This version of BIP! Finder aims to ease the exploration of COVID-19-related literature by enabling ranking articles based on various impact metrics.
Last Update: 18 - 01 - 2023 (628506 entries)
Popularity: Citation-based measure reflecting the current impact.
Influence: Citation-based measure reflecting the total impact.
Reader Attention: The current number of Mendeley readers.
Social Media Attention: The number of recent tweets related to this article.
*More details on these impact measures can be found here.
Exceptional score (in top 0.01%).
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Average score (in bottom 99%).
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CORD-19 dataset(1) (list of papers)
LitCovid hub(2) (list of papers)
PMC & PubMed (citations)
Mendeley (number of readers)
COVID-19-TweetIDs(3) (tweets)
| Title | Venue | Year | Impact | Source | |
|---|---|---|---|---|---|
| 6201 | Spread of SARS-CoV-2 in the Icelandic Population BACKGROUND: During the current worldwide pandemic, coronavirus disease 2019 (Covid-19) was first diagnosed in Iceland at the end of February. However, data are limited on how SARS-CoV-2, the virus that causes Covid-19, enters and spreads in a population. METHODS: We targeted testing to persons living in Iceland who were at high risk for infection (mainly those who were symptomatic, had recently traveled to high-risk countries, or had contact with infected persons). We also carried out population screening using two strategies: issuing an open invitation to 10,797 persons and sending random invitations to 2283 persons. We sequenced SARS-CoV-2 from 643 samples. RESULTS: As of April 4, a total of 1221 of 9199 persons (13.3%) who were recruited for targeted testing had positive results for infection with SARS-CoV-2. Of those tested in the general population, 87 (0.8%) in the open-invitation screening and 13 (0.6%) in the random-population screening tested positive for the virus. In total, 6% of the population was screened. Most persons in the targeted-testing group who received positive tests early in the study had recently traveled internationally, in contrast to those who tested positive later in the study. Children under 10 years of age were less likely to receive a positive result than were persons 10 years of age or older, with percentages of 6.7% and 13.7%, respectively, for targeted testing; in the population screening, no child under 10 years of age had a positive result, as compared with 0.8% of those 10 years of age or older. Fewer females than males received positive results both in targeted testing (11.0% vs. 16.7%) and in population screening (0.6% vs. 0.9%). The haplotypes of the sequenced SARS-CoV-2 viruses were diverse and changed over time. The percentage of infected participants that was determined through population screening remained stable for the 20-day duration of screening. CONCLUSIONS: In a population-based study in Iceland, children under 10 years of age and females had a lower incidence of SARS-CoV-2 infection than adolescents or adults and males. The proportion of infected persons identified through population screening did not change substantially during the screening period, which was consistent with a beneficial effect of containment efforts. (Funded by deCODE Genetics–Amgen.) | N Engl J Med | 2020 | LitCov and CORD-19 | |
| 6202 | Adverse reactions to BNT162b2 mRNA COVID-19 vaccine in medical staff with a history of allergy BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2, COVID-19) vaccination is progressing globally. Several adverse reactions have been reported with vaccination against COVID-19. It is unknown whether adverse reactions to COVID-19 vaccination are severe in individuals with allergies. METHODS: We administered the COVID-19 vaccine to the medical staff at Yamagata University Hospital from March to August 2021. Subsequently, we conducted an online questionnaire-based survey to investigate the presence of allergy and adverse reactions after vaccination and examine the association between allergy and adverse reactions after immunization. RESULTS: Responses were collected from 1586 and 1306 participants after the first and second administration of the BNT162b2 mRNA COVID-19 vaccine, respectively. Adverse reactions included injection site pain, injection site swelling, fever, fatigue or malaise, headache, chills, nausea, muscle pain outside the injection site, and arthralgia. The frequency of some adverse reactions and their severity were higher, and the duration of symptoms was longer in participants with allergies than in those without allergies. Although several participants visited the emergency room for treatment after the first and second vaccinations, no participant was diagnosed with anaphylaxis. CONCLUSIONS: This study suggests that the frequency and severity of adverse reactions after injection of BNT162b2 mRNA COVID-19 vaccine were higher in individuals with allergy; however, no severe adverse reactions such as anaphylaxis or death were observed. These results indicate that individuals with allergic histories may tolerate the BNT162b2 mRNA COVID-19 vaccine. | Respir Investig | 2021 | LitCov and CORD-19 | |
| 6203 | A new pharmacological approach based on remdesivir aerosolized administration on SARS-CoV-2 pulmonary inflammation: A possible and rational therapeutic application The new zoonotic coronavirus (SARS-CoV-2) responsible for coronavirus disease (COVID-19) is a new strain of coronavirus not previously seen in humans and which appears to come from bat species. It originated in Wuhan, Hubei Province, China, and spread rapidly throughout the world, causing over 2,341,066 global cases and 161,324 deaths in almost every country in the world, including Europe, particularly Italy. In general, based on existing data published to date, 80.9% of patients infected with the virus develop mild infection; 13.8% severe pneumonia; 4.7% respiratory failure, septic shock or multi-organ failure; 3% of these cases are fatal. Critical patients have been shown to develop acute respiratory distress syndrome (ARDS) and hospitalization in intensive care units. The average age of patients admitted to hospital is 57-79 years, with one third half with an underlying disease. Asymptomatic infections have also been described, but their frequency is not known. SARS-CoV-2 transmission is mainly airborne from one person to another via droplets. The data available so far seem to indicate that SARS-CoV-2 is capable of producing an excessive immune reaction in the host. The virus attacks type II pneumocytes in the lower bronchi through the binding of the Spike protein (S protein) to viral receptors, of which the angiotensin 2 conversion enzyme (ACE2) receptor is the most important. ACE2 receptor is widely expressed in numerous tissues, including the oropharynx and conjunctiva, but mostly distributed in ciliated bronchial epithelial cells and type II pneumocytes in the lower bronchi. The arrival of SARS-CoV-2 in the lungs causes severe primary interstitial viral pneumonia that can lead to the “cytokine storm syndrome”, a deadly uncontrolled systemic inflammatory response triggered by the activation of interleukin 6 (IL-6), whose effect is extensive lung tissue damage and disseminated intravascular coagulation (DIC), that are life-threatening for patients with COVID-19. In the absence of a therapy of proven efficacy, current management consists of off-label or compassionate use therapies based on antivirals, antiparasitic agents in both oral and parenteral formulation, anti-inflammatory drugs, oxygen therapy and heparin support and convalescent plasma. Like most respiratory viruses can function and replicate at low temperatures (i.e. 34-35°C) and assuming viral thermolability of SARS-CoV-2, local instillation or aerosol of antiviral (i.e. remdesivir) in humid heat vaporization (40°- 41°C) in the first phase of infection (phenotype I, before admission), both in asymptomatic but nasopharyngeal swab positive patients, together with antiseptic-antiviral oral gargles and povidone-iodine eye drops for conjunctiva (0,8-5% conjunctival congestion), would attack the virus directly through the receptors to which it binds, significantly decreasing viral replication, risk of evolution to phenotypes IV and V, reducing hospitalization and therefore death. | Med Hypotheses | 2020 | LitCov and CORD-19 | |
| 6204 | Decrease in COVID-19 adverse outcomes in adults during the Delta and Omicron SARS-CoV-2 waves, after vaccination in Mexico N/A | Front Public Health | 2022 | LitCov | |
| 6205 | Characteristics and roles of SARS-CoV-2-specific antibodies in patients with different severities of coronavirus 19 BACKGROUND: The diagnosis of COVID‐19 relies mainly on viral nucleic acid detection, but false negatives can lead to missed diagnosis and misdiagnosis. SARS‐CoV‐2‐specific antibody detection is convenient, safe, and highly sensitive. IgM and IgG are commonly used to serologically diagnose COVID‐19; however, the role of IgA is not well known. We aimed to quantify the levels of SARS‐CoV‐2‐specific IgM, IgA, and IgG antibodies, identify changes in them based on COVID‐19 severity, and establish the significance of combined antibody detection. METHODS: COVID‐19 patients, divided into a severe & critical group and a moderate group, and non‐COVID‐19 patients with respiratory disease were included in this study. A chemiluminescence method was used to detect the levels of SARS‐CoV‐2‐specific IgM, IgA, and IgG in the blood samples from the three groups. Epidemiological characteristics, symptoms, blood test results, and other data were recorded for all patients. RESULTS: Compared to the traditional IgM–IgG combined antibodies, IgA–IgG combined antibodies are better for diagnosing COVID‐19. During the disease process, IgA appeared first and disappeared last. All three antibodies had significantly higher levels in COVID‐19 patients than in non‐COVID‐19 patients. IgA and IgG were also higher for severe & critical disease than for moderate disease. All antibodies were at or near low levels at the time of tracheal extubation in critical patients. CONCLUSIONS: Detection of SARS‐CoV‐2‐specific combined IgA–IgG antibodies is advantageous in diagnosing COVID‐19. IgA detection is suitable during early and late stages of the disease. IgA and IgG levels correspond to disease severity. | Clin Exp Immunol | 2020 | LitCov and CORD-19 | |
