlling the spread of the pandemic while addressing the needs of both pandemic-related and ordinary patients. We also conduct a series of experiments to uncover managerial insights for policymakers to better utilize existing resources in response to pandemic outbreaks. Results indicate that admitting as many pandemic-related patients as possible during the initial phases of the outbreak can effectively flatten the pandemic peaks and alleviate strain on the healthcare system.

Advances in bio-analyte detection demonstrate the need for innovation to overcome the limitations of traditional methods. Emerging viruses evolve into variants, driving the need for fast screening to minimize the time required for positive detection and establish standardized detection. In this study, a SERS-active substrate with Au NPs on a regularly arranged ZrO2 nanoporous structure was utilized to obtain the SERS spectrum of inpatient samples from COVID-19 patients. Two analytical approaches were applied to classify clinical samples - empirical method to identify peak assignments corresponding to the target SARS-CoV-2 BA.2 variant, and machine learning (ML) method to build classifier models.

Comparison of spectral profiles of pure BA.2 variant and inpatient samples showed significant differences in the occurrence of SERS peaks, requiring the selection of regions of interest for further analysis through the empirical method. SERS spectra are classified into CoV (+) and CoV (-) using both empirical and machine learning methods, each demonstrating a sensitivity of 85.7 % and a specificity of 60 %. The former method relies on peak assignment, which is performed manually relying on established and results in a longer turnaround time. In contrast, the latter method is based on the mathematical correlations between variables across the entire spectrum. The machine must continuously learn from larger datasets, and the response time for interpretation is short. Nonetheless, both methods demonstrated their suitability in classifying clinical samples.

This study demonstrated that a more comprehensive discussion can be formed with the integration of machine learning classification with biochemical profiling with the empirical analysis approach. Further improvement is expected by combining these two methods by utilizing only the regions of interest instead of the entire spectrum as input for machine learning, as a feature extraction technique.

Background: The association between Coronavirus Disease-2019 (COVID-19) and new-onset cardiomyopathy (NOC) is unclear. Objectives: We aim to assess the incidence of NOC in hospitalized COVID-19 patients and its impact on short- and long-term survival. Methods: We retrospectively studied 2219 COVID-19 patients hospitalized between March 2020 and February 2022 who underwent an in-hospital echocardiogram. NOC was defined as a left-ventricular ejection fraction (LVEF) reduction of >10%, resulting in an LVEF of <54% for females and <52% for males. The 30-day and 1-year survival outcomes in patients without and with NOC were studied. Results: Among 25,943 hospitalized COVID-19 patients, 2219 met our inclusion criteria, with 209 (9.4%) having NOC. NOC patients were more likely to be male (56.1% vs. 68.4%, p = 0.001) and have chronic kidney disease (51.4% vs. 60.3%, p = 0.018). They had a higher 30-day mortality rate (29.1% vs. 32%, p = 0.033), but the 1-year survival rate was similar between the patients without and with NOC (36.9% vs. 41.6%, p = 0.12). Multivariable regression revealed that advanced age, admission to intensive care unit, mechanical ventilation, treatment with glucocorticoids, and treatment with vasopressors were associated with higher odds of 30-day mortality in NOC patients. Only 74 (35.4%) NOC patients had follow-up echocardiograms after discharge, of which 47 showed persistent cardiomyopathy. Conclusions: NOC can affect around 1 out of 10 hospitalized COVID-19 patients undergoing echocardiography. While NOC was associated with worse short-term survival, it did not impact the long-term mortality of these patients. Persistent LVEF deficits in some patients emphasize the need for improved outpatient follow-up to identify at-risk individuals and optimize treatment.

The prognosis of patients with acute myocardial infarction (AMI) in the setting of coronavirus disease 2019 (COVID-19) remains uncertain.

To evaluate patients' prognosis after an AMI concomitant with COVID-19.

