Search Results (339)

This study examines changes in frailty among patients hospitalized for acute ischemic stroke (AIS) in a nationwide hospital cohort in Germany. Data from AIS patients were compared between the period before the corona virus disease 2019 (COVID-19)-pandemic (1 January 2016 to 31 December 2019) vs the pandemic phase (1 January 2020 to 31 December 2022). Frailty was categorized using the Hospital Frailty Risk Score (HFRS). Inferential statistics were conducted using generalized linear mixed models. Among the 101,124 included AIS patients, the median HFRS decreased from 9.3 (interquartile range [IQR]: 5.2–15.5) in pre-pandemic years to 8.4 (IQR: 4.4–14.2) during the pandemic (p < 0.01). Among high frailty AIS patients, length of stay rose from 15.7 (±14.9) to 16.0 (±15.0) days, differing significantly from the decrease observed among low frailty patients from 5.9 (±3.7) to 5.0 (±3.5; p < 0.01) days. Compared to pre-pandemic levels, among low frailty patients, there was a significant increase in rates of thrombolysis (odds ratio [OR] 1.14 [95% CI 1.02–1.28; p = 0.020]) and thrombectomy (OR 1.35 [1.32–1.48; p = 0.047]). In this nationwide study in Germany, there was a longitudinal decrease in frailty among patients hospitalized for AIS which was accompanied by increased rates of thrombolysis and thrombectomy. Full article

Background: During the global outbreak of coronavirus disease 2019 (COVID-19), the Kingdom of Saudi Arabia (KSA) ranked second in terms of the highest rate of confirmed cases among the Arab Gulf countries. This situation significantly impacted its population, economy, and healthcare system, especially the psychological well-being of frontline healthcare workers, including frontline nurses. However, there is lack of studies on this topic, particularly on the experiences of frontline expatriate nurses in the KSA, necessitating the utilization of descriptive phenomenological design. Objective: This study aimed to explore the experiences of frontline expatriate nurses and their influence on psychological well-being while delivering care to patients with COVID-19. Methods: The study employed a qualitative, descriptive phenomenological design that adhered to the key features of Husserl’s phenomenological approach and purposive sampling to select 17 frontline expatriate nurses. They participated in face-to-face semi-structured interviews. Prior to the 17 semi-structured interviews, written consent was obtained from each of the frontline expatriate nurses. The qualitative data collected were analyzed through thematic analysis and rigor was ensured in this qualitative investigation. Results: Two primary themes were identified from the interviews: (1) psychological effects due to fear of contracting the corona virus, which included two sub-themes pertaining to organizational stressors resulting in having anxiety, depression, fear, mental stress, and stigmatization; and (2) resilience to cope with the challenges brought by the pandemic, which was characterized by three sub-themes focusing on the importance of accurate information, presence of family and social support, and maintaining good health. The expatriate status of frontline nurses is a key factor influencing in their psychological well-being and resilience. Conclusions: Findings indicated that the psychological well-being of frontline expatriate nurses was adversely affected during the pandemic while caring for COVID-19 patients. Consequently, targeted interventions aimed at alleviating the negative psychological impacts of the pandemic are urgently needed to bolster the resilience of frontline expatriate nurses in emergency situations such as the COVID-19 crisis to cope with the associated psychological challenges during the peak of the pandemic, particularly among expatriate nurses. Full article

Background/Objectives: The COVID-19 pandemic was characterized by the rapid transmission of the virus and a global race for vaccines, with vaccines such as AstraZeneca, CoronaVac, Pfizer, and Janssen arriving in Brazil in 2020. Concurrently, an infodemic of information, driven by the media and social media, highlighted the importance of health communication. This study examines how online newspapers in a Brazilian state disseminated information about vaccination and its relationship with vaccine adherence among the population. Methods: Quantitative research, in which a total of 5308 journalistic articles were verified, using two databases, one for the publication of journalistic articles and the other for vaccinations in the state, which applied 9,577,567 doses in the period. Results: The analyses demonstrated a positive correlation between the number of publications of articles and the number of applications of vaccines (rho = 0.407, p-value < 0.0005), revealing a relationship of both increase and decrease in the publication of newspaper articles and the application of vaccines in specific weeks during the analysis period. Vaccination data revealed low adherence to the booster dose by the population, with unequal values among the cities of the state. Conclusions: The study highlighted the potential importance of newspapers in disseminating information about vaccines during the pandemic, underscoring the need for regional health strategies to increase vaccination coverage. Full article

