Background: Multisystem Inflammatory Syndrome in Children (MISC) is a phenomenon that appeared in children infected with or exposed to SARS-CoV-2. The typical onset of MISC is 4-6 weeks following SARS-CoV-2 infection and is formulated to be due to an immune response. Methods: Our study retrospectively analyzed data from a tertiary center in UAE of MISC patients who were admitted to either general pediatric wards or pediatric intensive care (PICU) or who came exclusively for follow-up (post PICU admission) from May 2020 to August 2021.   Results: The total sample size is 50 patients and the study included a comparison of PICU admissions with none PICU admissions. The PICU sample size was 18 patients, 50% females, with mean age of 8.3 years all were previously healthy. PICU patients had deranged blood counts with a lower hemoglobin count, a more pronounced lymphopenia and thrombocytopenia along with hypoalbuminemia. PICU patients presented with relatively higher inflammatory markers: CRP, PCT, ferritin and D-dimer. Immunological studies were significantly higher for IL-6 levels in PICU patients. On echocardiography, higher myocardial dysfunction was more notable in patients admitted to PICU. Children admitted in PICU were provided with more extensive therapy. As part of our study course, we re-evaluated our PICU patients twice, once at 48 hours post PICU admission and again 4-6 weeks after discharge from the hospital. No deaths have been recorded in the cohort. Conclusion: This study evaluated risk factors of MISC and potential severity features. Follow up of patients on discharge showed improvement across all domains.

Severe acute respiratory distress syndrome in association with coronavirus 2 (SARS-CoV-2) occured more that 6 million cases in Poland since first patient  on 04, March 2020. We present patient with SARS-CoV-2 and thrombus in ascending aorta. Clinically patient had also significant coronary artery disease which schould be treated by cardiac surgeons. Surgery was performer by medial sternotomy and  systematic hipothermia.

Aim To provide a comprehensive assessment of the effect of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin receptor II blockers (ARBs) on COVID-19 related outcomes by summarising the currently available evidence. Methods This was an umbrella review of systematic reviews/meta-analysis conducted using Medline (OVID), Embase, Scopus, Cochrane library and medRxiv from inception to 1st February 2021. Systematic reviews with meta-analysis that evaluated the effect of ACEIs/ARBs on COVID-19 related clinical outcomes were eligible. Studies’ quality was appraised using the AMSTAR 2 Critical Appraisal Tool. Data were analysed using the random-effects modelling including several sub-group analyses. Heterogenicity was assessed using I2 statistic. The study protocol was registered in PROSPERO (CRD42021233398). Results Overall, 47 reviews were eligible for inclusion. Out of the nine COVID-19 outcomes evaluated, there was significant associations between ACEIs/ARBs use and each of death (OR=0.80, 95%CI=0.75-0.86; I2=51.9%), death/ICU admission as composite outcome (OR=0.86, 95%CI=0.80-0.92; I2=43.9%), severe COVID-19 (OR=0.86, 95%CI=0.78-0.95; I2=68%), and hospitalisation (OR=1.23, 95%CI=1.04-1.46; I2= 76.4%). The significant reduction in death/ICU admission, however, was higher among studies which presented adjusted measure of effects (OR=0.63, 95%CI=0.47-0.84) and were of moderate quality (OR=0.74, 95%CI=0.63-0.85). There was no evidence of any significant association between ACEIs, or ARBs and COVID-19 outcomes. Conclusions Collective evidence from observational studies indicate a good quality evidence on the significant association between ACEIs/ARBs use and reduction in death and death/ICU admission, but poor-quality evidence on both reducing severe COVID-19 and increasing hospitalisation. Our findings further support the current recommendations of not discontinuing ACEIs/ARBs therapy in patients with COVID-19.

Previously treated pulmonary tuberculosis and Corona Virus Disease -2019 predispose to CPA and other pulmonary fungal diseases due to residual lung damage. We report a case of CPA in a 63-years-old Cameroonian woman with a history of PTB, 13 months after suffering from COVID-19 and treated with itraconazole 100mg.

