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Public health in the United States faces a continuous cycle of "neglect, panic, repeat." As seen with 9/11, H1N1, and COVID-19, public health emergencies create a flurry of attention and resources, but once the crisis passes, focus quickly shifts to other matters until the next emergency, when the cycle repeats. This leaves the nation's public health system chronically under-resourced and ill-equipped to respond, resulting in a strained workforce that must remain nimble. Maintaining responsiveness to community needs requires a sustainable system with adequate worker supports. This perspective discusses findings from an assessment of short-term COVID-19 investments on long-term U.S. public health workforce needs, highlighting the need for a holistic approach to staffing and workforce development. Temporary staffing addressed immediate response needs, but presented challenges such as difficulties transitioning temporary staff into permanent roles and cohesively integrating temporary staff into ongoing agency operations, which often inadvertently increased administrative burdens on existing staff, exacerbating burnout and dampening morale. Ensuring a sustainable workforce necessitates innovative recruitment and retention strategies. Recommended strategies include holistic recruitment efforts in collaboration with community and academic partners, enhanced leadership training, staff compensation reviews, flexible work arrangements, and worker wellbeing initiatives. These findings guided the creation of the Putting Our People First Discussion Guide to empower agencies to engage workers in collective dialogue to improve workforce mental health, wellbeing, and retention. Bolstering a culture of worker wellbeing and retention alongside sustained funding and infrastructure is critical for the nation's public health agencies to effectively address current and future challenges.

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BACKGROUND: To systematically evaluate the effectiveness of regular coffee intake in the prevention or treatment of COVID-19 infection, and to explore its possible mechanism of action using computer molecular docking technology. METHODS: We searched for relevant ClinicalTrials.gov, Cochrane Library, PubMed, Web of Science, Embase, and China Biomedicine, Wanfang, CNKI, VIP databases to summarize studies on the effectiveness of coffee in preventing or treating COVID-19. The search period lasted until August 1, 2024. The 2 researchers screened the literature and data using Rev Man 5.4 software (the Cochrane Collaboration, 2020) for data analysis and used Schrodinger 2018-1 software to explore possible mechanisms of action. RESULTS: A total 5 studies with 39,290 participants were included. The results showed that compared with the control group that drank less or no coffee, the experimental group that drank more than 1 cup of coffee per day had significantly higher benefit rates (RD = 0.17, 95% confidence intervals [CI] = 0.08-0.27, P = .0005), including lower infection rates and improved recovery rates from COVID-19 (RD = 0.24, 95% CI = 0.13-0.35), P < .0001). Molecular docking showed that CGA and caffeine present in coffee could combine with key amino acid residues of ACE2 or 3CL proteins to form hydrogen bonds. CONCLUSIONS: Regular consumption of coffee may have certain preventive or therapeutic effects on COVID-19, and the mechanism of action may be that CGA or/caffeine in coffee may be related to the formation of hydrogen bonds by key amino acid residues such as ARG273/HIE345 of ACE2 and CYS145 of 3CL. Owing to the limited number and quality of the included studies, the effect evaluation needs to be further confirmed using clinical randomized controlled trials. The exact mechanism of action requires further verification at the molecular level, both inside and outside cells.

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AIM: Cough and airway secretions are part of daily life for people living with bronchiectasis. During the COVID-19 pandemic, infections associated with airway inflammation and cough amplified the health-related stigma and social unacceptability of coughing. This study explored the experiences and perceptions of adults with bronchiectasis during the pandemic to better understand the holistic impact of cough on their lives. METHOD: A qualitative, interpretive descriptive study was undertaken using semi-structured interviews with 15 adults living with bronchiectasis resident in Counties Manukau, Aotearoa New Zealand. RESULTS: Insights into the lives of adults living with bronchiectasis during the pandemic highlighted how they were impacted on multiple levels. Four key themes were developed that described participants' struggle: "feeling vulnerable but keeping safe"; "being treated differently"; adjusting to "becoming a virtual patient"; and participants articulating an increased focus on "self-care and supportive communities" as key strategies. Communication with health teams became crucial, offering essential support for respiratory health, medication access, reassurance and social connectivity. CONCLUSIONS: Health professionals play a key role in increasing public awareness around bronchiectasis and cough, helping to reduce stigma. While it is unknown when another disease outbreak mirroring that of COVID-19 will occur, the stigma of cough continues and warrants improved understanding.

