COVID-19: Current Status and Future Prospects

A special issue of Tropical Medicine and Infectious Disease (ISSN 2414-6366). This special issue belongs to the section "Infectious Diseases".

Deadline for manuscript submissions: closed (31 December 2022) | Viewed by 86652

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Guest Editor
1. Division of Tropical Health and Medicine, College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia
2. School of Medicine, College of Medicine, Nursing and Health Sciences, University of Galway, Galway, Ireland
Interests: neglected tropical diseases; lymphatic filariasis; dengue; malaria; occupational health; travel medicine; emerging public health threats
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Guest Editor
Pathologist, Parasitology Reference Lab, Centre for Emerging Zoonotic and Parasitic Diseases, National Institute for Communicable Diseases, University of the Witwatersrand, Johannesburg 2192, South Africa
Interests: parasitic and zoonotic infections; travel and tropical medicine
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Honorary Consultant, National Institute for Communicable Diseases of the National Health Laboratory Service, Johannesburg 2192, South Africa
Interests: one health; epidemic and pandemic preparedness and response; emerging zoonoses; malaria
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Special Issue Information

Dear Colleagues,

On 11 March 2020, the World Health Organization declared COVID-19 a global pandemic, and the disease now affects nearly every country and region. Caused by SARS-CoV-2, COVID-19 is nearly 18 months later continuing to present significant challenges to health systems and public health in both hemispheres, as well as the economies of each country. The morbidity and mortality of the infection caused by SARS-CoV-2 has been significant, and various waves of disease outbreaks initially overwhelmed many hospitals and clinics and continue to do so in many countries. This influences everyone, and public health countermeasures have been dramatic in terms of their impact on employment, social systems, and mental health.

This Special Issue follows on from the Special Issue “COVID-19: Current Challenges and Future Perspectives” and provides an avenue for authors from various disciplines to provide feedback on the response and our future preparedness around COVID-19 globally, as well as to disseminate critical information about the SARS-CoV-2 virus and the associated COVID-19 pandemic. We are accepting submissions from around the world, but we are particularly interested in submissions featuring perspectives from the southern hemisphere.

The scope of the issue shall encompass the following:

  • Original articles about COVID-19 (including epidemiology, modelling, clinical data, treatment, prevention, countermeasures, impact on tropical regions, vaccines, response, and preparedness);
  • Original articles about SARS-CoV-2 (microbiology, virology, diagnosis, transmission, pathology, and vaccinology);
  • Perspectives about COVID-19 and SARS-CoV-2 (comparisons with past coronavirus outbreaks, impactful local initiatives, novel responses and commentaries);
  • Reviews on COVID-19 (based on systematic and narrative reviews);
  • Innovations (vaccine development, drug trials, and other countermeasures).

Prof. Dr. Peter A. Leggat
Prof. Dr. John Frean
Prof. Dr. Lucille Blumberg
Guest Editors

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Tropical Medicine and Infectious Disease is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

  • Coronavirus
  • Countermeasures
  • COVID-19
  • Infectious disease
  • Microbiology
  • Origins
  • Outbreak
  • Pandemic
  • Pathology
  • Pneumonia
  • Preparedness
  • Psychological impacts
  • Public health
  • Response
  • SARS-CoV-2
  • Severe respiratory distress syndrome
  • Social effects
  • Southern hemisphere
  • Tropics
  • Vaccines
  • Virology
  • Zoonosis

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Published Papers (25 papers)

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Editorial

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5 pages, 215 KiB  
Editorial
COVID-19: Current Status and Future Prospects
by Peter A. Leggat, John Frean and Lucille Blumberg
Trop. Med. Infect. Dis. 2023, 8(2), 94; https://doi.org/10.3390/tropicalmed8020094 - 31 Jan 2023
Cited by 1 | Viewed by 1550
Abstract
This second Special Issue in a series of Special Issues in Tropical Medicine and Infectious Disease looks at recent global research on the current Coronavirus (COVID-19) Pandemic [...] Full article
(This article belongs to the Special Issue COVID-19: Current Status and Future Prospects)

