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3234 covid-19 Preprints

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Please note: These are preprints and have not been peer reviewed. Data may be preliminary.
Unlocking the Potential of Weight of Evidence and Entity Embedding Encoding for Categ...
Anitha 1∗ M ME
Nickolas PhD 1∗ S

Anitha 1∗ M ME

and 3 more

August 28, 2023
In the present era, healthcare systems grapple with substan- tial volumes of medical data. However, a significant portion of this data is marked by incompleteness, inconsistency, er- rors, and unsuitability for training Machine Learning (ML) or Deep Learning (DL) algorithms. This necessitates preprocess- ing the data to render it amenable to utilization by ML/DL al- gorithms. Medical datasets predominantly feature two types of attributes: numerical and categorical values. The conver- sion of categorical features into numerical vectors is a crucial step in preparing the data for ML/DL algorithms, known as Feature Engineering (FE) based categorical encoding. Con- ventional and straightforward encoding of categorical fea- tures, termed one-hot encoding, generates multiple columns, thereby transforming data from a lower-dimensional to a higher- dimensional space. This approach poses challenges, includ- ing increased memory requirements due to the proliferation of columns. Considering these issues, this research proposes an encoding technique named “Weight of Evidence with En- tity Embedding” (WoEEE). The WoEEE approach bolsters the predictive capabilities of ML/DL algorithms by calculating the weight of evidence and concurrently mitigates dimension- ality issues. To empirically validate the proposed method, it is tested on six diverse datasets: Breast Cancer, Hospital Readmission, Vadu, Covid-19, Stroke, and Heartstatlog. Four distinct ML/DL algorithms—Decision Tree (DT), Random For- est (RF), Logistic Regression (LR), and a simple Feed-forward Neural Network (NN)— are employed for testing. The re- sults obtained demonstrate that the WoEEE approach yields an average improvement of 11.18%, 10.37%, 5.83%, 7.58%, 7.83%, and 6.83% across all combinations of datasets, classi- fiers, and encoding methods. Furthermore, an Anova test is performed to confirm the effectiveness of WoEEE in encod- ing categorical data, especially for tasks involving binary clas- sification. This enhances the treatment of categorical data in ML and data analytics scenarios. Overall, WoEEE shows po- tential as a valuable approach for categorical data encoding, making a positive contribution to the creation of effective techniques for handling this type of data in real-world appli- cations.
COVID-19 Induced Immune Thrombocytopenia (ITP) Management Approach: A Case Report And...
Hatem Alahwal
Mansour Alsharif

Hatem Alahwal

and 8 more

August 28, 2023
A document by Hatem Alahwal. Click on the document to view its contents.
Do plants need sleep and also have emotions? -- Medicinal plants, lifestyle, and herb...
Chunsong Hu

Chunsong Hu

August 28, 2023
Since a magic “polypill” – the “Environment-Sleep-Emotion-Exercise-Diet” intervention [E(e)SEEDi] was discovered in 2018, it plays a pivotal role in control and prevention of human disease due to improvement of immunity by healthy lifestyle. It can be said that it is applicable, as long as one is a human and survival. However, do plants also need the magic “polypill”? When plants need a suitable environment, rational internal exercise, and balancing nutrients (fertilizers, herbicides, nutrients, pesticides, and others), do they also need sleep? And have also emotions like humans? These are interesting questions. Currently, obvious climate change threats herbal cultivation in both China and the globe, in particular the pandemic and post-COVID-19 era. Only when we understand and confirm that plants also need sleep and have emotions, can we better protect medicinal plants and promote herb cultivation and healthy growth, since traditional Chinese herbs have a good efficacy in combating cardiovascular disease.
Study on the Epidemiological Characteristics of Common Enterovirus among Pediatric Pa...
Yanhong Sun
Jianming Zhou

