The purpose of this study was to investigate the caregiving burden experienced by older family caregivers of homebound older individuals with dementia in Hong Kong, Singapore, and Japan before the COVID-19 pandemic. The study examined their attitudes towards supporting older parents and involved 540 family caregivers. Various scales and questionnaires were used to assess factors such as memory and behavior problems, perceived support, general health, burden, cultural justification, and coping strategies. The results revealed that greater memory and behavioral problems in dementia patients negatively impacted caregivers' mental health and influenced their coping strategies. The study found no direct correlation between support for older parents and mental health but identified a positive association with specific coping strategies. The similarities among family caregivers in Hong Kong, Singapore, and Japan were noted, including age, education, occupational status, and shared cultural values like Confucianism and respect for elders. It was observed that caregivers prioritize their own quality of life while addressing the challenges related to caring for older parents.

Objectives: Previous observational studies have revealed a connection between sarcopenia and COVID-19. To evaluate their causal relationship, we utilized a bidirectional two-sample Mendelian randomization (MR) analysis to study the link of cause and effect between sarcopenia and COVID-19. Methods: Inverse variance weighting (IVW), MR-Egger, weighted, and weighted median were used in this research. Then we used the MR Pleiotropy RESidual Sum and Outlier (MR-PRESSO) and MR-Egger regression methods to estimate the pleiotropy of instrumental variables (IVs), while the outliers were excluded by MR-PRESSO. Moreover, we used Cochran’s Q statistic to evaluate the heterogeneity among the IVs. And we used leave-one-out sensitivity analysis to identify the SNPs that significantly affect the outcomes. Finally, the Bonferroni correction was used to correct each result. Results: The IVW results suggested that faster WP decreased the risk of all types of COVID-19 (COVID-19 infection: OR = 0.469, 95% CI: 0.326,0.676, P = 4.82E-05; COVID-19 hospitalization: OR = 0.247, 95% CI: 0.122,0.502, P = 1.11E-04; severe COVID-19: OR = 0.120, 95% CI: 0.046,0.314, P = 1.53E-05). However, there was no causal relationship between ASM, LH or RH and COVID-19, and WP adjusted for BMI had no significant connection with all types of COVID-19. Furthermore, no causal association of COVID-19 on sarcopenia was observed in the results of reverse MR analysis. Conclusion: Our bidirectional two-sample MR study suggests the causal relationship between WP and COVID-19 but it may be caused by the mediating role of BMI, thus there is no causal association between sarcopenia and COVID-19.

Introduction: The novel corona-virus outbreak three years ago has changed people’s lives, with different responses around the world. As the largest developing country, China has taken strict prevention and control measures against this endemic. Although it is not very convenient, people have been used to such prevention and control methods. In December, 2022, China changed the prevention and control measures, a large number of patients were infected in a short period of time. Outpatient department acted as the first line of the hospital, and outpatient nurses acted as fighters, facing great difficulties and psychological pressure.In-depth understanding of the real experience of outpatient nurses after the change of COVID-19 prevention and control measures in China will provide reference for further improving the management level of emergency nursing. Methods: From December 2022 to January 2023, in the initial stage of the change of endemic prevention measures, 16 outpatient nurses from the First Affiliated Hospital of Soochow University conducted semi-structured interviews, and analyzed the interview data by Colaizzi analysis. Results: Based on the real experience of 16 outpatient nurses in this special period, four themes were extracted. The themes were the following:(1)Ethical challenges; (2)Changes in life; (3)Get experience, normalize, and adapt to the endemic; (4)Re-understanding for work and life. The suggestions were the following:(1)Pay more attention to the emotional changes of the outpatient nurses, and give them psychological support; (2)Strengthen the social support system and provide good logistics support; (3)Improve the management system, and pay attention to the suggestions and reflections of medical staff. Conclusion: Through this interview, it was discovered that outpatient nurses demonstrated a strong sense of responsibility and mission during the process of epidemic prevention policy changes. However, they also experienced negative psychological effects due to inadequate understanding of the disease, heavy treatment tasks, and risk of self-infection. Therefore, managers should optimize human resource allocation, promptly alleviate negative emotions among outpatient nurses, and provide them with psychological counseling services.