Research

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14 pages, 268 KiB  
Article
COVID-19 Risk Perception and Prevention Practices among High- and Low-Density Populations in Bangladesh: A Mixed-Methods Study
by Syed Moinuddin Satter, Kamal Ibne Amin Chowdhury, Refah Tamanna, Zarin Abdullah, S. M. Zafor Shafique, Md Saiful Islam, Nadia Ali Rimi, Muhammad Rashedul Alam, Arifa Nazneen, Mustafizur Rahman, Taufiqur Rahman Bhuiyan, Farzana Islam Khan, Mahbubur Rahman, A. S. M. Alamgir, Tahmina Shirin, Mahmudur Rahman, Firdausi Qadri, Meerjady Sabrina Flora and Sayera Banu
Trop. Med. Infect. Dis. 2022, 7(12), 447; https://doi.org/10.3390/tropicalmed7120447 - 19 Dec 2022
Cited by 2 | Viewed by 1751
Abstract
We aimed to explore coronavirus disease 2019 (COVID-19) risk perception and prevention practices among people living in high- and low-population density areas in Dhaka, Bangladesh. A total of 623 patients with confirmed COVID-19 agreed to participate in the survey. Additionally, we purposively selected [...] Read more.
We aimed to explore coronavirus disease 2019 (COVID-19) risk perception and prevention practices among people living in high- and low-population density areas in Dhaka, Bangladesh. A total of 623 patients with confirmed COVID-19 agreed to participate in the survey. Additionally, we purposively selected 14 participants from diverse economic and occupational groups and conducted qualitative interviews for them accordingly. Approximately 70% of the respondents had low socioeconomic status. Among the 623 respondents, 146 were from low-density areas, and 477 were from high-density areas. The findings showed that study participants perceived COVID-19 as a punishment from the Almighty, especially for non-Muslims, and were not concerned about its severity. They also believed that coronavirus would not survive in hot temperatures or negatively impact Bangladeshis. This study revealed that people were reluctant to undergo COVID-19 testing. Family members hid if anyone tested positive for COVID-19 or did not adhere to institutional isolation. The findings showed that participants were not concerned about COVID-19 and believed that coronavirus would not have a devastating impact on Bangladeshis; thus, they were reluctant to follow prevention measures and undergo testing. Tailored interventions for specific targeted groups would be relevant in mitigating the prevailing misconceptions. Full article
(This article belongs to the Special Issue COVID-19: Current Status and Future Prospects)
11 pages, 296 KiB  
Article
Clinical Features Related to Severity and Mortality among COVID-19 Patients in a Pre-Vaccine Period in Luanda, Angola
by Cruz S. Sebastião, Adis Cogle, Alice D’Alva Teixeira, Ana Micolo Cândido, Chissengo Tchoni, Maria João Amorim, N’gueza Loureiro, Paolo Parimbelli, Carlos Penha-Gonçalves, Jocelyne Demengeot, Euclides Sacomboio, Manuela Mendes, Margarete Arrais, Joana Morais, Jocelyne Neto de Vasconcelos and Miguel Brito
Trop. Med. Infect. Dis. 2022, 7(11), 338; https://doi.org/10.3390/tropicalmed7110338 - 29 Oct 2022
Cited by 3 | Viewed by 2048
Abstract
Background: Infection due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with clinical features of diverse severity. Few studies investigated the severity and mortality predictors of coronavirus disease 2019 (COVID-19) in Africa. Herein, we investigated the clinical features of severity and [...] Read more.
Background: Infection due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with clinical features of diverse severity. Few studies investigated the severity and mortality predictors of coronavirus disease 2019 (COVID-19) in Africa. Herein, we investigated the clinical features of severity and mortality among COVID-19 patients in Luanda, Angola. Methods: This multicenter cohort study involved 101 COVID-19 patients, between December 2020 and April 2021, with clinical and laboratory data collected. Analysis was done using independent-sample t-tests and Chi-square tests. The results were deemed significant when p < 0.05. Results: The mean age of patients was 51 years (ranging from 18 to 80 years) and 60.4% were male. Fever (46%), cough (47%), gastrointestinal symptoms (26.7%), and asthenia (26.7%), were the most common symptoms. About 64.4% of the patients presented coexistent disorders, including hypertension (42%), diabetes (17%), and chronic renal diseases (6%). About 23% were non-severe, 77% were severe, and 10% died during hospitalization. Variations in the concentration of neutrophil, urea, creatinine, c-reactive protein, sodium, creatine kinase, and chloride were independently associated with severity and/or mortality (p < 0.05). Conclusion: Several factors contributed to the severity and mortality among COVID-19 patients in Angola. Further studies related to clinical features should be carried out to help clinical decision-making and follow-up of COVID-19 patients in Angola. Full article
(This article belongs to the Special Issue COVID-19: Current Status and Future Prospects)
16 pages, 337 KiB  
Article
Factors Associated with Self-Medication during the COVID-19 Pandemic: A Cross-Sectional Study in Pakistan
by Bakhtawar Chaudhry, Saiza Azhar, Shazia Jamshed, Jahanzaib Ahmed, Laiq-ur-Rehman Khan, Zahid Saeed, Melinda Madléna, Márió Gajdács and Abdur Rasheed
Trop. Med. Infect. Dis. 2022, 7(11), 330; https://doi.org/10.3390/tropicalmed7110330 - 25 Oct 2022
Cited by 8 | Viewed by 2650
Abstract
Self-medication (SM) is characterized by the procurement and use of medicines by bypassing primary healthcare services and without consulting a physician, usually to manage acute symptoms of self-diagnosed illnesses. Due to the limited availability of primary healthcare services and the anxiety associated with [...] Read more.
Self-medication (SM) is characterized by the procurement and use of medicines by bypassing primary healthcare services and without consulting a physician, usually to manage acute symptoms of self-diagnosed illnesses. Due to the limited availability of primary healthcare services and the anxiety associated with the COVID-19 pandemic, the compulsion to SM by the public has increased considerably. The study aimed to assess the characteristics, practices, and associated factors of SM by the public during the COVID-19 pandemic in Sargodha, Pakistan. χ2-tests and univariable analyses were conducted to explore the identification of characteristics and the potential contributing factors for SM during COVID-19, while multivariable logistic regression models were run to study the effect of variables that maintained a significant association. The study was performed during July–September 2021, with n = 460 questionnaires returned overall (response rate: 99.5%). The majority of respondents were males (58.7%, n = 270) who live in the periphery of the town (63.9%, n = 294), and most of the respondents belonged to the age group of 18–28 years (73.3%, n = 339). A large number, 46.1% (n = 212), of the participants were tested for COVID-19 during the pandemic, and among them, 34.3% (n = 158) practiced SM during the pandemic; the most common source of obtaining medicines was requesting them directly from a pharmacy (25.0%; n = 127). The chances of practicing SM for medical health professionals were 1.482 (p-value = 0.046) times greater than for non-medical health personnel. The likelihood of practicing SM in participants whose COVID-19 test was positive was 7.688 (p-value < 0.001) times more than who did not test for COVID-19. Allopathic medicines, acetaminophen (23.6%), azithromycin (14,9%), and cough syrups (13%), and over the counter (OTC) pharmaceuticals, vitamin oral supplements, such as Vitamin C (39.1%), folic acid (23.5%), and calcium (22.6%), were the most commonly consumed medicines and supplements, respectively; being a healthcare professional or having a COVID-test prior showed a significant association with the usage of Vitamin C (p < 0.05 in all cases). Respondents who mentioned unavailability of the physician and difficulty in travelling/reaching healthcare professionals were found 2.062-times (p-value = 0.004) and 1.862-times (p-value = 0.021) more likely to practice SM, respectively; SM due to fear of COVID was more common in individuals who had received COVID-tests prior (p = 0.004). Practices of SM were observed at alarming levels among our participants. Consciousness and understanding about the possible adverse effects of SM must be established and validated on a continuous level; in addition, on a commercial level, collaboration from pharmacists not to sell products (especially prescription-only medicines) without a certified prescription must be developed and implemented. Full article
(This article belongs to the Special Issue COVID-19: Current Status and Future Prospects)
23 pages, 6396 KiB  
Article
Infectious Disease Modeling with Socio-Viral Behavioral Aspects—Lessons Learned from the Spread of SARS-CoV-2 in a University
by Nuning Nuraini, Kamal Khairudin Sukandar, Maria Yulita Trida Tahu, Ernawati Arifin Giri-Rachman, Anggraini Barlian, Sri Harjati Suhardi, Udjianna Sekteria Pasaribu, Sonny Yuliar, Diky Mudhakir, Herto Dwi Ariesyady, Dian Rosleine, Iyan Sofyan and Widjaja Martokusumo
Trop. Med. Infect. Dis. 2022, 7(10), 289; https://doi.org/10.3390/tropicalmed7100289 - 9 Oct 2022
Cited by 3 | Viewed by 2057
Abstract
When it comes to understanding the spread of COVID-19, recent studies have shown that pathogens can be transmitted in two ways: direct contact and airborne pathogens. While the former is strongly related to the distancing behavior of people in society, the latter are [...] Read more.