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) raced around the world across different populations; there needs to be a consolidated effort to understand the divergence of the epidemiology of SARS-CoV-2. Population-based epidemiological characteristics studies measure the extent of SARS-CoV-2 infection in a country. The current research study was designed to report epidemiological data from Pakistan. For this purpose, 246 SARS-CoV-2-infected patients were included in the study. For SARS-CoV-2 confirmation, viral samples were collected from all the study participants; SARS-CoV-2 infection was confirmed by viral nucleic acid detection using a nucleic acid detection kit. After SARS-CoV-2 confirmation, all the study participants were interviewed for epidemiological data through a detailed questionnaire. The study results showed that the disease ratio was higher between 30 and 59 years (51.21%) of age. The male ratio (55.28%) was higher compared to the female ratio (44.71%). The patients’ illiteracy and low socioeconomic status were 32.52% and 59.75%, respectively. The majority of the patients (97.56%) had cough, smell or taste disturbance (79.67%), or fever (76.42%), and 70.73% had fatigue. For comorbidities, a higher ratio was observed for diabetes (38.61%), hypertension (36.17%), and respiratory disease (16.26%). The vaccination status analysis revealed that 51.21% of patients had not received routine immunizations, and 65.5% were un-vaccinated against SARS-CoV-2. Notably, not a single patient was vaccinated for influenza vaccine. The current research study concluded that SARS-CoV-2 was more prevalent in individuals who were middle aged, male, and had low socio-economic status. The most common symptoms were cough, smell or taste disturbance, and fever. The patients’ vaccination status highlights a critical gap in preventive healthcare and shows the need to strengthen vaccination awareness and accessibility in the population to reduce vulnerability to future outbreaks. Future research should focus on investigating the impact of COVID-19 outcomes on comorbidities such as diabetes and hypertension. Full article

From the corona virus pandemic in Japan that started with the “Diamond Princess” accident, it became clear that rapid detection, a high sensitivity, multiple diagnostic items, one-step one-base point mutation detection, a fast speed of system development, portability (small size and light weight), full automation, random access, and other conditions are required for future point-of-care testing systems. The Eprimer-SmartAmp technology that was developed possesses characteristics fully aligned with these requirements. Building upon this platform, the “GenPad” system was subsequently established. The GenPad system is widely applicable not only to emerging foreign infectious diseases, but also to cancer, lifestyle-related diseases, and other areas of healthcare through telemedicine and intraoperative nucleic acid diagnoses. In collaboration with telecommunication systems, GenPad is expected to contribute to the establishment of a smart medical city with a countermeasure against emerging foreign infectious diseases, where individuals can check their own health conditions in all healthcare areas. Full article

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a rising threat for immunocompromised cancer patients. The reduced immune defense may be a result of the malignancy itself or a side effect of therapy. While many chemotherapies can severely diminish the effect of vaccines against SARS-CoV-2, the effect of radioligand therapy has not yet been studied so far. Methods: In our database, 64 patient records of patients with metastatic castration-resistant prostate cancer that were treated with PSMA-directed radioligand therapy (PRLT) were randomly selected and checked for specific information (vaccination status, past corona virus disease 2019 (COVID-19) infections, the period between PRLT and vaccination, and antibody titers). A total of 30 patient records had sufficient information to examine the interference between PRLT and the vaccination against SARS-CoV-2. Results: In the analyzed cohort, 96.7% of the patients achieved seroconversion after receiving—on average—the third (booster) vaccination against SARS-CoV-2 and two PRLT cycles with average administered activities of 16.1 ± 7.2 GBq (435.1 ± 194.6 mCi) of lutetium-177 and 13.7 ± 6.6 MBq (0.37 ± 0.18 mCi) of actinium-225 (as part of ‘TANDEM therapies’) per patient. Conclusions: In the reviewed population, neither the initial response nor the maintenance of a positive immune response against the SARS-CoV-2 virus was undesirably affected by PRLT. The seroconversion rate and the absolute immune titers (in many cases >25,000 BAU/mL) are comparable to the normal population. This result implies the clinically important conclusion that neither an initial nor a booster vaccination against COVID-19 must be postponed if a PRLT is planned (and vice versa). Full article