Yanhong Sun

and 4 more

August 28, 2023
Nonpharmaceutical interventions (NPIs) against coronavirus disease 2019 (COVID-19) reduced the prevalence of coronavirus among children and influenced the transmission of other viruses. This study investigates the impact of NPIs on human enterovirus (HEV) among children in Hangzhou, China. We collected and analyzed the laboratory results and clinical data of children diagnosed with hand, foot, and mouth disease (HFMD) or herpangina (HA) during the following periods: pre-COVID-19 (January 2019 to December 2019), COVID-19 pandemic (January 2020 to December 2022), and post-COVID-19 (January to August 2023). A total of 38,582 specimens that met the inclusion criteria were enrolled, of which 1,777 (5.58%) tested positive for enterovirus. In comparison to the pre-COVID-19 period, which had 695 (5.63%) HEV-positive specimens, the numbers dramatically decreased to 69 (1.19%), 398 (5.12%), and 112 (1.58%) in 2020, 2021, and 2022, respectively, but significantly increased to 503 (9.00%) in 2023. Seasonal peaks of infections occurred between May and August each year, with positive rates of 10.58%, 25.27%, 31.74%, and 10.97%, respectively. Notably, June and July accounted for half of all cases, with a rate of 57.01%. The difference in the positive rates of HEV infection between males and females was statistically significant (P<0.005), with 5.12% (1,084/21,176) and 4.43% (693/15,629) testing positive, respectively, resulting in a male to female ratio of 1.56:1. Among the same age groups, children aged 3-5 years and 5-7 years had the highest positive rates at 11.03% (342/3,102) and 10.03% (205/2,024), respectively, after synthesizing five years of data. The detection rate of HEV-positive cases increased with age, but after the age of 7, the rate declined. The detected types of HEV indicated that enterovirus 71 (EV-A71) and coxsackievirus A16 (CV-A16) are no longer the two common pathogens causing HFMD and HA. In conclusion, NPIs for COVID-19 are highly effective in reducing the transmission of HEV. However, the relaxation of NPIs results in a resurgence of HEVs, surpassing prepandemic levels. Active awareness and surveillance of the epidemiological characteristics of HEV are essential for preventing, controlling, and managing the development of HFMD and HA, as well as contributing to the development of a multivalent HFMD vaccine.
HIDDEN ENEMY OF PULMONARY ARTERIES: COVID-19
Ali Duygu
Uğur Küçük

Ali Duygu

and 1 more

August 24, 2023
Introduction: It has been reported that COVID-19 may cause severe endothelial damage. Pulmonary Artery Stiffness (PAS) is a strong predictor of right ventricular function. PAS can reveal important information about the endothelial functions of the pulmonary bed. In this study we aimed to elucidate the possible effect of COVID-19 on PAS. Materials & Method: The study was performed by measuring PAS values with transthoracic echocardiography in 130 patients, 60 of whom had COVID-19 and 70 were controls. COVID-19 patients with positive polymerase chain reaction (PCR) test results were included in the study 3-6 months after their positivity. Results: When the Maximal frequency shift (MFS) (Hz) results were examined, no significant difference was observed between the patient and control groups (2764 ± 279.24 and 2664.8 ± 673.91 p=0.340, respectively). There was a significant difference between the patient and control groups in favor of the patient group in pulmonary acceleration time (PAT) (msec) results (93.18 ± 14.99 and 126.1 ± 17.58, respectively, p<0.001) . There was a significant difference between the patient and control groups in favor of the patient group in pulmonary artery stiffness (PAS) (Hz/msec) results (30.28 ± 5.07 and 21.57 ± 7.04, respectively, p<0.001). Conclusion: It is possible that COVID19 may have adverse effects on the pulmonary artery wall and bed. As a result of endothelial damage due to COVID-19, an increase in PAS values can be observed.
Rapid and timely virus detection by optical technologies: prospects for future viruse...
Nader Shokoufi
Mehdi Kheirollahpour

Nader Shokoufi

and 2 more

August 21, 2023
The development of sensitive, fast, and more reliable diagnostic methods to prevent and control the outbreak of life-threatening pandemic infectious diseases, such as COVID-19, according to the WHO recommendations, is always in priority and necessity. Optical diagnostic methods, with their progress in technology, are central to most applications and now, in the health field, are an alternative to conventional methods because of their great sensitivity and capability utilized for SARS-CoV-2 detection such as generally applied PCR technology which is time-consuming, effortful, and has limited availability in resource-limited situations. Herein, we reviewed various optical methods engaged for virus detection such as fluorescence-based techniques, Raman spectroscopy (RS), Plasmonic methods (e.g., SPR, LSPR, SEF, and SERS), ATR-FTIR, super-resolution microscopy (SRM), and some integrated platforms like waveguides and MIP-based biosensors for the development of portable, sensitive, specific, and low-cost POC apparatus for the rapid virus detection.
An extensive arterial thrombosis with lower limb ischemia in a COVID-19 patient: a ca...
Johary Andriamamonjisoa
Etienne RAKOTOMIJORO

