Lab results of COVID-19 patients:Omicron vs delta variants

BACKGROUND The coronavirus disease 2019(COVID-19)virus has been a world-known pan-demic since February 2020.Multiple variances had been established;the most common variants in Israel were omicron and delta.AIM To analyze and compare laboratory values in the"omicron"and"delta"variants of the coronavirus by conducting follow-up examinations and laboratory audits on COVID-19 patients admitted to our institution.METHODS A retrospective study,two groups,50 patients in each group.Patients examined positive for COVID-19 were divided into groups according to the common variant at the given time.We reviewed demographic data and laboratory results such as complete blood count and full chemistry,including electrolytes and coagulation parameters.RESULTS The mean age was 52%,66.53±21.7 were female.No significance was found comparing laboratory results in the following disciplines:Blood count,hemo-globin,and lymphocytes(P=0.41,P=0.87,P=0.97).Omicron and delta variants have higher neutrophil counts,though they are not significantly different(P=0.38).Coagulation tests:Activated paritial thromoplastin test and international normalized ratio(P=0.72,P=0.68).We found no significance of abnormality for all electrolytes.CONCLUSION The study compares laboratory results of blood tests between two variants of the COVID-19 virus–omicron and delta.We found no significance between the variants.Our results show the need for further research with larger data as well as the need to compare all COVID-19 variants.

Symptomatic COVID-19 in University Students: A School-Wide Web-Based Questionnaire Survey during the Omicron Variant Outbreak

Aim: To detect risk and preventive factors associated with the Omicron variant infection in university students, a combination of a web-based survey and multivariate logistic regression analysis was introduced as the front-line initiatives by the school health practitioners. Design: Questionnaire survey. Methods: The school-wide web-based questionnaire survey was conducted among our university students as a part of the annual health check-up in April, 2023. The positive outcome was confined to the first symptomatic COVID-19 onset during the Omicron variant outbreak. Results: In this self-administered survey, risk or protective associations were merely estimated statistically in university students (n = 5406). 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. 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 be equivalent to or replace COVID-19 vaccines.

Real-world effectiveness of mRNA COVID-19 vaccines in the elderly during the Delta and Omicron variants:Systematic review

BACKGROUND As of 31 December 2022,there were over 6.6 million coronavirus disease 2019(COVID-19)deaths and over 651 million cases across 200 countries worldwide.Despite the increase in vaccinations and booster shots,COVID-19 cases and deaths continue to remain high.While the effectiveness of these vaccines has already been established by different manufacturers,the fact remains that these vaccines were created quickly for global emergency use,tested under controlled clinical conditions from voluntary subjects and age groups whose general characteristics may differ from the actual general population.AIM To conduct a systematic review to determine the real-world effectiveness of mRNA COVID-19 vaccines in the elderly during the predominance of Delta and Omicron variants in preventing COVID-19 related infection,hospital,intensive care unit(ICU)admission and intubation,and death.METHODS A combination of Medical Subject Headings and non–Medical Subject Headings was carried out to identify all relevant research articles that meets the inclusion and exclusion criteria from PubMed,Cochrane,CINAHL,Scopus,ProQuest,EMBASE,Web of Science,and Google Scholar databases,as well as qualified research studies from pre–print servers using medRxiv and Research Square,published from January 1,2021-December 31,2022.RESULTS As per the inclusion and exclusion criteria,the effectiveness of Pfizer-BioNTech and Moderna vaccines were evaluated from an estimated total study population of 26535692 using infection,hospital,ICU admission and intubation,and death as outcome measures from studies published between 2021 and 2022,conducted in New York,Finland,Canada,Costa Rica,Qatar,Greece,and Brazil.The risk of bias was evaluated using risk of bias in nonrandomized studies of interventions(ROBINS-I)tool for cohort,case-control,and cross-sectional studies.While clinical trial data on Pfizer-BioNTech and Moderna vaccines demonstrated 94%vaccine effectiveness in the elderly,the results in this study showed that vaccine effectiveness in real-world settings is marginally lower against infection(40%-89%),hospitalization(92%),ICU admission and intubation(98%-85%),and death(77%-87%)with an indication of diminished effectiveness of vaccine over time.Furthermore,2 doses of mRNA vaccines are inadequate and only provides interim protection.CONCLUSION Because of the natural diminishing effectiveness of the vaccine,the need for booster dose to restore its efficacy is vital.From a research perspective,the use of highly heterogeneous outcome measures inhibits the comparison,contrast,and integration of the results which makes data pooling across different studies problematic.While pharmaceutical intervention like vaccination is important to fight an epidemic,utilizing common outcome measurements or carrying out studies with minimal heterogeneity in outcome measurements,is equally crucial to better understand and respond to an international health crisis.

