\ BIP! Finder for COVID-19 - Impact-based ranking

BIP! Finder for COVID-19

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)

Provided impact measures:
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.
Score interpretations:
Exceptional score (in top 0.01%).
Substantial score (in top 1%).
Average score (in bottom 99%).
Score not available.
Main data sources:
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)

Use:  Impact  Relevance & Impact
TitleVenueYearImpactSource
6351Dietary Diversity among Chinese Residents during the COVID-19 Outbreak and Its Associated Factors  

COVID-19, a Public Health Emergency of International Concern, has imposed enormous challenges on the health system, economy, and food supply and has substantially modified people’s lifestyles. This study aimed to (1) explore the dietary diversity during the lockdown time in China and (2) examine factors associated with dietary diversity including socio-economic characteristics, sources for food and food purchases, and specific dietary behaviors responding to COVID-19 and isolation. A cross-sectional questionnaire-based survey was conducted online in March 2020. Multi-stage sampling was used to recruit participants living in Hubei Province and other parts of China. Dietary diversity was assessed using the Household Dietary Diversity Score (HDDS) and clustering analysis was used to categorize people with different propensities of methods for purchasing or obtaining foods. Logistic regression was used to model the associations among HDDS, participants’ characteristics, approaches to purchase or obtain food, and behaviors adopted to cope with COVID-19. Results: A total of 1938 participants were included in the analysis. The overall mean HDDS was 9.7 ± 2.1, and the median (25th, 75th) was 10 (8, 12). There were relatively low consumptions of fish, legumes, and miscellaneous foods (e.g., processed food like snacks and beverages). After adjusting for age, family income, and geographic regions, people living in places where laboratory confirmed COVID-19 cases were above 500 (OR(adjusted) = 0.79, 95%CI 0.65, 0.96), or living in Hubei Province (OR(adjusted) = 0.60, 95%CI 0.39, 0.93) had a lower HDDS. During isolation time, the most common sources for food and food purchases were in-house storage and in person grocery shopping. More than half of the participants (55.9%) purchased food at least once via online ordering and delivery services. There was no significant difference in HDDS among people with distinct dependences on different ways to obtain or purchase food (i.e., dependence on in-person grocery shopping, dependence on both in-house storage and in-person grocery shopping, or dependence on online food purchasing). We also identified a total of 37.7% participants who consumed certain foods or nutritional supplements to cope with COVID-19, which included vitamin C, probiotics, other dietary supplements, alcohol, and vinegar. People who reported these specific dietary behaviors had a significantly higher HDDS (OR(adjusted) = 1.23, 95%CI 1.02, 1.45) than those who did not do so. This study revealed an overall good dietary diversity among the studied Chinese residents during the COVID-19 pandemic. However, we observed a lower dietary diversity among people living in areas with a high number of confirmed COVID-19 cases. Online ordering and delivery services were popular and could serve as a feasible method to obtain and purchase food, contributing to ensure diversified diets during the time of lockdown. Certain dietary behaviors associated with COVID-19 were also identified and had significant impacts on HDDS.

Nutrients2020       LitCov and CORD-19
6352Development, deployment and in-field demonstration of mobile coronavirus SARS-CoV-2 Nucleic acid amplification test  

INTRODUCTION: The evolving SARS-CoV-2 coronavirus pandemic presents a series of challenges to clinical diagnostic services. Many proprietary PCR platforms deployed outside centralised laboratories have limited capacity to upscale when public health demands increase. We set out to develop and validate an open-platform mobile laboratory for remote area COVID-19 diagnosis, with a subsequent field trial. GAP STATEMENT: In regional Western Australia, molecular diagnostic support is limited to near point-of-care devices. We therefore aimed to demonstrate open-platform capability in a rapidly deployable format within the context of the COVID-19 pandemic. METHODOLOGY: We compared, selected and validated components of a SARS-CoV-2 RT-PCR assay in order to establish a portable molecular diagnostics laboratory. The optimal combination of PCR assay equipment, reagents and consumables required for operation to national standards in regional laboratories was identified. This comprised RNA extraction and purification (QuickGene-480, Kurabo, Japan), a duplex RT-PCR assay (Logix Smart COVID-19, Co-Diagnostics, USA), a Myra liquid handling robot (Biomolecular Systems, Australia) and a magnetic induction thermal cycler (MIC, Biomolecular Systems). RESULTS: The 95 and 99% limits of detection were 1.01 copies μl(−1) (5.05 copies per reaction) and 2.80 copies μl(−1) (14.00 copies per reaction) respectively. The Co-Diagnostics assay amplified both SARS-CoV-1 and −2 RNA but showed no other cross reactivity. Qualitative results aligned with the reference laboratory SARS-CoV-2 assay (sensitivity 100% [95 % CI 96.48–100%], specificity 100% [95% CI 96.52–100%]). In field trials, the laboratory was operational within an hour of arrival on-site, can process up to 36 samples simultaneously, produces results in two and a half hours from specimen reception, and performed well during six consecutive runs during a 1 week deployment. CONCLUSION: Our mobile laboratory enables an adaptive response to increased test demand, and unlike many proprietary point-of-care PCR systems, rapid substitution with an alternative assay if gene targets change or reagent supply chains fail. We envisage operation of this RT-PCR assay as a standby capability to meet varying regional test demands under public health emergency operations guidance.

J Med Microbiol2021       LitCov and CORD-19
6353Factors associated with social isolation and loneliness in community-dwelling older adults during pandemic times: a cross-sectional study  

INTRODUCTION: Psychosocial aspects need to be discussed in the context of the Covid-19 pandemic. Currently, no studies have investigated the factors associated with social isolation and loneliness among community-dwelling older adults. Therefore, this study analyzed the association of social isolation and loneliness with socioeconomic, clinical, and health characteristics, and Covid-19-related variables, among community-dwelling older adults during the pandemic. METHODS: A cross-sectional study was conducted via a telephone survey of community-dwelling older adults aged ≥60 years in Macapa, Amapa, Brazil. A structured form was used to collect data. Descriptive and inferential analyses were performed using Pearson's correlation test and a linear regression model. RESULTS: Participants comprised 86 community-dwelling older adults with a mean age of 71.78+6.98 years. Among them, 9.3% were diagnosed with Covid-19, of whom 3.5% were hospitalized. Most participants reported no difficulty obtaining food, medicines, or attending routine medical appointments during the pandemic. Furthermore, 23.3% (n=20) were socially isolated, and 20.9% (n=18) reported feelings of loneliness. The mean values for fear, anxiety, and obsession were 19.01±7.25, 1.01±1.90, and 2.84±3.28, respectively. A moderate positive correlation was identified between loneliness and the number of diseases, and a weak positive correlation between loneliness and the number of medications and depressive symptoms and risk for sarcopenia. The linear regression model indicated that higher loneliness scores were associated with a greater number of diseases (β=0.288; p=0.007). CONCLUSIONS: The findings suggest a probable resilience of the older population to Covid-19, despite the association of loneliness with many diseases in times of a pandemic.

Rev Soc Bras Med Trop2021       LitCov and CORD-19
6354Rapid Scaling Up of Telehealth Treatment for Tobacco-Dependent Cancer Patients During the COVID-19 Outbreak in New York City  

N/A

Telemed J E Health2021       LitCov and CORD-19
6355Sequelae in Adults at 6 Months After COVID-19 Infection  

This cohort study analyzed persistent symptoms among adults with coronavirus disease 2019 up to 9 months after illness onset.

JAMA Netw Open2021       LitCov and CORD-19
6356Teacher Learning in Difficult Times: Examining Foreign Language Teachers' Cognitions About Online Teaching to Tide Over COVID-19  

The sudden global outbreak of COVID-19 in late 2019 has led to thriving online teaching, including the teaching of languages, across the world. As the online teaching of English-as-a-foreign-language (EFL) in Chinese universities is facing new challenges, EFL teachers have been positively exploring new solutions. To understand how EFL teachers were coping with the challenges, we set up this research as part of a larger study to examine EFL teachers’ cognitions about online teaching in response to the disruption of normal teaching plans. We did so by taking a qualitative approach through analyzing in-depth interviews with three EFL teachers from a Chinese university. Through thematic analysis we found that teachers had clear cognitions about features, advantages, and constraints of online EFL teaching and that they acquired information and communication technology (ICT) literacy through understanding students’ learning needs, online teaching practice, and the necessity of integrating traditional classroom teaching methods into online delivery. We conclude this study with a discussion on its pedagogical implications for similar contexts or colleagues facing similar challenges in other parts of the world.

Front Psychol2020       LitCov and CORD-19
6357The Food Systems in the Era of the Coronavirus Pandemic Crisis  

The World Health Organization (WHO) declared the outbreak of coronavirus disease (COVID-19, broadly referred to as “coronavirus”) a global pandemic, while thousands of infections and deaths are reported daily. The current article explores the food systems in the era of the COVID-19 pandemic crisis. It provides insights about the properties of bioactive ingredients of foods and herbs for the support of the human immune system against infections before discussing the possibility of COVID-19 transmission through the food chain. It also highlights the global food security issues arising from the fact that one-third of the world’s population is on lockdown. Finally, it underlines the importance of sustainability in the food chain in order to avoid or reduce the frequency of relevant food and health crises in the future.