Johary Andriamamonjisoa

and 6 more

August 21, 2023
An extensive arterial thrombosis with lower limb ischemia in a COVID-19 patient: a case report.Johary Andriamamonjisoa Andriamizanaka1, Etienne Rakotomijoro2, Volatiana Andriananja3, Mihaja Raberahona4, Radonirina Lazasoa Andrianasolo5, Rivonirina Andry Rakotoarivelo6, Jean de Dieu Randria Mamy7
Racism, Discrimination and Inequity During COVID-19 Pandemic - A Review
Chanchal Maheshwari

Chanchal Maheshwari

September 07, 2023
1.Shehroz KhanJinnah Medical and Dental Collegedr.shehrozkhan@outlook.com0009-0008-9134-71282.Chanchal MaheshwariKarachi Medical and Dental Collegemaheshwarichanchal586@gmail.com0000-0002-3714-7554
A Snapshot on popular beliefs and misconceptions associated with COVID-19 pandemic
Chanchal Maheshwari
Shehroz Khan

Chanchal Maheshwari

and 1 more

August 17, 2023
Misinformation and misconceptions about certain diseases and infections have always triumphed in the world creating a sense of horror among people. Without proper guidance and counseling, ties with these myths cause panic and agitation giving an incentive to believe in them thoughtlessly. SARS-COV2, globally known as Coronavirus disease 19 emerged as a dreadful viral condition affecting millions of people all across the globe. With the rise in the frequency of cases of COVID-19, myths started to escalate resulting in a reduction in actually needed practices and precautionary measures. With passage of time various facts and invalid information has emerged disrupting the course of life. This paper highlights the role of misconceptions that spread like wildfire during COVID-19 pandemic.
Online Healthcare Service in relation to Customer Acceptance and Customer Decision Ma...
Raja Irfan Sabir
Ayesha Javed

Raja Irfan Sabir

and 2 more

August 17, 2023
Digital health, also known as digitalization in healthcare is a growing industry that is bringing several benefits to people around the globe. Online healthcare services are playing a major role in the digital transformation of the health sector. While there are various advantages of digitalization of health services including sharing medical history, easier and faster access of healthcare services, electronic data collection, reduced costs of building infrastructure, and efficiency in the delivery of healthcare services. On the other hand, this also poses challenges in the acceptance of customers and their decision-making towards online health services So, this research focuses on customer acceptance and customer decision-making for online healthcare services with digital transformation. There are two dependent variables in this research including customer acceptance and customer decision making and one independent variable of online healthcare service. The variable of digital transformation plays the role of mediator between online healthcare service and customer acceptance and decision making. Technology acceptance model is the underpinning theory of this research with the consumer decision-making model as a supporting theory. Quantitative research methodology was used by utilizing a survey strategy via questionnaire and data were collected from the customers of online healthcare services residing in Lahore. Moreover, SEM has been used for data analysis via AMOS. Out of four hypotheses of this study, three hypotheses (H2, H3, and H4) have been accepted and one hypothesis (H1) has been rejected as explained in the findings. The findings of this research are beneficial for future researchers as it adds to the existing knowledge and provides recommendations for future research. The findings of this research are beneficial for hospital administration and policymakers to help customers in catering their problems regarding online healthcare services and making lives better for society.
COVID-19 Infection in Children with Acute Lymphoblastic Leukemia Receiving Maintenanc...
Alissa Kahn
Elizabeth S Davis

