关键词： dexamethasone   methylprednisolone   glucocorticoid pathway   polymorphism   treatment outcome   COVID-19   POLYMORPHISM   PHARMACOKINETICS   ASSOCIATION   CYP3A4-ASTERISK-22   SENSITIVITY   MECHANISMS  

摘要： Introduction: Corticosteroids are widely used for the treatment of coronavirus disease (COVID)-19. Genetic polymorphisms of the glucocorticoid receptor, metabolizing enzymes, or transporters may affect treatment response to dexamethasone. This study aimed to evaluate the association of the glucocorticoid pathway polymorphisms with the treatment response and short-term outcomes in patients with severe ***: Our pilot study included 107 hospitalized patients with COVID-19 treated with dexamethasone and/or methylprednisolone, genotyped for 14 polymorphisms in the glucocorticoid ***: In total, 83% of patients had severe disease, 15.1% had critical disease and only 1.9% had moderate disease. CYP3A4 rs35599367 was the major genetic determinant of COVID-19 severity as carriers of this polymorphism had higher risk of critical disease (OR = 6.538; 95% confidence interval = 1.19-35.914: p = 0.031) and needed intensive care unit treatment more frequently (OR = 10; 95% CI = 1.754-57.021: p = 0.01). This polymorphism was also associated with worse disease outcomes, as those patients had to switch from dexamethasone to methylprednisolone more often (OR = 6.609; 95% CI = 1.137-38.424: p = 0.036), had longer hospitalization (p = 0.022) and needed longer oxygen supplementation (p = 0.040). Carriers of NR3C1 rs6198 polymorphic allele required shorter dexamethasone treatment (p = 0.043), but had higher odds for switching therapy with methylprednisolone (OR = 2.711; 95% CI = 1.018-7.22: p = 0.046). Furthermore, rs6198 was also associated with longer duration of hospitalization (p = 0.001) and longer oxygen supplementation (p = 0.001). NR3C1 rs33388 polymorphic allele was associated with shorter hospitalization (p = 0.025) and lower odds for ICU treatment (OR = 0.144; 95% CI = 0.027-0.769: p = 0.023). GSTP1 rs1695 was associated with duration of hospitalization (p = 0.015), oxygen supplementation and (p = 0.047) dexamethasone treatment (p = 0.022).Conclusion: Our

关键词： Acute renal injury   Covid-19   Dialysis   Chronic renal failure   Mortality  

摘要： BackgroundThe recent global pandemic due to severe acute respiratory syndrome coronavirus-2 resulted in a high rate of multi-organ failure and mortality in a large patient population across the world. As such, a possible correlation between acute kidney injury (AKI) and increased mortality rate in these patients has been suggested in *** is a two-year retrospective study of critically ill adult patients infected with COVID-19 that were admitted to the intensive care unit (ICU) on ventilatory support. Two groups of patients were identified in this study, those who were directly admitted to the ICU or those who were initially admitted to the Medical Floor and were later transferred to the ICU due to either worsening respiratory status or change in their hemodynamic conditions. Within each group, three subgroups were created based on the status of AKI, namely, those who did not develop AKI, those who developed AKI, and those who with previous history of dialysis dependent *** AKI subgroup had the highest mortality rate in the ICU and Floor patients. Of note, those patients who were directly admitted to the Floor and were later transferred to the ICU for worsening conditions also experienced a higher mortality rate if they had developed AKI during their course of hospital *** study identified a statistically significant higher mortality in patients who developed AKI than those who did not develop AKI among critically ill *** *** registration number NCT05964088. Date of registration: July 24 2023.