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Different respiratory viruses might cause similar symptoms, ranging from mild upper respiratory tract involvement to severe respiratory distress, which can rapidly progress to septic shock, coagulation disorders, and multiorgan failure, ultimately leading to death. The COVID-19 pandemic has shown that predicting clinical outcomes can be challenging because of the complex interactions between the virus and the host. Traditional Chinese medicine (TCM) has distinct benefits in the treatment of respiratory viral illnesses due to its adherence to the principles of "different treatments for the same disease" and "same treatment for different diseases". This paper examines the effectiveness and underlying mechanisms of key TCM treatments for viral pneumonia in recent years. The aim of this study was to discover and confirm the active substances of TCM with potential therapeutic effects on viral pneumonia and their integrative effects and synergistic mechanisms and to provide a scientific basis for elucidating the effectiveness of TCM treatment and drug discovery. Furthermore, a thorough analysis of previous research is necessary to evaluate the effectiveness of TCM in treating viral pneumonia.

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BACKGROUND: During the COVID-19 pandemic, long-term care (LTC) facilities in Canada were confronted with many rapidly changing public health safety guidelines. Based on the guidelines, LTC facilities had to implement a series of virus containment and mitigation measures, presenting significant challenges for both workers and residents. This research aims to provide insights that could be used to guide improvements in the experiences of LTC workers, and of residents, in future pandemic crises. METHODS: A qualitative multi-case study was used to explore the pandemic experiences of a demographically diverse group of LTC workers in Canada, focusing on how public health safety guidelines impacted them, and their perceptions of challenges faced by residents. Fourteen workers were engaged from facilities in Nova Scotia and British Columbia, which are regions distinct geographically and with differences in safety guidelines and implementation. Semi-structured interviews were conducted between April to October 2021. Using thematic analysis, we identified patterns within and across the interview transcripts. RESULTS: The thematic analysis provided an understanding of the experiences and perspectives of LTC workers. There were four key themes: (1) Tangling with Uncertainty, that describes the effects of ambiguous messaging and shifting COVID-19 safety guidance on workers; (2) Finding Voice, that highlights how workers coped with feelings of helplessness during the healthcare crisis; (3) Ripple Effects, of pandemic pressures on workers beyond resident care, that included strengthening of inter-colleague support as well as financial challenges, and; (4) Loss of Home, where workers perceived that protection of residents led to a loss of the residents' home environment, personal freedom, and autonomy. CONCLUSIONS: The findings suggest that LTC workers' experiences during future pandemics may be improved by their inclusion in the development of public health safety guidelines, facilitating inter-colleague support systems, and ensuring worker financial stability. A balance should be found between preventing infection in LTC facilities and retaining the principles of holistic and resident-centered care for workers' and residents' mental health benefits.

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Panic-buying and stockpiling during Covid disrupted the supply chain, causing food shortages and impacting the vulnerable. The government faced criticism for its lack of food system resilience, poor communications planning, and reliance on retailers. The British media frequently reported on panic-buying during early lockdown stages in 2020 and throughout Covid. The media play an important role in communicating information to the British public during times of crisis and influence public opinion. This mixed-method study examined English media portrayal of panic-buying, analysing text and visual data from six of the highest-circulating newspapers from March to July 2020. It reviewed reporting trends, use of imagery, themes, and prominent stakeholder voices. Content analysis of 209 articles showed that coverage was dominated by popular and left-wing press, with 89% of articles using sensationalised language and 68% coded as negative. In a subset of 125 articles, visual imagery showed empty shelves in 64% of analysed images, reinforcing the impression of food shortages. Supermarkets were the most quoted stakeholders, appearing in 62% of articles. Contradictions included reports of no food shortages alongside images of empty shelves and early newspaper advice encouraging stockpiling. Reporting peaked between March 16-22, 2020. Six key themes were identified: supermarket prominence, food supply/access, food policy, individual behaviour, socio-economic impacts, and panic-buying drivers-all themes had relevance to food system resilience. Future civil unrest linked to food-system challenges, potentially driven by climate change, conflict, or political instability, could see panic-buying play a significant role. Research on media portrayals of panic-buying can help policymakers enhance communication strategies and identify critical issues during crises. The Covid pandemic revealed crucial lessons about the media's potential role in shaping public behaviour, highlighting the need for stronger government communication and collaboration with both the media and retailers to ensure consistent messaging, particularly to protect vulnerable groups.

