Background:Though the COVID-19 pandemic recedes,and our society gradually returns to normal,Chinese people’s work and lifestyles are still influenced by the“pandemic aftermath”.In the post-pandemic era,employees ma...Background:Though the COVID-19 pandemic recedes,and our society gradually returns to normal,Chinese people’s work and lifestyles are still influenced by the“pandemic aftermath”.In the post-pandemic era,employees may feel uncertainty at work due to the changed organizational operations and management and perceive the external environment to be more dynamic.Both these perceptions may increase employees’negative emotions and contribute to conflicts between work and life.Drawing from the ego depletion theory,this study aimed to examine the impact of job insecurity during the post-pandemic era on employees’work-life conflicts,and the mediating effect of workplace anxiety in this relationship.Besides,this study also considered the uncertainty of the external macro environment as a boundary condition on the direct and indirect relationship between job insecurity and work-life conflicts.Methods:A two-wave questionnaire survey was conducted from October to December 2023 to collect data.MBA students and graduates from business school with full-time jobs are invited to report their perception of job insecurity,work anxiety,perceived environment uncertainty,and work-life conflict.This resulted in 253 valid responses.Data analysis was performed using the SPSS,Amos,and PROCESS.Results:The results showed that:(1)Employees’job insecurity would directly intensify the work-life conflict(B=0.275,p<0.001,95%CI[0.182,0.367]).(2)Employees’workplace anxiety mediates the relationship between job insecurity and work-life conflict(B=0.083,p<0.001,95%CI[0.047,0.130]).(3)The mediating effect of workplace anxiety between job insecurity and work-life conflict exists when perceived environmental uncertainty is high(B=0.049,95%CI[0.011,0.114]),while vanishes when perceived environmental uncertainty is low(B=0.024,95%CI[−0.005,0.068]).Conclusion:Job insecurity combined with perceived environmental uncertainty in the postpandemic era fuels employees’workplace anxiety and work-life conflicts.Post-pandemic trauma lingers,necessitating urgent attention and response.展开更多
BACKGROUND The recent and still ongoing pandemic caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)entailed various long-term complications,including post-infectious cholangiopathy.AIM To identi...BACKGROUND The recent and still ongoing pandemic caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)entailed various long-term complications,including post-infectious cholangiopathy.AIM To identify the available studies concerning post-coronavirus disease 2019(COVID-19)cholangiopathy.METHODS An extensive bibliographical search was carried out in PubMed and in Cochrane Library to identify the articles(retrospective and prospective studies,cohort studies,case series and case reports)published between January 1,2020 and August 22,2022,using both MeSH terms and free-language keywords:cholangiopathy;COVID-19;post-COVID-19 cholangiopathy;SARS-CoV-2.RESULTS Thirteen studies fulfilled the inclusion criteria,which included 64 patients suffering from this condition.The patients were male in 82.8%of cases.Liver transplant was executed in 6 patients and scheduled in 7 patients,while 2 patients refused the surgical approach.Therefore in 23.4%of the cases,performing this procedure appeared to be necessary.CONCLUSION This review has revealed that generally the involvement of the liver in the course of SARS-CoV-2 infection is mild and transient,inducing cholestasis of cholangiocytes but can also be severe enough to cause organ failure in some cases.展开更多
Post-coronavirus disease 2019(COVID-19)cholangiopathy(PCC)is a rare but lifethreatening complication of COVID-19 infection.PCC typically presents when patients recovering from the contagion and manifests as cholestasi...Post-coronavirus disease 2019(COVID-19)cholangiopathy(PCC)is a rare but lifethreatening complication of COVID-19 infection.PCC typically presents when patients recovering from the contagion and manifests as cholestasis in patients with no history of pre-existing liver disease.The pathogenesis of PCC is little understood.Hepatic injury in PCC could be mediated by the predilection of severe acute respiratory syndrome coronavirus 2 for cholangiocytes.Though PCC shows some resemblance to secondary sclerosing cholangitis in critically ill patients,it is considered as a separate and unique entity in the literature.Various treatment options like ursodeoxycholic acid,steroids,plasmapheresis,and endoscopic retrograde cholangiopancreatography guided interventions have been tried but with limited success.We have noticed significant improvement in liver function with antiplatelet therapy in a couple of patients.PCC can progress to end-stage liver disease necessitating liver transplantation.In this article,we discuss the current knowledge of PCC focusing on its pathophysiology,clinical manifestations,and management strategies.展开更多
