Choroiditis following severe acute respiratory syndrome coronavirus 2 infection in unvaccinated identical twins

ABSTRACT Unvaccinated identical twins developed bilateral anterior uveitis soon after the onset of coronavirus disease 2019 symptoms. During follow-up, both patients developed choroiditis, and one twine developed posterior scleritis and serous retinal detachment. Prompt treatment with oral prednisone ameliorated the lesions, and no recurrence was observed at the 18-month follow-up. Choroiditis may rarely be associated with severe acute respiratory syndrome coronavirus 2 infection, and it responds well to corticosteroid therapy. Although the exact mechanism is unknown, we hypothesize that the virus may act as an immunological trigger for choroiditis.

Prevalência de Influenza A, vírus sincicial respiratório eSARS-CoV-2 em pacientes com síndrome respiratóriaaguda grave em Passo Fundo, Rio Grande do Sul / Prevalence of Influenza A, respiratory syncytial virus andSARS-CoV-2 in patients with severe acute respiratorysyndrome in Passo Fundo, Rio Grande do Sul

A síndrome respiratória aguda grave (SRAG) é caracterizada por sintomas de febre alta, tosse e dispneia, e, na maioria dos casos, relacionada a uma quantidade reduzida de agentes infecciosos. O objetivo foi avaliar a prevalência dos vírus respiratórios Influenza A (FluA), vírus sincicial respiratório (RSV) e do novo coronavírus (SARS-CoV-2) em pacientes com internação hospitalar por SRAG. Estudo transversal, com pacientes em internação hospitalar com SRAG entre novembro de 2021 e maio de 2022. Dados sociodemográficos e clínicos e amostras da nasofaringe foram coletados/as, as quais foram submetidas à extração de RNA e testadas quanto à positividade para Influenza A, RSV e SARS-CoV-2 por meio da técnica de PCR em tempo real pelo método SYBR Green. Foram incluídos 42 pacientes, sendo 59,5% do sexo feminino, 57,1% idosos, 54,8% com ensino fundamental. A maior parte dos pacientes reportou hábito tabagista prévio ou atual (54,8%), não etilista (73,8%) e 83,3% deles apresentavam alguma comorbidade, sendo hipertensão arterial sistêmica e diabetes mellitus tipo 2 as mais prevalentes. Um total de 10,5% dos pacientes testou positivo para FluA, nenhuma amostra positiva para RSV e 76,3% positivos para SARS-CoV-2. Na população estudada, SRAG com agravo hospitalar foi observado em maior proporção, em mulheres, idosos e pessoas com comorbidades, embora sem significância estatística, sendo o novo coronavírus o agente etiológico mais relacionado, o que evidencia a patogenicidade desse agente e suas consequências ainda são evidentes após quase 2 anos de período pandêmico.

Severe acute respiratory syndrome (SARS) is characterized by symptoms of high fever, cough and dyspnea, and is in most cases related to a reduced amount of infectious agents. The objective was to assess the prevalence of respiratory viruses Influenza A (FluA), respiratory syncytial virus (RSV) and the new coronavirus (SARS-CoV-2) in patients hospitalized for SARS. Cross-sectional study, with patients hospitalized with SARS between November 2021 and May 2022. Sociodemographic and clinical data and nasopharyngeal samples were collected, which were subjected to RNA extraction and tested for positivity for Influenza A, RSV and SARS-CoV-2 using the real-time PCR technique using the SYBR Green method. 42 patients were included, 59.5% female, 57.1% elderly, 54.8% with primary education. Most patients reported previous or current smoking habits (54.8%), non-drinkers (73.8) and 83.3% of them had some comorbidity, with systemic arterial hypertension and type 2 diabetes mellitus being the most prevalent. A total of 10.5% of patients tested positive for FluA, no samples positive for RSV, and 76.3% positive for SARS-CoV-2. In the studied population, SARS with hospital injury was observed more frequently in women and the elderly, with associated comorbidities, with the new coronavirus being the most related etiological agent, which shows, although not statistically significant, that the pathogenicity of this agent and its consequences are still evident after almost 2 years of period pandemic.