When it comes to understanding the spread of COVID-19, recent studies have shown that pathogens can be transmitted in two ways: direct contact and airborne pathogens. While the former is strongly related to the distancing behavior of people in society, the latter are associated with the length of the period in which the airborne pathogens remain active. Considering those facts, we constructed a compartmental model with a time-dependent transmission rate that incorporates the two sources of infection. This paper provides an analytical and numerical study of the model that validates trivial insights related to disease spread in a responsive society. As a case study, we applied the model to the COVID-19 spread data from a university environment, namely, the Institut Teknologi Bandung, Indonesia, during its early reopening stage, with a constant number of students. The results show a significant fit between the rendered model and the recorded cases of infections. The extrapolated trajectories indicate the resurgence of cases as students’ interaction distance approaches its natural level. The assessment of several strategies is undertaken in this study in order to assist with the school reopening process. Full article
(This article belongs to the Special Issue COVID-19: Current Status and Future Prospects)
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13 pages, 685 KiB  
Article
A Risk Prediction Model and Risk Score of SARS-CoV-2 Infection Following Healthcare-Related Exposure
by Kantarida Sripanidkulchai, Pinyo Rattanaumpawan, Winai Ratanasuwan, Nasikarn Angkasekwinai, Susan Assanasen, Peerawong Werarak, Oranich Navanukroh, Phatharajit Phatharodom and Teerapong Tocharoenchok
Trop. Med. Infect. Dis. 2022, 7(9), 248; https://doi.org/10.3390/tropicalmed7090248 - 14 Sep 2022
Cited by 1 | Viewed by 2361
Abstract
Hospital workers are at high risk of contact with COVID-19 patients. Currently, there is no evidence-based, comprehensive risk assessment tool for healthcare-related exposure; so, we aimed to identify independent factors related to COVID-19 infection in hospital workers following workplace exposure(s) and construct a [...] Read more.
Hospital workers are at high risk of contact with COVID-19 patients. Currently, there is no evidence-based, comprehensive risk assessment tool for healthcare-related exposure; so, we aimed to identify independent factors related to COVID-19 infection in hospital workers following workplace exposure(s) and construct a risk prediction model. We analyzed the COVID-19 contact tracing dataset from 15 July to 31 December 2021 using multiple logistic regression analysis, considering exposure details, demographics, and vaccination history. Of 7146 included exposures to confirmed COVID-19 patients, 229 (4.2%) had subsequently tested positive via RT-PCR. Independent risk factors for a positive test were having symptoms (adjusted odds ratio 4.94, 95%CI 3.83–6.39), participating in an unprotected aerosol-generating procedure (aOR 2.87, 1.66–4.96), duration of exposure >15 min (aOR 2.52, 1.82–3.49), personnel who did not wear a mask (aOR 2.49, 1.75–3.54), exposure to aerodigestive secretion (aOR 1.5, 1.03–2.17), index patient not wearing a mask (aOR 1.44, 1.01–2.07), and exposure distance <1 m without eye protection (aOR 1.39, 1.02–1.89). High-potency vaccines and high levels of education protected against infection. A risk model and scoring system with good discrimination power were built. Having symptoms, unprotected exposure, lower education level, and receiving low potency vaccines increased the risk of laboratory-confirmed COVID-19 following healthcare-related exposure events. Full article
(This article belongs to the Special Issue COVID-19: Current Status and Future Prospects)
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14 pages, 2249 KiB  
Article
Mortality in Four Waves of COVID-19 Is Differently Associated with Healthcare Capacities Affected by Economic Disparities
by Lan Yao, J. Carolyn Graff, Lotfi Aleya, Jiamin Ma, Yanhong Cao, Wei Wei, Shuqiu Sun, Congyi Wang, Yan Jiao, Weikuan Gu, Gang Wang and Dianjun Sun
Trop. Med. Infect. Dis. 2022, 7(9), 241; https://doi.org/10.3390/tropicalmed7090241 - 10 Sep 2022
Cited by 3 | Viewed by 1960
Abstract
Background: The greatest challenges are imposed on the overall capacity of disease management when the cases reach the maximum in each wave of the pandemic. Methods: The cases and deaths for the four waves of COVID-19 in 119 countries and regions (CRs) were [...] Read more.
Background: The greatest challenges are imposed on the overall capacity of disease management when the cases reach the maximum in each wave of the pandemic. Methods: The cases and deaths for the four waves of COVID-19 in 119 countries and regions (CRs) were collected. We compared the mortality across CRs where populations experience different economic and healthcare disparities. Findings: Among 119 CRs, 117, 112, 111, and 55 have experienced 1, 2, 3, and 4 waves of COVID-19 disease, respectively. The average mortality rates at the disease turning point were 0.036, 0.019. 0.017, and 0.015 for the waves 1, 2, 3, and 4, respectively. Among 49 potential factors, income level, gross national income (GNI) per capita, and school enrollment are positively correlated with the mortality rates in the first wave, but negatively correlated with the rates of the rest of the waves. Their values for the first wave are 0.253, 0.346 and 0.385, respectively. The r value for waves 2, 3, and 4 are −0.310, −0.293, −0.234; −0.263, −0.284, −0.282; and −0.330, −0.394, −0.048, respectively. In high-income CRs, the mortality rates in waves 2 and 3 were 29% and 28% of that in wave 1; while in upper-middle-income CRs, the rates for waves 2 and 3 were 76% and 79% of that in wave 1. The rates in waves 2 and 3 for lower-middle-income countries were 88% and 89% of that in wave 1, and for low-income countries were 135% and 135%. Furthermore, comparison among the largest case numbers through all waves indicated that the mortalities in upper- and lower-middle-income countries is 65% more than that of the high-income countries. Interpretation: Conclusions from the first wave of the COVID-19 pandemic do not apply to the following waves. The clinical outcomes in developing countries become worse along with the expansion of the pandemic. Full article
(This article belongs to the Special Issue COVID-19: Current Status and Future Prospects)
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11 pages, 564 KiB  
Article
Comparison of Four Real-Time Polymerase Chain Reaction Assays for the Detection of SARS-CoV-2 in Respiratory Samples from Tunja, Boyacá, Colombia
by Lorenzo H. Salamanca-Neita, Óscar Carvajal, Juan Pablo Carvajal, Maribel Forero-Castro and Nidya Alexandra Segura
Trop. Med. Infect. Dis. 2022, 7(9), 240; https://doi.org/10.3390/tropicalmed7090240 - 10 Sep 2022
Cited by 2 | Viewed by 1748
Abstract
Coronavirus disease (COVID-19) is an infectious disease caused by SARS-CoV-2. In Colombia, many commercial methods are now available to perform the RT-qPCR assays, and laboratories must evaluate their diagnostic accuracy to ensure reliable results for patients suspected of being positive for COVID-19. The [...] Read more.
Coronavirus disease (COVID-19) is an infectious disease caused by SARS-CoV-2. In Colombia, many commercial methods are now available to perform the RT-qPCR assays, and laboratories must evaluate their diagnostic accuracy to ensure reliable results for patients suspected of being positive for COVID-19. The purpose of this study was to compare four commercial RT-qPCR assays with respect to their ability to detect the SARS-CoV2 virus from nasopharyngeal swab samples referred to Laboratorio Carvajal IPS, SAS in Tunja, Boyacá, Colombia. We utilized 152 respiratory tract samples (Nasopharyngeal Swabs) from patients suspected of having SARS-CoV-2. The diagnostic accuracy of GeneFinderTM COVID-19 Plus RealAmp (In Vitro Diagnostics) (GF-TM), One-Step Real-Time RT-PCR (Vitro Master Diagnostica) (O-S RT-qPCR), and the Berlin modified protocol (BM) were assessed using the gold-standard Berlin protocol (Berlin Charité Probe One-Step RT-qPCR Kit, New England Biolabs) (BR) as a reference. Operational characteristics were estimated in terms of sensitivity, specificity, agreement, and predictive values. Using the gold-standard BR as a reference, the sensitivity/specificity of the diagnostic tests was found to be 100%/92.7% for GF-TM, 92.75%/67.47% for O-S RT-qPCR, and 100%/96.39% for the BM protocol. Using BR as a reference, the sensitivity/specificity for the diagnostic tests were found to be 100%/92.7% for the GF-TM assay, 92.72%/67.47% for the O-S RT-qPCR, and 100%/96.39% for BM. Relative to the BR reference protocol, the GF-TM and BM RT-PCR assays obtained similar results (k = 0.92 and k = 0.96, respectively), whereas the results obtained by O-S-RT-qPCR were only moderately similar. We conclude that the GF-TM and BM protocols offer the best sensitivity and specificity, with similar results in comparison to the gold-standard BR protocol. We recommend evaluating the diagnostic accuracy of the OS-RT-qPCR protocol in future studies with a larger number of samples. Full article
(This article belongs to the Special Issue COVID-19: Current Status and Future Prospects)
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20 pages, 9630 KiB  
Article