Diabetes Risk Factor and Its Relationship to Increasing Coronavirus (COVID-19) Mortality Rate in United States in 2019-2022: An Epidemiological Study

As an effort to understand the effect of diabetes on the increasing rate of COVID-19 infection, we embarked upon a detailed statistical analysis of various datasets that include COVID-19 infection and mortality rate, diabetes and diseases that may contribute to the severity and risk factor of diabetes in individuals and this impact on COVID-19 and the mortality rate. These diseases include respiratory diseases, cardiovascular diseases, and obesity. Equally significant is the statistical analysis on ethnicity, age, and sex on COVID-19 infection as well as mortality rate. Their possible contributions to increasing the severity and risk factor of diabetes as a risk to mortality to individuals who have COVID-19. Objectives: The ultimate objectives of this investigation are as follow: 1) Is there a risk factor of diabetes on COVID-19 infection and increasing mortality rate? 2) To what extent do other disease conditions that include, obesity, heart failure, and respiratory diseases influence the severity and risk factor of diabetes on increasing COVID-19 infection and mortality rate? 3) To what extent does age, race, and gender increase the mortality of COVID-19 and increase the severity and risk factor of diabetes on COVID-19 mortality rate? 4) How and why COVID-19 virus increases the risk of diabetes in children? 5) Diabetes and COVID-19: Who is most at Risk? Lastly, understanding the misconception of COVID-19 and diabetes.

The latest research progress of COVID-19 mutant strain "Mu" virus strain

Novel coronavirus pneumonia(COVID-19)is a highly pathogenic infectious disease caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).Until now,the new crown pneumonia has caused hundreds of millions of people worldwide to be infected.Novel coronavirus pneumonia is still a high level of variation.Due to the high variability of COVID-19,there are already a large number of COVID-19 variant strains that are still at a high level of infection worldwide.Recently,WHO(WHO)released a new variant,"Mu"(μ,B.1.621)may be a high vaccine tolerance.This paper reviews the latest research progress of"Mu"virus strain in detail.

Synthesis of Novel Virus-Like Mesoporous Silica-ZnO-Ag Nanoparticles and Quercetin Synergize with NIR Laser for Omicron Mutated Covid-19 Virus Infectious Diseases Treatment

This work shows that novel virus-like mesopore silica-zinc oxide/Ag nanoparticles (SZnOAg) synthesized and professionally collected on NIR laser irradiation with quercetin to improve the elimination the mutated virus as a biomedical application. A unique type of silica nanoparticles with a self-in- flating tubular surface has been successfully synthesized using a novel single-micelle epitaxial growth process. The properties of the nanoparticles can be tuned with respect to their core diameter, tubular length, and outer diameter. Due to their biomimetic appearance, they can rapidly transform living cells into virus-like particles, this SZnOAg nanomaterial has specific elimination effect on bacteriophage and Covid-19. Using epitaxial growth, we can construct virus-like structures that can be used for biomedicine applications. These nanomaterials and NIR laser could open the way to a new range of antiviral materials, due to the low-efficiency cellular uptake of current nanoparticles, their applications in the biomedical field are limited. Herein, it clearly shows that novel mesoporous silica nanoparticles can be easily exhibited superior cellular uptake property.

