A Comparative Study of Myocardial Damage Caused by Novel Coronavirus Infection and Influenza A Virus Infection in Children during the COVID-19 Epidemic Period

Objective: To explore the comparative study of myocardial damage in children infected with COVID-19 and influenza A virus during the COVID-19 pandemic. Method: Retrospective analysis of myocardial injury caused by COVID-19 infection and influenza A virus infection in children during the COVID-19 from October 2022 to May 2023, including 106 cases of COVID-19 infection, that is, the COVID-19 group;And 164 cases of influenza A virus infection, namely, H1N1 group;Two groups were tested for various indicators of myocardial enzyme spectrum, and the situation of myocardial injury was compared between the two groups. Result: In the enrolled cases, there was no statistically significant difference in the prevalence rate of men and women in the COVID-19 group (P > 0.05);There was no statistically significant difference in the average age between men and women (P > 0.05);The comparison of the incidence rates between males and females in the H1N1 group showed a statistically significant difference (P 0.05);There was no statistically significant difference in the average age between the two groups of girls (P > 0.05). A comparison between two groups of various indicators of myocardial enzyme spectra showed that the results of AST, -HBDH and LDH were statistically significant (P 0.05). Conclusion: Both COVID-19 infection and influenza A virus infection in children have different degrees of myocardial damage, but COVID-19 infection causes more myocardial damage than influenza A virus infection, and influenza A virus is more prone to myocardial infarction, which deserves our attention.

Practice of Infection Prevention and Control Strategies in Risk Departments during the COVID-19 Epidemic

Objective: To explore the practice and application of infection prevention and control strategies in risk departments during the COVID-19 epidemic, and to formulate the infection prevention and control measures to provide advice and guidance in risk departments. Methods: According to the latest plan of diagnosis and treatment, prevention and control issued by the National Health Commission, expert advice and consensus, combined with the actual situation in our hospital, a series of infection prevention and control measures of COVID-19 in risk department was formulated. Results: During the epidemic period, the prevention and control measures of nine risk departments including emergency operation, anesthesiology, endoscopy center, blood purification center, otolaryngology, stomatology, medical imaging department, medical cosmetology department and pulmonary function room were established from six aspects, including pre-examination and screening, medical technology control, personnel management, personal protection, environmental disinfection, medical waste disposal, etc. Conclusion: During the epidemic period, the infection prevention and control strategy of risk departments is one of the key links to control the spread of the epidemic, and risk departments must pay attention to and strictly implement various infection prevention and control measures.

Combined prevention and treatment measures are essential to control nosocomial infections during the COVID-19 pandemic

Severe acute respiratory syndrome coronavirus-2 is a highly contagious positive-sense,single-stranded RNA virus that has rapidly spread worldwide.As of December 17,2023,772838745 confirmed cases including 6988679 deaths have been reported globally.This virus primarily spreads through droplets,airborne transmission,and direct contact.Hospitals harbor a substantial number of confirmed coronavirus disease 2019(COVID-19)patients and asymptomatic carriers,accompanied by high population density and a larger susceptible population.These factors serve as potential triggers for nosocomial infections,posing a threat during the COVID-19 pandemic.Nosocomial infections occur to varying degrees across different countries worldwide,emphasizing the urgent need for a practical approach to prevent and control the intra-hospital spread of COVID-19.This study primarily concentrated on a novel strategy combining preventive measures with treatment for combating COVID-19 nosocomial infections.It suggests preventive methods,such as vaccination,disinfection,and training of heathcare personnel to curb viral infections.Additionally,it explored therapeutic strategies targeting cellular inflammatory factors and certain new medications for COVID-19 patients.These methods hold promise in rapidly and effectively preventing and controlling nosocomial infections during the COVID-19 pandemic and provide a reliable reference for adopting preventive measures in the future pandemic.

