\ 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
6701Parent's Perspective towards Child COVID-19 Vaccination: An Online Cross-Sectional Study in Mexico  

COVID-19 vaccination programs continue in child populations. Thus, parents’ attitude towards COVID-19 vaccination of their children is crucial for these strategies to succeed. The present study derives from the application of an online COVID-19 Vaccine Acceptance & Hesitancy Questionnaire (COV-AHQ) in which we measure parent’s hesitancy towards children’s vaccination (section 4 of the COV-AHQ) and other significant factors. A logistic regression analysis with backward stepwise method was used to quantify the associations between factors and parent’s hesitancy. According to the correlation analysis, the most representative factors predicting vaccine hesitancy/acceptance were positive attitude towards vaccination, parents believing that the COVID-19 vaccine will enhance the economic situation of the country, parents actively researching information, having the willingness to obtain the COVID-19 vaccine themselves, and the possibility of their children developing adverse effects. Our findings also showed that parents are highly interested in having their children vaccinated. Nonetheless, parents expressed high levels of concern involving their children in developing adverse effects from the vaccine. In addition, obtaining influenza immunization prompted interest in obtaining the COVID-19 vaccine, and younger-aged parents are much more concerned with having their children vaccinated. Therefore, in order to ensure successful vaccination programs, policymakers and health authorities should design strategies to gain confidence and provide security amongst the population, including giving continuous information about the benefits of vaccination and presenting the frequency of side effects to bring parents on board with vaccinating their children.

Int J Environ Res Public Healt2021       LitCov and CORD-19
6702Effectiveness of Covid-19 vaccines (CovishieldTM and Covaxin ) in healthcare workers in Mumbai, India: A retrospective cohort analysis  

N/A

PLoS One2022       LitCov
6703Analytical sensitivity of the Rapid Antigen Test kits for detection of SARS-CoV-2 Omicron variant BA.2 sublineage  

N/A

J Med Virol2022       LitCov
6704Case Report: Stepwise Anti-Inflammatory and Anti-SARS-CoV-2 Effects Following Convalescent Plasma Therapy With Full Clinical Recovery  

In these times of COVID-19 pandemic, concern has been raised about the potential effects of SARS-CoV-2 infection on immunocompromised patients, particularly on those receiving B-cell depleting agents and having therefore a severely depressed humoral response. Convalescent plasma can be a therapeutic option for these patients. Understanding the underlying mechanisms of convalescent plasma is crucial to optimize such therapeutic approach. Here, we describe a COVID-19 patient who was deeply immunosuppressed following rituximab (anti-CD20 monoclonal antibody) and concomitant chemotherapy for chronic lymphoid leukemia. His long-term severe T and B cell lymphopenia allowed to evaluate the treatment effects of convalescent plasma. Therapeutic outcome was monitored at the clinical, biological and radiological level. Moreover, anti-SARS-CoV-2 antibody titers (IgM, IgG and IgA) and neutralizing activity were assessed over time before and after plasma transfusions, alongside to SARS-CoV-2 RNA quantification and virus isolation from the upper respiratory tract. Already after the first cycle of plasma transfusion, the patient experienced rapid improvement of pneumonia, inflammation and blood cell counts, which may be related to the immunomodulatory properties of plasma. Subsequently, the cumulative increase in anti-SARS-CoV-2 neutralizing antibodies due to the three additional plasma transfusions was associated with progressive and finally complete viral clearance, resulting in full clinical recovery. In this case-report, administration of convalescent plasma revealed a stepwise effect with an initial and rapid anti-inflammatory activity followed by the progressive SARS-CoV-2 clearance. These data have potential implications for a more extended use of convalescent plasma and future monoclonal antibodies in the treatment of immunosuppressed COVID-19 patients.

Front Immunol2021       LitCov and CORD-19
6705A laboratory-based study examining the properties of silk fabric to evaluate its potential as a protective barrier for personal protective equipment and as a functional material for face coverings during the COVID-19 pandemic  

The worldwide shortage of single-use N95 respirators and surgical masks due to the COVID-19 pandemic has forced many health care personnel to use their existing equipment for as long as possible. In many cases, workers cover respirators with available masks in an attempt to extend their effectiveness against the virus. Due to low mask supplies, many people instead are using face coverings improvised from common fabrics. Our goal was to determine what fabrics would be most effective in both practices. Under laboratory conditions, we examined the hydrophobicity of fabrics (cotton, polyester, silk), as measured by their resistance to the penetration of small and aerosolized water droplets, an important transmission avenue for the virus causing COVID-19. We also examined the breathability of these fabrics and their ability to maintain hydrophobicity despite undergoing repeated cleaning. Laboratory-based tests were conducted when fabrics were fashioned as an overlaying barrier for respirators and when constructed as face coverings. When used as material in these two situations, silk was more effective at impeding the penetration and absorption of droplets due to its greater hydrophobicity relative to other tested fabrics. We found that silk face coverings repelled droplets in spray tests as well as disposable single-use surgical masks, and silk face coverings have the added advantage over masks such that they can be sterilized for immediate reuse. We show that silk is a hydrophobic barrier to droplets, can be more breathable than other fabrics that trap humidity, and are re-useable via cleaning. We suggest that silk can serve as an effective material for making hydrophobic barriers that protect respirators, and silk can now be tested under clinical conditions to verify its efficacy for this function. Although respirators are still the most appropriate form of protection, silk face coverings possess properties that make them capable of repelling droplets.

PLoS One2020       LitCov and CORD-19
6706Mental health implications of COVID-19 pandemic and its response in India  

INTRODUCTION: Mental health concerns and treatment usually take a backseat when the limited resources are geared for pandemic containment. In this global humanitarian crisis of the COVID-19 pandemic, mental health issues have been reported from all over the world. OBJECTIVES: In this study, we attempt to review the prevailing mental health issues during the COVID-19 pandemic through global experiences, and reactive strategies established in mental health care with special reference to the Indian context. By performing a rapid synthesis of available evidence, we aim to propose a conceptual and recommendation framework for mental health issues during the COVID-19 pandemic. METHODS: A search of the PubMed electronic database and google scholar were undertaken using the search terms ‘novel coronavirus’, ‘COVID-19’, ‘nCoV’, SARS-CoV-2, ‘mental health’, ‘psychiatry’, ‘psychology’, ‘anxiety’, ‘depression’ and ‘stress’ in various permutations and combinations. Published journals, magazines and newspaper articles, official webpages and independent websites of various institutions and non-government organizations, verified social media portals were compiled. RESULTS: The major mental health issues reported were stress, anxiety, depression, insomnia, denial, anger and fear. Children and older people, frontline workers, people with existing mental health illnesses were among the vulnerable in this context. COVID-19 related suicides have also been increasingly common. Globally, measures have been taken to address mental health issues through the use of guidelines and intervention strategies. The role of social media has also been immense in this context. State-specific intervention strategies, telepsychiatry consultations, toll free number specific for psychological and behavioral issues have been issued by the Government of India. CONCLUSION: Keeping a positive approach, developing vulnerable-group-specific need-based interventions with proper risk communication strategies and keeping at par with the evolving epidemiology of COVID-19 would be instrumental in guiding the planning and prioritization of mental health care resources to serve the most vulnerable.

Int J Soc Psychiatry2020       LitCov and CORD-19
6707mRNA-1273 and BNT162b2 mRNA vaccines have reduced neutralizing activity against the SARS-CoV-2 Omicron variant  

N/A

bioRxiv2021       CORD-19
6708Post-acute COVID-19 syndrome: a new tsunami requiring a universal case definition  

Clin Microbiol Infect2021       LitCov and CORD-19
6709Targeting the viral-entry facilitators of SARS-CoV-2 as a therapeutic strategy in COVID-19  

Severe acute respiratory syndrome coronavirus‐2 (SARS‐CoV‐2) is the causative agent of coronavirus disease 2019 (COVID‐19) infection, which has emerged as a global pandemic causing serious concerns. Lack of specific and effective therapeutics for the treatment of COVID‐19 is a major concern and the development of vaccines is another important aspect in managing the infection effectively. The first step in the SARS‐CoV‐2 pathogenesis is the viral entry and it is mediated by its densely glycosylated spike protein (S‐protein). Similar to the SARS‐CoV, SARS‐CoV‐2 also engages angiotensin‐converting enzyme 2 (ACE2) as the host cell entry receptor. In addition to ACE2, several recent studies have implicated the crucial role of cell surface heparan sulfate (HS) as a necessary assisting cofactor for ACE2‐mediated SARS‐CoV‐2 entry. Furthermore, SARS‐CoV‐2 was also identified to use both endosomal cysteine proteases cathepsin B and L (CatB/L) and the transmembrane serine protease 2 (TMPRSS2) for the pivotal role of S‐protein priming mediating viral entry. As the entry of SARS‐CoV‐2 into host cells is mandatory for viral infection, it becomes an extremely attractive therapeutic intervention point. In this regard, this review will focus on the therapeutic targeting of the crucial steps of SARS‐CoV‐2 viral entry like S‐protein/ACE2 interaction and S‐protein priming by host cell proteases. In addition, this review will also give insights to the readers on several therapeutic opportunities, pharmacological targeting of the viral‐entry facilitators like S‐Protein, ACE2, cell surface HS, TMPRSS2, and CatB/L and evidence for those drugs currently ongoing clinical studies.