Omicron变异株病毒学特征:关键突变、致病性、免疫逃逸

新型冠状病毒(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2) Omicron变异株首次在博茨瓦纳被检出,随后造成了全世界范围内的感染人数激增。截至目前,Omicron是需要关注的SARS-CoV-2变异株中突变数量最多的毒株,已在整个基因组中发生至少50次突变。Omicron基因组发生的突变赋予病毒一定的适应性优势,如受体结合域与人类血管紧张素转换酶2受体亲和力增强导致病毒传播能力增强;与先前变异株相比,病毒复制能力减弱导致在COVID-19患者中引起的症状相对较轻。此外,该变异株具有较高的环境稳定性,部分逃脱了来自疫苗接种或先前感染诱导的宿主免疫反应,且对大多数治疗性抗体具有较高的耐药性。本文对Omicron变异株的关键突变、病毒学特征、致病性和免疫逃逸能力进行总结,以期为完善疫情防控策略和公共卫生举措提供科学参考。

长春市方舱医院755例Omicron感染患者临床特征和用药分析

目的:分析方舱医院Omicron感染患者的临床特征,为Omicron感染患者的防治和管理提供临床参考。方法:采用回顾性研究方法,纳入2022年4月6-22日吉林省长春市奢岭方舱医院收治的755例感染Omicron的COVID-19患者,采集患者入院时的一般资料和临床症状、在院时主要药物使用情况。按照病情和药物使用情况分为无症状感染者组和轻型患者组、连花清瘟组和非连花清瘟组,分别分析组间各项参数的差异。结果:患者以发热(18.4%)、咳嗽咳痰(57.7%)、咽部不适(27.8%)、乏力(23.8%)、头昏头痛(18.0%)等症状为主要临床表现。接种3次和2次疫苗无症状感染者的核酸转阴时间均显著小于未接种疫苗者(P<0.05)。连花清瘟组的核酸转阴时间和住院天数均显著小于非连花清瘟组(P<0.001)。结论:方舱医院是一种针对Omicron无症状感染者和轻型患者收治和管理的有效有段之一,应重视COVID-19疫苗的加强接种,同时针对无症状感染者和轻型患者,连花清瘟胶囊应被考虑为Omicron感染患者干预治疗的方案之一。

Based on Network Pharmacology and Molecular Mechanism of Action of Ganlu Yin in the Treatment of COVID-19

[Objectives]This study was conducted to explore the mechanism of Ganlu Yin in the treatment of COVID-19 based on network pharmacology and molecular docking technology. [Methods] TCMSP, ETCM and TCMID databases were used to dig out the chemical components in the compound ingredients of Ganlu Yin. Swiss ADME platform was used for ADME screening and Swiss Target Prediction server was used to predict potential targets of chemical components. The COVID-19 related genes were obtained from GeneCards database and Drugbank website, and the intersection targets between Ganlu Yin and COVID-19 were obtained by Venn analysis. The targets were imported into String analysis platform to construct a protein interaction network, and Cytoscape 3.9.0 software was used for visualization processing. GO enrichment and KEGG pathway analysis were performed on the intersection targets through David database. The core components, clinical antiviral drugs, core targets and novel Coronavirus(SARS-COV-2) hydrolase 3 CLpro(Mpro), omicron B.1.1.529 spike protein and angiotensin converting enzyme 2(ACE2) were tested by molecular docking. [Results] A total of 213 effective chemical components and 1 023 drug targets in Ganlu Yin were screened out, including 4 620 COVID-19 related genes and 328 intersection targets. The core components mainly included β-sitosterol, quercetin, and kaherol. The key core targets involved GAPDH, AKT1, TNF, ALB, and EGFR, etc. A total of 241 items were screened by GO functional enrichment, including inflammatory response, protein phosphorylation, positive regulation of gene expression and other biological processes. A total of 85 KEGG pathways were screened out, which were mainly enriched in influenza A, HIF-1 signaling pathway, hepatitis C and other pathways. The results of molecular docking showed that the core chemical components in Ganlu Yin had good binding ability with core targets and disease targets ACE2, 3 CLpro and spike protein, especially kahenol with ACE2, β-sitosterol with 3 CLpro, and quercetin with spike protein. [Conclusions] Prescription Ganlu Yin has the characteristics of multi-component and multi-target action, and can treat COVID-19 through multiple signaling pathways.

