The present article is an attempt to highlight some of the major psychosocial issues faced by children during the pandemic through a case study. The study emphasizes upon a child's mental health care during the covid-19 pandemic. he case study can help clinicians, mental to understand the emotional, behavioral impact

Studies have shown that fluvoxamine can be useful in preventing the spread of Covid-19 disease (in the early stages of the disease) by strengthening the body’s immune system. For this purpose, in this work, the structural and electronic properties of fluvoxamine drug were investigated using quantum theory of atom in molecule (QTAIM) and Density-functional theory (DFT) at B3LYP-DFT/6-311G+ (at presence of water as solvent and the CPCM model) computational level. Also, in order to improve the electronic/pharmaceutical properties, the effect of electron donor/acceptor groups of NO2 and NH2 on fluvoxamine was studied. According to the results, electronic properties changed significantly in the presence of the NO2 group. So that (in the presence of NO2) cohesive energy, energy gap, dipole moment, adsorption energy, antioxidant properties, and recovery time improved by 20%, 70%, 84%, 48%, 48%, and 46% respectively. Although the electronic properties were improved in the presence of the NH2 group, the effect of the NO2 functional group was more noticeable. Therefore, it is expected that the presence of the NO2 electron-acceptor electron group will improve its medicinal function by changing the electronic properties of the drug fluvoxamine.

The use of the nasopharyngeal swab as a diagnostic procedure for CoVID-19 infection has become widespread. It is generally accepted as a safe procedure with few data on complications. We describe the case of a patient who developed a CSF fistula after nasal swabbing.

COVID-19 can lead to heart failure (HF) and even cardiac death. The 2’,5’-oligoadenylate synthetase (OAS) gene family is associated with the antiviral immune responses of COVID-19. While the potential association of OAS family with cardiac injury and failure in COVID-19 has not been determined. Hence, in our study, the expression levels and biological functions of OAS gene family in SARS-CoV-2 infected cardiomyocytes dataset (GSE150392) and HF dataset (GSE120852) were determined by comprehensive bioinformatic analysis and experimental validation. miRNAs targeting OAS gene family were explored from Targetscan and HF miRNA database. The potential OAS gene family-regulatory chemicals or ingredients were predicted using Comparative Toxicogenomics Database (CTD) and SymMap database. Results showed that OAS genes were highly expressed in both SARS-CoV-2 infected cardiomyocytes and failing hearts. The differentially expression genes (DEGs) in two datasets were enriched in cardiovascular disease and COVID-19 related pathways, respectively. The miRNAs-target analysis indicated that 10 miRNAs increase OAS genes expression. A variety of chemicals or ingredients were predicted regulating the expression of OAS gene family, especially estradiol. In conclusion, OAS gene family is an important mediator of HF in COVID-19 and may serve as a potential therapeutic target for cardiac injury and HF in COVID-19.

A 57-year-old man suffered chest pain during the COVID-19 pandemic, but he delayed medical treatment due to fear of infection. Four months later, symptoms chest tightness and shortness of breath appeared. Electrocardiogram (ECG) revealed old myocardial infarction; color sonography and myocardial CT revealed apical myocardial defect. He refused surgery and percutaneous transcatheter closure, and follow-up observation. After 22 months, the symptoms of chest tightness and shortness of breath aggravated. He recovered after percutaneous transcatheter closure, and was discharged. This case shows delayed closure is one of the possible options for the patients without severe organ dysfunction or hemodynamic disturbance.