Alissa Kahn

and 14 more

August 17, 2023
Background: Unlike other pediatric cancers, acute lymphoblastic leukemia (ALL) treatment includes a prolonged maintenance phase during which children typically resume regular activities. As COVID-19 transmission persists despite the end of the public health emergency declaration, physicians need data regarding the impact of COVID-19 in this population to guide families in managing risk. Procedure: The Pediatric Oncology COVID-19 Case Report (POCC) collected de-identified clinical and sociodemographic data on children with cancer and COVID-19. This subset analysis compares 481 children (≤21yo at COVID-19 infection) with ALL in maintenance (ALL-MTN) to other children with cancer and COVID-19 (n=1,190). Results: Children in ALL-MTN had fewer hospitalizations, (23% vs 29%, p=0.01), intensive care unit admissions (ICU: 3% vs 5%, p=0.01), and were less likely to die (0% vs 2%, p=<0.01). However, they more often had cancer therapy changed (50% vs 33%, p=<0.01). Lower odds of hospitalization and ICU admission persisted in multivariable analyses adjusting for age, race/ethnicity, insurance, ANC, and comorbidities. There were independent associations among children in ALL-MTN with sociodemographic factors (Hispanic ethnicity, public insurance) and clinical characteristics (comorbid conditions, neutropenia) and both hospitalization and ICU admission. Vaccination decreased odds of hospitalization. Conclusions: Children in ALL-MTN continue to have significant COVID-19 risks, with less hospitalization and ICU admission but more therapy changes than other children with cancer. These risks should be addressed when discussing participation in activities (school, camp, sports, etc.), prevention (COVID-19 vaccination) and mitigation (masking) strategies. The high level of therapy modifications could have long-term consequences and should continue to be followed.
The trade-off between deaths by infection and socio-economic costs in the emerging in...
Akira Watanabe
Hiroyuki  Matsuda

Akira Watanabe

and 1 more

August 17, 2023
COVID-19, caused by the novel coronavirus (SARS-CoV-2), is an emerging infectious disease (EID) with a relatively high infectivity and mortality rate. During the state of emergency announced by the Japanese government in the spring of 2020, citizens were requested to stay home, the number of infected people was drastically reduced without a legally-binding lockdown. It is well-acknowledged that there is a trade-off between maintaining economic activity and preventing the spread of infectious diseases. We aimed to reduce the total loss caused by the epidemic of an EID like COVID-19 in the present study. We focused on early and late stages of the epidemic and proposed a framework to reduce the total loss resulted from the damage by infection and the cost for the countermeasure. Mathematical epidemic models were used to estimate the effect of interventions on the number of deaths by infection. The total loss was converted into the monetary base and different policies were compared. In the early stage, we calculated the damage by infection when behavioral restrictions were implemented. The favorable intensity of the intervention depended on the basic reproduction number, infection fatality rate, and the economic impact. In the late stage, we calculated indicators and showed it depended on the ratio of the cost to maintain the hospitalization system to the monetary loss per deaths by infection which strategies should be adopted.
Prone Position Improves Survival rate of Covid-19 Invasive Mechanical Ventilation Pat...
yuwei zheng
Xiaojie Bi

yuwei zheng

and 15 more

August 16, 2023
Background:Invasive mechanical ventilation is a crucial intervention for the management of critical COVID-19 patients. However, the impact of prone position (PP) on patients undergoing invasive mechanical ventilation remains uncertain. This study aims to investigate the potential benefits of PP in terms of improving the oxygenation index and prognosis. Methods:A total of 289 critically ill COVID-19 patients were retrospectively gathered from ICU of three general hospitals located in Taizhou, Zhejiang Province from December 1, 2022 to February 1, 2023, all patients were invasive mechanical ventilated. 78 cases of PP group and 78 cases of non-PP group were matched with propensity score matching. The study compared clinical data, laboratory results, and hospitalization survival rate between two groups of patients. Furthermore, we compared the laboratory results, and hospitalization survival across varying numbers of PPs. Results:The mean oxygenation index exhibited a greater increase in PP group compared to non-PP group (48 vs 32mmHg). Hospital survivors of PP group (63 patients) demonstrated more substantial decrease in their Sequential Organ Failure Assessment scores and C-reactive protein levels compared to non-PP group (51 patients). The initial PP cycle resulted in a significant elevation of the oxygenation index by 30.8 (-16.4,46.9) mmHg; the second PP cycle demonstrated a maximum increase of 56.3 (13.0,92.8) mmHg. A higher frequency of PP yielded a more pronounced improvement in oxygenation and had the potential to enhance the survival rate. Additionally, the eight patients who was improvements in their oxygenation index during the initial three PP cycles and successfully survived had higher lymphocyte counts (0.2-2.4) vs (0.1-0.5)×10 9/L and a longer duration of PP (53.0-113.5) vs (36.0-98.5)h. Conclusion:PP has the potential to enhance the oxygenation index and survival rates among critically ill COVID-19 patients invasive mechanical ventilated. Notably, a positive correlation was observed between the frequency of PP and the improvement of oxygenation. Our investigation further revealed that the efficacy of the PP may be influenced by lymphocyte count and duration of PP.
Gastrointestinal manifestations are associated with severe COVID-19 in children
Esra Betul Akkoyun
Bilal Ashraf