Chinese Herbs for Pharyngitis Including COVID-19-Related Sore Throat

Sore throatis one of the most prominentclinical manifestations seen among mild cases of coronavirus disease 2019(COVID-19).Traditional Chinese medicine(TCM)modalities,especially Chinese herbs,have accumulated rich experience in successfully treating sore throats in both acute and chronic pharyngitis.By sharing a real-world case study of three patients suffering pharyngeal discomfort including sore throat that might be related to the new coronavirus infection and have similar manifestations to general viral-induced pharyngitis,the article systematically presents and summarizes key Chinese herbsfor acute and chronic pharyngitis based on TCM herbal prescriptions(principles of herbal formula writing)below:clearing heat and removing toxins,nourishing yin and the throat,loosening the stools and soothing the throat,along withTCM syndrome differentiation ordisease differentiation andtreatment.Moreover,a modern interpretation of these principles in terms of the relationship between Shanghuo and Fire Rising,which may often be characterized by local redness,swelling,fever,and pain in the mouth or throat along with possible inflammation,and the correspondence between the pharynx and the anus are proposed.Finally,the article will share their experience in applying specific herbs locally via various pharyngeal deliverymodalities to improve efficacy including recommended prescriptions fora variety of acute and chronic pharyngitis,as well as those that may be caused by the new coronavirus infection.

Chest computed tomography findings of the Omicron variants of SARS-CoV-2 with different cycle threshold values

BACKGROUND The Omicron variant of severe acute respiratory syndrome coronavirus 2(SARSCoV-2)mainly infects the upper respiratory tract.This study aimed to determine whether the probability of pulmonary infection and the cycle threshold(Ct)measured using the fluorescent polymerase chain reaction(PCR)method were related to pulmonary infections diagnosed via computed tomography(CT).AIM To analyze the chest CT signs of SARS-CoV-2 Omicron variant infections with different Ct values,as determined via PCR.METHODS The chest CT images and PCR Ct values of 331 patients with SARS-CoV-2Omicron variant infections were retrospectively collected and categorized into low(<25),medium(25.00-34.99),and high(≥35)Ct groups.The characteristics of chest CT images in each group were statistically analyzed.RESULTS The PCR Ct values ranged from 13.36 to 39.81,with 99 patients in the low,155 in the medium,and 77 in the high Ct groups.Six abnormal chest CT signs were detected,namely,focal infection,patchy consolidation shadows,patchy groundglass shadows,mixed consolidation ground-glass shadows,subpleural interstitial changes,and pleural changes.Focal infections were less frequent in the low Ct group than in the medium and high Ct groups;these infections were the most common sign in the medium and high Ct groups.Patchy consolidation shadows and pleural changes were more frequent in the low Ct group than in the other two groups.The number of patients with two or more signs was greater in the low Ct group than in the medium and high Ct groups.CONCLUSION The chest CT signs of patients with pulmonary infection caused by the Omicron variants of SARSCoV-2 varied depending on the Ct values.Identification of the characteristics of Omicron variant infection can help subsequent planning of clinical treatment.

Comprehensive Left Ventricular Mechanics Analysis by Speckle Tracking Echocardiography in COVID-19