BACKGROUND Smell disorders are the most frequent persistent coronavirus disease 2019(COVID-19)complications.AIM To describe the patterns and characteristics of persistent smell and taste disorders in Egyptian patients...BACKGROUND Smell disorders are the most frequent persistent coronavirus disease 2019(COVID-19)complications.AIM To describe the patterns and characteristics of persistent smell and taste disorders in Egyptian patients.METHODS Assessment was done to 185 patients(adults=150,age:31.41±8.63 years;children=35;age:15.66±1.63 years).Otolaryngology and neuropsychiatric evaluations were done.Measurements included:A clinical questionnaire(for smell and taste);sniffin'odor,taste and flavor identification tests and the Questionnaire of Olfactory Disorders-Negative Statements(sQOD-NS).RESULTS Duration of disorders was 11.53±3.97 ms(6-24 ms).Parosmia(n=119;64.32%)was developed months after anosmia(3.05±1.87 ms).Objective testing showed anosmia in all,ageusia and flavor loss in 20%(n=37)and loss of nasal and oral trigeminal sensations in 18%(n=33)and 20%(n=37),respectively.Patients had low scoring of sQOD-NS(11.41±3.66).There were no specific differences in other demographics and clinical variables which could distinguish post-COVID-19 smell and taste disorders in children from adults.CONCLUSION The course of small and taste disorders are supportive of the nasal and oral neuronal compromises.Post-COVID-19 taste and trigeminal disorders were less frequent compared to smell disorders.Post-COVID-19 flavor disorders were solely dependent on taste and not smell disorders.There were no demographics,clinical variables at onset or specific profile of these disorders in children compared to adults.展开更多
Introduction: Mucormycosis is a common fungal infection in India even before the COVID-19 pandemic. The incidence of Mucor mycosis has entered public consciousness in response to an outbreak of cases in India during C...Introduction: Mucormycosis is a common fungal infection in India even before the COVID-19 pandemic. The incidence of Mucor mycosis has entered public consciousness in response to an outbreak of cases in India during COVID-19 pandemic. Mortality is unacceptably high, reaching 80% in some case series. Prompt diagnosis is crucial because treatment initiation is time-critical due to the rapid progression of the infection. Direct KOH mount is a simple, rapid, inexpensive point-of-care test, which requires minimum technical aids. Interpretation of KOH smears requires some amount of experience. The present study was to evaluate the sensitivity and specificity of Direct Microscopical examination by KOH preparation of suspected Mucor mycosis samples taking the fungal culture as gold standard. Material and Methods: 230 samples were received in Microbiology Department from May 2021 to August 2021 from the patients suspected of Mucor mycosis. Samples were processed for KOH preparation using different concentrations of KOH like 20% and 40% till all tissues get digested. Samples were cultured also in Sabourauds dextrose agar (SDA) medium. Results of microscopy and culture were statistically analyzed using SPSS software version 23. Result: Sensitivity of KOH preparation was 67%, specificity was 87%. Positive predictive value was 76% and negative predictive value was 81% and accuracy was 80% when compared with the fungal culture. Discussion: Direct microscopic examinations using KOH preparation are the simplest, cheapest method used for the diagnosis of mycotic infections. This study is valuable in establishing a reliable method for early information on diagnosis of Mucor mycosis that may be crucial for determining appropriate therapy for the successful treatment of Mucor mycosis patients. Conclusion: KOH examination plays an important role in the diagnosis of Mucor mycosis suspected patients during COVID-19 pandemic era when compared with fungal culture which is a gold standard test in diagnosis of Fungal infection. It is the simplest and cheapest method that can be developed easily with minimal infrastructure or human resources in resource-limited countries during the COVID-19 era.展开更多
Background:Adult patients with congenital heart disease(ACHD)might be at high risk of Coronavirus disease-2019(COVID-19).This study aimed to report on a one-year tertiary center experience regards COVID-19 infection i...Background:Adult patients with congenital heart disease(ACHD)might be at high risk of Coronavirus disease-2019(COVID-19).This study aimed to report on a one-year tertiary center experience regards COVID-19 infection in ACHD patients.Methods:This is a one-year(March-2020 to March-2021)tertiary-center retrospective study that enrolled all ACHD patients;COVID-19 positive patients’medical records,and management were reported.Results:We recorded 542 patients,205(37.8%)COVID-19-positive,and 337(62.2%)COVID-19-negative patients.Palliated single ventricle and Eisenmenger syndrome patients were more vulnerable to COVID-19 infection(P<0.05*).Cardiovascular COVID-19 complications were arrhythmias in 47(22.9%)patients,heart failure in 39(19.0%)patients,cyanosis in 12(5.9%)patients,stroke/TIA in 5(2.4%)patients,hypertension and infective endocarditis in 2(1.0%)patients for each,pulmonary hypertension and pulmonary embolism in 1(0.5%)patient for each.11(5.4%)patients were managed with home isolation,147(71.7%)patients required antibiotics,32(15.6%)patients required intensive care unit(ICU),8(3.9%)patients required inotropes,7(3.4%)patients required mechanical ventilation,and 2(1.0%)patients required extracorporeal membrane oxygenation(ECMO).Thromboprophylaxis was given to all 46(22.4%)hospitalized patients.American College of Cardiology/American Heart Association classification revealed that complex lesions,and FC-C/D categories were more likely to develop severe/critical symptoms,that required mechanical ventilation and ECMO(P<0.05*).Mortality was reported in 3(0.6%)patients with no difference between groups(P=0.872).193(35.6%)patients were vaccinated.Conclusions:COVID-19 infection in ACHD patients require individualized risk stratification and management.Eisenmenger syndrome,single ventricle palliation,complex lesions,and FC-C/D patients were more vulnerable to severe/critical symptoms that required ICU admission,mechanical ventilation,and ECMO.The vaccine was mostly tolerable.展开更多