关键词： abdominal aortic aneurysm (AAA)   COVID-19   hypercoagulation   immune system   renin-angiotensin-aldosterone system (RAAS)   NEUTROPHIL EXTRACELLULAR TRAPS   ENDOVASCULAR REPAIR   ACUTE THROMBOSIS   ACE2   PATIENT   SARS   PATHOGENESIS   INFLAMMATION   EXPRESSION   RECEPTOR  

摘要： Background: The COVID-19 virus not only has significant pathogenicity but also influences the progression of many diseases, altering patient prognosis. Cardiovascular diseases, particularly aortic aneurysms, are among the most life-threatening *** Idea: COVID-19 infection is reported to accelerate the progression of abdominal aortic aneurysms (AAAs) and increase the risk of rupture; however, a comprehensive understanding of the underlying mechanisms remains elusive. This article primarily reviews the relevant foundational research, focusing on disruptions in the renin-angiotensin-aldosterone system (RAAS), immune system activation, and coagulation disorders. Furthermore, we summarize related clinical research, including the epidemiology of aortic aneurysms during the pandemic and specific case ***: COVID-19 infection can influence the onset and progression of aortic aneurysms by affecting the RAAS, triggering inflammation and immune dysregulation in the arterial wall, and inducing a hypercoagulation state. It is crucial to comprehensively understand the impact of pandemic viral infections on aortic diseases at the foundational and clinical levels, thereby identifying potential preventative or therapeutic approaches and preparing for potential future outbreaks.

关键词： COMMUNITY-BASED COHORT   PHYSICAL-ACTIVITY   ADULTS   COVID-19   PREVENTION   MORTALITY   DIET   UK  

摘要： Effective prevention strategies for post-COVID complications are crucial for patients, clinicians, and policy makers to mitigate their cumulative burden. This study evaluated the association of modifiable lifestyle factors (smoking, alcohol intake, BMI, physical activity, sedentary time, sleep duration, and dietary habits) with COVID-19 multisystem sequelae, death, and hospitalization in the UK Biobank cohort (n = 68,896). A favorable lifestyle (6-10 healthy factors; 46.4%) was associated with a 36% lower risk of multisystem sequelae (HR, 0.64; 95% CI, 0.58-0.69; ARR at 210 days, 7.08%; 95% CI, 5.98-8.09) compared to an unfavorable lifestyle (0-4 factors; 12.3%). Risk reductions spanned all 10 organ systems, including cardiovascular, coagulation, metabolic, gastrointestinal, kidney, mental health, musculoskeletal, respiratory disorders, and fatigue. This beneficial effect was largely attributable to direct lifestyle impacts independent of corresponding pre-infection comorbidities (71% for any sequelae). A favorable lifestyle was also related to the risk of post-COVID death (HR 0.59, 0.52-0.66) and hospitalization (HR 0.78, 0.73-0.84). These associations persisted across acute and post-acute infection phases, irrespective of hospitalization status, vaccination, or SARS-CoV-2 variant. These findings underscore the clinical and public health importance of adhering to a healthy lifestyle in mitigating long-term COVID-19 adverse impacts and enhancing future pandemic preparedness. The impact of modifiable lifestyle factors on the risk of post-COVID-19 sequelae is not well understood. Here, the authors perform a prospective cohort study amongst UK Biobank participants and show that a healthy lifestyle is associated with lower risk of post-COVID-19 sequelae across multiple organ systems.

关键词： COVID-19 infection   Inflammatory factors   Lymphocyte   Tracheal intubation   Death   SERUM CYTOKINES  

摘要： ObjectiveThis study aims to investigate the prognostic significance of inflammatory cytokines and lymphocyte levels in predicting disease progression among patients with COVID-19 ***-two hospitalized COVID-19 patients were retrospectively included as subjects for this study. General clinical information and various indicators, including lymphocyte count, interleukin-2 (IL-2), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), tumor necrosis factor (TNF), were collected. All patients received treatment according to the ninth edition of the guidelines for COVID-19. Incidences of endotracheal intubation and mortality within 28 days were *** the analysis of intubation impact, multivariate analysis identified age, immunoglobulins, lymphocytes, and IL-6 as independent risk factors. When analyzing the impact on patient mortality, multivariate analysis revealed age, prealbumin, and BNP as independent risk factors. 2. Lymphocyte count and inflammatory factors demonstrated predictive value for endotracheal intubation in COVID-19 patients. The critical lymphocyte count value was 0.91, with a sensitivity of 38.8%, specificity of 92.9%, and AUC of 0.687 (95% CI: 0.580-0.795). The critical IL-6 value was 38.21, with a sensitivity of 81%, specificity of 63.3%, and AUC of 0.771 (95% CI: 0.6670.872). The area under the ROC curve for IL-8, IL-10 and TNF is 0.665, 0.712 and 0.648, respectively. *** count and inflammatory factors also exhibited predictive value for death in COVID-19 patients. The critical lymphocyte count value was 0.56, with a sensitivity of 71.2%, specificity of 57.5%, and AUC of 0.641 (95% CI: 0.528-0.754). The critical IL-6 value was 53.05, with a sensitivity of 75%, specificity of 71.2%, and AUC of 0.770 (95% CI: 0.6690.870). The area under the ROC curve for IL-8, IL-10 and TNF is 0.687, 0.683 and 0.636, *** inflammatory factors and decreased lymphocyte levels have prognosti

