Background: The aim of the study was to determine the effectiveness of tocilizumab treatment in patients with COVID-19. Methods: 60 patients infected with SARS-CoV-2 were enrolled in the study. The patients were divided into two groups according to whether they treated with tocilizumab or did not. Demographic and clinical features of the patients, laboratory findings, treatments, and clinical outcome were evaluated. Results: The mean age of 30 patients in group 1 was 63.6±16.3 years and male/female ratio was 3.2, whereas the mean age of 30 patients in group 2 was 59.4±11 years and male/female ratio was 2.7 (P=0.244 and P=0.766, respectively). pO2/FiO2 and lymphocyte count at baseline, 2nd day and 7th day were significantly lower in group 1 treated with standard treatment without tocilizumab than group 2 additionally treated with tocilizumab (P<0.05). D-dimer level at 7th day, ferritin and CRP levels at 2nd and 7th day were significantly higher in group 1 than group 2 (P=0.015, P<0.001, P<0.001, P<0.001, P<0.001, respectively). The patients in group 1 had higher intensive care unit need and mortality rate than the patients in tocilizumab group (P=0.015). 28-day survival was lower in group 1 than tocilizumab group (P=0.024). Conclusions: We observed clinical improvement and lower mortality rate in hospitalized patients with severe COVID-19 with tocilizumab treatment.

Summary: This study evaluates through modeling the possible individual and combined effect of three populational parameters of pathogens (reproduction rate; rate of novelty emergence; and propagule size) on the colonization of new host species – putatively the most fundamental process leading to the emergence of new infectious diseases. The results are analyzed under the theoretical framework of the Stockholm Paradigm using IBM simulations to better understand the evolutionary dynamics of the pathogen population and the possible role of Ecological Fitting. The simulations suggest that all three parameters positively influence the success of colonization of new hosts by a novel parasite population but contrary to the prevailing belief, the rate of novelty emergence (e.g. mutations) is the least important factor. Maximization of all parameters result in a synergetic facilitation of the colonization and emulates the expected scenario for pathogenic microorganisms. The simulations also provide theoretical support for the retention of the capacity of fast-evolving lineages to retro-colonize their previous host species/lineage by ecological fitting. Capacity is, thus, much larger than we can anticipate. Hence, the results support the empirical observations that opportunity of encounter (i.e. the breakdown in mechanisms for ecological isolation) is a fundamental determinant to the emergence of new associations – especially Emergent Infectious Diseases - and the dynamics of host exploration, as observed in SARS-CoV-2. Insights on the dynamics of Emergent Infectious Diseases derived from the simulations and from the Stockholm Paradigm are discussed.

Background: The aim of the study was to evaluate the management and outcomes of the patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a secondary hospital. Methods: A total of 699 hospitalized patients who had positive rRT-PCR for SARS-CoV-2 and/or typical findings of COVID-19 at chest computed tomography (CT) were enrolled in this study. Demographics, comorbities, initial laboratory tests on admission, treatment modalities, complications and outcomes were evaluated retrospectively. Results: The mean age was 57.0±15.6 (range:16-94 years), and male:female ratio was 1.24. 58.7% of the patients had at least one underlying comorbidity, the most common was hypertension. 72.8% of the patients had positive RT-PCR. 18.1% of the patients had lymphopenia, 35.7% hyperferritinemia, 58.3% increased lactate dehydrogenase, and 58.5% increased D-dimer. Chest CT revealed moderate and severe stage in 57.9% of the patients, and bilateral lung involvement in 78.7%. Hydroxychloroquine was given to 37.2% and favipiravir 67.1% of the patients. No significant difference was observed between treatment groups in terms of mortality (P=0.487). 5.8% of the patients were transferred to the ICU, of whom 75.6% were needed non-invasive and 36.5% invasive mechanical ventilation. The overall case fatality rate was 0.9. Conclusions: Older age, male sex, low lymphocyte count, CT findings including bilateral involvement and severe stage were significantly associated with poor prognosis and mortality.