Hepatobiliary system and intestinal injury in new coronavirus infection(COVID-19):A retrospective study

BACKGROUND An important area of effective control of the coronavirus disease 19(COVID-19)pandemic is the study of the pathogenic features of severe acute respiratory syndrome coronavirus 2 infection,including those based on assessing the state of the intestinal microbiota and permeability.AIM To study the clinical features of the new COVID-19 in patients with mild and moderate severity at the stage of hospitalization,to determine the role of hepatobiliary injury,intestinal permeability disorders,and changes in the qualitative and quantitative composition of the microbiota in the development of systemic inflammation in patients with COVID-19.METHODS The study was performed in 80 patients with COVID-19,with an average age of 45 years,19 of whom had mild disease,and 61 had moderate disease severity.The scope of the examination included traditional clinical,laboratory,biochemical,instrumental,and radiation studies,as well as original methods for studying microbiota and intestinal permeability.RESULTS The clinical course of COVID-19 was studied,and the clinical and biochemical features,manifestations of systemic inflammation,and intestinal microbiome changes in patients with mild and moderate severity were identified.Intestinal permeability characteristics against the background of COVID-19 were evaluated by measuring levels of proinflammatory cytokines,insulin,faecal calprotectin,and zonulin.CONCLUSION This study highlights the role of intestinal permeability and microbiota as the main drivers of gastroenterological manifestations and increased COVID-19 severity.

Deep Learning ResNet101 Deep Features of Portable Chest X-Ray Accurately Classify COVID-19 Lung Infection

This study is designed to develop Artificial Intelligence(AI)based analysis tool that could accurately detect COVID-19 lung infections based on portable chest x-rays(CXRs).The frontline physicians and radiologists suffer from grand challenges for COVID-19 pandemic due to the suboptimal image quality and the large volume of CXRs.In this study,AI-based analysis tools were developed that can precisely classify COVID-19 lung infection.Publicly available datasets of COVID-19(N=1525),non-COVID-19 normal(N=1525),viral pneumonia(N=1342)and bacterial pneumonia(N=2521)from the Italian Society of Medical and Interventional Radiology(SIRM),Radiopaedia,The Cancer Imaging Archive(TCIA)and Kaggle repositories were taken.A multi-approach utilizing deep learning ResNet101 with and without hyperparameters optimization was employed.Additionally,the fea-tures extracted from the average pooling layer of ResNet101 were used as input to machine learning(ML)algorithms,which twice trained the learning algorithms.The ResNet101 with optimized parameters yielded improved performance to default parameters.The extracted features from ResNet101 are fed to the k-nearest neighbor(KNN)and support vector machine(SVM)yielded the highest 3-class classification performance of 99.86%and 99.46%,respectively.The results indicate that the proposed approach can be bet-ter utilized for improving the accuracy and diagnostic efficiency of CXRs.The proposed deep learning model has the potential to improve further the efficiency of the healthcare systems for proper diagnosis and prognosis of COVID-19 lung infection.

Liver involvement in patients with COVID-19 infection:A comprehensive overview of diagnostic imaging features

During the first wave of the pandemic,coronavirus disease 2019(COVID-19)infection has been considered mainly as a pulmonary infection.However,different clinical and radiological manifestations were observed over time,including involvement of abdominal organs.Nowadays,the liver is considered one of the main affected abdominal organs.Hepatic involvement may be caused by either a direct damage by the virus or an indirect damage related to COVID-19 induced thrombosis or to the use of different drugs.After clinical assessment,radiology plays a key role in the evaluation of liver involvement.Ultrasonography(US),computed tomography(CT)and magnetic resonance imaging(MRI)may be used to evaluate liver involvement.US is widely available and it is considered the first-line technique to assess liver involvement in COVID-19 infection,in particular liver steatosis and portal-vein thrombosis.CT and MRI are used as second-and third-line techniques,respectively,considering their higher sensitivity and specificity compared to US for assessment of both parenchyma and vascularization.This review aims to the spectrum of COVID-19 liver involvement and the most common imaging features of COVID-19 liver damage.