| 6206 | What has changed in the experiences of people with mental health problems during the COVID-19 pandemic: a coproduced, qualitative interview study PURPOSE: We sought to understand how the experiences of people in the UK with pre-existing mental health conditions had developed during the course of the COVID-19 pandemic. METHODS: In September–October 2020, we interviewed adults with mental health conditions pre-dating the pandemic, whom we had previously interviewed 3 months earlier. Participants had been recruited through online advertising and voluntary sector community organisations. Semi-structured qualitative interviews were conducted by telephone or video-conference by researchers with lived experience of mental health difficulties, and, following principles of thematic analysis, were analysed to explore changes over time in people’s experience of the pandemic. RESULTS: We interviewed 44 people, achieving diversity of demographic characteristics (73% female, 54% White British, aged 18–75) and a range of mental health conditions and service use among our sample. Three overarching themes were derived from interviews. The first theme “spectrum of adaptation” describes how participants reacted to reduced access to formal and informal support through personal coping responses or seeking new sources of help, with varying degrees of success. The second theme describes “accumulating pressures” from pandemic-related anxieties and sustained disruption to social contact and support, and to mental health treatment. The third theme “feeling overlooked” reflects participants’ feeling of people with mental health conditions being ignored during the pandemic by policy-makers at all levels, which was compounded for people from ethnic minority communities or with physical health problems. CONCLUSION: In line with previous research, our study highlights the need to support marginalised groups who are at risk of increased inequalities, and to maintain crucial mental and physical healthcare and social care for people with existing mental health conditions, notwithstanding challenges of the pandemic. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00127-022-02254-6. | Soc Psychiatry Psychiatr Epide | 2022 | LitCov and CORD-19 | |
| 6207 | Clinical characteristics of patients infected with SARS-CoV-2 in North Wollo Zone, North-East Ethiopia INTRODUCTION: severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); the causative agent of coronavirus disease 2019 (COVID-19), pandemics has remained to be a public health emergency of international concern. This ongoing pandemic has resulted in the death of millions of people globally. About one and a half thousand people have died due to this illness in Ethiopia. The clinical presentations of the disease vary with geography and populations. We therefore aimed at investigating the clinical characteristics of patients infected with SARS-CoV-2 in North-East Ethiopia. METHODS: real time polymerase chain reaction (PCR) was conducted for 18,112 individuals suspected of SARS-CoV-2 infection during June 27 to October 20, 2020, at Woldia university COVID-19 testing center. Recorded data of 372 Ethiopians who tested positive for SARS-CoV-2 infection at Woldia university COVID-19 testing center were retrospectively extracted and analyzed using SPSS v25.0. A P-value of < 0.05 was considered statistically significant. RESULTS: nearly 2.1% of the screened participants were found positive for SARS-CoV-2 infection. Among them, three fourth of SARS-CoV-2 infected patients were male, with an overall median age of 30 years. About 85% of the patients were asymptomatic. The most common clinical manifestations were cough (14.2%), followed by fever (11.0%) and headache (8.6%), whereas hypertension (1.6%), human immunodeficiency virus (HIV) (1.6%) diabetes mellitus (1.1%), and chronic respiratory diseases (1.1%) were relatively the most common comorbidities noted. The case-fatality ratio was found at 1.6%. Age and underlying comorbidities had a statistically significant association with severity and poor outcome of patients (P < 0.001). CONCLUSION: the finding from this study indicated that older age and people with underlying comorbidities are at high risk of having the severe disease and poor outcomes. Hence, appropriate care and priority should be given to these people to decrease the morbidity and mortality caused by this illness. The presence of higher asymptomatic infection is the possible indicator of potential asymptomatic transmissions within the community. This highlights the need for widespread testing, and contact tracing to flatten the transmission curve. | Pan Afr Med J | 2021 | LitCov and CORD-19 | |
| 6208 | Correlates of Transitions in Food Insecurity Status during the Early Stages of the COVID-19 Pandemic among Ethnically Diverse Households in Central Texas Food insecurity increased substantially in the USA during the early stages of the 2020 COVID-19 pandemic. The purpose of this study was to identify potential sociodemographic and food access-related factors that were associated with continuing or transitioning into food insecurity in a diverse population. An electronic survey was completed by 367 households living in low-income communities in Central Texas during June–July 2020. Multinomial logistic regression models were developed to examine the associations among food insecurity transitions during COVID-19 and various sociodemographic and food access-related factors, including race/ethnicity, children in the household, loss of employment/wages, language, and issues with food availability, accessibility, affordability, and stability during the pandemic. Sociodemographic and food access-related factors associated with staying or becoming newly food insecure were similar but not identical. Having children in the household, changes in employment/wages, changing shopping location due to food availability, accessibility and/or affordability issues, issues with food availability, and stability of food supply were associated with becoming newly food insecure and staying food insecure during the pandemic. Identifying as Latino and/or Black was associated with staying food insecure during COVID-19. These findings suggest that the COVID-19 pandemic did not create new food insecurity disparities. Rather, the pandemic exacerbated pre-existing disparities. | Nutrients | 2021 | LitCov and CORD-19 | |
| 6209 | Review of the Clinical Characteristics of COVID-19 In late December 2019, a cluster of cases with 2019 Novel Coronavirus pneumonia (SARS-CoV-2) in Wuhan, China, aroused worldwide concern. Previous studies have reported epidemiological and clinical characteristics of coronavirus disease 2019 (COVID-19). The purpose of this brief review is to summarize those published studies as of late February 2020 on the clinical features, symptoms, complications, and treatments of COVID-19 and help provide guidance for frontline medical staff in the clinical management of this outbreak. | J Gen Intern Med | 2020 | LitCov and CORD-19 | |
| 6210 | Determinants of COVID-19 skepticism and SARS-CoV-2 vaccine hesitancy: findings from a national population survey of US adults BACKGROUND: The enduring presence of COVID-19 skepticism and SARS-CoV-2 vaccine hesitancy is an ongoing impediment to the global response effort to the current pandemic. This study seeks to identify determinants of skepticism and vaccine hesitancy in U.S. adults. METHODS: Data are from the Values and Beliefs of the American Public Survey, conducted in 2021 by the Gallup Organization in conjunction with Baylor University. The survey used stratified random probability sampling of the U.S. adult population (N = 1222). Outcome measures were respective single items assessing COVID-19 skepticism and SARS-CoV-2 vaccine hesitancy. Exposure variables included political, religious, and sociodemographic indicators, and moderators assessed personal history of COVID-19 and losing a relative or close friend to COVID-19. RESULTS: Skepticism and vaccine hesitancy were strongly associated with conservative and Republican political preference and conservative religious beliefs, and less so with socioeconomic status. Personal experience with COVID-19 did not mitigate the effect of politics on skepticism and barely reduced the odds for hesitancy. Results confirm that attitudes toward COVID-19 are politically and religiously conditioned, and are especially a product of conservative political preference. CONCLUSION: Skepticism about COVID-19 and hesitancy regarding SARS-CoV-2 vaccination are highest among the political and religious right. Efforts to increase immunization through public education may be inadequate; resistance appears ideological. Other solutions may need to be considered, which risk widespread pushback both politically and religiously motivated. | BMC Public Health | 2022 | LitCov and CORD-19 | |
| 6211 | Incubation period of 2019 novel coronavirus (2019-nCoV) infections among travellers from Wuhan, China, 20-28 January 2020 A novel coronavirus (2019-nCoV) is causing an outbreak of viral pneumonia that started in Wuhan, China. Using the travel history and symptom onset of 88 confirmed cases that were detected outside Wuhan in the early outbreak phase, we estimate the mean incubation period to be 6.4 days (95% credible interval: 5.6–7.7), ranging from 2.1 to 11.1 days (2.5th to 97.5th percentile). These values should help inform 2019-nCoV case definitions and appropriate quarantine durations. | Euro Surveill | 2020 | LitCov and CORD-19 | |
| 6212 | Olfactory and gustatory dysfunctions due to the coronavirus disease: a review of current evidence INTRODUCTION: It is reported that coronavirus disease (COVID-19) can affect the sense of smell and taste of infected people. The pathobiology of this virus is still incompletely known, and it is therefore important to explore the impact of COVID-19 infections on olfactory and gustatory functions. We aimed to review current evidence on olfactory and gustatory dysfunctions caused by COVID-19. METHODS: This study was a narrative review performed in 2020 to investigate the olfactory and gustatory dysfunctions of the COVID-19. We searched eight keywords in six databases to determine the related documents on the main objective of the study. To discover studies meeting the inclusion criteria, the authors screened the titles and abstracts of the identified articles. The appropriate studies were included and their results were discussed to make the final selection. RESULTS: We have studied 24 current articles on the olfactory and gustatory dysfunctions due to COVID-19. A review of current studies has shown that we have a surge in the spread of olfactory and gustatory dysfunctions that happened during the epidemic of COVID-19 infection. Most studies (95.8%) have confirmed the symptoms of anosmia in patients with SARS-CoV-2 infection. A review of current studies showed that, in addition to anosmia, evidence of ageusia and dysgeusia (parageusia) was also seen in patients with COVID-19. CONCLUSION: The results of our study support recent reports that SARS-CoV-2 may infect oral and nasal tissues and cause olfactory and gustatory dysfunctions. These findings may aid future research on the diagnosis, prevention, and treatment of COVID-19 consequences. | Eur Arch Otorhinolaryngol | 2020 | LitCov and CORD-19 | |