Background: The rapid expansion of telemedicine globally, especially during the COVID-19 pandemic, has been critical for maintaining the continuity of chronic care, including in low- and middle-income countries (LMICs). In the context of maintaining health services during major hazards, telemedicine offers a potential solution for reducing the impact of associated disruptions and maintaining the functionality of hospitals. This study aims to evaluate the application of telemedicine for chronic diseases in LMICs during COVID-19, with a focus on its role in enhancing health system resilience during disastrous events. Methods: A systematised review was conducted by searching PubMed, Scopus, Global Health, and Google Scholar for primary literature published between January 2020 and July 2023. English-language articles on chronic disease management were targeted; they were freely accessible and excluded abstracts, conference papers, posters, and grey literature. A multilevel evaluation framework was applied, covering access, cost, patient and health worker experiences, and the effectiveness of telemedicine interventions. Results: After screening one thousand six hundred seventy-eight records, twenty-three studies and two additional snowball-sourced papers from ten countries were included. Findings revealed that while telemedicine enhanced access to care, patient experiences, and effectiveness, cost analysis remains an understudied area. Discrepancies in perspectives were noted between patients and health workers, particularly regarding access and effectiveness. Nevertheless, the majority of studies agree on telemedicine’s positive impact on the accessibility and resilience of health systems during major emergencies, which reduces costs and improves the overall patient experience. However, concerns such as outdated regulations and policies and poor internet connectivity pose a challenge that needs to be addressed. Conclusions: This review highlights the potential of telemedicine in strengthening health system resilience, particularly in LMICs where more work is needed to update regulations and policies and to strengthen infrastructure for more affordable and uninterruptable connectivity. Further research is needed to explore the long-term sustainability of telemedicine in these contexts and to identify strategies for successful implementation across diverse public health challenges. Full article

Background: The COVID-19 pandemic has spurred a global race for a preventive vaccine, with a few becoming available just one year after describing this novel coronavirus disease. Among these are inactivated virus vaccines like CoronaVac (Sinovac Biotech), which are used in several countries to reduce the pandemic’s effects. However, its use was associated with low protection, particularly against novel virus variants that quickly appeared in the following months. Vaccines play a crucial role in activating the immune system to combat infections, with Memory B-cells being a key part of this mechanism, eliciting protective neutralizing antibodies. This work focused on studying B-cell memory repertoire after two consecutive doses of CoronaVac. Methodology: Memory B-cells were isolated from five CoronaVac vaccinated and five pre-pandemic individuals and subsequently stimulated in vitro before high-throughput Illumina sequencing of the Heavy Chain Variable repertoire. Results: We observed a shift in the VH repertoire with increased HCDR3 length and enrichment of IGVH 3-23, 3-30, 3-7, 3-72, and 3-74 for IgA BCRs and IGHV 4-39 and 4-59 for IgG BCRs. A high expansion of IgA-specific clonal populations was observed in vaccinated individuals relative to pre-pandemic controls, accompanied by shared IgA variable heavy chain (VH) sequences among memory B cells across different vaccine recipients of IgA clones was also observed in vaccinated individuals compared to pre-pandemic controls, with several IgA VH sharing between memory B cells from different vaccines. Moreover, a high convergence was observed among vaccinees and SARS-CoV-2 neutralizing antibody sequences found in the CoV-abDab database. Conclusion: These data show the ability of CoronaVac to elicit antibodies with characteristics similar to those previously identified as neutralizing antibodies, supporting its protective efficacy. Furthermore, this analysis of the immunological repertoire in the context of viral infections reinforces the importance of immunization in generating convergent antibodies for the antiviral response. Full article

Feline infectious peritonitis (FIP), a devastating disease with near-complete mortality, is caused by the feline coronavirus (FCoV) and affects domestic cats worldwide. Herein, we report the development of a reverse transcription loop-mediated isothermal amplification (RT-LAMP) assay incorporating xylenol orange (XO) as a visual indicator for FCoV detection. The assay employed six oligonucleotide primers targeting regions of the nucleocapsid (N) gene. Under optimized conditions (65 °C, 60 min), amplification products were detected through pH-dependent colour changes in the XO dye. The RT-LAMP-XO assay exhibited high specificity for FCoV, with no cross-reactivity against other common feline viral pathogens. While the detection limit (1.7 × 10¹ copies/µL) was an order of magnitude higher than that of qPCR, the method offered advantages in simplicity and speed compared to existing diagnostic approaches. Although less sensitive than qPCR, the RT-LAMP-XO assay may serve as a rapid screening tool when used in combination with additional primer sets. These findings demonstrate the potential utility of XO-based RT-LAMP as a simple, visual detection method for FCoV infection. Full article