Estresse percebido e sofrimento psíquico em gestoresde saúde na pandemia da Covid-19 / Perceived stress and psychic suffering in healthmanagers in the Covid-19 pandemic

Objetivo: analisar o nível de estresse percebido e sofrimento psíquico em gestores de saúde na pandemia da Covid-19. Método: estudo descritivo, transversal com abordagem quantitativa. A coleta ocorreu de abril a setembro de 2021, com 40 gestores de serviço de saúde. Utilizou-se para a coleta de dados um instrumento para caracterização sociodemográfica e ocupacional e as escalas "Perceived Stress Scale-14" e "Self Reporting Questionnaire" para avaliação do estresse percebido e sofrimento psíquico. Os dados coletados foram analisados no Statistical Package for the Social Sciences versão 22.0. O presente estudo faz parte de um projeto intitulado "Trabalhadores dos Serviços de Saúde Frente à Pandemia de Covid-19", aprovado pelo Comitê de Ética em Pesquisa sob CAAE número 35260620.9.0000.5231. Resultados: a maioria dos profissionais eram do sexo feminino (90%, N=36), casados (70%, N=28), com filhos (80%, N=32), com média de idade de 45 anos e com pós--graduação (47,5%, N=19). A média dos escores relacionados ao estresse percebido foi 31,13 pontos (DP=3,77) sendo o mínimo 24 e máximo de 42 pontos. Com relação ao sofrimento psíquico, (40%, N=16) os gestores apresentaram prováveis casos de transtornos. A prática de atividades físicas e de lazer (p<0,05) tem papel importante na diminuição do estresse percebido e do sofrimento psíquico. Conclusão: os gestores em saúde apresentaram, durante a pandemia, estresse e sofrimento psíquico, resultados esses que devem ser considerados para promoção de autocuidado aos gestores de saúde, enfatizando a necessidade da realização de atividades físicas e de lazer.

Objective: to analyze the level of perceived stress and psychological suffering in health managers during the Covid-19 pandemic. Method: descriptive, cross-sectional study with a quantitative approach. The collection took place from April to September 2021, with 40 health service managers. An instrument for socio-demographic and occupational characterization and the "Perceived Stress Scale-14" and "Self Reporting Questionnaire" scales were used for the assessment of perceived stress and psychic suffering. The collected data were analyzed using the Statistical Package for the Social Sciences version 22.0. The present study is part of a project entitled "Health Service Workers in the Face of the Covid-19 Pandemic", approved by the Research Ethics Committee under CAAE number 35260620.9.0000.5231. Results: most professionals were female (90%, N=36), married (70%, N=28), with children (80%, N=32), with a mean age of 45 years and with a postgraduate degree. -graduation (47.5%, N=19). The average score related to perceived stress was 31.13 points (SD=3.77), with a minimum of 24 and a maximum of 42 points. With regard to psychic suffering, (40%, N=16) the managers presented probable cases of disorders. The practice of physical and leisure activities (p<0.05) plays an important role in reducing perceived stress and psychological distress. Conclusion: health managers presented, during the pandemic, stress and psychic suffering, results that should be considered for promoting self-care to health managers, emphasizing the need to carry out physical and leisure activities.Keywords: Health manager; Occupational stress; Covid-19; Coronavirus infections.

Chest CT Airway and Vascular Measurements in Females with COPD or Long-COVID.

Chest CT provides a way to quantify pulmonary airway and vascular tree measurements. In patients with COPD, CT airway measurement differences in females are concomitant with worse quality-of-life and other outcomes. CT total airway count (TAC), airway lumen area (LA), and wall thickness (WT) also differ in females with long-COVID. Our objective was to evaluate CT airway and pulmonary vascular and quality-of-life measurements in females with COPD as compared to ex-smokers and patients with long-COVID. Chest CT was acquired 3-months post-COVID-19 infection in females with long-COVID for comparison with the same inspiratory CT in female ex-smokers and COPD patients. TAC, LA, WT, and pulmonary vascular measurements were quantified. Linear regression models were adjusted for confounders including age, height, body-mass-index, lung volume, pack-years and asthma diagnosis. Twenty-one females (53 ± 14 years) with long-COVID, 17 female ex-smokers (69 ± 9 years) and 13 female COPD (67 ± 6 years) patients were evaluated. In the absence of differences in quality-of-life scores, females with long-COVID reported significantly different LA (p = 0.006) compared to ex-smokers but not COPD (p = 0.7); WT% was also different compared to COPD (p = 0.009) but not ex-smokers (p = 0.5). In addition, there was significantly greater pulmonary small vessel volume (BV5) in long-COVID as compared to female ex-smokers (p = 0.045) and COPD (p = 0.003) patients and different large (BV10) vessel volume as compared to COPD (p = 0.03). In females with long-COVID and highly abnormal quality-of-life scores, there was CT evidence of airway remodelling, similar to ex-smokers and patients with COPD, but there was no evidence of pulmonary vascular remodelling.Clinical Trial Registration: www.clinicaltrials.gov NCT05014516 and NCT02279329.