Transmission Dynamics and Genomic Epidemiology of Emerging Variants of SARS-CoV-2 in Bangladesh
by Md. Abu Sayeed, Jinnat Ferdous, Otun Saha, Shariful Islam, Shusmita Dutta Choudhury, Josefina Abedin, Mohammad Mahmudul Hassan and Ariful Islam
Trop. Med. Infect. Dis. 2022, 7(8), 197; https://doi.org/10.3390/tropicalmed7080197 - 20 Aug 2022
Cited by 5 | Viewed by 2541
Abstract
With the progression of the global SARS-CoV-2 pandemic, the new variants have become more infectious and continue spreading at a higher rate than pre-existing ones. Thus, we conducted a study to explore the epidemiology of emerging variants of SARS-CoV-2 that circulated in Bangladesh [...] Read more.
With the progression of the global SARS-CoV-2 pandemic, the new variants have become more infectious and continue spreading at a higher rate than pre-existing ones. Thus, we conducted a study to explore the epidemiology of emerging variants of SARS-CoV-2 that circulated in Bangladesh from December 2020 to September 2021, representing the 2nd and 3rd waves. We collected new cases and deaths per million daily data with the reproduction rate. We retrieved 928 SARS-CoV-2 sequences from GISAID and performed phylogenetic tree construction and mutation analysis. Case counts were lower initially at the end of 2020, during January–February and April–May 2021, whereas the death toll reached the highest value of 1.587 per million on the first week of August and then started to decline. All the variants (α, β, δ, η) were prevalent in the capital city, Dhaka, with dispersion to large cities, such as Sylhet and Chattogram. The B.1.1.25 lineage was prevalent during December 2020, but the B.1.617.2/δ variant was later followed by the B.1.351/β variant. The phylogeny revealed that the various strains found in Bangladesh could be from numerous countries. The intra-cluster and inter-cluster communication began in Bangladesh soon after the virus arrived. The prominent amino acid substitution was D614G from December 2020 to July 2021 (93.5 to 100%). From February–April, one of the VOC’s important mutations, N501Y substitution, was also estimated at 51.8%, 76.1%, and 65.1% for the α, β and γ variants, respectively. The γ variant’s unique mutation K417T was detected only at 1.8% in February. Another frequent mutation was P681R, a salient feature of the δ variant, detected in June (88.2%) and July (100%). Furthermore, only one γ variant was detected during the entire second and third wave, whereas no η variant was observed in this period. This rapid growth in the number of variants identified across Bangladesh shows virus adaptation and a lack of strict quarantine, prompting periodic genomic surveillance to foresee the spread of new variants, if any, and to take preventive measures as soon as possible. Full article
(This article belongs to the Special Issue COVID-19: Current Status and Future Prospects)
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13 pages, 1265 KiB  
Article
Coordination and Management of COVID-19 in Africa through Health Operations and Technical Expertise Pillar: A Case Study from WHO AFRO One Year into Response
by Nsenga Ngoy, Ishata Nannie Conteh, Boniface Oyugi, Patrick Abok, Aminata Kobie, Peter Phori, Cephas Hamba, Nonso Ephraim Ejiofor, Kaizer Fitzwanga, John Appiah, Ama Edwin, Temidayo Fawole, Rashidatu Kamara, Landry Kabego Cihambanya, Tasiana Mzozo, Caroline Ryan, Fiona Braka, Zabulon Yoti, Francis Kasolo, Joseph C. Okeibunor and Abdou Salam Gueyeadd Show full author list remove Hide full author list
Trop. Med. Infect. Dis. 2022, 7(8), 183; https://doi.org/10.3390/tropicalmed7080183 - 15 Aug 2022
Cited by 1 | Viewed by 1867
Abstract
Background: following the importation of the first Coronavirus disease 2019 (COVID-19) case into Africa on 14 February 2020 in Egypt, the World Health Organisation (WHO) regional office for Africa (AFRO) activated a three-level incident management support team (IMST), with technical pillars, to coordinate [...] Read more.
Background: following the importation of the first Coronavirus disease 2019 (COVID-19) case into Africa on 14 February 2020 in Egypt, the World Health Organisation (WHO) regional office for Africa (AFRO) activated a three-level incident management support team (IMST), with technical pillars, to coordinate planning, implementing, supervision, and monitoring of the situation and progress of implementation as well as response to the pandemic in the region. At WHO AFRO, one of the pillars was the health operations and technical expertise (HOTE) pillar with five sub-pillars: case management, infection prevention and control, risk communication and community engagement, laboratory, and emergency medical team (EMT). This paper documents the learnings (both positive and negative for consideration of change) from the activities of the HOTE pillar and recommends future actions for improving its coordination for future emergencies, especially for multi-country outbreaks or pandemic emergency responses. Method: we conducted a document review of the HOTE pillar coordination meetings’ minutes, reports, policy and strategy documents of the activities, and outcomes and feedback on updates on the HOTE pillar given at regular intervals to the Regional IMST. In addition, key informant interviews were conducted with 14 members of the HOTE sub pillar. Key Learnings: the pandemic response revealed that shared decision making, collaborative coordination, and planning have been significant in the COVID-19 response in Africa. The HOTE pillar’s response structure contributed to attaining the IMST objectives in the African region and translated to timely support for the WHO AFRO and the member states. However, while the coordination mechanism appeared robust, some challenges included duplication of coordination efforts, communication, documentation, and information management. Recommendations: we recommend streamlining the flow of information to better understand the challenges that countries face. There is a need to define the role and responsibilities of sub-pillar team members and provide new team members with information briefs to guide them on where and how to access internal information and work under the pillar. A unified documentation system is important and could help to strengthen intra-pillar collaboration and communication. Various indicators should be developed to constantly monitor the HOTE team’s deliverables, performance and its members. Full article
(This article belongs to the Special Issue COVID-19: Current Status and Future Prospects)
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9 pages, 392 KiB  
Article
Dengue and COVID-19: Managing Undifferentiated Febrile Illness during a “Twindemic”
by Liang En Wee, Edwin Philip Conceicao, Jean Xiang-Ying Sim, May Kyawt Aung, Aung Myat Oo, Yang Yong, Shalvi Arora and Indumathi Venkatachalam
Trop. Med. Infect. Dis. 2022, 7(5), 68; https://doi.org/10.3390/tropicalmed7050068 - 7 May 2022
Cited by 4 | Viewed by 3088
Abstract
Background: During the COVID-19 pandemic, distinguishing dengue from COVID-19 in endemic areas can be difficult, as both may present as undifferentiated febrile illness. COVID-19 cases may also present with false-positive dengue serology. Hospitalisation protocols for managing undifferentiated febrile illness are essential in mitigating [...] Read more.
Background: During the COVID-19 pandemic, distinguishing dengue from COVID-19 in endemic areas can be difficult, as both may present as undifferentiated febrile illness. COVID-19 cases may also present with false-positive dengue serology. Hospitalisation protocols for managing undifferentiated febrile illness are essential in mitigating the risk from both COVID-19 and dengue. Methods: At a tertiary hospital contending with COVID-19 during a dengue epidemic, a triage strategy of routine COVID-19 testing for febrile patients with viral prodromes was used. All febrile patients with viral prodromes and no epidemiologic risk for COVID-19 were first admitted to a designated ward for COVID-19 testing, from January 2020 to December 2021. Results: A total of 6103 cases of COVID-19 and 1251 cases of dengue were managed at our institution, comprising a total of 3.9% (6103/155,452) and 0.8% (1251/155,452) of admissions, respectively. A surge in dengue hospitalisations in mid-2020 corresponded closely with the imposition of a community-wide lockdown. A total of 23 cases of PCR-proven COVID-19 infection with positive dengue serology were identified, of whom only two were true co-infections; both had been appropriately isolated upon admission. Average length-of-stay for dengue cases initially admitted to isolation during the pandemic was 8.35 days (S.D. = 6.53), compared with 6.91 days (S.D. = 8.61) for cases admitted outside isolation (1.44 days, 95%CI = 0.58–2.30, p = 0.001). Pre-pandemic, only 1.6% (9/580) of dengue cases were admitted initially to isolation-areas; in contrast, during the pandemic period, 66.6% (833/1251) of dengue cases were initially admitted to isolation-areas while awaiting the results of SARS-CoV-2 testing. Conclusions: During successive COVID-19 pandemic waves in a dengue-endemic country, coinfection with dengue and COVID-19 was uncommon. Routine COVID-19 testing for febrile patients with viral prodromes mitigated the potential infection-prevention risk from COVID-19 cases, albeit with an increased length-of-stay for dengue hospitalizations admitted initially to isolation. Full article
(This article belongs to the Special Issue COVID-19: Current Status and Future Prospects)
