Post-Acute Effect of SARS-CoV-2 Infection on the Cardiac Autonomic Function

Background Recent studies reported a long-lasting effect of COVID-19 infection that extends beyond the active disease and disrupts various body systems besides the respiratory system. The current study aims to investigate the post-acute effect of SARS-CoV-2 infection on cardiovascular autonomic activity, reactivity and sensitivity in patients who had the infection at least 3 months before. Methods This was a comparative cross-sectional observational study. Fifty-nine subjects were allocated into two groups, controls (n=31), who had no history of positive COVID-19 infection, and the post-COVID patients (n=28) who were recruited 3 to 8 months after testing positive for SARS-CoV-2 by reverse transcription polymerase chain reaction (RT-PCR). Baseline cardiovascular autonomic activity was evaluated through recording of baseline heart rate variability (HRV), autonomic reactivity was determined through standard cardiovascular autonomic reflex tests (CART), and cardiac autonomic sensitivity was assessed through cardiac baroreceptor sensitivity (cBRS). Results Higher incidence of orthostatic hypotension was observed in post-COVID patients compared to controls (39.3% and 3.2%, respectively, p <0.001). Additionally, significantly reduced handgrip test, and heart rate response to head-up tilt was illustrated in the post-COVID group (p <0.001). About 85.7% of post-COVID participants had at least one abnormal cardiovascular reflex test (CART) compared to the control group (p <0.001). Although HRV parameters (TP, LF, HF, SDRR, RMSSD, pRR50), and the cBRS were numerically lower in the post-COVID-19 group, this did not reach the level of significance. Conclusion The results of the present study are suggestive of altered cardiovascular reactivity in post-acute COVID patients and demand further investigation and longer term follow up.

The Effect of Short Treatment with Nigella Sativa on Symptoms, the Cluster of Differentiation (CD) Profile, and Inflammatory Markers in Mild COVID-19 Patients: A Randomized, Double-Blind Controlled Trial.

The current study investigated the impact of different doses of Nigella sativa seeds on the symptoms, the cluster of differentiation profile group, and inflammatory markers of mild COVID-19 cases. METHODS: The study was a double-blind placebo-controlled clinical trial. Patients with mild and asymptomatic SARS-CoV-2 infection patients were randomly subdivided into seven subgroups: Group (GP) 1: received charcoal capsules as a control group, and GP 2: received three capsules of whole Nigella sativa seeds daily, two capsules in the morning and one in the evening; GP 3: received three capsules of whole Nigella sativa seeds every 12 h, GP 4: received five capsules in the morning and four capsules of whole Nigella sativa seeds in the evening, GP 5: received one capsule of Nigella sativa powder every 12 h; GP 6: received two capsules of Nigella sativa powder every 12 h; GP 7: received three capsules of Nigella sativa powder every 12 h; all treatment course was for ten days. Inflammatory parameters were assessed before and after interventions. RESULTS: 262 subjects were included in the final analysis. No significant difference was detected regarding age, gender, and nationality. No significant differences were detected between the inflammatory marker in all groups. The WBCs showed a significant difference between before and after the intervention. While for procalcitonin, a significant difference was demonstrated in groups 1,4, and 6. CONCLUSIONS: The current randomized clinical trial did not reveal a significant effect of ten days of treatment with various doses of Nigella sativa on symptoms, differentiation profile, and inflammatory markers of patients with COVID-19. As a natural product, the effect of Nigella sativa on disease requires weeks to manifest itself.

Correlation of racial effect with severity of disease and in-hospital outcome in individuals diagnosed with COVID-19.

INTRODUCTION: There are many countries that inhibit diverse populations and hence, studies have been conducted to find the relation between ethnic and racial groups within a society and incidence or mortality because of coronavirus disease-19 (COVID-19). OBJECTIVES: The purpose of this study was to evaluate the racial effect on the severity of disease and in-hospital outcomes in individuals diagnosed with COVID-19. PATIENTS AND METHODS: This retrospective study is based on records of 804 tested positive COVID-19 patients presented at Dammam Medical Complex and Braira quarantine from March 2020 to May 2020 was conducted after approval from the ethical board. Patient's records included the routine patient's consent statement about the explanation of all the investigations and procedures before being performed. Data were retrieved and included in the analysis were age, gender, country of origin, racial background (Arab, Caucasian, Asian, Black, Latin and Hispanic), the severity of COVID-19 and outcome. RESULTS: Out of total 804 confirmed patients of COVID-19, there were 647 (80.5%) male patients and 157 (19.5%) female patients (M:F ratio = 4.1:1). Male preponderance was seen in all racial groups and significantly higher amongst the Asians than the Middle Eastern race (91.2% vs. 70.3%, p = .000). The mean age of Asians was significantly higher than the mean age of the Middle Eastern and Black and Caucasian races (42.8 ± 10.0 vs. 39.6 ± 16.3 vs. 37.0 ± 10.3, p = .003). The proportion of deaths was considerably higher amongst Asians (5.4%) compared with Middle Eastern patients (1.2%) (p value = .001). CONCLUSION: Severity and in-hospital outcome were varying considerably amongst the racial groups. East and South Asian COVID-19 patients had more severe symptoms and less recovery rate compared with other groups, late presentation may be a contributory reason. Hence, evaluation of the severity of COVID-19 in relation to the various racial groups along with demographic characteristics and other risk factors can provide baseline guidance to the clinical care providers to initiate earlier and appropriate treatment.

A Study to assess the awareness and use of Silver Diammine Fluoride and Hall Technique among dental professionals and dental students in the Eastern Province.

BACKGROUND: A major shift has occured in the trend of dealing with dental caries from primary to secondary prevention, specially after SDF approval off-label by US FDA in recent years and Hall Technique (HT) in the last decade. OBJECTIVES: To determine the frequency of awareness and use of Silver Diammine Fluoride (SDF) and Hall technique among dental professionals in the Eastern province of Saudi Arabia. METHODS: This cross-sectional study was conducted in a public hospital, metropolitan city of Middle Eastern region between March 15, 2019 & January 31, 2020. Dental practitioners were requested, with their consent, to fill up a digitally designed survey. Chi-square test on SPSS-20.0 was applied to compare frequency of awareness and use of SDF and HALL Technique among the survey participants. RESULTS: The awareness of SDF was found to be 73.6% among specialists, 54.9% among graduates and 29.6% among students whereas awareness of HALL technique for stainless steel crown in pediatric dentistry was found statistically similar in all participants groups i.e. 42.7% in students, 55.5% in graduates and 54.9% in specialist group (p = 0.125). CONCLUSION: The results show potential with regards to awareness of dental specialists & postgraduate residents but inadequate among general dentists and students though all were keen advocates and found committed to its use to help the community. It points towards a further need of the of education for all groups. Those non- invasive techniques are very useful tools in general but specifically during Covid-19 pandemic where they can play a major role in preventing the spread of infection, arresting decay, alleviating pain and anxiety without resorting to aggressive treatment like pulp treatment/extraction. Low response rate may be improved in future through the respondents' counselling and regular follow up.