The COVID-19 and iron-repertoire in an observational cross-sectional analytical study of Egyptian patients

Background and rationale: Coronavirus disease 2019 (COVID-19) infection is a respiratory tract infection because of a novel coronavirus. The clinical picture ranges from asymptomatic to severe manifestations mandating intensive care and respiratory support. We aimed to assess the serum level of iron, total iron binding capacity (TIBC), and transferrin saturation in COVID-19 patients and their relation to disease severity and outcome. Methodology: This observational cross-sectional analytical study was conducted on 100 confirmed cases of COVID-19 who were admitted to Kasr Al-Ainy hospitals between June and December 2020.Serum levels of iron, total iron binding capacity (TIBC), and transferrin saturation were measured for all study populations. Result: One hundred patients were involved in this research, 51males and 49 females, with a mean age of 51±14.9years. Regarding the disease severity,53% were moderate cases, 34% were mild, and 13% were severe cases. Fifty-two (54.2%) patients showed normal serum levels of iron, 38 patients (39.6%) showed high serum levels of iron, and 6 patients (6.3%) showed low serum levels of iron. The mean ±SD values of iron, TIBC, and transferrin saturation were 163.1±105 mcg/dL, 366 ± 162.6 mcg/dL, 44.4 ± 20.2 %, respectively. Iron, total iron binding capacity (TIBC) levels and transferrin saturation did not show a significant association as regards either COVID-19 severity or mortality. Mortality and deterioration were detected in 31.7% out of 60 patients with COVID-19. The results showed that obese patients showed a higher percentage of severe COVID-19,which was statistically significant (p=0.037).There was a statistically significant higher mortality rate in patients with severe COVID-19 (p=0.000).High mortality was observed significantly in patients with diabetes mellitus (p=0.041).Iron levels, total iron binding capacity (TIBC) levels and transferrin saturation did not show a significant association regarding either COVID-19 severity or mortality. Conclusion: In our study, COVID-19 severity was not related to iron metabolism but was affected by obesity and diabetes mellitus. COVID-19 mortality was significantly associated with diabetes. © 2020 The author (s). Published by Zagazig University.

Anticoagulant effect of Feijoa sellowiana extracts generated by different biotechnological techniques.

Blood clotting has become one of the most dangerous side effects associated with Corona virus, as well as the high level of cholesterol and triglycerides in the blood. Therefore, it has become necessary to use medicinal plants that are biologically safe and containing anti-clotting compound. Feijoa sellowiana represents a prolific source diverse compounds that may have thrombolytic activity. Therefore, the main research point is the production and scaling up of a target contents that have anticoagulants by using biotechnological techniques; calli production, and bioreactors and assessed their activity through in-vivo study. Murashige and Skoog (MS) medium enriched with varying concentrations of benzyl adenine (BA) and naphthalene acetic acid (NAA) was used to cultivate calli and cell suspension cultures from F. sellowiana seeds. Bioreactors were employed to boost active constituent's production. Moreover, the bioreactor physical factors such as effect of controlled or uncontrolled pH medium were investigated. The leaves of the main plant were extracted by ethanol 70% and polar and non-polar extracts were also prepared. The ethanol extract of calli and cells resulting from bioreactors were also prepared. All prepared extracts were subjected to chemical analysis by HPLC, in-vitro antioxidant assays, in-vivo anticoagulant activity and histopathological examination. Calli and cell suspension cultures were produced by using MS medium fortified with 1 mg/L BA+ 0.1 mg/L NAA. It was found that culturing of cell cultures in a bioreactor with uncontrolled pH and aeration at the value of 0.5 L/min gave the maximum and economical fresh and dry weights of the plants. After evaluation of all extracts; it was found that the calli ethanol extract for each plant was the highest value of total phenolic and total flavonoid contents either quantitatively or qualitatively. All extracts of Feijoa had antioxidant activity. The IC50 of the DPPH of Feijoa calli extract was 13.45 µg/mL, it was also confirmed by FRAP and ABTs values. Feijoa calli extract decreased platelet aggregation by suppression of thrombin, extended aPTT, PT, bleeding and clotting times. It was safer than warfarin medication. From these findings the authors can conclude that Feijoa had highly anticoagulant activity and the calli production achieved the goal of the enhancement of the phenolic constituent and thus their activity.