Objective: We aimed to evaluate histopathologic alterations in the lung, heart, liver, and spleen of coronavirus disease 2019 (COVID-19) decedents through postmortem core needle biopsies. Materials and Methods: Patients who died of reverse transcription-polymerase chain reaction-proven COVID-19 were included in this postmortem case series. Postmortem percutaneous ultrasound-guided biopsies using 14- and 16-gauge needles were performed in the lungs, heart, liver, and spleen. Biopsy samples were stained with hematoxylin-eosin and examined under a light microscope. Clinicodemographic characteristics, chest computed tomography (CT) images, and COVID-19-related treatments of the patients were also collected. Results: Seven patients were included in this study. Liver and heart tissue samples were available from all patients, and lung and spleen tissues were available from five and three patients, respectively. Chest CT images predominantly revealed bibasilar ground-glass opacities. Lung biopsies showed diffuse alveolar damage in all biopsy specimens. Heart findings were nonspecific and largely compatible with the underlying disease. Patchy necrosis, steatosis, and mononuclear cellular infiltration were the main findings in the liver biopsies. Splenic histopathological examination showed that splenic necrosis and neutrophil infiltration were the common findings in all patients. Conclusion: Tissue acquisition was complete for the heart and liver and acceptable for lungs. The amount of tissue was sufficient for a proper histopathologic examination. The histopathological findings were generally in accordance with previous autopsy studies. The lung radiological findings were also correlated with the histopathologic findings. We consider that a postmortem biopsy is a feasible alternative for histopathological examinations in COVID-19 decedents.

Introduction COVID-19 shows similar clinical and radiological findings with other viral pneumonias. This study designed to explore the likelihood of the existence of COVID-19 pneumonia in our country before March 11th, date of first official COVID-19 case detected in Turkey, by using a diagnostic model designed with radiologic and laboratory findings. Materials and Methods 273 patients were aggrouped according to hospitalization date, naso-oropharyngeal swab PCR results. Thoracic tomographies, C-reactive protein (CRP), leukocyte, lymphocyte, monocyte, eosinophil, platelet values of all patients were evaluated. Results Laboratory findings of lymphocyte, eosinophil counts (p<0.05) were significantly low; radiologic findings of round opacity, cobblestone, nodüle, subpleural line were significant in COVID-19 group (p<0.05). ‘Round opacity’, ‘subpleural line’, ‘nodule’, ‘lymphocyte’ variables were found to be statistically significant for final model (p<0.05). COVID-19 diagnosis possibility; increases 302.9% by ‘round opacity’, 355.6% by ‘subpleural lines’; and decreases 59.1% by ‘nodule’ presence, 31.7% by one unit increase in lymphocyte level. Based on final model; 49.3% of the participants before 11 March 2020 were predicted to be positive for COVID-19. Conclusion According to these findings, we can say that COVID-19 patients existed before March 11th, 2020 in Turkey, for the first time. Also subpleural lines, presence of cobblestone, round opacity appearances and absence of nodules on tomography, and the presence of lymphopenia and eosinopenia in the cell count can also be used to support the diagnosis of COVID pneumonia.