Background Cardiovascular complications are frequently reported among patients with pulmonary coronavirus disease 2019 (COVID-19) infection. Echocardiography has been immensely implemented for diagnosing cardiovascular involvements. We aimed to evaluate the changes in echocardiographic parameters in health care workers infected with COVID-19 during follow-up. Methods This prospective study was conducted during Iran’s third COVID-19 wave in November 2020 among health care workers who were infected with COVID-19 but otherwise healthy. A total of 100 patients underwent echocardiographic examination six to eight weeks following recovery, an early follow-up. Six months after the COVID-19 diagnosis, as the late follow-up, 63 subjects underwent echocardiographic evaluations. Moreover, based on clinical and radiological evidence, individuals were categorized into two groups of non-severe and severe COVID-19. Results The participants’ mean age was 40.4±8.1 years. In the non-severe COVID-19 group, Right Ventricle Free-Wall Global Longitudinal Strain (RVFWGLS) significantly decreased in the follow-up echocardiogram (-32.3±4.6% vs. -28.8±5.8%, p-value=0.002). RV Fraction Area Change (RV-FAC) (46.6% [43.6-53] vs. 39.7% [25-43] , p-value <0.001) and, Tricuspid Annular Plane Systolic Excursion (TAPSE) (21 mm [19-24] vs. 23 mm [20-25], p-value=0.09) did not show a significant change. In the severe COVID-19 group in late echocardiogram, RVFWGLS showed no statistically significant change (-28.3%±3.5 vs. -28.6%±5.1, p-value=0.79). The RV-FAC (47.2% [42.3-52.2] vs. 36.4% [31.1-45], p-value=0.002) showed a significant decrease, and TAPSE (22.5 mm [19.1-24.2] vs. 23 mm [21-25], p-value= 0.55) was comparable. Conclusion Although LV and RV functions did not vary significantly over time in our entire cohort, different patterns of changes were discovered according to baseline function.

Objective: This study aimed to evaluate the effectiveness and optimal use of corticosteroids in children with severe coronavirus disease 2019 (COVID-19) pneumonia. Methods: We conducted a retrospective study and included patients (aged<18 years) with severe COVID-19 pneumonia and/or acute respiratory distress syndrome (ARDS) who received standard doses (2–4 mg/kg/day) and high doses (>250 mg/day) of methylprednisolone (MPZ). We adjusted for patients on steroid treatments with a propensity score and patient survival. Results: Fifty-nine patients were included: 61% were male, the median age was 8 (interquartile range [IQR], 2–15) years. The overall survival was 84.4% in patients treated with standard-dose MPZ (n = 45, 76.3%) and 92.2% in patients treated with high-dose MPZ (n = 14, 23.7%; p = 0.67). The demographic, clinical, and laboratory data didn’t differ significantly after propensity score matching, apart from bradycardia, which was a prominent feature of the high-dose group. The clinical and radiological response rates on Day 7 were higher and the need for invasive mechanical ventilation (IMV) was lower in the high-dose group. Conclusion: Pulse MPZ treatment seems to result in better clinical and radiological responses, with less need for IMV, although the mortality rate doesn’t differ between standard and high-dose regimens of MPZ.

Background. Prior to the introduction of vaccines, COVID-19 hospitalizations of non-institutionalized persons in Connecticut disproportionately affected communities of color and individuals of low socioeconomic status (SES). Whether the magnitude of these disparities changed 7-9 months after vaccine rollout during the Delta wave is not well documented. Methods. All initially hospitalized patients with laboratory-confirmed COVID-19 during July-September 2021, were obtained from the Connecticut COVID-NET database, including patients’ geocoded residential addresses. Census tract measures of poverty and crowding were determined by linking geocoded residential addresses to the 2014-2018 American Community Survey. Age-adjusted incidence and relative rates of COVID-19 hospitalization were calculated and compared to those from July-December 2020. Vaccination levels by age and race/ethnicity at the beginning and end of the study period were obtained from Connecticut’s COVID vaccine registry and age-adjusted average values were determined. Results. There were 708 COVID-19 hospitalizations among community residents of the two counties, July-September 2021. Age-adjusted incidence was highest among non-Hispanic Blacks and Hispanic/Latinx compared to non-Hispanic Whites ((RR 4.10 (95% CI 3.41-4.94) and 3.47 (95% CI 2.89-4.16)). While RR decreased significantly among Hispanic/Latinx and among the lowest SES groups, it increased among non-Hispanic Blacks (from RR 3.1 (95% CI 2.83-3.32) to RR 4.10). Average age-adjusted vaccination rates among those >12 years were lowest among non-Hispanic Blacks compared to Hispanic/Latinx and non-Hispanic Whites (50.6% vs 64.7% and 66.6%). Conclusions. While racial/ethnic and SES disparities in COVID-19 hospitalization have mostly decreased over time, disparities among non-Hispanic Blacks increased, possibly due to differences in vaccination rates.