Mucormycosis is an opportunistic infection that has become a serious concern as a result of the immunosuppressive drugs used during COVID-19. In this report, we describe two cases of rhino-orbital-cerebral mucormycosis with neurological presentation and ophthalmologic problems accompanied by a history of COVID-19 and diabetes.

A young man, a recent coronavirus patient, was readmitted with hypoesthesia and dysarthria following a rapid deterioration of respiratory symptoms. The brain and lung CT scans revealed ischemia and cavitary lung lesions. Clinical suspicion for aspergillus leads to prompt treatment, confirmed by biopsy. Neurologic and pulmonary symptoms resolved ultimately.

Background: The Omicron (lineage B.1.1.529) variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was first reported in Wales, UK on 3rd December 2021. The aim of the study was to describe the first 1000 cases of the Omicron variant by demographic, vaccination status, travel and severe outcome status and compare this to contemporaneous cases of the Delta variant. Methods: Testing, typing and contact tracing data were collected by Public Health Wales and analysis undertaken by the Communicable Disease Surveillance Centre (CDSC). Prevalence ratios for demographic factors and symptoms were calculated comparing Omicron cases to Delta cases identified over the same time period. Results: By 14th December 2021, 1000 cases of the Omicron variant had been identified in Wales. Of the first 1000, just 3% of cases had a prior history of travel revealing rapid community transmission. Most cases (82%) were double vaccinated (65.9%) or boosted (16.1%) and overall, 0.5% were hospitalised. Conclusion: Key findings include a lower prevalence of anosmia and a reduced risk of hospitalisation in the first 1000 Omicron cases compared to co-circulating Delta cases. We also identify that existing measures for travel restrictions to control importations of new variants identified outside the UK did not prevent the rapid ingress of Omicron within Wales.

Although sporadic Creutzfeldt Jakob disease is always fatal and no accepted treatment is currently available. Moreover, prevalence of COVID-19 in the same patient makes management protocol difficult and prognosis worse.

To report two cases of suprachoroidal hemorrhage (SCH) during otherwise uncomplicated phacoemulsification, in whom COVID-19 was documented with PCR about one month before the surgery.

Immune-inflammatory proteome of elite ice hockey players before and after SARS-CoV-2 infection

A document by Joseph De Luca F, written on Authorea.

Background: Covid-19 can have remarkable effects on pregnancy, and pregnant women with this infection are at higher risk for developing ketoacidosis. In this case report, we report a 35-year-old pregnant woman infected with Covid-19 with early manifestations of ketoacidosis during term pregnancy.

Dynamic digital radiography (DDR) is a motion-detective technique with high temporal resolution. Flexible laryngoscopy is a common modality for observation of the larynx, but it is aerosol generating. DDR is an easy and less risky screening test for diagnosis of recurrent laryngeal nerve paralysis during the COVID-19 pandemic.

Objective: To evaluate for cardiac involvement in recovered COVID-19 patients using cardiac magnetic resonance imaging (MRI). Methods: A total of 30 subjects recently recovered from COVID-19 and abnormal left ventricular global longitudinal strain were enrolled. Routine investigations, inflammatory markers and cardiac MRI were done at baseline with follow-up scan at 6 months in individuals with abnormal baseline scan. Additionally, 20 age-and sex-matched individuals were enrolled as healthy controls (HCs). Results: All 30 enrolled subjects were symptomatic during active COVID-19 disease and were categorized as mild: 11 (36.7%), moderate: 6 (20%) and severe: 13 (43.3%). Of the 30 patients, 16 (53.3%) had abnormal CMR findings. Myocardial edema was reported in 12 (40%) patients while 10 (33.3%) had LGE. No difference was observed in terms of conventional LV parameters however, COVID-19 recovered patients had significantly lower right ventricular (RV) ejection fraction, RV stroke volume and RV cardiac index compared to HCs. Follow-up scan was abnormal in 4/16 (25%) with LGE persisting in 3 patients. Myocardial T1 (1284 + 43.8 ms vs 1147.6 + 68.4 ms; P<0.0001) and T2 values (50.8+16.7 ms vs 42.6+3.6 ms; P=0.04) were significantly higher in post COVID-19 subjects compared to HCs. Similarly, T1 and T2 values of severe COVID-19 patients were significantly higher compared to mild and moderate cases. Conclusions: An abnormal CMR was seen in half of recovered patients with persistent abnormality in one-fourth at six months. Our study suggests a need for closer follow-up among recovered subjects in order to evaluate for long term cardiovascular sequalae.