CRT-200.08 In-Hospital Outcomes of Atrial Fibrillation in COVID-19 Hospitalizations: An Insight From the National Inpatient Sample Database

Introduction: It is known that patients with COVID-19 infection have a significant incidence of arrhythmias. According to a study from Wuhan, China in 2020, approximately 17% of hospitalized COVID-19 patients suffered from arrhythmia, including Atrial Fibrillation (AF). Here we present a study of the outcomes of AF in COVID admissions at the national cohort registry. Method(s): Utilizing the NIS of the year 2020, we identified patients with diagnosis of COVID-19 and subsequently classified COVID-admission into with and without AF. Multilogistic regression analysis (OR) was done to compare in hospital outcomes. Result(s): Of 1,060,976 patients with diagnosis of COVID, 57,011 (5.37%) had AF. On adjusted analysis, COVID-AF patients had significantly higher odds of heart failure (aOR 1.25, 95% CI 1.19-1.31, P=0.001). On the contrary, there was no statistically significant difference in the odds of MACCE (aOR 0.97, 95% CI 0.91-1.01, P=0.19), in hospital mortality (aOR 0.93, 95% CI 0.88-0.09, P=0.07), AMI (aOR 1.12, 95% CI 1.03-1.22, P=0.08), MCS (aOR 0.86, 95% CI 2.08 - 2.60, P= 0.789), cardiogenic shock (aOR 1.15, 95% CI 0.90-1.45, P=0.257), major bleeding (aOR 1.12, 95% CI 0.96-1.30, P=0.136), PCA (aOR 0.30, 95% CI 0.87-1.93, P=0.205), PCI (aOR 0.10, 95% CI 0.49-2.40, P= 0.82), stroke (aOR 1.02, 95% CI 0.84-1.23, P=0.871) between the two cohorts. The presence of AF in COVID-19 hospitalizations was associated with higher length of stay (9.25 +/-9.05 vs 7.35 +/- 8) and higher adjusted total charge(97,321 155,117+/- vs 77,372+/- 149,354) compared to COVID without AF association. Conclusion(s): COVID-19 patients with AF can have higher odds of heart failure compared to COVID-19 patients without AF. The odds of in hospital mortality, MACCE, MCS, AMI, major bleeding, PCI, PCA and stroke were similar. Large prospective trials are needed to validate these findings. [Formula presented]Copyright © 2023

CRT-200.06 Cardiovascular Outcomes of Congestive Heart Failure on COVID-19 Hospitalizations: A Nationwide Analysis

Introduction: Congestive heart failure (CHF) is the most common cardiac admission diagnosis worldwide with high risk of morbidity and mortality. The data on the clinical impact of CHF on COVID-19 hospitalizations is limited. Here we present a study of the cardiovascular outcomes of baseline CHF on COVID-19 admissions at a national level. Method(s): The National Inpatient Sample database from 2020 was queried to identify patients with a primary diagnosis of COVID-19 and stratified based on the presence of congestive heart failure. Multivariate regressions analysis was done to compare inpatient outcomes among COVID patients with and without CHF. The primary outcome measure was in-hospital mortality. Secondary outcomes were in hospital cardiovascular outcomes. The adjusted odds ratios (aOR) of in-hospital outcomes were calculated using chi-square statistics in software STATA v.17. Result(s): 1,060,885 weighted COVID-19 hospitalizations were identified, of which 115,685(10.9%) were associated with CHF. On adjusted analysis, patients with COVID-CHF had significantly higher odds of MACCE (aOR 1.23, 95% CI 1.182-1.28, P<0.001), MCS ( aOR 3.22, 95% CI 2.26-3.26, P<0.001), cardiogenic shock ( aOR 2.72, 95% CI 2.26-3.26, P<0.001), AMI (aOR 2.72, 95% C. On the contrary, patients with COVID and baseline CHF had a lower incidence of inpatient AKI (aOR 0.64, 95% CI 0.49-0.84, P<0.001). The odds of in-hospital mortality, major bleeding and cardiac arrest between the two cohorts were similar. Additionally, presence of CHF in COVID hospitalization was associated with higher length of stay (8.81+/- 8.91 vs 7.28 +/-7.9) and adjusted total charge ($96,640 +/- 177,439 vs $76,214 +/-145,830) compared to COVID without CHF Conclusion(s): COVID 19 patients with CHF have increased odds of MACCE, MCS, cardiogenic shock, AMI, PCA and PCI. Out of hospital outcomes need further studies. [Formula presented]Copyright © 2023

CRT-200.07 Cardiovascular Outcomes of Long-Term Anticoagulation in COVID-19 Hospitalizations: A Nationwide Analysis