Initially, there was little data on the safety of immunization against COVID-19 infection in pregnant women. However, previous studies revealed no safety concerns for pregnant women or newborns who received an mRNA COVID-19 vaccine during pregnancy. Therefore, this study aimed to investigate the effects of COVID-19 vaccination on perinatal outcomes. Methods: This cross-sectional study. It started from January 2022 to June 2022. The questionnaire was developed and validated by experts. This study included all women admitted to the postpartum ward who were more than 18 years old and had received the COVID-19 vaccine. The study excluded women without proof of their vaccination status or who could not complete the questionnaire. The primary outcome was the effect of COVID-19 vaccination on gestational age and birth weight. Results: A total of 365 participants. The mean gestational age of the unvaccinated women was 38.83 ± 1.62 weeks (p < 0.001), higher than that of vaccinated women (37.69 ± 2.9 weeks). However, the average birth weight for the unvaccinated women was 2.96 ± 0.4 kg (p = 0.89) and for vaccinated women (2.97 ± 0.66 kg). Conclusion: COVID-19 vaccination, regardless of the type of vaccine received before, during, or after pregnancy, is not associated with any unfavorable perinatal outcomes.

Objective: To study the incidence of sinonasal mucormycosis in active and post COVID-19 patients in a district-level hospital in India. Study Design: A prospective, interventional cohort study conducted from April 2021 to January 2022. Setting: A district-level/secondary level hospital in North India. Methods: Inclusion Criteria: All COVID-19 positive patients with diabetes mellitus as co-morbidity and with at least one of the following:received steroid therapy and/or on high flow oxygen therapy and/or had prolonged hospital stay (>7 days). Exclusion Criteria: Patients already immunocompromised/having malignancy/organ transplant recipients. Clinical workup: History, examination, imaging (CECT/MRI nose and paranasal sinuses if indicated), diagnostic nasal endoscopy + Nasal scrapings for KOH mount to detect fungal elements. Results: Fourteen out of 250 patients tested positive for Mucormycosis (incidence 5.6%). Out of these 13 were symptomatic and only one patient was asymptomatic and detected on screening. No significant difference was found in mucormycosis vs. non-mucormycosis group with respect to HbA1c status, vaccination status or steroid + oxygen treatment (p>0.05 in all scenarios). Patients were treated with intravenous Liposomal Amphotericin B and surgical debridement when indicated. Two succumbed to disease (survival 85.7%). A clinical screening protocol was thus developed which can be used as an effective tool even at far-flung and remote healthcare facilities for diagnosis and timely referral of patients. Conclusion: Mucormycosis is a potentially lethal disease which needs rapid diagnosis and timely action to decrease morbidity and mortality.

Coronavirus (COVID-19) infection exposes patients with heart failure to a higher risk of morbidity and mortality. In LVAD patients, one of the key problems that can lead to life-threatening low-flow or pump malfunction due to thrombus development in the inflow cannula, device body, or outflow graft, implicating hemodynamic instability, hemolysis, renal or hepatic failure, or cerebral or peripheral thromboembolism. [Endothelial protein C receptor and thrombomodulin levels are elevated along with procoagulants such as factor VIII, P-selectin, and von Willebrand factor and downregulated along with thrombomodulin as a result of the cytokine storm released by endothelial and immune cells. In general ,](#ref-0013) LVAD thrombosis has been found to occur in 2–13% of adult patients who use current continuous-flow devices. However, LVAD thrombosis due to COVID-19 is underreported and a few cases presented. We present a case of accelerated LVAD outflow thrombosis in the setting of COVID-19 infection with multiorgan failure.