Foods2020       LitCov and CORD-19
6358Cryo-EM structure of the SARS-CoV-2 Omicron spike  

The recently reported B.1.1.529 omicron variant of SARS-CoV-2 includes 34 mutations in the spike protein relative to the Wuhan strain, including 15 mutations in the receptor binding domain (RBD). Functional studies have shown omicron to substantially escape the activity of many SARS-CoV-2-neutralizing antibodies. Here we report a 3.1 Å resolution cryo-electron microscopy (cryo-EM) structure of the omicron spike protein ectodomain. The structure depicts a spike that is exclusively in the 1-RBD-up conformation with high mobility of RBD. Many mutations cause steric clashes and/or altered interactions at antibody binding surfaces, whereas others mediate changes of the spike structure in local regions to interfere with antibody recognition. Overall, the structure of the omicron spike reveals how mutations alter its conformation and explains its extraordinary ability to evade neutralizing antibodies.

Cell Rep2022       LitCov and CORD-19
6359Attenuated replication and pathogenicity of SARS-CoV-2 B.1.1.529 Omicron  

N/A

Nature2022       LitCov and CORD-19
6360Laboratory Diagnosis of COVID-19: Current Issues and Challenges  

The COVID-19 outbreak has had a major impact on clinical microbiology laboratories in the past several months. This commentary covers current issues and challenges for the laboratory diagnosis of infections caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In the preanalytical stage, collecting the proper respiratory tract specimen at the right time from the right anatomic site is essential for a prompt and accurate molecular diagnosis of COVID-19. Appropriate measures are required to keep laboratory staff safe while producing reliable test results. In the analytic stage, real-time reverse transcription-PCR (RT-PCR) assays remain the molecular test of choice for the etiologic diagnosis of SARS-CoV-2 infection while antibody-based techniques are being introduced as supplemental tools. In the postanalytical stage, testing results should be carefully interpreted using both molecular and serological findings. Finally, random-access, integrated devices available at the point of care with scalable capacities will facilitate the rapid and accurate diagnosis and monitoring of SARS-CoV-2 infections and greatly assist in the control of this outbreak.

J Clin Microbiol2020       LitCov and CORD-19
6361Early High-Titer Plasma Therapy to Prevent Severe Covid-19 in Older Adults  

BACKGROUND: Therapies to interrupt the progression of early coronavirus disease 2019 (Covid-19) remain elusive. Among them, convalescent plasma administered to hospitalized patients has been unsuccessful, perhaps because antibodies should be administered earlier in the course of illness. METHODS: We conducted a randomized, double-blind, placebo-controlled trial of convalescent plasma with high IgG titers against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in older adult patients within 72 hours after the onset of mild Covid-19 symptoms. The primary end point was severe respiratory disease, defined as a respiratory rate of 30 breaths per minute or more, an oxygen saturation of less than 93% while the patient was breathing ambient air, or both. The trial was stopped early at 76% of its projected sample size because cases of Covid-19 in the trial region decreased considerably and steady enrollment of trial patients became virtually impossible. RESULTS: A total of 160 patients underwent randomization. In the intention-to-treat population, severe respiratory disease developed in 13 of 80 patients (16%) who received convalescent plasma and 25 of 80 patients (31%) who received placebo (relative risk, 0.52; 95% confidence interval [CI], 0.29 to 0.94; P=0.03), with a relative risk reduction of 48%. A modified intention-to-treat analysis that excluded 6 patients who had a primary end-point event before infusion of convalescent plasma or placebo showed a larger effect size (relative risk, 0.40; 95% CI, 0.20 to 0.81). No solicited adverse events were observed. CONCLUSIONS: Early administration of high-titer convalescent plasma against SARS-CoV-2 to mildly ill infected older adults reduced the progression of Covid-19. (Funded by the Bill and Melinda Gates Foundation and the Fundación INFANT Pandemic Fund; Dirección de Sangre y Medicina Transfusional del Ministerio de Salud number, PAEPCC19, Plataforma de Registro Informatizado de Investigaciones en Salud number, 1421, and ClinicalTrials.gov number, NCT04479163.)

N Engl J Med2021       LitCov and CORD-19
6362Transitioning to telegenetics in the COVID-19 era: Patient satisfaction with remote genetic counseling in adult neurology  

The COVID‐19 pandemic rapidly changed genetic counseling services across the United States. At the University of Pennsylvania (UPenn), a large academic hospital in an urban setting, nearly all genetic counseling (GC) visits for adult–onset disorders within the Department of Neurology were conducted via secure videoconferencing (telegenetics) or telephone between March and December 2020. Although telemedicine services have been steadily emerging, many clinical programs, including the neurogenetics program at UPenn, had not built infrastructure or widely utilized these services prior to the pandemic. Thus, little is known about patient attitudes toward receiving clinical GC services remotely. From May 18 to October 18, 2020, all individuals seen remotely for GC in adult neurology via telephone or telegenetics were surveyed about their satisfaction with telehealth GC (N = 142), with a response rate of 42% (N = 60/142). Telephone and telegenetics services were referred to as ‘telehealth’ in the surveys to capture patient perspectives on all remote GC services, though the majority (N = 49/60) of these visits were completed via telegenetics. Surveys included the modified telehealth usability questionnaire (MTUQ), genetic counseling satisfaction scale (GCSS), and novel questions about future telehealth use. Preliminary results suggest that patients were satisfied with receiving remote GC services in adult neurology, with most participants strongly agreeing to all items about satisfaction with telehealth. Just 2% of participants preferred only in‐person visits in the future, but every participant was willing to consider using telehealth for future visits if their genetic counselor felt it was appropriate. Most participants preferred a hybrid model (73%), and some (25%) preferred only telehealth for future visits. Additionally, we found no differences in satisfaction with remote services based on visit type (initial vs. results disclosure) nor age. We conclude that remote GC is an acceptable method for the provision of services in adult neurology that is well‐received by patients.

J Genet Couns2021       LitCov and CORD-19
6363Dentists' Awareness, Perception and Attitude Regarding COVID-19 and Infection Control: Cross-Sectional Study Among Jordanian Dentists  

BACKGROUND: Despite the availability of prevention guidelines and recommendations on infection control, many dental practices lack the minimum requirements for infection control. OBJECTIVE: This study aimed to assess the level of awareness, perception, and attitude regarding the coronavirus disease (COVID-19) and infection control among Jordanian dentists. METHODS: The study population consisted of dentists who worked in private clinics, hospitals, and health centers in Jordan. An online questionnaire was sent to a sample of Jordanian dentists in March 2020. The questionnaire was comprised of a series of questions about dentists’ demographic characteristics; their awareness of the incubation period, the symptoms of the disease, mode of transmission of COVID-19 and infection control measures for preventing COVID-19; and their attitude toward treating patients with COVID-19. RESULTS: This study included a total of 368 dentists aged 22-73 years (mean 32.9 years, SD 10.6 years). A total of 112 (30.4%) dentists had completed a master or residency program in dentistry, 195 (53.0%) had received training in infection control in dentistry, and 28 (7.6%) had attended training or lectures regarding COVID-19. A total of 133 (36.1%) dentists reported that the incubation period is 1-14 days. The majority of dentists were aware of COVID-19 symptoms and ways of identifying patients at risk of having COVID-19, were able to correctly report known modes of transmission, and were aware of measures for preventing COVID-19 transmission in dental clinics. A total of 275 (74.7%) believed that it was necessary to ask patients to sit far from each other, wear masks while in the waiting room, and wash hands before getting in the dental chair to decrease disease transmission. CONCLUSIONS: Jordanian dentists were aware of COVID-19 symptoms, mode of transmission, and infection controls and measures in dental clinics. However, dentists had limited comprehension of the extra precautionary measures that protect the dental staff and other patients from COVID-19. National and international guidelines should be sent by the regional and national dental associations to all registered dentists during a crisis, including the COVID-19 pandemic, to make sure that dentists are well informed and aware of best practices and recommended disease management approaches.