Background: Cardiac involvement and the consequences of inflammation induced by SARS-CoV2 infection could have catastrophic long-term consequences. Left ventricular mechanics could identify a specific pattern of myocardial fiber damage in patients infected with COVID-19. To our knowledge there are no publications referring to the global description of ventricular mechanics in patients with COVID-19. Objective: To describe left ventricular mechanics in hospitalized patients with COVID-19. Methods: In this cross-sectional study, we included 40 hospitalized patients with confirmed diagnostic of COVID-19, from April 11, 2020, to September 6, 2020. Demographic and laboratory data, clinical and echocardiographic characteristics were collected, as well as events during hospitalization. Left ventricular deformation was analyzed and reported. Results: Subclinical dysfunction was observed in 82.5% (left ventricular longitudinal strain [LVGLS] -17.05% and global circumferential strain [GCS] -18.6%) of the patients, likewise, the mean twist and apical rotation were preserved, and even increased as part of the compensating mechanism to maintain the ejection fraction. Conclusion: In patients hospitalized with COVID-19, despite having a normal left ventricular ejection fraction, subclinical myocardial damage was found, manifested by a decrease in Global Longitudinal Strain (GLS) and Global Circumferential Strain (GCS). This behavior is similar to that of cardiomyopathies in the early stage of the disease, and given the pathophysiological mechanisms involved in the disease, its long-term consequences should be monitored and evaluated.

COVID-19 Infection: The Virus and Its Origin, the Variants, the Immune Defense, the Multiorgan Autoimmune Reactions, and the Targeted Treatments

Background: SARS-CoV-2, the virus responsible for the current COVID-19 infection pandemic, has caused substantial damage and negative impacts in the world, including physical sickness, mental illness, death, society lock down, work interruption, and productivity reduction. From the onset in early 2020, the pandemic has not yet totally subsided as of July 2022. Although great efforts have been made to understand the nature of this pandemic by the medical and scientific communities, a comprehensive review of this pandemic has not been reported. Purpose: We aimed to perform a thorough review of the subject in order to come to a better understanding of the origin of the virus, its mutations and their corresponding health effects, its pathophysiology, and its responses to therapeutic intervention. A more comprehensive set of data on these subject matters, if available, would give healthcare providers a valuable tool in formulating the best methods to respond to the current disease and prevent the disease from spreading in the future. Method: An extensive literature search on the subjects of COVID-19 was conducted regarding the possible origin of the viral pathogen, its evolutionary changes and health impacts, the world’s responses to COVID-19 and outcomes of their responses, and healthcare professional’s actions to understand and manage the disease and the results of their actions. To gather these data, websites of PubMed and Google Scholar were utilized for the search with the following keywords: Pandemic, COVID-19, coronavirus, SARS, SARS-CoV, SARS-CoV-2, origin, pathogenesis, and treatment. Results: Our review revealed data that points to an interesting autoimmune phenomenon where most seriously sick patients affected by COVID-19 were documented by an IgA-dominant immune response to the pathogen, along with a neutrophil-directed infiltration to the vital organ in the lung aveola, resulting in critical lung injury, leading to respiratory failure, multi-organ failure, and death. Surprisingly, this IgA-mediated and neutrophil-directed disease pattern is nearly identical to a group of IgA-mediated autoimmune skin diseases, such as dermatitis herpetiformis, IgA bullous dermatosis, and IgA pemphigus, which respond well to treatment by dapsone, a sulfone class of antibiotic/anti-inflammatory drug. Moreover, the usefulness of dapsone was supported by a small clinical study. In addition, systemic corticosteroid, a trusted anti-inflammatory medication, has been used in this pandemic with variable degrees of success. Conclusion: The data collected from our review of the subject, together with our prior search knowledge, compel us to conclude that the underlying pathophysiology that causes serious respiratory distress and multi-organ failure is most likely to be autoimmune in nature and that strategies to counter these multifacet autoimmune disorders would be the most valuable in life-saving. Specifically, we identified clinical and laboratory evidence pointing to IgA autoimmune reaction as a key factor that causes significant mortality in many patients. Accordingly, we proposed the utilization of a combination of dapsone, corticosteroid, and anti-thrombotic drugs in severely ill patients at the earliest point of the disease process. The autoimmune multi-organ syndrome may explain the pathogenesis of COVID-19 as well as Post-COVID conditions and may guide healthcare professionals in a better direction to manage the disease. The possible origin of the viral pathogen may shed light on a better understanding of the pathogenesis of the disease.

Symptoms associated with nucleic acid turning-negative-time in COVID-19 patients?