Objectives Diagnostic challenges during the COVID-19 pandemic forced the radiology regulating body to adopt the use of CT Chest as a triage and diagnostic tool, which was subsequently abandoned. The Royal Wolverhampton hospital followed both protocols. Here, we investigate the evidence behind this decision within the context of surgical admissions during the COVID-19 peak in our hospital. Methods Retrospective data collection and analysis of all surgical admissions between the 1st of March to the 31st of May. Data was collected from the radiology and electronic portal looking into patients undergoing CT chest to diagnose the presence of C-19 as well as swab results. Results 78 patients fulfilled our inclusion criteria. The scan either confirmed the presence or absence (4, 63 patients) of C-19 but was sometimes inconclusive (11 patients). Comparing these to the results of the swabs; CT showed sensitivity 42.86 %, Specificity 97.92%, and accuracy 90.91 %. In the inconclusive CT report group, chances of having a positive swab result were 45%: None of the scan results changed any of the surgical planning. Lymphocyte count in the context of surgical presentation did not have any statistical significance to predict the presence of C-19 (P=0.7). Cost implications on our cohort of patients for adding the chest CT is estimated to be around £31,000. Conclusion CT Thorax during the pandemic was a good negative predictor but had limited diagnostic value and did not change patient management. Newer, faster techniques of PCR swabs and antibody testing would be a better and cheaper alternative. Advances in knowledge This paper provides evidence to support the decision from the regulatory bodies not to use CT scan as a screening tool for COVID 19 diagnosis.

Objective: Medication nonadherence (MNA) is a main problem in patients with asthma and COPD. Association of anxiety and MNA is confusing and is not clear. Improper inhaler technique is an unintentional component of inhaler MNA. In this study, we aimed to investigate the association between inhaler medication usage skills and general anxiety or coronavirus anxiety scales. Materials and methods: Inhaler usage techniques of 70 asthma and COPD patients were evaluated by three clinical pharmacists. The anxiety scores of the patients were calculated by a pulmonologist according to the Hamilton Anxiety Rating Scale (HAM-A) and Coronavirus Anxiety Scale (CAS). Results: Only 32.9% of the patients were using their inhalers properly. There were only 10 (%13.3) patients who had all steps correct. CAS score, age, comorbidity and inhaler type were not found to be associated with proper inhaler technique. Only the HAM-A stage (p=0.096) and educational status (p=0.074) approached statistical significance in affecting the proper inhaler technique. A weak correlation was found between age and CAS score (r=-0.278, p=0.02). Coronavirus anxiety rate is higher in asthma patients than in COPD patients (p=0.036). HAM-A and CAS scores of female patients were higher than men (p<0.05). There was a moderate correlation between HAM-A score and CAS score (r=0.407, p<0.001). The correlation between HAM-A score and inhalation skills score approached statistical significance (r=-0.208, p=0.083). Conclusion: Most COPD and asthma patients use their inhalers improperly. More attention should be paid to inhaler use skills training, especially in the low education level group and moderate-severe anxiety group.

Vaccination created a breakthrough towards the improvement to the global health. The development of vaccine and their practice made a substantial control in infectious diseases. The emergence of new vaccines has facilitated targeting populations to alleviate and eliminate contagious pathogens from their innate reservoir. However, along with the infections like malaria and human immunodeficiency virus (HIV), effective immunisation remains obscure and imparts a great challenge unto the realm of science. The vaccines developed after utilizing plant based system supported technology comprises the incorporation of the preferred genes to express the specific protein (antigen) for a particular disease condition into the genome of plant tissues using several techniques. Though plant-supported vaccines propose several benefits to the vaccine industry, still there remain challenges that limit the rate of effective production of vaccines of this third-generation. A novel Corona virus SARS-CoV-2 reason for causing Corona virus diseases 2019 (COVID-19) crashed the human population and rapidly spread round the world within the half of 2020 created a worldwide epidemic. The need for establishing a protected and compelling COVID-19 immunization is a global requirement to end this pandemic. Even though there exist lot of limitations, continuous efforts has put forward so as to develop highly competent and effective vaccine for many human and animal linked diseases due to its unlimited prospective. This review article focus on the historical outlook and the development of the vaccine as it is a crucial area of research where the life of the human is saved from various potential dise