JMIR Public Health Surveill2020       LitCov and CORD-19
6364The diagnostic and predictive role of NLR, d-NLR and PLR in COVID-19 patients  

Abstract Aim To accumulate evidence that indicates the key role played by virus-triggered inflammation in the 2019-novel coronavirus disease (COVID-19) which emerged in Wuhan City and rapidly spread throughout China. Methods Age, neutrophil(NEU)-to-lymphocyte (LYM) ratio (NLR), lymphocyte-to-monocyte(MON) ratio, platelet-to-lymphocyte ratio(PLR), and C-reactive protein(CRP) of 93 patients with laboratory confirmed COVID-19 were investigated and compared. The receiver operating characteristic curve was applied to determine the thresholds for five bio-markers, and their prognostic values were assessed via the Kaplan–Meier curve and multivariate COX regression models. Results The median age was 46.4 years old, and 37cases were females. A total of 26.8% of patients had been to Wuhan, and 73.1% had contacted with people from Wuhan. Fever (83.8%) and cough (70.9%) were the two most common symptoms. Elevated NLR and age were significantly associated with illness severity. The binary logistic analysis identified elevated NLR (hazard risk [HR] 2.46, 95% confidence interval [CI] 1.98–4.57) and age (HR 2.52, 95% CI 1.65–4.83) as independent factors for poor clinical outcome of COVID-19. NLR exhibited the largest area under the curve at 0.841, with the highest specificity (63.6%) and sensitivity (88%). Conclusions Elevated age and NLR can be considered independent biomarkers for indicating poor clinical outcomes.

Int Immunopharmacol2020       LitCov and CORD-19
6365Prone positioning in non-intubated patients with COVID-19 associated acute respiratory failure, the PRO-CARF trial: A structured summary of a study protocol for a randomised controlled trial  

OBJECTIVES: To assess the effect of prone positioning therapy on intubation rate in awake patients with COVID-19 and acute respiratory failure. TRIAL DESIGN: This is a two-center parallel group, superiority, randomized (1:1 allocation ratio) controlled trial. PARTICIPANTS: All patients admitted to the Hospital Civil de Guadalajara and Hospital General de Occidente in Mexico for COVID-19 associated acute respiratory failure and in need of supplementary oxygen through high-flow nasal cannula are screened for eligibility. Inclusion criteria: all adult patients admitted to the COVID-19 unit who test positive for COVID-19 by PCR-test and in need for oxygen are eligible for inclusion. Randomization starts upon identification of requirement of a fraction of inspired oxygen ≥30% for an oxygen capillary saturation of ≥90% Exclusion criteria: less than 18 years-old, pregnancy, patients with immediate need of invasive mechanical ventilation (altered mental status, fatigue), vasopressor requirement to maintain median arterial pressure >65 mmHg, contraindications for prone positioning therapy (recent abdominal or thoracic surgery or trauma, facial, pelvic or spine fracture, untreated pneumothorax, do-not-resuscitate or do-not-intubate order, refusal or inability of the patient to enroll in the study. INTERVENTION AND COMPARATOR: Patients of the intervention group will be asked to remain in a prone position throughout the day as long as possible, with breaks according to tolerance. Pillows will be offered for maximizing comfort at chest, pelvis and knees. Monitoring of vital signs will not be suspended. Inspired fraction of oxygen will be titrated to maintain a capillary saturation of 92%-95%. For patients in the control group, prone positioning will be allowed as a rescue therapy. Staff intensivists will monitor the patient’s status in both groups on a 24/7 basis. All other treatment will be unchanged and left to the attending physicians. MAIN OUTCOMES: Endotracheal intubation rate for mechanical ventilation at 28 days. RANDOMISATION: Patients will be randomly allocated to either prone positioning or control group at 1:1 ratio. Such randomization will be computer generated and stratified by center with permuted blocks and length of 4. BLINDING (MASKING): Due to logistical reasons, only principal investigators and the data analyst will be blinded to group assignment. NUMBERS TO BE RANDOMISED (SAMPLE SIZE): With an intubation rate of 60% according to recent reports from some American centers, and assuming a decrease to 40% to be clinically relevant, we calculated a total of 96 patients per group, for a beta error of 0.2, and alpha of 0.5. Therefore, we plan to recruit 200 patients, accounting for minimal losses to follow up, with 100 non-intubated patients in the prone position group and a 100 in the control group. TRIAL STATUS: The local registration number is 048-20, with the protocol version number 2.0. The date of approval is 3rd May 2020. Recruitment started on 3(rd) May and is expected to end in December 2020. TRIAL REGISTRATION: The protocol was retrospectively registered under the title: “Prone Positioning in Non-intubated Patients With COVID-19 Associated Acute Respiratory Failure. The PRO-CARF trial” in ClinicalTrials.gov with the registration number: NCT04477655. Registered on 20 July 2020. FULL PROTOCOL: The full protocol is attached as an additional file, accessible from the Trials website (Additional file 1). In the interest in expediting dissemination of this material, the familiar formatting has been eliminated; this Letter serves as a summary of the key elements of the full protocol. The study protocol has been reported in accordance with the Standard Protocol Items: Recommendations for Clinical Interventional Trials (SPIRIT) guidelines (Additional file 2). SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13063-020-04882-2.

Trials2020       LitCov and CORD-19
6366Temporal Course of SARS-CoV-2 Antibody Positivity in Patients with COVID-19 following the First Clinical Presentation  

Knowledge of the sensitivities of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibody tests beyond 35 days after the clinical onset of COVID-19 is insufficient. We aimed to describe positivity rate of SARS-CoV-2 assays employing three different measurement principles over a prolonged period. Two hundred sixty-eight samples from 180 symptomatic patients with COVID-19 and a reverse transcription polymerase chain reaction (RT-PCR) test followed by serological investigation of SARS-CoV-2 antibodies were included. We conducted three chemiluminescence (including electrochemiluminescence assay (ECLIA)), four enzyme-linked immunosorbent assay (ELISA), and one lateral flow immunoassay (LFIA) test formats. Positivity rates, as well as positive (PPVs) and negative predictive values (NPVs), were calculated for each week after the first clinical presentation for COVID-19. Furthermore, combinations of tests were assessed within an orthogonal testing approach employing two independent assays and predictive values were calculated. Heat maps were constructed to graphically illustrate operational test characteristics. During a follow-up period of more than 9 weeks, chemiluminescence assays and one ELISA IgG test showed stable positivity rates after the third week. With the exception of ECLIA, the PPVs of the other chemiluminescence assays were ≥95% for COVID-19 only after the second week. ELISA and LFIA had somewhat lower PPVs. IgM exhibited insufficient predictive characteristics. An orthogonal testing approach provided PPVs ≥ 95% for patients with a moderate pretest probability (e.g., symptomatic patients), even for tests with a low single test performance. After the second week, NPVs of all but IgM assays were ≥95% for patients with low to moderate pretest probability. The confirmation of negative results using an orthogonal algorithm with another assay provided lower NPVs than the single assays. When interpreting results from SARS-CoV-2 tests, the pretest probability, time of blood draw, and assay characteristics must be carefully considered. An orthogonal testing approach increases the accuracy of positive, but not negative, predictions.

Biomed Res Int2020       LitCov and CORD-19
6367Disparities in COVID-19 Outcomes by Race, Ethnicity and Socioeconomic Status: A Systematic-Review and Meta-analysis  

IMPORTANCE: COVID-19 has disproportionately affected racial and ethnic minority groups, and race and ethnicity have been associated with disease severity. However, the association of socioeconomic determinants with racial disparities in COVID-19 outcomes remains unclear. OBJECTIVE: To evaluate the association of race and ethnicity with COVID-19 outcomes and to examine the association between race, ethnicity, COVID-19 outcomes, and socioeconomic determinants. DATA SOURCES: A systematic search of PubMed, medRxiv, bioRxiv, Embase, and the World Health Organization COVID-19 databases was performed for studies published from January 1, 2020, to January 6, 2021. STUDY SELECTION: Studies that reported data on associations between race and ethnicity and COVID-19 positivity, disease severity, and socioeconomic status were included and screened by 2 independent reviewers. Studies that did not have a satisfactory quality score were excluded. Overall, less than 1% (0.47%) of initially identified studies met selection criteria. DATA EXTRACTION AND SYNTHESIS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. Associations were assessed using adjusted and unadjusted risk ratios (RRs) and odds ratios (ORs), combined prevalence, and metaregression. Data were pooled using a random-effects model. MAIN OUTCOMES AND MEASURES: The main measures were RRs, ORs, and combined prevalence values. RESULTS: A total of 4 318 929 patients from 68 studies were included in this meta-analysis. Overall, 370 933 patients (8.6%) were African American, 9082 (0.2%) were American Indian or Alaska Native, 101 793 (2.4%) were Asian American, 851 392 identified as Hispanic/Latino (19.7%), 7417 (0.2%) were Pacific Islander, 1 037 996 (24.0%) were White, and 269 040 (6.2%) identified as multiracial and another race or ethnicity. In age- and sex-adjusted analyses, African American individuals (RR, 3.54; 95% CI, 1.38-9.07; P = .008) and Hispanic individuals (RR, 4.68; 95% CI, 1.28-17.20; P = .02) were the most likely to test positive for COVID-19. Asian American individuals had the highest risk of intensive care unit admission (RR, 1.93; 95% CI, 1.60-2.34, P < .001). The area deprivation index was positively correlated with mortality rates in Asian American and Hispanic individuals (P < .001). Decreased access to clinical care was positively correlated with COVID-19 positivity in Hispanic individuals (P < .001) and African American individuals (P < .001). CONCLUSIONS AND RELEVANCE: In this study, members of racial and ethnic minority groups had higher risks of COVID-19 positivity and disease severity. Furthermore, socioeconomic determinants were strongly associated with COVID-19 outcomes in racial and ethnic minority populations.