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14 pages, 1980 KiB  
Article
Transmission of SARS-CoV-2 in the Population Living in High- and Low-Density Gradient Areas in Dhaka, Bangladesh
by Syed Moinuddin Satter, Taufiqur Rahman Bhuiyan, Zarin Abdullah, Marjahan Akhtar, Aklima Akter, S. M. Zafor Shafique, Muhammad Rashedul Alam, Kamal Ibne Amin Chowdhury, Arifa Nazneen, Nadia Ali Rimi, A. S. M. Alamgir, Mahbubur Rahman, Farzana Islam Khan, Tahmina Shirin, Meerjady Sabrina Flora, Sayera Banu, Mustafizur Rahman, Mahmudur Rahman and Firdausi Qadri
Trop. Med. Infect. Dis. 2022, 7(4), 53; https://doi.org/10.3390/tropicalmed7040053 - 25 Mar 2022
Cited by 2 | Viewed by 4075
Abstract
Community transmission of SARS-CoV-2 in densely populated countries has been a topic of concern from the beginning of the pandemic. Evidence of community transmission of SARS-CoV-2 according to population density gradient and socio-economic status (SES) is limited. In June–September 2020, we conducted a [...] Read more.
Community transmission of SARS-CoV-2 in densely populated countries has been a topic of concern from the beginning of the pandemic. Evidence of community transmission of SARS-CoV-2 according to population density gradient and socio-economic status (SES) is limited. In June–September 2020, we conducted a descriptive longitudinal study to determine the community transmission of SARS-CoV-2 in high- and low-density areas in Dhaka city. The Secondary Attack Rate (SAR) was 10% in high-density areas compared to 20% in low-density areas. People with high SES had a significantly higher level of SARS-CoV-2-specific Immunoglobulin G (IgG) antibodies on study days 1 (p = 0.01) and 28 (p = 0.03) compared to those with low SES in high-density areas. In contrast, the levels of seropositivity of SARS-CoV-2-specific Immunoglobulin M (IgM) were comparable (p > 0.05) in people with high and low SES on both study days 1 and 28 in both high- and low-density areas. Due to the similar household size, no differences in the seropositivity rates depending on the population gradient were observed. However, people with high SES showed higher seroconversion rates compared to people with low SES. As no difference was observed based on population density, the SES might play a role in SARS-CoV-2 transmission, an issue that calls for further in-depth studies to better understand the community transmission of SARS-CoV-2. Full article
(This article belongs to the Special Issue COVID-19: Current Status and Future Prospects)
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12 pages, 955 KiB  
Article
The Effectiveness of the Use of Regdanvimab (CT-P59) in Addition to Remdesivir in Patients with Severe COVID-19: A Single Center Retrospective Study
by Ganghee Chae, Aram Choi, Soyeoun Lim, Sooneun Park, Seungjun Lee, Youngick Ahn, Jinhyoung Kim, Seungwon Ra, Yangjin Jegal, Jongjoon Ahn, Eunji Park, Jaebum Jun, Woonjung Kwon and Taehoon Lee
Trop. Med. Infect. Dis. 2022, 7(3), 51; https://doi.org/10.3390/tropicalmed7030051 - 18 Mar 2022
Cited by 4 | Viewed by 2769
Abstract
Introduction: Coronavirus disease 2019 (COVID-19) still has a high mortality rate when it is severe. Regdanvimab (CT-P59), a neutralizing monoclonal antibody that has been proven effective against mild to moderate COVID-19, may be effective against severe COVID-19. This study was conducted to determine [...] Read more.
Introduction: Coronavirus disease 2019 (COVID-19) still has a high mortality rate when it is severe. Regdanvimab (CT-P59), a neutralizing monoclonal antibody that has been proven effective against mild to moderate COVID-19, may be effective against severe COVID-19. This study was conducted to determine the effectiveness of the combined use of remdesivir and regdanvimab in patients with severe COVID-19. Methods: From March to early May 2021, 124 patients with severe COVID-19 were admitted to Ulsan University Hospital (Ulsan, Korea) and received oxygen therapy and remdesivir. Among them, 25 were also administered regdanvimab before remdesivir. We retrospectively compared the clinical outcomes between the remdesivir alone group [n = 99 (79.8%)] and the regdanvimab/remdesivir group [n = 25 (20.2%)]. Results: The oxygen-free days on day 28 (primary outcome) were significantly higher in the regdanvimab/remdesivir group [mean ± SD: 19.36 ± 7.87 vs. 22.72 ± 3.66, p = 0.003]. The oxygen-free days was also independently associated with use of regdanvimab in the multivariate analysis, after adjusting for initial pulse oximetric saturation (SpO2)/fraction of inspired oxygen (FiO2) ratio (severity index). Further, in the regdanvimab/remdesivir group, the lowest SpO2/FiO2 ratio during treatment was significantly higher (mean ± SD: 237.05 ± 89.68 vs. 295.63 ± 72.74, p = 0.003), and the Kaplan-Meier estimates of oxygen supplementation days in surviving patients (on day 28) were significantly shorter [mean ± SD: 8.24 ± 7.43 vs. 5.28 ± 3.66, p = 0.024]. Conclusions: In patients with severe COVID-19, clinical outcomes can be improved by administering regdanvimab, in addition to remdesivir. Full article
(This article belongs to the Special Issue COVID-19: Current Status and Future Prospects)
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9 pages, 1143 KiB  
Article
Analysis of Excess All-Cause Mortality and COVID-19 Mortality in Peru: Observational Study
by Max Carlos Ramírez-Soto and Gutia Ortega-Cáceres
Trop. Med. Infect. Dis. 2022, 7(3), 44; https://doi.org/10.3390/tropicalmed7030044 - 5 Mar 2022
Cited by 15 | Viewed by 4238
Abstract
During the COVID-19 pandemic, an excess of all-cause mortality has been recorded in several countries, including Peru. Most excess deaths were likely attributable to COVID-19. In this study, we compared the excess all-cause mortality and COVID-19 mortality in 25 Peruvian regions to determine [...] Read more.
During the COVID-19 pandemic, an excess of all-cause mortality has been recorded in several countries, including Peru. Most excess deaths were likely attributable to COVID-19. In this study, we compared the excess all-cause mortality and COVID-19 mortality in 25 Peruvian regions to determine whether most of the excess deaths in 2020 were attributable to COVID-19. Excess deaths were calculated as the difference between the number of observed deaths from all causes during the COVID-19 pandemic (in 2020) and the number of expected deaths in 2020 based on a historical from recent years (2017–2019). Death data were retrieved from the Sistema Informatico Nacional de Defunciones (SINADEF) at the Ministry of Health of Peru from January 2017 to December 2020. Population counts were obtained from projections from Peru’s Instituto Nacional de Estadística e Informática (INEI). All-cause excess mortality and COVID-19 mortality were calculated by region per 100,000 population. Spearman’s test and linear and multiple regression models were used to estimate the correlation between excess all-cause mortality and COVID-19 mortality per 100,000 population. Excess all-cause death rates varied widely among regions (range: 115.1 to 519.8 per 100,000 population), and COVID-19 mortality ranged between 83.8 and 464.6 per 100,000 population. There was a correlation between the all-cause excess mortality and COVID-19 mortality (r = 0.90; p = 0.00001; y = 0.8729x + 90.808; R2 = 0.84). Adjusted for confounding factors (mean age in the region, gender balance, and number of intensive care unit (ICU) beds), the all-cause excess mortality rate was correlated with COVID-19 mortality rate (β = 0.921; p = 0.0001). These findings suggest that most of the excess deaths in Peru are related to COVID-19. Therefore, these findings can help decision-makers to understand the high COVID-19 mortality rates in Peru. Full article
(This article belongs to the Special Issue COVID-19: Current Status and Future Prospects)
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24 pages, 783 KiB  
Article
Depression, Anxiety and Associated Factors among Frontline Hospital Healthcare Workers in the Fourth Wave of COVID-19: Empirical Findings from Vietnam
by Quoc-Hung Doan, Nguyen-Ngoc Tran, Manh-Hung Than, Hoang-Thanh Nguyen, Van-San Bui, Dinh-Hung Nguyen, Hoang-Long Vo, Trong-Thien Do, Ngoc-Thach Pham, Tuan-Khanh Nguyen, Duc-Chinh Cao, Vu-Trung Nguyen, Thin-Mai T. Tran, Ba-Hien Pham, Anh-Long Tran, Van-Thuong Nguyen, Van-Thanh Nguyen, Xuan-Thang Tran, Duc-Truong Lai, Quang-Hieu Vu and Satoko Otsuadd Show full author list remove Hide full author list
Trop. Med. Infect. Dis. 2022, 7(1), 3; https://doi.org/10.3390/tropicalmed7010003 - 23 Dec 2021
Cited by 17 | Viewed by 4472
Abstract
(1) Background: This study aims to assess the magnitude of, and factors associated with, depression and anxiety among Vietnamese frontline hospital healthcare workers in the fourth wave of COVID-19; (2) Methods: A hospital based cross-sectional study was carried out within two weeks, October [...] Read more.