Objective:To explore on the association between nucleic acid turning-negative-time and traditional Chinese medicine(TCM)symptoms in coronavirus disease 2019(COVID-19)patients with the Omicron variant.Method:For this retrospective cross-sectional study,we enrolled 189 patients with COVID-19(age 20-90 years)were included.multiple linear regression models were used to investigate the TCM symptoms affecting the nucleic acid turning-negative-time of COVID-19 patients,during the process of data analysis,taking with nucleic acid turning-negative-time as the dependent variable,and TCM symptoms as independent variables,and at the same time,sex,age,hypertension,diabetes,and coronary heart disease were as confounding variables.Results:The study found that the most common TCM symptoms of COVID-19 patients with Omicron were cough,dry throat,expectoration,fever,sore throat,pharyngeal itching,running nose,and nasal congestion.Regression analysis showed that the fit regressive equation showed a significant difference(F=4.286,P<0.001),R=0.400,the adjusted R^(2)=0.123,and three variables in the regression equation showed significant difference(P<0.05).The results showed that nucleic acid turningnegative-time was mostly related to constipation,fever,and expectoration.If the patients had the symptoms of constipation,fever,and expectoration;that is,if patients showed these symptoms,the turning-negative-time of nucleic acid in patients with Omicron will be prolonged.Conclusions:Treatment based on symptoms for patients with constipation,fever,and expectoration may have important clinical significance for the COVID-19 patients with Omicron.

Neutralizing Antibody Responses against Five SARS-CoV-2 Variants and T Lymphocyte Change after Vaccine Breakthrough Infections from the SARS-CoV-2 Omicron BA.1 Variant in Tianjin, China: A Prospective Study

Objective To investigate whether Omicron BA.1 breakthrough infection after receiving the SARS-CoV-2 vaccine could create a strong immunity barrier.Methods Blood samples were collected at two different time points from 124 Omicron BA.1 breakthrough infected patients and 124 controls matched for age,gender,and vaccination profile.Live virus-neutralizing antibodies against five SARS-CoV-2 variants,including WT,Gamma,Beta,Delta,and Omicron BA.1,and T-lymphocyte lymphocyte counts in both groups were measured and statistically analyzed.Results The neutralizing antibody titers against five different variants of SARS-CoV-2 were significantly increased in the vaccinated population infected with the Omicron BA.1 variant at 3 months after infection,but mainly increased the antibody level against the WT strain,and the antibody against the Omicron strain was the lowest.The neutralizing antibody level decreased rapidly 6 months after infection.The T-lymphocyte cell counts of patients with mild and moderate disease recovered at 3 months and completely returned to the normal state at 6 months.Conclusion Omicron BA.1 breakthrough infection mainly evoked humoral immune memory in the original strain after vaccination and hardly produced neutralizing antibodies specific to Omicron BA.1.Neutralizing antibodies against the different strains declined rapidly and showed features similar to those of influenza.Thus,T-lymphocytes may play an important role in recovery.

Detection of Omicron Caused Pneumonia from Radiology Images Using Convolution Neural Network(CNN)

COVID-19 disease caused by the SARS-CoV-2 virus has created social and economic disruption across theworld.The ability of the COVID-19 virus to quickly mutate and transfer has created serious concerns across the world.It is essential to detectCOVID-19 infection caused by different variants to take preventive measures accordingly.The existing method of detection of infections caused by COVID-19 and its variants is costly and time-consuming.The impacts of theCOVID-19 pandemic in developing countries are very drastic due to the unavailability of medical facilities and infrastructure to handle the pandemic.Pneumonia is the major symptom of COVID-19 infection.The radiology of the lungs in varies in the case of bacterial pneumonia as compared to COVID-19-caused pneumonia.The pattern of pneumonia in lungs in radiology images can also be used to identify the cause associated with pneumonia.In this paper,we propose the methodology of identifying the cause(either due to COVID-19 or other types of infections)of pneumonia from radiology images.Furthermore,because different variants of COVID-19 lead to different patterns of pneumonia,the proposed methodology identifies pneumonia,the COVID-19 caused pneumonia,and Omicron caused pneumonia from the radiology images.To fulfill the above-mentioned tasks,we have used three Convolution Neural Networks(CNNs)at each stage of the proposed methodology.The results unveil that the proposed step-by-step solution enhances the accuracy of pneumonia detection along with finding its cause,despite having a limited dataset.