JAMA Netw Open2021       LitCov and CORD-19
6368COVID-19 patients' clinical characteristics, discharge rate and fatality rate of meta-analysis  

The aim of this study was to analyze the clinical data, discharge rate, and fatality rate of COVID‐19 patients for clinical help. The clinical data of COVID‐19 patients from December 2019 to February 2020 were retrieved from four databases. We statistically analyzed the clinical symptoms and laboratory results of COVID‐19 patients and explained the discharge rate and fatality rate with a single‐arm meta‐analysis. The available data of 1994 patients in 10 literatures were included in our study. The main clinical symptoms of COVID‐19 patients were fever (88.5%), cough (68.6%), myalgia or fatigue (35.8%), expectoration (28.2%), and dyspnea (21.9%). Minor symptoms include headache or dizziness (12.1%), diarrhea (4.8%), nausea and vomiting (3.9%). The results of the laboratory showed that the lymphocytopenia (64.5%), increase of C‐reactive protein (44.3%), increase of lactic dehydrogenase (28.3%), and leukocytopenia (29.4%) were more common. The results of single‐arm meta‐analysis showed that the male took a larger percentage in the gender distribution of COVID‐19 patients 60% (95% CI [0.54, 0.65]), the discharge rate of COVID‐19 patients was 52% (95% CI [0.34,0.70]), and the fatality rate was 5% (95% CI [0.01,0.11]).

J Med Virol2020       LitCov and CORD-19
6369Eating Habits and Lifestyle during COVID-19 Lockdown in the United Arab Emirates: A Cross-Sectional Study  

The coronavirus disease is still spreading in the United Arab Emirates (UAE) with subsequent lockdowns and social distancing measures being enforced by the government. The purpose of this study was to assess the effect of the lockdown on eating habits and lifestyle behaviors among residents of the UAE. A cross-sectional study among adults in the UAE was conducted using an online questionnaire between April and May 2020. A total of 1012 subjects participated in the study. During the pandemic, 31% reported weight gain and 72.2% had less than eight cups of water per day. Furthermore, the dietary habits of the participants were distanced from the Mediterranean diet principles and closer to “unhealthy” dietary patterns. Moreover, 38.5% did not engage in physical activity and 36.2% spent over five hours per day on screens for entertainment. A significantly higher percentage of participants reported physical exhaustion, emotional exhaustion, irritability, and tension “all the time” during the pandemic compared to before the pandemic (p < 0.001). Sleep disturbances were prevalent among 60.8% of the participants during the pandemic. Although lockdowns are an important safety measure to protect public health, results indicate that they might cause a variety of lifestyle changes, physical inactivity, and psychological problems among adults in the UAE.

Nutrients2020       LitCov and CORD-19
6370Humoral and Cellular Immune Response Elicited by mRNA Vaccination Against SARS-CoV-2 in People Living With Human Immunodeficiency Virus Receiving Antiretroviral Therapy Based on Current CD4 T-Lymphocyte Count  

BACKGROUND: Data on SARS-CoV-2 vaccine immunogenicity in PLWH are currently limited. Aim of the study was to investigate immunogenicity according to current CD4 T-cell count. METHODS: PLWH on ART attending a SARS-CoV-2 vaccination program, were included in a prospective immunogenicity evaluation after receiving BNT162b2 or mRNA-1273. Participants were stratified by current CD4 T-cell count (poor CD4 recovery, PCDR: <200/mm (3); intermediate CD4 recovery, ICDR: 200-500/mm (3) high CD4 recovery, HCDR: >500/mm (3)). RBD-binding IgG, SARS-CoV-2 neutralizing antibodies (nAbs) and IFN-γ release were measured. As control group, HIV-negative healthcare workers (HCWs) were used. FINDINGS: Among 166 PLWH after 1 month from the second dose, detectable RBD-binding IgG were elicited in 86.7% of PCDR, 100% of ICDR, 98.7% of HCDR, and a neutralizing titre ≥1:10 elicited in 70.0%, 88.2% and 93.1%, respectively. Compared to HCDR, all immune response parameters were significantly lower in PCDR. After adjusting for confounders, current CD4 T-cell <200/mm (3) significantly predicted a poor magnitude of anti-RDB, nAbs and IFN-γ response. As compared with HCWs, PCDR elicited a consistently reduced immunogenicity for all parameters, ICDR only a reduced RBD-binding antibody response, whereas HCDR elicited a comparable immune response for all parameters. CONCLUSION: Humoral and cell-mediated immune response against SARS-CoV-2 were elicited in most of PLWH, albeit significantly poorer in those with CD4 T-cell <200/mm (3) versus those with >500 cell/mm (3) and HIV-negative controls. A decreased RBD-binding antibody response than HCWs was also observed in PLWH with CD4 T-cell 200-500/mm (3), whereas immune response elicited in PLWH with a CD4 T-cell >500/mm (3) was comparable to HIV-negative population.

Clin Infect Dis2022       LitCov and CORD-19
6371The immediate impact of the 2019 novel coronavirus outbreak on subjective sleep status  

BACKGROUND: An outbreak of the 2019 novel coronavirus (COVID-19) has been ongoing in China since January 2020. The threat of infection affects the work and life of most of the population and may also damage sleep. This study aims to examine the subjective sleep status and mental health of the population during the peak of the COVID-19 epidemic. METHOD: The data were collected through an online questionnaire with a sample of 5461 individuals in China from February 5, 2020, to February 23, 2020. Participants were divided into four groups based on their degree of threat from COVID-19: Group 1 was most closely associated with COVID-19, including inpatients diagnosed with COVID-19, first-line hospital workers and first-line management staff; Group 2 included outpatients diagnosed with COVID-19 and patients who developed a fever and visited the hospital; Group 3 included people related to Group 1 or 2, such as their colleagues, relatives, friends and rescuers; and Group 4 was the farthest removed from contact with COVID-19, covering the general public affected by COVID-19 prevention strategies. The Insomnia Severity Index (ISI), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale (GAD-7) and Acute Stress Disorder Scale (ASDS) were used. RESULTS: Threat degree of COVID-19 (groups) had significant correlations with insomnia, depression, anxiety, and stress (p < 0.05, p < 0.01). Age, gender, and area (Hubei province or other provinces) had significant correlations with insomnia (p < 0.01). A total of 1380 (24.46%) participants were suspected of having major depression based on the PHQ-9. Additionally, 1042 (18.47%) participants were suspected of having generalized anxiety disorder based on the GAD-7. A total of 892 (15.8%) of the participants had Acute Stress Disorder (ASD) according to the ASDS. The prevalence of clinical insomnia during the outbreak was 20.05% (1131) according to the ISI. The factors of satisfaction with the current sleep pattern and how perceptible the symptoms of the current sleep pattern are to other people (p < 0.05) and the middle (difficulty staying asleep) and terminal (waking up too early) (p < 0.01) factors of the ISI were significantly different across groups. A total of 1129 (20.01%) participants spent more than one hour awake in bed. CONCLUSION: The results indicated that insomnia is more severe in people who are female, young, living in the epicenter and experiencing a high degree of threat from COVID-19. As prevention and treatment efforts continue with regard to COVID-19, the general public has developed poor sleep hygiene habits, which deserve attention.

Sleep Med2020       LitCov and CORD-19
6372Mapping the human genetic architecture of COVID-19  

The genetic make-up of an individual contributes to the susceptibility and response to viral infection. Although environmental, clinical and social factors have a role in the chance of exposure to SARS-CoV-2 and the severity of COVID-19(1,2), host genetics may also be important. Identifying host-specific genetic factors may reveal biological mechanisms of therapeutic relevance and clarify causal relationships of modifiable environmental risk factors for SARS-CoV-2 infection and outcomes. We formed a global network of researchers to investigate the role of human genetics in SARS-CoV-2 infection and COVID-19 severity. Here we describe the results of three genome-wide association meta-analyses that consist of up to 49,562 patients with COVID-19 from 46 studies across 19 countries. We report 13 genome-wide significant loci that are associated with SARS-CoV-2 infection or severe manifestations of COVID-19. Several of these loci correspond to previously documented associations to lung or autoimmune and inflammatory diseases(3–7). They also represent potentially actionable mechanisms in response to infection. Mendelian randomization analyses support a causal role for smoking and body-mass index for severe COVID-19 although not for type II diabetes. The identification of novel host genetic factors associated with COVID-19 was made possible by the community of human genetics researchers coming together to prioritize the sharing of data, results, resources and analytical frameworks. This working model of international collaboration underscores what is possible for future genetic discoveries in emerging pandemics, or indeed for any complex human disease.