J Med Virol2021       LitCov and CORD-19
6710Acute myocarditis after COVID-19 vaccination with mRNA-1273 in a patient with former SARS-CoV-2 infection  

We describe a case of a 20‐year‐old healthy man developing chest pain and classical symptoms of vaccine reactogenicity 12 h after receiving the first dose of mRNA‐1273 (Moderna). Cardiac troponin T was increased, and subepicardial inflammation and focal contractile dysfunction were detected by cardiac magnetic resonance imaging and echocardiography. We confirmed the diagnosis of acute myocarditis by endomyocardial biopsy demonstrating significant infiltration of monocytes and T lymphocytes. Although we detected IgG against nucleocapsid protein of severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) indicating prior infection, the patient repeatedly tested negative for SARS‐CoV‐2 and had been asymptomatic for several months. Furthermore, viral genome analysis of endomyocardial biopsy samples was negative for SARS‐CoV‐2 and other potential cardiotropic viruses. These findings and the strong temporal relation between the vaccination and the symptom onset imply a potential side effect of mRNA‐1273.

ESC Heart Fail2021       LitCov and CORD-19
6711A qualitative study of physician perceptions and experiences of caring for critically ill patients in the context of resource strain during the first wave of the COVID-19 pandemic  

BACKGROUND: The COVID-19 pandemic has led to global shortages in the resources required to care for critically ill patients and to protect frontline healthcare providers. This study investigated physicians’ perceptions and experiences of caring for critically ill patients in the context of actual or anticipated resource strain during the COVID-19 pandemic, and explored implications for the healthcare workforce and the delivery of patient care. METHODS: We recruited a diverse sample of critical care physicians from 13 Canadian Universities with adult critical care training programs. We conducted semi-structured telephone interviews between March 25–June 25, 2020 and used qualitative thematic analysis to derive primary themes and subthemes. RESULTS: Fifteen participants (eight female, seven male; median age = 40) from 14 different intensive care units described three overarching themes related to physicians’ perceptions and experiences of caring for critically ill patients during the pandemic: 1) Conditions contributing to resource strain (e.g., continuously evolving pandemic conditions); 2) Implications of resource strain on critical care physicians personally (e.g., safety concerns) and professionally (e.g. practice change); and 3) Enablers of resource sufficiency (e.g., adequate human resources). CONCLUSIONS: The COVID-19 pandemic has required health systems and healthcare providers to continuously adapt to rapidly evolving circumstances. Participants’ uncertainty about whether their unit’s planning and resources would be sufficient to ensure the delivery of high quality patient care throughout the pandemic, coupled with fear and anxiety over personal and familial transmission, indicate the need for a unified systemic pandemic response plan for future infectious disease outbreaks. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12913-021-06393-5.

BMC Health Serv Res2021       LitCov and CORD-19
6712Safety and immunogenicity of S-Trimer (SCB-2019), a protein subunit vaccine candidate for COVID-19 in healthy adults: a phase 1, randomised, double-blind, placebo-controlled trial  

BACKGROUND: As part of the accelerated development of vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), we report a dose-finding and adjuvant justification study of SCB-2019, a protein subunit vaccine candidate containing a stabilised trimeric form of the spike (S)-protein (S-Trimer) combined with two different adjuvants. METHODS: Our study is a phase 1, randomised, double-blind placebo-controlled trial at a specialised clinical trials centre in Australia. We enrolled healthy adult volunteers in two age groups: younger adults (aged 18–54 years) and older adults (aged 55–75 years). Participants were randomly allocated either vaccine or placebo using a list prepared by the study funder. Participants were to receive two doses of SCB-2019 (either 3 μg, 9 μg, or 30 μg) or a placebo (0·9% NaCl) 21 days apart. SCB-2019 either had no adjuvant (S-Trimer protein alone) or was adjuvanted with AS03 or CpG/Alum. The assigned treatment was administered in opaque syringes to maintain masking of assignments. Reactogenicity was assessed for 7 days after each vaccination. Humoral responses were measured as SCB-2019 binding IgG antibodies and ACE2-competitive blocking IgG antibodies by ELISA and as neutralising antibodies by wild-type SARS-CoV-2 microneutralisation assay. Cellular responses to pooled S-protein peptides were measured by flow-cytometric intracellular cytokine staining. This trial is registered with ClinicalTrials.gov, NCT04405908; this is an interim analysis and the study is continuing. FINDINGS: Between June 19 and Sept 23, 2020, 151 volunteers were enrolled; three people withdrew, two for personal reasons and one with an unrelated serious adverse event (pituitary adenoma). 148 participants had at least 4 weeks of follow-up after dose two and were included in this analysis (database lock, Oct 23, 2020). Vaccination was well tolerated, with two grade 3 solicited adverse events (pain in 9 μg AS03-adjuvanted and 9 μg CpG/Alum-adjuvanted groups). Most local adverse events were mild injection-site pain, and local events were more frequent with SCB-2019 formulations containing AS03 adjuvant (44–69%) than with those containing CpG/Alum adjuvant (6–44%) or no adjuvant (3–13%). Systemic adverse events were more frequent in younger adults (38%) than in older adults (17%) after the first dose but increased to similar levels in both age groups after the second dose (30% in older and 34% in younger adults). SCB-2019 with no adjuvant elicited minimal immune responses (three seroconversions by day 50), but SCB-2019 with fixed doses of either AS03 or CpG/Alum adjuvants induced high titres and seroconversion rates of binding and neutralising antibodies in both younger and older adults (anti-SCB-2019 IgG antibody geometric mean titres at day 36 were 1567–4452 with AS03 and 174–2440 with CpG/Alum). Titres in all AS03 dose groups and the CpG/Alum 30 μg group were higher than were those recorded in a panel of convalescent serum samples from patients with COVID-19. Both adjuvanted SCB-2019 formulations elicited T-helper-1-biased CD4(+) T-cell responses. INTERPRETATION: The SCB-2019 vaccine, comprising S-Trimer protein formulated with either AS03 or CpG/Alum adjuvants, elicited robust humoral and cellular immune responses against SARS-CoV-2, with high viral neutralising activity. Both adjuvanted vaccine formulations were well tolerated and are suitable for further clinical development. FUNDING: Clover Biopharmaceuticals and the Coalition for Epidemic Preparedness Innovations.

Lancet2021       LitCov and CORD-19
6713Deploying Machine and Deep Learning Models for Efficient Data-Augmented Detection of COVID-19 Infections  

This generation faces existential threats because of the global assault of the novel Corona virus 2019 (i.e., COVID-19). With more than thirteen million infected and nearly 600000 fatalities in 188 countries/regions, COVID-19 is the worst calamity since the World War II. These misfortunes are traced to various reasons, including late detection of latent or asymptomatic carriers, migration, and inadequate isolation of infected people. This makes detection, containment, and mitigation global priorities to contain exposure via quarantine, lockdowns, work/stay at home, and social distancing that are focused on “flattening the curve”. While medical and healthcare givers are at the frontline in the battle against COVID-19, it is a crusade for all of humanity. Meanwhile, machine and deep learning models have been revolutionary across numerous domains and applications whose potency have been exploited to birth numerous state-of-the-art technologies utilised in disease detection, diagnoses, and treatment. Despite these potentials, machine and, particularly, deep learning models are data sensitive, because their effectiveness depends on availability and reliability of data. The unavailability of such data hinders efforts of engineers and computer scientists to fully contribute to the ongoing assault against COVID-19. Faced with a calamity on one side and absence of reliable data on the other, this study presents two data-augmentation models to enhance learnability of the Convolutional Neural Network (CNN) and the Convolutional Long Short-Term Memory (ConvLSTM)-based deep learning models (DADLMs) and, by doing so, boost the accuracy of COVID-19 detection. Experimental results reveal improvement in terms of accuracy of detection, logarithmic loss, and testing time relative to DLMs devoid of such data augmentation. Furthermore, average increases of 4% to 11% in COVID-19 detection accuracy are reported in favour of the proposed data-augmented deep learning models relative to the machine learning techniques. Therefore, the proposed algorithm is effective in performing a rapid and consistent Corona virus diagnosis that is primarily aimed at assisting clinicians in making accurate identification of the virus.