Pandemics are epidemics or disease outbreaks, which rampage across countries and continents. The ongoing corona virus disease 2019 (COVID-19) has been a full-fledged pandemic for over a year now. With the death count mounting above two million, COVID-19 has globally impacted the economy, society, public health and all spheres of human life. COVID-19 is the third type of coronavirus disease outbreak after Severe Acute Respiratory Syndrome and Middle East Respiratory Syndrome. This review paper discusses the medical perspectives of COVID-19 along with a recount on the numerous pandemics that have wreaked havoc in the past. AIDS which is ongoing, and cholera, influenza and plague have been recurring pandemics and merciless killers. Even with tremendous advancement in medical science, new pathogens continue to cause uncontrollable infections and deaths worldwide. Research in the fields of medicine, health and social sciences, psychology and so on is soaring as the world battles with COVID-19. Additionally, scientometric analysis has been performed using the Web of Science platform, a global citation database, to project the impact of COVID-19 on research in terms of scientific publications. As of 04th April 2021, 98,020 scientific works have been published of which 28 % are from the USA. Medical and health sciences have been the major focus of research globally, as the world works tirelessly to develop the ‘right’ vaccine that will make COVID-19 a disease of the distant past.

Background: The prevalence of positive SARS-CoV-2 nucleic acid in recovered COVID-19 patients has attracted attention. We aimed to investigate the repositive rate of SARS-CoV-2 and the clinical features of discharged COVID-19 patients. Methods: In this systematic review and meta-analysis, we searched PubMed, Embase, Web of Science, China National Knowledge Internet, Wanfang Data, China BioMedical Literature, VIP, and Google Scholar. Fixed or random-effect models were used to determine effect estimates. Results: Eleven studies were included. The pooled positive rate of viral RNA in discharged patients was 11% (95% CI 7-15; I2=90.4%). The median days from discharge to repositivity were 7 to 8 days. Coughing was the most common clinical symptom, occurring in 16% (95% CI 11-20; I2=0%) of patients at readmission. Chest CT and laboratory indicators of positive retest (PR) patients showed significant recovery trends. The prevalence of comorbidities between the PR patients and the negative retest patients were not significant (OR 0.86 [95% CI 0.38–1.95]; p=0.002; I2=76.5%). No close contacts were positive for SARS-CoV-2 RNA. Conclusion: PR patients were uncommon. The repositive result was likely due to the incomplete clearance of virus from a previous disease course. PR patients were less likely to be contagious. However, close monitoring and quarantine after discharge from the hospital are necessary. Registration: The protocol has been registered on PROSPERO, registration ID: CRD42021239650 Keywords: COVID-19, SARS-CoV-2, discharged patients, positive retest rate

COVID-19 has been associated with both transient and persistent systemic symptoms that do not appear to be a direct consequence of viral infection. The generation of autoantibodies has been proposed as a mechanism to explain these symptoms. To understand this phenomenon in more detail, we investigated the frequency and specificity of clinically relevant autoantibodies in 84 individuals previously infected with SARS-CoV-2, suffering from COVID-19 of varying severity in both the acute and convalescent setting. These were compared with results from 32 individuals who were on ITU for non COVID reasons. We demonstrate a higher frequency of autoantibodies in the COVID-19 ITU group compared with non-COVID-19 ITU disease control patients and that autoantibodies were also found in the serum 3-5 months post COVID-19 infection. Non-COVID patients displayed a diverse pattern of autoantibodies; in contrast, the COVID-19 groups had a more restricted panel of autoantibodies including skin, skeletal muscle and cardiac antibodies. Our results demonstrate that severe COVID-19 induces a pattern of autoantibodies that may correlate with and contribute to the immune pathology associated with the long-term sequelae of infection.