Introduction: It is now evident that anticoagulation plays a key role in the management of COVID-19 infection, however the significance of previous long-term oral anticoagulation in patients who later presented with COVID-19 is still unknown. Here we present an analysis of the impact of long-term oral AC on COVID-19 hospitalizations at the national cohort registry. Method(s): The NIS database from 2020 was queried to identify COVID-19 patients on long term AC use. Multivariate regression was done to compare inpatient outcomes among COVID-19 patients with and without AC. Result(s): Of 1,060,925 patients with primary diagnosis of COVID, 102, 560 (9.6%) were on AC. On adjusted analysis, patients with COVID-19 and AC use had significantly lower odds of MACCE (aOR 0.63, 95% CI 0.6-0.66, p<0.001), in-hospital mortality (aOR 0.61, 95% CI 0.58-0.64, p<0.001), cardiac arrest (aOR 0.67, 95% CI 0.6-0.75, P<0.001), acute MI (aOR 0.72, 95% CI 0.63-0.83, P<0.001), stroke (aOR 0.79, 95% CI 0.66-0.95, P=0.002), cardiogenic shock (aOR 0.58, 95% CI 0.44-0.75, P<0.001), ICU admission, (aOR 0.53, 95% CI 0.49-.57, p<0.001) mechanical ventilation,(aOR 0.54, 95% CI 0.51-.58, p<0.001) tracheostomy, (aOR 0.4, 95% CI 0.32-.5, p<0.001) and septic shock, (aOR 0.53, 95% CI 0.48-.58, p<0.001) compared to patients without AC. Additionally, lower adjusted total charge ($70,987+/-109,234 vs 79,239+/-153,418, p<0.001) in patients taking AC was observed. However, the adjusted OR of major bleeding, MCS, PCI, new HD and length of stay were similar between the two groups. Conclusion(s): Patients with COVID-19 infection who are on long term AC use have lower risk of MACCE, in-hospital mortality, cardiac arrest, acute MI, stroke cardiogenic shock and ICU admissions with no significant increased risk of major bleeding. Large prospective trials are needed to validate these findings. [Formula presented]Copyright © 2023

Evaluation of Sodium, Potassium, and Calcium level in Pfizer-BioNTech vaccinated Iraq's people

locale: The huge enlarge of the Coronavirus is one of the dangers facing the earth at the initiate time, which causes respiratory disorders. This new nimbus Virus is transmitted from individual nature to anyone and has caused foremost deaths in broad, which has led to the determination of the potent disease. This authenticity of the Disease varies same a large amount from individual creature to parcel. Forcing scientists to include on inspect to discover a vaccine for this disease in in christen to inspection and boundary the stretch of the disease. This evaluation was ponder to bang upon out whether at this thrust are corner not public estate on vaccinated satisfy who routine covid-19 vaccine or not by measuring the body's vim by sphere-shaped about of biochemical tests.Subjects:75 people between women and men aged(17-68 years)were enrolled in this dissect.Several biochemical tests were performed on them before compelling the vaccine,a week to10 continuation after the chief dose, and a week to 10 life after the second dose of covid-19 vaccine. RESULTS: Apiece and everyone subjects in this make inquiries customary the Pfizer-Bio N Tech vaccine and no end corner goods were feasible in subjects vaccinated during the examination manuscript period. Conclusions: From the argue of the contemporary study, at this point were no abnormal biochemical markers, increased, or changes in imperative departed functions after individual rewarded the Pfizer vaccine. © 2023, ResearchTrentz Academy Publishing Education Services. All rights reserved.

Identification of potent COVID-19 main protease inhibitors by loading of favipiravir on Mg12O12 and Zn12O12 nanoclusters: an in silico strategy for COVID-19 treatment.

Pandemic new severe acute respiratory syndrome coronavirus (SARS-CoV-2) virus has increased throughout the world. There is no effective treatment against this virus until now. Since its appearance in Wuhan, China in December 2019, SARS-CoV-2 becomes the largest challenge the world is opposite today, including the discovery of an antiviral drug for this virus. Several viral proteins have been prioritized as SARS-CoV-2 antiviral drug targets, among them the papain-like protease (PLpro) and the main protease (Mpro). Inhibition of these proteases would target viral replication, viral maturation and suppression of host innate immune responses. Potential candidates have been identified to show inhibitory effects against Mpro, both in biochemical assays and viral replication in cells. There are different molecules such as lopinavir and favipiravir considerably inhibit the activity of Mpro in vitro. Different studies have shown that structurally improved favipiravir and other similar compounds can inhibit SARS-CoV-2 main protease. In this work, we study the interactions between favipiravir with Mg12O12 and Zn12O12 nanoclusters by density functional theory (DFT) and quantum mechanics atoms in molecules (QMAIM) methods to summarize the ability to load favipiravir onto Mg12O12 and Zn12O12 nanoclusters. Favipiravir-Mg12O12 and favipiravir-Zn12O12 lowest structures complexes were chosen to dock inside the SARS-CoV-2 main protease by molecular docking study. The molecular docking analysis revealed that the binding affinity of Mg12O12 and Zn12O12 nanoclusters inside the Mpro receptor is larger than that of favipiravir. Also, the loading of favipiravir on the surface of Mg12O12 and Zn12O12 nanoclusters increased the binding affinity against the Mpro receptor. Subsequently, 100 ns molecular dynamics simulation of the favipiravir-Mg12O12, and favipiravir-Zn12O12 docked inside the Mpro complexes established that favipiravir-Mg12O12, forms the most stable complex with the Mpro. Further molecular mechanics Poisson Boltzmann surface area (MMPBSA) analyses using the MD trajectories also demonstrated the higher binding affinity of favipiravir-Mg12O12 inside the Mpro. In summary, this study demonstrates a new way to characterize leads for novel anti-viral drugs against SARS-CoV-2, by improving the drug ability of favipiravir via loading it on Mg12O12 and Zn12O12 nanoclusters.Communicated by Ramaswamy H. Sarma.