Clinico-Epidemiological Characteristics and Survival Outcomes of COVID-19 Infection in Kassala, Eastern Sudan

Introduction: Severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) represents a major health problem worldwide. Thus, early detection and appropriate management of the virus will influence the outcome of the disease. This study aimed to investigate the epidemiological characteristics and survival outcomes of patients with COVID-19 infection in Kassala, Eastern Sudan. Methods: A cross-sectional hospital-study was conducted among patients visiting Kassala teaching hospital with suspicion of COVID-19 infection. A structured questionnaire was used to gather clinical and socio-demo- graphic information from COVID-19 patients. Nasopharyngeal specimens and blood samples were collected and tested to confirm the diagnosis of COVID-19 infection using RT-PCR. Results: A total of 371 patients were enrolled in the study from September 2020 to January 2021, with mean age ± SD was 42.9 ± 19.9. The prevalence of COVID-19 infection was estimated at 61.7%. The majority were males 159 (69.4%), of university-level education, 96 (49.7%), and urban residents, 175 (9.7%). The most common symptoms were fever 215 (93.9%), cough 188 (82.1%), headache 179 (78.2%), and shortness of breath 154 (67.2%). Overall all mortality was reported as 16%. Older age group with the age ≥ 70, P P = 0.020, diabetes mellitus P = 0.029 were significantly associated with high case fatality. Conclusion: This study demonstrated that older age, male gender, laboratory tests (leukocytosis, lymphopenia, low Hemoglobin and high CRP) and various comorbid conditions significantly increase the disease severity and mortality. Therefore, attention should be paid to preventive measures to reduce the considerable impacts of the disease.

Periocular necrotising fasciitis after traumatic laceration and concurrent COVID-19 infection:a case report

Background:Necrotising fasciitis(NF)is a rare but severe necrotising infection of the subcutaneous tissues.We report a case of periocular NF associated with a concurrent COVID-19 infection and explore potential mechanisms of pathogenesis of COVID-19 infection and necrotising superinfections.Case Description:A 33-year-old previously healthy female presented with right-sided progressive periocular swelling,erythema,pain and fever,two days after sustaining a laceration to the right superolateral brow from a clenched fist.She had a concurrent COVID-19 infection,detected on nasopharyngeal polymerase chain reaction swab thirteen days prior to presentation and again at presentation.She did not have an oxygen requirement.There was a large bulbous collection of the right upper lid with fluctuance and overlying erythema,and a communicating sinus drained frank pus from the superolateral brow.Pre-operative T2-weighted MRI demonstrated fascial hyperintensity involving the pre-septal tissues and extending to the anterior temporal fossa.She was commenced on intravenous meropenem,clindamycin and vancomycin,and underwent early surgical debridement.Initial debridement demonstrated right upper lid necrosis involving the dermal and pre-septal layers,including the orbicularis,but sparing the tarsus.Streptococcus pyogenes was isolated,and she was continued on a prolonged course of intravenous antibiotic.Periocular defects were repaired with a right-sided brow adipo-fascial flap based on the supratrochlear artery,browpexy and dual full thickness skin grafts on the right upper lid and flap.Conclusions:NF is an acute fulminant infection rarely affecting the periocular tissues.This represents a unique case of periocular NF associated with a concurrent COVID-19 infection.

Multidrug resistant organism infections in patients with COVID-19:risk factors and outcomes

Background:Coronavirus disease 2019(COVID-19)has now spread to most countries and regions of the world.Risk factors associated with multi-drug resistant organism(MDRO)infections in patients with COVID-19 have not been well studied yet.In the present study,we aimed to identify the risk factors associated with the MDRO infections and their impact on in-hospital mortality of COVID-19 patients.Methods:This retrospective cohort study was conducted between December 2019 and April 2020 at two tertiary hospitals in Wuhan,China.Data of cases were collected through electronic medical records system.This study was focused on cases with bacterial culture records.Risk factors and outcomes associated with MDRO infections were analyzed using logistic regression model.Results:Of the 2891 patients,370 patients have bacterial culture results,and MDROs were isolated in 38 patients.Respiratory tract infections(67.3%)were the most common hospital acquired infections.Variables independently associated with MDRO infections were dyspnea at admission(odds ratio(OR)4.74;95%confidence interval(CI)2.06-10.88;P<0.001),intensive care unit(ICU)admission(OR 5.02;95%CI 1.99-12.63;P<0.01),and invasive mechanical ventilation(OR 5.13;95%CI 2.15-12.27;P<0.001),adjusted for age and gender.MDROs infection was also a significant risk factor of death for the patients,adjusted for age,gender,severity of illness,ICU admission and mechanical ventilation(OR 1.12,95%CI:0.43-2.96,P=0.817).Conclusion:In our study,dyspnea at admission,ICU admission and invasive mechanical ventilation were associated with the presence of MDRO infections,and clinicians should be alert in MDRO infections in COVID-19 hospitalized patients.