In 2022, Monkey pox disease was declared as a Global Health Emergency. With the emergence of an epidemic such as this, it becomes imperative that accurate information is imparted to all the individuals. However, as seen in the case of Covid-19 pandemic, it is evident that people consume most of the information through social media platforms such as Instagram, Facebook, Twitter and others. With this, there is a possibility of an increase in dissemination of misinformation which was very well noted in case of Covid-19 Pandemic. Aims: To analyse the information that is available on Instagram regarding Monkey Pox disease and to determine its accuracy. Methodology: A cross-sectional, observational type of study where total of 522 posts were analysed over a period of two days was done. Top 90 posts from the top six monkey pox related hashtags were analysed on the basis of a proforma made of pre-selected questions via the platform google docs and accordingly the results were calculated. Results showed that, most of the posts are descriptive in nature, and only a few(11.65%) were posted by doctors. Most of them were posted by news or other agencies. Some of the posts were from unverified sources as well(27.65%). Discussion: As witnessed in Covid 19, there is prevalent misinformation when a global health emergency is concerned, attributed to vast access to social media platforms. In order to combat this dissemination of false information, such platforms should be regulated and should operate under guidelines of WHO.

PRES is a rare neurological disease possibly associated with the use of calcineurin inhibitors like cyclosporine A. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus, is responsible for the outbreak of coronavirus disease 19 (COVID-19) and can cause neurological manifestations. We describe a case of CSA-related PRES whose diagnosis was difficult due to concurrent infection with SARS-CoV-2. The 16-year-old patient was known to have corticosteroid-resistant nephrotic syndrome secondary to minimal change disease. CSA was therefore introduced and on the fifth day of treatment, he presented with seizures followed by fever. Biological and MRI data were in favor of SARS-CoV-2 encephalitis. Relief of immunosuppression by discontinuation of CSA was decided and the patient was put on anticonvulsants. After being declared cured of COVID-19, which was without other clinical signs, the CSA was reintroduced but the patient presented with seizures the next day. This allowed us to rectify the diagnosis and relate the seizures to a CSA-related PRES. We concluded that infection with SARS-CoV-2 could be a differential diagnosis of a PRES related to anticalcineurins.

Since late 2021, the highly transmissible SARS-CoV-2 Omicron variant has driven a new surge of infections across the world. We used a case-ascertained study to determine the features of household transmission of SARS-CoV-2 Omicron variant in Shanghai, China. We collected detailed information on 323 pediatric cases and their 951 household members, all received consecutively intensive RT-PCR testing. We estimated the transmission parameters. Both secondary infection attack rates (SARI) and secondary clinical attack rates (SARC) among adult household contacts were computed, through which the transmission heterogeneities in infectivity and susceptibility were characterized and the vaccine effectiveness were estimated. The mean incubation period and serial interval of Omicron variant were estimated to be 4.6±2.1 days and 3.9±3.7 days. The overall SARI and SARC among adult household contacts were 77.11% (95% confidence interval [CI]: 73.58%-80.63%) and 67.03% (63.09%-70.98%). We found higher household susceptibility in females, while infectivity was not significantly different in primary cases by age, sex, vaccination status and clinical severity. Full vaccination and booster vaccination of inactivated vaccines were 14.8% (5.8%-22.9%) and 18.9% (9.0%-27.7%) effective against Omicron infection and 21.5% (10.4%-31.2%) and 24.3% (12.3%-34.7%) effective against symptomatic disease. Overall, we found high household transmission during the Omicron wave in Shanghai due to asymptomatic and pre-symptomatic transmission in the context of city-wide lockdown, indicating the importance of early detection and timely isolation of SARS-CoV-2 infections and quarantine of close contacts. Marginal effectiveness of inactivated vaccines against Omicron infection poses great challenge for prevention and control of the SARS-CoV-2 Omicron variant.