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Background: The COVID-19 pandemic exacerbated pre-existing societal inequities. Our study addresses the dearth of studies on how intersecting factors of disadvantage and discrimination affected pandemic daily life for disabled people from minoritised ethnic groups, aiming to improve their experiences and social, health and well-being outcomes. Objectives: Through an intersectionality lens, to: explore and compare, by location and time, survey and qualitative data on changing needs for social, health and well-being outcomes relate coping strategies/solutions to these explore formal and informal network issues/affordances gain insights from synthesising our data contextualise and explore transferability of findings co-create outputs with stakeholders. Design: Mixed-methods, asset-based, underpinned by embodiment disability models and intersectionality, integrating three strands: (secondary): analysis of existing cohort/panel data, literature review (primary: quantitative): new survey (n = 4326), three times over 18 months (primary: qualitative): semistructured interviews (n = 271), interviewee co-create workshops (n = 104) 5 and 10 months later, mixed stakeholder co-design workshops (n = 30) for rapid-impact solutions to issues, key informant interviews (n = 4). Setting: United Kingdom and Republic of Ireland. Participants: Strand 2: community-dwelling migrants, White British comparators, with/without disability. Strand 3: focus on Arab, South Asian, African, Central/East European, or White British heritage with/without disability. Results: We found strong adherence to pandemic restrictions (where accommodation, economic situations and disability allowed) due to COVID-19 vulnerabilities. High vaccine hesitancy (despite eventual uptake) resulted from side-effect concerns and (mis)trust in the government. Many relied on food banks, local organisations, communities and informal networks. Pandemic-related income loss was common, particularly affecting undocumented migrants. Participants reported a crisis in mental health care, non-holistic social and housing care, and inaccessible, poor-quality and discriminatory remote health/social care. They preferred private care (which they could not easily afford), community or self-help online support. Lower socioeconomic status, mental health and mobility issues reduced well-being. Individual and community assets and coping strategies mitigated some issues, adapted over different pandemic phases, and focused on empowerment, self-reflection, self-care and social connectivity. Technology needs cut across these. Limitations: We could not explore area-level social distancing and infection rates. Data collection was largely online, possibly excluding some older, digitally deprived or more disabled participants. Participants engaged differently in online and face-to-face co-create workshops. Our qualitative data over-represent England and South Asian people and use contestable categories. Conclusions: Different intersecting factors led to different experiences, with low socioeconomic status particularly significant. Overall, disability and minoritised ethnic identities led to worse pandemic experiences. Our co-design work shows how to build on the assets and strengths; simple changes in professional communication and understanding should improve experience. Minoritised groups can easily be involved in policy and practice decision-making, reducing marginalisation, with better сare and outcomes. Future work: More research is needed on: (1) the impact of the post-pandemic economic situation and migration policies on migrant mental health/well-being; (2) supporting empowerment strategies across disadvantaged intersecting identities; and (3) technological deprivation and the cultural and disability-relevant acceptability of remote consultations. We found some differences in the devolved nations, which need elucidation. Study registration: This study is registered as ISRCTN40370, PROSPERO CRD42021262590 and CRD42022355254. Funding: This award was funded by the National Institute for Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: NIHR132914) and is published in full in Health and Social Care Delivery Research; Vol. 13, No. 2. See the NIHR Funding and Awards website for further award information.

Many disabled people from minoritised ethnic groups face barriers to accessing appropriate support, health and social care or vital 'resources', such as medicine and food. We wanted to understand how to improve these experiences, considering how different combinations of ethnicity and disability interacted with factors such as citizenship and income during the COVID-19 pandemic. This is known as an intersectional approach. We summarised relevant articles and data from existing surveys, and surveyed 4326 United Kingdom and Republic of Ireland residents three times over 2021­2. In 2021­2 we interviewed 231 disabled Arab, South Asian, African or Central/East European migrants across England, Scotland and Wales, 20 who were not disabled, and 20 disabled/non-disabled White British people (total n = 271). In group work 5 and 10 months later, interviewees, lay and central team members and partners shared knowledge and discussed post-interview changes. We co-designed simple solutions to issues in workshops with charity, health and social care staff, community leaders and participants. We asked policy-makers, general practitioners and community leaders how to put these into immediate practice. We found challenges greatest in: those with economic, mental health, hand loss or mobility issues; undocumented migrants; or people living alone or in substandard accommodation. Participants mistrusted National Health Service and social care, preferring informal support from friends, family and neighbours, and private care even when not affordable. Most issues could be reduced if people felt more empowered, had better technology access and were supported in self-care, and if health and social care professionals improved their communication and their understanding of people's day-to-day needs and beliefs. Our study is unusual because we used an intersectional approach, successfully involved lay (community or peer) co-researchers, initiated a professional 'community of practice' to exchange ideas, and dramatised our data for a public theatre show. We showed that, with appropriate approaches, minoritised groups, including migrants refused visas, can easily be involved in policy and practice decision-making, with better сare and outcomes for all.