Analysis of the current Covid-19 infection and vaccination status in patients with neurofibromatosis type 1

Background:To investigate the common symptoms after Covid-19 infection,characteristics of adverse events after vaccination,changes in clinical manifestations related to Neurofibromatosis type 1(NF1),as well as the current vaccination status and factors related to vaccine hesitation among NF1 patients,in order to provide a basis for scientific protection and vaccine acceptance in NF1 individuals in the new phase of pandemic management.Methods:From December 29,2022,to January 10,2023,we conducted a self-assessment questionnaire survey among diagnosed NF1 patients.General data were provided including sex,age,main clinical presentations,and current treatment.This study mainly focused on the infection and vaccination status of Covid-19 among these patients with NF1.The data were statistically analyzed using SPSS26.0 software.Results:Of the 250 questionnaires distributed,226 were valid.Among the 164 patients(72.6%)with Covid-19 infection,the most common infection symptoms and incidence of patients were not significantly different from those in the normal population(P>0.05),but the incidence of symptoms such as nasal congestion,headache,myalgia,sore throat,abdominal pain,diarrhea,and eye discomfort was higher than that in the normal population(P<0.05),and no severe infection was observed;186 patients(82.3%)had completed the Covid-19 vaccination,and more than half of those who were not vaccinated had no plans for vaccination.Among the vaccinated patients,there was no significant difference in the incidence of adverse events,such as fever,pain,redness,and swelling at the injection site after vaccination,compared to the normal population(P>0.05),but the incidence of fatigue and headache was higher in NF1 patients(P<0.001).Most patients with NF1 believe that there is no significant progressive change in NF1-related clinical manifestations after Covid-19 infection and vaccination.Conclusion:Currently,some NF1 patients appear to be worried about the evolution of their disease after Covid-19 infection in the face of large fluctuations in the pandemic situation,and some patients hesitate to receive the vaccine due to their special disease condition.Thus,clinical trials should be conducted to develop a refined pandemic response and vaccination program for this special group.

Immunobiology of COVID-19: Mechanistic and therapeutic insights from animal models

The distribution of the immune system throughout the body complicates in vitro assessments of coronavirus disease 2019(COVID-19)immunobiology,often resulting in a lack of reproducibility when extrapolated to the whole organism.Consequently,developing animal models is imperative for a comprehensive understanding of the pathology and immunology of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.This review summarizes current progress related to COVID-19 animal models,including non-human primates(NHPs),mice,and hamsters,with a focus on their roles in exploring the mechanisms of immunopathology,immune protection,and long-term effects of SARS-CoV-2 infection,as well as their application in immunoprevention and immunotherapy of SARS-CoV-2 infection.Differences among these animal models and their specific applications are also highlighted,as no single model can fully encapsulate all aspects of COVID-19.To effectively address the challenges posed by COVID-19,it is essential to select appropriate animal models that can accurately replicate both fatal and non-fatal infections with varying courses and severities.Optimizing animal model libraries and associated research tools is key to resolving the global COVID-19 pandemic,serving as a robust resource for future emerging infectious diseases.

Evaluation of dry eye disease symptomatology and mental health status among patients with different COVID-19 statuses