Eye Strain Detection During Online Learning

The recent outbreak of the coronavirus disease of 2019(Covid-19)has been causing many disruptions among the education systems worldwide,most of them due to the abrupt transition to online learning.The sudden upsurge in digital electronic devices usage,namely personal computers,laptops,tablets and smart-phones is unprecedented,which leads to a new wave of both mental and physical health problems among students,for example eye-related illnesses.The overexpo-sure to electronic devices,extended screen time usage and lack of outdoor sun-light have put a consequential strain on the student’s ophthalmic health because of their young age and a relative lack of responsibility on their own health.Failure to take appropriate external measures to mitigate the negative effects of this pro-cess could lead to common ophthalmic illnesses such as myopia or more serious conditions.To remedy this situation,we propose a software solution that is able to track and capture images of its users’eyes to detect symptoms of eye illnesses while simultaneously giving them warnings and even offering treatments.To meet the requirements of a small and light model that is operable on low-end devices without information loss,we optimized the original MobileNetV2 model with depth-wise separable convolutions by altering the parameters in the last layers with an aim to minimize the resizing of the input image and obtained a new model which we call EyeNet.Combined with applying the knowledge distillation tech-nique and ResNet-18 as a teacher model to train the student model,we have suc-cessfully increased the accuracy of the EyeNet model up to 87.16%and support the development of a model compatible with embedded systems with limited computing power,accessible to all students.

Omicron Infections in Otolaryngology Practice: A Retrospective Observational Study on Testing, Symptoms and Vaccination Status

Background: With the appearance of the SARS-CoV-2 Omicron variant the high rate of vaccination breakthroughs showed that current vaccines against COVID-19 can no longer provide adequate protection against infection. However, it is still assumed that vaccination might have a positive effect on the course of the disease. In Germany, general practitioners and specialists are usually the first treatment providers for acute illnesses. In addition, patients with infections of the upper respiratory tract often primarily consult an ear, nose and throat specialist. Most of the Omicron-infected people have a mild course of the disease and, if necessary, receive medical care on an outpatient basis. Little is known about the effectiveness of corona vaccinations on Omicron infections in relation to the clinical symptoms. In our outpatient office, we recorded a sharp increase of corona positive Omicron-infections in the beginning of 2022, despite of vaccinations against COVID-19. In a retrospective analysis, we evaluated the data of our SARS-CoV-2 tested patients with regard to clinical symptoms reported and vaccination status. The focus was particularly on the question to what extent the vaccination status in the case of Omicron infections influences the symptoms of the disease. Methods: We retrospectively evaluated the data of all patients in the first quarter of 2022 who were suspected for COVID-19. At that time, the Omicron variant was dominant in Germany. Clinical symptoms, cycle threshold (Ct) values, and the vaccination status were recorded. Symptomatic patients who tested negative for SARS-CoV-2 served as a control group. Results: Of the total cohort (n = 353), 241 (68%) patients were tested SARS-CoV-2 positive. The symptoms of the corona-positive patients were essentially similar to those of a mild to moderate cold, but compared to SARS-CoV-2-negative patients (n = 69) with a clear shift in favor of fever (35% versus 16%), cough (76% versus 52%) and increased feeling of illness (59% versus 43%), respectively. Ct values revealed no difference between unvaccinated (mean 19.15;SD 3.52) and vaccinated cases (mean 18.15;SD 3.87;p = 0.272). There was no significant correlation between the vaccination status and clinical symptom score in different age groups (age 12 to 17, r (28) = 0.26, p = 0.26;age > 18 to 60, r (191) = 0.06, p = 0.378). Conclusions: According to our results with infections with the Omicron variant, there were no differences between unvaccinated and vaccinated patients concerning clinical symptoms or potential infectivity, especially in children and adolescents. This might have impact on further vaccination programs.