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The SARS-CoV-2 vaccine is an important keystone in fighting against the virus. The vaccination alone could not prevent all SARS-CoV-2 viral infections or even its spread, especially after the emergence of newly mutant strains. The immune response to the SARS-CoV-2 vaccines varies greatly from one person to another. Age, along with adequate micronutrients, especially vitamin D, are major factors influencing immunity. We aimed to analyze SARS-CoV-2 vaccine neutralization potency and the total IgG antibodies along with 25-hydroxy-cholecalciferol concentrations in a cohort of healthy Egyptian vaccinated adults. 196 individuals were included; 145 females and 51 males, with an age range between 22 and 59 years old, from the first time of vaccination and over 16 weeks long. Three blood samples were taken from each individual at three time points; before the 1st dose of vaccination, before the 2nd dose of vaccination, and after 8 weeks of complete vaccination. The samples were analyzed using a chemiluminescent immunoassay to measure vitamin D level and titer of neutralizing and IgG antibodies. A lower level of neutralizing antibodies was detected in deficient and insufficient vitamin D-vaccinated individuals. However, a sufficient titer was detected in individuals with normal vitamin D. Vitamin D deficiency is associated with a suppressed immune response against SARS-CoV-2 despite vaccination. Thus, we made inquiries about using vitamin D as an adjuvant to SARS-CoV-2 vaccination, and its relation with the production of anti-SARS-CoV-2 antibodies.

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BACKGROUND: Despite a large number of published studies, the effect of vitamin D3 supplementation on mortality in hospitalized patients, as well as the recommended dose and duration of therapy, is unclear. In our retrospective study, we aimed to investigate the impact of vitamin D deficiency and moderately high-dose vitamin D3 supplementation on mortality and disease outcomes in patients with COVID-19 infection. METHODS: We analyzed data from 148 COVID-19-infected hospitalized patients in two different departments, Internal Medicine and Oncology, at Semmelweis University. The severity of COVID-19 and the treatment used were the same except at one of the departments, where patients received circa 90,000 IU of vitamin D3. We compared in-hospital mortality rates between the groups. In a subgroup analysis, we evaluated the efficacy and safety of vitamin D3 supplementation by assessing 25(OH)D and 1,25(OH)2D concentrations on days 0, 4, and 8. RESULTS: As a result of the supplementation, the deficiency was resolved in 4 days in deficient patients, and none of the 25(OH)D or 1,25(OH)2D concentrations exceeded the normal range. Mortality was significantly lower and decreased 67% in the group receiving vitamin D3 supplementation, regardless of baseline 25(OH)D concentrations. CONCLUSIONS: The supplemental dosage, 3 × 30,000 IU of vitamin D3, is effective and safe and may reduce mortality in COVID-19 infection.

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BACKGROUND/OBJECTIVES: The impact of the COVID-19 infection on athletes was reported to influence physical health, both decreasing performance and increasing the risk of injuries. This study aimed to assess the physical performance (maximal aerobic power, muscle function, and speed) of a group of male adolescent soccer players before and after COVID-19 infection and to compare the effects of nutrition intervention on physical performance. METHODS: This study included 99 male soccer players, between 13 and 15 years old, that had mild SARS-CoV-2 infection. Their physical performance was evaluated in three periods (1 month before and 1 and 3 months after the infection). The subjects were divided into two groups, one with rigorous nutrition intervention and one without. Physical performance was evaluated through five tests: hand grip strength, 10 m sprint test, 30 m sprint test, beep test, and bench press. RESULTS: A total of 20.2% had mild restrictions at spirometry after infection. One month after the infection, four of the five tests (hand grip strength, 10 m sprint test, 30 m sprint test, and beep test) showed statistically significantly (p < 0.005) better results in the nutrition intervention group. The same difference in results in the four tests was maintained 3 months after infection (p < 0.005). CONCLUSIONS: Nutrition intervention with a strict dietary plan and an increase in daily calories and protein and also vitamin and mineral supplements in young athletes may be effective for faster recovery of physical parameters from COVID-19 infection, and its beneficial effects should be studied further in this infection as well as in other respiratory tract infections.