(1) Background: This study aims to assess the magnitude of, and factors associated with, depression and anxiety among Vietnamese frontline hospital healthcare workers in the fourth wave of COVID-19; (2) Methods: A hospital based cross-sectional study was carried out within two weeks, October 2020, at a central COVID-19 treatment hospital. Depression and anxiety were measured with PHQ-9 and GAD-7, respectively. Bivariate and multivariate logistic regression analysis were applied to recognize variables related to depression and anxiety, respectively; (3) Results: Among 208 frontline hospital healthcare workers, overall prevalence of depressive symptoms, anxiety symptoms, and both symptoms of depression and anxiety was 38.94%, 25.48% and 24.04%, respectively, in healthcare workers. In a reduced model after using multivariate stepwise logistic regression, age (OR = 0.9, p = 0.001), marital status (OR = 7.84, p = 0.027), profession (OR = 0.39, p = 0.028), having experienced traumatic stress following a work event (OR = 46.24, p < 0.001), feeling at very high risk for COVID-19 (OR = 0.02, p < 0.04), and affected by workplace conditions (OR = 5.36, p < 0.001) were associated with the symptoms of depression. With regard to symptoms of anxiety, single status (OR: 12.18, p = 0.002), being medical technician (OR: 68.89, p < 0.001), alcohol use (OR: 6.83, p = 0.014), using pain relief medications (OR: 25.50, p = 0.047), having experienced traumatic stress following a family event (OR: 130.32, p = 0.001), having experienced traumatic stress following a work event (OR: 181.55, p = 0.002), reporting at very high risk for COVID-19 (OR: 29.64, p = 0.011), treating moderate (OR: 6.46, p = 0.038) and severe (OR: 18.96, p = 0.004) COVID-19 patients, and being significantly affected by the community (OR: 6.33, p = 0.003) were increased risk factors for the symptoms of anxiety. Meanwhile, those living with 4–5 people (OR: 0.15, p = 0.011), specializing in infectious disease (OR: 0.13, p = 0.044)/resuscitation and emergency medicine (OR: 0.04, p = 0.046), and having knowledge preparation before participating in COVID-19 (OR: 0.008, p = 0.014) were less associated with the symptoms of anxiety; (4) Conclusions: There was a relatively high prevalence among Vietnamese hospital healthcare workers exhibiting symptoms of depression and anxiety during the ongoing pandemic. Greater attention to training in psychological skills should be suggested for those belonging to a younger age group, being single/widowed/divorced, treating moderate and severe COVID-19 patients, feeling at very high risk for COVID-19, being significantly affected a lot the community or workplace conditions, or experiencing traumatic stress following a family/work event in the past week. Full article
(This article belongs to the Special Issue COVID-19: Current Status and Future Prospects)
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7 pages, 944 KiB  
Article
Association between Obesity and COVID-19 Mortality in Peru: An Ecological Study
by Max Carlos Ramírez-Soto, Miluska Alarcón-Arroyo, Yajaira Chilcon-Vitor, Yelibeth Chirinos-Pérez, Gabriela Quispe-Vargas, Kelly Solsol-Jacome and Elizabeth Quintana-Zavaleta
Trop. Med. Infect. Dis. 2021, 6(4), 182; https://doi.org/10.3390/tropicalmed6040182 - 7 Oct 2021
Cited by 8 | Viewed by 3440
Abstract
There is a gap in the epidemiological data on obesity and COVID-19 mortality in low and middle-income countries worst affected by the COVID-19 pandemic, including Peru. In this ecological study, we explored the association between body mass index (BMI), the prevalence of overweight [...] Read more.
There is a gap in the epidemiological data on obesity and COVID-19 mortality in low and middle-income countries worst affected by the COVID-19 pandemic, including Peru. In this ecological study, we explored the association between body mass index (BMI), the prevalence of overweight and obesity, and the COVID-19 mortality rates in 25 Peruvian regions, adjusted for confounding factors (mean age in the region, mean income, gender balance and number of Intensive Care Unit (ICU) beds) using multiple linear regression. We retrieved secondary region-level data on the BMI average and prevalence rates of overweight and obesity in individuals aged ≥ 15 years old, from the Peruvian National Demographics and Health Survey (ENDES 2020). COVID-19 death statistics were obtained from the National System of Deaths (SINADEF) from the Peruvian Ministry of Health and were accurate as of 3 June 2021. COVID-19 mortality rates (per 100,000 habitants) were calculated among those aged ≥ 15 years old. During the study period, a total of 190,046 COVID-19 deaths were registered in individuals aged ≥ 15 years in 25 Peruvian regions. There was association between the BMI (r = 0.74; p = 0.00001) and obesity (r = 0.76; p = 0.00001), and the COVID-19 mortality rate. Adjusted for confounding factors, only the prevalence rate of obesity was associated with COVID-19 mortality rate (β = 0.585; p = 0.033). These findings suggest that as obesity prevalence increases, the COVID-19 mortality rates increase in the Peruvian population ≥ 15 years. These findings can help to elucidate the high COVID-19 mortality rates in Peru. Full article
(This article belongs to the Special Issue COVID-19: Current Status and Future Prospects)
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8 pages, 476 KiB  
Article
An Autochthonous Outbreak of the SARS-CoV-2 P.1 Variant of Concern in Southern Italy, April 2021
by Daniela Loconsole, Anna Sallustio, Francesca Centrone, Daniele Casulli, Maurizio Mario Ferrara, Antonio Sanguedolce, Marisa Accogli and Maria Chironna
Trop. Med. Infect. Dis. 2021, 6(3), 151; https://doi.org/10.3390/tropicalmed6030151 - 12 Aug 2021
Cited by 4 | Viewed by 3714
Abstract
The SARS-CoV-2 P.1 variant of concern (VOC) was first identified in Brazil and is now spreading in European countries. It is characterized by the E484K mutation in the receptor-binding domain, which could contribute to the evasion from neutralizing antibodies. In Italy, this variant [...] Read more.
The SARS-CoV-2 P.1 variant of concern (VOC) was first identified in Brazil and is now spreading in European countries. It is characterized by the E484K mutation in the receptor-binding domain, which could contribute to the evasion from neutralizing antibodies. In Italy, this variant was first identified in January 2021. Here, we report an autochthonous outbreak of SARS-CoV-2 P.1 variant infections in southern Italy in subjects who had not travelled to endemic areas or outside the Apulia region. The outbreak involved seven subjects, three of whom had received a COVID-19 vaccine (one had received two doses and two had received one dose). Four patients had a mild clinical presentation. Laboratory investigations of nasopharyngeal swabs revealed that all strains were S-gene target failure-negative and molecular tests revealed they were the P.1 variant. Whole-genome sequencing confirmed that five subjects were infected with closely related strains classified as the P.1 lineage. The circulation of VOCs highlights the importance of strictly monitoring the spread of SARS-CoV-2 variants through genomic surveillance and of investigating local outbreaks. Furthermore, public health measures including social distancing, screening, and quarantine for travelers are key tools to slow down the viral transmission and to contain and mitigate the impact of VOC diffusion, and rapid scaling-up of vaccination is crucial to avoid a possible new epidemic wave. Full article
(This article belongs to the Special Issue COVID-19: Current Status and Future Prospects)
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10 pages, 470 KiB  
Article
Newly Diagnosed Diabetes in Patients with COVID-19: Different Types and Short-Term Outcomes
by Alaa A. Farag, Hassan M. Hassanin, Hanan H. Soliman, Ahmad Sallam, Amany M. Sediq, Elsayed S. Abd elbaser and Khaled Elbanna
Trop. Med. Infect. Dis. 2021, 6(3), 142; https://doi.org/10.3390/tropicalmed6030142 - 2 Aug 2021
Cited by 26 | Viewed by 5917
Abstract
A great global concern is currently focused on the coronavirus disease 2019 (COVID-19) pandemic and its associated morbidities. The goal of this study was to determine the frequency of newly diagnosed diabetes mellitus (DM) and its different types among COVID-19 patients, and to [...] Read more.
A great global concern is currently focused on the coronavirus disease 2019 (COVID-19) pandemic and its associated morbidities. The goal of this study was to determine the frequency of newly diagnosed diabetes mellitus (DM) and its different types among COVID-19 patients, and to check the glycemic control in diabetic cases for three months. After excluding known cases of DM, 570 patients with confirmed COVID-19 were studied. All participants were classified as non-diabetic or newly discovered diabetic. According to hemoglobin A1c (HbA1c) and fasting insulin, newly discovered diabetic patients were further classified into pre-existing DM, new-onset type 1 DM, and new-onset type 2 DM. Glycemic control was monitored for three months in newly diagnosed diabetic patients. DM was diagnosed in 77 patients (13.5%); 12 (2.1%) with pre-existing DM, 7 (1.2%) with new-onset type 1 DM, and 58 (10.2%) with new-onset type 2 DM. Significantly higher rates of severe infection and mortality (p < 0.001 and p = 0.046) were evident among diabetic patients. Among survived diabetic patients (n = 63), hyperglycemia and the need for anti-diabetic treatment persisted in 73% of them for three months. COVID-19 was associated with a new-onset of DM in 11.4% of all participants and expression of pre-existing DM in 2.1% of all participants, both being associated with severe infection. COVID-19 patients with newly diagnosed diabetes had high risk of mortality. New-onset DM persisted for at least three months in more than two-thirds of cases. Full article
(This article belongs to the Special Issue COVID-19: Current Status and Future Prospects)
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Review