| 6213 | SARS-CoV-2 seroprevalence and transmission risk factors among high-risk close contacts: a retrospective cohort study BACKGROUND: The proportion of asymptomatic carriers and transmission risk factors of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) among household and non-household contacts remains unclear. In Singapore, extensive contact tracing by the Ministry of Health for every diagnosed COVID-19 case, and legally enforced quarantine and intensive health surveillance of close contacts provided a rare opportunity to determine asymptomatic attack rates and SARS-CoV-2 transmission risk factors among community close contacts of patients with COVID-19. METHODS: This retrospective cohort study involved all close contacts of confirmed COVID-19 cases in Singapore, identified between Jan 23 and April 3, 2020. Household contacts were defined as individuals who shared a residence with the index COVID-19 case. Non-household close contacts were defined as those who had contact for at least 30 min within 2 m of the index case. All patients with COVID-19 in Singapore received inpatient treatment, with access restricted to health-care staff. All close contacts were quarantined for 14 days with thrice-daily symptom monitoring via telephone. Symptomatic contacts underwent PCR testing for SARS-CoV-2. Secondary clinical attack rates were derived from the prevalence of PCR-confirmed SARS-CoV-2 among close contacts. Consenting contacts underwent serology testing and detailed exposure risk assessment. Bayesian modelling was used to estimate the prevalence of missed diagnoses and asymptomatic SARS-CoV-2-positive cases. Univariable and multivariable logistic regression models were used to determine SARS-CoV-2 transmission risk factors. FINDINGS: Between Jan 23 and April 3, 2020, 7770 close contacts (1863 household contacts, 2319 work contacts, and 3588 social contacts) linked to 1114 PCR-confirmed index cases were identified. Symptom-based PCR testing detected 188 COVID-19 cases, and 7582 close contacts completed quarantine without a positive SARS-CoV-2 PCR test. Among 7518 (96·8%) of the 7770 close contacts with complete data, the secondary clinical attack rate was 5·9% (95% CI 4·9–7·1) for 1779 household contacts, 1·3% (0·9–1·9) for 2231 work contacts, and 1·3% (1·0–1·7) for 3508 social contacts. Bayesian analysis of serology and symptom data obtained from 1150 close contacts (524 household contacts, 207 work contacts, and 419 social contacts) estimated that a symptom-based PCR-testing strategy missed 62% (95% credible interval 55–69) of COVID-19 diagnoses, and 36% (27–45) of individuals with SARS-CoV-2 infection were asymptomatic. Sharing a bedroom (multivariable odds ratio [OR] 5·38 [95% CI 1·82–15·84]; p=0·0023) and being spoken to by an index case for 30 min or longer (7·86 [3·86–16·02]; p<0·0001) were associated with SARS-CoV-2 transmission among household contacts. Among non-household contacts, exposure to more than one case (multivariable OR 3·92 [95% CI 2·07–7·40], p<0·0001), being spoken to by an index case for 30 min or longer (2·67 [1·21–5·88]; p=0·015), and sharing a vehicle with an index case (3·07 [1·55–6·08]; p=0·0013) were associated with SARS-CoV-2 transmission. Among both household and non-household contacts, indirect contact, meal sharing, and lavatory co-usage were not independently associated with SARS-CoV-2 transmission. INTERPRETATION: Targeted community measures should include physical distancing and minimising verbal interactions. Testing of all household contacts, including asymptomatic individuals, is warranted. FUNDING: Ministry of Health of Singapore, National Research Foundation of Singapore, and National Natural Science Foundation of China. | Lancet Infect Dis | 2020 | LitCov and CORD-19 | |
| 6214 | Coronavirus-Associated Psychological Distress Among Medical Students in Iran N/A | Adv Exp Med Biol | 2021 | LitCov and CORD-19 | |
| 6215 | Performance evaluation of two SARS-CoV-2 IgG/IgM rapid tests (Covid-Presto and NG-Test) and one IgG automated immunoassay (Abbott) The aim of this study was to assess the analytical performances, sensitivity and specificity, of two rapid tests (Covid- Presto® test rapid Covid-19 IgG/IgM and NG-Test® IgM-IgG COVID-19) and one automated immunoassay (Abbott SARS-CoV-2 IgG) for detecting anti- SARS-CoV-2 antibodies. This study was performed with: (i) a positive panel constituted of 88 SARS-CoV-2 specimens collected from patients with a positive SARS-CoV-2 RT-PCR, and (ii) a negative panel of 120 serum samples, all collected before November 2019, including 64 samples with a cross-reactivity panel. Sensitivity of Covid-Presto® test for IgM and IgG was 78.4% and 92.0%, respectively. Sensitivity of NG-Test® for IgM and IgG was 96.6% and 94.9%, respectively. Sensitivity of Abbott IgG assay was 96.5% showing an excellent agreement with the two rapid tests (κ = 0.947 and κ = 0.936 for NGTest ® and Covid-Presto® test, respectively). An excellent agreement was also observed between the two rapid tests (κ = 0.937). Specificity for IgM was 100% and 86.5% for Covid-Presto® test and NG-Test®, respectively. Specificity for IgG was 92.0%, 94.9% and 96.5% for Covid-Presto®, NGTest ®, and Abbott, respectively. Most of the false positive results observed with NG-Test® resulted from samples containing malarial antibodies. In conclusion, performances of these 2 rapid tests are very good and comparable to those obtained with automated immunoassay, except for IgM specificity with the NG-Test®. Thus, isolated IgM should be cautiously interpreted due to the possible false-positive reactions with this test. Finally, before their large use, the rapid tests must be reliably evaluated with adequate and large panel including early seroconversion and possible cross-reactive samples | J Clin Virol | 2020 | LitCov and CORD-19 | |
| 6216 | Psychological resilience, coping behaviours and social support among Healthcare workers during the COVID-19 pandemic: A systematic review of quantitative studies AIM: To appraise and synthesize studies examining resilience, coping behaviours and social support among health care workers during the coronavirus pandemic. BACKGROUND: A wide range of evidence has shown that health care workers, currently on the frontlines in the fight against COVID‐19, are not spared from the psychological and mental health‐related consequences of the pandemic. Studies synthesizing the role of coping behaviours, resilience and social support in safeguarding the mental health of health care workers during the pandemic are largely unknown. EVALUATION: This is a systematic review with a narrative synthesis. A total of 31 articles were included in the review. KEY ISSUES: Health care workers utilized both problem‐centred and emotion‐centred coping to manage the stress associated with the coronavirus pandemic. Coping behaviours, resilience and social support were associated with positive mental and psychological health outcomes. CONCLUSION: Substantial evidence supports the effectiveness of coping behaviours, resilience and social support to preserve psychological and mental health among health care workers during the COVID‐19 pandemic. IMPLICATIONS FOR NURSING MANAGEMENT: In order to safeguard the mental health of health care workers during the pandemic, hospital and nursing administrators should implement proactive measures to sustain resilience in HCWs, build coping skills and implement creative ways to foster social support in health care workers through theory‐based interventions, supportive leadership and fostering a resilient work environment. | J Nurs Manag | 2021 | LitCov and CORD-19 | |
| 6217 | The furin cleavage site in the SARS-CoV-2 spike protein is required for transmission in ferrets N/A | Nat Microbiol | 2021 | LitCov and CORD-19 | |
| 6218 | SARS-CoV-2 vaccine effectiveness in preventing confirmed infection in pregnant women N/A | J Clin Invest | 2021 | LitCov and CORD-19 | |
| 6219 | Evidence of coinfections during Delta and Omicron SARS-CoV-2 variants co-circulation through prospective screening and sequencing N/A | Clin Microbiol Infect | 2022 | LitCov | |
| 6220 | Antibody Response of Combination of BNT162b2 and CoronaVac Platforms of COVID-19 Vaccines against Omicron Variant By vaccinating SARS-CoV-2 naïve individuals who have already received two doses of COVID-19 vaccines, we aimed to investigate whether a heterologous prime-boost strategy, using vaccines of different platforms as the booster dose, can enhance the immune response against SARS-CoV-2 virus variants. Participants were assigned into four groups, each receiving different combination of vaccinations: two doses of BNT162b2 followed by one dose of BNT162b2 booster (B-B-B); Combination of BNT162b2 (first dose) and CoronaVac (second dose) followed by one dose of BNT162b2 booster (B-C-B); two doses of CoronaVac followed by one dose of CoronaVac booster (C-C-C); two doses of CoronaVac followed by one dose of BNT162b2 booster (C-C-B). The neutralizing antibody in sera against the virus was determined with live virus microneutralization assay (vMN). The B-B-B group and C-C-B group demonstrated significantly higher immunogenicity against SARS-CoV-2 Wild type (WT), Beta variant (BV) and Delta variant (DV). In addition, the B-B-B group and C-C-B group showed reduced but existing protection against Omicron variant (OV). Moreover, A persistent rise in vMN titre against OV was observed 3 days after booster dose. Regarding safety, a heterologous prime-boost vaccine strategy is well tolerated. In this study, it was demonstrated that using vaccines of different platforms as booster dose can enhance protection against SARS-CoV-2 variants, offering potent neutralizing activity against wild-type virus (WT), Beta variant (BV), Delta variant (DV) and some protection against the Omicron variant (OV). In addition, a booster mRNA vaccine results in a more potent immune response than inactivated vaccine regardless of which platform was used for prime doses. | Vaccines (Basel) | 2022 | LitCov and CORD-19 | |