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Vitamin D receptor [VDR] expression promotes LL37 expression, possibly contributing to host defense. The hypothesis was that an increase in 25 hydroxyvitamin D [25vitD] could lead to enhanced VDR expression and increased LL-37 production, thereby contributing to improved prognosis in critically ill patients. Methods: A nonblinded, randomized controlled trial was conducted. A total of 207 patients admitted to ICU with severe SARS-CoV-2 pneumonia were included and received different doses of cholecalciferol (500 MU, 3 MU/day, no cholecalciferol) during their ICU and hospital stay. 25vitD levels as well as LL37 and monocytes' VDR gene expression were evaluated on admission and after. Clinical evolution, ICU mortality, hospital mortality, and 60-day mortality were evaluated. Results: The median age was 57.7 years and the majority of patients were Caucasian [87.4%] and male [70.5%]. There was a significant difference in 25vitD levels between groups on the third [p = 0.002] and seventh [p < 0.001] days. Patients supplemented with 500 MU of cholecalciferol had a very significant increase in monocytes' VDR gene expression and showed a better clinical evolution in the ICU, with a significant correlation to evolution factors. Higher LL37 on admission had a significant negative association with hospital and ICU mortality, lost after adjustment for comorbidities to a nearly significant association with ICU, hospital, and 60-day mortality. Conclusion: Supplementation with higher doses of cholecalciferol may contribute to a significant increase in 25vitD levels but not in LL37 levels. Higher LL37 levels on admission may be related to a decrease in ICU, hospital, and 60-day mortality. VDR gene expression in monocytes is much higher in patients supplemented with higher doses of cholecalciferol.

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Clinical trials consistently demonstrate an inverse correlation between serum 25-hydroxyvitamin D [25(OH)D; calcifediol] levels and the risk of symptomatic SARS-CoV-2 disease, complications, and mortality. This systematic review (SR), guided by Bradford Hill's causality criteria, analyzed 294 peer-reviewed manuscripts published between December 2019 and November 2024, focusing on plausibility, consistency, and biological gradient. Evidence confirms that cholecalciferol (D3) and calcifediol significantly reduce symptomatic disease, complications, hospitalizations, and mortality, with optimal effects above 50 ng/mL. While vitamin D requires 3-4 days to act, calcifediol shows effects within 24 h. Among 329 trials, only 11 (3%) showed no benefit due to flawed designs. At USD 2/patient, D3 supplementation is far cheaper than hospitalization costs and more effective than standard interventions. This SR establishes a strong inverse relationship between 25(OH)D levels and SARS-CoV-2 vulnerability, meeting Hill's criteria. Vitamin D3 and calcifediol reduce infections, complications, hospitalizations, and deaths by ~50%, outperforming all patented, FDA-approved COVID-19 therapies. With over 300 trials confirming these findings, waiting for further studies is unnecessary before incorporating them into clinical protocols. Health agencies and scientific societies must recognize the significance of these results and incorporate D3 and calcifediol for prophylaxis and early treatment protocols of SARS-CoV-2 and similar viral infections. Promoting safe sun exposure and adequate vitamin D3 supplementation within communities to maintain 25(OH)D levels above 40 ng/mL (therapeutic range: 40-80 ng/mL) strengthens immune systems, reduces hospitalizations and deaths, and significantly lowers healthcare costs. When serum 25(OH)D levels exceed 70 ng/mL, taking vitamin K2 (100 µg/day or 800 µg/week) alongside vitamin D helps direct any excess calcium to bones. The recommended vitamin D dosage (approximately 70 IU/kg of body weight for a non-obese adult) to maintain 25(OH)D levels between 50-100 ng/mL is safe and cost-effective for disease prevention, ensuring optimal health outcomes.