Antiviral Activity of Graphene Oxide-Silver Nanocomposites Against Murine Betacoronavirus.

Background: The high infectivity of coronaviruses has led to increased interest in developing new strategies to prevent virus spread. Silver nanoparticles (AgNPs) and graphene oxide (GO) have attracted much attention in the antiviral field. We investigated the potential antiviral activity of GO and AgNPs combined in the nanocomposite GO-Ag against murine betacoronavirus MHV using an in vitro model. Methods: GO, AgNPs, and GO-Ag characterization (size distribution, zeta potential, TEM visualization, FT-IR, and EDX analysis) and XTT assay were performed. The antiviral activity of GO-Ag nanocomposites was evaluated by RT-qPCR and TCID50 assays. The results were compared with free AgNPs and pure GO. Cell growth and morphology of MHV-infected hepatocytes treated with GO-Ag composites were analyzed by JuLI™Br. Immunofluorescence was used to visualize the cell receptor used by MHV. Ultrastructural SEM analysis was performed to examine cell morphology after MHV infection and GO-Ag composite treatment. Results: A significant reduction in virus titer was observed for all nanocomposites tested, ranging from 3.2 to 7.3 log10 TCID50. The highest titer reduction was obtained for GO 5 µg/mL - Ag 25 µg/mL in the post-treatment method. These results were confirmed by RT-qPCR analysis. The results indicate that GO-Ag nanocomposites exhibited better antiviral activity compared to AgNPs and GO. Moreover, the attachment of AgNPs to the GO flake platform reduced their cytotoxicity. In addition, the GO-Ag composite modulates the distribution of the Ceacam1 cell receptor and can modulate cell morphology. Conclusion: Graphene oxide sheets act as a stabilizing agent, inhibiting the accumulation of AgNPs and reducing their cellular toxicity. The GO-Ag composite can physically bind and inhibit murine betacoronavirus from entering cells. Furthermore, the constant presence of GO-Ag can inhibit MHV replication and significantly limit its extracellular release. In conclusion, GO-Ag shows promise as an antiviral coating on solid surfaces to minimize virus transmission and spread.

SARS-CoV-2 as a trigger of IgA vasculitis: a clinical case and literature review.

Coronavirus Disease 2019 (COVID-19), caused by SARS-CoV-2, has negatively affected global health. COVID-19 has been associated with a variety of autoimmune and inflammatory disorders, complicating its respiratory manifestations. SARS-CoV-2 triggers inflammatory reactions which may involve multiple organs and systems. The proof for IgA involvement in the immune reactions to coronavirus infection is growing, particularly in the case of IgA immune complex deposition diseases such as IgA vasculitis (IgAV) and IgA nephropathy.This report presents a case of IgAV caused by SARS-CoV-2 in a 53-year-old man. His symptoms included papillomatous, bright red rashes, urticaria throughout the body, aphthous stomatitis, pain in all joints and muscles, weakness, malaise, abdominal pain, face swelling, and arterial hypertension (160/100 mmHg). He received intravenous methylprednisolone (250 mg) and then oral methylprednisolone (16 mg) treatment, which improved his condition. This improvement included the disappearance of abdominal and joint pain and skin rashes.This article also provides an overview of published cases of IgAV after SARS-CoV-2. It may alert rheumatologists and allied specialists of clinical features of IgAV and guide them how to diagnose and treat this disease.

Effectiveness of Paxlovid in the treatment of the SARS-CoV-2 Omicron variant infection in children with hematologic malignancies: a retrospective cohort study.