| 6221 | Socioeconomic and Demographic Disparities in the Use of Telemedicine for Ophthalmic Care during the COVID-19 Pandemic PURPOSE: To identify disparities in the use of telemedicine during the coronavirus disease 2019 (COVID-19) pandemic. DESIGN: A cross-sectional study of completed clinical encounters in an academic ophthalmology center from March 2020, through August 2020. PARTICIPANTS: A total of 5023 patients comprising 8116 ophthalmic clinical encounters. METHODS: Medical charts were abstracted for demographic information. We identified zip code-level socioeconomic characteristics, which were drawn from the 2019 American Community Survey 5-year estimates. MAIN OUTCOME MEASURES: The completion of a synchronous video encounter, the completion of a telephone (audio-only) encounter in the absence of any video encounters, or the completion of in-person encounters only. RESULTS: During the study period, 8116 total clinical encounters were completed for 5023 unique patients. Of these patients, 446 (8.9%) participated in a video encounter, 642 (12.8%) completed a telephone encounter, and 3935 (78.3%) attended clinical appointments in person only. In adjusted analysis, patients who were Black (odds ratio [OR], 0.65; 95% confidence interval [CI], 0.52–0.80; P < 0.001) or Hispanic/Latino (OR, 0.65; 95% CI, 0.49–0.85; P = 0.002) were significantly less likely to complete a video or telephone appointment. Older patients (OR, 0.99; 95% CI, 0.98–0.99; P < 0.001), patients whose primary language was not English (OR, 0.49; 95% CI, 0.28–0.82; P = 0.01), Black patients (OR, 0.45; 95% CI, 0.32–0.62; P < 0.001), and Hispanic/Latino patients (OR, 0.56; 95% CI, 0.37–0.83; P = 0.005) were significantly less likely to complete a video encounter. Finally, among patients completing any type of telemedicine encounter, older age, (OR, 1.02; 95% CI, 1.01–1.03; P < 0.001), Medicare insurance (OR, 1.55; 95% CI, 1.11–2.17; P = 0.01), and Black race (OR, 1.97; 95% CI, 1.33–2.94; P < 0.001) were associated with using only phone visits. CONCLUSIONS: Ethnic/racial minorities, older patients, and non–English-speaking individuals were significantly less likely to complete a video telehealth encounter. With the expansion of telemedicine and the need to reduce the disparate impact of COVID-19 on minorities, it will be increasingly important to identify barriers to telehealth use and opportunities to improve access. | Ophthalmology | 2021 | LitCov and CORD-19 | |
| 6222 | The Association between Wearing a Mask and COVID-19 With the widespread and increasing number of cases of Coronavirus Disease (2019) globally, countries have been taking preventive measures against this pandemic. However, there is no universal agreement across cultures on whether wearing face masks are an effective physical intervention against disease transmission. We investigated the relationship between mask wearing and COVID-19 among close contacts of COVID-19 patients in the Hiroshima Prefecture, Japan. In the Hiroshima Prefecture, a COVID-19 form adapted from the reporting form, “Japanese Surveillance in Post-Extreme Emergencies and Disasters”, was developed to collect data from COVID-19 patients’ close contacts under active epidemiological surveillance at Public Health Centers. The relative risk of COVID-19 for mask users versus non-mask users was calculated. A total of 820 interviewees were included in the analysis and 53.3% of them responded that they wore masks. Non-mask users were infected at a rate of 16.4%, while mask users were infected at a rate of 7.1%. Those who wore masks were infected at a rate of 0.4 times that of those who did not wear masks. (RR = 0.4, 95%CI = 0.3–0.6; Adjusted RR = 0.6, 95%CI = 0.3–0.9). These findings implied that COVID-19 could be avoided to a certain degree by wearing a mask. | Int J Environ Res Public Healt | 2021 | LitCov and CORD-19 | |
| 6223 | Sex Disparities and Neutralizing-Antibody Durability to SARS-CoV-2 Infection in Convalescent Individuals The coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) has now caused over 2 million deaths worldwide and continues to expand. Currently, much is unknown about functionally neutralizing human antibody responses and durability to SARS-CoV-2 months after infection or the reason for the discrepancy in COVID-19 disease and sex. Using convalescent-phase sera collected from 101 COVID-19-recovered individuals 21 to 212 days after symptom onset with 48 additional longitudinal samples, we measured functionality and durability of serum antibodies. We also evaluated associations of individual demographic and clinical parameters with functional neutralizing antibody responses to COVID-19. We found robust antibody durability out to 6 months, as well as significant positive associations with the magnitude of the neutralizing antibody response and male sex and in individuals with cardiometabolic comorbidities. IMPORTANCE In this study, we found that neutralizing antibody responses in COVID-19-convalescent individuals vary in magnitude but are durable and correlate well with receptor binding domain (RBD) Ig binding antibody levels compared to other SARS-CoV-2 antigen responses. In our cohort, higher neutralizing antibody titers are independently and significantly associated with male sex compared to female sex. We also show for the first time that higher convalescent antibody titers in male donors are associated with increased age and symptom grade. Furthermore, cardiometabolic comorbidities are associated with higher antibody titers independently of sex. Here, we present an in-depth evaluation of serologic, demographic, and clinical correlates of functional antibody responses and durability to SARS-CoV-2 which supports the growing literature on sex discrepancies regarding COVID-19 disease morbidity and mortality, as well as functional neutralizing antibody responses to SARS-CoV-2. | mSphere | 2021 | LitCov and CORD-19 | |
| 6224 | Airborne transmission of SARS-CoV-2 to healthcare workers: a narrative review Healthcare workers are at risk of infection during the severe acute respiratory syndrome coronavirus‐2 pandemic. International guidance suggests direct droplet transmission is likely and airborne transmission occurs only with aerosol‐generating procedures. Recommendations determining infection control measures to ensure healthcare worker safety follow these presumptions. Three mechanisms have been described for the production of smaller sized respiratory particles (‘aerosols’) that, if inhaled, can deposit in the distal airways. These include: laryngeal activity such as talking and coughing; high velocity gas flow; and cyclical opening and closure of terminal airways. Sneezing and coughing are effective aerosol generators, but all forms of expiration produce particles across a range of sizes. The 5‐μm diameter threshold used to differentiate droplet from airborne is an over‐simplification of multiple complex, poorly understood biological and physical variables. The evidence defining aerosol‐generating procedures comes largely from low‐quality case and cohort studies where the exact mode of transmission is unknown as aerosol production was never quantified. We propose that transmission is associated with time in proximity to severe acute respiratory syndrome coronavirus‐1 patients with respiratory symptoms, rather than the procedures per se. There is no proven relation between any aerosol‐generating procedure with airborne viral content with the exception of bronchoscopy and suctioning. The mechanism for severe acute respiratory syndrome coronavirus‐2 transmission is unknown but the evidence suggestive of airborne spread is growing. We speculate that infected patients who cough, have high work of breathing, increased closing capacity and altered respiratory tract lining fluid will be significant producers of pathogenic aerosols. We suggest several aerosol‐generating procedures may in fact result in less pathogen aerosolisation than a dyspnoeic and coughing patient. Healthcare workers should appraise the current evidence regarding transmission and apply this to the local infection prevalence. Measures to mitigate airborne transmission should be employed at times of risk. However, the mechanisms and risk factors for transmission are largely unconfirmed. Whilst awaiting robust evidence, a precautionary approach should be considered to assure healthcare worker safety. | Anaesthesia | 2020 | LitCov and CORD-19 | |
| 6225 | Comparative therapeutic efficacy of remdesivir and combination lopinavir, ritonavir and interferon beta against MERS-CoV Middle East respiratory syndrome coronavirus (MERS-CoV) is the causative agent of a severe respiratory disease associated with more than 2468 human infections and over 851 deaths in 27 countries since 2012. There are no approved treatments for MERS-CoV infection although a combination of lopinavir, ritonavir and interferon beta (LPV/RTV-IFNb) is currently being evaluated in humans in the Kingdom of Saudi Arabia. Here, we show that remdesivir (RDV) and IFNb have superior antiviral activity to LPV and RTV in vitro. In mice, both prophylactic and therapeutic RDV improve pulmonary function and reduce lung viral loads and severe lung pathology. In contrast, prophylactic LPV/RTV-IFNb slightly reduces viral loads without impacting other disease parameters. Therapeutic LPV/RTV-IFNb improves pulmonary function but does not reduce virus replication or severe lung pathology. Thus, we provide in vivo evidence of the potential for RDV to treat MERS-CoV infections. | Nat Commun | 2020 | CORD-19 | |