We present a case of a 16-year-old female patient who has recently been diagnosed with anorexia nervosa. Although our findings reflect one clinical case, they are consistent with new reports showing that restrictions during a pandemic situation have long-term significant adverse effects on the mental and physical health of adolescents.

Leukocytoclastic vasculitis (LCV) is a small-vessel vasculitis characterized by immune complex deposition in the walls of dermal capillaries and venules. With the COVID-19 pandemic, more adults are receiving the MMR vaccine. We report a case of MMR vaccine-related LCV occurring only on the upper extremities with associated conjunctivitis.

Coronavirus disease 2019 (COVID-19) is the most prevalent disease in society today, and vaccination is a powerful weapon against COVID-19. However, there have been many recent reports of vaccine-induced skin side effects. Autoimmune bullous reactions caused by the COVID-19 vaccine are rare. We identified a case of refractory PV associated with COVID-19 vaccination that improved after 2 RTX injections.

Introduction: In March 2020, new guidelines allowed patients with epistaxis to be discharged home with nasal packs in situ to reduce the risk of inpatient covid transmission rates. Our objective is to review how successful these new guidelines have been and whether they could be safely maintained in future practice. Methods: This was a retrospective data analysis at a local tertiary ENT referral hospital. The study group consisted of patients admitted with epistaxis over one year. The “Pack and Home” criteria pathway was implemented. We reviewed the pathway 6 months pre and 6 months post pathway introduction. Primary outcome measure included compliance with the “Pack and Home” criteria and length of inpatient admissions. Results: A total of 131 patients required nasal packing, with 72 patients (55%) in loop 1 and 59 patients (45%) in loop 2. In the first loop all 72 patients (100%) were admitted for inpatient care. However, in the second loop 21 patients (36%) were discharged home with nasal pack in situ and 59 patients (64%) were admitted. Of those discharged, 2 patients re-presented after 48 hours with re-bleeding. The average total length of inpatient stay in loop 1 was significantly higher at 45.7 hours and 29.6 hours in loop 2 (p<0.05). All discharged patients attended their outpatient appointment in under 3 days. Conclusion The “Pack and Home” criteria can successfully identify patients who are suited for an outpatient management pathway. This could reduce surgical inpatient load and the way we manage epistaxis.

We developed a deterministic model with multiple compartments by a system of differential equations, which allows for simulating novel coronavirus (COVID-19) transmission dynamics with human adaptive behaviors and vaccine effects, aiming at predicting the end time of COVID-19 infection in global scale. Based on the surveillance information (reported cases and vaccination data) between January 22, 2020 and July 18, 2022, we validated the model by MCMC fitting method. We found that (1) if without protective and control behaviors, the epidemic could sweep the world in 2022 and 2023, causing 3.098 billion of human infections, which is 5.39 times of the current number; (2) there could be 645 million people avoided from infection due to vaccine; (3) if following current scenarios of protective/control behaviors and vaccine rate, the cumulative number of cases would increase slowly, leveling off around 2023, and the epidemic would end completely in June 2025, causing 1.024 billion infections. Our findings suggest that collective protection behavior and vaccination remain the key determinants of the global process of COVID-19 transmission.

Background: Epistaxis management frequently includes the insertion of a non-absorbable nasal pack, and patients may often be admitted during this treatment. During the recent COVID-19 pandemic, UK guidance to discharge “suitable” patients, with pack in-situ, was published in order to minimise hospital admissions and viral nosocomial transmission. Evidence which defines patient suitability for discharge, however, is lacking. Method: The medical records of 100 patients admitted for idiopathic epistaxis in our trust, managed with non-absorbable packing, were analysed. We sought to determine whether risk factors for re-bleeding through packs, or for haemorrhage-related complications, for which inpatient admission would allow more timely treatment, could be identified. Patient factors and outcomes were correlated using binomial logistic regression. Results: 13 patients re-bled through nasal packing. Statistically significant (1 tailed, P<0.05) predictors of bleeding despite packing were male sex, hypertension diagnosis, and aspirin use, with younger patients being at a modestly increased risk. Warfarin or direct oral anticoagulant (DOAC) use was not associated with increased bleeding risk. Conclusion: This study provides initial evidence of factors that affect the risk of bleeding through packs, and which patients may require inpatient care when packed. We recommend a future multicentre study with larger recruitment numbers to expand upon this pilot study’s results.