Viruses2020       LitCov and CORD-19
6714The Experiences and Perceptions of Healthcare Workers During the COVID-19 Pandemic in Muscat, Oman: A Qualitative Study  

INTRODUCTION: Predominantly, studies on COVID-19 report quantitative data that often miss the social implications and other determinants of health. The objective of this study was to explore the experiences and perceptions of health care workers (HCWs) in primary health care in the management of COVID-19 with respect to medical response experiences, socio-cultural and religious reforms, psychological impressions, and lessons learned. METHODS: This was a qualitative study using an empirical phenomenological approach. Six focus group discussions were conducted across various stakeholders working frontline in the management of COVID-19 (managerial, public health/field/community and primary care health centers). They participated in semi-structured, in-depth group discussions from 11th to 20th May 2020. All discussions were audio-recorded, transcribed verbatim and analyzed using thematic analysis. RESULTS: Forty participants were involved in this study. Three themes emerged related to the medical response experiences, including the rapid re-structuring of the PHC services, use of technology and challenges of working on COVID-19. Perceptions on the socio-cultural and religious reforms included changes in social and religious norms, and anticipated gaps in accessing health care among the vulnerable groups (elderly, expatriates, and individuals with low economic status). Perceptions on psychological disturbances were themed as consequences of social distancing, management of dead bodies, exhaustion among the health care workers, and risk of exposure. Finally, lessons learned were centered around building on the existing epidemiological and public health capacities, improving access to health care and overcoming resistance to change. Most participants labelled their experience in COVID-19 as an “experience of wisdom” in which learning was a continuous process. CONCLUSION: This qualitative study amongst primary HCWs revealed certain aspects of response to COVID-19 in Muscat, Oman. Results has unfolded various aspects of COVID-19. The situation was perceived by primary HCWs as a new experience that challenged the primary health care; enforced the utilization of public health/epidemiological skills, and linked to unfavorable socio-religious and psychological events.

J Prim Care Community Health2020       LitCov and CORD-19
6715Risk factors for non-invasive/invasive ventilatory support in patients with COVID-19 pneumonia: A retrospective study within a multidisciplinary approach  

Objectives To investigate risk factors for non-invasive/invasive-ventilatory support (NI/I-VS) in Coronavirus diseases 2019 (COVID-19) patients. Methods All consecutive patients admitted, from February 25 to April 25, 2020, to the Infectious Diseases Unit and Intensive Care Unit of Santa Maria Annunziata Hospital (Florence, Italy) with confirmed COVID-19 diagnosis were enrolled in this retrospective cohort study. NI/I-VS was defined as need for continuous positive airway pressure (CPAP) or bilevel positive pressure non-invasive ventilation (BPAP) or mechanical ventilation (MV) than low-flow systems oxygen-therapy as Venturi Mask (VM) or nasal cannula. Results Ninety-seven patients were enrolled; 61,9% (60/97) were male, median age was 64 years; intra-hospital mortality was 9.3%. Thirty five out of 97 (36%) patients required ICU admission and 94.8% (92/97) were prescribed oxygen-therapy: 10.8% (10/92) with nasal cannula, 44.5% (41/92) with VM, 31.5% (29/92) with CPAP, 2.2% (2/92) with BPAP and 10.8% (10/92) underwent intubation for MV. Patients with body mass index >30, type II diabetes mellitus and presenting at the admission with dyspnoea, asthenia, SOFA score ≥2 points, PaO2/FiO2 < 300, temperature >38 °C, increased levels of lactate dehydrogenase (LDH), alanine aminotransferase, C-reactive protein and a d-dimer >1000 ng/ml underwent more frequently NI/I-VS at the univariate analysis. Multivariate logistic regression analysis confirmed temperature >38 °C (odds ratio [OR] 21.2, 95% confidential interval [95%CI] 3.5-124.5, p = 0.001), LDH > 250 U/L (OR 15.2, 95%CI 1.8-128.8, p = 0.012) and d-dimer >1000 ng/ml (OR 4.5, 95%CI 1.2-17.3, p = 0.027) as significantly associated with NI/I-VS requirement. A non-significant trend (p = 0.051) was described for PaO2/FiO2 < 300. Conclusions Temperature >38 °C, LDH > 250 U/L and d-dimer >1000 ng/ml resulted to be indipendent risk factors for NI/I-VS in COVID-19 patients. In order to quickly recognize patients likely at risk to develop a critical illness, inflammatory markers assessment should be warranted upon hospital admission.

Int J Infect Dis2020       LitCov and CORD-19
6716Early Adoption of Longitudinal Surveillance for SARS-CoV-2 among Staff in Long-Term Care Facilities: Prevalence, Virologic and Sequence Analysis  

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in 2019 and has become a major global pathogen in an astonishingly short period of time. The emergence of SARS-CoV-2 has been notable due to its impacts on residents in long-term care facilities (LTCFs). LTCF residents tend to possess several risk factors for severe outcomes of SARS-CoV-2 infection, including advanced age and the presence of comorbidities. Indeed, residents of LTCFs represent approximately 40% of SARS-CoV-2 deaths in the United States. Few studies have focused on the prevalence and transmission dynamics of SARS-CoV-2 among LTCF staff during the early months of the pandemic, prior to mandated surveillance testing. To assess the prevalence and incidence of SARS-CoV-2 among LTCF staff, characterize the extent of asymptomatic infections, and investigate the genomic epidemiology of the virus within these settings, we sampled staff for 8 to 11 weeks at six LTCFs with nasopharyngeal swabs from March through June of 2020. We determined the presence and levels of viral RNA and infectious virus and sequenced 54 nearly complete genomes. Our data revealed that over 50% of infections were asymptomatic/mildly symptomatic and that there was a strongly significant relationship between viral RNA (vRNA) and infectious virus, prolonged infections, and persistent vRNA (4+ weeks) in a subset of individuals, and declining incidence over time. Our data suggest that asymptomatic SARS-CoV-2-infected LTCF staff contributed to virus persistence and transmission within the workplace during the early pandemic period. Genetic epidemiology data generated from samples collected during this period support that SARS-CoV-2 was commonly spread between staff within an LTCF and that multiple-introduction events were less common. IMPORTANCE Our work comprises unique data on the characteristics of SARS-CoV-2 dynamics among staff working at LTCFs in the early months of the SARS-CoV-2 pandemic prior to mandated staff surveillance testing. During this time period, LTCF residents were largely sheltering-in-place. Given that staff were able to leave and return daily and could therefore be a continued source of imported or exported infection, we performed weekly SARS-CoV-2 PCR on nasal swab samples collected from this population. There are limited data from the early months of the pandemic comprising longitudinal surveillance of staff at LTCFs. Our data reveal the surprisingly high level of asymptomatic/presymptomatic infections within this cohort during the early months of the pandemic and show genetic epidemiological analyses that add novel insights into both the origin and transmission of SARS-CoV-2 within LTCFs.

Microbiol Spectr2021       LitCov and CORD-19
6717Pregnancy Outcomes in COVID-19: A Prospective Cohort Study in Singapore  

N/A

Ann Acad Med Singap2020       LitCov and CORD-19
6718Immunogenicity of Anti-SARS-CoV-2 Vaccines in Common Variable Immunodeficiency  

Common variable immunodeficiency (CVID) is characterized by hypogammaglobulinemia and/or a defective antibody response to T-dependent and T-independent antigens. CVID response to immunization depends on the antigen type, the vaccine mechanism, and the specific patient immune defect. In CVID patients, humoral and cellular responses to the currently used COVID-19 vaccines remain unexplored. Eighteen CVID subjects receiving 2-dose anti-SARS-CoV-2 vaccines were prospectively studied. S1-antibodies and S1-specific IFN-γ T cell response were determined by ELISA and FluoroSpot, respectively. The immune response was measured before the administration and after each dose of the vaccine, and it was compared to the response of 50 healthy controls (HC). The development of humoral and cellular responses was slower in CVID patients compared with HC. After completing vaccination, 83% of CVID patients had S1-specific antibodies and 83% had S1-specific T cells compared with 100% and 98% of HC (p = 0.014 and p = 0.062, respectively), but neutralizing antibodies were detected only in 50% of the patients. The strength of both humoral and cellular responses was significantly lower in CVID compared with HC, after the first and second doses of the vaccine. Absent or discordant humoral and cellular responses were associated with previous history of autoimmunity and/or lymphoproliferation. Among the three patients lacking humoral response, two had received recent therapy with anti-B cell antibodies. Further studies are needed to understand if the response to COVID-19 vaccination in CVID patients is protective enough. The 2-dose vaccine schedule and possibly a third dose might be especially necessary to achieve full immune response in these patients.

J Clin Immunol2021       LitCov and CORD-19
6719Lived Experience of Emergency Healthcare Utilization during the COVID-19 Pandemic: A Qualitative Study  

INTRODUCTION: As the understanding of health care worker lived experience during coronavirus disease 2019 (COVID-19) grows, the experiences of those utilizing emergency health care services (EHS) during the pandemic are yet to be fully appreciated. STUDY OBJECTIVE: The objective of this research was to explore lived experience of EHS utilization in Victoria, Australia during the COVID-19 pandemic from March 2020 through March 2021. METHODS: An explorative qualitative design underpinned by a phenomenological approach was applied. Data were collected through semi-structured, in-depth interviews, which were transcribed verbatim and analyzed using Colaizzi’s approach. RESULTS: Qualitative data were collected from 67 participants aged from 32 to 78-years-of-age (average age of 52). Just over one-half of the research participants were male (54%) and three-quarters lived in metropolitan regions (75%). Four key themes emerged from data analysis: (1) Concerns regarding exposure and infection delayed EHS utilization among participants with chronic health conditions; (2) Participants with acute health conditions expressed concern regarding the impact of COVID-19 on their care, but continued to access services as required; (3) Participants caring for people with sensory and developmental disabilities identified unique communication needs during interactions with EHS during the COVID-19 pandemic; communicating with emergency health care workers wearing personal protective equipment (PPE) was identified as a key challenge, with face masks reported as especially problematic for people who are deaf or hard-of-hearing; and (4) Children and older people also experienced communication challenges associated with PPE, and the need for connection with emergency health care workers was important for positive lived experience during interactions with EHS throughout the pandemic. CONCLUSION: This research provides an important insight into the lived experience of EHS utilization during the COVID-19 pandemic, a perspective currently lacking in the published peer-reviewed literature.