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BACKGROUND: Post-Acute COVID Syndrome (PACS) is a complex disorder that currently lacks effective evidenced-based therapies to manage it. This randomized controlled trial aims to evaluate the effects of balneotherapy (BT) on PACS symptomatology. METHODS: Ninety-eight adults with PACS visited at Hospital del Mar Research Institute, Barcelona (Spain) were included to the study. Participants in the intervention group (n = 51) were allocated to 12 sessions of BT and aquatic exercises delivered in one month while the control group (n = 47) did not. The primary outcome was to evaluate the absolute change in questionnaire scores between baseline and two follow-up points: immediately after balneotherapy (or one-month post-baseline for the control group) and 2 months post-baseline. The following scales/questionnaires were employed: Post-COVID-19 functional status scale, mMRC dyspnea Scale, SF-36, Pittsburgh Sleep Quality Index (PSQI), Hospital Anxiety and Depression Scale (HADS), Memory failures in everyday life following severe head injury, and Visual Analogic Scale (VAS). RESULTS: Forty-seven patients in the BT group and 43 in the control group completed the study. The majority of participants were middle-aged women (> 84%; mean age 48 years), and the most prevalent symptoms were fatigue, musculoskeletal pain, and neurocognitive impairment (> 88%). Noteworthy, the vast majority did not undergo a severe primary infection (ICU admissions < 3%). After BT, significant improvement was detected in the BT group vs. the control group in various SF-36 domains, PSQI total score (Beta-coefficient [95%CI] 2.641 [1.15;4.12]; p -value = 0.003), HAD's anxiety subscale (Beta-coefficient [95%CI] 1.72 [0.40;3.03;p-value = 0.023), and VAS (Beta-coefficient [95%CI] 1.625 [0.32;2.96]; p-value = 0.026). Among these, SF-36's energy/fatigue and pain subscales exhibited the most prominent changes with a Beta-coefficient [95%CI] of -17.45 [-24.23;-10.66] and - 21.634 [-30.48;-12.78], respectively (p-value < 0.0001). No severe adverse effects were reported during BT although seventeen patients reported mild and transient worsening of preexisting symptoms, particularly fatigue/post-exertional malaise mainly in the first sessions of BT. CONCLUSION: Balneotherapy comprise an effective therapeutic modality that can alleviate several symptoms that characterize PACS, particularly musculoskeletal pain and fatigue. However, the sustainability of these effects over time remains uncertain, as evidenced by the loss of some between-group differences at the one-month follow-up. TRIAL REGISTRATION: ClinicalTrials.gov NCT05765591 (13/03/2023).

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Background: Vitamin D deficiency has been a critical global health issue within the pediatric population. Closed-off management brought about by the COVID-19 pandemic has drastically impacted outdoor activities and sunlight exposure, however, whether it indirectly further exacerbated the vitamin D deficiency has not been largely investigated, especially among children in China. The purpose of this study was to evaluate 25(OH)D concentrations in children before and during the COVID-19 lockdown and to analyze the factors influencing their vitamin D status. Methods: A cross-sectional survey included children aged 1-6 years from Han Zhong Central Hospital in the southern Shanxi Province of China. This study examined healthy children from a pediatric health care department over two periods: before COVID-19 (March 2019-February 2020), and during COVID-19 (March 2020-February 2021). Total 25(OH)D concentrations were compared between the two observation periods. Vitamin D status was determined by 25(OH)D concentrations: deficient (<20 ng/ml), insufficient (20-29 ng/ml), and sufficient (30-100 ng/ml). Results: The study involved 6,780 children, with 52.8% being 1-year-olds, 23.1% being 2-year-olds, and 24.1% being 3 to 6-year-olds. Boys and girls were 52.8 and 47.2%, respectively. The actual prevalence of deficiency in vitamin D nutritional status among children was 2.8%, with 87.1% of cases in those aged 3 to 6 years. Vitamin D insufficiency was 18.3%, affecting 54.8% of the same demographic. The average of 25(OH)D concentration were 38.2 ±â€¯9.8 ng/ml, significantly varying by age and season. 25(OH)D concentrations decreased with age, from 42.3 ±â€¯8.8 ng/ml at 1-year-olds to 37.4 ±â€¯8.2 ng/ml at 2-year-olds, and further to 30.2 ±â€¯8.1 ng/ml at 3 to 6-year-olds. Seasonal variations showed that 25(OH)D concentrations were higher in spring (38.7 ±â€¯10.1 ng/ml), summer (38.7 ±â€¯10.0 ng/ml), and fall (38.6 ±â€¯9.2 ng/ml) in comparison to winter (36.0 ±â€¯9.8 ng/ml). Additionally, the concentrations of 25(OH)D in spring exhibited a decrease during the COVID-19 pandemic (37.9 ±â€¯10.3 ng/ml) in comparison to the pre-pandemic measurements (39.3 ±â€¯9.9 ng/ml) (p = 0.008), while winter concentrations increased from (35.1 ±â€¯10.4 ng/ml) to (37.9 ±â€¯10.3 ng/ml) during the pandemic (p = 0.002). Conclusion: The research indicated that vitamin D deficiency is uncommon among Chinese children, with 25(OH)D concentrations experiencing a notable decline in those aged 3-6 years. The findings suggested a potential need for tailored supplementation strategies and possibly higher doses for this age group, along with monitoring 25(OH)D concentrations to evaluate supplementation effectiveness. COVID-19-related restrictions minimally affected children's 25(OH)D concentrations, revealing the nutritional implications of the pandemic.

