\ 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
4851How Did the COVID-19 Lockdown Affect Children and Adolescent's Well-Being: Spanish Parents, Children and Adolescents Respond  

Background: During the COVID-19 pandemic, lockdown strategies have been widely used to contain SARS-CoV-2 virus spread. Children and adolescents are especially vulnerable to suffering psychological effects as result of such measures. In Spain, children were enforced to a strict home lockdown for 42 days during the first wave. Here, we studied the effects of lockdown in children and adolescents through an online questionnaire. Methods: A cross-sectional study was conducted in Spain using an open online survey from July (after the lockdown resulting from the first pandemic wave) to November 2020 (second wave). We included families with children under 16 years-old living in Spain. Parents answered a survey regarding the lockdown effects on their children and were instructed to invite their children from 7 to 16 years-old (mandatory scholar age in Spain) to respond a specific set of questions. Answers were collected through an application programming interface system, and data analysis was performed using R. Results: We included 1,957 families who completed the questionnaires, covering a total of 3,347 children. The specific children's questionnaire was completed by 167 kids (7–11 years-old), and 100 adolescents (12–16 years-old). Children, in general, showed high resilience and capability to adapt to new situations. Sleeping problems were reported in more than half of the children (54%) and adolescents (59%), and these were strongly associated with less time doing sports and spending more than 5 h per day using electronic devices. Parents perceived their children to gain weight (41%), be more irritable and anxious (63%) and sadder (46%). Parents and children differed significantly when evaluating children's sleeping disturbances. Conclusions: Enforced lockdown measures and isolation can have a negative impact on children and adolescent's mental health and well-being. In future waves of the current pandemic, or in the light of potential epidemics of new emerging infections, lockdown measures targeting children, and adolescents should be reconsidered taking into account their infectiousness potential and their age-specific needs, especially to facilitate physical activity and to limit time spent on electronic devices.

Front Public Health2021       LitCov and CORD-19
4852Impact of SARS-CoV-2 Vaccination on Inflammatory Bowel Disease Activity and Development of Vaccine-Related Adverse Events: Results From PREVENT-COVID  

BACKGROUND: Severe acute respiratory syndrome coronavirus 2 vaccination is recommended for all individuals with inflammatory bowel disease (IBD), including those on immunosuppressive therapies; however, little is known about vaccine safety and efficacy in these patients or the impact of vaccination on IBD disease course. METHODS: We evaluated coronavirus disease 2019 (COVID-19) vaccine–related adverse events (AEs) and the effect of vaccination on IBD disease course among participants in the PREVENT-COVID (Partnership to Report Effectiveness of Vaccination in populations Excluded from iNitial Trials of COVID) study, a prospective, observational cohort study. Localized and systemic reactions were assessed via questionnaire. Disease flare was defined by worsening IBD symptoms and change in IBD medications. Outcomes were stratified by vaccine type and IBD medication classes. RESULTS: A total of 3316 individuals with IBD received at least 1 COVID-19 vaccine. Injection site tenderness (68%) and fatigue (46% dose 1, 68% dose 2) were the most commonly reported localized and systemic AEs after vaccination. Severe localized and systemic vaccine-related AEs were rare. The mRNA-1273 vaccine was associated with significantly greater severe AEs at dose 2 (localized 4% vs 2%, systemic 15% vs 10%; P < .001 for both). Prior COVID-19 infection, female sex, and vaccine type were associated with severe systemic reactions to dose 1, while age <50 years, female sex, vaccine type, and antitumor necrosis factor and vedolizumab use were associated with severe systemic reactions to dose 2. Overall rates (2%) of IBD flare were low following vaccination. CONCLUSIONS: Our findings provide reassurance that the severe acute respiratory syndrome coronavirus 2 vaccine is safe and well tolerated among individuals with IBD, which may help to combat vaccine hesitancy and increase vaccine confidence.