Esra Betul Akkoyun

and 4 more

August 16, 2023
Background: Although less severe than in adults, children can experience a range of COVID-19 symptoms, from asymptomatic to life-threatening, including respiratory and gastrointestinal symptoms. Medical conditions may also increase the severity of the disease in infected children. Methods: A study was performed at a single center, comparing cases and controls, and involving 253 pediatric patients who had been diagnosed with COVID-19. Two different outcomes were assessed. The first categorized symptomatic individuals who were hospitalized with COVID-19 (Hospital) from those who were not (Nonhospital). The second categorized admitted individuals who spent at least one day in the intensive care unit (ICU) from those who did not require ICU (Floor). Results: Ninety individuals (36%) had at least one underlying medical condition, with the most common being pulmonary disorders, such as asthma (12%), followed by neurodevelopmental disorders (8%), gastrointestinal disorders (6%). The Hospital group was more likely to have any comorbidity such as obstructive sleep apnea (OSA), diabetes mellitus, seizure disorder, hypertension, sickle cell disease, neurodevelopmental disorder, and immunocompromising conditions including cancer, bone marrow transplant, and other immunodeficiencies, compared to the Nonhospital group. Abdominal pain was more common in the Hospital group. shortness of breath (SOB) and diarrhea were significantly more common in the ICU group than in the Floor group. Conclusions: Early identification of pediatric patients with severe COVID-19 is important to improve outcomes. In our single center case control study, we found that the presence of G symptoms on presentation was more commonly associated with severe COVID-19 in children.
A case report on Multisystem Inflammatory Syndrome in Children (MIS-C) associated wit...
Roshan Bhandari
Richa Paudyal

Roshan Bhandari

and 3 more

August 14, 2023
A document by Roshan Bhandari. Click on the document to view its contents.
Factors associated with SARS-CoV-2 symptomatic infection in university students: a sc...
Mai Katahira
Hisami Sameshima

Mai Katahira

and 10 more

August 14, 2023
Background: The Omicron outbreak is characterized by breakthrough infection and reinfection. If no strategic solution can be found, vaccination-rate-based risk compensation may prolong the COVID-19 crisis. Infection control in university students may have an indirect impact on the COVID-19 burden for other age groups Methods: To reveal the association between related factors and a symptomatic episode of COVID-19, a school-wide web-based questionnaire survey was conducted among university students as a part of the annual health check-up in April, 2023. The positive outcome was confined to the first symptomatic onset during the Omicron variant outbreak. Results: In this self-administered and non-observational survey, risk or protective associations were merely estimated statistically in university students (n = 5,406). In measured factors, karaoke and club/group activities could maintain the statistical significance in adjusted odds ratios (ORs) as (relative) risk factors, and science course, measles/rubella (MR) vaccination, and COVID-19 vaccination remained as (relative) protective factors in adjusted OR analyses. Club/group activities (with member gathering) and karaoke sing-along sessions in university students may frequently have WHO’s three Cs. These risk factors are still important topics for the infection control of COVID-19 in university students. Together with some recent reports from other researchers, the significant protective role of MR vaccine in our survey warrants further clinical investigation. Conclusions: If the breakthrough infection continuously constitutes the majority of infection, real data in test-negative case-control or web-based questionnaire design continue to be important for statistical analysis to determine the minimal requirement of our strategies which may replace COVID-19 vaccines.
A Novel Prophylaxis Strategy Using Ecotin as A Promising Adjuvant for Fc-RBD Fusion P...
Hui Wang
Yakun Sun

Hui Wang

and 10 more

August 14, 2023
A Novel Prophylaxis Strategy Using Ecotin as A Promising Adjuvant for Fc-RBD Fusion Protein Vaccine of SARS-CoV-2Yakun Sun#, Rui Zheng#, Deyu Li#,Yitai Fang#, Liangyan Zhang, Xiaolan Yang, Wenjing Yu, Yeqing Tu, Dan Lu, Deyan Luo*, Hui Wang*Department of Infection Immunity&Defense, State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, ChinaCorrespondence to:Dr. Hui Wangwanghui_dyx@hotmail.com20 Dongda Street, Fengtai District, Beijing 100071, ChinaTel: +86 10 66948532; Fax: +86 10 66948532Dr Deyan Luoldy612@126.com20 Dongda Street, Fengtai District, Beijing 100071, ChinaTel: +86 10 66948549; Fax: +86 10 66948532#These authors contributed equally to this article.
Left Ventricular Thrombus Formation in a COVID-19 Patient with a Complex Course of Pe...
Jalil Golshani
Zahra Kalantari