Nature2021       LitCov and CORD-19
6373Sixteen novel lineages of SARS-CoV-2 in South Africa  

N/A

Nat Med2021       LitCov and CORD-19
6374TMPRSS2 and TMPRSS4 promote SARS-CoV-2 infection of human small intestinal enterocytes  

Gastrointestinal symptoms and fecal shedding of SARS-CoV-2 RNA are frequently observed in COVID-19 patients. However, it is unclear whether SARS-CoV-2 replicates in the human intestine and contributes to possible fecal-oral transmission. Here, we report productive infection of SARS-CoV-2 in ACE2(+) mature enterocytes in human small intestinal enteroids. Expression of two mucosa-specific serine proteases, TMPRSS2 and TMPRSS4, facilitated SARS-CoV-2 spike fusogenic activity and promoted virus entry into host cells. We also demonstrate that viruses released into the intestinal lumen were inactivated by simulated human colonic fluid, and infectious virus was not recovered from the stool specimens of COVID-19 patients. Our results highlight the intestine as a potential site of SARS-CoV-2 replication, which may contribute to local and systemic illness and overall disease progression.

Sci Immunol2020       LitCov and CORD-19
6375Network-based drug repurposing for novel coronavirus 2019-nCoV/SARS-CoV-2  

Human coronaviruses (HCoVs), including severe acute respiratory syndrome coronavirus (SARS-CoV) and 2019 novel coronavirus (2019-nCoV, also known as SARS-CoV-2), lead global epidemics with high morbidity and mortality. However, there are currently no effective drugs targeting 2019-nCoV/SARS-CoV-2. Drug repurposing, representing as an effective drug discovery strategy from existing drugs, could shorten the time and reduce the cost compared to de novo drug discovery. In this study, we present an integrative, antiviral drug repurposing methodology implementing a systems pharmacology-based network medicine platform, quantifying the interplay between the HCoV–host interactome and drug targets in the human protein–protein interaction network. Phylogenetic analyses of 15 HCoV whole genomes reveal that 2019-nCoV/SARS-CoV-2 shares the highest nucleotide sequence identity with SARS-CoV (79.7%). Specifically, the envelope and nucleocapsid proteins of 2019-nCoV/SARS-CoV-2 are two evolutionarily conserved regions, having the sequence identities of 96% and 89.6%, respectively, compared to SARS-CoV. Using network proximity analyses of drug targets and HCoV–host interactions in the human interactome, we prioritize 16 potential anti-HCoV repurposable drugs (e.g., melatonin, mercaptopurine, and sirolimus) that are further validated by enrichment analyses of drug-gene signatures and HCoV-induced transcriptomics data in human cell lines. We further identify three potential drug combinations (e.g., sirolimus plus dactinomycin, mercaptopurine plus melatonin, and toremifene plus emodin) captured by the “Complementary Exposure” pattern: the targets of the drugs both hit the HCoV–host subnetwork, but target separate neighborhoods in the human interactome network. In summary, this study offers powerful network-based methodologies for rapid identification of candidate repurposable drugs and potential drug combinations targeting 2019-nCoV/SARS-CoV-2.

Cell Discov2020       LitCov and CORD-19
6376Evaluation of pediatric rheumatology telehealth satisfaction during the COVID-19 pandemic  

BACKGROUND: During the Coronavirus disease 2019 pandemic, ambulatory pediatric rheumatology healthcare rapidly transformed to a mainly telehealth model. However, pediatric patient and caregiver satisfaction with broadly deployed telehealth programs remains largely unknown. This study aimed to evaluate patient/caregiver satisfaction with telehealth and identify the factors associated with satisfaction in a generalizable sample of pediatric rheumatology patients. METHODS: Patients with an initial telehealth video visit with a rheumatology provider between April and June 2020 were eligible. All patients/caregivers were sent a post-visit survey to assess a modified version of the Telehealth Usability Questionnaire (TUQ) and demographic and clinical characteristics. TUQ total and sub-scale (usefulness, ease of use, effectiveness, satisfaction) scores were calculated and classified as “positive” based on responses of “agree” or “strongly agree” on a 5-point Likert scale. Results were analyzed using standard descriptive statistics and Wilcoxon signed rank testing. The association between demographic and clinical characteristics with TUQ scores was assessed using univariate linear regression. RESULTS: 597 patients/caregivers met inclusion criteria, and the survey response rate was 42% (n = 248). Juvenile idiopathic arthritis was the most common diagnosis (33.5%). The majority of patients were diagnosed greater than 6 months previously (72.6%) and were prescribed chronic medications (59.7%). The median total TUQ score was 4 (IQR: 4–5) with positive responses in 81% of items. Of the subscales, usefulness scores were lowest (median: 4, p < 0.001). Telehealth saves time traveling was the highest median item score (median = 5, IQR: 4–5). Within subscales, items that scored significantly lower included convenience, providing for needs, seeing rheumatologist as well as in person, and being an acceptable way to receive rheumatology services (all p < 0.001). There were no significant demographic or clinical features associated with TUQ scores. CONCLUSIONS: Our results suggest telehealth is a promising mode of healthcare delivery for pediatric rheumatic diseases but also identifies opportunities for improvement. Innovation and research are needed to design a telehealth system that delivers high quality and safe care that improves healthcare outcomes. Since telehealth is a rapidly emerging form of pediatric rheumatology care, improved engagement and training of patients, caregivers, and providers may help improve the patient experience in the future. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12969-021-00649-4.

Pediatr Rheumatol Online J2021       LitCov and CORD-19
6377Prevalence and associated characteristics of anti-SARS-CoV-2 antibodies in Mexico 5 months after pandemic arrival  

BACKGROUND: Seroprevalence of anti-SARS-CoV-2 antibodies is now available in several world regions to better estimate transmission dynamics. However, to date, there is no epidemiological data regarding anti-SARS-CoV-2 prevalence in Mexico. Therefore, we aimed to determine the prevalence of anti-SARS-CoV-2 antibodies and define the clinical and demographic characteristics associated with seroprevalence. METHODS: We conducted a cross-sectional serological survey in Ciudad Guadalupe, NL, Mexico. City government employees voluntarily participated during July 2020. Demographic and clinical characteristics were collected at the time of blood sampling to analyze the associated characteristics. IgM/IgG antibodies were determined using a qualitative chemiluminescent immunoassay. Descriptive statistics were used for categorical and continuous variables. Statistical significance was tested using the Chi-squared test, Student’s t-test and the Mann–Whitney. Logistic regression models and the odds ratios (adjusted and unadjusted) were used to estimate the association of demographic and clinical characteristics. RESULTS: Of the 3,268 participants included, 193 (5.9%, 95% CI 5.1–6.8) tested positive for IgM/IgG against SARS-CoV-2. Sex, city of residence, and comorbidities did not show any association with having IgM/IgG antibodies. A total of 114 out of 193 (59.1%) subjects with a positive test were asymptomatic, and the odds of being positive were higher in those who reported symptoms of COVID-19 in the previous four weeks to the survey (OR 4.1, 95% CI 2.9–5.5). CONCLUSIONS: There is a low rate of SARS-CoV-2 infection among government employees that have continuously been working during the pandemic. Six in ten infections were asymptomatic, and seroprevalence is low and still far from herd immunity. Epidemiological surveillance and preventive measures should be mandatory.

BMC Infect Dis2021       LitCov and CORD-19
6378Telehealth in response to the COVID-19 pandemic: Implications for rural health disparities  

Telehealth programs have long held promise for addressing rural health disparities perpetuated by inadequate healthcare access. The COVID-19 pandemic and accompanying social distancing measures have hastened the implementation of telehealth programs in hospital systems around the globe. Here, we provide specific examples of telehealth efforts that have been implemented in a large rural healthcare system in response to the pandemic, and further describe how the massive shift to telehealth and reliance on virtual connections in these times of social isolation may impact rural health disparities for those without access to necessary broadband to deploy digital technologies. Finally, we provide recommendations for researchers and policy makers to ensure that telehealth initiatives do not amplify existing health disparities experienced by those living in rural communities.

J Am Med Inform Assoc2020       LitCov and CORD-19
6379SARS-CoV-2 specific antibody and neutralization assays reveal the wide range of the humoral immune response to virus  

Development of antibody protection during SARS-CoV-2 infection is a pressing question for public health and for vaccine development. We developed highly sensitive SARS-CoV-2-specific antibody and neutralization assays. SARS-CoV-2 Spike protein or Nucleocapsid protein specific IgG antibodies at titers more than 1:100,000 were detectable in all PCR+ subjects (n = 115) and were absent in the negative controls. Other isotype antibodies (IgA, IgG1-4) were also detected. SARS-CoV-2 neutralization was determined in COVID-19 and convalescent plasma at up to 10,000-fold dilution, using Spike protein pseudotyped lentiviruses, which were also blocked by neutralizing antibodies (NAbs). Hospitalized patients had up to 3000-fold higher antibody and neutralization titers compared to outpatients or convalescent plasma donors. Interestingly, some COVID-19 patients also possessed NAbs against SARS-CoV Spike protein pseudovirus. Together these results demonstrate the high specificity and sensitivity of our assays, which may impact understanding the quality or duration of the antibody response during COVID-19 and in determining the effectiveness of potential vaccines.