AIM:To evaluate dry eye disease(DED)symptomatology and mental health status in different COVID-19 patients.METHODS:A cross-sectional observational design was used.Totally 123 eligible adults(46.34%of men,age range,18-59y)with COVID-19 included in the study from August to November,2022.Ocular Surface Disease Index(OSDI),Five-item Dry Eye Questionnaire(DEQ-5),Hospital Anxiety and Depression Scale(HADS),and Pittsburgh Sleep Quality Index(PSQI)were used in this study.RESULTS:OSDI scores were 6.82(1.25,15.91)in asymptomatic carriers,7.35(2.50,18.38)in mild cases,and 16.67(4.43,28.04)in recurrent cases,with 30.00%,35.56%,and 57.89%,respectively evaluated as having DED symptoms(χ2=7.049,P=0.029).DEQ-5 score varied from 2.00(0,6.00)in asymptomatic carriers,3.00(0,8.00)in mild cases,and 8.00(5.00,10.00)in recurrent cases,with 27.50%,33.33%,and 55.26%,respectively assessed as having DED symptoms(χ2=8.532,P=0.014).The prevalence of clinical anxiety(50.00%)and depression(47.37%)symptoms were also significantly higher in patients with recurrent infection(χ2=24.541,P<0.001;χ2=30.871,P<0.001).Recurrent infection was a risk factor for high OSDI scores[odds ratio,2.562;95%confidence interval(CI),1.631-7.979;P=0.033]and DEQ-5 scores(odds ratio,3.353;95%CI,1.038-8.834;P=0.043),whereas having a fixed occupation was a protective factor for OSDI scores(odds ratio,0.088;95%CI,0.022-0.360;P=0.001)and DEQ-5 scores(odds ratio,0.126;95%CI,0.039-0.405;P=0.001).CONCLUSION:Patients with recurrent COVID-19 have more severe symptoms of DED,anxiety,and depression.

Subdural effusion associated with COVID-19 encephalopathy: A case report

BACKGROUND The precise mechanism by which severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)impacts the central nervous system remains unclear,with manifestations spanning from mild symptoms(e.g.,olfactory and gustatory deficits,hallucinations,and headache)to severe complications(e.g.,stroke,seizures,encephalitis,and neurally demyelinating lesions).The occurrence of single-pass subdural effusion,as described below,is extremely rare.CASE SUMMARY A 56-year-old male patient presented with left-sided limb weakness and slurred speech as predominant clinical symptoms.Through comprehensive imaging and diagnostic assessments,he was diagnosed with cerebral infarction complicated by hemorrhagic transformation affecting the right frontal,temporal,and parietal regions.In addition,an intracranial infection with SARS-CoV-2 was identified during the rehabilitation process;consequently,an idiopathic subdural effusion developed.Remarkably,the subdural effusion underwent absorption within 6 d,with no recurrence observed during the 3-month follow-up.CONCLUSION Subdural effusion is a potentially rare intracranial complication associated with SARS-CoV-2 infection.

Harnessing immunity:Immunomodulatory therapies in COVID-19

An overly exuberant immune response,characterized by a cytokine storm and uncontrolled inflammation,has been identified as a significant driver of severe coronavirus disease 2019(COVID-19)cases.Consequently,deciphering the intricacies of immune dysregulation in COVID-19 is imperative to identify specific targets for intervention and modulation.With these delicate dynamics in mind,immunomodulatory therapies have emerged as a promising avenue for miti-gating the challenges posed by COVID-19.Precision in manipulating immune pathways presents an opportunity to alter the host response,optimizing antiviral defenses while curbing deleterious inflammation.This review article compre-hensively analyzes immunomodulatory interventions in managing COVID-19.We explore diverse approaches to mitigating the hyperactive immune response and its impact,from corticosteroids and non-steroidal drugs to targeted biologics,including anti-viral drugs,cytokine inhibitors,JAK inhibitors,convalescent plasma,monoclonal antibodies(mAbs)to severe acute respiratory syndrome coronavirus 2,cell-based therapies(i.e.,CAR T,etc.).By summarizing the current evidence,we aim to provide a clear roadmap for clinicians and researchers navigating the complex landscape of immunomodulation in COVID-19 treatment.CS Glucocorticoids are among the most widely prescribed drugs with their immune-suppressive and anti-inflammatory effect[84].The current guidelines for the treatment of COVID-19 recommend against the use of dexamethasone or other systemic CS in non-hospitalized patients in the absence of another indication[70].The RECOVERY trial demonstrates the reduced 28-d mortality among hospitalized patients with COVID-19 using dexamethasone compared to the usual standard of care,along with other investigators,such as Ahmed and Hassan[85].The benefit of dexamethasone was seen only among participants receiving either oxygen alone or invasive mechanical ventilation at randomization but not among those receiving no respiratory support at enrollment[85].In a systematic review and meta-analysis,Albuquerque et al[86]showed that in comparison to tocilizumab,baricitinib,and sarilumab are associated with high probabilities of similar mortality reductions among hospitalized COVID-19 concurrently treated with CS.As a result of the absence of SARS-CoV-2-specific antiviral medications,the effectiveness of COVID-19 treatments is reduced.Several COVID-19 therapies are now under investigation.However,the majority of them lack specificity,efficacy,and safety[87].Immunotherapy is a ground-breaking medical treatment that manipulates the immune system to fight diseases.Translational research is rapidly progressing,recognized as a significant breakthrough in 2013[88].Among the immunotherapeutic options for treating COVID-19 are Immunoglobulin,CP,antibodies,mAbs(mAbs),NK cells,T cells,TLR,cytokine therapies and immune modulators.