Background: The increasing COVID-19 cases and rising scientific interest on the role of ABO blood type in disease susceptibility and outcomes highlight the need to explore the associations among Filipinos, cognizant of racial and genetic predisposition. This study determined the relative risk of COVID-19 infection and disease outcomes with ABO blood type among Filipino patients. Methods: Employing an ambispective cohort, 550 consecutively-selected, hospitalized Filipino adult patients with SARS-CoV-2 RT-PCR result were included. Medical records of previously admitted patients were retrospectively reviewed and pertinent data were extracted. Prospectively, patients who were still admitted were recruited and followed-up. Risk ratio estimated the risk of primary (COVID-19 infection and severity) and secondary outcomes (ICU admission, intubation, and mortality). Findings: The risk of COVID-19 infection was 20% higher among type A (aRR=1·20, p=0·021) but was 19% lower among type O (aRR=0·84, p=0·023). Blood type A (aRR=1·25, p=0·041) was 25% at greater risk for severe-to-critical COVID-19 infection, while moderate COVID-19 was 62% higher among type AB (aRR=1·62, p=0.037) and was 54% lower among type O (aOR=0·65, p=0·010). ABO blood type did not predict any disease outcomes. Interpretation: ABO blood type was an independent predictor of COVID-19 infection and severity but not disease outcomes. Type A has higher risk for COVID-19 infection and severe-to-critical COVID-19, while type O had lower risk. This information can be utilized in identifying the population-at-risk, developing programs and interventions, increasing vigilance in medical management, and promoting adherence to precautionary and protective health-seeking behaviors. Funding: Philippine Council for Health Research and Development

COVID-19 infection is still a mystery in terms of its long-term effect on health and its consequences on hematological disorders. In this article, we are presenting two cases of pediatric B-lymphoblastic leukemia (B-ALL) with a previous history of COVID-19 infection. Notably, in both the cases the fluorescence-in situ hybridization (FISH) studies showed pathologic alteration of the RUNX1 gene. The finding of this genetic alteration along with known pre-leukemic translocation ETV6-RUNX1, opens a door for further exploration of the “second-hit” hypothesis regarding an infectious agent precipitating development of B-ALL in a genetically susceptible individual.

A document by Rafat Noeiaghdam. Click on the document to view its contents.

Objective: To investigate whether severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection increases the adverse reactions of subcutaneous specific immunotherapy in children. Methods: This study was conducted by collecting relevant data from children who underwent house dust mite SCIT from April 3, 2021 to March 18, 2023, including information on the time of COVID-19 infection, symptoms, and adverse reactions after each allergen injection. A mixed-effects model was used to analyze the changes in adverse reactions before and after COVID-19 infection. Results: Among the records of adverse reactions from 2658 injections in 123 children who underwent SCIT, the overall adverse reaction rate before COVID-19 infection was 39.8% and 30.0% after COVID-19 infection. Compared with pre-infection with COVID-19, the risks of overall adverse reactions, local adverse reactions, and systemic adverse reactions of desensitization treatment after COVID-19 infection were reduced (OR = 0.24, 0.31, and 0.28, all P <0.05). Among the local adverse reactions, the incidence of the unvaccinated group was the highest (15.3% vs. 7.1%). The incidence of overall and local adverse reactions to SCIT decreased in 2-vaccinated COVID-19 recipients (OR = 0.29–0.31, P <0.05) Conclusions: SARS-CoV-2 infection does not increase the incidence of adverse reactions to SCIT in children. SCIT can be performed according to the course of treatment after the SARS-CoV-2 infection is controlled, just like with other common infectious diseases.

There is evidence of an overall decline in maternal mental health in the wake of the COVID-19 pandemic. However, there is also heterogeneity in maternal responses. A latent transition analysis was conducted to identify profiles of anxiety, depression, and stress among 289 low-income mothers. Using these identified profiles, we examined the transitional patterns between profiles before and during COVID-19 and the sociodemographic and familial factors related to these profiles. A three-profile solution was identified prior to COVID-19, and a four-profile solution during COVID-19, with some profiles exhibiting qualitatively different defining characteristics. Latent transition analyses found diverse patterns of mental health shifts after the onset of COVID-19. However, mothers with better mental health prior to COVID-19 tended to have the most stable mental health during COVID-19. In contrast, mothers who were highly stressed prior to COVID-19 were equally likely to improve or decline after the onset of the pandemic. In addition, the relationships between ethnicity, parenting practices, child temperament, and mental health were significantly related to maternal mental health. These findings describe mothers' experiences and areas where policymakers and practitioners can tailor support to low-income mothers.