关键词： COVID-19   infection rates   case-fatality rates   continents   income levels   MORTALITY   COUNTRY  

摘要： Objectives Analyzing and comparing COVID-19 infection and case-fatality rates across different regions can help improve our response to future *** We used public data from the WHO to calculate and compare the COVID-19 infection and case-fatality rates in different continents and income levels from 2019 to *** The Global prevalence of COVID-19 increased from 0.011 to 0.098, while case fatality rates declined from 0.024 to 0.009. Europe reported the highest cumulative infection rate (0.326), with Africa showing the lowest (0.011). Conversely, Africa experienced the highest cumulative case fatality rates (0.020), with Oceania the lowest (0.002). Infection rates in Asia showed a steady increase in contrast to other continents which observed initial rises followed by decreases. A correlation between economic status and infection rates was identified; high-income countries had the highest cumulative infection rate (0.353) and lowest case fatality rate (0.006). Low-income countries showed low cumulative infection rates (0.006) but the highest case fatality rate (0.016). Initially, high and upper-middle-income countries experienced elevated initial infection and case fatality rates, which subsequently underwent significant *** COVID-19 rates varied significantly by continent and income level. Europe and the Americas faced surges in infections and low case fatality rates. In contrast, Africa experienced low infection rates and higher case fatality rates, with lower- and middle-income nations exceeding case fatality rates in high-income countries over time.

关键词： protective factor   resilience   child and adolescent mental health   pediatric psychiatry   service usage   COVID-19 pandemic   ADOLESCENT  

摘要： Youth with developmental and pre-existing mental health conditions have been particularly vulnerable to declines in psychological functioning during the COVID-19 pandemic. This study aimed to first, analyze service usage within an outpatient child and adolescent psychiatry clinic in the months preceding and during the COVID-19 pandemic, and second, to examine associations with potential protective factors against mental health concerns in a treatment-engaged sample. Service usage was examined using clinic billing data, and reports on protective factors were gathered via parent survey of 81 children ages 6-17 years who received mental health treatment in an outpatient psychiatry clinic during the pandemic. Protective factors were assessed at the individual, family, and community levels, and included children's use of coping strategies, parental resilience, and parents' perceived social supports. Study outcomes, including mental health concerns, mental health emergencies, pandemic-related distress, and social impact of the pandemic, were analyzed via Pearson correlations and simultaneous multiple linear regressions. Findings suggest increased service usage and child coping, parental resilience, and social connectedness as factors associated with fewer mental health concerns in youth with psychiatric concerns during the pandemic. This study lends support for expanding psychiatric services with continued use of telemedicine platforms. Further, findings suggest a mental health benefit to optimizing individual, parental, and community-based resources to enhance children's psychological functioning, particularly for youth with pre-existing mental health conditions.