Role of biomedical markers in the monitoring of Pfizer-BioNTech vaccine efficacy among Iraq's people

Coronavirus disease 2019 (COVID-19) is a kind of viral pneumonia which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The emergence of SARS-CoV-2 has been marked as the third introduction of a highly pathogenic coronavirus into the human population after the severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV) in the twenty-first century, Forcing scientists to continue Research to discover a vaccine for this disease in in request to control and boundary the range Of the disease. This study was designed to hit upon out whether here are side effects on vaccinated people who received covid-19 vaccine or not by measuring the body's vitality by some of biochemical tests.Subjects:75 individuals between women and men aged (17-68 years)were enrolled in this study .Several biochemical tests were performed on them before taking the vaccine,a week to10 days after the first dose, and a week to 10 days after the second dose of covid-19 vaccine. RESULT(S): All subjects in this Study received the Pfizer-Bio N Tech vaccine and no systemic side effects were Observed in subjects vaccinated during the study period. Conclusion(s): From the Results of the current study, there were no abnormal biochemical markers, increased, or changes in basic body functions after receiving the Pfizer vaccine. Copyright © 2022 Wolters Kluwer Medknow Publications. All rights reserved.

Serum Procalcitonin Level and Comorbidity in Covid-19 Patients in UAE

Background: Most COVID-19 patients experience a mild form of the disease, but there is a certain percentage of patients who progress to a very severe disease state that requires intensive care and invasive ventilation. In order to ensure better patient management and improved outcomes, early identification of patients who may be at a higher risk of severe infection can play an important role. The aim of this study was to assess the association between the mean procalcitonin (PCT) level and comorbidity in hospitalized patients with COVID-19. Methods and Results: A total of 231 COVID-19-positive patients aged between 20 and 82 years (170[73.6 %] males and 61[26.4%] females) were included in this study. Serum PCT was accessed by procalcitonin assay using the Beckman Coulter UniCel DxI 800 instrument. All patients were classified into 5 groups according to age: 20-29 years-20(8.7%), 30-39 years-47(20.3%), 40-49 years-72(31.2%), 50-59 years-48(20.8%) and >60years-44(19.0%). Eighty-seven (37.7%) patients had no chronic disease, while 144(62.3%) had comorbidities: hypertension (37[16.0%]), diabetes mellitus (44[19.0%]), a combination of diabetes mellitus with hypertension (32[13.9%]), asthma (6[2.6%]), hyperlipidemia (4[1.7%]), renal disease (1[0.4%]), and COPD (1[0.4%]). COVID-19 patients with diabetes in combination with hypertension had a statistically greater PCT level than COVID-19 patients without comorbidities (P=0.0273). However, there were no statistically significant differences in the mean PCT levels between other comorbidities. There were no statistically significant differences in the mean PCT level between different age categories (P=0.7390). The serum PCT measurement could evaluate the prognosis of the disease in some COVID-19 patients. © 2022, International Medical Research and Development Corporation. All rights reserved.

Diffractive Phase Interferometry (DPI), CRP and COVID-19 RT-PCR Tests in COVID-19 Patients with Different Ages in AJMAN, UAE: A Comparative Study