Jalil Golshani

and 5 more

August 12, 2023
Left Ventricular Thrombus Formation in aCOVID-19 Patient with a Complex Course of Pericarditis and Myocardial Infarction.
Resolution of Chronic Cough Following Treatment for Iron Deficiency Anemia
Eric Mull
Swati Jayaram

Eric Mull

and 4 more

August 12, 2023
A previously healthy 4-year-old female presented for a cough that was not responsive to treatment of inhaled corticosteroid (ICS). Pertinent history included meconium aspiration with no respiratory support required and a course of confirmed SARS-CoV-2 with fever and mild respiratory symptoms of a cough, that resolved in 2-3 weeks. Child was seen in Allergy clinic 2 months before first Pulmonary clinic appointment with a compliant of cough that redeveloped. Cough was dry, associated with strenuous activity, and noticeably present at night. She was started on albuterol 2 puffs every 4 hours, as needed.
Whole Genome CRISPR Screening Strategy to Identify Genes Contributing to SARS-CoV-2 S...
Adam Hoppe
Md Saddam Hossain

Adam Hoppe

and 2 more

August 12, 2023
Background Understanding the cellular host factors that promote and inhibit viral entry is important for identifying viral countermeasures. CRISPR whole genome screens can be used to rapidly discover host factors that contribute to or impair viral entry. However, when using the live viruses and cellular lethality for selection, these screens can identify an overwhelming number of genes without specificity for the stage of the viral infection cycle. New screening methods are needed to identify host machinery contributing to specific steps of viral infection. Here, we developed a CRISPR whole genome screen and counter screen strategy based on a pseudoviral platform that allowed identification of genes specific to SARS-CoV-2 spike and vesicular stomatitis virus glycoprotein VSV-G mediated entry. Methods To focus the screen onto the entry step, we used non-lytic fluorescent reporters in combination with a comparative counter screen strategy to distinguish host genes affecting the pseudoviral reporter from those unique to envelope-mediated entry. Screening of SARS-CoV-2 spike and VSV-G on the same lentiviral pseudovirus allowed identification of entry-specific genes relative to genes associated with retro-transcription, integration, and reporter expression from the lentiviral pseudovirus. Second, a Cre-Gag fusion protein in the pseudovirus was used to bypass retro-transcription and integration by directly activating a floxed GFP reporter upon entry to reduce the number of gene hits and increase specificity for viral entry. Results Our approach correctly identified SARS-CoV-2 and VSV-G receptors ACE2 and LDLR, respectively and distinguished genes associated with retroviral reporter expression from envelope-mediated entry. Moreover, the CRE-Gag fusion/flox reporter increased the screen specificity for viral entry associated genes. Validation of a few hits demonstrates that this approach distinguishes envelope-specific host factors from genes affecting reporter expression. Conclusion Overall, this approach provides a new strategy for identifying host genes influencing viral entry without the confounding complexity of live-viral screens which produce long gene lists associated with all aspects of viral pathogenesis and replication. This approach provides a pathway for increasing the specificity of CRISPR whole genome screens for identifying host genes contributing to specific steps in viral infection.
Solidarity is a core capacity for emergency preparedness and response
Brooke Atkins
Tania Cossich

Brooke Atkins

and 4 more

August 10, 2023
At the beginning of the COVID-19 pandemic, Dr Tedros, Director-General of the World Health Organization (WHO) called for solidarity in our global response. While the call has echoed in various World Health Assembly (WHA) resolutions and other major public health commitments, many responses (local, national, and global) to the pandemic have seen shortfalls in solidarity. This viewpoint uses the COVID-19 pandemic to explore the roots of solidarity and trust and the political, economic, and social values and forces that shape it. The shortfall in our pandemic response exposes the limits and conditions of solidarity. However, we argue that solidary can be strengthened to contribute to global health security. Lastly, we reflect on the importance of solidarity in emergency preparedness, response, and recovery and the implications for public health practice.
Respiratory sequelae after COVID-19 infection in Thai healthy children
Sirapoom Niamsanit
Wicharn Boonjindasup