Prehosp Disaster Med2021       LitCov and CORD-19
6720Epidemiology of and Risk Factors for Coronavirus Infection in Healthcare Workers: A Living Rapid Review  

BACKGROUND: Health care workers (HCWs) are at risk for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection. PURPOSE: To examine the burden of SARS-CoV-2, SARS-CoV-1, and Middle Eastern respiratory syndrome (MERS)-CoV on HCWs and risk factors for infection, using rapid and living review methods. DATA SOURCES: Multiple electronic databases including the WHO Database of Publications on Coronavirus Disease and medRxiv preprint server (2003 through 27 March 2020, with ongoing surveillance through 24 April 2020), and reference lists. STUDY SELECTION: Studies published in any language reporting incidence of or outcomes associated with coronavirus infections in HCWs and studies on the association between risk factors (demographic characteristics, role, exposures, environmental and administrative factors, and personal protective equipment [PPE] use) and HCW infections. New evidence will be incorporated on an ongoing basis by using living review methods. DATA EXTRACTION: One reviewer abstracted data and assessed methodological limitations; verification was done by a second reviewer. DATA SYNTHESIS: 64 studies met inclusion criteria; 43 studies addressed burden of HCW infections (15 on SARS-CoV-2), and 34 studies addressed risk factors (3 on SARS-CoV-2). Health care workers accounted for a significant proportion of coronavirus infections and may experience particularly high infection incidence after unprotected exposures. Illness severity was lower than in non-HCWs. Depression, anxiety, and psychological distress were common in HCWs during the coronavirus disease 2019 outbreak. The strongest evidence on risk factors was on PPE use and decreased infection risk. The association was most consistent for masks but was also observed for gloves, gowns, eye protection, and handwashing; evidence suggested a dose–response relationship. No study evaluated PPE reuse. Certain exposures (such as involvement in intubations, direct patient contact, or contact with bodily secretions) were associated with increased infection risk. Infection control training was associated with decreased risk. LIMITATION: There were few studies on risk factors for SARS-CoV-2, the studies had methodological limitations, and streamlined rapid review methods were used. CONCLUSION: Health care workers experience significant burdens from coronavirus infections, including SARS-CoV-2. Use of PPE and infection control training are associated with decreased infection risk, and certain exposures are associated with increased risk. PRIMARY FUNDING SOURCE: World Health Organization.

Ann Intern Med2020       LitCov and CORD-19
6721Maternal clinical characteristics and perinatal outcomes among pregnant women with COVID-19. A systematic review  

OBJECTIVE: To describe the maternal clinical characteristics, maternal and perinatal outcomes in COVID-19-positive pregnant women. METHODS: Articles in all languages on the SARS-CoV-2 infection in pregnant women were sought from MEDLINE, EMBASE, Cochrane Library and LILACS; China National Knowledge Infrastructure Database (CNKI), Chinese Science and Technology Periodical Database (VIP) and Wan Fang Data between December 1, 2019 and April 27, 2020. Bulletins and national reports were also searched. RESULTS: From 12168 retrieved articles, 143 were selected for full-text assessment; 33 for descriptive analyses, and 4 case-controls for meta-analysis. In 322 infected pregnant women, aged 20-45 years, the most frequent maternal comorbidity was obesity (24.2%). Forty-two (28.4%) were asymptomatic at admission. Cough (n=148,59.7%) and fever (n=147,59.3%) were the most prevalent symptoms. In the meta-analysis, fever (OR: 0.13,95% CI 0.05 to 0.36) and cough (0.26,95% CI 0.11 to 0.59) were lower in pregnant women with COVID-19 than non-pregnant women with COVID-19. 195 (60.6%) delivered, and 125 (38.8%) remained pregnant during the study. Cesarean was reported in 99 (50.8%) women and vaginal delivery in 64 (32.8%). The main adverse obstetric outcome was premature birth (n=37,18.9%). Thirty patients (10.3%) with COVID-19-related complications required intensive care, one (0.3%) died. SARS-CoV-2 was absent in breast milk, amniotic fluid, placenta or umbilical cord blood. CONCLUSIONS: The maternal clinical characteristics of COVID-19-positive pregnant include frequently fever and cough; however significantly less frequently than non-pregnant women with COVID-19. Iatrogenic preterm birth is the main adverse obstetric outcome. Current data does not support vertical transmission in the third trimester.

Travel Med Infect Dis2020       LitCov and CORD-19
6722Investigating the Psychology of Financial Markets During COVID-19 Era: A Case Study of the US and European Markets  

The novel coronavirus (COVID-19) has imperatively shaken the behavior of the global financial markets. This study estimated the impact of COVID-19 on the behavior of the financial markets of Europe and the US. The results revealed that the returns of the S&P 500 index have been greatly affected by a lockdown in the US owing to COVID-19. However, the health crisis generated due to the novel coronavirus significantly decreased the stock returns of the Nasdaq Composite index. The results also showed that the economic crisis generated from the pandemic in Spain has had more impact on the IBEX 35 as compared to the health crisis itself. On the other hand, in the long-run, Italy’s stock markets are more affected by the health crisis as contrasted with the economic crisis, while, in the short-run, both lockdown conditions and economic instability lower the stock returns of FTSE MIB. The UK stock markets witnessed that in the short-run, deficiency of health management systems imperatively damaged the stock returns of the London Stock Exchange. The investigation revealed that deficiency of health systems and lockdown conditions have imperatively damaged the structure of financial markets, inferring that sustainable development of these nations is at risk due to COVID-19. The study suggested that governments should allocate more of their budget to the health sector to overcome a health crisis in the future.

Front Psychol2020       LitCov and CORD-19
6723Does comorbidity increase the risk of patients with COVID-19: evidence from meta-analysis  

Currently, the number of patients with coronavirus disease 2019 (COVID-19) has increased rapidly, but relationship between comorbidity and patients with COVID-19 still not clear. The aim was to explore whether the presence of common comorbidities increases COVID-19 patients’ risk. A literature search was performed using the electronic platforms (PubMed, Cochrane Library, Embase, and other databases) to obtain relevant research studies published up to March 1, 2020. Relevant data of research endpoints in each study were extracted and merged. All data analysis was performed using Stata12.0 software. A total of 1558 patients with COVID-19 in 6 studies were enrolled in our meta-analysis eventually. Hypertension (OR: 2.29, P<0.001), diabetes (OR: 2.47, P<0.001), chronic obstructive pulmonary disease (COPD) (OR: 5.97, P<0.001), cardiovascular disease (OR: 2.93, P<0.001), and cerebrovascular disease (OR:3.89, P=0.002)were independent risk factors associated with COVID-19 patients. The meta-analysis revealed no correlation between increased risk of COVID-19 and liver disease, malignancy, or renal disease. Hypertension, diabetes, COPD, cardiovascular disease, and cerebrovascular disease are major risk factors for patients with COVID-19. Knowledge of these risk factors can be a resource for clinicians in the early appropriate medical management of patients with COVID-19.