The pandemic caused by severe acute respiratory syndrome coronavirus-2(SARSCoV-2)in 2019-2022 leads to a multisystem illness that results in damage to numerous organ systems.In this review,our goal was to assess curre...The pandemic caused by severe acute respiratory syndrome coronavirus-2(SARSCoV-2)in 2019-2022 leads to a multisystem illness that results in damage to numerous organ systems.In this review,our goal was to assess current research on long-term respiratory,cardiac,neurological,digestive,rheumatological,urogenital,and dermatological system complications of coronavirus disease 2019(COVID-19).Bibliographic searches were conducted in December 2021 using PubMed and Google Scholar,retrospectively,covering all COVID-19 literature to determine the consequences of the disease.This review may help to determine the prospects for new studies and predict the upcoming aspects requiring assessment in post-COVID-19 syndrome.展开更多
BACKGROUND The Coronavirus disease 19(COVID-19)-related psychiatric burden partly results from prolonged social stress world-wide.Studies have examined the psychiatric impact of COVID-19 on Diagnostic and Statistical ...BACKGROUND The Coronavirus disease 19(COVID-19)-related psychiatric burden partly results from prolonged social stress world-wide.Studies have examined the psychiatric impact of COVID-19 on Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM 5)and International Classification of Diseases 11th Revision(ICD-11)categories,implicating multiple diagnoses,complicating clinical management.AIM To verify whether COVID-19-related psychopathology spans multiple DSM-5 and ICD-11 diagnoses,but not in a random pattern.Consequently,empirical analysis of the multiple associated symptoms will better describe COVID-19-related psychopathology.METHODS We conducted a bi-national study during the first surge of the pandemic:an Italian sample(n=21217,studied March-April 2020);and three representative longitudinal samples from Israel(n=1276,1189,and 1432 respectively,studied May-July 2020).Data in Italy were collected by a national internet-based survey with an initially approached sample of about one million persons and in Israel by the Israeli Central Bureau of Statistics using probability-based national representative sampling.Data analysis focused on the frequency and patterns of reported multiple mental health symptoms.RESULTS Combinations with all symptoms were more prevalent than combinations with fewer symptoms,with no majorities-minorities differences in both countries,demonstrating the generalizability of the transdiagnostic pattern of mental health issues in both nations.A history of previous mental disorder(Italian study)and an increase in symptom prevalence over time(Israel study)were associated with an increased number of symptoms.Conclusions:Based on finding correlated symptom diversity spanning conventional diagnostic categories,we suggest that the pattern of mental health issues associated with the COVID-19 pandemic is transdiagnostic.CONCLUSION The findings have implications for improving prevention and treatment of COVID-19 related psychopathology and for post-pandemic times in conditions resulting from multiplicity of stressors with mixed symptomatology in the clinical picture.展开更多
As the world continues to grapple with the novel coronavirus[coronavirus disease 2019(COVID-19)],many treatments have been proposed to help alleviate the symptoms and reduce the mortality rate.Hydroxychloroquine(HCQ)i...As the world continues to grapple with the novel coronavirus[coronavirus disease 2019(COVID-19)],many treatments have been proposed to help alleviate the symptoms and reduce the mortality rate.Hydroxychloroquine(HCQ)is an antimalarial drug that is typically used for several autoimmune,rheumatic,and dermatological conditions.It has also been considered to treat and prevent COVID-19 and subsequent arthritis associated with the infection.This drug is known to cause retinal toxicity,which can lead to vision impairment or loss.While the exact mechanism is not yet fully understood,it is thought to be due to the accumulation of the drug in the retinal pigment epithelium.The risk of toxicity increases with long-term use or with high doses of the drug and is more likely to occur in patients with pre-existing retinal diseases or those who are predisposed to retinal diseases.In this context,several steps can be taken to monitor and minimize the risk of ophthalmological adverse events when using HCQ to treat patients with COVID-19.展开更多
At the end of 2019,the sudden outbreak of the COVID-19 epidemic brought great challenges to the world,and China's tourism industry suffered an unprecedented heavy blow.Exploring the impact of the epidemic on touri...At the end of 2019,the sudden outbreak of the COVID-19 epidemic brought great challenges to the world,and China's tourism industry suffered an unprecedented heavy blow.Exploring the impact of the epidemic on tourism consumption structure has become a research focus in the post-epidemic era.In this study,based on Shandong Tourism Statistics Handbook from 2018 to 2020,taking Shandong Province as an example,the changes of total tourism revenue and tourism consumption structure in Shandong Province before and after the COVID-19 epidemic were compared to predict the development of tourism in Shandong Province in the post-epidemic era and find out existing problems,and optimization paths were put forward for the development of tourism in Shandong Province in the post-epidemic era.展开更多