Background: Fast and accurate diagnosis plays an important role in controlling and further preventing COVID-19. This study was conducted in the Thumbay laboratory of Gulf Medical University (Ajman, UAE) to assess the correlations between DPI (Diffractive Phase Interferometry), COVID-19 RT-PCR, and CRP tests in COVID-19 patients of different ages and to compare the effectiveness of each parameter. Methods and Results: A cross-sectional analytic study was conducted among 150 patients diagnosed with COVID-19 who were admitted to the Thumbay University Hospital. Their general data was collected from the LDM system, and from among the suspected patients who came to do the RT-PCR test, 230 were selected as volunteers to participate in this study, and further laboratory tests like CRP level and DPI test were done for them. The nasal swab was collected for a PCR test. Out of 230 nasal swab samples, 150 were positive and 80 were negative for SARS-CoV-2 RNA by real-time RT-PCR assay. Among the 150 positive RT-PCR, 90 false negative DPI tests were from a sample with a high real-time RT-PCR. While 60 true positive DPI tests were positive real-time RT-PCR for swab specimens. Among the 80 negative RT-PCR, 79 were true negative and 1 was a false positive. The predictive positive value of the DPI test was 40% and the predictive negative value of the test was 98%. DPI has at least one tie between the positive actual state group and the negative actual state group. The results show weak and moderate positive correlations between CRP and the age groups. Conclusion: The combined detection of the three indicators (RT-PCR, DPI, and CRP) are positively related to COVID-19 infection;therefore, these indicators will enable effective intervention measures to be implemented in time and the rates of severe illness and mortality to be reduced. © 2022, International Medical Research and Development Corporation. All rights reserved.

ASSESSING THE RELATIONSHIP OF STRATEGIC ALIGNMENT WITH STRATEGIC RESPONSE: MEDIATING ROLE OF STRATEGIC THINKING: PROSPECTIVE ANALYTICAL RESEARCH IN KARKH HEALTH DIRECTORATE - BAGHDAD / IRAQ

In light of the global repercussions of the recent Corona pandemic, past research examines the responsibilities of contemporary organizations to respond to these novel and complex challenges. In this setting, it is crucial to have the strategic tools to determine the magnitude, direction, and projected effects of environmental changes and develop adaptation and management plans by enhancing strengths and reducing weaknesses. Therefore, the present study aims to investigate the role of strategic thinking as a variable mediating between strategic alignment and strategic reaction. The research problem was established with various intellectual and applied problems, represented by an investigation into the understanding of levels of strategic alignment dimensions and their influence on levels of strategic response through strategic thinking. To fulfill the research purpose, a questionnaire based on a Likert five-point scale and sent to a sample of (95) respondents from the Baghdad Health Department - Karkh was developed as the primary data collection instrument. The statistical programs SmartPLS and SPSS were utilized for data analysis. According to research, strategic alignment, strategic thinking, and strategic response in the Baghdad Health Department, Al-Karkh, have positive and morally significant linkages and effects. Based on research findings, one of the most important recommendations is that administrative leaders in Karkh Health Directorate should focus on strategic thinking to improve strategic response and develop their skills and abilities in this area through specialized training courses. © 2022,International Journal of eBusiness and eGovernment Studies. All rights reserved.

Evaluation of Pfizer Vaccine Efficacy and Effect on Thrombosis in Type-2 Diabetes Mellitus Iraqi Patients

Background diabetes mellitus type 2 is associated with the highest risk of SARS-CoV-2 and complications, Vaccination against COVID-19 is highly effective in reducing mortality and morbidity in T2DM objectives The effect of the Pfizer vaccine on humoral immune responses in T2DM was measured by measuring serum Anti-Nucleocapsid SARS-CoV-2-Specific IgG Concentration Antibodies and detecting an effect on D-dimer and platelets after the second dose of the Pfizer vaccine. Methods Venous blood was collected following the second dosage of vaccination, serum Anti-Nucleocapsid SARS-CoV-2-Specific IgG concentration was assayed by ichroma-2 sandwich immunodetection method in which fluorescence and D-dimer measured by HiproBiotechnology (Nephelometry immunoassay). Results the results revealed the efficacy of the Pfizer vaccine in a diabetic is low in comparison to controls while D-dimer is higher in diabetics and lower in controls and platelets are higher in diabetics and lower in controls. Conclusion these results showed lower efficacy of the Pfizer vaccine in diabetics in comparison with control in regard to the studied parameters and the Pfizer vaccine does not effect on thrombosis. © 2022, ResearchTrentz Academy Publishing Education Services. All rights reserved.

The Relationship of Some Biochemical Markers with Inflammatory Prognosis in COVID-19 Patients

Background and objectives: For COVID-19 patients who need effective management, it is necessary to identify the laboratory biomarkers of progression approaching morbidity and mortality. This study aims to demonstrate numerous biochemical tests that seriously afflicted individuals. Such as ferritin, Interleukin-6 (IL6), D-dimer, Uric acid (UA), Lactate dehydrogenase (LDH), and C-reactive protein (CRP) have been proposed as disease biomarkers. Materials and methods: Blood samples were collected from 30 healthy individuals. In addition, other 60 patients confirmed by RT-PCR as COVID-19 positive after 3 to 5 days followed up with them every five days for fifteen days from the beginning of symptoms for the above parameters. All patients attended Isolated Hospital in Tikrit City / Iraq from February to June 2021. Results: Ferritin, D-dimer, IL6, CRP, LDH, and UA gradually increased to the maximum mean (1138±782.7, 1155±400.42, 23.28±4.73, 104.86±53.69, 424.91±95.4 and 5.94±1.765.94±1.76) respectively after (8-10) days and return to normal range after 15 days. Conclusion: There is a significant association of these parameters with inflammatory prognosis in COVID-19 patients. © 2022 Medicina Moderna. All rights reserved.