关键词： Neglected tropical diseases   Funding   WHO   Research and development   Investment   Disability adjusted life years   COVID-19   Millennium development goals   Sustainable development goals   CLIMATE-CHANGE   LEPROSY   AFRICA  

摘要： BackgroundThis study investigates the impact of the COVID-19 pandemic on the prevalence, management, and control of the neglected tropical diseases (NTDs) highlighting the current or prospective impact of COVID-19 on research and development funding for, and execution of, NTD programmes. This review was conducted to determine if, and how, NTDs were affected by COVID-19, and whether those effects will delay the elimination goals of the Sustainable Development *** open-source available data from policy and documentation from official websites of the relevant stakeholders including but not limited to World Health Organization (WHO) documents and policies, government foreign aid documents, and the Policy Cures G-Finder reports, this scoping review explored ongoing challenges to supporting research and development (R&D) for the NTDs and in maintaining NTD control programs; examined the constraints posed for NTD management by the pandemic from disruptions to healthcare services, reduction of finance and explored the potential long-term implications and consequences for those poorer, neglected populations in low and middle income-countries (LMICs). This was done by a scoping review literature search, publications were subject to an initial practical screening step to ensure the most relevant publications were selected for full screening, with the focus on scoping the designated topic of the impact of COVID-19 on NTDs. We further undertook an evaluation of the socio-economic factors exacerbating the impact of COVID-19 on NTD *** disruptions and setbacks, likely to affect NTD programmes and progress towards their elimination targets were identified in this study. R&D funding for the NTDs and AIDs and TB has declined since the funding high point of 2019, and for malaria since the high point of 2018. Significant changes in allocation of R&D funding within the NTDs are observed post pandemic, likely because of prioritization among donors. Disea

摘要： Corona virus (SARS-CoV-2) is a collection of viruses that infect the respiratory system. The disease caused by infection with this virus is called Covid-19 which can cause mild disturbances to the respiratory system and can cause death. The SEQIJR epidemic model (Susceptible, Exposed, Quarantine, Infectious not hospital, Hospitalized Infectious, Recovered) was studied by adding control variables to analyze the dynamics of the spread of Covid-19. Optimal control strategy is applied to minimize the number of infected individuals, with controls in the form of awareness campaign, quarantine and isolation. In the mathematical model of the spread of Covid-19, there are many unknown parameters, so the genetic algorithm method is used to estimate the parameters of the Covid-19 spread model. To reduce the spread of Covid-19, an optimal control design is applied using the Pontryagin minimum principle. Furthermore, it is simulated numerically with the forward-backward sweep method. Based on the simulation results, it shows that providing optimal control can bring down the spread of Covid-19 by 99.18% with minimal costs 322917.

摘要： The East Java Province has experienced a significant surge in number of confirmed cases of COVID-19. This study endeavors to investigate the potential correlation between weather conditions and the incidence of number of confirmed cases of COVID-19 in East Java. To achieve this, a nonparametric regression model, specifically, the Negative Binomial Regression (NBR) model based on the least squares spline estimator, was utilized. The outcomes of the study indicate that the Mean Absolute Percentage Error (MAPE) of nonparametic regression model is 0.30. Meanwhile, the MAPE for the parametric regression model is 0.34. The results show that a nonparametric regression model approach is better than parametric regression model approach. The study establishes that the truncated spline estimator based NBR model represents the best fit, with an MLCV value of -256.71. The findings of the study suggest that a temperature less than 21.75°C is associated with a decrease of 13.28 number of confirmed cases of COVID-19 per each 1°C increase, while a temperature between 21.75°C and 25.78°C is linked to an increase of 6.85 number of confirmed cases of COVID-19 per each 1°C increase. In contrast, a temperature greater than 25.78°C is associated with a decrease of 139.42 number of confirmed cases of COVID-19 per each 1°C increase. Similarly, a wind speed less than 5.57 m/s is related to a decrease of 12.99 number of confirmed cases of COVID-19 per each 1 m/s increase, whereas a wind speed between 5.57 m/s and 8.99 m/s is associated with a decrease of 10.29 number of confirmed cases of COVID-19 per each 1 m/s increase. Furthermore, a wind speed greater than 8.99 m/s is linked to a decrease of 19.16 number of confirmed cases of COVID-19 per each 1 m/s increase. The study provides evidence that higher temperatures and wind speeds result in a slower rise in the incidence of the number of confirmed cases of COVID-19. Consequently, it is recommended that the local government remains vigilant du