Background: Patients with hematologic malignancies (HMs) may be immunocompromised after receiving anti-tumor therapy. Those who also have the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus infection face many challenges, including a lack of effective antiviral drugs. This study aimed to investigate the clinical features of the SARS-CoV-2 Omicron variant infection in children with HMs, and the effectiveness of Paxlovid. Methods: A retrospective, non-randomized study was conducted on pediatric patients with HMs infected with the SARS-CoV-2 Omicron variant who had been admitted to the Shanghai Children's Medical Center, Shanghai, China from December 1, 2022 to March 1, 2023. The Paxlovid-treated group (Group P) comprised 21 patients, and the non-Paxlovid-treated group (Group N) comprised 21 patients. The patients' demographic data, clinical features, and therapeutic outcomes were collected. Statistical tests were used to evaluate the effectiveness of the treatment and related factors. Results: The clinical course of the SARS-CoV-2 Omicron variant infection for most of the children with HMs was non-severe (97.6%), and only one child progressed to severe disease (2.4%). The most common symptoms were fever (66.7%) and cough (52.4%). Compared with the children in Group N, those in Group P had worse clinical characteristics, including those who previously underwent hematopoietic stem cell transplantation (HSCT) or chimeric antigen receptor T (CAR-T) cell treatment (71.4% vs. 28.6%, P=0.005), and those in the myelosuppressive phase (57.1% vs. 4.8%, P<0.001). Most of the children in Group P were treated with more than two types of antibiotics (76.2% vs. 42.9%, P=0.02). The patients treated with Paxlovid within 5 days of diagnosis had a median viral clearance time of 5 days [interquartile range (IQR), 4-8 days], which was significantly shorter than that of the patients who were not treated with Paxlovid (P=0.03). There were no significant differences in the clinical outcomes between the two groups after the propensity score matching (PSM) analyses. Eight patients (19%) had repeat-positive (re-positive) test results. No factor was found to be statistically significant in predicting re-positive test results based on the binary logistic regression analysis. Conclusions: Administering Paxlovid within 5 days of the diagnosis of the SARS-CoV-2 Omicron variant infection in children may effectively shorten the clearance time of the virus, but there is still the possibility the patients may have re-positive test results.

Rapid identification of SARS CoV-2 omicron sub-variant JN.1 (BA.2.86.1.1) with mass spectrometry.

Objective: The rapid detection and differentiation of strains of the BA.2.86 lineage including the new sub-variant JN.1 (BA.2.86.1.1) is demonstrated employing selected ion monitoring (SIM) and high resolution mass spectrometry. Methods: A study of a preliminary set of BA.2.86 lineage positive specimens, identified BA.2.86 and BA.2.86.1.1 peptide markers in 62.5 % and 29.1 % of samples. Results: Peptide-specific markers in the surface spike protein associated with the L455S mutation are confidently detected with high sensitivity in protein and virus digests.The virus was thus confidently assigned in over 91 % of positive specimens. Conclusions: A rise in the global prevalence of the JN.1 (BA.2.86.1.1) immune evasive sub-variant, that emerged in late 2023, requires that new strategies and protocols to detect such strains in human specimens are accelerated and implemented.

Multisystem inflammatory syndrome in neonates associated with pneumothorax: Case report.

The coronavirus disease 2019 (COVID-19) pandemic that was spread worldwide since 2019 and showed a highly contagious character affecting the lifestyle of people worldwide causing symptoms that are not limited to the respiratory system only but had multi-systemic effects that may progress to severe complications that roughly affect people's health. A newly recognized SARS-CoV-2-associated syndrome called pediatric multisystem inflammatory syndrome has been described worldwide. Initially, it was reported as hyper-inflammatory shock and "Kawasaki-like" symptoms with fever and conjunctivitis, a similar syndrome is also reported in neonates and called Multisystem Inflammatory Syndrome of neonates (MIS-N). In this paper, we presented a case of a newborn baby girl born by caesarian section affected by multisystem inflammatory syndrome of neonates presenting with respiratory distress on her third day of life, then she developed bilateral pneumothorax and pneumomediastinum respectively that required intubation, which highlights that the recognition of pneumothorax and pneumomediastinum as potential presentations of immunoglobulin G (IgG) positive MIS-N in newborns remains crucial.

Evaluation of fibroblast activation protein-specific PET/CT in a patient with post-COVID pneumonitis.

Coronavirus disease 2019 (COVID-19) often leads to a spectrum of pulmonary complications, including interstitial lung disease (ILD) with the potential for fibrotic sequelae. Assessing the presence of ongoing active inflammation versus established residual fibrosis as a result of lung parenchymal injury and repair in these patients is a clinical challenge. Better understanding of the disease process is crucial for guiding appropriate therapeutic strategies. We aim to investigate the use of positron emission tomography / computer tomography (PET/CT) scans and their role in diagnosing interstitial pneumonitis (IP) post COVID infections.