TIME TO EXPAND THE USE OF CASIRIVIMAB/IMDEVIMAB MONOCLONAL ANTIBODY THERAPY? A CASE OF COMPASSIONATE USE IN SEVERE COVID-19 PNEUMONIA

SESSION TITLE: COVID-19 Case Report Posters 1 SESSION TYPE: Case Report Posters PRESENTED ON: 10/17/2022 12:15 pm - 01:15 pm INTRODUCTION: The FDA limits REGEN-COV (Casirivimab/Imdevimab) use to asymptomatic adults at high risk for progression to severe COVID-19 pneumonia or post-exposure prophylaxis. Here, we present a case of compassionate use of REGEN-COV in severe COVID-19 pneumonia. CASE PRESENTATION: A 76-year-old male with a medical history significant for COPD, Rheumatoid arthritis (treated with hydroxychloroquine and low dose steroids), and monoclonal gammopathy of undetermined significance (MGUS) presented with one week of fever, cough, and fatigue. He was febrile to 103 F, with normal oxygen saturation on admission. SARS-CoV-2 rapid molecular PCR was positive. He was started on Levofloxacin, but he did not meet the criteria for administration of dexamethasone, remdesivir, or monoclonal antibody (mAb) therapy. On day one of admission, he became hypoxemic and was subsequently started on dexamethasone and remdesivir. He was given convalescent plasma to address inadequate antibody response to COVID-19 immunization secondary to his chronic immunosuppressed/immunodeficient state. His hypoxemia continued to worsen, requiring high-flow nasal cannula oxygen (HFNC). A regimen of tocilizumab was also initiated. CT chest angiography ruled out pulmonary embolism but revealed diffuse bilateral patchy opacities. His oxygen requirements continued to increase with decreasing ROX index and hence was transferred to the Intensive Care Unit. Repeat PCR for SARS-COV-2 was significant for a high viral load. Approval for compassionate use of REGEN-COV was obtained and administered to the patient. Following administration, his symptoms improved significantly with the transition from HFNC to simple nasal cannula oxygen. Repeat PCR for SARS-CoV-2 also showed a remarkable decline of the viral load. He was transferred back to the medical floors and later to the skilled nursing facility once he was clinically more stable. DISCUSSION: In the United States, REGEN-COV (Casirivimab/Imdevimab) treatment has been approved for emergency use since November 2020. The combination of these two neutralizing immunoglobulin gamma 1 (IgG1) mAb attacks the spike protein of the SARS-CoV-2 virus and has been shown to effectively prevent the progression of symptomatic COVID-19 pneumonia and decrease the high viral load of SARS-CoV-2. It also reduces COVID-19 related hospitalization or death, especially in immunosuppressed patients. Our patient received dexamethasone, remdesivir, tocilizumab, and convalescent plasma as part of conventional COVID-19 treatment with continued worsening of COVID-19 pneumonia. However, the compassionate use of REGEN-COV led to rapid clinical improvement of the patient's symptoms and reduced the SARS-CoV-2 viral load. CONCLUSIONS: Hence, physicians and FDA should consider expanding the use of REGEN-COV mAB therapy to immunosuppressed patients with rapidly worsening COVID-19 pneumonia in adjunct to conventional COVID-19 treatment. Reference #1: Stein D, Oviedo-Orta E, Kampman WA, McGinniss J, Betts G, McDermott M, Holly B, Lancaster JM, Braunstein N, Yancopoulos GD, Weinreich DM. Compassionate Use of REGEN-COV ® in Patients with COVID-19 and Immunodeficiency-Associated Antibody Disorders. Clin Infect Dis. 2021 Dec 31:ciab1059. doi: 10.1093/cid/ciab1059. Epub ahead of print. PMID: 34971385;PMCID: PMC8755381. Reference #2: O'Brien MP, Forleo-Neto E, Musser BJ, Isa F, Chan KC, Sarkar N, Bar KJ, Barnabas RV, Barouch DH, Cohen MS, Hurt CB, Burwen DR, Marovich MA, Hou P, Heirman I, Davis JD, Turner KC, Ramesh D, Mahmood A, Hooper AT, Hamilton JD, Kim Y, Purcell LA, Baum A, Kyratsous CA, Krainson J, Perez-Perez R, Mohseni R, Kowal B, DiCioccio AT, Stahl N, Lipsich L, Braunstein N, Herman G, Yancopoulos GD, Weinreich DM;Covid-19 Phase 3 Prevention Trial Team. Subcutaneous REGEN-COV Antibody Combination to Prevent Covid-19. N Engl J Med. 2021 Sep 23;385(13):1184-1195. doi: 10.1056/NEJMoa2109682. Epub 2021 Aug 4. PMID: 34347950;PMCI : PMC8362593. Reference #3: Weinreich DM, Sivapalasingam S, Norton T, Ali S, Gao H, Bhore R, Xiao J, Hooper AT, Hamilton JD, Musser BJ, Rofail D, Hussein M, Im J, Atmodjo DY, Perry C, Pan C, Mahmood A, Hosain R, Davis JD, Turner KC, Baum A, Kyratsous CA, Kim Y, Cook A, Kampman W, Roque-Guerrero L, Acloque G, Aazami H, Cannon K, Simón-Campos JA, Bocchini JA, Kowal B, DiCioccio AT, Soo Y, Geba GP, Stahl N, Lipsich L, Braunstein N, Herman G, Yancopoulos GD;Trial Investigators. REGEN-COV Antibody Combination and Outcomes in Outpatients with Covid-19. N Engl J Med. 2021 Dec 2;385(23):e81. doi: 10.1056/NEJMoa2108163. Epub 2021 Sep 29. PMID: 34587383;PMCID: PMC8522800. DISCLOSURES: No relevant relationships by Mubashir Ayaz Ahmed No relevant relationships by Shayet Hossain Eshan No relevant relationships by Sami Hussein No relevant relationships by Khalid Hussein No relevant relationships by Kamalnath Sankaran Rajagopalan No relevant relationships by Chenyu Sun