| 6226 | A Global Survey on the Impact of COVID-19 on Urological Services BACKGROUND: The World Health Organization (WHO) declared coronavirus disease-19 (COVID-19) as a pandemic on March 11, 2020. The impact of COVID-19 on urological services in different geographical areas is unknown. OBJECTIVE: To investigate the global impact of COVID-19 on urological providers and the provision of urological patient care. DESIGN, SETTING, AND PARTICIPANTS: A cross-sectional, web-based survey was conducted from March 30, 2020 to April 7, 2020. A 55-item questionnaire was developed to investigate the impact of COVID-19 on various aspects of urological services. Target respondents were practising urologists, urology trainees, and urology nurses/advanced practice providers. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary outcome was the degree of reduction in urological services, which was further stratified by the geographical location, degree of outbreak, and nature and urgency of urological conditions. The secondary outcome was the duration of delay in urological services. RESULTS AND LIMITATIONS: A total of 1004 participants responded to our survey, and they were mostly based in Asia, Europe, North America, and South America. Worldwide, 41% of the respondents reported that their hospital staff members had been diagnosed with COVID-19 infection, 27% reported personnel shortage, and 26% had to be deployed to take care of COVID-19 patients. Globally, only 33% of the respondents felt that they were given adequate personal protective equipment, and many providers expressed fear of going to work (47%). It was of concerning that 13% of the respondents were advised not to wear a surgical face mask for the fear of scaring their patients, and 21% of the respondents were advised not to discuss COVID-19 issues or concerns on media. COVID-19 had a global impact on the cut-down of urological services, including outpatient clinic appointments, outpatient investigations and procedures, and urological surgeries. The degree of cut-down of urological services increased with the degree of COVID-19 outbreak. On average, 28% of outpatient clinics, 30% of outpatient investigations and procedures, and 31% of urological surgeries had a delay of >8 wk. Urological services for benign conditions were more affected than those for malignant conditions. Finally, 47% of the respondents believed that the accumulated workload could be dealt with in a timely manner after the COVID-19 outbreak, but 50% thought the postponement of urological services would affect the treatment and survival outcomes of their patients. One of the limitations of this study is that Africa, Australia, and New Zealand were under-represented. CONCLUSIONS: COVID-19 had a profound global impact on urological care and urology providers. The degree of cut-down of urological services increased with the degree of COVID-19 outbreak and was greater for benign than for malignant conditions. One-fourth of urological providers were deployed to assist with COVID-19 care. Many providers reported insufficient personal protective equipment and support from hospital administration. PATIENT SUMMARY: Coronavirus disease-19 (COVID-19) has led to significant delay in outpatient care and surgery in urology, particularly in regions with the most COVID-19 cases. A considerable proportion of urology health care professionals have been deployed to assist in COVID-19 care, despite the perception of insufficient training and protective equipment. | Eur Urol | 2020 | LitCov and CORD-19 | |
| 6227 | Supporting population mental health and wellness during the COVID-19 pandemic in Canada: protocol for a sequential mixed-method study INTRODUCTION: The global COVID-19 pandemic has reported to have a negative impact on the mental health and well-being of individuals around the world. Mental health system infrastructure, primarily developed to support individuals through in-person care, struggled to meet rising demand for services even prior to COVID-19. With public health guidelines requiring the use of physical distancing during the pandemic, digital mental health supports may be one way to address the needs of the population. Despite this, barriers exist in promoting and supporting access to existing and emerging digital resources. Text messaging may address some of these barriers, extending the potential reach of these digital interventions across divides that may separate some vulnerable or disadvantaged groups from essential mental health supports. Building on an existing knowledge synthesis project identifying key digital resources for improved mental health, this research will establish low-tech connections to assess need and better match access to services for those who need it most. The aim of this study is to codesign a customised two-way texting service to explore need and better align access to mental health supports for Canadians located in Saskatchewan during the COVID-19 pandemic. METHODS AND ANALYSIS: This study will be completed in Saskatchewan, Canada. For this project, the RE-AIM (reach, effectiveness, adoption, implementation, maintenance) framework will be used to support three phases of a sequential mixed-method study. An advisory committee of Saskatchewan residents will guide this work with the study team. A 10-week service will be launched to connect individuals with appropriately suited digital mental health interventions through the use of text messaging. In phase 1, implementation and prototyping will be conducted with collaborative codesign for key elements related to features of an enrolment survey and initial messaging content. Phase 2 will focus on advancing the effectiveness of the service using quantitative user data. In phase 3, an embedding approach will be used to integrate both qualitative and quantitative data collected to understand the overall acceptability, satisfaction and perceived benefit of the text messaging service. Thematic analysis and descriptive statistics will be used as analytic methods. ETHICS AND DISSEMINATION: This study has received approval from the Research Ethics Board at the University of Saskatchewan. A knowledge dissemination plan has been developed that includes traditional academic approaches such as conference presentations, and academic publications, as well as mainstream approaches such as social media, radio and dissemination through the advisory committee. | BMJ Open | 2021 | LitCov and CORD-19 | |
| 6228 | Elevated levels of IL-6 and CRP predict the need for mechanical ventilation in COVID-19 Abstract Background COVID-19 can manifest as a viral induced hyperinflammation with multi-organ involvement. Such patients often experience rapid deterioration and need for mechanical ventilation. Currently, no prospectively validated biomarker of impending respiratory failure is available. Objective We aimed to identify and prospectively validate biomarkers that allow the identification of patients in need of impending mechanical ventilation. Methods Patients with COVID-19 hospitalized from February 29th to April 09th, 2020 were analyzed for baseline clinical and laboratory findings at admission and during the disease. Data from 89 evaluable patients were available for the purpose of analysis comprising an initial evaluation cohort (n=40) followed by a temporally separated validation cohort (n=49). Results We identified markers of inflammation, LDH and creatinine as most predictive variables of respiratory failure in the evaluation cohort. Maximal interleukin-6 (IL-6) levels before intubation showed the strongest association with the need of mechanical ventilation followed by maximal CRP. Respective AUC values for IL-6 and CRP in the evaluation cohort were 0.97 and 0.86 and similar in the validation cohort 0.90 and 0.83. The calculated optimal cutoff values in the course of disease from the evaluation cohort (IL-6> 80 pg/ml and CRP> 97 mg/l) both correctly classified 80% of patients in the validation cohort regarding their risk of respiratory failure. Conclusion Maximal levels of IL-6 followed by CRP were highly predictive of the need for mechanical ventilation. This suggests the possibility of using IL-6 or CRP levels to guide escalation of treatment in patients with COVID-19 related hyperinflammatory syndrome. | J Allergy Clin Immunol | 2020 | LitCov and CORD-19 | |
| 6229 | Comparison of clinical and pathological features between severe acute respiratory syndrome and COVID-19 N/A | Zhonghua Jie He He Hu Xi Za Zh | 2020 | LitCov and CORD-19 | |
| 6230 | Epidemiology and Pathophysiology of COVID-19 Associated Mucormycosis: India Versus the Rest of the World The coronavirus disease 2019 (COVID-19) pandemic has led to a concerning resurgence of mucormycosis. More than 47,000 cases of mucormycosis were reported in three months from India. We update our systematic review on COVID-19-associated mucormycosis (CAM) till June 21st, 2021, comparing cases reported from India and elsewhere. We included individual patient details of 275 cases of CAM, of which 233 were reported from India and 42 from the rest of the world. Diabetes mellitus was the most common underlying risk factor for CAM in India than in other countries. The fatality rate of cases reported from India (36.5%) was less than the globally reported cases (61.9%), probably due to the predominance of rhino-orbital mucormycosis. On a multivariate analysis, we found that pulmonary or disseminated mucormycosis cases and admission to the intensive care unit were associated with increased mortality, while combination medical therapy improved survival. The paucity of pulmonary and disseminated mucormycosis cases from India suggests that these cases were either not diagnosed or reported, further supported by a trend of search data from the Google search engine. In this review, we discuss the factors explaining the substantial rise in cases of CAM. We also propose a hypothetical model describing the epidemiologic triad of CAM. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s11046-021-00584-8. | Mycopathologia | 2021 | LitCov and CORD-19 | |
| 6231 | Specific allelic discrimination of N501Y and other SARS-CoV-2 mutations by ddPCR detects B.1.1.7 lineage in Washington State Real‐time epidemiological tracking of variants of concern (VOCs) can help limit the spread of more contagious forms of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), such as those containing the N501Y mutation. Typically, genetic sequencing is required to be able to track VOCs in real‐time. However, sequencing can take time and may not be accessible in all laboratories. Genotyping by RT‐ddPCR offers an alternative to rapidly detect VOCs through discrimination of specific alleles such as N501Y, which is associated with increased transmissibility and virulence. Here we describe the first cases of the B.1.1.7 lineage of SARS‐CoV‐2 detected in Washington State by using a combination of reverse‐transcription polymerase chain reaction (RT‐PCR), RT‐ddPCR, and next‐generation sequencing. We initially screened 1035 samples positive for SARS‐CoV‐2 by our CDC‐based laboratory‐developed assay using ThermoFisher's multiplex RT‐PCR COVID‐19 assay over four weeks from late December 2020 to early January 2021. S gene target failures (SGTF) were subsequently assayed by RT‐ddPCR to confirm four mutations within the S gene associated with the B.1.1.7 lineage: a deletion at amino acid (AA) 69‐70 (ACATGT), deletion at AA 145, (TTA), N501Y mutation (TAT), and S982A mutation (GCA). All four targets were detected in two specimens; follow‐up sequencing revealed a total of 9 mutations in the S gene and phylogenetic clustering within the B.1.1.7 lineage. Next, we continued screening samples for SGTF detecting 23 additional B.1.1.7 variants by RT‐ddPCR and confirmed by sequencing. As VOCs become increasingly prevalent, molecular diagnostic tools like RT‐ddPCR can be utilized to quickly, accurately, and sensitively distinguish more contagious lineages of SARS‐CoV‐2. | J Med Virol | 2021 | LitCov and CORD-19 | |