This retrospective nationwide observational cohort study was based on the French administrative hospital discharge database. Primary outcomes were incidences of all-cause death, cardiovascular death, heart failure (HF), recurrence of AMI, ischaemic stroke, incident atrial fibrillation (AF), ventricular tachycardia/ventricular fibrillation (VT/VF) and cardiac arrest. Patients with AMI and COVID-19 were matched to those without COVID-19 (using propensity score matching techniques) to account for differences between the two populations.

A total of 288,408 patients hospitalized for AMI in France from March 2020 to January 2023 were included; 26,879 had a COVID-19-positive test between 15 days before to 5 days after admission. Patients with COVID-19 were older, more frequently had diabetes mellitus and obesity but less frequently smoked. They more frequently had non-ST-segment elevation myocardial infarction presentation and more often had lung disease. After matching, patients with COVID-19 had higher risks of all-cause death (hazard ratio [HR] 1.255; 95% confidence interval [CI] 1.203-1.308; P<0.0001), HF (HR 1.205; 95% CI 1.159-1.254; P<0.0001), ischaemic stroke (HR 1.237; 95% CI 1.084-1.411; P=0.002), incident AF (HR 1.160; 95% CI 1.070-1.258; P=0.0003) and VT/VF (1.360; 95% CI 1.200-1.540; P<0.0001). Surprisingly, cardiovascular death risk was lower in patients with COVID-19 (HR 0.932; 95% CI 0.879-0.988; P=0.02) as a result of competition with non-cardiovascular death. No statistical difference was found for cardiac arrest or recurrent AMI.

In this French nationwide cohort study, AMI in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) increased all-cause death incidence compared to non-infected AMI, but this poorer prognosis was not due to cardiovascular death. Further investigations are needed to elucidate the aetiologies of death.

Pneumonia is a major cause of mortality and health burden in children under five, yet its genetic etiology remains poorly understood. Methyltransferase 4, N6-adenosine (METTL4), is a methyltransferase enzyme responsible for RNA and DNA methylation and is known to be activated under hypoxic conditions. However, its potential link to susceptibility to pneumonia has not been evaluated. This study aimed to explore candidate regulatory single nucleotide polymorphisms (SNPs) within the METTL4 gene and their association with the development of severe pneumonia.

In this study, we recruited a cohort of 1034 children with severe pneumonia and 8426 healthy controls. We investigated the associations of candidate regulatory single nucleotide polymorphisms (SNPs) within METTL4 polymorphisms with severe pneumonia. Our results indicated that the C allele of rs9989554 (P = 0.00023, OR = 1.21, 95% CI: 1.09-1.34) and the G allele of rs16943442 (P = 0.0026, OR = 1.22, 95% CI: 1.07-1.38) were significantly associated with an increased risk of severe pneumonia. The regulatory potential of these two SNPs in the lung was investigated using tools such as expression quantitative trait loci (eQTLs), RegulomeDB, and FORGEdb.

This study represents the first investigation elucidating the role of genetic variations in the METTL4 gene and their influence on susceptibility to severe pneumonia in pediatric populations. METTL4 is identified as a novel predisposing gene for severe pneumonia and a potential therapeutic target. Further research is warranted to validate this correlation and to comprehensively elucidate the biological role of the METTL4 gene in severe pneumonia.

This study aimed to assess the incidence of small for gestational age (SGA) newborns in pregnant women infected with COVID-19 and examine the associated neonatal outcomes.

This study involved a secondary analysis of the REBRACO Network, a prospective cohort study conducted in 15 maternity hospitals in Brazil before the introduction of COVID-19 vaccination (February 2020 to February 2021). Demographic data of pregnant women tested for COVID-19 were analyzed, and fetal outcomes were compared between women with positive and negative COVID-19 results who had SGA fetuses.