Using an organizational change model to improve lung cancer surgery services over five years.

Background: Lung cancer is the most common cause of cancer death in the UK resulting in 21% of all cancer deaths. In 2016, local lung cancer surgery services required improvement due to under-representation in cancer resections and resource scarcity during the pandemic, which affected critical care bed availability and extended postoperative stays. The aim of this service improvement was to increase the number of lung cancer resection; develop minimally invasive techniques and reduce the use of Critical Care Unit beds by 35% (a subsequent goal). Methods: A five-year plan, guided by Kotter's 8-step change model, was initiated to address these issues. This model promotes sustainable change by setting clear goals, effective communication, and stakeholder involvement. Initial changes included hiring a thoracic surgeon experienced in uniportal video assisted thoracoscopy and enhanced recovery protocols. The team grew to three thoracic surgeons by 2020. The service increased operating theatre days and adopted new postoperative practices to reduce complications and hospital stays. Lung Cancer Multidisciplinary Team Meetings were consistently covered by thoracic surgeons, ensuring comprehensive care. Data on surgical activity were collected from departmental databases and national audits, with internal audits conducted regularly. Statistical significance was tested using chi-square tests with P values <0.05. Results: The number of surgical procedures more than doubled, with primary lung cancer resections increasing nearly three-fold from 12.8% to 29.8% over six years. Postoperative complications and mortality rates remained low. Critical care bed usage dropped significantly during the pandemic, with new protocols enabling safe recovery in general surgical areas. Conclusions: The successful expansion of thoracic surgical services was attributed to the dedicated minimally invasive surgeons, enhanced recovery measures, and skilled staff. The change model facilitated efficient and dynamic progress. With the introduction of lung cancer screening programs, the demand for surgical services is expected to rise. The effective change model will be re-applied to meet this demand. The organizational change model, focused on patients and staff, achieved sustained quality improvement in lung cancer care despite challenging conditions like the coronavirus disease 2019 pandemic.

Long-term effect of corticosteroid treatment during acute COVID-19 infection on pulmonary function test results.

Background: The outbreak of the novel coronavirus 19 has led to unprecedented clinical challenges globally. Various therapeutic and pharmacologic interventions have been proposed, yet evidence of their long-term efficacy remains limited. Corticosteroids (CS) have shown efficacy in the sub-acute phase of the pandemic. This study aims to evaluate the long-term effects on pulmonary function tests (PFTs) in patients treated with CS during acute coronavirus disease 2019 (COVID-19) infection. Methods: A retrospective study was conducted from February 2020 to March 2021. Clinical and demographic data were extracted from electronic medical records of patients attending the post-COVID outpatient clinic at the Pulmonary Institute of Soroka University Medical Center. A multivariate linear mixed effects model was employed to obtain adjusted estimates for the impact over time. Results: The study included 405 patients, of whom 155 (38.3%) received CS treatment. Approximately 60% completed two or more follow-up visits. PFTs [forced expiratory volume in the first second (FEV1), forced vital capacity (FVC)] returned to baseline more rapidly (0.9% and 0.85% per month, respectively) in patients treated with CS. This accelerated recovery was observed across all patients, including those with a body mass index (BMI) above 30 kg/m2 and those with known chronic lung disease. Conclusions: Systemic CS treatment during acute COVID-19 infection was associated with a faster recovery of PFTs during long-term follow-up, even among subgroups at higher risk of long-term pulmonary damage.

A Narrative Review of the Factors Affecting the Mental Health of Adolescents and Young People During the COVID-19 Pandemic.

Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, led to a worldwide pandemic. There were unprecedented changes in the mental health of children, adolescents, and youth in the age group of 8-18 years as a result of COVID-19. The objective of this review is to identify direct and indirect factors that influenced these changes. We identified three main groups of factors that could have impacted the mental health of young people during the pandemic: (i) familial factors, (ii) social and educational factors, and (iii) positive variables. Our review suggests that the COVID-19 pandemic negatively impacted the mental health of children and adolescents through stressors like social isolation, parental unemployment and loss, and disrupted routines. As a result, sadness, hopelessness, depression, and generalized anxiety all increased significantly among adolescents during the pandemic, coupled with a simultaneous increase in substance use, suicide attempts, and violence. However, the pandemic also offered some positive variables such as reduced bullying, more family time, and improved relationships for those with adequate socioeconomic resources. The complex factors affecting the mental health of young people during the pandemic underscore the necessity for additional research to comprehend their individual effects. We advocate for collaborative youth-centered initiatives involving educational organizations, mental health experts, policymakers, healthcare systems, and other community stakeholders to effectively tackle these challenges.