| 6232 | Comparison of patients hospitalized with COVID-19, H7N9 and H1N1 BACKGROUND: There is an urgent need to better understand the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), for that the coronavirus disease 2019 (COVID-19) continues to cause considerable morbidity and mortality worldwide. This paper was to differentiate COVID-19 from other respiratory infectious diseases such as avian-origin influenza A (H7N9) and influenza A (H1N1) virus infections. METHODS: We included patients who had been hospitalized with laboratory-confirmed infection by SARS-CoV-2 (n = 83), H7N9 (n = 36), H1N1 (n = 44) viruses. Clinical presentation, chest CT features, and progression of patients were compared. We used the Logistic regression model to explore the possible risk factors. RESULTS: Both COVID-19 and H7N9 patients had a longer duration of hospitalization than H1N1 patients (P < 0.01), a higher complication rate, and more severe cases than H1N1 patients. H7N9 patients had higher hospitalization-fatality ratio than COVID-19 patients (P = 0.01). H7N9 patients had similar patterns of lymphopenia, neutrophilia, elevated alanine aminotransferase, C-reactive protein, lactate dehydrogenase, and those seen in H1N1 patients, which were all significantly different from patients with COVID-19 (P < 0.01). Either H7N9 or H1N1 patients had more obvious symptoms, like fever, fatigue, yellow sputum, and myalgia than COVID-19 patients (P < 0.01). The mean duration of viral shedding was 9.5 days for SARS-CoV-2 vs 9.9 days for H7N9 (P = 0.78). For severe cases, the meantime from illness onset to severity was 8.0 days for COVID-19 vs 5.2 days for H7N9 (P < 0.01), the comorbidity of chronic heart disease was more common in the COVID-19 patients than H7N9 (P = 0.02). Multivariate analysis showed that chronic heart disease was a possible risk factor (OR > 1) for COVID-19, compared with H1N1 and H7N9. CONCLUSIONS: The proportion of severe cases were higher for H7N9 and SARS-CoV-2 infections, compared with H1N1. The meantime from illness onset to severity was shorter for H7N9. Chronic heart disease was a possible risk factor for COVID-19.The comparison may provide the rationale for strategies of isolation and treatment of infected patients in the future. | Infect Dis Poverty | 2020 | LitCov and CORD-19 | |
| 6233 | Necessity for detection of SARS-CoV-2 RNA in multiple types of specimens for the discharge of the patients with COVID-19 BACKGROUND: The SARS-CoV-2 RNA was detected positive again after discharged from hospital in some COVID-19 patients, with or without clinical symptoms such as fever or dry cough. METHODS: 1008 severe COVID-19 patients, with SARS-CoV-2 RNA positive detected with the mixed specimen of nasopharyngeal swab and oropharyngeal swab by real-time fluorescence quantitative PCR (RT-qPCR), were selected to monitor SARS-CoV-2 RNA with the 12 types of specimens by RT-qPCR during hospitalization. All of 20 discharged cases with COVID-19 were selected to detect SARS-CoV-2 RNA in isolation period with 7 types of specimens by RT-qPCR before releasing the isolation period. RESULTS: Of the enrolled 1008 severe patients, the nasopharyngeal swab specimens showed the highest positive rate of SARS-CoV-2 RNA (71.06%), followed by alveolar lavage fluid (66.67%), oropharyngeal swab (30.77%), sputum (28.53%), urine (16.30%), blood (12.5%), stool (12.21%), anal swab (11.22%) and corneal secretion (2.99%), and SARS-CoV-2 RNA couldn’t be detected in other types of specimen in this study. Of the 20 discharged cases during the isolation period, the positive rate of SARS-CoV-2 RNA was 30% (6/20): 2 cases were positive in sputum at the eighth and ninth day after discharge, respectively, 1 case was positive in nasopharynx swab at the sixth day after discharge, 1 case was positive in anal swab at the eighth day after discharge, and 1 case was positive in 3 specimens (nasopharynx swab, oropharynx swab and sputum) simultaneously at the fourth day after discharge, and no positive SARS-CoV-2 RNA was detected in other specimens including stool, urine and blood at the discharged patients. CONCLUSIONS: SARS-CoV-2 RNA should be detected in multiple specimens, such as nasopharynx swab, oropharynx swab, sputum, and if necessary, stool and anal swab specimens should be performed simultaneously at discharge when the patients were considered for clinical cure and before releasing the isolation period. | J Transl Med | 2020 | LitCov and CORD-19 | |
| 6234 | Severe acute respiratory syndrome coronavirus infection causes neuronal death in the absence of encephalitis in mice transgenic for human ACE2 N/A | J Virol | 2008 | CORD-19 | |
| 6235 | The Development of SARS-CoV-2 Variants: The Gene Makes the Disease A novel coronavirus (SARS-CoV-2) emerged towards the end of 2019 that caused a severe respiratory disease in humans called COVID-19. It led to a pandemic with a high rate of morbidity and mortality that is ongoing and threatening humankind. Most of the mutations occurring in SARS-CoV-2 are synonymous or deleterious, but a few of them produce improved viral functions. The first known mutation associated with higher transmissibility, D614G, was detected in early 2020. Since then, the virus has evolved; new mutations have occurred, and many variants have been described. Depending on the genes affected and the location of the mutations, they could provide altered infectivity, transmissibility, or immune escape. To date, mutations that cause variations in the SARS-CoV-2 spike protein have been among the most studied because of the protein’s role in the initial virus–cell contact and because it is the most variable region in the virus genome. Some concerning mutations associated with an impact on viral fitness have been described in the Spike protein, such as D614G, N501Y, E484K, K417N/T, L452R, and P681R, among others. To understand the impact of the infectivity and antigenicity of the virus, the mutation landscape of SARS-CoV-2 has been under constant global scrutiny. The virus variants are defined according to their origin, their genetic profile (some characteristic mutations prevalent in the lineage), and the severity of the disease they produce, which determines the level of concern. If they increase fitness, new variants can outcompete others in the population. The Alpha variant was more transmissible than previous versions and quickly spread globally. The Beta and Gamma variants accumulated mutations that partially escape the immune defenses and affect the effectiveness of vaccines. Nowadays, the Delta variant, identified around March 2021, has spread and displaced the other variants, becoming the most concerning of all lineages that have emerged. The Delta variant has a particular genetic profile, bearing unique mutations, such as T478K in the spike protein and M203R in the nucleocapsid. This review summarizes the current knowledge of the different mutations that have appeared in SARS-CoV-2, mainly on the spike protein. It analyzes their impact on the protein function and, subsequently, on the level of concern of different variants and their importance in the ongoing pandemic. | J Dev Biol | 2021 | LitCov and CORD-19 | |
| 6236 | Microwave-Generated Steam Decontamination of N95 Respirators Utilizing Universally Accessible Materials The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has caused a severe, international shortage of N95 respirators, which are essential to protect health care providers from infection. Given the contemporary limitations of the supply chain, it is imperative to identify effective means of decontaminating, reusing, and thereby conserving N95 respirator stockpiles. To be effective, decontamination must result in sterilization of the N95 respirator without impairment of respirator filtration or user fit. Although numerous methods of N95 decontamination exist, none are universally accessible. In this work, we describe a microwave-generated steam decontamination protocol for N95 respirators for use in health care systems of all sizes, geographies, and means. Using widely available glass containers, mesh from commercial produce bags, a rubber band, and a 1,100-W commercially available microwave, we constructed an effective, standardized, and reproducible means of decontaminating N95 respirators. Employing this methodology against MS2 phage, a highly conservative surrogate for SARS-CoV-2 contamination, we report an average 6-log(10) plaque-forming unit (PFU) (99.9999%) and a minimum 5-log(10) PFU (99.999%) reduction after a single 3-min microwave treatment. Notably, quantified respirator fit and function were preserved, even after 20 sequential cycles of microwave steam decontamination. This method provides a valuable means of effective decontamination and reuse of N95 respirators by frontline providers facing urgent need. | mBio | 2020 | LitCov and CORD-19 | |
| 6237 | Receptor binding and priming of the spike protein of SARS-CoV-2 for membrane fusion Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is initiated by virus binding to the ACE2 cell-surface receptors(1–4), followed by fusion of the virus and cell membranes to release the virus genome into the cell. Both receptor binding and membrane fusion activities are mediated by the virus spike glycoprotein(5–7). As with other class-I membrane-fusion proteins, the spike protein is post-translationally cleaved, in this case by furin, into the S1 and S2 components that remain associated after cleavage(8–10). Fusion activation after receptor binding is proposed to involve the exposure of a second proteolytic site (S2′), cleavage of which is required for the release of the fusion peptide(11,12). Here we analyse the binding of ACE2 to the furin-cleaved form of the SARS-CoV-2 spike protein using cryo-electron microscopy. We classify ten different molecular species, including the unbound, closed spike trimer, the fully open ACE2-bound trimer and dissociated monomeric S1 bound to ACE2. The ten structures describe ACE2-binding events that destabilize the spike trimer, progressively opening up, and out, the individual S1 components. The opening process reduces S1 contacts and unshields the trimeric S2 core, priming the protein for fusion activation and dissociation of ACE2-bound S1 monomers. The structures also reveal refolding of an S1 subdomain after ACE2 binding that disrupts interactions with S2, which involves Asp614(13–15) and leads to the destabilization of the structure of S2 proximal to the secondary (S2′) cleavage site. | Nature | 2020 | LitCov and CORD-19 | |