Commun Biol2021       LitCov and CORD-19
6380Modelling the COVID-19 epidemic and implementation of population-wide interventions in Italy  

In Italy, 128,948 confirmed cases and 15,887 deaths of people who tested positive for SARS-CoV-2 were registered as of 5 April 2020. Ending the global SARS-CoV-2 pandemic requires implementation of multiple population-wide strategies, including social distancing, testing and contact tracing. We propose a new model that predicts the course of the epidemic to help plan an effective control strategy. The model considers eight stages of infection: susceptible (S), infected (I), diagnosed (D), ailing (A), recognized (R), threatened (T), healed (H) and extinct (E), collectively termed SIDARTHE. Our SIDARTHE model discriminates between infected individuals depending on whether they have been diagnosed and on the severity of their symptoms. The distinction between diagnosed and non-diagnosed individuals is important because the former are typically isolated and hence less likely to spread the infection. This delineation also helps to explain misperceptions of the case fatality rate and of the epidemic spread. We compare simulation results with real data on the COVID-19 epidemic in Italy, and we model possible scenarios of implementation of countermeasures. Our results demonstrate that restrictive social-distancing measures will need to be combined with widespread testing and contact tracing to end the ongoing COVID-19 pandemic.

Nat Med2020       LitCov and CORD-19
6381Considerations for Meeting Students' Mental Health Needs at a US University During the COVID-19 Pandemic: A Qualitative Study  

OBJECTIVE: To better understand the potential ongoing effects of the COVID-19 pandemic on U.S. university students' mental health and to generate hypotheses as to how universities may best meet students' mental health needs. PARTICIPANTS: Students at a large public university in the United States. METHODS: Students were invited via email to participate in either interviews or focus groups regarding their COVID-19 pandemic experiences, including mental health impacts. Recruitment took place in two waves. Sessions were led by student members of the research team and took place via video conference between December 2020 and June 2021. Interviews were audio-recorded and transcribed via Zoom and manually edited and de-identified by the research team. Interview data were analyzed deductively and inductively using a modified grounded theory approach. RESULTS: A total of 40 undergraduate and graduate students took part in the study. Major themes included: (1) Overall impact of the pandemic on mental health; (2) Sources of pandemic stress/mental health impacts; (3) Subsequent coping strategies; and (4) Suggestions for improving university support for student mental health. Subthemes were identified within each major theme. Students reported substantial anxiety and other mental health impacts and felt improvements in communication and access to mental health resources could better support students. CONCLUSIONS: This study provides context for the ways in which the COVID-19 pandemic may be continuing to impact mental health in a north-American university setting and identifies suggestions for potential interventions that future studies may test for effectiveness.

Front Public Health2022       LitCov and CORD-19
6382Mobility as a driver of SARS-CoV-2 in cancer patients during the second COVID-19 pandemic wave  

We retrospectively analyzed the epidemiological characteristics of cancer patients with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection and their correlations with publicly available mobility data. Between 19 October 2020 and 28 February 2021, 4754 patient visits were carried out, and 1454 treatments have been applied at the Haemato‐Oncology Day Hospital Merano. Additional measures to prevent local SARS‐CoV‐2 transmission included a specific questionnaire for coronavirus disease 2019 (COVID‐19) symptoms as well as a SARS‐CoV‐2 real‐time polymerase‐chain reaction (RT‐PCR) 2 days prior to any intravenous or subcutaneous therapy. Community mobility was assessed through publicly available mobile phone tracking data from Google; 106/719 (14.7%) cancer patients have been tested positive for SARS‐CoV‐2 by PCR during the second wave compared to 5/640 (0.8%) within the first wave (P < .001); 66/106 (62%) had solid tumors, and 40/106 (38%) had hematological malignancies; 90/106 (85%) patients received ongoing antitumor therapies. Mortality rate of COVID‐19 positive cancer patients (7/106; 6.6%) was higher compared to the overall population (731/46 421; 1.6%; P < .001). Strict control measures at our department led to a significantly lower test positivity rate compared to the general population, resulting in a reduction of 58.5% of new SARS‐CoV‐2 cases. Over time, infection rates and community mobility correlated in the first and second wave after initiating and lifting restrictions. Our findings underscore the importance of strict preventive control measures including testing and contact tracing in vulnerable subpopulations such as cancer patients, particularly if social restriction policies are being lifted. Smartphone‐based mobility data may help to guide policy makers to prevent a vulnerable population like cancer patients from virus transmission.

Int J Cancer2021       LitCov and CORD-19
6383The effect of frailty on survival in patients with COVID-19 (COPE): a multicentre, European, observational cohort study  

BACKGROUND: The COVID-19 pandemic has placed unprecedented strain on health-care systems. Frailty is being used in clinical decision making for patients with COVID-19, yet the prevalence and effect of frailty in people with COVID-19 is not known. In the COVID-19 in Older PEople (COPE) study we aimed to establish the prevalence of frailty in patients with COVID-19 who were admitted to hospital and investigate its association with mortality and duration of hospital stay. METHODS: This was an observational cohort study conducted at ten hospitals in the UK and one in Italy. All adults (≥18 years) admitted to participating hospitals with COVID-19 were included. Patients with incomplete hospital records were excluded. The study analysed routinely generated hospital data for patients with COVID-19. Frailty was assessed by specialist COVID-19 teams using the clinical frailty scale (CFS) and patients were grouped according to their score (1–2=fit; 3–4=vulnerable, but not frail; 5–6=initial signs of frailty but with some degree of independence; and 7–9=severe or very severe frailty). The primary outcome was in-hospital mortality (time from hospital admission to mortality and day-7 mortality). FINDINGS: Between Feb 27, and April 28, 2020, we enrolled 1564 patients with COVID-19. The median age was 74 years (IQR 61–83); 903 (57·7%) were men and 661 (42·3%) were women; 425 (27·2%) had died at data cutoff (April 28, 2020). 772 (49·4%) were classed as frail (CFS 5–8) and 27 (1·7%) were classed as terminally ill (CFS 9). Compared with CFS 1–2, the adjusted hazard ratios for time from hospital admission to death were 1·55 (95% CI 1·00–2·41) for CFS 3–4, 1·83 (1·15–2·91) for CFS 5–6, and 2·39 (1·50–3·81) for CFS 7–9, and adjusted odds ratios for day-7 mortality were 1·22 (95% CI 0·63–2·38) for CFS 3–4, 1·62 (0·81–3·26) for CFS 5–6, and 3·12 (1·56–6·24) for CFS 7–9. INTERPRETATION: In a large population of patients admitted to hospital with COVID-19, disease outcomes were better predicted by frailty than either age or comorbidity. Our results support the use of CFS to inform decision making about medical care in adult patients admitted to hospital with COVID-19. FUNDING: None.

Lancet Public Health2020       LitCov and CORD-19
6384A comparison of clinical, laboratory and chest CT findings of laboratory-confirmed and clinically diagnosed COVID-19 patients at first admission  

N/A

Diagn Interv Radiol2021       LitCov and CORD-19
6385Knowledge, attitudes, anxiety and preventive behaviours towards COVID-19 among Healthcare providers in Yemen: an online cross-sectional survey  

BACKGROUND: The growing incidence of coronavirus (COVID-19) continues to cause fear, anxiety, and panic amongst the community, especially for healthcare providers (HCPs), as the most vulnerable group at risk of contracting this new SARS-CoV-2 infection. To protect and enhance the ability of HCPs to perform their role in responding to COVID-19, healthcare authorities must help to alleviate the level of stress and anxiety amongst HCPs and the community. This will improve the knowledge, attitude and practice towards COVID-19, especially for HCPs. In addition, authorities need to comply in treating this virus by implementing control measures and other precautions. This study explores the knowledge, attitude, anxiety, and preventive behaviours among Yemeni HCPs towards COVID-19. METHODS: A descriptive, web-based-cross-sectional study was conducted among 1231 Yemeni HCPs. The COVID-19 related questionnaire was designed using Google forms where the responses were coded and analysed using the Statistical Package for the Social Sciences software package (IBM SPSS), version 22.0. Descriptive statistics and Pearson’s correlation coefficient test were also employed in this study. A p-value of < 0.05 with a 95% confidence interval was considered as statistically significant. The data collection phase commenced on 22nd April 2020, at 6 pm and finished on 26th April 2020 at 11 am. RESULTS: The results indicated that from the 1231 HCPs participating in this study, 61.6% were male, and 67% were aged between 20 and 30 years with a mean age of 29.29 ± 6.75. Most (86%) held a bachelor’s degree or above having at least 10 years of work experience or less (88.1%). However, while 57.1% of the respondents obtained their information via social networks and news media, a further 60.0% had never attended lectures/discussions about COVID-19. The results further revealed that the majority of respondents had adequate knowledge, optimistic attitude, moderate level of anxiety, and high-performance in preventive behaviours, 69.8, 85.10%, 51.0 and 87.70%, respectively, towards COVID-19. CONCLUSION: Although the Yemeni HCPs exhibited an adequate level of knowledge, optimistic attitude, moderate level of anxiety, and high-performance in preventive behaviours toward COVID-19, the results highlighted gaps, particularly in their knowledge and attitude towards COVID-19.