BACKGROUND Diagnosis of coronavirus disease 2019(COVID-19)-related neurological events in the pediatric population is challenging.Overlapping clinical picture of children with altered neurological state and inborn err...BACKGROUND Diagnosis of coronavirus disease 2019(COVID-19)-related neurological events in the pediatric population is challenging.Overlapping clinical picture of children with altered neurological state and inborn errors of metabolism,in addition to the frequency of asymptomatic COVID-19 cases,pose the main challenges for diagnosis.Diagnostic approaches to the onset post-COVID 19 subacute encephalopathy are still troublesome as seronegative autoimmune encephalitis(AIE)is reported.CASE SUMMARY A 27-mo-old boy was admitted for stormy refractory seizure of polymorphic semiology and altered mental status followed by various neuropsychiatric features that were suggestive of AIE.Brain magnetic resonance imaging and cerebrospinal fluid analysis were normal.Neither the immunological assessment,including viral serologies,antinuclear antibodies,autoimmune antibodies(NMDA,AMPA,CASPR2,LG11,GABARB,Hu,Yo,Ri,CV2,PNMA2,SOX1,Titin,amphiphysin,Recoverin),nor the metabolic assessment for lactate and pyruvate showed significant anomaly.Both positive history of COVID-19 infection and the findings of characteristic repetitive extreme delta brush played a key role in the diagnosis of COVID-19-related AIE.A remarkable improvement in the state of the child was noted after two pulse doses of intravenous Veinoglobulin and high dose of intravenous Corticosteroid.CONCLUSION Diagnostic biomarkers for AIE might aid effective treatment.展开更多
自2020年世界卫生组织(World Health Organization,WHO)正式宣布新型冠状病毒肺炎疫情成为全球大流行之后,全球114个国家或区域受到不同程度的影响。后疫情时代的到来要求各国采取新的疫情防控措施,以应对未来可能出现的问题和挑战。为...自2020年世界卫生组织(World Health Organization,WHO)正式宣布新型冠状病毒肺炎疫情成为全球大流行之后,全球114个国家或区域受到不同程度的影响。后疫情时代的到来要求各国采取新的疫情防控措施,以应对未来可能出现的问题和挑战。为帮助我国在后疫情时代巩固几年来的防疫成果并获取更大的发展窗口,本文探析了全球疫情变化及各国主要防治政策的变化,总结归纳了我国疫情防治政策的发展变迁,提出适应我国国情的以家庭为核心的新型精准防控措施。展开更多
Solar home systems for rural electrification are often designed with a limited energy supply,which presents a drawback for the technology.Furthermore,uncontrolled livestock faeces in rural communities constitute envir...Solar home systems for rural electrification are often designed with a limited energy supply,which presents a drawback for the technology.Furthermore,uncontrolled livestock faeces in rural communities constitute environmental sanitation and health risks.Livestock excrement can be used through a biogas digester to supplement solar energy to provide adequate and sustainable elec-tricity access to underserved rural communities while achieving waste management.Therefore,this study presents a hybrid solar-biogas system for a more dynamic energy supply and waste management for post-Covid recovery plans in rural communities.A parametric research approach that involves the use of the Integrated Environment Solution Virtual Environment software application and mathematical models to design the desired household load and the hybrid system sizing is used in the study.The findings show that the daily household energy consumption was 6.6 kWh,equivalent to 206.40 kWh/month.A 1.2-kWp and 1.2-m^(3)hybrid solar-biogas system was found to adequately power the house.Financially,the total initial investment cost of the system was$5777.20 with a net present value of$6566.78,net profit of$4443.6,a payback period of 14 years and 8 months,and a levelized cost of energy of$0.21/kWh;these include a 60%initial investment and maintenance costs subsidy.Energy performance contracting and energy-as-a-service were recommended to effectively run and operate the system.The study successfully revealed the design,specifications and upscaling mechanism of the proposed hybrid solar-biogas system.More research is required to unveil the efficacy of the system,the performance gap and the perception of the technology by the beneficiaries.展开更多
BACKGROUND Chronic liver disease(CLD)was associated with adverse clinical outcomes among people with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.AIM To determine the effects of SARS-CoV-2 infe...BACKGROUND Chronic liver disease(CLD)was associated with adverse clinical outcomes among people with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.AIM To determine the effects of SARS-CoV-2 infection on the incidence and treatment strategy of hepatocellular carcinoma(HCC)among patients with CLD.METHODS A retrospective,territory-wide cohort of CLD patients was identified from an electronic health database in Hong Kong.Patients with confirmed SARS-CoV-2 infection[coronavirus disease 2019(COVID-19)+CLD]between January 1,2020 and October 25,2022 were identified and matched 1:1 by propensity-score with those without(COVID-19-CLD).Each patient was followed up until death,outcome event,or November 15,2022.Primary outcome was incidence of HCC.Secondary outcomes included all-cause mortality,adverse hepatic outcomes,and different treatment strategies to HCC(curative,non-curative treatment,and palliative care).Analyses were further stratified by acute(within 20 d)and post-acute(21 d or beyond)phases of SARS-CoV-2 infection.Incidence