Alzheimer’s disease risk after COVID-19:a view from the perspective of the infectious hypothesis of neurodegeneration

In light of the rising evidence of the association between viral and bacterial infections and neurodegeneration,we aimed at revisiting the infectious hypothesis of Alzheimer’s disease and analyzing the possible implications of COVID-19 neurological sequelae in long-term neurodegeneration.We wondered how SARS-CoV-2 could be related to the amyloid-βcascade and how it could lead to the pathological hallmarks of the disease.We also predict a paradigm change in clinical medicine,which now has a great opportunity to conduct prospective surveillance of cognitive sequelae and progression to dementia in people who suffered severe infections together with other risk factors for Alzheimer’s disease.

Perceived infection transmission routes, infection control practices, psychosocial changes, and management of COVID-19 infected healthcare workers in a tertiary acute care hospital in Wuhan: a cross-sectional survey

Background:Many healthcare workers were infected by coronavirus disease 2019(COVID-19)early in the epidemic posing a big challenge for epidemic control.Hence,this study aims to explore perceived infection routes,influencing factors,psychosocial changes,and management procedures for COVID-19 infected healthcare workers.Methods:This is a cross-sectional,single hospital-based study.We recruited all 105 confirmed COVID-19 healthcare workers in the Zhongnan Hospital of Wuhan University from February 15 to 29,2020.All participants completed a validated questionnaire.Electronic consent was obtained from all participants.Perceived causes of infection,infection prevention,control knowledge and behaviour,psychological changes,symptoms and treatment were measured.Results:Finally,103 professional staff with COVID-19 finished the questionnaire and was included(response rate:98.1%).Of them,87 cases(84.5%)thought they were infected in working environment in hospital,one(1.0%)thought their infection was due to the laboratory environment,and 5(4.9%)thought they were infected in daily life or community environment.Swab of throat collection and physical examination were the procedures perceived as most likely causing their infection by nurses and doctors respectively.Forty-three(41.8%)thought their infection was related to protective equipment,utilization of common equipment(masks and gloves).The top three first symptoms displayed before diagnosis were fever(41.8%),lethargy(33.0%)and muscle aches(30.1%).After diagnosis,88.3%staff experienced psychological stress or emotional changes during their isolation period,only 11.7%had almost no emotional changes.Arbidol(Umifenovir;an anti-influza drug;69.2%)was the drug most commonly used to target infection in mild and moderate symptoms.Conclusion:The main perceived mode of transmission was not maintaining protection when working at a close distance and having intimate contact with infected cases.Positive psychological intervention is necessary.

Infection Prevention Strategy in Operating Room during Coronavirus Disease 2019(COVID-19)Outbreak

A novel coronavirus that emerged in late 2019 rapidly spread around the world.Most severe cases need endotracheal intubation and mechanical ventilation,and some mild cases may need emergent surgery under general anesthesia.The novel coronavirus was reported to transmit via droplets,contact and natural aerosols from human to human.Therefore,aerosol-producing procedures such as endotracheal intubation and airway suction may put the healthcare providers at high risk of nosocomial infection.Based on recently published articles,this review provides detailed feasible recommendations for primary anesthesiologists on infection prevention in operating room during COVID-19 outbreak.