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) has been the most significant public health challenge in over a century. SARS-COV-2 has infected over 765 million people worldwide, resulting in over 6.9 million deaths. This study aimed to detect community transmission of SARS-CoV-2 and monitor the co-circulation of SARS-CoV-2 with other acute respiratory pathogens in Rift Valley, Kenya. We conducted a cross-sectional active sentinel surveillance for the SARS-CoV-2 virus among patients with acute respiratory infections at four sites in Rift Valley from January 2022 to December 2022. 1271 patients of all ages presenting with influenza-like illness were recruited into the study. Nasopharyngeal swab specimens were screened using a multiplex RT–qPCR for SARS-CoV-2, Influenza A, Influenza B and RSV. Influenza A and RSV samples were subtyped, and all the SARS-CoV-2 positive samples were further screened for 12 viral and 7 bacterial respiratory pathogens. We had a prevalence of 13.93% SARS-CoV-2, Influenza A 5.7%, Influenza B 1.96% and 0.94%. Influenza A-H1pdm09 and RSV B were the most dominant circulating subtypes of Influenza A and RSV, respectively. The most common co-infecting pathogens were Streptococcus pneumoniae and Haemophilus influenzae, accounting for 16.4% and 10.7% of all the SARS-CoV-2 positive samples. Augmenting syndromic testing in ARI surveillance is crucial to inform evidence-based clinical and public health interventions.

Introduction: The adoption of telemedicine within the healthcare industry has experienced a surge in momentum as a result of the exceptional circumstances brought about by the COVID-19 pandemic. The present study sought to explore the views of different stakeholders regarding the feasibility of introducing telemedicine for foot and ankle management delivered in a primary care context. Method: A mixed-methods approach was adopted, wherein the main source of data collected was quantitative, consisting of online questionnaires. Additionally, focus groups and interviews were conducted to corroborate the findings obtained from the questionnaires. Results: An agreement between patients, podiatrists, and senior healthcare management was reached regarding the introduction of a telemedicine service for foot and ankle management. Proposed measures entail the establishment of a comprehensive evidence-based framework and standard operating procedures for both users and providers, the provision of appropriate training and professional development opportunities for healthcare practitioners, and enhanced community education and outreach initiatives aimed at raising awareness about the scope, beneficiaries, and modalities of this service. Discussion: This research has highlighted the need for the introduction of telemedicine services for foot and ankle care management. Impromptu interventions due to the pandemic were executed without adequate evidence-based guidelines for healthcare professionals to follow. This unforeseen situation created a favourable opportunity for further research and to reconsider what measures are necessary to determine appropriate guidelines and training for the introduction of this service.

：Since the Covid-19 outbreak and widely spread, global attentions have been increasingly drawn to the epidemic spread and pandemic development. Many researchers focus on the modelling of the development of the COVID-19 and the effect of intervention on containment of the spread. We systematically reviewed the epidemic models of COVID-19 transmission and its public health interventions: a) COVID-19 epidemic models, including its hypothesis, key input epidemiological parameters, asymptomatic proportion and mortality; b) the impact of public health interventions, including social isolation, contact tracking, improving quarantine rate and reporting rate, travel restrictions, etc. To help the modelling researchers to calibrate the epidemiological model accurately based on the actual situation, the public health authorities should work out accurate epidemiology data. Different countries should take appropriate public health interventions to control the development of the epidemic. Although strict travel restrictions can significantly suppress the spread of COVID-19, while contact tracking, isolation and other measures can identify and control the infection source timely and effectively, which can cut off the transmission, but protective face mask is the intervention measure with the lowest economic cost and social cost. After the recession of the epidemic in Wuhan, the result of centralized nucleic acid detection on 9.97 million people showed that the asymptomatic infection ratio was very low and asymptomatic infection was not infectious, suggesting that the existing Covid-19 epidemiological models may overestimate the risk of epidemic. Excessive public preventive measures may do more harm than good, and hinder the recovery of normal economic life order.