Background Since the severity of symptoms affects the treatment option for Coronavirus Disease 2019 (COVID-19) patients, the treatment pattern for mild to moderate non-ICU cases must be evaluated, particularly in the current scenario of mutation and variant strain for effective decision making. Objectives This retrospective study’s objectives were to assess clinical and treatment outcomes in mild to moderate non-ICU COVID-19 patients in Saudi Arabia. Methods Non-ICU patients with COVID-19 with mild to moderate symptoms who were admitted to major tertiary care hospitals in Al Baha, Saudi Arabia, between April and August 2019 were studied retrospectively for clinical outcomes. Results A total of 811 people were admitted for COVID-19 treatment, with age ranging from 14 to 66, diabetes mellitus (31 %, n = 248) and hypertension (24%, n = 198) were the most common comorbid conditions. The majority of the patients (77 %, n = 621) had reported symptoms for COVID -19 infection. The hydroxychloroquine (HCQ) treated group (G1 n = 466) had an MD of 8 and an IQR of 5-13 for time in hospital with a 4.3 % mortality rate, while the non-HCQ group (G2 n = 345) had an MD of 6 and an IQR of 3-11 for time in hospital with a 3.2 % mortality rate. The mortality rate among non-HCQ treated patients varied, but a combination of antiviral and antibiotic treatment was found to be effective, other most frequent intervention was analgesics 85.7 %, anticoagulant 75 %, minerals (Zinc 83 % and Vit D3 82 %). Conclusions The COVID 19 therapy and clinical outcomes from the past will be the guiding factor to treat the mutant strain infection in the future. Patients treated HCQ had a higher mortality rate, whereas those who were given a non-HCQ combination had a greater clinical outcome profile.

Background: Acute hypoxemic respiratory failure (AHRF) is common in COVID-19. Tracheal intubation in such patients is fraught with higher mortality, therefore, high flow nasal oxygen therapy (HFNOT) is being used in AHRF. In this study, we aimed to determine the impact of HFNOT on oxygenation status and also various predictors of HFNOT failure. Methods: A prospective observational cohort study was conducted in COVID-positive critically ill adult patients (aged>18 years) with AHRF, who were unable to maintain SpO2>90% on a non-rebreathing face mask at an oxygen flow ≥15 litres/minute. Respiratory variables (PaO2/FiO2, SpO2, and RR) before HFNOT (baseline), then at 1-hour, 6-hour, 7-day, and 14-day after HFNOT application, were recorded. Borg CR10 scale and visual analog scale were used to evaluate the subjective sensation of dyspnoea and comfort level respectively. Student’s t, Mann–Whitney U or Wilcoxon signed-rank tests were used as applicable. Multivariate logistic regression and Receiver-Operating Characteristic (ROC) analyses were performed to determine factors associated with HFNOT failure. Results: 114 patients were included with HFNOT failure rate of 29%. The Median PaO2/FiO2 ratio at baseline (before initiation of HFNOT) was 99.5 (80-110) which significantly increased at various time points (1-hour, 6-hour, 7-days, and 14-day) after HFNOT initiation in the successful group. Patients reported significant improvement in sensation of breathlessness (9 [8-10], 3 [2-4]; p<0.001) as well as in comfort level (2 [1-2], 8 [4-9]; p<0.001). Multivariate logistic regression analysis, SOFA>7, APACHE II>20, admission P/F ratio<100, D-dimer>2mg/L, IL-6>40 pg/mL, Random Blood Sugar (RBS)>250 mg/dL, 6-hour ROX Index<3.5, were independent prognostic factors of HFNOT failure. Conclusion: In COVID-19 patients with AHRF, the use of HFNOT significantly improved oxygenation levels at various time points after HFNOT initiation. Age, SOFA, APACHE II, and ROX scores, admission P/F ratio, IL-6, D-dimer, and RBS were independent prognostic factors of HFNOT failure in this cohort.