Aging (Albany NY)2020       LitCov and CORD-19
6724Reactogenicity and immunogenicity after a late second dose or a third dose of ChAdOx1 nCoV-19 in the UK: a substudy of two randomised controlled trials (COV001 and COV002)  

BACKGROUND: COVID-19 vaccine supply shortages are causing concerns about compromised immunity in some countries as the interval between the first and second dose becomes longer. Conversely, countries with no supply constraints are considering administering a third dose. We assessed the persistence of immunogenicity after a single dose of ChAdOx1 nCoV-19 (AZD1222), immunity after an extended interval (44–45 weeks) between the first and second dose, and response to a third dose as a booster given 28–38 weeks after the second dose. METHODS: In this substudy, volunteers aged 18–55 years who were enrolled in the phase 1/2 (COV001) controlled trial in the UK and had received either a single dose or two doses of 5 × 10(10) viral particles were invited back for vaccination. Here we report the reactogenicity and immunogenicity of a delayed second dose (44–45 weeks after first dose) or a third dose of the vaccine (28–38 weeks after second dose). Data from volunteers aged 18–55 years who were enrolled in either the phase 1/2 (COV001) or phase 2/3 (COV002), single-blinded, randomised controlled trials of ChAdOx1 nCoV-19 and who had previously received a single dose or two doses of 5 × 10(10) viral particles are used for comparison purposes. COV001 is registered with ClinicalTrials.gov, NCT04324606, and ISRCTN, 15281137, and COV002 is registered with ClinicalTrials.gov, NCT04400838, and ISRCTN, 15281137, and both are continuing but not recruiting. FINDINGS: Between March 11 and 21, 2021, 90 participants were enrolled in the third-dose boost substudy, of whom 80 (89%) were assessable for reactogenicity, 75 (83%) were assessable for evaluation of antibodies, and 15 (17%) were assessable for T-cells responses. The two-dose cohort comprised 321 participants who had reactogenicity data (with prime-boost interval of 8–12 weeks: 267 [83%] of 321; 15–25 weeks: 24 [7%]; or 44–45 weeks: 30 [9%]) and 261 who had immunogenicity data (interval of 8–12 weeks: 115 [44%] of 261; 15–25 weeks: 116 [44%]; and 44–45 weeks: 30 [11%]). 480 participants from the single-dose cohort were assessable for immunogenicity up to 44–45 weeks after vaccination. Antibody titres after a single dose measured approximately 320 days after vaccination remained higher than the titres measured at baseline (geometric mean titre of 66·00 ELISA units [EUs; 95% CI 47·83–91·08] vs 1·75 EUs [1·60–1·93]). 32 participants received a late second dose of vaccine 44–45 weeks after the first dose, of whom 30 were included in immunogenicity and reactogenicity analyses. Antibody titres were higher 28 days after vaccination in those with a longer interval between first and second dose than for those with a short interval (median total IgG titre: 923 EUs [IQR 525–1764] with an 8–12 week interval; 1860 EUs [917–4934] with a 15–25 week interval; and 3738 EUs [1824–6625] with a 44–45 week interval). Among participants who received a third dose of vaccine, antibody titres (measured in 73 [81%] participants for whom samples were available) were significantly higher 28 days after a third dose (median total IgG titre: 3746 EUs [IQR 2047–6420]) than 28 days after a second dose (median 1792 EUs [IQR 899–4634]; Wilcoxon signed rank test p=0·0043). T-cell responses were also boosted after a third dose (median response increased from 200 spot forming units [SFUs] per million peripheral blood mononuclear cells [PBMCs; IQR 127–389] immediately before the third dose to 399 SFUs per milion PBMCs [314–662] by day 28 after the third dose; Wilcoxon signed rank test p=0·012). Reactogenicity after a late second dose or a third dose was lower than reactogenicity after a first dose. INTERPRETATION: An extended interval before the second dose of ChAdOx1 nCoV-19 leads to increased antibody titres. A third dose of ChAdOx1 nCoV-19 induces antibodies to a level that correlates with high efficacy after second dose and boosts T-cell responses. FUNDING: UK Research and Innovation, Engineering and Physical Sciences Research Council, National Institute for Health Research, Coalition for Epidemic Preparedness Innovations, National Institute for Health Research Oxford Biomedical Research Centre, Chinese Academy of Medical Sciences Innovation Fund for Medical Science, Thames Valley and South Midlands NIHR Clinical Research Network, AstraZeneca, and Wellcome.

Lancet2021       LitCov and CORD-19
6725COVID-19 and Immune-Mediated RBC Destruction  

OBJECTIVES: To summarize the epidemiologic, clinical, and laboratory characteristics of autoimmune hemolytic anemia (AIHA) secondary to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection or vaccination. METHODS: We conducted a systematic review using standardized keyword search to identify all reports of SARS-CoV-2 infection or vaccination and AIHA across PubMed, Web of Science, Scopus, and Google Scholar through September 24, 2021. RESULTS: Fifty patients (mean [SD] age, 50.8 [21.6] years) diagnosed with coronavirus disease 2019 (COVID-19) and AIHA were identified. AIHA subtypes and number of patients were as follows: cold AIHA (n = 18), warm AIHA (n = 14), mixed-type AIHA (n = 3), direct antiglobulin test (DAT)–negative AIHA (n = 1), DAT-negative Evans syndrome (n = 1), Evans syndrome (n = 3), and subtype not reported (n = 10). Mean (SD) hemoglobin at AIHA diagnosis was 6.5 [2.8] g/dL (95% confidence interval, 5.7-7.3 g/dL). Median time from COVID-19 symptom onset to AIHA diagnosis was 7 days. In total, 19% (8/42) of patients with COVID-19–associated AIHA with reported outcomes were deceased. Four patients (mean [SD] age, 73.5 [16.9] years) developed AIHA following SARS-CoV-2 vaccination: Pfizer-BioNTech BNT162b2 vaccine (n = 2); Moderna mRNA-1273 vaccine (n = 1); undisclosed mRNA vaccine (n = 1). AIHA occurred after 1 dose in 3 patients (median, 5 days). CONCLUSIONS: SARS-CoV-2 infection and vaccination are associated with multiple AIHA subtypes, beginning approximately 7 days after infectious symptoms and 5 days after vaccination.

Am J Clin Pathol2021       LitCov and CORD-19
6726Health workers' perceptions and experiences of using mHealth technologies to deliver primary healthcare services: a qualitative evidence synthesis  

N/A

Cochrane Database Syst Rev2020       CORD-19
6727Potential Anionic Substances Binding to Platelet Factor 4 in Vaccine induced Thrombotic Thrombocytopenia of ChAdOx1-S Vaccine for SARS-CoV-2  

Recent reports of rare ChAdOx1-S vaccine-related venous thrombosis led to the suspension of its usage in several countries. Vaccine-induced thrombotic thrombocytopenia (VITT) is characterized by thrombocytopenia and thrombosis in association with anti-platelet factor 4 (PF4) antibodies. Herein, we propose five potential anionic substances of the ChAdOx1-S vaccine that can combine with PF4 and trigger VITT, including (1) the proteins on the surface of adenovirus, e.g., negative charged glycoprotein, (2) the adjuvant components of the vaccine, e.g., Tween 80, (3) the DNA of adenovirus, (4) the S protein antigen expressed by the vaccine, and (5) the negatively charged impurity proteins expressed by the vaccine, e.g., adenovirus skeleton proteins. After analysis of each case, we consider the most possible trigger to be the negatively charged impurity proteins expressed by the vaccine. Then, we display the possible extravascular route and intravascular route of the formation of PF4 autoantibodies triggered by the negatively charged impurity proteins, which is accordant with the clinical situation. Accordingly, the susceptible individuals of VITT after ChAdOx1-S vaccination may be people who express negatively charged impurity proteins and reach a certain high titer.

Front Immunol2021       LitCov and CORD-19
6728CVDNet: A novel deep learning architecture for detection of coronavirus from chest x-ray images  

The COVID-19 pandemic is an emerging respiratory infectious disease, also known as coronavirus 2019. It appears in November 2019 in Hubei province (in China), and more specifically in the city of Wuhan, then spreads in the whole world. As the number of cases increases with unprecedented speed, many parts of the world are facing a shortage of resources and testing. Faced with this problem, physicians, scientists and engineers, including specialists in Artificial Intelligence (AI), have encouraged the development of a Deep Learning model to help healthcare professionals to detect COVID-19 from chest X-ray images and to determine the severity of the infection in a very short time, with low cost. In this paper, we propose CVDNet, a Deep Convolutional Neural Network (CNN) model to classify COVID-19 infection from normal and other pneumonia cases using chest X-ray images. The proposed architecture is based on the residual neural network and it is constructed by using two parallel levels with different kernel sizes to capture local and global features of the inputs. This model is trained on a dataset publically available containing a combination of 219 COVID-19, 1341 normal and 1345 viral pneumonia chest x-ray images. The experimental results reveal that our CVDNet. These results represent a promising classification performance on a small dataset which can be further achieve better results with more training data. Overall, our CVDNet model can be an interesting tool to help radiologists in the diagnosis and early detection of COVID-19 cases.

Chaos Solitons Fractals2020       LitCov and CORD-19
6729A Sequence Homology and Bioinformatic Approach Can Predict Candidate Targets for Immune Responses to SARS-CoV-2  

Effective countermeasures against the recent emergence and rapid expansion of the 2019 novel coronavirus (SARS-CoV-2) require the development of data and tools to understand and monitor its spread and immune responses to it. However, little information is available about the targets of immune responses to SARS-CoV-2. We used the Immune Epitope Database and Analysis Resource (IEDB) to catalog available data related to other coronaviruses. This includes SARS-CoV, which has high sequence similarity to SARS-CoV-2 and is the best-characterized coronavirus in terms of epitope responses. We identified multiple specific regions in SARS-CoV-2 that have high homology to the SARS-CoV virus. Parallel bioinformatic predictions identified a priori potential B and T cell epitopes for SARS-CoV-2. The independent identification of the same regions using two approaches reflects the high probability that these regions are promising targets for immune recognition of SARS-CoV-2. These predictions can facilitate effective vaccine design against this virus of high priority.