Sleep–wake disturbances are common in post-COVID-19 syndrome but lack extensive objective characterization. This study evaluated sleep–wake patterns in 31 patients with post-COVID-19 syndrome referred for fatigue and excessive daytime sleepiness (EDS). Assessments included questionnaires (the fatigue severity scale, the Epworth sleepiness scale, and the Beck Depression Index-II), video polysomnography (V-PSG), the multiple sleep latency test (MSLT, n = 15), and actigraphy (n = 29). Patients (70% female, mean age 45 years) had mostly mild acute SARS-CoV-2 infections and were assessed a median of 31 weeks post-infection. Fatigue (fatigue severity scale, median 6.33), sleepiness (the Epworth sleepiness scale, median 15), and depression (Beck depression inventory-II, median 20) scores were elevated. V-PSG showed moderate sleep apnea in 35.5%, increased arousal index in 77.4%, and median sleep stage percentages of NREM1 (12%), NREM2 (37%), NREM3 (19%), and REM (15.8%). MSLT revealed only 13.3% with sleep latencies under 8 min and no sleep-onset REM periods. Actigraphy indicated increased inactivity index in 96.6%, with high variability in time in bed. These findings highlight a polysomnographic and actigraphic profile of increased arousal and clinophilia, alongside moderate sleep apnea and limited objective sleepiness on MSLT. Addressing these multifactorial sleep disturbances is crucial in managing post-COVID-19 syndrome. Full article

Background/Objectives: Feline coronavirus (FCoV) belongs to the family Coronaviridae and includes two pathotypes, the less virulent feline enteric coronavirus (FECV), which replicates in the enteric epithelial cells, and feline infectious peritonitis virus (FIPV), which is more virulent, replicates efficiently within monocytes/macrophages with systemic involvement and may cause feline infectious peritonitis (FIP), a progressive and often fatal disease. The diagnosis of FIP is complex and requires different examinations. Among serological tests, the indirect immunofluorescent antibody test (IFAT), considered the gold standard, and the enzyme-linked immunosorbent assay (ELISA) are the most widely used to detect FCoV antibodies. The aim of this work was the development of FCoVCHECK Ab ELISA, a new rapid indirect test for the detection of FCoV antibodies in feline serum/plasma samples. Methods: FCoVCHECK Ab ELISA was developed after a meticulous set-up and cut-off analysis through several methods, including the Youden’s index and ROC curve, to achieve the best test performance. It was validated by testing 110 feline sera (62 positives and 48 negatives) against the reference IFAT and compared with two other rapid ELISA tests, INgezim Corona Felino (Gold Standard Diagnostics) and ImmunoComb Feline Coronavirus (FCoV) [FIP] Antibody Test Kit (Biogal). Conclusions: FCoVCHECK Ab ELISA agreed with IFAT at 96.4% (93.5% sensitivity, 95% confidence interval (CI): 83.5–97.9%; 100% specificity, 95% CI: 90.8–100%), with ImmunoComb FCoV at 93.6% and with INgezim Corona Felino at 82.7%. Intra- and inter-assay accuracy and precision gave coefficients of variation lower than 20%. Compared to IFAT, the new assay correctly identifies positive and negative samples with a good correlation, and, in addition, it is simpler, faster and provides a less subjective reading of the results. Full article

Carica papaya, a tropical fruit-bearing plant, has attracted significant attention for its diverse phytomedical properties and its ability to regulate both innate and adaptive immunity, making it a promising natural therapeutic agent. C. papaya is rich in bioactive compounds that play a multifaceted role in immunomodulation. These bioactive constituents have demonstrated efficacy not only against the dengue virus but also against other viral infections, including COVID-19 (Corona Virus Disease 2019), Human Immunodeficiency Virus (HIV), Zika virus, and others. The antiviral effects of C. papaya are achieved through its ability to enhance host immunity, mitigate inflammation, reduce oxidative stress, inhibit viral replication, and modulate immune responses. These mechanisms highlight its potential as a candidate for antiviral therapies, paving the way for further exploration of its pharmacological applications and promoting eco-friendly, accessible healthcare solutions for combating viral diseases. This review highlights the antiviral potential of C. papaya extracts in inhibiting viral replication and modulating immune responses, emphasizing the need for further studies and clinical trials to validate their efficacy against other medically significant viruses causing human diseases. Full article