BMC Public Health2020       LitCov and CORD-19
6386Experiences of American Older Adults with Pre-existing Depression During the Beginnings of the COVID-19 Pandemic: A Multicity, Mixed-Methods Study  

OBJECTIVE: To determine the effect of the COVID-19 pandemic on the mental health of older adults with pre-existing major depressive disorder (MDD). PARTICIPANTS: Participants were 73 community-living older adults with pre-existing MDD (mean age 69 [SD 6]) in Los Angeles, New York, Pittsburgh, and St Louis. DESIGN AND MEASUREMENTS: During the first two months of the pandemic, we interviewed participants with a semi-structured qualitative interview evaluating access to care, mental health, quality of life, and coping. We also assessed depression, anxiety, and suicidality with validated scales and compared scores before and during the pandemic. RESULTS: Five themes from the interviews highlight the experience of older adults with MDD: (1) They are more concerned about the risk of contracting the virus than the risks of isolation. (2) They exhibit resilience to the stress and isolation of physical distancing. (3) Most are not isolated socially, with virtual contact with friends and family. (4) Their quality of life is lower, and they worry their mental health will suffer with continued physical distancing. (5) They are outraged by an inadequate governmental response to the pandemic. Depression, anxiety, and suicidal ideation symptom scores did not differ from scores before the pandemic. CONCLUSIONS: Most older adults with pre-existing MDD show resilience in the first two months of the COVID-19 pandemic but have concerns about the future. Policies and interventions to provide access to medical services and opportunities for social interaction are needed to help to maintain mental health and quality of life as the pandemic continues.

Am J Geriatr Psychiatry2020       LitCov and CORD-19
6387Can we get out of the COVID pandemic without adequate vaccination coverage in the pediatric population?  

N/A

Ital J Pediatr2022       LitCov
6388Multisystem Inflammatory Syndrome in an Adolescent Following SARS-CoV-2 Exposure Despite Three Doses of a COVID-19 Vaccine  

N/A

R I Med J (2013)2022       LitCov and CORD-19
6389The mental health of university students during the COVID-19 pandemic: An online survey in the UK  

Higher education students’ mental health has been a growing concern in recent years even before the COVID-19 pandemic. The stresses and restrictions associated with the pandemic have put university students at greater risk of developing mental health issues, which may significantly impair their academic success, social interactions and their future career and personal opportunities. This paper aimed to understand the mental health status of University students at an early stage in the pandemic and to investigate factors associated with higher levels of distress. An online survey including demographics, lifestyle/living situations, brief mental well-being history, questions relating to COVID-19 and standardised measures of depression, anxiety, resilience and quality of life was completed by 1173 students at one University in the North of England. We found high levels of anxiety and depression, with more than 50% experiencing levels above the clinical cut offs, and females scoring significantly higher than males. The survey also suggested relatively low levels of resilience which we attribute to restrictions and isolation which reduced the opportunities to engage in helpful coping strategies and activities rather than enduring personality characteristics. Higher levels of distress were associated with lower levels of exercising, higher levels of tobacco use, and a number of life events associated with the pandemic and lockdown, such as cancelled events, worsening in personal relationships and financial concerns. We discuss the importance of longer-term monitoring and mental health support for university students.

PLoS One2022       LitCov and CORD-19
6390Role of COVID-19 Vaccines in SARS-CoV-2 Variants  

N/A

Front Immunol2022       LitCov
6391Detection of COVID-19 from Chest X-Ray Images Using Convolutional Neural Networks  

The detection of severe acute respiratory syndrome coronavirus 2 (SARS CoV-2), which is responsible for coronavirus disease 2019 (COVID-19), using chest X-ray images has life-saving importance for both patients and doctors. In addition, in countries that are unable to purchase laboratory kits for testing, this becomes even more vital. In this study, we aimed to present the use of deep learning for the high-accuracy detection of COVID-19 using chest X-ray images. Publicly available X-ray images (1583 healthy, 4292 pneumonia, and 225 confirmed COVID-19) were used in the experiments, which involved the training of deep learning and machine learning classifiers. Thirty-eight experiments were performed using convolutional neural networks, 10 experiments were performed using five machine learning models, and 14 experiments were performed using the state-of-the-art pre-trained networks for transfer learning. Images and statistical data were considered separately in the experiments to evaluate the performances of models, and eightfold cross-validation was used. A mean sensitivity of 93.84%, mean specificity of 99.18%, mean accuracy of 98.50%, and mean receiver operating characteristics–area under the curve scores of 96.51% are achieved. A convolutional neural network without pre-processing and with minimized layers is capable of detecting COVID-19 in a limited number of, and in imbalanced, chest X-ray images.

SLAS Technol2020       LitCov and CORD-19
6392COVID-19 induced Disruptions of School Feeding Services Exacerbate Food Insecurity in Nigeria  

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic and associated lockdown measures have disrupted educational and nutrition services globally. Understanding the overall and differential impacts of disruption of nutritional (school feeding) services is critical for designing effective post-COVID-19 recovery policies. OBJECTIVES: The aim of this study was to examine the impact of COVID-19-induced disruption of school feeding services on household food security in Nigeria. METHODS: We combined household-level, pre-COVID-19 in-person survey data with postpandemic phone survey data, along with local government area (LGA)–level information on access to school feeding services. We used a difference-in-difference approach and examined temporal trends in the food security of households with and without access to school feeding services. Of the sampled households, 83% live in LGAs with school feeding services. RESULTS: Households experienced an increase in food insecurity in the post-COVID-19 survey round. The share of households skipping a meal increased by 47 percentage points (95% CI: 44–50 percentage points). COVID-19-induced disruptions of school feeding services increased households' experiences of food insecurity, increasing the probability of skipping a meal by 9 percentage points (95% CI: 3–17 percentage points) and the likelihood of going without eating for a whole day by 3 percentage points (95% CI: 2–11 percentage points). Disruption of school feeding services is associated with a 0.2 SD (95% CI: 0.04–0.41 SD) increase in the food insecurity index. Households residing in states experiencing strict lockdown measures reported further deterioration in food insecurity. Single mothers and poorer households experienced relatively larger deteriorations in food security due to disruption of school feeding services. CONCLUSIONS: Our findings show that COVID-19-induced disruptions in educational and nutritional services have exacerbated households’ food insecurity in Nigeria. These findings can inform the designs of immediate and medium-term policy responses, including the designs of social protection policies and alternative programs to substitute nutritional services affected by the pandemic.

J Nutr2021       LitCov and CORD-19
6393Mental health consequences of COVID-19 media coverage: the need for effective crisis communication practices  

During global pandemics, such as coronavirus disease 2019 (COVID-19), crisis communication is indispensable in dispelling fears, uncertainty, and unifying individuals worldwide in a collective fight against health threats. Inadequate crisis communication can bring dire personal and economic consequences. Mounting research shows that seemingly endless newsfeeds related to COVID-19 infection and death rates could considerably increase the risk of mental health problems. Unfortunately, media reports that include infodemics regarding the influence of COVID-19 on mental health may be a source of the adverse psychological effects on individuals. Owing partially to insufficient crisis communication practices, media and news organizations across the globe have played minimal roles in battling COVID-19 infodemics. Common refrains include raging QAnon conspiracies, a false and misleading “Chinese virus” narrative, and the use of disinfectants to “cure” COVID-19. With the potential to deteriorate mental health, infodemics fueled by a kaleidoscopic range of misinformation can be dangerous. Unfortunately, there is a shortage of research on how to improve crisis communication across media and news organization channels. This paper identifies ways that legacy media reports on COVID-19 and how social media-based infodemics can result in mental health concerns. This paper discusses possible crisis communication solutions that media and news organizations can adopt to mitigate the negative influences of COVID-19 related news on mental health. Emphasizing the need for global media entities to forge a fact-based, person-centered, and collaborative response to COVID-19 reporting, this paper encourages media resources to focus on the core issue of how to slow or stop COVID-19 transmission effectively.