Measuring Workload Among Family Medicine Health Professionals During the COVID-19 Pandemic.

The global COVID-19 pandemic presented a period of considerable stress for healthcare professionals on a global scale. The strain on healthcare facilities nationwide has resulted in profound implications for the well-being of numerous healthcare practitioners. A heightened demand for extended working hours emerged, potentially amplifying the workload for these professionals. This study aims to scrutinize the workload levels experienced by healthcare professionals specializing in family medicine at a tertiary medical center. Our findings reveal a persistent escalation in workload over the course of the study. Notably, the overall mean workload index score exhibited a substantial increase from phase one to phase two (48.07 compared to 66.36). Recognizing the impact of workload variations according to professional roles is crucial for devising effective solutions. Consequently, comprehending the nuances of workload distribution among healthcare professionals is imperative for the successful implementation of targeted interventions.

Anticoagulant Use in COVID-19 Patients: A Longitudinal Study From Zanjan, Iran.

Background The mortality and morbidity of thrombotic events in patients with coronavirus disease 2019 (COVID-19) are increasing worldwide. The clinical impact of prophylactic anticoagulation regimens among these patients in Iran remains unclear. This study aimed to evaluate the use of prophylactic anticoagulants and outcomes among COVID-19 patients admitted to a tertiary referral hospital. Methodology Patients diagnosed with COVID-19 and hospitalized between March 20 and June 20, 2020, were included in this longitudinal study after obtaining informed consent. Demographic and clinical data were collected from the hospital information system and medical records. Outcomes during this period were also evaluated. The data were entered into the preparation checklist and analyzed using SPSS version 24 software (IBM Corp., Armonk, NY, USA), employing chi-square, Fisher's exact, and Mann-Whitney U tests. Results Of the 831 enrolled patients, 51.9% were female, and 10.6% needed to be admitted to the intensive care unit (ICU). The mean age of the patients was 57.16 ± 17.32 years, and the mortality rate was estimated to be 9.4%. Mortality rates were significantly higher at older ages, in men, patients with ICU admission, severe pulmonary involvement, malignancy, airway obstruction, ischemic heart disease, and previous cerebrovascular accidents. ICU admission and mortality were statistically significantly higher in those who received concurrent prophylactic anticoagulants and aspirin than in other individuals. Conclusions Our study demonstrated that administering prophylactic aspirin with or without anticoagulant agents in COVID-19 patients did not reduce mortality rates or ICU transfers. However, it is worth noting that anticoagulant prescription was associated with a decrease in ICU admissions, which could potentially alleviate the significantly higher mortality rates observed among ICU patients in this study. Further research is needed to explore the potential benefits of anticoagulants in COVID-19 treatment.

The potential role of dyslipidemia in COVID-19 severity among Iraqi patients.

BACKGROUND: The correlation between dyslipidemia and the severity of coronavirus disease 2019 has been widely categorized. Dyslipidemia is one of the most dominant disorders among these patients. Systemic inflammation accompanied by cytokine storm hemostasis modifications and severe vasculitis have all been reported to occur among COVID-19 patients, and these may contribute to some severe complications. OBJECTIVE: The aim of this study is to assess the possible relationship between dyslipidemia and the severity of coronavirus disease 2019. METHODS: This work encompassed 200 patients with coronavirus disease 2019 (100 dyslipidemic and 100 normolipidemic) who were hospitalized at Baghdad Teaching Hospital/ Medical City-Baghdad, Iraq, from October 2021 to October 2022; their ages ranged between 40 and 55. Eligible individuals had a positive nasal swab polymerase chain reaction for severe acute respiratory syndrome coronavirus 2 infection. Every participant's anthropometric and clinical features were measured. The study includes the measurements of glycemic, lipid profile, renal function test, D-dimer, C-reactive protein, serum ferritin, and interleukin-6 in dyslipidemic and normolipidemic groups. RESULTS: Considerable increase (p= 0.001) in glycemic and lipid levels in the dyslipidemic group compared to normolipidemic. Moreover, dyslipidemic patients have higher lipid indices (ratios) than the normolipidemic group. Significant increases (p= 0.001) in serum urea and creatinine levels were found among the dyslipidemic group compared to normolipidemic. There was a non-considerable decrease (p= 0.062) in serum total protein in the dyslipidemic group concerning the normolipidemic. In contrast, a considerable decrease (p= 0.045) in serum albumin was detected in the dyslipidemic group compared to normolipidemic. D-dimer, serum C-reactive protein, ferritin, and interleukin-6 were significantly increased (p= 0.001) in the dyslipidemic group compared to normolipidemic. CONCLUSION: Dyslipidemia potentially raises the severity of coronavirus disease 2019. There was a significant disturbance in renal function tests among coronavirus disease 2019 patients. The study found a significant and statistical difference in kidney functions between dyslipidemic and normolipidemic groups. The patients, especially the dyslipidemic ones, have experienced protein abnormalities and a significant inflammation rate reflected by higher C-reactive protein and interleukin-6, which is due to the severity of coronavirus disease 2019. It is possible to conduct more research with a larger sample size. The majority of people who have dyslipidemia need to be enlightened.