Since the onset of the COVID-19 (COronaVIrus Disease 19) pandemic, SARS-CoV-2 has exhibited a high transmission rate, further enhanced by new variants able to better adapt to humans. Addressing this issue has been challenging due to viral resistance and side effects associated with antiviral drugs and vaccines. As a result, there has been a growing interest in plant-derived compounds with antiviral properties. Our study revealed that pistachio extracts significantly inhibited SARS-CoV-2 viral entry. Employing pseudotyped particles bearing the S protein of SARS-CoV-2, we demonstrated that treatment with pistachio extracts inhibited binding of alpha (α) and omicron (ο) SARS-CoV-2 variants. Furthermore, our study revealed that the pistachio carotenoid zeaxanthin exhibited a different inhibitory activity against two SARS-CoV-2 variants. In silico analyses demonstrated a strong interaction between zeaxanthin and the receptor-binding domain (RBD) domain of the omicron spike (S) protein, thus reducing pseudovirus entry. However, zeaxanthin’s weaker interaction with the alpha variant’s RBD was insufficient to inhibit entry. Additionally, zeaxanthin suppressed the expression of the host protease TMPRSS2 at the protein level, thereby limiting the internalization of the alpha variant, which relies on TMPRSS2 for cellular entry. Full article

Background/Objectives: Corona virus disease 2019 (COVID-19) poses a threat to global public health. The early identification of critical cases is crucial to providing timely treatment to patients. Here, we investigated whether the neutrophil levels could predict COVID-19 complications. Methods: We performed a retrospective study of patients with COVID-19, admitted to the Cheikh Khalifa International University Hospital, Casablanca, Morocco. Laboratory test results collected upon admission and during hospitalization were analyzed based on clinical information. Results: Our study revealed that a rise in neutrophil “PNN” levels was associated with respiratory deterioration and intubation. They were positively correlated with the procalcitonin and C-reactive protein levels. Interestingly, PNN (polynuclear neutrophil) levels on day 5 proved to be a better predictor of intubation, acute respiratory distress syndrome (ARDS), and mortality than the initial PNN counts, C-reactive protein, or procalcitonin. Moreover, binary logistic regression with stratified PNN-day 5 data revealed that a PNN level on day 5 > 7.7 (109/L) was an independent risk factor for mortality and ARDS. Finally, the PNN levels on day 5 and proinflammatory cytokine IL-6 were positively correlated. Conclusions: Our data showed that neutrophilia proved to be an excellent predictor of complications and mortality during hospitalization and could be used to improve the management of patients with COVID-19. Full article

Objective: To evaluate the humoral response to and impact of SARS-CoV-2 vaccination in patients with systemic lupus erythematosus in a multicenter cohort design. Methods: Data for this analysis were obtained from the Study of Safety, Effectiveness and Duration of Immunity after Vaccination against SARS-CoV-2 in Patients with Immune-Mediated Inflammatory Diseases (SAFER), a prospective, multicenter, phase IV, real-world study conducted across different regions of Brazil from June/2021 to March/2024. Patients aged >18 years with systemic lupus erythematosus (SLE) who received any one of the SARS-CoV-2 vaccines approved by the Brazilian health regulatory agency (CoronaVac [inactivated SARS-CoV-2 vaccine], ChAdOx-1 [AstraZeneca], or BNT162b2 [Pfizer-BioNTech]) were included. Immunogenicity was assessed in pre- and post-vaccination blood samples, and patients were monitored in person and remotely for the occurrence and severity of COVID-19. Results: Two hundred and thirty-five patients with SLE who had completed their vaccination schedules (two doses + booster dose) were included in this study. Most patients were female (89.3%) and had low disease activity or were in remission (72.4%); the majority were also on some form of immunosuppressive therapy (58.1%). One hundred and sixteen patients received two doses of CoronaVac followed by one dose of BNT162b2 (Pfizer-BioNTech) vaccine, eighty-seven received two doses of ChAdOx1-S (AstraZeneca) followed by one dose of BNT162b2 (Pfizer-BioNTech) vaccine, and thirty-two received three doses of BNT162b2 (Pfizer-BioNTech) vaccine. Twenty-eight cases of COVID-19, none meeting criteria for severe COVID-19, were recorded in patients with respiratory symptoms after the second dose of a SARS-CoV-2 vaccine. Regarding immunogenicity, an increase in seroconversion rate was observed following consecutive vaccine doses, with no difference between vaccination schedules, reaching 97.57% seropositivity after a booster dose. The geometric mean IgG titers differed between the different vaccination schedules after the first and the second vaccine dose, being lowest for the CoronaVac-based schedule, but titers were similar after the administration of a booster dose. Conclusion: In patients with SLE, SARS-CoV-2 vaccines are immunogenic, inducing a robust humoral response. No severe outcomes associated with death or hospitalization were found in the evaluated patient sample. Complete vaccination schedules including a booster dose induced higher humoral responses than incomplete schedules, especially in patients initially immunized with an inactivated virus vaccine schedule and those with a suboptimal humoral response. Full article