COVID-19 can lead to pneumonia or acute respiratory distress syndrome. Non-respiratory manifestations of COVID-19 include venous and arterial thrombosis. The disease can affect kidneys and lead to renal vein thrombosis leading to symptoms such as flank pain, hematuria, or acute kidney damage.

Background: Cancer patients are a particularly vulnerable risk group of the severe course of COVID-19 due to, i.e. suppression of the immune system. The study aimed to find links between parameters registered on admission to the hospital, and the risk of latter death in oncology patients with COVID-19. Design: Retrospective cohort study. Methods: The study included patients with a reported history of malignant tumor (N=151) and the control group with no history of cancer (N=151) hospitalized due to COVID-19 between March 2020 and August 2021. The variables registered on admission were divided into categories for which we calculated the multivariate Cox proportional hazards models. Results: The median age of the study group was 68 years (min-max: 17-95). 50.33% (76/151) were women. Multivariate Cox proportional hazards models were successfully obtained for the following categories: Patient data, Comorbidities, Signs recorded on admission, Medications used before hospitalization and Laboratory results recorded on admission. With the models developed for oncology patients, we identified the following variables that registered on patients’ admission were linked to significantly increased risk of death: male sex, presence of metastases in neoplastic disease, impaired consciousness (somnolence or confusion), wheezes/rhonchi, the levels of white blood cells and neutrophiles. Conclusion: Identifying the predictors of a poorer prognosis may serve clinicians in better tailoring treatment among cancer patients with COVID-19. Our results can help develop prognostic models or compare the results of other studies, which will translate into better treatment management and better prognosis in this group of patients.

Background: Acute lower respiratory tract infections (ALRI) are one leading cause of morbidity and mortality among people of all ages worldwide, particularly in low- and middle-income countries (LMICs). The purpose of this study was to determine epidemiological characteristics of respiratory viruses in ARI patients during the SARS-CoV-2 pandemic in Yaoundé, Cameroon. Methods: Patients were monitored for respiratory symptoms as part of surveillance of SARS-CoV-2 and other respiratory viral infections. Patients of all ages with respiratory symptoms less than 5 days were considered. Sociodemographic and clinical data as well as nasopharyngeal samples was collected from patients. Nasopharyngeal samples were tested for SARS-CoV-2, Influenza and Respiratory Syncytial Virus (RSV) using real-time reverse-transcription polymerase chain reaction methods. Virus distribution and demographic data were analyzed with R version 2.15.1. Results: From July 2020 to October 2021, 1120 patients were included. The overall viral detection rate was 32.5%, including 9.5 % for RSV (Respiratory Syncytial Virus), 12.6 % for influenza virus and 12.8 % for SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2). Co-infections were detected in 6.9% of positive cases. While RSV and influenza virus showed seasonal trends, SARS-CoV-2 was detected throughout the study period. Conclusion: We found that during SARS-CoV-2 pandemic, respiratory viruses play an important role in aetiology of influenza-like illness in Cameroon, and this observation was true for patients of all ages.

Vulnerable patient populations have seen decreased rates of vaccination against SARS-CoV2 (COVID-19) due to hesitancies and distrust, magnified by a paucity of data for certain populations. The rates of COVID-19 vaccination in children with Sickle Cell Disease (SCD) remains low despite the risk for severe complications, resulting in continued infections and hospitalizations from COVID-19. We sought to describe vaccine reactions including vaso-occlusive crises, emergency department visits, and hospitalizations in children with SCD. Our findings will start to provide the necessary vaccine side effect data to inform patients, caregivers, and clinicians considering the COVID-19 primary vaccination series.