A total of 729 symptomatic pregnant women with COVID-19 were included in the study. However, there were 248 participants with missing information regarding childbirth or loss of follow-up, and 107 participants without confirmatory tests for COVID-19. Among the remaining participants, 198 had confirmed COVID-19 and 176 tested negative. The incidence of SGA among women with COVID-19 was 22.4%, whereas the incidence among women who tested negative for COVID-19 was 14.8%. SGA newborns born to COVID-19 positive pregnant women were 1.6 times more likely to experience adverse outcomes (such as prematurity, stillbirth, neonatal death, and admission to a neonatal ICU) compared to non-SGA newborns [OR = 1.655 (1.145 - 2.394); P=0.017]. In SGA newborns of pregnant women with confirmed COVID-19 infection, mechanical ventilation use was found to be associated with the infection [OR = 0.692 (0.562 - 0.853); P=0.002].

The higher incidence of SGA newborns and its stronger association with prematurity in pregnant women with confirmed COVID-19 infection suggest that COVID-19 infection is a significant factor contributing to neonatal morbidity and mortality.

The clinical consequences of the co-infection with novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and respiratory syncytial virus (RSV) are not optimistic. Nevertheless, there is currently no approved therapeutic regimen specifically targeting SARS-CoV-2/RSV co-infection, with existing monotherapies showing limited efficacy. According to recent studies, probenecid has both anti-SARS-CoV-2 and anti-RSV effects. Therefore, as one probable molecular candidate for the co-infection with SARS-CoV-2 and RSV, probenecid was researched in this exploration.

Using systems pharmacology and bioinformatics, we characterized the targets associated with probenecid for the treatment of SARS-CoV-2/RSV co-infection, focusing on their biological functions, mechanisms and binding activities. To further validate these findings, we conducted molecular docking, MD simulations, electrostatic potential mapping, and SAR analysis to explore the binding interactions between probenecid and the identified core targets.

We identified 141 targets that overlapped with the co-infection and probenecid, and used these shared targets to construct a protein-protein interaction (PPI) network. Subsequently, we obtained the top 16 hub targets of probenecid for SARS-CoV-2/RSV co-infection, namely, AKT1, ALB, EGFR, CASP3, CTNNB1, SRC, HSP90AA1, and so on. According to the enrichment analysis, probenecid might affect inflammation, immunity, oxidative stress, and virus defenses; Toll-like receptor, TNF, IL-17, NOD-like receptor, cytokine-cytokine receptor, among others. Additionally, based on molecular docking analysis, probenecid is effectively bound to the targets related to the SARS-CoV-2/RSV co-infection. Meanwhile, according to molecular dynamics (MD) simulations and structure-activity relationship (SAR) analysis, we speculated that SRC and HSP90AA1 are more likely to be the target proteins of probenecid than the other proteins.

Our findings from systems pharmacology and bioinformatics analysis indicate that immune and inflammatory responses play a pivotal role in the therapeutic effects of probenecid. Infectious disease-related pathways also contribute significantly to its effectiveness in treating SARS-CoV-2/RSV co-infection. Further validation was conducted through molecular docking, MD simulations, electrostatic potential mapping, and SAR analysis. These analyses suggest that SRC and HSP90AA1 are the potential binding targets of probenecid. This study provides valuable preliminary insights into the molecular mechanisms of probenecid. It establishes a strong foundation for future research to explore its potential as a therapeutic strategy for SARS-CoV-2/RSV co-infection.

COVID-19 patients in intensive care units (ICUs) requiring invasive mechanical ventilation (IMV) have few available treatment options. PANAMO, a multicenter, double-blind, randomized, placebo-controlled phase 3 study of vilobelimab, which blocks the inflammatory process caused by complement component 5a, demonstrated a significant mortality benefit at 28 and 60 days in these patients. A cost-effectiveness analysis was conducted to assess the incremental cost per quality-adjusted life-year (QALY).

A Markov model was used to estimate QALYs and the incremental cost-effectiveness ratio (ICER) of vilobelimab plus standard of care (SOC) versus SOC alone. The model simulated progression from severe COVID-19 to survival or death over a lifetime horizon. Outcomes data (COVID-19 all-cause mortality and renal replacement therapy) were incorporated from the PANAMO trial. COVID-19 mortality estimates were based on Centers for Disease Control and Prevention age-specific survival data. Utility values and hospital costs came from the literature. Vilobelimab cost was obtained from RED BOOK Online.