rate ratios(IRRs)were estimated by Poisson regression models.RESULTS Of 193589 CLD patients(>95%non-cirrhotic)in the cohort,55163 patients with COVID-19+CLD and 55163 patients with COVID-19-CLD were included after 1:1 propensity-score matching.Upon 249-d median follow-up,COVID-19+CLD was not associated with increased risk of incident HCC(IRR:1.19,95%CI:0.99-1.42,P=0.06),but higher risks of receiving palliative care for HCC(IRR:1.60,95%CI:1.46-1.75,P<0.001),compared to COVID-19-CLD.In both acute and post-acute phases of infection,COVID-19+CLD were associated with increased risks of allcause mortality(acute:IRR:7.06,95%CI:5.78-8.63,P<0.001;post-acute:IRR:1.24,95%CI:1.14-1.36,P<0.001)and adverse hepatic outcomes(acute:IRR:1.98,95%CI:1.79-2.18,P<0.001;post-acute:IRR:1.24,95%CI:1.13-1.35,P<0.001),compared to COVID-19-CLD.CONCLUSION Although CLD patients with SARS-CoV-2 infection were not associated with increased risk of HCC,they were more likely to receive palliative treatment than those without.The detrimental effects of SARS-CoV-2 infection persisted in post-acute phase.展开更多
文摘Background:Though the COVID-19 pandemic recedes,and our society gradually returns to normal,Chinese people’s work and lifestyles are still influenced by the“pandemic aftermath”.In the post-pandemic era,employees may feel uncertainty at work due to the changed organizational operations and management and perceive the external environment to be more dynamic.Both these perceptions may increase employees’negative emotions and contribute to conflicts between work and life.Drawing from the ego depletion theory,this study aimed to examine the impact of job insecurity during the post-pandemic era on employees’work-life conflicts,and the mediating effect of workplace anxiety in this relationship.Besides,this study also considered the uncertainty of the external macro environment as a boundary condition on the direct and indirect relationship between job insecurity and work-life conflicts.Methods:A two-wave questionnaire survey was conducted from October to December 2023 to collect data.MBA students and graduates from business school with full-time jobs are invited to report their perception of job insecurity,work anxiety,perceived environment uncertainty,and work-life conflict.This resulted in 253 valid responses.Data analysis was performed using the SPSS,Amos,and PROCESS.Results:The results showed that:(1)Employees’job insecurity would directly intensify the work-life conflict(B=0.275,p<0.001,95%CI[0.182,0.367]).(2)Employees’workplace anxiety mediates the relationship between job insecurity and work-life conflict(B=0.083,p<0.001,95%CI[0.047,0.130]).(3)The mediating effect of workplace anxiety between job insecurity and work-life conflict exists when perceived environmental uncertainty is high(B=0.049,95%CI[0.011,0.114]),while vanishes when perceived environmental uncertainty is low(B=0.024,95%CI[−0.005,0.068]).Conclusion:Job insecurity combined with perceived environmental uncertainty in the postpandemic era fuels employees’workplace anxiety and work-life conflicts.Post-pandemic trauma lingers,necessitating urgent attention and response.
文摘BACKGROUND The recent and still ongoing pandemic caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)entailed various long-term complications,including post-infectious cholangiopathy.AIM To identify the available studies concerning post-coronavirus disease 2019(COVID-19)cholangiopathy.METHODS An extensive bibliographical search was carried out in PubMed and in Cochrane Library to identify the articles(retrospective and prospective studies,cohort studies,case series and case reports)published between January 1,2020 and August 22,2022,using both MeSH terms and free-language keywords:cholangiopathy;COVID-19;post-COVID-19 cholangiopathy;SARS-CoV-2.RESULTS Thirteen studies fulfilled the inclusion criteria,which included 64 patients suffering from this condition.The patients were male in 82.8%of cases.Liver transplant was executed in 6 patients and scheduled in 7 patients,while 2 patients refused the surgical approach.Therefore in 23.4%of the cases,performing this procedure appeared to be necessary.CONCLUSION This review has revealed that generally the involvement of the liver in the course of SARS-CoV-2 infection is mild and transient,inducing cholestasis of cholangiocytes but can also be severe enough to cause organ failure in some cases.
文摘Post-coronavirus disease 2019(COVID-19)cholangiopathy(PCC)is a rare but lifethreatening complication of COVID-19 infection.PCC typically presents when patients recovering from the contagion and manifests as cholestasis in patients with no history of pre-existing liver disease.The pathogenesis of PCC is little understood.Hepatic injury in PCC could be mediated by the predilection of severe acute respiratory syndrome coronavirus 2 for cholangiocytes.Though PCC shows some resemblance to secondary sclerosing cholangitis in critically ill patients,it is considered as a separate and unique entity in the literature.Various treatment options like ursodeoxycholic acid,steroids,plasmapheresis,and endoscopic retrograde cholangiopancreatography guided interventions have been tried but with limited success.We have noticed significant improvement in liver function with antiplatelet therapy in a couple of patients.PCC can progress to end-stage liver disease necessitating liver transplantation.In this article,we discuss the current knowledge of PCC focusing on its pathophysiology,clinical manifestations,and management strategies.