Increasing health insurance has been a challenge during the pandemic in developing countries. For this reason, we analysed the regulations issued by the Peruvian government about health insurance and the health insurance affiliation at the national level during the pandemic. We carried out a cross-sectional study that included a review of national government regulations and an analysis of secondary data on people enrolled in health insurance. We identified eight national regulations oriented to foster health insurance from the last quarter of 2019 to the third quarter of 2021. We also found an increase in health insurance coverage at the national level, represented by insurer organisations: Comprehensive Health System (SIS) (72.5%), Social Security (ESSALUD) (27.6%), Private Insurers (2.7%), Armed Forces/Police’s insurer (1.9%), and other insurer companies (6.2%). The affiliation increased mainly in quintile 5 (23.4%) and quintile 4 (20.2%). During the pandemic, there have been developed and implemented regulations that have promoted health insurance at the national level; likewise, we found an increase in the number of enrolled people, with the greatest increase in the SIS.

Background: Within the ECDC-VEBIS project, we prospectively monitored vaccine effectiveness (VE) against COVID-19 hospitalisation and COVID-19-related death, using electronic health registries (EHR), between October 2021 and November 2022, in community-dwelling residents aged 65–79 and ≥80-years in six European countries. Methods: EHR linkage was used to construct population cohorts in Belgium, Denmark, Luxembourg, Navarre (Spain), Norway and Portugal. Using a common protocol, for each outcome (hospitalisation and death), VE was estimated monthly over eight-week follow-up periods, allowing one month-lag for data consolidation. Cox proportional-hazards regression models were used to estimate adjusted hazard ratios (aHR) and VE=(1 – aHR) x100. Site-specific estimates were pooled using random-effects meta-analysis. Results: For ≥80-years, VE against COVID-19 hospitalisation decreased from 66.9% (95%CI: 60.1; 72.6) to 36.1% (95%CI: -27.3; 67.9) for the primary vaccination and from 95.6% (95%CI: 88.0; 98.4) to 67.7% (95%CI: 45.9; 80.8) for the first booster. Similar trends were observed for 65-79-years. The second booster VE against hospitalisation ranged between 82.0% (95%CI: 75.9; 87.0) and 83.9% (95%CI: 77.7; 88.4) for the ≥80-years and between 39.3% (95%CI: -3.9; 64.5) and 80.6% (95%CI: 67.2; 88.5) for 65-79-years. The first booster VE against COVID-19-related death declined over time for both age groups, while the second booster VE against death remained above 80% for the ≥80-years. Conclusions: Successive vaccine boosters played a relevant role in maintaining protection against COVID-19 hospitalisation and death, in the context of decreasing VE over time. Multi-country data from EHR facilitate robust near-real-time monitoring of VE in the EU/EEA and supports public health decision-making.

Abstract Introduction Somalia faced significant COVID-19 exposure due to limited lab capacity for pathogen detection. The country’s healthcare system is strained by poverty, conflict, malnutrition, and outbreaks. Urgent action was required to enhance COVID-19 detection, save lives, and support nationwide vaccination and healthcare efforts. Methods With WHO and other partners, the Ministry of Health formed the COVID-19 incident management committee to address infections. Testing was initiated at the National Public Health Laboratory, and through training and investment, expanded to 11 additional sites. Genomic surveillance was established to monitor circulating genotypes. A comprehensive data management system was implemented to track infections from patient to reporting, ensuring effective monitoring and response. Results The enhanced laboratory capacity identified 26,439 confirmed SARS-CoV-2 cases, resulting in 1,361 deaths and a case fatality rate (CFR) of 5.15%. A total of 344,002 suspected samples were tested within the country. Genomic surveillance was initiated in March, 2022, and the first results were reported in Agoust, 2022. The e-SPAR tool assessment demonstrated a significant improvement in laboratory capacity, rising from 27% in 2018 to 56% in 2021, marking an overall improvement of 210%. Discussion Somalia has made notable strides in enhancing and expanding in-country molecular diagnostic capacity, enabling swift COVID-19 diagnosis. This capacity is being expanded to encompass other pathogens as part of an integrated disease surveillance program. The objective is to enhance response capabilities to emerging pathogen outbreaks. The implementation of a data management system has improved data monitoring and evaluation, serving as a crucial foundation for Labs