Context: Multisystem Inflammatory Syndrome in Children (MISC) is a newly and rising condition, particularly in SARS-CoV-2 high transmission communities. Objective: Analyze current literature and reported cases of MISC, concerning its clinical spectrum, complications associated, therapeutic strategies and distinguishing features of other clinical syndromes. Data Sources: Extensive literature research was performed in MEDLINE (trough PubMed), Scopus and Web of Science from December 2019 to December 2020.Study Selection: First analysis included all article titles and abstracts screening to identify relevant studies and second analysis included a full text screening of previous selected studies. Eligibility was assessed independently by two authors and disagreements were resolved by discussion and consensus. Data Extraction: Data were extracted on MISC definition, demographic data, clinical features, diagnostic tests, laboratory analysis andimaging, therapeutical approach and outcomes. Results: Common symptoms included: gastrointestinal (70%), rash (57%) and cardiovascular (52% with shock). Notable differences with Kawasaki Disease were identified including age, clinical presentation and cardiac involvement. 30% presented positive SARS-CoV-2 2 reverse transcription polymerase chain reaction and 51% positive serologies. 62% received intravenous immunoglobulin and 42% glucocorticoids. 62% required intensive care, 21 children died (<2%). Severe presentations were associated with neurological symptoms, hepatitis and acute kidney injury. Limitations: As a recently documented disease, there was limited prospective and follow-up studies, therefore disregarding long-term sequelae and prognosis. Conclusions: MISC raises concern on its severe cardiac involvement at presentation, with frequent intensive care and immunomodulatory therapy need. Short term outcomes seem to be favorable, with cardiac disfunction recovery and low mortality rates.

Introduction: The covid-19 disease is a pandemic threat for humanity’s healthcare system, social, economic, and psychological well-being for both developed and developing nations. In the case of developing nations such as the resource of Ethiopia, however, the key obstacle is to buy the vaccine and administer it to their people.. In the study area, however, the degree of adherence to the covid-19 preventive measure was not well established. The aim of this study is to determine adherence to covid-19 prevention measures in Hossana town. Methods: From 3 to 29 January 2021, a community-based cross-sectional study was conducted among individuals living in the Hosanna town. We used a sample size of 384. The sample size was distributed to all 8 kebeles in proportion to the size of the households contained in each kebele in the town of Hossana. Systematic sampling methods were used and both descriptive and advanced analysis, data was entered into Epi-data and exported to SPSS. Binary logistic regression was used to identify variables associated with adherence to preventive measures for covid-19. Result: 50.4% of the study participants had good adherence with the COVID-19 preventive measures. 145 (38.5%) of all respondents had poor knowledge on COVID-19 preventive measures and 40.3 % had poor COVID-19 transmission methods knowledge. Age [AOR: 0.34; 95 % CI (0.131-0.912)], educational status [AOR: 0.32; 95% CI (0.165-0.632)], marital status [AOR: 2; % CI (1.191-3.803)], family size [AOR: 2.4; % CI (1.322-4.366)]] and covid-19 complication [AOR: 0.49: 95% CI (0.242-0.979)]] were significantly associated with covid-19 prevention measurement adherence in multivariate analysis. Conclusion: This study found that approximately half of the participants had poor adherence to COVID-19 preventive measures. Factors associated with covid-19 preventive measures were age, educational age, marital status, family size, and heard about complication of COVID-19 were associated with preventive measures.

Background: Many treatments for COVID-19 are currently under studying, such as combination therapies with hydroxychloroquine plus antiviral drugs. In this study, we compared the efficacy and side effects of two types of combination therapy including atazanavir /ritonavir (ATV/r) or lopinavir /ritonavir (LPV/r) plus hydroxychloroquine among COVID-19 patients. Methods: In a non-randomized clinical trial, 108 eligible patients with moderate and severe form of COVID-19 were divided into two groups. Each group consisted of 54 patients. One group received ATV/r plus hydroxychloroquine and the other group received hydroxychloroquine plus LPV/r. Then, the two groups were evaluated and compared for clinical symptoms, recovery rates and complications of treatment regimens. Results: The findings of this research showed a significant increase in bilirubin in ATV/r receiving group compared to LPV/r receivers (p<0.001). there was also a significant increase in arrhythmias in the LPV/r group compared to ATV/r group during the treatment period (p=0.019). Other findings including length of hospital stay, outcome, and treatment complications were not statistically significant. Conclusions: There is not statistically significant difference between protease inhibitor drugs including ATV/r and LPV/r in the treatment of COVID-19 regarding to progress and clinical outcomes. However, some side effects such as hyperbilirubinemia and arrhythmia was significantly different by application of atazanavir or lopinavir.