文摘BACKGROUND Smell disorders are the most frequent persistent coronavirus disease 2019(COVID-19)complications.AIM To describe the patterns and characteristics of persistent smell and taste disorders in Egyptian patients.METHODS Assessment was done to 185 patients(adults=150,age:31.41±8.63 years;children=35;age:15.66±1.63 years).Otolaryngology and neuropsychiatric evaluations were done.Measurements included:A clinical questionnaire(for smell and taste);sniffin'odor,taste and flavor identification tests and the Questionnaire of Olfactory Disorders-Negative Statements(sQOD-NS).RESULTS Duration of disorders was 11.53±3.97 ms(6-24 ms).Parosmia(n=119;64.32%)was developed months after anosmia(3.05±1.87 ms).Objective testing showed anosmia in all,ageusia and flavor loss in 20%(n=37)and loss of nasal and oral trigeminal sensations in 18%(n=33)and 20%(n=37),respectively.Patients had low scoring of sQOD-NS(11.41±3.66).There were no specific differences in other demographics and clinical variables which could distinguish post-COVID-19 smell and taste disorders in children from adults.CONCLUSION The course of small and taste disorders are supportive of the nasal and oral neuronal compromises.Post-COVID-19 taste and trigeminal disorders were less frequent compared to smell disorders.Post-COVID-19 flavor disorders were solely dependent on taste and not smell disorders.There were no demographics,clinical variables at onset or specific profile of these disorders in children compared to adults.
文摘Introduction: Mucormycosis is a common fungal infection in India even before the COVID-19 pandemic. The incidence of Mucor mycosis has entered public consciousness in response to an outbreak of cases in India during COVID-19 pandemic. Mortality is unacceptably high, reaching 80% in some case series. Prompt diagnosis is crucial because treatment initiation is time-critical due to the rapid progression of the infection. Direct KOH mount is a simple, rapid, inexpensive point-of-care test, which requires minimum technical aids. Interpretation of KOH smears requires some amount of experience. The present study was to evaluate the sensitivity and specificity of Direct Microscopical examination by KOH preparation of suspected Mucor mycosis samples taking the fungal culture as gold standard. Material and Methods: 230 samples were received in Microbiology Department from May 2021 to August 2021 from the patients suspected of Mucor mycosis. Samples were processed for KOH preparation using different concentrations of KOH like 20% and 40% till all tissues get digested. Samples were cultured also in Sabourauds dextrose agar (SDA) medium. Results of microscopy and culture were statistically analyzed using SPSS software version 23. Result: Sensitivity of KOH preparation was 67%, specificity was 87%. Positive predictive value was 76% and negative predictive value was 81% and accuracy was 80% when compared with the fungal culture. Discussion: Direct microscopic examinations using KOH preparation are the simplest, cheapest method used for the diagnosis of mycotic infections. This study is valuable in establishing a reliable method for early information on diagnosis of Mucor mycosis that may be crucial for determining appropriate therapy for the successful treatment of Mucor mycosis patients. Conclusion: KOH examination plays an important role in the diagnosis of Mucor mycosis suspected patients during COVID-19 pandemic era when compared with fungal culture which is a gold standard test in diagnosis of Fungal infection. It is the simplest and cheapest method that can be developed easily with minimal infrastructure or human resources in resource-limited countries during the COVID-19 era.
文摘Background:Adult patients with congenital heart disease(ACHD)might be at high risk of Coronavirus disease-2019(COVID-19).This study aimed to report on a one-year tertiary center experience regards COVID-19 infection in ACHD patients.Methods:This is a one-year(March-2020 to March-2021)tertiary-center retrospective study that enrolled all ACHD patients;COVID-19 positive patients’medical records,and management were reported.Results:We recorded 542 patients,205(37.8%)COVID-19-positive,and 337(62.2%)COVID-19-negative patients.Palliated single ventricle and Eisenmenger syndrome patients were more vulnerable to COVID-19 infection(P<0.05*).Cardiovascular COVID-19 complications were arrhythmias in 47(22.9%)patients,heart failure in 39(19.0%)patients,cyanosis in 12(5.9%)patients,stroke/TIA in 5(2.4%)patients,hypertension and infective endocarditis in 2(1.0%)patients for each,pulmonary hypertension and pulmonary embolism in 1(0.5%)patient for each.11(5.4%)patients were managed with home isolation,147(71.7%)patients required antibiotics,32(15.6%)patients required intensive care unit(ICU),8(3.9%)patients required inotropes,7(3.4%)patients required mechanical ventilation,and 2(1.0%)patients required extracorporeal membrane oxygenation(ECMO).Thromboprophylaxis was given to all 46(22.4%)hospitalized patients.American College of Cardiology/American Heart Association classification revealed that complex lesions,and FC-C/D categories were more likely to develop severe/critical symptoms,that required mechanical ventilation and ECMO(P<0.05*).Mortality was reported in 3(0.6%)patients with no difference between groups(P=0.872).193(35.6%)patients were vaccinated.Conclusions:COVID-19 infection in ACHD patients require individualized risk stratification and management.Eisenmenger syndrome,single ventricle palliation,complex lesions,and FC-C/D patients were more vulnerable to severe/critical symptoms that required ICU admission,mechanical ventilation,and ECMO.The vaccine was mostly tolerable.