Background and Aims: The relationship between SARS-CoV-2 infection and ICD shock remains unclear. We analyzed the characteristics of patients received shocks after SARS-CoV-2 infection to explore causes of these shocks to provide information for subsequent treatment. Methods: We retrospectively analyzed data from seven patients who hospitalized the First People’s Hospital of Yunnan Province between December 2022 and January 2023 after experiencing ICD shock or ventricular arrhythmias following SARS-CoV-2 infection. We collected baseline information i.e., age and sex, device type, arrhythmia type, comorbidities, etc to analyze the causes of electrical shocks. Results: All patients’ devices were implanted in our hospital. The patients’ mean age was 67±10 years. Four underwent implantation for primary prevention, and three for secondary prevention. These patients received 80 ICD shocks after SARS-CoV-2 infection, 71 (88.75%) nine (11.25%) of which were treatment for ventricular tachycardia and atrial fibrillation, respectively. There were 54 antitachycardia pacing(ATP) treatments, which forty-eight arrhythmic events were terminated through antitachycardia pacing and six not. Laboratory tests conducted upon admission revealed that six patients had blood potassium levels below 4.0 mmol/L. Five patients had blood calcium levels below 2.11 mmol/L. Four of seven patients had elevated troponin concentrations (0.030–0.297 ng/mL). All patients had significantly elevated N-terminal pro-B-type natriuretic peptide levels (608.8–25,758 pg/mL). Six patients had a QT interval of > 440 ms and a mean QT interval of 460±46 ms. Conclusion: SARS-CoV-2 infection may be associated with ICD shock. Clinicians should pay close attention to patients with implanted devices after SARS-CoV-2 infection and actively eliminate arrhythmogenic triggers to minimize the likelihood of ICD shock.

In Mexico, the BA.4 and BA.5 Omicron variants dominated the fifth epidemic wave (summer 2022), superseding BA.2, which had circulated during the inter-wave period. The present study uses genome sequencing and statistical and phylogenetic analyses to examine these variants’ prevalence, distribution, and genetic diversity in Mexico from April to August 2022. Over 35% of the sequenced genomes in this period corresponded to the BA.2 variant, 8% to the BA.4, and 56% to the BA.5 variant. Multiple subvariants were identified, but only BA.2.9, BA.2.12.1, BA.5.1, BA.5.2, BA.5.2.1, and BA.4.1 circulated throughout the fifth wave across the entire country, not forming geographical clusters. Contrastingly, other subvariants exhibited a geographically restricted distribution, most notably in the Southeast region, which showed a distinct subvariant dynamic. This study supports previous results showing that this region may be a major entry point and may have contributed to the introduction and evolution of novel variants in Mexico. Furthermore, a differential distribution was observed for certain subvariants among specific States throughout time, which may have contributed to the overall increased diversity observed during this wave compared to the previous one. This study highlights the importance of sustaining genomic surveillance to identify novel variants that may impact public health.