For COVID-19 ICU patients, total costs of care were $103,414 (SOC) and $132,247 (SOC plus vilobelimab), respectively, resulting in an incremental cost of $28,833. SOC provided 6.70 QALYs versus 7.99 QALYs for vilobelimab, an additional 1.29 QALYs. The ICER for vilobelimab plus SOC versus SOC alone was $22,287/QALY. Probabilistic sensitivity analysis demonstrated the robustness of the cost-effectiveness result as vilobelimab plus SOC was favored at a willingness-to-pay threshold of $50,000 in over 81% of iterations.

Vilobelimab provides a cost-effective option to treat ICU patients with severe COVID-19 receiving IMV compared to SOC, at well below the commonly accepted $50,000 US willingness-to-pay threshold.

Implemented public health measures to avoid the spread of SARS-CoV-2, influenced the circulation of various viral infections including parvovirus B19. Notably, pregnancies affected by parvovirus B19 have a high risk for severe fetal anemia and fetal demise. This study evaluates changes in parvovirus infection rates after the SARS-CoV-2 pandemic.

This was a retrospective cohort-study assessing the prevalence of parvovirus B19 among pregnant women at a tertiary referral center in Austria from January 2013 to December 2023 with particular interest in the influence of the COVID-19 pandemic on infection rates of parvovirus B19. Women who had PCR testing for parvovirus due to suspicion of infection were included in this study. To compare infection rates before, during, and after the pandemic, three study groups were defined in concordance with Austrian public health measures: A pre-pandemic group (Group 1) including all pregnant women who tested for parvovirus B19 from January 2013 to the beginning of the COVID-19 lockdown in March 2020, a pandemic group (Group 2) including all patients who had PCR testing during the COVID-19 lockdown and a post-pandemic group (Group 3) including all patients who had PCR testing from the end of the pandemic in April 2023 to December 2023.

A total of 251 pregnant women who had PCR testing for parvovirus B19 during the study period were identified, including 27 women with a positive test result. In the pre-pandemic group (n = 141) 14 women had a positive test result, in the pandemic group (n = 83) 3 women tested positive and in the post-pandemic group (n = 27) 10 women tested positive. The overall prevalence of parvovirus B19 was 0.108, and annually, it varies from 0.000 in 2021 to 0.355 in 2023. Considering the predefined study groups, the highest prevalence was demonstrated in the post-pandemic group (0.370), whereas the lowest was in the pandemic group (0.036). In the pre-pandemic group, the prevalence was 0.099. Prevalence of the predefined study groups differed significantly (p ≤ 0.001).

This study demonstrates a significant rise of parvovirus B19 infections among pregnant women after the COVID-19 pandemic indicating a major impact of the pandemic and associated public health measures on parvovirus B19 infection rates.

Inflammation is one defense mechanism of the body that has multiple origins, ranging from physical agents to infectious agents including viruses and bacteria. The resolution of inflammation has emerged as a critical endogenous process that protects host tissues from prolonged or excessive inflammation, which can become chronic. Failure of the inflammation resolution is a key pathological mechanism that drives the progression of numerous inflammatory diseases. Owing to the various side effects of currently available drugs to control inflammation, novel therapeutic agents that can prevent or suppress inflammation are needed. Supersulfides are highly reactive and biologically potent molecules that function as antioxidants, redox regulators, and modulators of cell signaling. The catenation state of individual sulfur atoms endows supersulfides with unique biological activities. Great strides have recently been made in achieving a molecular understanding of these sulfur species, which participate in various physiological and pathological pathways. This review mainly focuses on the anti-inflammatory effects of supersulfides. The review starts with an overview of supersulfide biology and highlights the roles of supersulfides in both immune and inflammatory responses. The various donors used to generate supersulfides are assessed as research tools and potential therapeutic agents. Deeper understanding of the molecular and cellular bases of supersulfide-driven biology can help guide the development of innovative therapeutic strategies to prevent and treat diseases associated with various immune and inflammatory responses.