Global Health2021       LitCov and CORD-19
6394The impact of COVID-19 on air pollution levels and other environmental indicators-A case study of Egypt  

The outbreak of coronavirus disease (COVID-19) not only affected health and economics, but also its effect extended to include other aspects, such as the environment. Using Egypt as a case study, this paper presents the impact of COVID-19 pandemic on air pollution levels by studying nitrogen dioxide (NO(2)), ozone (O(3)), particulate matter represented in absorbing aerosol index (AAI), carbon monoxide (CO), and greenhouse gas (GHG) emissions. The paper also highlights the impact of COVID-19 pandemic on other environmental indicators including environmental noise, medical and municipal solid wastes. The paper presents the Egyptian COVID-19 story from its different angles including the development of confirmed COVID-19 cases, containment measures from the government, the impact on the country’s economy and the national energy consumption so as to effectively evaluate the effect on both the air pollution levels and the other studied environmental indicators. For the other environmental indicators, a strong link was observed between COVID-19 lockdown and the reduction in environmental noise, beaches, surface and groundwater pollution. For environmental noise, this has been confirmed by officially governmental announcements which reported that the level of environmental noise in Egypt was reduced by about 75% during the lockdown period. On the other hand, there are some negative effects, including an increase in medical solid waste (from 70 to 300 ton/day), municipal solid waste, as well as a less efficient solid waste recycling process. For air pollution levels, the data were obtained from National Aeronautics and Space Administration (NASA) and European Space Agency satellite data sets. The data for the lockdown period in 2020 have been extracted and compared to the corresponding months in the selected baseline period (2015-2019) to identify the effect that the lockdown period had on the air pollution levels in Egypt with focus on Cairo and Alexandria governorates. It was found that the AAI decreased by about 30%, the NO(2) decreased by 15 and 33% over Cairo and Alexandria governorates, respectively, and that the CO decreased by about 5% over both governorates. In addition, the GHG emissions in Egypt were reduced by at least 4% during the pandemic. In contrast, ozone levels increased by about 2% over Cairo and Alexandria governorates. It can be concluded that the implemented containment measures during COVID-19 pandemic had resulted in both positive and negative environmental impacts. The positive environmental impacts are not sustainable and deterioration on them is expected to occur after the lockdown as it was before the pandemic. Therefore, stricter laws must be enacted to protect the environment in Egypt.

J Environ Manage2020       LitCov and CORD-19
6395Predictions for COVID-19 with deep learning models of LSTM, GRU and Bi-LSTM  

COVID-19, responsible of infecting billions of people and economy across the globe, requires detailed study of the trend it follows to develop adequate short-term prediction models for forecasting the number of future cases. In this perspective, it is possible to develop strategic planning in the public health system to avoid deaths as well as managing patients. In this paper, proposed forecast models comprising autoregressive integrated moving average (ARIMA), support vector regression (SVR), long shot term memory (LSTM), bidirectional long short term memory (Bi-LSTM) are assessed for time series prediction of confirmed cases, deaths and recoveries in ten major countries affected due to COVID-19. The performance of models is measured by mean absolute error, root mean square error and r2_score indices. In the majority of cases, Bi-LSTM model outperforms in terms of endorsed indices. Models ranking from good performance to the lowest in entire scenarios is Bi-LSTM, LSTM, GRU, SVR and ARIMA. Bi-LSTM generates lowest MAE and RMSE values of 0.0070 and 0.0077, respectively, for deaths in China. The best r2_score value is 0.9997 for recovered cases in China. On the basis of demonstrated robustness and enhanced prediction accuracy, Bi-LSTM can be exploited for pandemic prediction for better planning and management.

Chaos Solitons Fractals2020       LitCov and CORD-19
6396Low performance of rapid antigen detection test as frontline testing for COVID-19 diagnosis  

BACKGROUND: Ensuring accurate diagnosis is essential to limit the spread of the SARS-CoV-2 and for the clinical management of COVID-19. Although real-time reverse transcription polymerase chain reaction (RT- qPCR) is the current recommended laboratory method to diagnose SARS-CoV-2 acute infection, several factors such as requirement of special equipment and skilled staff limit the use of these time-consuming molecular techniques. Recently, several easy to perform rapid antigen detection tests were developed and recommended in some countries as the first line of diagnostic. OBJECTIVES: The aim of this study was to evaluate the performances of the Coris COVID-19 Ag Respi-Strip. Study design. We performed a comparison study by testing nasopharyngeal samples with RT-qPCR and antigen rapid test. RESULTS: 148 nasopharyngeal swabs were tested. Amongst the 106 positive RT-qPCR samples, 32 were detected by the rapid antigen test, given an overall sensitivity of 30.2%. All the samples detected positive with the antigen rapid tests were also positive with RT-qPCR. CONCLUSIONS: Highest viral load is associated with better antigen detection rates. Unfortunately, the overall poor sensitivity of the COVID-19 Ag Respi-Strip does not allow using it alone as the frontline testing for COVID-19 diagnosis.

J Clin Virol2020       LitCov and CORD-19
6397Delayed Cutaneous Hypersensitivity Reaction to Vaxzevria (ChAdOx1-S) Vaccine against SARS-CoV-2  

Recently, an increasing number of cases with delayed cutaneous reaction after immunization with mRNA-based vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have been reported. This adverse reaction, which is considered a delayed-type or T cell-mediated hypersensitivity reaction, has been described for the Moderna (mRNA-1273) and Comirnaty (Pfizer/BioNTech, BNT162b2) vaccines. We describe a delayed large local cutaneous reaction in a patient who received the viral vector vaccine Vaxzevria (ChAdOx1-S, AstraZeneca). The time course and clinical symptoms of delayed skin reaction after mRNA vaccines have a similar pattern that we recognized in our patient after Vaxzevria vaccination. This phenomenon has not been described in the Vaxzevria clinical trials and is to our knowledge the first report of this adverse reaction to a vector-based SARS-CoV-2 vaccine. With this, we hope to raise awareness about delayed injection site reactions that also occur after viral vector vaccines and to encourage additional reporting and patient education regarding the cutaneous reactions after coronavirus disease 2019 (COVID-19) vaccination.

Drugs R D2021       LitCov and CORD-19
6398Impact of COVID-19 pandemic on the sleep quality of medical professionals in Brazil  

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Arq Neuropsiquiatr2021       LitCov and CORD-19
6399Clinical and virological data of the first cases of COVID-19 in Europe: a case series  

BACKGROUND: On Dec 31, 2019, China reported a cluster of cases of pneumonia in people at Wuhan, Hubei Province. The responsible pathogen is a novel coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We report the relevant features of the first cases in Europe of confirmed infection, named coronavirus disease 2019 (COVID-19), with the first patient diagnosed with the disease on Jan 24, 2020. METHODS: In this case series, we followed five patients admitted to Bichat-Claude Bernard University Hospital (Paris, France) and Pellegrin University Hospital (Bordeaux, France) and diagnosed with COVID-19 by semi-quantitative RT-PCR on nasopharyngeal swabs. We assessed patterns of clinical disease and viral load from different samples (nasopharyngeal and blood, urine, and stool samples), which were obtained once daily for 3 days from hospital admission, and once every 2 or 3 days until patient discharge. All samples were refrigerated and shipped to laboratories in the National Reference Center for Respiratory Viruses (The Institut Pasteur, Paris, and Hospices Civils de Lyon, Lyon, France), where RNA extraction, real-time RT-PCR, and virus isolation and titration procedures were done. FINDINGS: The patients were three men (aged 31 years, 48 years, and 80 years) and two women (aged 30 years and 46 years), all of Chinese origin, who had travelled to France from China around mid-January, 2020. Three different clinical evolutions are described: (1) two paucisymptomatic women diagnosed within a day of exhibiting symptoms, with high nasopharyngeal titres of SARS-CoV-2 within the first 24 h of the illness onset (5·2 and 7·4 log(10) copies per 1000 cells, respectively) and viral RNA detection in stools; (2) a two-step disease progression in two young men, with a secondary worsening around 10 days after disease onset despite a decreasing viral load in nasopharyngeal samples; and (3) an 80-year-old man with a rapid evolution towards multiple organ failure and a persistent high viral load in lower and upper respiratory tract with systemic virus dissemination and virus detection in plasma. The 80-year-old patient died on day 14 of illness (Feb 14, 2020); all other patients had recovered and been discharged by Feb 19, 2020. INTERPRETATION: We illustrated three different clinical and biological types of evolution in five patients infected with SARS-CoV-2 with detailed and comprehensive viral sampling strategy. We believe that these findings will contribute to a better understanding of the natural history of the disease and will contribute to advances in the implementation of more efficient infection control strategies. FUNDING: REACTing (Research & Action Emerging Infectious Diseases).

Lancet Infect Dis2020       LitCov and CORD-19
6400Retrospective Cohort Observational Study to compare the Effect of Mycobacterium w along with Standard of Care vs Standard of Care alone in critically ill COVID-19 Patients  

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J Assoc Physicians India2022       LitCov

(1) COVID-19 Open Research Dataset (CORD-19). 2020. Version 2022-06-02. Retrieved from https://ai2-semanticscholar-cord-19.s3-us-west-2.amazonaws.com/historical_releases.html. Accessed 2022-06-05. doi:10.5281/zenodo.3715506
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(3) Currently tweets of June 23rd to June 29th 2022 have been considered.

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