Taking and Sharing Photographs of Virtual Court Proceedings to Social Media: A Critical Appraisal on the Law of Contempt in Malaysia

In response to the spread of the Covid-19 pandemic, virtual Court hearings in Malaysia are now conducted in a way that enables proceedings to continue, ensuring its accessibility to the public. However, the attendees of virtual Court hearings remain bound to the same prohibitions as those enforced in conventional hearings. In Malaysia, the Court bans photography of any proceedings in the Courtroom, in which, disregarding the prohibition, can cite one for contempt of Court. The excessive use of digital photography may trigger photo manipulation by creating unrealistic images, which causes a public misconception. However, Zoom Court hearings have remained a permanent feature of the Malaysian justice system post-Covid-19. This research aims to examine whether photography in Court proceedings amounts to contempt by disrupting the ongoing process. The methodology used is qualitative approach based on library and internet research. This research found that photography of Court proceedings and sharing the photographs on social media platforms give rise to the dangers of witness intimidation and prejudice to the accused person’s right to a fair hearing. It suggests a need to envision a detailed guideline, clearer signage, and develop special measures for the stakeholders to use mobile phones with cameras in Court proceedings © 2022. The Author(s). This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC-BY 4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. See http://creativecommons.org/licenses/by/4.0/. International Journal for Court Administration is a peer-reviewed open access journal published by International Association for Court Administration

Diagnosis of COVID-19 from X-rays Using Recurrent Neural Network

Nearly two years ago, the COVID-19 pandemic caused by the SARS-CoV-2 virus has caused drastic changes in many aspects of life at many levels in the world, and this has affected people's lifestyles. This impact was particularly significant and impactful on the health sectors, among many others. The COVID-19 virus has essentially increased the demand for treatment, diagnosis and testing. The definitive test for diagnosing COVID-19 is reverse transcriptase polymerase chain reaction (RT-PCR);nevertheless, chest x-ray is a quick, effective and inexpensive diagnosis to detect possible pneumonia associated with COVID-19. In this study, the feasibility of using a deep learning-based Recurrent Neural Network (RNN) classifier to detect COVID-19 from CXR images is investigated. The proposed classifier consists of an RNN, trained by a deep learning model. The RNN identifies abnormal images that contain signs of COVID-19. The experiment used in the study employed 286 COVID-19 samples from the Kaggle Repository. The proposed technique is compared with the decision tree algorithm in order to prove the efficiency of the proposed one. The results revealed that the accuracy of the RNN was 97.90%, with a low data loss rate of 2.10%, while the decision tree accuracy was 75.8741%, and a relatively high data loss rate of 24.1259%. These results support the usefulness of the proposed deep learning-based RNN classifier in pre-screening patients for triage and decision-making before RT-PCR data are available. © 2022 NSP Natural Sciences Publishing Cor.