To our knowledge this is the first published case of NP associated with COVID-19 in an individual with CF and the first associated with Nocardia infection. We suspect the combination of cystic fibrosis, COVID-19 pneumonitis and co-infection with Nocardia farcinia caused this young man’s NP and ultimately his untimely death. We hope this case will highlight individuals with CF of all ages are at risk of severe COVID-19 infection.

Our patient is a 39-year-old male with normal baseline blood parameters who presented with COVID-19 infection, associated with neutropenia and then progressed to critical disease culminating into CSS. Based on risks and benefits evaluation, he was treated with Tocilizumab reinforced with G-CSF leading to full recovery including reversal of neutropenia.

Non covalent biliproteins are found in a growing number of living organisms and even in viruses, such as SARS-CoV-2. Unlike the well described covalent biliproteins, such as the phytochromes, they present a vast structural and functional diversity, and often with limited experimental information. A very important tool (and sometimes the only one available) to study these systems is the UV-Vis spectrum, which is modulated both by conformational changes of the biliverdin chromophore and specific interactions with the apoprotein. In this work we present a theoretical study of the microscopic determinants of the UV-Vis spectrum of these compounds through the use of hybrid QM(TD-DFT)/MM techniques and molecular dynamics simulations. Comparing our results with existing experimental data, we prove that it is possible to predict spectroscopic properties, such as relative position and intensity ratio of main bands, with affordable methods, and to provide a microscopic explanation of them. This systematic information can be very useful for the study of described biliproteins or for those yet unknown.

Purpose: Peripartum cardiomyopathy (PPCM) is a rare complication of pregnancy manifesting with acute cardiac failure. Coronavirus Disease 2019 (COVID-19) can be complicated by cardiomyopathy, which can be difficult to differentiate from PPCM. The aim of this publication is to investigate different outcomes of cases with cardiomyopathy during pregnancy. Methods: Here, we report 4 peripartum cases with COVID-19 and acute cardiac failure due to cardiomyopathy. Moreover, to find previous similar cases, a comprehensive review on PPCM and COVID-19 associated cardiomyopathy was conducted in PubMed, Scopus, Embase, and Google Scholar. Results: Out of 4 cases we had, two cases deceased and one became a candidate for heart transplant. Despite advanced diagnostic approaches, differentiating COVID-19 associated cardiomyopathy from PPCM was challenging. According to the literature review, 7 cases with similar conditions were found. Conclusion: Pregnant women with COVID-19 may develop acute cardiac failure associated with PPCM or COVID-19 associated cardiomyopathy or both. This condition may be deadly due to rapid disease progression, atypical manifestations, and limited treatment options.

Objective: To assess the utility of a test-based approach to shorten isolation of healthcare workers with COVID-19 in the setting of the highly transmissible omicron variant Methods: Between December 24th, 2021, to January 5th, 2022 HCWs who tested positive for SARS-CoV-2 were re-tested at least five days since onset of symptoms. Results: 46 sequential fully COVID-19 vaccinated HCWs who had tested positive for SARS-CoV-2 underwent follow up testing. All the isolates were confirmed as omicron variants and only 4 (8.7%) were negative 5 days or more since onset of symptoms., Conclusions: Implementation of a test-based strategy is logistically challenging, increases costs and did not lead to shorter isolation in our institution.