To determine the hearing outcomes in patients with sudden sensorineural hearing loss (SSNHL) after exposure to different brands of vaccines against COVID-19.

Cohort study.

Tertiary referral center.

Patients who met the International Classification of Disease, Tenth Revision code, medications, and procedure criteria for SSNHL in 2021. Patients were classified according to their vaccination status. A total of 128 patients (71 males and 57 females; mean age, 53.9 ± 16.5 yr; range, 7.6-82.1 yr) who met the criteria of idiopathic SSNHL were included.

Exposure to COVID-19 vaccines in 2021.

Hearing outcomes were classified according to the pure-tone audiometry hearing level, including complete recovery (CR), partial recovery (PR), and no recovery (NR). Time to recovery was defined as the point at which the patient achieved CR or PR.

Among them, 35, 54, and 39 patients achieved CR, PR, and NR, respectively. The median time to recovery was 22 (interquartile range, 11-37) days. No significant differences were observed in hearing recovery in vaccinated or unvaccinated patients.

Our preliminary study failed to show significant differences in hearing recovery among patients with SSNHL regardless of the vaccine exposure status. The administration of COVID-19 vaccines should not be influenced by their potential association with SSNHL, as our findings indicate no significant effect on hearing outcomes. However, as a preliminary study with limited statistical power, future large-scale studies are necessary to validate these results.

Cell-free DNA (cfDNA) holds significant promise for diagnostic and therapeutic advancements in medicine. This review delineates the utility of cfDNA in diagnostics and its therapeutic potential through clearance mechanisms for an array of diseases. Damage-associated molecular patterns (DAMPs) are endogenous molecules released by host cells during stress, or injury. As a trigger for inflammatory responses via damage-associated molecular patterns (DAMPs), cfDNA's removal via nanotechnological approaches can attenuate inflammation and promote tissue repair. While the application of cfDNA clearance is particularly auspicious in cancer, sepsis, and inflammatory conditions, it is confronted with challenges including toxicity, specificity, and the rigors of clinical trial validation. Collectively, this review delineates novel therapeutic targets to inform the development of innovative treatment strategies.

To identify the symptom burden in children and adolescents with post COVID-19, a validated and reliable instrument is needed, particularly to assess symptoms and their impact on the child. The aim of this study was to describe the development, validation, and reliability of the Post COVID-19 in Kids Questionnaire (POCOKIDS-Q), which was designed to assess post COVID-19 symptoms in children and adolescents.

The POCOKIDS-Q was developed based on literature, clinical experience, and questionnaires for adults with post COVID-19. The linguistic validation involved 9- to 17-year-old children. Children and adolescents with the onset of post COVID-19 symptoms were asked to complete the final version through a web link. Exploratory and confirmatory factor analyses were performed to identify a factor structure that explains the covariances between the variables.

The link to the POCOKIDS-Q was opened 324 times and fully completed by 213 (66%) children and young adults (median age 14 years) with post COVID-19 symptoms. Confirmatory factor analyses revealed four significant and correlated factors: brain fatigue, cognitive impact, physical impact, and emotional impact. The explanatory power of the factor model is high.

The POCOKIDS-Q is applicable for assessing post COVID-19 symptoms in children and young adults.

SARS-CoV-2 infection frequently involves the respiratory system and may impact on pulmonary function tests (PFT) of recovered individuals. Studies which compare post-COVID-19 PFT to pre-illness measurements are scarce. The primary objective of this study was to assess the effect of COVID-19 on PFT soon after infection.

In this prospective observational study, PFT were measured early following recovery from COVID-19 among healthy military aircrew. Spirometry values were compared to pre-COVID-19 measurements, and abnormality rates of lung volumes and diffusion capacity for carbon monoxide (DLCO) were assessed.