Navigating Harm Through Lovingkindness: A Community-Engaged Qualitative Study With Diverse Meditators During COVID-19

Methods: In partnership between university researchers and a community-based meditation center, we conducted virtual focus groups on experiences lovingkindness meditation before and during the COVID-19 pandemic. We used reflexive thematic analysis to analyze focus group data, with a member checking process. Results: 47 people participated in 6 focus groups (mean age 47;62% LGBTQ+;32% white, 23% Asian, 19% Black, 13% Hispanic/Latina/o, 24% multi-racial). Qualitative analysis revealed two central themes: (1) Diverse meditators' participation in a community of practice, including adaptation to virtual-only formats during COVID-19;(2) The use of metta to navigate harmful situations, both individual stressors and systems of oppression. Background: Inclusive research is needed to understand how contemplative practices are used by people across a range of identities. Lovingkindness meditation (LKM) may be particularly relevant for efforts towards equity and justice because of the social nature of the practice. Using community-based participatory research and an intersectional framework, this qualitative study focuses on how people in a diversemeditation community teach and practice lovingkindness or metta meditation. Conclusion: Diverse participants in a meditation community found lovingkindness practice supportive for coping with the stress of microaggressions and structural oppression. They used LKM to navigate hardships caused by the COVID- 19 pandemic, offer compassion to themselves and others, and cultivate the ability to hold multiple difficult emotions. Community-engaged approaches to meditation research are feasible during the COVID-19 pandemic and other times of crisis and should be used more widely. Health Services Research.

The Association of C-Reactive Protein and Ferritin Levels with the Severity of COVID-19 in Ajman, UAE

Background: SARS-Cov-2, a new strain of coronavirus first identified in Wuhan city, China, has spread worldwide, causing severe illnesses and a high mortality rate. Many studies have shown the association of elevated levels of pro-inflammatory markers, such as ferritin and C-reactive protein (CRP), with the severe course of coronavirus disease The aim of this research was to investigate the association between CRP and ferritin levels, and the severity of COVID-19. Methods and Results: This cross-sectional study was performed in Thumbay Hospital, Ajman, United Arab Emirates, from January 2021 to October 2021. A total of 100 COVID-19 positive patients were included in this study. Serum CRP and ferritin were measured by immunoturbidimetric assay. We found statistically significant differences between ferritin levels and disease severity (P=0.005), age category (P=0.030), and the clinical wards (P=0.016). Statistically significant differences were found between the ferritin levels in mild to moderate cases (P=0.023) and mild to severe cases (P.007). There were significant differences in CRP in mild to moderate cases (P 4).012), and in mild to severe cases (P=0.000). Thus, the results obtained showed that CRP and ferritin levels are considerably greater in severe cases than in mild and moderate cases of COVID-19. The findings of the current study indicate that CRP and serum ferritin levels might be considered as an essential indication of the progression and severity of COVID-19.

Destabilizing the structural integrity of COVID-19 by caulerpin and its derivatives along with some antiviral drugs: An in silico approaches for a combination therapy.

Presently, the SARS-CoV-2 (COVID-19) pandemic has been spreading throughout the world. Some drugs such as lopinavir, simeprevir, hydroxychloroquine, chloroquine, and amprenavir have been recommended for COVID-19 treatment by some researchers, but these drugs were not effective enough against this virus. This study based on in silico approaches was aimed to increase the anti-COVID-19 activities of these drugs by using caulerpin and its derivatives as an adjunct drug against SARS-CoV-2 receptor proteins: the SARS-CoV-2 main protease and the SARS-CoV-2 spike protein. Caulerpin exhibited antiviral activities against chikungunya virus and herpes simplex virus type 1. Caulerpin and some of its derivatives showed inhibitory activity against Alzheimer's disease. The web server ANCHOR revealed higher protein stability for the two receptors with disordered score (< 0.6). Molecular docking analysis showed that the binding energies of most of the caulerpin derivatives were higher than all the suggested drugs for the two receptors. Also, we deduced that inserting NH2, halogen, and vinyl groups can increase the binding affinity of caulerpin toward 6VYB and 6LU7, while inserting an alkyl group decreases the binding affinity of caulerpin toward 6VYB and 6LU7. So, we can modify the inhibitory effect of caulerpin against 6VYB and 6LU7 by inserting NH2, halogen, and vinyl groups. Based on the protein disordered results, the SARS-CoV-2 main protease and SARS-CoV-2 spike protein domain are highly stable proteins, so it is quite difficult to unstabilize their integrity by using individual drugs. Also, molecular dynamics (MD) simulation indicates that binding of the combination therapy of simeprevir and the candidate studied compounds to the receptors was stable and had no major effect on the flexibility of the protein throughout the simulations and provided a suitable basis for our study. So, this study suggested that caulerpin and its derivatives could be used as a combination therapy along with lopinavir, simeprevir, hydroxychloroquine, chloroquine, and amprenavir for disrupting the stability of SARS-CoV2 receptor proteins to increase the antiviral activity of these drugs.