| 6238 | Papain-like protease regulates SARS-CoV-2 viral spread and innate immunity The papain-like protease PLpro is an essential coronavirus enzyme that is required for processing viral polyproteins to generate a functional replicase complex and enable viral spread(1,2). PLpro is also implicated in cleaving proteinaceous post-translational modifications on host proteins as an evasion mechanism against host antiviral immune responses(3–5). Here we perform biochemical, structural and functional characterization of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PLpro (SCoV2-PLpro) and outline differences with SARS-CoV PLpro (SCoV-PLpro) in regulation of host interferon and NF-κB pathways. SCoV2-PLpro and SCoV-PLpro share 83% sequence identity but exhibit different host substrate preferences; SCoV2-PLpro preferentially cleaves the ubiquitin-like interferon-stimulated gene 15 protein (ISG15), whereas SCoV-PLpro predominantly targets ubiquitin chains. The crystal structure of SCoV2-PLpro in complex with ISG15 reveals distinctive interactions with the amino-terminal ubiquitin-like domain of ISG15, highlighting the high affinity and specificity of these interactions. Furthermore, upon infection, SCoV2-PLpro contributes to the cleavage of ISG15 from interferon responsive factor 3 (IRF3) and attenuates type I interferon responses. Notably, inhibition of SCoV2-PLpro with GRL-0617 impairs the virus-induced cytopathogenic effect, maintains the antiviral interferon pathway and reduces viral replication in infected cells. These results highlight a potential dual therapeutic strategy in which targeting of SCoV2-PLpro can suppress SARS-CoV-2 infection and promote antiviral immunity. | Nature | 2020 | LitCov and CORD-19 | |
| 6239 | Psychological distress, fear and coping among Malaysians during the COVID-19 pandemic INTRODUCTION: The COVID-19 pandemic has enormously affected the psychological well-being, social and working life of millions of people across the world. This study aimed to investigate the psychological distress, fear and coping strategies as a result of the COVID-19 pandemic and its associated factors among Malaysian residents. METHODS: Participants were invited to an online cross-sectional survey from Aug-Sep 2020. The study assessed psychological distress using the Kessler Psychological Distress Scale, level of fear using the Fear of COVID-19 Scale, and coping strategies using the Brief Resilient Coping Scale. Univariate and multivariate logistic regression analyses were conducted to adjust for potential confounders. RESULTS: The mean age (±SD) of the participants (N = 720) was 31.7 (±11.5) years, and most of them were females (67.1%). Half of the participants had an income source, while 216 (30%) identified themselves as frontline health or essential service workers. People whose financial situation was impacted due to COVID-19 (AOR 2.16, 95% CIs 1.54–3.03), people who drank alcohol in the last four weeks (3.43, 1.45–8.10), people who were a patient (2.02, 1.39–2.93), and had higher levels of fear of COVID-19 (2.55, 1.70–3.80) were more likely to have higher levels of psychological distress. Participants who self-isolated due to exposure to COVID-19 (3.12, 1.04–9.32) and who had moderate to very high levels of psychological distress (2.56, 1.71–3.83) had higher levels of fear. Participants who provided care to a family member/patient with a suspected case of COVID-19 were more likely to be moderately to highly resilient compared to those who did not. CONCLUSION: Vulnerable groups of individuals such as patients and those impacted financially during COVID-19 should be supported for their mental wellbeing. Behavioural interventions should be targeted to reduce the impact of alcohol drinking during such crisis period. | PLoS One | 2021 | LitCov and CORD-19 | |
| 6240 | SARS-CoV-2 in Zimbabwe: milestones and challenges faced towards achieving the expected 60% herd immunity In response to COVID-19 pandemic, the Zimbabwe government put in place various rigorous measures to curb the spread of the virus. Although roll-out and access to COVID-19 vaccines in Africa have been slow, the World Health Organization (WHO)-led COVID-19 Vaccines Global Access (COVAX) consortium and the African vaccine acquisition task team are striving to provide 720 million doses of COVID-19 vaccines to achieve 60% coverage in Africa by June, 2022. In line with this, the Zimbabwe vaccination programme commenced on the 26(th) February 2021 and as of 9(th) June 2021, approximately, 2.6% of the population have been fully vaccinated in the country. Although the COVID-19 pandemic has crippled the economy and caused significant strain on the public health system, much has been done in the country since the first case was recorded (20(th) March 2020). However, much more needs to be done to finally reach the expected 60% herd immunity by June 2022. | Pan Afr Med J | 2021 | LitCov and CORD-19 | |
| 6241 | Omicron SARS-CoV-2 variant: Unique features and their impact on pre-existing antibodies Severe Acute Respiratory Coronavirus (SARS-CoV-2) has been emerging in the form of different variants since its first emergence in early December 2019. A new Variant of Concern (VOC) named the Omicron variant (B.1.1.529) was reported recently. This variant has a large number of mutations in the S protein. To date, there exists a limited information on the Omicron variant. Here we present the analyses of mutation distribution, the evolutionary relationship of Omicron with previous variants, and probable structural impact of mutations on antibody binding. Our analyses show the presence of 46 high prevalence mutations specific to Omicron. Twenty-three of these are localized within the spike (S) protein and the rest localized to the other 3 structural proteins of the virus, the envelope (E), membrane (M), and nucleocapsid (N). Phylogenetic analysis showed that the Omicron is closely related to the Gamma (P.1) variant. The structural analyses showed that several mutations are localized to the region of the S protein that is the major target of antibodies, suggesting that the mutations in the Omicron variant may affect the binding affinities of antibodies to the S protein. | J Autoimmun | 2021 | LitCov and CORD-19 | |
| 6242 | Knowledge, attitudes and perceptions towards COVID-19 vaccinations: a cross-sectional community survey in Bangladesh BACKGROUND: Several vaccines have been approved for use against coronavirus disease (COVID-19) and distributed globally in different regions. However, general community knowledge, attitudes and perceptions towards COVID-19 vaccinations are poorly understood. Thus, the study aimed to investigate community knowledge, attitudes and perceptions towards COVID-19 vaccinations in Bangladesh. METHODS: An exploratory and anonymous population-based e-survey was conducted among 1658 general individuals (55.6% male; mean age = 23.17 ± 6.05 years; age range = 18–65 years). The survey was conducted using a semi-structured and self-reported questionnaire containing informed consent along with four sections (i.e., socio-demographics, knowledge, attitudes, and perceptions). Multiple linear regression was performed to determine the variables predicting knowledge, and attitudes towards COVID-19 vaccinations. RESULTS: The mean scores of knowledge and attitudes were 2.83 ± 1.48 (out of 5) and 9.34 ± 2.39 (out of 12) respectively. About a quarter of participants thought that the COVID-19 vaccination available in Bangladesh is safe, only 60% will have the vaccination and about two-thirds will recommend it to family and friends. In the multiple regression model, higher SES, having university/ higher levels of education, having nuclear families and having previous history of essential vaccines uptake were associated with knowledge; whilst attitudes were significantly associated with being female and having previous history of essential vaccines uptake. Just over half of the participants thought that everyone should be vaccinated and 61% responded that health workers should be vaccinated first on priority basis. 95% of respondents believed the vaccine should be administered free of charge in Bangladesh and almost 90% believed that the COVID-19 vaccine used in Bangladesh may have side effects. CONCLUSIONS: The findings reflect inadequate knowledge but more positive attitudes towards COVID-19 vaccine among the general population in Bangladesh. In order to improve knowledge, immediate health education programs need to be initiated before mass vaccination are scheduled. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12889-021-11880-9. | BMC Public Health | 2021 | LitCov and CORD-19 | |
| 6243 | Effects of the SARS-CoV-2 pandemic on women affected by endometriosis: a large cross-sectional online survey INTRODUCTION: The SARS-CoV-2 pandemic has forced healthcare providers to reorganize their activities to protect the population from infection, postponing or suspending many medical procedures. Patients affected by chronic conditions were among the most affected. In the case of catastrophes, women have a higher lifetime prevalence of post-traumatic stress disorder (PTSD), and those with endometriosis have higher anxiety levels, making them fragile in such circumstances. MATERIALS AND METHODS: In this cross-sectional study, conducted in May 2020, we considered all women aged ≥18 years, followed up at our referral centre for endometriosis. Patients were sent an anonymous 6-section questionnaire via email, containing different validated tools for the evaluation of anxiety levels and the risk of PTSD. A multivariable linear regression was performed to assess the impact of patients’ characteristics on the distress caused by the SARS-COV-2 pandemic. RESULTS: Among the 468 women recruited, 68.8% were quite-to-extremely worried about not being able to access gynaecologic care, with almost one-third of them scoring ≥33 on the IES-R. Older age and increased levels of anxiety were associated with higher risks of PTSD (age: b = 0.28, 95% CI = 0.12 − 0.44; GAD-7: b = 1.71, 95% CI = 1.38 − 2.05), with up to 71.8% of patients with severe anxiety (GAD-7 > 15) having an IES-R score ≥33 suggestive for PTSD. Women who could leave home to work showed lower levels of PTSD (b = −4.79, 95% CI = −8.44 to − 1.15, ref. unemployed women). The implementation of telemedicine in routine clinical practice was favourably viewed by 75.6% of women. DISCUSSION: Women with endometriosis are particularly exposed to the risk of PTSD during the SARS-CoV-2 pandemic, especially if they are older or have higher levels of anxiety. Gynaecologists should resort to additional strategies, and telemedicine could represent a feasible tool to help patients cope with this situation. KEY MESSAGES: The COVID-19 pandemic significantly impacted the lives of women with endometriosis, who appeared to have a considerable risk of PTSD. Older age, higher anxiety levels and unemployment were independently associated with the risk of developing PTSD. Clinicians should develop successful alternative strategies to help patients cope with this situation, and telemedicine might represent an applicable and acceptable solution. | Ann Med | 2021 | LitCov and CORD-19 | |