Cell Host Microbe2020       LitCov and CORD-19
6730COVID-19: Emerging and Future Challenges for Dental and Oral Medicine  

The epidemic of coronavirus disease 2019 (COVID-19), originating in Wuhan, China, has become a major public health challenge for not only China but also countries around the world. The World Health Organization announced that the outbreaks of the novel coronavirus have constituted a public health emergency of international concern. As of February 26, 2020, COVID-19 has been recognized in 34 countries, with a total of 80,239 laboratory-confirmed cases and 2,700 deaths. Infection control measures are necessary to prevent the virus from further spreading and to help control the epidemic situation. Due to the characteristics of dental settings, the risk of cross infection can be high between patients and dental practitioners. For dental practices and hospitals in areas that are (potentially) affected with COVID-19, strict and effective infection control protocols are urgently needed. This article, based on our experience and relevant guidelines and research, introduces essential knowledge about COVID-19 and nosocomial infection in dental settings and provides recommended management protocols for dental practitioners and students in (potentially) affected areas.

J Dent Res2020       LitCov and CORD-19
6731SARS-CoV-2 infection, clinical features and outcome of COVID-19 in United Kingdom nursing homes  

OBJECTIVES: To understand SARS-Co-V-2 infection and transmission in UK nursing homes in order to develop preventive strategies for protecting the frail elderly residents. METHODS: An outbreak investigation involving 394 residents and 70 staff, was carried out in 4 nursing homes affected by COVID-19 outbreaks in central London. Two point-prevalence surveys were performed one week apart where residents underwent SARS-CoV-2 testing and had relevant symptoms documented. Asymptomatic staff from three of the four homes were also offered SARS-CoV-2 testing. RESULTS: Overall, 26% (95% CI 22–31) of residents died over the two-month period. All-cause mortality increased by 203% (95% CI 70–336) compared with previous years. Systematic testing identified 40% (95% CI 35–46) of residents as positive for SARS-CoV-2, and of these 43% (95% CI 34–52) were asymptomatic and 18% (95% CI 11–24) had only atypical symptoms; 4% (95% CI −1 to 9) of asymptomatic staff also tested positive. CONCLUSIONS: The SARS-CoV-2 outbreak in four UK nursing homes was associated with very high infection and mortality rates. Many residents developed either atypical or had no discernible symptoms. A number of asymptomatic staff members also tested positive, suggesting a role for regular screening of both residents and staff in mitigating future outbreaks.

J Infect2020       LitCov and CORD-19
6732Pooled-Testing for SARS-CoV-2 Reverse Transcription PCR (RT-PCR) in asymptomatic healthcare workers in EL-Raghy isolation COVID-19 hospital, Assiut University  

N/A

Egypt J Immunol2022       LitCov and CORD-19
6733Safety and immunogenicity of a candidate Middle East respiratory syndrome coronavirus viral-vectored vaccine: a dose-escalation, open-label, non-randomised, uncontrolled, phase 1 trial  

BACKGROUND: Cases of Middle East respiratory syndrome coronavirus (MERS-CoV) infection continue to rise in the Arabian Peninsula 7 years after it was first described in Saudi Arabia. MERS-CoV poses a significant risk to public health security because of an absence of currently available effective countermeasures. We aimed to assess the safety and immunogenicity of the candidate simian adenovirus-vectored vaccine expressing the full-length spike surface glycoprotein, ChAdOx1 MERS, in humans. METHODS: This dose-escalation, open-label, non-randomised, uncontrolled, phase 1 trial was done at the Centre for Clinical Vaccinology and Tropical Medicine (Oxford, UK) and included healthy people aged 18–50 years with negative pre-vaccination tests for HIV antibodies, hepatitis B surface antigen, and hepatitis C antibodies (and a negative urinary pregnancy test for women). Participants received a single intramuscular injection of ChAdOx1 MERS at three different doses: the low-dose group received 5 × 10(9) viral particles, the intermediate-dose group received 2·5 × 10(10) viral particles, and the high-dose group received 5 × 10(10) viral particles. The primary objective was to assess safety and tolerability of ChAdOx1 MERS, measured by the occurrence of solicited, unsolicited, and serious adverse events after vaccination. The secondary objective was to assess the cellular and humoral immunogenicity of ChAdOx1 MERS, measured by interferon-γ-linked enzyme-linked immunospot, ELISA, and virus neutralising assays after vaccination. Participants were followed up for up to 12 months. This study is registered with ClinicalTrials.gov, NCT03399578. FINDINGS: Between March 14 and Aug 15, 2018, 24 participants were enrolled: six were assigned to the low-dose group, nine to the intermediate-dose group, and nine to the high-dose group. All participants were available for follow-up at 6 months, but five (one in the low-dose group, one in the intermediate-dose group, and three in the high-dose group) were lost to follow-up at 12 months. A single dose of ChAdOx1 MERS was safe at doses up to 5 × 10(10) viral particles with no vaccine-related serious adverse events reported by 12 months. One serious adverse event reported was deemed to be not related to ChAdOx1 MERS. 92 (74% [95% CI 66–81]) of 124 solicited adverse events were mild, 31 (25% [18–33]) were moderate, and all were self-limiting. Unsolicited adverse events in the 28 days following vaccination considered to be possibly, probably, or definitely related to ChAdOx1 MERS were predominantly mild in nature and resolved within the follow-up period of 12 months. The proportion of moderate and severe adverse events was significantly higher in the high-dose group than in the intermediate-dose group (relative risk 5·83 [95% CI 2·11–17·42], p<0·0001) Laboratory adverse events considered to be at least possibly related to the study intervention were self-limiting and predominantly mild in severity. A significant increase from baseline in T-cell (p<0·003) and IgG (p<0·0001) responses to the MERS-CoV spike antigen was observed at all doses. Neutralising antibodies against live MERS-CoV were observed in four (44% [95% CI 19–73]) of nine participants in the high-dose group 28 days after vaccination, and 19 (79% [58–93]) of 24 participants had antibodies capable of neutralisation in a pseudotyped virus neutralisation assay. INTERPRETATION: ChAdOx1 MERS was safe and well tolerated at all tested doses. A single dose was able to elicit both humoral and cellular responses against MERS-CoV. The results of this first-in-human clinical trial support clinical development progression into field phase 1b and 2 trials. FUNDING: UK Department of Health and Social Care, using UK Aid funding, managed by the UK National Institute for Health Research.

Lancet Infect Dis2020       CORD-19
6734Why COVID-19 Transmission Is More Efficient and Aggressive Than Viral Transmission in Previous Coronavirus Epidemics?  

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is causing a pandemic of coronavirus disease 2019 (COVID-19). The worldwide transmission of COVID-19 from human to human is spreading like wildfire, affecting almost every country in the world. In the past 100 years, the globe did not face a microbial pandemic similar in scale to COVID-19. Taken together, both previous outbreaks of other members of the coronavirus family (severe acute respiratory syndrome (SARS-CoV) and middle east respiratory syndrome (MERS-CoV)) did not produce even 1% of the global harm already inflicted by COVID-19. There are also four other CoVs capable of infecting humans (HCoVs), which circulate continuously in the human population, but their phenotypes are generally mild, and these HCoVs received relatively little attention. These dramatic differences between infection with HCoVs, SARS-CoV, MERS-CoV, and SARS-CoV-2 raise many questions, such as: Why is COVID-19 transmitted so quickly? Is it due to some specific features of the viral structure? Are there some specific human (host) factors? Are there some environmental factors? The aim of this review is to collect and concisely summarize the possible and logical answers to these questions.

Biomolecules2020       LitCov and CORD-19
6735Reconstruction of transmission chains of SARS-CoV-2 amidst multiple outbreaks in a geriatric acute-care hospital: a combined retrospective epidemiological and genomic study  

N/A

Elife2022       LitCov
6736Effect of Sotrovimab on Hospitalization or Death Among High-risk Patients With Mild to Moderate COVID-19: A Randomized Clinical Trial  

N/A

JAMA2022       LitCov and CORD-19
6737Estimation of Psychological Impairment and Coping Strategies during COVID-19 Pandemic among University Students in Saudi Arabia: A Large Regional Analysis  

N/A

Int J Environ Res Public Healt2022       LitCov
6738Head-to-Head Comparison of Two SARS-CoV-2 Serology Assays  

BACKGROUND: While molecular techniques remain the gold standard for diagnosis of acute SARS-CoV-2 infection, serological tests have the unique potential to ascertain how much of the population has been exposed to the COVID-19 pathogen. There have been limited published studies to date documenting the performance of SARS-CoV-2 antibody assays. METHODS: We compared the DiaSorin Liaison SARS-CoV-2 S1/S2 IgG and Roche Diagnostics Elecsys Anti-SARS-CoV-2 assays using 228 samples spanning patients with positive PCR for SARS-CoV-2, patients with compatible symptoms but negative PCR, pre-COVID specimens, and potential cross-reactives. RESULTS: Both assays detected antibodies in 18/19 samples collected at least one week after a positive PCR result. Neither method consistently detected antibodies in specimens collected within one week of a positive PCR result (sensitivity < 50%), but antibodies were detected by only Roche in four samples in this time frame. Using 139 pre-COVID and 35 PCR-negative samples, the Roche and DiaSorin assays demonstrated specificities of 100.0% and 98.9%, respectively. Neither assay demonstrated cross-reactivity from other coronaviruses (229E, HKU1, NL63, OC43), respiratory pathogens (adenovirus, metapneumovirus, rhinovirus/enterovirus), or antibodies to other viruses (HIV, EBV, CMV, HBV, HCV, HAV). DISCUSSION: Overall, the qualitative interpretations afforded by the Roche and DiaSorin assays agreed for 99% of samples evaluated. Minor discrepancies in sensitivity and specificity were observed between methods, with the differences in specificity more clinically significant for our low-prevalence population. For the DiaSorin assay, all disagreements with the Roche assay occurred in samples with quantitative signals near the cut-off determining positivity.