The Effectiveness of Infection Control Practices among Health Care Workers Responding to the COVID-19 Pandemic in Nigeria

Background: The world is currently experiencing a healthcare crisis caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Healthcare workers (HCWs) are at the forefront of controlling the spread of the disease;this response has resulted in a huge number of infections amongst HCWs and unfortunately some casualties. Infection prevention and control practices (IPC) are practical, proven methods that prevent avoidable harm to patients and protect health workers from contagious infection. This study was done to evaluate the effectiveness of IPC practices utilized in COVID-19 testing drive through facility in Lagos Nigeria. Method: The facility recruited 42 HCWs who were trained on IPC and use of Personal Protective Equipment (PPEs). Training on donning and doffing of PPEs, preparation of decontaminants and sample handling were done for relevant personnel. A daily log for monitoring COVID-19 symptoms was deployed to all HCWs;to help early detection of COVID-19 infection and prevent transmission amongst staff. Results: Of 42 personnel, 92.8% had a tertiary level of education while 71.4% had at least 5 years work experience. A total of 5 (11.9%) out of 42 HCWs were positive by week six of the study. All infected persons worked at the drive through centre. Most common symptom filled in the daily log tool was headache and fatigue. Conclusion: Despite all the measures introduced, 11.9% of HCWs became positive within 6 weeks, showing the highly infectious nature of the virus and the need to research into more effective measures in preventing the transmission of highly infectious pathogens to HCWs during outbreaks.

Psychiatric sequelae in COVID-19 survivors:A narrative review

In December 2019,a novel coronavirus disease 2019(COVID-19)caused by severe acute respiratory syndrome coronavirus-2(SARS-CoV-2)was initially reported in Wuhan,China.Previous epidemics including SARS and middle east respiratory syndrome raises concern that COVID-19 infection may pose a significant threat to the mental health of affected individuals.Studies and reviews have shown the acute psychiatric manifestations in COVID-19 patients,although long term psychiatric sequelae are predicted,there are only few review studies about the long term psychiatry outcome in COVID-19 survivors.Clinically significant posttraumatic stress disorder,anxiety,and/or depression among COVID-19 survivors during 14-90 d were observed following the diagnosis.Risk of anxiety or depression were higher in patients with more severe illness at 6 mo follow-up,early convalescence,and at 1 mo follow-up.Diagnosis of COVID-19 Led to more first diagnoses and relapses of psychiatric illness during the first 14-90 d after COVID-19 diagnosis.The possible underlying mechanisms of psychiatric sequelae in COVID-19 infection are neurotropism,immune response to SARS-CoV-2,hypothalamo-pituitary-adrenal axis hyperactivity,disrupted neuronal circuits in several brain regions,increased stress levels,neuroinflammation,and neuronal death.This study will review the psychiatric sequelae in previous coronavirus pandemics,current studies,risk factors,and thorough explanation on pathophysiology of the psychiatric sequalae in COVID-19 survivors.

Mortality rate of COVID-19 infection in end stage kidney disease patients on maintenance hemodialysis:A systematic review and meta-analysis

BACKGROUND Coronavirus disease 2019(COVID-19)has been the most talked-about disease of the past few years.Patients with significant comorbidities have been at particular risk of adverse outcomes.This study looked at the outcomes and risk factors for adverse outcomes among patients on chronic hemodialysis for end-stage renal disease,a group of patients known to be particularly susceptible to infectious complications.AIM To assess outcomes and risk factors for adverse outcomes of COVID-19 infection among patients on chronic hemodialysis.METHODS We searched PubMed/MEDLINE,EMBASE,Reference Citation Analysis(https://www.referencecitationanalysis.com/)and Web of Science databases for relevant terms and imported the results into the Covidence platform.From there,studies were assessed in two stages for relevance and quality,and data from studies that satisfied all the requirements were extracted into a spreadsheet.The data was then analyzed descriptively and statistically.RESULTS Of the 920 studies identified through the initial database search,only 17 were included in the final analysis.The studies included in the analysis were mostly carried out during the first wave.We found that COVID-19 incidence among patients on hemodialysis was significant,over 10%in some studies.Those who developed COVID-19 infection were most likely going to be hospitalized,and over 1 in 5 died from the infection.Intensive care unit admission rate was lower than the infection lethality rate.Biochemical abnormalities and dyspnea were generally reported to be associated with adverse outcomes.CONCLUSION This systematic review confirms that patients on chronic hemodialysis are very high-risk individuals for COVID-19 infections,and a significant proportion was infected during the first wave.Their prognosis is overall much worse than in the general population,and every effort needs to be made to decrease their exposure.