Swallowing during provision of helmet ventilation: Review and provisional multidisciplinary guidance.

Use of noninvasive ventilation provided by a helmet increased globally during and after the COVID-19 pandemic. This approach may reduce need for intubation and its associated clinical complications in critically ill patients. Use of helmet interface minimizes virus aerosolization while enabling verbal communication, oral feeding and coughing/expectoration of secretions during its administration. Although improved oral hydration is a recognized benefit of helmet NIV, relatively little is known about the safety and efficiency of swallowing during helmet NIV. Risk of aspiration is a key consideration given the fragile pulmonary status of critically ill patients requiring respiratory support, and therefore the decision to initiate oral intake is best made based on multidisciplinary input. We reviewed the current published evidence on NIV and its effects on upper airway physiology and swallowing function. We then presented a case example demonstrating preservation of swallowing performance with helmet NIV. Last, we offer provisional multidisciplinary guidance for clinical practice, and provide directions for future research.

Immunological and homeostatic pathways of alpha -1 antitrypsin: a new therapeutic potential.

α -1 antitrypsin (A1AT) is a 52 kDa acute-phase glycoprotein belonging to the serine protease inhibitor superfamily (SERPIN). It is primarily synthesized by hepatocytes and to a lesser extent by monocytes, macrophages, intestinal epithelial cells, and bronchial epithelial cells. A1AT is encoded by SERPINA1 locus, also known as PI locus, highly polymorphic with at least 100 allelic variants described and responsible for different A1AT serum levels and function. A1AT inhibits a variety of serine proteinases, but its main target is represented by Neutrophil Elastase (NE). However, recent attention has been directed towards its immune-regulatory and homeostatic activities. A1AT exerts immune-regulatory effects on different cell types involved in innate and adaptive immunity. Additionally, it plays a role in metal and lipid metabolism, contributing to homeostasis. An adequate comprehension of these mechanisms could support the use of A1AT augmentation therapy in many disorders characterized by a chronic immune response. The aim of this review is to provide an up-to-date understanding of the molecular mechanisms and regulatory pathways responsible for immune-regulatory and homeostatic activities of A1AT. This knowledge aims to support the use of A1AT in therapeutic applications. Furthermore, the review summarizes the current state of knowledge regarding the application of A1AT in clinical and laboratory settings human and animal models.

Birds as reservoirs: unraveling the global spread of Gamma- and Deltacoronaviruses.

Avian migration is a global phenomenon that transcends geographical boundaries. These migratory birds serve as unwitting carriers of diverse Gammacoronaviruses (γ-CoVs) and Deltacoronaviruses (δ-CoVs). While recombination events have been documented among γ-CoVs in avian species and ß-CoVs in mammals, evidence for recombination between CoVs of distinct genera remains limited. This minireview examines the prevalence of CoVs in both domestic waterfowl (ducks and geese) and wild bird populations inhabiting various regions. We investigate the dissemination patterns of γ-CoVs and δ-CoVs among these populations, highlighting their shared characteristics. Furthermore, the review explores the intricate web of cross-species transmission of δ-CoVs from wild birds to mammals, with a particular focus on pigs. Understanding the distinct features of CoVs harbored by waterfowl and wild birds and their potential for cross-species transmission is crucial for preparedness and response to future CoV epidemics.