The study included 252 aviators, 97.6% males, mean age 34.9-years, following recovery from SARS-CoV-2 infection. Participants manifested mild symptoms (79.4%) or were asymptomatic (20.6%). Post-COVID-19 spirometry results 10.79 ± 5.67 days following infection were compared to measurements performed 41.3 ± 28.59 months earlier. Pre- and post-COVID-19 results were comparable, with similar minimal abnormalities rates (2% and 4.4%, respectively). In addition, there were no restrictive abnormalities following infection, and just 7.7% of individuals had a marginally low DLCO of 70-80% of predicted.

Among vaccinated, healthy adults, mild COVID-19 had no significant impact on PFT early post-infection. The data suggest that systematic PFT testing might not be necessary for asymptomatic healthy individuals who recovered from mild COVID-19.

To explore the effectiveness and safety of azvudine and nirmatrelvir-ritonavir in a real-world setting.

This retrospective cohort study included adult patients with confirmed COVID-19 who received azvudine or nirmatrelvir-ritonavir treatment at Shanghai Changhai Hospital between 1 November 2022, and 30 March 2023. Data were collected from the hospital's electronic medical record system using a standardized data extraction form. Propensity score matching (PSM) was used to control for potential confounding factors. The primary outcome was the incidence of composite disease progression, defined as the occurrence of death, ICU admission, invasive respiratory support, or high-flow oxygen therapy. Multivariable Cox regression analysis was performed to identify the factors independently associated with the composite progression outcomes.

This study included 476 patients: 296 treated with azvudine and 180 treated with nirmatrelvir-ritonavir. After PSM, 139 patients were included in each group. There were no statistically significant differences between the two groups regarding the composite outcome (log-rank: P = 0.475; HR: 0.82, 95%CI: 0.46-1.43, P = 0.478), death (log-rank: P = 0.526; HR: 0.82, 95%CI: 0.44-1.52, P = 0.528), ICU admission (log-rank: P = 0.525; HR: 0.69, 95%CI: 0.22-2.18, P = 0.526), invasive ventilation (log-rank: P = 0.814; HR: 1.20, 95%CI: 0.27-5.39, P = 0.814), or oxygen use (log-rank: P = 0.370; HR: 1.44, 95%CI: 0.65-3.18, P = 0.372). The multivariable analysis showed that the antiviral drug (HR = 0.861, 95%CI: 0.486-1.524, P = 0.607) was not independently associated with the composite outcome. Only severe COVID-19 was independently associated with the composite outcome (HR = 3.322, 95%CI: 1.569-7.031, P = 0.002). The safety outcomes were similar between the two groups.

This real-world study demonstrates comparable efficacy and safety profiles between azvudine and nirmatrelvir-ritonavir in treating COVID-19 patients, regardless of disease severity or baseline characteristics. The findings support azvudine as a practical alternative for treatment selection, particularly in resource-constrained settings or for patients with contraindications to specific therapies. Clinical decisions should prioritize patient-specific needs, accessibility, and cost-effectiveness. Further large-scale prospective studies are needed to validate these observations and refine subgroup-specific treatment strategies.

COVID-19 caused by the coronavirus SARS-CoV-2 has resulted in a global pandemic. Considering some patients with COVID-19 rapidly develop respiratory distress and hypoxemia, early assessment of the prognosis for COVID-19 patients is important, yet there is currently a lack of research on a comprehensive multi-marker approach for disease prognosis assessment. Here, we utilized a large sample of hospitalized individuals with COVID-19 to systematically compare the clinical characteristics at admission and developed a nomogram model that was used to predict prognosis. In all cases, those with pneumonia, older age, and higher PT-INR had a poor prognosis. Besides, pneumonia patients with older age and higher PT-INR also had a poor prognosis. A nomogram model incorporating presence of pneumonia, age and PT-INR could evaluate the prognosis in all patients with SARS-CoV-2 infections well, while a nomogram model incorporating age and PT-INR could evaluate the prognosis in those with pneumonia well. Together, our study establishes a prognostic prediction model that aids in the timely identification of patients with poor prognosis and helps facilitate the improvement of treatment strategies in clinical practice in the future.