J Appl Lab Med2020       LitCov and CORD-19
6739Americans' perceptions of privacy and surveillance in the COVID-19 pandemic  

OBJECTIVE: To study the U.S. public’s attitudes toward surveillance measures aimed at curbing the spread of COVID-19, particularly smartphone applications (apps) that supplement traditional contact tracing. METHOD: We deployed a survey of approximately 2,000 American adults to measure support for nine COVID-19 surveillance measures. We assessed attitudes toward contact tracing apps by manipulating six different attributes of a hypothetical app through a conjoint analysis experiment. RESULTS: A smaller percentage of respondents support the government encouraging everyone to download and use contact tracing apps (42%) compared with other surveillance measures such as enforcing temperature checks (62%), expanding traditional contact tracing (57%), carrying out centralized quarantine (49%), deploying electronic device monitoring (44%), or implementing immunity passes (44%). Despite partisan differences on a range of surveillance measures, support for the government encouraging digital contact tracing is indistinguishable between Democrats (47%) and Republicans (46%), although more Republicans oppose the policy (39%) compared to Democrats (27%). Of the app features we tested in our conjoint analysis experiment, only one had statistically significant effects on the self-reported likelihood of downloading the app: decentralized data architecture increased the likelihood by 5.4 percentage points. CONCLUSION: Support for public health surveillance policies to curb the spread of COVID-19 is relatively low in the U.S. Contact tracing apps that use decentralized data storage, compared with those that use centralized data storage, are more accepted by the public. While respondents’ support for expanding traditional contact tracing is greater than their support for the government encouraging the public to download and use contact tracing apps, there are smaller partisan differences in support for the latter policy.

PLoS One2020       LitCov and CORD-19
6740Pulmonary Embolism in Patients With COVID-19: Awareness of an Increased Prevalence  

N/A

Circulation2020       LitCov and CORD-19
6741A longitudinal study of SARS-CoV-2-infected patients reveals a high correlation between neutralizing antibodies and COVID-19 severity  

Understanding the immune responses elicited by SARS-CoV-2 infection is critical in terms of protection against reinfection and, thus, for public health policy and vaccine development for COVID-19. In this study, using either live SARS-CoV-2 particles or retroviruses pseudotyped with the SARS-CoV-2 S viral surface protein (Spike), we studied the neutralizing antibody (nAb) response in serum samples from a cohort of 140 SARS-CoV-2 qPCR-confirmed infections, including patients with mild symptoms and also more severe forms, including those that required intensive care. We show that nAb titers correlated strongly with disease severity and with anti-spike IgG levels. Indeed, patients from intensive care units exhibited high nAb titers; conversely, patients with milder disease symptoms had heterogeneous nAb titers, and asymptomatic or exclusive outpatient-care patients had no or low nAbs. We found that nAb activity in SARS-CoV-2-infected patients displayed a relatively rapid decline after recovery compared to individuals infected with other coronaviruses. Moreover, we found an absence of cross-neutralization between endemic coronaviruses and SARS-CoV-2, indicating that previous infection by human coronaviruses may not generate protective nAbs against SARS-CoV-2. Finally, we found that the D614G mutation in the spike protein, which has recently been identified as the current major variant in Europe, does not allow neutralization escape. Altogether, our results contribute to our understanding of the immune correlates of SARS-CoV-2-induced disease, and rapid evaluation of the role of the humoral response in the pathogenesis of SARS-CoV-2 is warranted.

Cell Mol Immunol2021       LitCov and CORD-19
6742Characteristics of Peripheral Lymphocyte Subset Alteration in COVID-19 Pneumonia  

BACKGROUND: In December 2019, novel coronavirus (SARS-CoV-2) pneumonia (COVID-19) was reported in Wuhan and has since rapidly spread throughout China. We aimed to clarify the characteristics and clinical significance of peripheral lymphocyte subset alteration in COVID-19. METHODS: The levels of peripheral lymphocyte subsets were measured by flow cytometry in 60 hospitalized COVID-19 patients before and after treatment, and their association with clinical characteristics and treatment efficacy was analyzed. RESULTS: Total lymphocytes, CD4(+) T cells, CD8(+) T cells, B cells, and natural killer (NK) cells decreased in COVID-19 patients, and severe cases had a lower level than mild cases. The subsets showed a significant association with inflammatory status in COVID-19, especially CD8(+) T cells and CD4(+)/CD8(+) ratio. After treatment, 37 patients (67%) showed clinical response, with an increase in CD8(+) T cells and B cells. No significant change in any subset was detected in nonresponsive cases. In multivariate analysis, posttreatment decrease in CD8(+) T cells and B cells and increase in CD4(+)/CD8(+) ratio were indicated as independent predictors of poor efficacy. CONCLUSIONS: Peripheral lymphocyte subset alteration was associated with clinical characteristics and treatment efficacy of COVID-19. CD8(+) T cells tended to be an independent predictor for COVID-19 severity and treatment efficacy.

J Infect Dis2020       LitCov and CORD-19
6743Knowledge, Attitude and Practice (KAP) toward COVID-19 Pandemic among the Public in Taiwan: A Cross-Sectional Study  

Purpose: Knowledge, attitude, and practice (KAP) models are often used by researchers in the field of public health to explore people’s healthy behaviors. Therefore, this study mainly explored the relationships among participants’ sociodemographic status, COVID-19 knowledge, affective attitudes, and preventive behaviors. Method: This study adopted an online survey, involving a total of 136 males and 204 females, and used a cross-sectional study to investigate the relationships between variables including gender, age, COVID-19 knowledge, positive affective attitudes (emotional wellbeing, psychological wellbeing, and social wellbeing), negative affective attitudes (negative self-perception and negative perceptions of life), and preventive behaviors (hygiene habits, reducing public activities, and helping others to prevent the epidemic). Results: The majority of participants in the study were knowledgeable about COVID-19. The mean COVID-19 knowledge score was 12.86 (SD = 1.34, range: 7–15 with a full score of 15), indicating a high level of knowledge. However, the key to decide whether participants adopt COVID-19 preventive behaviors was mainly their affective attitudes, especially positive affective attitudes (β = 0.18–0.25, p < 0.01), rather than COVID-19 disease knowledge (β = −0.01–0.08, p > 0.05). In addition, the sociodemographic status of the participants revealed obvious differences in the preventive behaviors; females had better preventive behaviors than males such as cooperating with the epidemic prevention hygiene habits (t = −5.08, p < 0.01), reducing public activities (t = −3.00, p < 0.01), and helping others to prevent the epidemic (t = −1.97, p < 0.05), while the older participants were more inclined to adopt preventive behaviors including epidemic prevention hygiene habits (β = 0.18, p = 0.001, R(2) = 0.03), reducing public activities (β = 0.35, p < 0.001, R(2) = 0.13), and helping others to prevent the epidemic (β = 0.27, p < 0.001, R(2) = 0.07). Conclusions: Having adequate COVID-19 knowledge was not linked to higher involvement in precautionary behaviors. Attitudes toward COVID-19 may play a more critical function in prompting individuals to undertake preventive behaviors, and different positive affective attitudes had different predictive relationships with preventive behaviors.

Int J Environ Res Public Healt2022       LitCov and CORD-19
6744Effect of Bamlanivimab vs Placebo on Incidence of COVID-19 Among Residents and Staff of Skilled Nursing and Assisted Living Facilities: A Randomized Clinical Trial  

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JAMA2021       LitCov and CORD-19
6745A 59-Year-Old Woman with Extensive Deep Vein Thrombosis and Pulmonary Thromboembolism 7 Days Following a First Dose of the Pfizer-BioNTech BNT162b2 mRNA COVID-19 Vaccine  

Patient: Female, 59-year-old Final Diagnosis: Deep vein thrombosis • pulmonary embolism • thrombosis Symptoms: Chest pain • shortness of breath Medication: — Clinical Procedure: — Specialty: Hematology • Infectious Diseases • General and Internal Medicine OBJECTIVE: Unusual clinical course BACKGROUND: The COVID-19 pandemic is an ongoing cause of the current global healthcare crisis. Several vaccines were approved for use by emergency vaccination campaigns worldwide. At present, there are very few reports of COVID-19 vaccine-induced immune-thrombotic thrombocytopenia, a variant of heparin-induced thrombocytopenia (HIT), in comparison to the massive number of vaccinated people worldwide. CASE REPORT: A 59-year-old woman presented to the Emergency Department with a 3-day history of sudden-onset left leg pain 7 days after receiving her first dose of BNT162b2 mRNA COVID-19 (Pfizer-BioNTech). She was diagnosed with deep vein thrombosis (DVT) and pulmonary embolism (PE) and found to have a positive HIT screen with optical density (OD) of 0.6 via ELISA test. She was hospitalized for 4 days and discharged home with an oral anticoagulant (rivaroxaban). CONCLUSIONS: This case report describes a possible link between BNT162b2 mRNA COVID-19 (Pfizer-BioNTech) vaccination and thromboembolism. However, further data are needed to support such an association.