| 6244 | Racial and Ethnic Disparities in Disease Severity on Admission Chest Radiographs among Patients Admitted with Confirmed COVID-19: A Retrospective Cohort Study BACKGROUND: Disease severity on chest radiographs (CXR) has been associated with higher risk of disease progression and adverse outcomes from COVID-19. Few studies have evaluated COVID-19-related racial/ethnic disparities in radiology. PURPOSE: To evaluate whether Non-White minority patients hospitalized with confirmed COVID-19 infection presented with increased severity on admission CXR compared with White/Non-Hispanic patients. METHODS: Single-institution, retrospective cohort study approved by the IRB. Patients hospitalized with confirmed COVID-19 infection (3/27/20-4/10/20) were identified using the electronic medical record (EMR) (n=326, mean age: 59 years (SD: 17 years), M:F (188:138). Primary outcome was severity of lung disease on admission CXR, measured by modified Radiographic Assessment of Lung Edema (mRALE) score. Secondary outcome was a composite adverse clinical outcome of intubation, ICU admission, or death. Primary exposure was racial/ethnic category: White/Non-Hispanic versus Non-White [i.e., Hispanic, Black, Asian, Other]. Multivariable linear regression analyses were performed to evaluate the association between mRALE scores and race/ethnicity. RESULTS: Non-White patients had significantly higher mRALE scores (median 6.1, 95% CI 5.4–6.7) compared with White/Non-Hispanic patients (median 4.2, 95% CI 3.6–4.9) (unadjusted average difference 1.8, 95% CI 0.9–2.8, p<0.01). For both White (Adjusted HR, 1.3, 95%CI 1.2-1.4, p<0.001) and Non-White patients (Adjusted HR 1.2, 95%CI 1.1-1.3, p<0.001), increasing mRALE scores were associated with a higher likelihood of experiencing composite adverse outcome with no evidence of interaction (p = 0.16). Multivariable linear regression analyses demonstrated that Non-White patients presented with higher mRALE scores on admission CXR versus White/Non-Hispanic patients (adjusted average difference 1.6, 95% CI 0.5–2.7, p<0.01). Adjustment for hypothesized mediators revealed that the association between race/ethnicity and mRALE scores was mediated by limited English proficiency (p<0.01). CONCLUSION: Non-White patients hospitalized with COVID-19 infection were more likely to present with higher severity of disease on admission CXR than White/Non-Hispanic patients, and increased severity was associated with worse outcomes for all patients. | Radiology | 2020 | LitCov and CORD-19 | |
| 6245 | Corilagin and 1,3,6-Tri-O-galloy-beta-D-glucose: potential inhibitors of SARS-CoV-2 variants N/A | Phys Chem Chem Phys | 2021 | LitCov and CORD-19 | |
| 6246 | Reduced Antibodies and Innate Cytokine Changes in SARS-CoV-2 BNT162b2 mRNA Vaccinated Transplant Patients With Hematological Malignancies N/A | Front Immunol | 2022 | LitCov | |
| 6247 | Sustained Effectiveness of Pfizer-BioNTech and Moderna Vaccines Against COVID-19 Associated Hospitalizations Among Adults-United States, March-July 2021 Real-world evaluations have demonstrated high effectiveness of vaccines against COVID-19-associated hospitalizations (1-4) measured shortly after vaccination; longer follow-up is needed to assess durability of protection. In an evaluation at 21 hospitals in 18 states, the duration of mRNA vaccine (Pfizer-BioNTech or Moderna) effectiveness (VE) against COVID-19-associated hospitalizations was assessed among adults aged ≥18 years. Among 3,089 hospitalized adults (including 1,194 COVID-19 case-patients and 1,895 non-COVID-19 control-patients), the median age was 59 years, 48.7% were female, and 21.1% had an immunocompromising condition. Overall, 141 (11.8%) case-patients and 988 (52.1%) controls were fully vaccinated (defined as receipt of the second dose of Pfizer-BioNTech or Moderna mRNA COVID-19 vaccines ≥14 days before illness onset), with a median interval of 65 days (range = 14-166 days) after receipt of second dose. VE against COVID-19-associated hospitalization during the full surveillance period was 86% (95% confidence interval [CI] = 82%-88%) overall and 90% (95% CI = 87%-92%) among adults without immunocompromising conditions. VE against COVID-19- associated hospitalization was 86% (95% CI = 82%-90%) 2-12 weeks and 84% (95% CI = 77%-90%) 13-24 weeks from receipt of the second vaccine dose, with no significant change between these periods (p = 0.854). Whole genome sequencing of 454 case-patient specimens found that 242 (53.3%) belonged to the B.1.1.7 (Alpha) lineage and 74 (16.3%) to the B.1.617.2 (Delta) lineage. Effectiveness of mRNA vaccines against COVID-19-associated hospitalization was sustained over a 24-week period, including among groups at higher risk for severe COVID-19; ongoing monitoring is needed as new SARS-CoV-2 variants emerge. To reduce their risk for hospitalization, all eligible persons should be offered COVID-19 vaccination. | MMWR Morb Mortal Wkly Rep | 2021 | LitCov and CORD-19 | |
| 6248 | Trends in Violent Penetrating Injuries During the First Year of the COVID-19 Pandemic IMPORTANCE: Public health measures instituted to reduce the spread of COVID-19 led to severe disruptions to the structure of daily life, and the resultant social and financial impact may have contributed to an increase in violence. OBJECTIVE: To examine the trends in violent penetrating injuries during the first COVID-19 pandemic year compared with previous years. DESIGN, SETTING, AND PARTICIPANTS: This retrospective cross-sectional study was performed to compare the prevalence of violent penetrating injuries during the first COVID-19 pandemic year, March 2020 to February 2021, with the previous 5 years, March 2015 to February 2020. This study was performed among all patients with a violent penetrating injury presenting at Boston Medical Center, an urban, level I trauma center that is the largest safety-net hospital and busiest trauma center in New England. Data were analyzed from January 4 to November 29, 2021. MAIN OUTCOMES AND MEASURES: The primary outcomes were the incidence and timing of emergency department presentation for violent penetrating injuries during the first year of the COVID-19 pandemic compared with the previous 5 years. Patient demographics and injury characteristics were also assessed. RESULTS: A total of 2383 patients (median [IQR] age, 29.5 [23.4-39.3] years; 2032 [85.4%] men and 351 [14.6%] women) presenting for a violent penetrating injury were evaluated, including 1567 Black patients (65.7%), 448 Hispanic patients (18.8%), and 210 White patients (8.8%). There was an increase in injuries during the first pandemic year compared with the previous 5 years, with an increase in shootings (mean [SD], 0.61 [0.89] injuries per day vs 0.46 [0.76] injuries per day; P = .002) but not stabbings (mean [SD], 0.60 [0.79] injuries per day vs 0.60 [0.82] injuries per day; P = .78). This surge in firearm violence began while Massachusetts was still under a stay-at-home advisory and before large-scale racial justice protests began. Patients presenting with violent penetrating injuries in the pandemic surge months (April-October 2020) compared with the same period in previous years were disproportionately male (153 patients [93.3%] vs 510 patients [87.6%]; P = .04), unemployed (70 patients [57.4%] vs 221 patients [46.6%]; P = .03), and Hispanic (40 patients [26.0%] vs 99 patients [17.9%]; P = .009), with a concurrent decrease in White patients (0 patients vs 26 patients [4.7%]), and were more likely to have no previous history of violent penetrating injury (146 patients [89.0%] vs 471 patients [80.9%]; P = .02). CONCLUSIONS AND RELEVANCE: These findings suggest that unprecedented measures implemented to mitigate the spread of COVID-19 were associated with an increase in gun violence. As the pandemic abates, efforts at community violence prevention and intervention must be redoubled to defend communities against the epidemic of violence. | JAMA Netw Open | 2022 | LitCov and CORD-19 | |
| 6249 | Psychological Impact of COVID-19 Pandemic on Healthcare Workers in Riyadh, Saudi Arabia: Perceived Stress Scale Measures BACKGROUND: The COVID-19 pandemic has been stressful and of considerable concern among health care workers (HCWs). Being particularly at increased risk for exposure, HCWs worry about becoming infected as well as infecting co-workers, patients and family members. Such distress and panic may have destructive effects on individuals and may last long after the pandemic situation leading to depression or post-traumatic stress disorder. Therefore, the aim of the current study is to measure and investigate the prevalence of the factors affecting psychological stress during the COVID-19 pandemic among HCWs. METHODS: A self-administered online survey—including perceived stress scale (PSS) questions—was disseminated among HCWs in Riyadh, Saudi Arabia (SA) between1st June and 30th July 2020. RESULTS: A total of 469 HCWs responded to the survey for a high response rate (93.8%). The PSS revealed that 15.8% of the respondents were suffering from high stress levels, 77.2% were suffering from moderate stress levels and 7% with low stress levels. Females and junior frontline staff reported more severe stress levels. Participation on the pandemic team shows significant impact on stress levels. CONCLUSION: COVID-19 pandemic has increased stress levels among HCWs and affects their psychological wellbeing. Designing programs promoting HCWs mental health are crucial and emotional and psychological support strategies should be part of every public health crisis management plan. | J Epidemiol Glob Health | 2021 | LitCov and CORD-19 | |
| 6250 | Stress and psychological distress among SARS survivors 1 year after the outbreak N/A | Can J Psychiatry | 2007 | CORD-19 |
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