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OBJECTIVES: To explore the experiences of older adult patients hospitalised with COVID-19 infection by identifying any issues they encountered, how they were able or unable to adapt, as well as their opinion of such issues. METHODS: A qualitative study was conducted by inviting a purposive sample of older adults from a metropolitan tertiary hospital in Sydney, Australia, to undertake semi-structured telephone interviews. Data was analysed using a thematic approach and adhered to the COREQ guidelines. RESULTS: A total of 16 participants were interviewed. Three predominant themes were identified from their described experiences. The majority accepted that hospitalisation was necessary for their recovery. The use of single isolation rooms affected their psychological state; however, this could have impacted them either positively or negatively. The quality of nursing care received elicited emotions of self-worth and participants also reported a variety of experiences ranging from positive to negative. CONCLUSIONS: This study identified common themes of situational acceptance and the psychological impacts of both isolation and nursing care quality as important towards the overall experience amongst older adults who had been hospitalised with COVID-19. Opportunities to improve the patient experience were also identified, and practical next steps such as tailoring the type and delivery of care to individual patient needs and preferences may assist in this.

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Since the coronavirus disease 2019 (COVID-19) outbreak, research has been conducted on treatment and countermeasures against the causative severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, the development of new seeds is urgently needed because viruses have the characteristic of becoming resistant through mutation. We hypothesize that endophytes produce antiviral substances to combat foreign viruses in host plants. According to this hypothesis, the seeds of therapeutic agents for infectious diseases could be obtained from endophytes by culture experiments. This report found that Aspergillus sp. endophyte isolated from Catharanthus roseus produced ( +)-eupenoxide and its 3-ketone form with anti-SARS-CoV-2 activity. In addition, ( +)-eupenoxide-3,6-diketon was discovered as a new compound with potent 3C-like protease inhibitory activity (IC50: 0.048 µM) by synthesis based on ( +)-eupenoxide. This finding could be an important evidence that endophytic fungi symbiosis with medicinal plants is useful as antiviral producers.

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BACKGROUND: The pandemic of coronavirus disease 2019 (COVID-19), caused by severe acute respiratory disease coronavirus 2 (SARS-CoV-2), has led to millions of infected cases and deaths worldwide. Clinical practice and clinical trials in China suggested that integrated Chinese herbal medicine (CHM) and conventional Western monotherapy (ICW) have achieved significant clinical effectiveness in treating COVID-19 patients. OBJECTIVES: This article aims to systematically evaluate the effects of ICW in treating patients at distinct stages of COVID-19. The most frequently used components of the CHM formulas have been summarized to define the most promising drug candidates. METHODS: In this meta-analysis, seven databases up to May 20, 2024, were systematically searched to collect relevant randomized controlled trials (RCTs) and cohort studies (CSs). Difference in mean (MD) or ratio risk (RR) with 95% confidence interval (CI) was utilized for data processing analysis. RESULTS: A total of 46 studies, consisting of 24 RCTs and 22 CSs, and 10492 patients were included. ICW group showed significant improvement over the conventional Western monotherapy (CWM) group at all stages of COVID-19 patients. ICW therapy was effective in improving recovery rate of chest CT (RR = 1.21, 95%CI [1.13,1.29]), shortening negativity time of nucleic acid (MD = -2.14,95% CI [-3.70, -0.58]), suppressing the transition of mild/moderate patients into severe conditions (RR = 0.45, 95% CI [0.33,0.62]), and reducing mortality (RR = 0.45, 95% CI [0.37,0.55]) for severe/critical COVID-19. Furthermore, compared with severe/critical patients, mild/moderate COVID-19 patients proved more effective after being treated with ICW therapy. They had a higher recovery rate of chest CT manifestations (75.4% vs. 69.1%), shorter negativity time of nucleic acid (9.21 d vs. 14.89 d), reduced time to clinical symptom reduction (3.85d vs. 11d) and shortened days of hospital stays (15.9d vs 19.1d). As for inflammatory markers analysis, ICW regimens decreased the level of lymphocytes in mild/moderate and severe/critical patients (MD = -0.15, 95% CI [-0.18, -0.13]), but no statistical difference was observed in white blood cell count and neutrophils count (MD = 0.02, 95% CI [-0.14, -0.18]; MD = 0.22,95% CI [-0.7, 1.15], respectively). A different tendency was found in the C-reactive protein level, which significantly decreased at the early stage of COVID-19 in the ICW group (MD = 2.56, 95%CI [1.28,3.83]). CONCLUSION: This meta-analysis demonstrates the significant superiority of ICW over single western monotherapy in improving clinical efficacy at distinct stages of Chinese COVID-19 patients. Subgroup analysis further showed that the earlier intervention of CHM may contribute to a better therapeutic effect. TRIAL REGISTRATION: PROSPERO ID: CRD42023401200.