Jump to: Editorial, Research, Other

18 pages, 1135 KiB  
Review
Coagulopathy of Dengue and COVID-19: Clinical Considerations
by Amin Islam, Christopher Cockcroft, Shereen Elshazly, Javeed Ahmed, Kevin Joyce, Huque Mahfuz, Tasbirul Islam, Harunor Rashid and Ismail Laher
Trop. Med. Infect. Dis. 2022, 7(9), 210; https://doi.org/10.3390/tropicalmed7090210 - 25 Aug 2022
Cited by 7 | Viewed by 8253
Abstract
Thrombocytopenia and platelet dysfunction commonly occur in both dengue and COVID-19 and are related to clinical outcomes. Coagulation and fibrinolytic pathways are activated during an acute dengue infection, and endothelial dysfunction is observed in severe dengue. On the other hand, COVID-19 is characterised [...] Read more.
Thrombocytopenia and platelet dysfunction commonly occur in both dengue and COVID-19 and are related to clinical outcomes. Coagulation and fibrinolytic pathways are activated during an acute dengue infection, and endothelial dysfunction is observed in severe dengue. On the other hand, COVID-19 is characterised by a high prevalence of thrombotic complications, where bleeding is rare and occurs only in advanced stages of critical illness; here thrombin is the central mediator that activates endothelial cells, and elicits a pro-inflammatory reaction followed by platelet aggregation. Serological cross-reactivity may occur between COVID-19 and dengue infection. An important management aspect of COVID-19-induced immunothrombosis associated with thrombocytopenia is anticoagulation with or without aspirin. In contrast, the use of aspirin, nonsteroidal anti-inflammatory drugs and anticoagulants is contraindicated in dengue. Mild to moderate dengue infections are treated with supportive therapy and paracetamol for fever. Severe infection such as dengue haemorrhagic fever and dengue shock syndrome often require escalation to higher levels of support in a critical care facility. The role of therapeutic platelet transfusion is equivocal and should not be routinely used in patients with dengue with thrombocytopaenia and mild bleeding. The use of prophylactic platelet transfusion in dengue fever has strained financial and healthcare systems in endemic areas, together with risks of transfusion-transmitted infections in low- and middle-income countries. There is a clear research gap in the management of dengue with significant bleeding. Full article
(This article belongs to the Special Issue COVID-19: Current Status and Future Prospects)
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12 pages, 808 KiB  
Review
COVID-19: Current Status in Gastrointestinal, Hepatic, and Pancreatic Diseases—A Concise Review
by Jorge Aquino-Matus, Misael Uribe and Norberto Chavez-Tapia
Trop. Med. Infect. Dis. 2022, 7(8), 187; https://doi.org/10.3390/tropicalmed7080187 - 16 Aug 2022
Cited by 7 | Viewed by 2985
Abstract
The gastrointestinal tract plays an important role in the pathogenesis of COVID-19. The angiotensin-converting enzyme 2 receptor and the transmembrane protease serine 2 receptor bind and activate SARS-CoV-2 and are present in high concentrations throughout the gastrointestinal tract. Most patients present with gastrointestinal [...] Read more.
The gastrointestinal tract plays an important role in the pathogenesis of COVID-19. The angiotensin-converting enzyme 2 receptor and the transmembrane protease serine 2 receptor bind and activate SARS-CoV-2 and are present in high concentrations throughout the gastrointestinal tract. Most patients present with gastrointestinal symptoms and/or abnormal liver function tests, both of which have been associated with adverse outcomes. The mechanisms of liver damage are currently under investigation, but the damage is usually transient and nonsevere. Liver transplantation is the only definitive treatment for acute liver failure and end-stage liver disease, and unfortunately, because of the need for ventilators during the COVID-19 pandemic, most liver transplant programs have been suspended. Patients with gastrointestinal autoimmune diseases require close follow-up and may need modification in immunosuppression. Acute pancreatitis is a rare manifestation of COVID-19, but it must be considered in patients with abdominal pain. The gastrointestinal tract, including the liver and the pancreas, has an intimate relationship with COVID-19 that is currently under active investigation. Full article
(This article belongs to the Special Issue COVID-19: Current Status and Future Prospects)
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Other