Purpose: The novel coronavirus disease 2019 (COVID-19) has spread all over the world. The diagnosis of COVID-19 in asymptomatic patients and patients with non-respiratory symptoms remains a big concern. In this study, we aimed to evaluate the incidence of missed diagnosed COVID-19 pneumonia on abdominal computed tomography (CT) performed in patients admitted to our urology outpatient clinic. Methods: We reviewed the files of patients who were admitted to the urology outpatient clinic from 1 April to 1 November retrospectively. We included the patients who performed abdominal CT at the urology outpatient clinic for any reason and recorded demographic data and abdominal CT findings. We excluded patients with pulmonary symptoms and previously diagnosed with COVID-19. Also, patients without abdominal CT were excluded. We evaluated the rates of missed diagnosed COVID-19 pneumonia detection on the lung base images of abdominal CT. Results: 1024 patients were included in this study. We observed that 99 (9.7%) of these patients had findings related to COVID-19 pneumonia on the lung base images of abdominal CT. Although 885 (86.4%) patients had no pathological pulmonary findings, 40 (3.9%) patients had other pathological pulmonary findings. Conclusion: COVID-19 disease has become a pandemic all over the world. All healthcare professionals, including urologists, play an active role in the diagnosis and treatment of this disease. So, it should be kept in mind that COVID-19 pneumonia should be evaluated in patients admitted to the urology outpatient clinic with renal colic or abdominal pain.

Background There are limited data in paediatric populations evaluating whether chronic cardiorespiratory conditions are associated with increased risk of COVID-19. We aimed to compare the rates of chronic cardiac and respiratory disease in children testing positive (SARS-CoV-2[+]) compared to those testing negative (SARS-CoV-2[-]) at our institution. Method Prospective cohort with nested case-control study of all children tested by PCR for SARS-CoV-2 by nasopharyngeal/oropharyngeal sampling between March and October 2020. Children were identified prospectively via laboratory notification with age and sex-matching of SARS-CoV-2[+] to SARS-CoV-2[-] (1:2). Clinical data were extracted from the electronic medical record. Results In total, 179 SARS-CoV-2[+] children (44% female, median age 3.5 yrs, range 0.1 to 19.0 yrs) were matched to 391 SARS-CoV-2[-] children (42% female, median age 3.7 yrs, range 0.1 to 18.3 yrs). The commonest co-morbidities showed similar frequencies in the SARS-CoV-2[+] and [-] groups: asthma (n = 9, 5% vs n = 17, 4.4%, p = 0.71), congenital heart disease (n = 6, 3.4% vs n = 7, 1.8%, p = 0.25) and obstructive sleep apnoea (n = 4, 2.2% vs n = 10, 2.3%, p = 0.82). In the SARS-CoV-2 group, the prevalence of symptomatic disease was similar amongst children with and without cardiorespiratory comorbidities (n = 12, 75% vs n = 103, 57%, p = 0.35) who tested positive. A high proportion of children hospitalised with SARS-CoV-2 infection had cardiac comorbidities (23.8%). Conclusions In this single site dataset, rates of pre-existing cardiorespiratory disease were similar in SARS-CoV-2[+] and SARS-CoV-2[-] children. High rates of comorbid cardiac disease were observed amongst hospitalised children with COVID-19, warranting further research to inform public health measures and vaccine prioritisation.