Continued Immunotherapy of Patient with Lung Cancer with COVID-19 InfectionJiadi Gan1, Jiaxuan Wu1, Huohuo Zhang1, Weimin Li#1 Department of Respiratory and Critical Care Medicine, Institute of Respiratory Health, Center of Precision Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, ChinaFinancial/nonfinancial disclosures: None declared.FUNDING/SUPPORT: This work was supported by the Clinical Research Incubation Project of West China Hospital of Sichuan University (2018HXFH012), the National Natural Science Foundation of China (82200078)Address for correspondence: Weimin Li, MD, PhD, Department of Respiratory and Critical Care Medicine, Institute of Respiratory Health, Center of Precision Medicine, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China. E-mail:[email protected] the Editor :The COVID-19 pandemic has infected over 763.7 million people globally, causing over 6.9 million deaths (https://covid19.who.int/; accessed 15 April 2023). Omicron has received much attention for just 2 weeks after its appearance on November 11th, 2021 for its rapidly spreaded variants infectivity. The emerging of new variants of SARS-CoV-2 become the predominant strains during the pandemic. Similar with comorbidities such as diabetes and cardiovascular disease1, patients with cancer seems to be highly risk of acute respiratory syndrome coronavirus 2 (SARS-CoV-2)2.A major consideration in the delivery of cancer care is to balance the duration of delaying the cancer-directed therapy. SARS-CoV-2 can mediated immune system activation by triggerring cytokine release3, which may lead to a great potential for treating SARS-CoV-2 infections by targeting immune related receptors. To mild to moderate COVID-19 or asymptomatic positive SARS-CoV-2 patients, the NCCN Guidelines recommend considerring holding immune checkpoint inhibitors therapy for at least 10 days and until improvement of symptoms (https://www.nccn.org). Whether checkpoint inhibitor treatment lead to a better or worse outcome maintain controversial. Here, we report the management of three lung cancer patients during Omicron period through a multidisciplinary perspective on the basis of clinical experience and the available data in the literature, the general characteristic of patients were showed in Table 1 .The first case is a 65-year-old male, 30 years of smoking history, with a 1.8cm*1.3cm right lower lobe node, with liver and multiple bone metastases. Liver lesion puncture biopsy prompt neuroendocrine tumor. Next generation sequencing (NGS) detection indicated no oncogenic mutations. The patient had symptoms of fatigue and fever and performed rapid test of nasopharyngeal swab for respiratory SARS-CoV-2 viruse, which prompt strongly positive. He commenced with slurryMab combined with etoposide and carboplatin as first-line therapy. A computed tomography (CT) scan of the chest revealed lesion reduction after 3 months, with disease assessment of partial response (PR) (Figure 1B ). The second case was a 63-year-old Chinese male ex-smoker presented with a pulmonary mass in the right lobe lung apex mass discovered on chest enhanced-CT scan, with bilateral lung and bone metastasis. Histologic examination of the biopsy samples at lung mass led to the diagnosis of advanced lung squamous carcinoma. COVID-19 nucleic acid test prompt positive. He signed informed consent and was treated with was treated with Pembrolizumab+Vibostolimab. CT scan after 2 month showed obvious shrinkage in lung mass, contributing to PR (Figure 1B ). The patient reported feeling better after and no side effects occurred. The third was a 70-year-old male never-smoker referred to a local hospital for repetitive cough in June 2022. Chest-CT scan revealed a pulmonary mass in the left upper lobe and left pleural thickening. Cerebral magnetic resonance image demonstrated no brain metastasis and bone imag revealed multiple bone metastases. Biopsy on lung tissue demonstrated squamous carcinoma and subsequent targeted NGS detected no oncogenic mutations. Then the patient started duvalizumab combined with albumin paclitaxel and carboplatin as first-line therapy for four circles and single-agent duvalizumab maintenance for two cycles. Nasal swab was positive for COVID-19 in January 12th, 2023. He received nirmatrelvir plus ritonavirand for strongly positive of COVID-19 nucleic acid test with low Ct value. The clinical cough symptom of patients improved two days later and he continued receiving duvalizumab maintenance treatment. Stable lung lesions were shown through CT scan after 1 months and no novel added COVID-19 symptoms presented (Figure 1B ). Above patients manifest no viral symptom after active treatment with checkpoint inhibitor and continue to receive anti-tumor treatment (Figure 1A ).The cancer patients receiving antitumour treatments should be strictly screened for COVID-19 infection during epidemic period and avoid treatments causing immunosuppression or decrease the dosages of medication. These cases emphasized immunotherapy has no detrimental effect on the outcome of mild to moderate patients with COVID-19.

Abstract: Background: Sotrovimab, a monoclonal antibody, is among the approved therapies for coronavirus disease – 2019 (COVID-19). Sotrovimab binds to the spike protein of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and inhibits virus attachment to human cells. Real-life experience about the effectiveness of Sotrovimab is limited. We aimed to evaluate the efficacy of Sotrovimab in preventing COVID-19 hospitalizations and other patient-related outcomes as well as the appropriateness of use in an academic hospital in Lebanon. Methodology: In this retrospective observational study, we included adult patients with positive test results for SARS-CoV-2 who received intravenous (IV) Sotrovimab at the American University of Beirut Medical Center (AUBMC) from November 2021 through March 2022. The data collected included patient demographics and comorbidities. Primary outcomes were hospitalization, deterioration after 24 hours, and death due to any cause up to 60 days after the Sotrovimab infusion. Secondary outcomes were progression to critical illness and adverse events. Results: A total of 62 subjects received Sotrovimab infusion at our hospital. More than 50% of the patients had a malignancy. About 77% of the cohort belonged to Tier 1 of the National Institutes of Health (NIH) criteria for Sotrovimab use, and 21% of the patients had clinical deterioration 24 hours after Sotrovimab infusion. The percentage of progression to critical disease was 9.7% and the mortality 6.5 %. Conclusion: Sotrovimab is effective against COVID-19 infection and prevents mortality in high-risk patients.