Primary assessment of the diversity of Omicron sublineages and the epidemiologic features of autumn/winter 2022 COVID-19 wave in Chinese mainland

With the recent ongoing autumn/winter 2022 COVID-19 wave and the adjustment of public health control measures,there have been widespread SARS-CoV-2 infections in Chinese mainland.Here we have analyzed 369 viral genomes from recently diagnosed COVID-19 patients in Shanghai,identifying a large number of sublineages of the SARS-CoV-2 Omicron family.Phylogenetic analysis,coupled with contact history tracing,revealed simultaneous community transmission of two Omicron sublineages dominating the infections in some areas of China(BA.5.2 mainly in Guangzhou and Shanghai,and BF.7 mainly in Beijing)and two highly infectious sublineages recently imported from abroad(XBB and BQ.1).Publicly available data from August 31 to November 29,2022 indicated an overall severe/critical case rate of 0.035%nationwide,while analysis of 5706 symptomatic patients treated at the Shanghai Public Health Center between September 1 and December 26,2022 showed that 20 cases(0.35%)without comorbidities progressed into severe/critical conditions and 153 cases(2.68%)with COVID-19-exacerbated comorbidities progressed into severe/critical conditions.These observations shall alert healthcare providers to place more resources for the treatment of severe/critical cases.Furthermore,mathematical modeling predicts this autumn/winter wave might pass through major cities in China by the end of the year,whereas some middle and western provinces and rural areas would be hit by the upcoming infection wave in mid-to-late January 2023,and the duration and magnitude of upcoming outbreak could be dramatically enhanced by the extensive travels during the Spring Festival(January 21,2023).Altogether,these preliminary data highlight the needs to allocate resources to early diagnosis and effective treatment of severe cases and the protection of vulnerable population,especially in the rural areas,to ensure the country’s smooth exit from the ongoing pandemic and accelerate socio-economic recovery.

Development and validation of a nomogram to predict failure of 14-day negative nucleic acid conversion in adults with non-severe COVID-19 during the Omicron surge: a retrospective multicenter study

Background With the variability in emerging data,guidance on the isolation duration for patients with coronavirus disease 2019(COVID-19)due to the Omicron variant is controversial.This study aimed to determine the predictors of prolonged viral RNA shedding in patients with non-severe COVID-19 and construct a nomogram to predict patients at risk of 14-day PCR conversion failure.Methods Adult patients with non-severe COVID-19 were enrolled from three hospitals of eastern China in Spring 2022.Viral shedding time(VST)was defined as either the day of the first positive test or the day of symptom onset,whichever was earlier,to the date of the first of two consecutively negative PCR tests.Patients from one hospital(Cohort I,n=2033)were randomly grouped into training and internal validation sets.Predictors of 14-day PCR conversion failure were identified and a nomogram was developed by multivariable logistic regression using the training dataset.Two hospitals(Cohort II,n=1596)were used as an external validation set to measure the performance of this nomogram.Results Of the 2033 patients from Cohort I,the median VST was 13.0(interquartile range:10.0-16.0)days;716(35.2%)lasted>14 days.In the training set,increased age[per 10 years,odds ratio(OR)=1.29,95%confidence interval(CI):1.15-1.45,P<0.001]and high Charlson comorbidity index(OR=1.25,95%CI:1.08-1.46,P=0.004)were independent risk factors for VST>14 days,whereas full or boosted vaccination(OR=0.63,95%CI:0.42-0.95,P=0.028)and antiviral therapy(OR=0.56,95%CI:0.31-0.96,P=0.040)were protective factors.These predictors were used to develop a nomogram to predict VST>14 days,with an area under the ROC curve(AUC)of 0.73 in the training set(AUC,0.74 in internal validation set;0.76 in external validation set).Conclusions Older age,increasing comorbidities,incomplete vaccinations,and lack of antiviral therapy are risk factors for persistent infection with Omicron variant for>14 days.A nomogram based on these predictors could be used as a prediction tool to guide treatment and isolation strategies.