Objectives: In this study, we aimed to evaluate the perspectives of the citizens ranking last in COVID-19 vaccination groups towards the vaccination process. Materials and Methods: In-depth interviews were made with the participants using video conferencing method. Twenty-eight video conferencing interviews were conducted with citizens who ranked last in the vaccination groups. With the permission of the participants, audio recording was obtained in all interviews, transcribed verbatim and checked. Thematic approach was used to analyze the data. Data were collected until saturated. Results: Findings were summarized into three main categories. The first was “Satisfaction.” Participants expressed their satisfaction about process management, home vaccinations and continuous information. The second theme was “Dissatisfaction.” Some participants expressed their dissatisfaction with the prioritization of elderly people in vaccination and late vaccination of actively working individuals. The third theme was “Reservations.” Participants stated that they have reservations regarding possible complacency in the society after vaccination and delay in vaccination of non-prioritized groups. In general, participants stated that they were satisfied with the supply of vaccines and applications. However, active working individuals think that they should have priority over the elderly in vaccination. Conclusion: To ensure full compliance with the vaccine administration, it is necessary to enlighten all individuals, especially those ranking last in the vaccination groups, about the prioritization process and which variables are given importance.

The most effective way to prevent and control infectious disease outbreak is through vaccines. The increasing use of vaccines has elevated the need to establish new manufacturing strategies. One of the major approaches is cell-based production, which creates a need for high cell density to enable higher cell production levels. This has led to development of the technology of cell carriers, including micro and macro cell carriers. To follow the production process, quantifying the number of cells on these carriers is required, as well as the tracking of their viability and proliferation. However, owing to various carriers’ unique structures, tracking the cell’s is challenging using current traditional assays that were originally developed for monolayers of adherent cells. The current “gold standard” method is counting cell nuclei, separating cells from the carrier, staining with crystal violet and visually counting under a microscope. This method is tedious and counts both live and dead cells. A few other techniques were developed but were specific to the carrier type and involved specialized equipment. In this study, we describe a broadly ranging method for counting cells on carriers that was developed and employed as part of the production of a vaccine for use in the SARS-CoV-2 pandemic. The method is based on the Alamar blue dye, a well-known, common marker for cell activity, and was found to be successful in tracking cell adsorption, cell growth and viability on carriers. No separation of the cells from the carriers is needed, nor is any specialized equipment; the method is simple and rapid, and provides comprehensive details necessary for process control of viral vaccine production in cells. This method can be easily implemented in any of a number of cell-based processes and other unique platforms for measuring growth of encapsulated cells.

A 48-year-old woman, considered as a close contact of her husband who was diagnosed with COVID-19. She was clinically diagnosed with COVID-19-related pneumonia because of a positive antibody test. Her BALF contained an elevated lymphocyte fraction, which might explain why steroids are effective against COVID-19-related pneumonia.

This report describes a case of 45 years old male patient who tested positive for COVID-19 presented to the emergency department on March 2021 complaining of fever, cough, runny nose, and shortness of breath. The patient denied any history of nausea or diarrhea who has eventually developed favipiravir-induced nephrotoxicity.

Tension pneumomediastinum (TPM) is a rare but potentially fatal clinical entity. This leads to leakage of air into the mediastinal cavity and increased pressure on thoracic vessels, respiratory tract, and the heart. We report a series of five cases of COVID-19 complicating into acute respiratory distress syndrome and developing TPM.

The novel coronavirus SARS-COV-2 or COVID-19 was first discovered in Wuhan, China in late December 2019 and soon became a global pandemic. The virus causes flu-like symptoms and is potentially lethal. The rapid spread of the virus leaves the world in total paralysis and has devastating effects on the health, economic, and social levels of most countries. No treatment has been approved yet and the world really needs a precise and urgent medication. Certainly, the developing of a new specific drug for COVID-19 would take a longer time than expected but it is hoped that this task will be completed sooner than later; therefore recent studies have prioritized testing previously FDA-approved drugs for other indications and whether they have significant effects on COVID-19 or not. In this study, we discuss recent applications, protocols, and the outcomes of these drugs as advised by healthcare institutions and providers, as well as to conduct a literature review.