文摘The pandemic caused by severe acute respiratory syndrome coronavirus-2(SARSCoV-2)in 2019-2022 leads to a multisystem illness that results in damage to numerous organ systems.In this review,our goal was to assess current research on long-term respiratory,cardiac,neurological,digestive,rheumatological,urogenital,and dermatological system complications of coronavirus disease 2019(COVID-19).Bibliographic searches were conducted in December 2021 using PubMed and Google Scholar,retrospectively,covering all COVID-19 literature to determine the consequences of the disease.This review may help to determine the prospects for new studies and predict the upcoming aspects requiring assessment in post-COVID-19 syndrome.
文摘BACKGROUND The Coronavirus disease 19(COVID-19)-related psychiatric burden partly results from prolonged social stress world-wide.Studies have examined the psychiatric impact of COVID-19 on Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition(DSM 5)and International Classification of Diseases 11th Revision(ICD-11)categories,implicating multiple diagnoses,complicating clinical management.AIM To verify whether COVID-19-related psychopathology spans multiple DSM-5 and ICD-11 diagnoses,but not in a random pattern.Consequently,empirical analysis of the multiple associated symptoms will better describe COVID-19-related psychopathology.METHODS We conducted a bi-national study during the first surge of the pandemic:an Italian sample(n=21217,studied March-April 2020);and three representative longitudinal samples from Israel(n=1276,1189,and 1432 respectively,studied May-July 2020).Data in Italy were collected by a national internet-based survey with an initially approached sample of about one million persons and in Israel by the Israeli Central Bureau of Statistics using probability-based national representative sampling.Data analysis focused on the frequency and patterns of reported multiple mental health symptoms.RESULTS Combinations with all symptoms were more prevalent than combinations with fewer symptoms,with no majorities-minorities differences in both countries,demonstrating the generalizability of the transdiagnostic pattern of mental health issues in both nations.A history of previous mental disorder(Italian study)and an increase in symptom prevalence over time(Israel study)were associated with an increased number of symptoms.Conclusions:Based on finding correlated symptom diversity spanning conventional diagnostic categories,we suggest that the pattern of mental health issues associated with the COVID-19 pandemic is transdiagnostic.CONCLUSION The findings have implications for improving prevention and treatment of COVID-19 related psychopathology and for post-pandemic times in conditions resulting from multiplicity of stressors with mixed symptomatology in the clinical picture.
文摘As the world continues to grapple with the novel coronavirus[coronavirus disease 2019(COVID-19)],many treatments have been proposed to help alleviate the symptoms and reduce the mortality rate.Hydroxychloroquine(HCQ)is an antimalarial drug that is typically used for several autoimmune,rheumatic,and dermatological conditions.It has also been considered to treat and prevent COVID-19 and subsequent arthritis associated with the infection.This drug is known to cause retinal toxicity,which can lead to vision impairment or loss.While the exact mechanism is not yet fully understood,it is thought to be due to the accumulation of the drug in the retinal pigment epithelium.The risk of toxicity increases with long-term use or with high doses of the drug and is more likely to occur in patients with pre-existing retinal diseases or those who are predisposed to retinal diseases.In this context,several steps can be taken to monitor and minimize the risk of ophthalmological adverse events when using HCQ to treat patients with COVID-19.
文摘At the end of 2019,the sudden outbreak of the COVID-19 epidemic brought great challenges to the world,and China's tourism industry suffered an unprecedented heavy blow.Exploring the impact of the epidemic on tourism consumption structure has become a research focus in the post-epidemic era.In this study,based on Shandong Tourism Statistics Handbook from 2018 to 2020,taking Shandong Province as an example,the changes of total tourism revenue and tourism consumption structure in Shandong Province before and after the COVID-19 epidemic were compared to predict the development of tourism in Shandong Province in the post-epidemic era and find out existing problems,and optimization paths were put forward for the development of tourism in Shandong Province in the post-epidemic era.
文摘BACKGROUND Diagnosis of coronavirus disease 2019(COVID-19)-related neurological events in the pediatric population is challenging.Overlapping clinical picture of children with altered neurological state and inborn errors of metabolism,in addition to the frequency of asymptomatic COVID-19 cases,pose the main challenges for diagnosis.Diagnostic approaches to the onset post-COVID 19 subacute encephalopathy are still troublesome as seronegative autoimmune encephalitis(AIE)is reported.CASE SUMMARY A 27-mo-old boy was admitted for stormy refractory seizure of polymorphic semiology and altered mental status followed by various neuropsychiatric features that were suggestive of AIE.Brain magnetic resonance imaging and cerebrospinal fluid analysis were normal.Neither the immunological assessment,including viral serologies,antinuclear antibodies,autoimmune antibodies(NMDA,AMPA,CASPR2,LG11,GABARB,Hu,Yo,Ri,CV2,PNMA2,SOX1,Titin,amphiphysin,Recoverin),nor the metabolic assessment for lactate and pyruvate showed significant anomaly.Both positive history of COVID-19 infection and the findings of characteristic repetitive extreme delta brush played a key role in the diagnosis of COVID-19-related AIE.A remarkable improvement in the state of the child was noted after two pulse doses of intravenous Veinoglobulin and high dose of intravenous Corticosteroid.CONCLUSION Diagnostic biomarkers for AIE might aid effective treatment.