Sirapoom Niamsanit

and 7 more

August 10, 2023
Background and Aims: The long-term respiratory sequelae of COVID-19 infection in children remain poorly understood and may differ across countries. This study aims to investigate the respiratory sequelae, including residual respiratory symptoms and pulmonary function in Thai children. The secondary aim is to identify factors associated with the respiratory sequelae. Materials and Methods: This is an observational study involving 56 healthy children, aged between 7-18 years, who were diagnosed with COVID-19 infection from July 2021 to February 2023. Clinical data relating to COVID-19 infection and persistent symptoms after the infection were assessed after the infection up to six months. Spirometry was performed to assess pulmonary function. Results: Post COVID-19 symptoms were identified in 14 patients (25%), with fatigue, cough, and dyspnea being common symptoms (28-35%). A significant correlation was found between post COVID-19 symptoms and pneumonia (OR = 6.00, 95%CI [1.54,23.33], p=0.01). Abnormal pulmonary function was identified in 10 patients (17.8%) with obstructive impairment being the most common. However, there were no significant association between clinical factors and pulmonary function impairment. Conclusion: Prolonged respiratory symptoms and abnormal pulmonary function following COVID-19 infection are not uncommon in children. The post COVID-19 symptoms are possibly associated with COVID-19 pneumonia.
COVID-19 Hospitalization Rates in Kidney Transplant Patients Treated with Tixagevimab...
Katherine Dugan
Jillian Casale

Katherine Dugan

and 4 more

August 10, 2023
Background Despite the limited evidence in immunocompromised populations, the U.S. Food and Drug Administration issued an Emergency Use Authorization in December 2021 for tixagevimab/cilgavimab (T/C) indicated for COVID-19 pre-exposure prophylaxis. T/C has been used widely at our center, therefore, we sought to determine the safety and effectiveness of T/C for this indication in a cohort of kidney transplant recipients. Methods This was a retrospective, single-center, Institutional Review Board-approved study evaluating the outcomes of 122 kidney transplant recipients who received tixagevimab/cilgavimab for pre-exposure prophylaxis of COVID-19. Adult patients who received T/C between January 1 st, 2022 and March 31 st, 2022 were reviewed for inclusion. The efficacy population (n= 115) comprised those who received two doses and the safety population (n=122) comprised those who received any amount of T/C. The primary outcome was the rate of hospitalization for COVID-19 infection within six months of the first dose of T/C. The secondary outcome was serious adverse events attributed to T/C. Results Within six months of administration, low rates of hospitalization (2%) and adverse events (2%) were found, with no incidence of heart failure, myocardial infarction, or anaphylaxis. Conclusion Overall, our study demonstrated that T/C in kidney transplant recipients was safe and associated with low rates of hospitalization for COVID-19 infection when susceptible Omicron subvariants were dominant.
The maternal environment is rich in SARS-related receptors which could be protective...
April Rees
Megan Chambers

April Rees

and 9 more

August 10, 2023
Background: While risk of infection with SARS-CoV-2 is low to pregnant women and the fetus, there is increased risk of preterm birth and admission into ICU. The fetus is relatively protected against infection, with cases of vertical transmission being rare. Various receptors and accessory molecules which are known to regulate SARS-CoV-2 viral entry into host cells have soluble versions which could act as decoy traps. Following on from our previous findings regarding the abundance of some of these molecules in breast milk and amniotic fluid, we show the maternal-fetal interface is also rich in these molecules and how systemically they can be differentially expressed between males, non-pregnant females, pregnant females, and neonates. Methods: Archived placental samples from before the pandemic, and blood from participants in late 2020 who had not tested positive for COVID-19 were analysed for the presence of receptors by ELISA, immunohistochemistry, immunoblotting and flow cytometry. Results: We have confirmed that the placenta and membranes are particularly rich in CD26 and CD147 and gone on to consider if it is possible that shedding of these molecules into the maternal and fetal circulation occurs. However, except for sCD147 in umbilical cord plasma compared to all groups and sNRP-1 in pregnant women in comparison to men and neonates, the expression of soluble forms of these molecules is primarily consistent between the groups studied here. Conclusion: The maternal-fetal interface has potential mechanisms to protect the fetus from contracting SARS-CoV-2 by being rich with soluble versions of receptors involved in host cell entry of the virus, thereby limiting infection of host cells.
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