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In a recent clinical trial, beetroot juice supplementation for 14 days yielded positive effects on systemic inflammation in adults with long COVID. Here, we explored the relationship between circulating markers of mitochondrial quality and inflammation in adults with long COVID as well as the impact of beetroot administration on those markers. We conducted secondary analyses of a placebo-controlled randomized clinical trial testing beetroot juice supplementation as a remedy against long COVID. Analyses were conducted in 25 participants, 10 assigned to placebo (mean age: 40.2 ± 11.5 years, 60% women) and 15 allocated to beetroot juice (mean age: 38.3 ± 7.7 years, 53.3% women). Extracellular vesicles were purified from serum by ultracentrifugation and assayed for components of the electron transport chain and mitochondrial DNA (mtDNA) by Western blot and droplet digital polymerase chain reaction (ddPCR), respectively. Inflammatory markers and circulating cell-free mtDNA were quantified in serum through a multiplex immunoassay and ddPCR, respectively. Beetroot juice administration for 14 days decreased serum levels of interleukin (IL)-1ß, IL-8, and tumor necrosis factor alpha, with no effects on circulating markers of mitochondrial quality control. Significant negative associations were observed between vesicular markers of mitochondrial quality control and the performance on the 6 min walk test and flow-mediated dilation irrespective of group allocation. These findings suggest that an amelioration of mitochondrial quality, possibly mediated by mitochondria-derived vesicle recycling, may be among the mechanisms supporting improvements in physical performance and endothelial function during the resolution of long COVID.

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Remdesivir and moxifloxacin hydrochloride are among the most frequently co-administered drugs used for COVID-19 treatment. The current work aims to evaluate green spectrophotometric methodologies for estimating remdesivir and moxifloxacin hydrochloride in different matrices for the first time. The proposed approaches were absorbance subtraction, extended ratio subtraction and amplitude modulation methods. In order to determine the absorbance of the investigated medications in combination at the isoabsorptive point, the pure moxifloxacin hydrochloride absorbance factor is applied using the absorbance subtraction method, which modifies the zero absorption spectra of the drugs under investigation at the isoabsorptive point (229 nm). The spectrum of moxifloxacin hydrochloride is more extended in the plateau area between 340 and 400 nm, where remdesivir exhibits no absorption. So, also, the ratio spectra were successfully manipulated for quantification of the two drugs. Regarding the pharmacokinetic profile of remdesivir (Cmax 4420 ng/mL) and moxifloxacin hydrochloride (Cmax 3.56 µg/mL), the proposed methods were effectively used to spectrophotometrically determine remdesivir and moxifloxacin hydrochloride in plasma matrix. The new approach was validated using the ICH guidelines for specificity, linearity, precision, and accuracy. The greenness of the reported methodologies was evaluated using two metrics: the analytical eco-scale and the green analytical procedure index.

RESUMEN

Coronaviruses (CoVs) pose a significant threat to human health, as demonstrated by the COVID-19 pandemic. The large size of the CoV genome (around 30 kb) represents a major obstacle to the development of reverse genetics systems, which are invaluable for basic research and antiviral drug screening. In this study, we established a rapid and convenient method for generating reverse genetic systems for various CoVs using a bacterial artificial chromosome (BAC) vector and Gibson DNA assembly. Using this system, we constructed infectious cDNA clones of coronaviruses from three genera: human coronavirus 229E (HCoV-229E) of the genus Alphacoronavirus, mouse hepatitis virus A59 (MHV-59) of Betacoronavirus, and porcine deltacoronavirus (PDCoV-Haiti) of Deltacoronavirus. Since beta coronaviruses including severe acute respiratory syndrome coronavirus (SARS-CoV), severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and Middle East respiratory syndrome coronavirus (MERS-CoV) represent major human pathogens, we modified the infectious clone of the beta coronavirus MHV-A59 by replacing its NS5a gene with a fluorescent reporter gene to create a system suitable for high-throughput drug screening. Thus, this study provides a practical and cost-effective approach to developing reverse genetics platforms for CoV research and antiviral drug screening.