8 pages, 644 KiB  
Opinion
Overlapping of Pulmonary Fibrosis of Postacute COVID-19 Syndrome and Tuberculosis in the Helminth Coinfection Setting in Sub-Saharan Africa
by Luis Fonte, Armando Acosta, María E. Sarmiento, Mohd Nor Norazmi, María Ginori, Yaxsier de Armas and Enrique J. Calderón
Trop. Med. Infect. Dis. 2022, 7(8), 157; https://doi.org/10.3390/tropicalmed7080157 - 30 Jul 2022
Cited by 3 | Viewed by 1814
Abstract
There is an increasing attention to the emerging health problem represented by the clinical and functional long-term consequences of SARS-CoV-2 infection, referred to as postacute COVID-19 syndrome. Clinical, radiographic, and autopsy findings have shown that a high rate of fibrosis and restriction of [...] Read more.
There is an increasing attention to the emerging health problem represented by the clinical and functional long-term consequences of SARS-CoV-2 infection, referred to as postacute COVID-19 syndrome. Clinical, radiographic, and autopsy findings have shown that a high rate of fibrosis and restriction of lung function are present in patients who have recovered from COVID-19. Patients with active TB, or those who have recovered from it, have fibrotic scarred lungs and, consequently, some degree of impaired respiratory function. Helminth infections trigger predominantly type 2 immune responses and the release of regulatory and fibrogenic cytokines, such as TGF-β. Here, we analyze the possible consequences of the overlapping of pulmonary fibrosis secondary to COVID-19 and tuberculosis in the setting of sub-Saharan Africa, the region of the world with the highest prevalence of helminth infection. Full article
(This article belongs to the Special Issue COVID-19: Current Status and Future Prospects)
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4 pages, 204 KiB  
Commentary
Commentary on COVID-19 Vaccine Hesitancy in sub-Saharan Africa
by Severin Kabakama, Eveline T. Konje, Jerome Nyhalah Dinga, Colman Kishamawe, Imran Morhason-Bello, Peter Hayombe, Olufela Adeyemi, Ernest Chimuka, Ivan Lumu, John Amuasi, Theophilus Acheampong and Tafadzwa Dzinamarira
Trop. Med. Infect. Dis. 2022, 7(7), 130; https://doi.org/10.3390/tropicalmed7070130 - 11 Jul 2022
Cited by 32 | Viewed by 4148
Abstract
Rates of vaccination against COVID-19 remain lower in sub-Saharan Africa than in other low and middle-income regions. This is, in part, attributed to vaccine hesitancy, mainly due to misinformation about vaccine origin, efficacy and safety. From August to December 2021, we gathered the [...] Read more.
Rates of vaccination against COVID-19 remain lower in sub-Saharan Africa than in other low and middle-income regions. This is, in part, attributed to vaccine hesitancy, mainly due to misinformation about vaccine origin, efficacy and safety. From August to December 2021, we gathered the latest experiences and opinions on four vaccine hesitancy-related areas (policies, perceived risk religious beliefs, and misinformation) from 12 sub-Saharan African researchers, four of whom have published about COVID-19 vaccine hesitancy. The authors included two political and business experts, six public health specialists, five epidemiologists, and four biostatisticians from ten sub-Saharan African countries( Cameroon, Ghana, Kenya, Liberia, Nigeria, Sierra Leone, South Africa, Tanzania, Uganda, and Zimbabwe). The authors’ overarching opinions were that political influences, religious beliefs and low perceived risk exists in sub-Saharan Africa, and they collectively contribute to COVID-19 vaccine hesitancy. Communication strategies should target populations initially thought by policy makers to be at low risk, use multiple communication avenues and address major concerns in the population. Full article
(This article belongs to the Special Issue COVID-19: Current Status and Future Prospects)
25 pages, 707 KiB  
Systematic Review
Characteristics of COVID-19 Breakthrough Infections among Vaccinated Individuals and Associated Risk Factors: A Systematic Review
by Shilpa Gopinath, Angela Ishak, Naveen Dhawan, Sujan Poudel, Prakriti Singh Shrestha, Prabhjeet Singh, Emily Xie, Peggy Tahir, Sima Marzaban, Jack Michel and George Michel
Trop. Med. Infect. Dis. 2022, 7(5), 81; https://doi.org/10.3390/tropicalmed7050081 - 22 May 2022
Cited by 19 | Viewed by 4331
Abstract
We sought to assess breakthrough SARS-CoV-2 infections in vaccinated individuals by variant distribution and to identify the common risk associations. The PubMed, Web of Science, ProQuest, and Embase databases were searched from 2019 to 30 January 2022. The outcome of interest was breakthrough [...] Read more.
We sought to assess breakthrough SARS-CoV-2 infections in vaccinated individuals by variant distribution and to identify the common risk associations. The PubMed, Web of Science, ProQuest, and Embase databases were searched from 2019 to 30 January 2022. The outcome of interest was breakthrough infections (BTIs) in individuals who had completed a primary COVID-19 vaccination series. Thirty-three papers were included in the review. BTIs were more common among variants of concern (VOC) of which Delta accounted for the largest number of BTIs (96%), followed by Alpha (0.94%). In addition, 90% of patients with BTIs recovered, 11.6% were hospitalized with mechanical ventilation, and 0.6% resulted in mortality. BTIs were more common in healthcare workers (HCWs) and immunodeficient individuals with a small percentage found in fully vaccinated healthy individuals. VOC mutations were the primary cause of BTIs. Continued mitigation approaches (e.g., wearing masks and social distancing) are warranted even in fully vaccinated individuals to prevent transmission. Further studies utilizing genomic surveillance and heterologous vaccine regimens to boost the immune response are needed to better understand and control BTIs. Full article
(This article belongs to the Special Issue COVID-19: Current Status and Future Prospects)
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19 pages, 1676 KiB  
Systematic Review
Global and Regional Prevalence and Outcomes of COVID-19 in People Living with HIV: A Systematic Review and Meta-Analysis
by Tope Oyelade, Jaber S. Alqahtani, Ahmed M. Hjazi, Amy Li, Ami Kamila and Reynie Purnama Raya
Trop. Med. Infect. Dis. 2022, 7(2), 22; https://doi.org/10.3390/tropicalmed7020022 - 3 Feb 2022
Cited by 30 | Viewed by 4664
Abstract
Background: The relationship between HIV (human immunodeficiency virus) and COVID-19 clinical outcome is uncertain, with conflicting data and hypotheses. We aimed to assess the prevalence of people living with HIV (PLWH) among COVID-19 cases and whether HIV infection affects the risk of severe [...] Read more.
Background: The relationship between HIV (human immunodeficiency virus) and COVID-19 clinical outcome is uncertain, with conflicting data and hypotheses. We aimed to assess the prevalence of people living with HIV (PLWH) among COVID-19 cases and whether HIV infection affects the risk of severe COVID-19 or related death at the global and continental level. Methods: Electronic databases were systematically searched in July 2021. In total, 966 studies were screened following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Narratives were synthesised and data pooled for the global and continental prevalence of HIV–SARS-CoV-2 coinfection. The relative risks of severity and mortality in HIV-infected COVID-19 patients were computed using a random-effect model. Risk of bias was assessed using the Newcastle–Ottawa score and Egger’s test, and presented as funnel plots. Results: In total, 43 studies were included involving 692,032 COVID-19 cases, of whom 9097 (1.3%) were PLWH. The global prevalence of PLWH among COVID-19 cases was 2% (95% CI = 1.7–2.3%), with the highest prevalence observed in sub-Saharan Africa. The relative risk (RR) of severe COVID-19 in PLWH was significant only in Africa (RR = 1.14, 95% CI = 1.05–1.24), while the relative risk of mortality was 1.5 (95% CI = 1.45–2.03) globally. The calculated global risk showed that HIV infection may be linked with increased COVID-19 death. The between-study heterogeneity was significantly high, while the risk of publication bias was not significant. Conclusions: Although there is a low prevalence of PLWH among COVID-19 cases, HIV infection may increase the severity of COVID-19 in Africa and increase the risk of death globally. Full article
(This article belongs to the Special Issue COVID-19: Current Status and Future Prospects)
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Systematic Review
SARS-CoV-2 mRNA Vaccine Breakthrough Infections in Fully Vaccinated Healthcare Personnel: A Systematic Review
by Caterina Ledda, Claudio Costantino, Giuseppe Motta, Rosario Cunsolo, Patrizia Stracquadanio, Giuseppe Liberti, Helena C. Maltezou and Venerando Rapisarda
Trop. Med. Infect. Dis. 2022, 7(1), 9; https://doi.org/10.3390/tropicalmed7010009 - 13 Jan 2022
Cited by 14 | Viewed by 4087
Abstract
The number of people vaccinated against COVID-19 increases worldwide every day; however, it is important to study the risk of breakthrough infections in vaccinated individuals at high risk of exposure such as healthcare personnel (HCP). A systematic literature review (SLR) applying the PRISMA [...] Read more.
The number of people vaccinated against COVID-19 increases worldwide every day; however, it is important to study the risk of breakthrough infections in vaccinated individuals at high risk of exposure such as healthcare personnel (HCP). A systematic literature review (SLR) applying the PRISMA declaration and the PECOS format using the following entry terms was used: “Health Personnel OR Healthcare Worker OR Healthcare Provider OR Healthcare Personnel AND breakthrough OR infection after vaccine*”. The research was carried out utilizing the following databases: SCOPUS, PubMed, Embase, and Web of Sciences. An overall very low incidence of post-vaccination breakthrough infections was found, ranging from 0.011 to 0.001 (per 100 individuals at risk). Our findings further support the published high effectiveness rates of mRNA vaccines in preventing SARS-CoV-2 infections among fully vaccinated HCP. Additional studies are needed to define the duration of the vaccine-induced protection among HCP. Full article
(This article belongs to the Special Issue COVID-19: Current Status and Future Prospects)
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