Anti-glutamic acid decarboxylase(Anti-GAD) are associated with various neurologic condition; but, no meningitis has been reported with it, so far. Evidence demonstrates the associated of autoimmune meningoencephalitis with Covid-19 infection. Here we report a 44-year-old female with progressive loss of consciousness with anti-GAD65 meningoencephalitis after Covid-19 infection.

Background Household studies are crucial for understanding the transmission of SARS-CoV-2 infection, which may be underestimated from PCR testing of respiratory samples alone. We aim to combine assessment of household mitigation measures; nasopharyngeal, saliva and stool PCR testing; along with mucosal and systemic SARS-CoV-2 specific antibodies, to comprehensively characterise SARS-CoV-2 infection and transmission in households. Methods Between March and September 2020, we obtained samples from 92 participants in 26 households in Melbourne, Australia, in a 4-week period following onset of infection with ancestral SARS-CoV-2 variants. Results The secondary attack rate was 36% (24/66) when using nasopharyngeal swab (NPS) PCR positivity alone. However, when respiratory and non-respiratory samples were combined with antibody responses in blood and saliva, the secondary attack rate was 76% (50/66). SARS-CoV-2 viral load of the index case and household isolation measures were key factors that determine secondary transmission. In 27% (7/26) of households, all family members tested positive by NPS for SARS-CoV-2 and were characterised by lower respiratory Ct-values than low transmission families (Median 22.62 vs 32.91; IQR 17.06 to 28.67 vs 30.37 to 34.24). High transmission families were associated with enhanced plasma antibody responses to multiple SARS-CoV-2 antigens and the presence of neutralising antibodies. Three distinguishing saliva SARS-CoV-2 antibody features were identified according to age (IgA1 to Spike 1, IgA1 to nucleocapsid protein (NP), suggesting that adults and children generate distinct mucosal antibody responses during the acute phase of infection. Conclusion Utilising respiratory and non-respiratory PCR testing, along with measurement of SARS-CoV-2 specific local and systemic antibodies, provides a more accurate assessment of infection within households and highlights some of the immunological differences in response between children and adults.

A document by Luise Erpenbeck, written on Authorea.

Objective. To compare the estimates of preterm birth (PTB; 22-36 weeks gestational age, GA) and stillbirth rates during COVID-19 pandemic in Italy with those recorded in the three previous years. Design. A population-based cohort study of liveborn and stillborn infants was conducted using data from Regional Health Systems and comparing the pandemic period (March 1st, 2020-March 31st, 2021, N= 362,129) to an historical period (January 2017- February 2020, N=1,117,172). The cohort covered 84.3% of the births in Italy. Methods. Logistic regressions were run in each Region and meta-analyses were performed centrally. We used an interrupted time series regression analysis to study the trend of preterm births from 2017 to 2021. Main Outcome Measures. The primary outcomes were PTB and stillbirths. Secondary outcomes were late PTB (32-36 weeks’ GA), very PTB (<32 weeks’ GA), and extreme PTB (<28 weeks’ GA), overall and stratified into singleton and multiples. Results. The pandemic period compared with the historical one was associated with a reduced risk for PTB (Odds Ratio: 0.90; 95% Confidence Interval, CI: 0.87, 0.93), late PTB (0.91; 0.87, 0.94), very PTB (0.87; 0.84, 0.91), and extreme PTB (0.88; 0.82, 0.94). In multiples, point estimates were not very different, but had wider CIs. No association was found for stillbirths (1.01; 0.90, 1.13). A linear decreasing trend in PTB rate was present in the historical period, with a further reduction after the lockdown. Conclusions We demonstrated a decrease in PTB rate after the introduction of COVID-19 restriction measures, without an increase in stillbirths.

We present a case series of 5 patients who were found to have COVID-19 encephalitis. There is still no disease defining test for diagnosis so the mainstay of diagnosis is the exclusion of all common causes of encephalitis. Brain MRI and CSF analysis perform an ancillary in the diagnostic tools.