文摘自2020年世界卫生组织(World Health Organization,WHO)正式宣布新型冠状病毒肺炎疫情成为全球大流行之后,全球114个国家或区域受到不同程度的影响。后疫情时代的到来要求各国采取新的疫情防控措施,以应对未来可能出现的问题和挑战。为帮助我国在后疫情时代巩固几年来的防疫成果并获取更大的发展窗口,本文探析了全球疫情变化及各国主要防治政策的变化,总结归纳了我国疫情防治政策的发展变迁,提出适应我国国情的以家庭为核心的新型精准防控措施。
文摘Solar home systems for rural electrification are often designed with a limited energy supply,which presents a drawback for the technology.Furthermore,uncontrolled livestock faeces in rural communities constitute environmental sanitation and health risks.Livestock excrement can be used through a biogas digester to supplement solar energy to provide adequate and sustainable elec-tricity access to underserved rural communities while achieving waste management.Therefore,this study presents a hybrid solar-biogas system for a more dynamic energy supply and waste management for post-Covid recovery plans in rural communities.A parametric research approach that involves the use of the Integrated Environment Solution Virtual Environment software application and mathematical models to design the desired household load and the hybrid system sizing is used in the study.The findings show that the daily household energy consumption was 6.6 kWh,equivalent to 206.40 kWh/month.A 1.2-kWp and 1.2-m^(3)hybrid solar-biogas system was found to adequately power the house.Financially,the total initial investment cost of the system was$5777.20 with a net present value of$6566.78,net profit of$4443.6,a payback period of 14 years and 8 months,and a levelized cost of energy of$0.21/kWh;these include a 60%initial investment and maintenance costs subsidy.Energy performance contracting and energy-as-a-service were recommended to effectively run and operate the system.The study successfully revealed the design,specifications and upscaling mechanism of the proposed hybrid solar-biogas system.More research is required to unveil the efficacy of the system,the performance gap and the perception of the technology by the beneficiaries.
基金Supported by Collaborative Research Fund Scheme,University Grants Committee,No.C7154-20GFData Discovery for Health(D24H)Innovation and Technology Commission,AIR@InnoHK.
文摘BACKGROUND Chronic liver disease(CLD)was associated with adverse clinical outcomes among people with severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection.AIM To determine the effects of SARS-CoV-2 infection on the incidence and treatment strategy of hepatocellular carcinoma(HCC)among patients with CLD.METHODS A retrospective,territory-wide cohort of CLD patients was identified from an electronic health database in Hong Kong.Patients with confirmed SARS-CoV-2 infection[coronavirus disease 2019(COVID-19)+CLD]between January 1,2020 and October 25,2022 were identified and matched 1:1 by propensity-score with those without(COVID-19-CLD).Each patient was followed up until death,outcome event,or November 15,2022.Primary outcome was incidence of HCC.Secondary outcomes included all-cause mortality,adverse hepatic outcomes,and different treatment strategies to HCC(curative,non-curative treatment,and palliative care).Analyses were further stratified by acute(within 20 d)and post-acute(21 d or beyond)phases of SARS-CoV-2 infection.Incidence rate ratios(IRRs)were estimated by Poisson regression models.RESULTS Of 193589 CLD patients(>95%non-cirrhotic)in the cohort,55163 patients with COVID-19+CLD and 55163 patients with COVID-19-CLD were included after 1:1 propensity-score matching.Upon 249-d median follow-up,COVID-19+CLD was not associated with increased risk of incident HCC(IRR:1.19,95%CI:0.99-1.42,P=0.06),but higher risks of receiving palliative care for HCC(IRR:1.60,95%CI:1.46-1.75,P<0.001),compared to COVID-19-CLD.In both acute and post-acute phases of infection,COVID-19+CLD were associated with increased risks of allcause mortality(acute:IRR:7.06,95%CI:5.78-8.63,P<0.001;post-acute:IRR:1.24,95%CI:1.14-1.36,P<0.001)and adverse hepatic outcomes(acute:IRR:1.98,95%CI:1.79-2.18,P<0.001;post-acute:IRR:1.24,95%CI:1.13-1.35,P<0.001),compared to COVID-19-CLD.CONCLUSION Although CLD patients with SARS-CoV-2 infection were not associated with increased risk of HCC,they were more likely to receive palliative treatment than those without.The detrimental effects of SARS-CoV-2 infection persisted in post-acute phase.