Introduction The Eastern Mediterranean region was highly exposed to COVID-19 due to diverse challenges and lack of laboratory resources and relevant expertise in these countries limited the quality of detection and surveillance of circulating strains. UAE, through the Reference Laboratory for Infectious Disease-Abu Dhabi (RLID-AD), played a central role in providing genomic support to these countries. Methods SARS-CoV-2 samples were transported to RLID-AD with support from WHO/EMRO, then sequenced primarily using the Midnight workflow and GridION from Oxford Nanopore Technology and the data were analysed using the CLC platform from Qiagen, and lineages assigned using Pangolin. Results Between April 2021 and March 2022, RLID-AD received 170 COVID-19 samples from Syria, Yemen and Lebanon for genomic analysis. Of these , 159 were successfully sequenced (93.5%) with >90% coverage and 30x depth, with lineages being successfully assigned through Pangolin. The lineages discovered were predominantly alpha, beta, and delta variants, largely consistent with the global waves at the time. Turnaround time from receipt at the lab to result sharing with member states was 2-3 weeks. Conclusion The implementation of a hub-and-spoke model for sequencing support was a key aspect to the COVID-19 response in the EMRO region. UAE played a critical role in supporting genomics surveillance in the region, despite the logistic challenges faced with transport and importing of samples to UAE. The challenges faced during COVID19 pandemic clearly demonstrates the need for implementation of national-level sequencing laboratories that contribute data to the region, with hubs acting in technical and emergency support.

Introduction. - The frequency of emergency department visits for asthma is a major public health problem in pediatrics. The aim of this study is to identify the characteristics of children who visit the pediatric emergency department for asthma exacerbation and to evaluate their therapeutic management before admission. Methods. - A prospective study conducted over a 6-month period in the pediatric emergency departments of 5 hospitals on children aged 1 to 16 years who were admitted to the department with a clinical diagnosis of asthma exacerbation. Results. – 143 patients were enrolled in the study. Asthma episodes were moderate to severe in 69.2% of cases (n = 99). Initial therapeutic treatment before admission to the emergency department was appropriate in 17.5% of cases (n = 25). Hospitalizations greater than 24 hours only occurred in 18.2% ( n = 26) . In children under 3 years of age, the viral context was present in 91.4% (n = 64) & exacerbations were more severe in younger patients (P = 0.002) and economically disadvantaged children (P = 0.025). Only 17.4% (n=25) were found to be positive by an antigen test or PCR test for SARS-CoV-2. suggesting that the involvement of traditional respiratory viruses in asthma exacerbation continues even in pandemic times. Regarding the pre-hospital care, 70.6% (n=101) had received prior treatment, but this treatment was inappropriate in 53.1 % (n=76). Conclusions. - This study shows that asthmatic children and their families know little about the disease and that physicians are not sufficiently aware of current recommendations for the management of asthmatic children. Admission to the emergency department for asthma could be partially avoided by better diagnosis and therapeutic education .

Introduction: Centralized management of queues helps to reduce the surgical waiting time in the publicly funded healthcare system, but this is not a reality in the Brazilian Unified Healthcare System. Objectives: To describe the implementation of the “Patients with Surgical Indication” (PSI) in a Brazilian public tertiary hospital; To assess the impact on waiting time and its use in rationing oncological surgeries during the COVID-19 Pandemic. Methods: Retrospective observational study of elective surgical requests (2016-2022) in a Brazilian general, public, tertiary university hospital. We recovered information regarding the inflows (indications), outflows and their reasons, the number of patients, and waiting time in queue. Results: We enrolled 82,844 indications in the PSI (2016-2022). The waiting time (median and interquartile range) in days decreased from 98(48;168) in 2016 to 14(3;152) in 2022 (p<0.01). The same occurred with the backlog that ranged from 6,884 in 2016 to 844 in 2022 (p<001). During the Pandemic, there was a reduction in the number of non-oncological surgeries per month (95% confidence interval) of -10.9(-18.0;-3.8) during Phase I (January 2019-March 2020), maintenance in Phase II (April 2020-August 2021) 0.1(-10.0;10.4) and increment in Phase III (September 2021-December 2022) of 23.0(15.3;30.8). In the oncological conditions, these numbers were 0.6(-2.1;3.3) for Phase I, an increase of 3.2(0.7;5.6) in Phase II and 3.9(1 ,4;6,4) in Phase III. Conclusion: Implementing a centralized list of surgical indications and developing queue management principles proved feasible, with effective rationing. It unprecedentedly demonstrated the decrease in the median waiting time in Brazil.