Am J Case Rep2021       LitCov and CORD-19
6746Deep Learning on Chest X-ray Images to Detect and Evaluate Pneumonia Cases at the Era of COVID-19  

Coronavirus disease 2019 (COVID-19) is an infectious disease with first symptoms similar to the flu. COVID-19 appeared first in China and very quickly spreads to the rest of the world, causing then the 2019-20 coronavirus pandemic. In many cases, this disease causes pneumonia. Since pulmonary infections can be observed through radiography images, this paper investigates deep learning methods for automatically analyzing query chest X-ray images with the hope to bring precision tools to health professionals towards screening the COVID-19 and diagnosing confirmed patients. In this context, training datasets, deep learning architectures and analysis strategies have been experimented from publicly open sets of chest X-ray images. Tailored deep learning models are proposed to detect pneumonia infection cases, notably viral cases. It is assumed that viral pneumonia cases detected during an epidemic COVID-19 context have a high probability to presume COVID-19 infections. Moreover, easy-to-apply health indicators are proposed for estimating infection status and predicting patient status from the detected pneumonia cases. Experimental results show possibilities of training deep learning models over publicly open sets of chest X-ray images towards screening viral pneumonia. Chest X-ray test images of COVID-19 infected patients are successfully diagnosed through detection models retained for their performances. The efficiency of proposed health indicators is highlighted through simulated scenarios of patients presenting infections and health problems by combining real and synthetic health data.

J Med Syst2021       LitCov and CORD-19
6747UniProt: the universal protein knowledgebase in 2021  

The aim of the UniProt Knowledgebase is to provide users with a comprehensive, high-quality and freely accessible set of protein sequences annotated with functional information. In this article, we describe significant updates that we have made over the last two years to the resource. The number of sequences in UniProtKB has risen to approximately 190 million, despite continued work to reduce sequence redundancy at the proteome level. We have adopted new methods of assessing proteome completeness and quality. We continue to extract detailed annotations from the literature to add to reviewed entries and supplement these in unreviewed entries with annotations provided by automated systems such as the newly implemented Association-Rule-Based Annotator (ARBA). We have developed a credit-based publication submission interface to allow the community to contribute publications and annotations to UniProt entries. We describe how UniProtKB responded to the COVID-19 pandemic through expert curation of relevant entries that were rapidly made available to the research community through a dedicated portal. UniProt resources are available under a CC-BY (4.0) license via the web at https://www.uniprot.org/.

Nucleic Acids Res2020       LitCov and CORD-19
6748Demographic Disparity in Use of Telemedicine for Ambulatory General Surgical Consultation During the COVID-19 Pandemic: Analysis of the Initial Public Health Emergency and Second Phase Periods  

N/A

J Am Coll Surg2022       LitCov and CORD-19
6749Transmission of community- and hospital-acquired SARS-CoV-2 in hospital settings in the UK: A cohort study  

BACKGROUND: Nosocomial spread of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has been widely reported, but the transmission pathways among patients and healthcare workers (HCWs) are unclear. Identifying the risk factors and drivers for these nosocomial transmissions is critical for infection prevention and control interventions. The main aim of our study was to quantify the relative importance of different transmission pathways of SARS-CoV-2 in the hospital setting. METHODS AND FINDINGS: This is an observational cohort study using data from 4 teaching hospitals in Oxfordshire, United Kingdom, from January to October 2020. Associations between infectious SARS-CoV-2 individuals and infection risk were quantified using logistic, generalised additive and linear mixed models. Cases were classified as community- or hospital-acquired using likely incubation periods of 3 to 7 days. Of 66,184 patients who were hospitalised during the study period, 920 had a positive SARS-CoV-2 PCR test within the same period (1.4%). The mean age was 67.9 (±20.7) years, 49.2% were females, and 68.5% were from the white ethnic group. Out of these, 571 patients had their first positive PCR tests while hospitalised (62.1%), and 97 of these occurred at least 7 days after admission (10.5%). Among the 5,596 HCWs, 615 (11.0%) tested positive during the study period using PCR or serological tests. The mean age was 39.5 (±11.1) years, 78.9% were females, and 49.8% were nurses. For susceptible patients, 1 day in the same ward with another patient with hospital-acquired SARS-CoV-2 was associated with an additional 7.5 infections per 1,000 susceptible patients (95% credible interval (CrI) 5.5 to 9.5/1,000 susceptible patients/day) per day. Exposure to an infectious patient with community-acquired Coronavirus Disease 2019 (COVID-19) or to an infectious HCW was associated with substantially lower infection risks (2.0/1,000 susceptible patients/day, 95% CrI 1.6 to 2.2). As for HCW infections, exposure to an infectious patient with hospital-acquired SARS-CoV-2 or to an infectious HCW were both associated with an additional 0.8 infection per 1,000 susceptible HCWs per day (95% CrI 0.3 to 1.6 and 0.6 to 1.0, respectively). Exposure to an infectious patient with community-acquired SARS-CoV-2 was associated with less than half this risk (0.2/1,000 susceptible HCWs/day, 95% CrI 0.2 to 0.2). These assumptions were tested in sensitivity analysis, which showed broadly similar results. The main limitations were that the symptom onset dates and HCW absence days were not available. CONCLUSIONS: In this study, we observed that exposure to patients with hospital-acquired SARS-CoV-2 is associated with a substantial infection risk to both HCWs and other hospitalised patients. Infection control measures to limit nosocomial transmission must be optimised to protect both staff and patients from SARS-CoV-2 infection.

PLoS Med2021       LitCov and CORD-19
6750Remote Teaching in a Preclinical Phantom Course in Operative Dentistry During the COVID-19 Pandemic: Observational Case Study  

BACKGROUND: During the acute COVID-19 pandemic, physical access to the University Medical Center Göttingen was restricted for students. For the first time at our dental school, theoretical knowledge was imparted to students via asynchronous online screencasts and discussed via synchronous video meetings only. OBJECTIVE: We aimed to assess the acceptance and effectiveness of distance education as a new teaching format for theoretical knowledge within the preclinical course in Operative Dentistry (sixth semester of the undergraduate dental curriculum in Germany). METHODS: The phantom course comprised distance education (first phase, 11 weeks) and subsequent on-site practical demonstrations and training (second phase, 10 weeks). All theoretical knowledge was taught via online screencasts during distance education (except for the first week, 3 screencasts were uploaded per week resulting in a total of 30 screencasts). Until the end of the term, all students (N=33) were able to view the screencasts for an unlimited number of times. Theoretical knowledge was assessed in a summative examination after practical on-site teaching. Acceptance and effectiveness of the new curriculum and distance education were also measured based on an evaluation survey and students’ self-perceived learning outcome, which was compared to the outcome from the two pre–COVID-19 terms. RESULTS: Each screencast was viewed by a mean of 24 (SD 3.3) students and accessed a mean of 5.6 (SD 1.2) times per user (ie, by students who accessed the respective screencast at least once). During distance education, the number of accesses showed a linear trend over time. During the practical training phase, screencast views declined and increased again prior to the examination. Screencasts covering topics in Cariology, Restorative Dentistry, and Preventive Dentistry were viewed by more students than screencasts covering topics in Endodontology or Periodontology (both P=.047). Examination items in Periodontology showed inferior results compared to the other topics (P<.001). Within the different topics, students’ self-perceived learning outcome did not differ from that during the pre–COVID-19 terms. Although most students agreed that the presented screencasts contributed to their learning outcome, pre–COVID-19 term students more strongly felt that lectures significantly contributed to their learning outcome (P=.03). CONCLUSIONS: Screencasts showed high acceptance and effectiveness among the students but were not used as a learning tool by all students. However, students who viewed the screencasts accessed each screencast more frequently than they could have attended a conventional lecture. Screencast views were mostly due to intrinsic motivation.

JMIR Med Educ2021       LitCov and CORD-19

(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
(2) Chen Q, Allot A, & Lu Z. (2020) Keep up with the latest coronavirus research, Nature 579:193 and Chen Q, Allot A, Lu Z. LitCovid: an open database of COVID-19 literature. Nucleic Acids Research. 2020. (version 2023-01-10)
(3) Currently tweets of June 23rd to June 29th 2022 have been considered.

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