INTRODUCTION The novel severe acute respiratory syndrome virus 2 (SARS-CoV-2), which is responsible Coronavirus disease (COVID-19), spread worldwide from China, causing a pandemic from late December 2019. Due to the high proportion of asymptomatic or mild infections (approximately 80%), data restricted to laboratory-confirmed cases do not capture the true extent of the spread or burden of the virus, or its infection-fatality ratio. Therefore, serological detection of specific antibodies against SARS-CoV-2 can better estimate the true number of infections. The current study aims to estimate the seroprevalence of SARS-CoV-2 antibodies among the whole blood donors without any prior COVID-19 history or symptoms. OBJECTIVE 1. To determine seroprevalence of SARS-CoV-2 (COVID-19) antibody (IgG and IgM) among asymptomatic healthy blood donors. METHODS This was a cross sectional study conducted between March and July, 2021 among 300 blood donors without any prior COVID-19 history or symptoms who came to a tertiary care, multispecialty hospital in south India. Any donor who had recently travelled abroad or donors who had received COVID-19 vaccine are excluded from the study. 3 ml venous blood was drawn in EDTA tube from participants and was tested by “Access SARS CoV-2 IgG assay” and “Access SARS CoV-2 IgM assay” by UniCel DxI 800 Immunoassay analyzer (Beckman coulter). The Access SARS CoV-2 IgG assay and the Access SARS Cov-2 IgM assay detect antibodies to the Receptor Binding Domain (RBD) of the Spike Protein. Result was reported as Reactive if Signal/Cut-off (S/CO)>1.0 and non-Reactive if S/CO <1. Data was collected and entered into excel sheets and was analyzed by using the software SPSS version 25. RESULTS A total of 300 healthy blood donors were included. The study reported seroprevalence of 15.3% for IgG and 4.3% for IgM (95%CI) among asymptomatic whole blood donors. No significant difference was observed across age groups, diet, BMI, ABO/Rh blood type or Ayurveda/homeo immune medicine intake with respect to IgG and IgM reactivity. CONCLUSION 15% of blood donors were seroconverted for COVID-19 during second wave. This is a reflection of widespread seroprevalence in the adult population. Real-time seroprevalence studies will help to know the herd immunity among the blood donors which will assist in knowing the COVID-19 transmission dynamics and distribution of immunity levels at a particular point in time. KEYWORDS COVID-19, Seroprevalence, Blood donors.

Introduction: Autoimmune diseases result from an immune response directed against self-antigens; however, the precise underlying mechanisms remain incompletely understood. Molecular mimicry represents one proposed mechanism whereby infectious agents possess antigens that resemble host proteins, leading to immune cross-reactivity.Objectives: The primary objective of our study was to employ bioinformatics techniques in order to investigate the existence of molecular mimicry between SARS-CoV-2 and the human proteome.Methods: In pursuit of our objective, we generated sequences comprising eight consecutive amino acids from structural proteins of SARS-CoV-2, including spike, nucleocapsid, membrane, and envelope proteins. Subsequently, we assessed the extent of mimicry between these sequences and the human proteome, while also evaluating their antigenicity, allergenicity, toxicity, TAP affinity, as well as their potential to induce IFNγ and IL-10.Results: Furthermore, we calculated the affinity of the amino acid sequence DEDDSEPV, which demonstrated molecular mimicry, towards HLA receptors and determined it to possess favorable binding energy. Through our in silico analysis, we identified that the DEDDSEPV amino acid sequence may provoke autoimmunity due to its similarity to the myosin-16 protein.Conclusion: The outcomes of our investigation provide substantiation for the potential of SARS-CoV-2 to trigger autoimmunity through molecular mimicry. These findings bear significant implications for comprehending the pathophysiology of autoimmune diseases and have the potential to contribute to the development of novel therapeutic strategies.

Objectives: In this study, it was aimed to investigate the effect of biochemical blood values on the course of the disease. Material and Methods: This is a retrospective study. For the treatment of COVID-19, clinical features and biochemical test parameters of 243 patients who applied to Malatya Training and Research Hospital in Malatya province of Turkey between 03 March and 31 December 2021 were used. Results: In the regression analysis performed in patients with Covid, glucose, urea, ALP, LDH, albumin, calcium and potassium levels were found to be effective on the severity of the disease. Conclusion: Biochemical parameters can be used as clinical findings to predict the diagnosis and course of COVID-19.