Inflamm Bowel Dis2021       LitCov and CORD-19
4853Patient Perceptions and Satisfaction With Teledermatology During the COVID-19 Pandemic: A Survey-Based Study  

N/A

J Drugs Dermatol2021       LitCov and CORD-19
4854Anti-SARS-CoV-2 receptor-binding domain antibody evolution after mRNA vaccination  

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection produces B cell responses that continue to evolve for at least a year. During that time, memory B cells express increasingly broad and potent antibodies that are resistant to mutations found in variants of concern(1). As a result, vaccination of coronavirus disease 2019 (COVID-19) convalescent individuals with currently available mRNA vaccines produces high levels of plasma neutralizing activity against all variants tested(1,2). Here we examine memory B cell evolution five months after vaccination with either Moderna (mRNA-1273) or Pfizer-BioNTech (BNT162b2) mRNA vaccine in a cohort of SARS-CoV-2-naive individuals. Between prime and boost, memory B cells produce antibodies that evolve increased neutralizing activity, but there is no further increase in potency or breadth thereafter. Instead, memory B cells that emerge five months after vaccination of naive individuals express antibodies that are similar to those that dominate the initial response. While individual memory antibodies selected over time by natural infection have greater potency and breadth than antibodies elicited by vaccination, the overall neutralizing potency of plasma is greater following vaccination. These results suggest that boosting vaccinated individuals with currently available mRNA vaccines will increase plasma neutralizing activity but may not produce antibodies with equivalent breadth to those obtained by vaccinating convalescent individuals.

Nature2021       LitCov and CORD-19
4855Protease Inhibitory Effect of Natural Polyphenolic Compounds on SARS-CoV-2: An In Silico Study  

The current pandemic, caused by SARS-CoV-2 virus, is a severe challenge for human health and the world economy. There is an urgent need for development of drugs that can manage this pandemic, as it has already infected 19 million people and led to the death of around 711,277 people worldwide. At this time, in-silico studies are providing lots of preliminary data about potential drugs, which can be a great help in further in-vitro and in-vivo studies. Here, we have selected three polyphenolic compounds, mangiferin, glucogallin, and phlorizin. These compounds are isolated from different natural sources but share structural similarities and have been reported for their antiviral activity. The objective of this study is to analyze and predict the anti-protease activity of these compounds on SARS-CoV-2main protease (Mpro) and TMPRSS2 protein. Both the viral protein and the host protein play an important role in the viral life cycle, such as post-translational modification and viral spike protein priming. This study has been performed by molecular docking of the compounds using PyRx with AutoDock Vina on the two aforementioned targets chosen for this study, i.e., SARS-CoV-2 Mpro and TMPRSS2. The compounds showed good binding affinity and are further analyzed by (Molecular dynamic) MD and Molecular Mechanics Poisson-Boltzmann Surface Area MM-PBSA study. The MD-simulation study has predicted that these natural compounds will have a great impact on the stabilization of the binding cavity of the Mpro of SARS-CoV-2. The predicted pharmacokinetic parameters also show that these compounds are expected to have good solubility and absorption properties. Further predictions for these compounds also showed no involvement in drug-drug interaction and no toxicity.

Molecules2020       LitCov and CORD-19
4856Unlocking COVID therapeutic targets: A structure-based rationale against SARS-CoV-2, SARS-CoV and MERS-CoV Spike  

There are no approved target therapeutics against SARS-CoV-2 or other beta-CoVs. The beta-CoV Spike protein is a promising target considering the critical role in viral infection and pathogenesis and its surface exposed features. We performed a structure-based strategy targeting highly conserved druggable regions resulting from a comprehensive large-scale sequence analysis and structural characterization of Spike domains across SARSr- and MERSr-CoVs. We have disclosed 28 main consensus druggable pockets within the Spike. The RBD and SD1 (S1 subunit); and the CR, HR1 and CH (S2 subunit) represent the most promising conserved druggable regions. Additionally, we have identified 181 new potential hot spot residues for the hSARSr-CoVs and 72 new hot spot residues for the SARSr- and MERSr-CoVs, which have not been described before in the literature. These sites/residues exhibit advantageous structural features for targeted molecular and pharmacological modulation. This study establishes the Spike as a promising anti-CoV target using an approach with a potential higher resilience to resistance development and directed to a broad spectrum of Beta-CoVs, including the new SARS-CoV-2 responsible for COVID-19. This research also provides a structure-based rationale for the design and discovery of chemical inhibitors, antibodies or other therapeutic modalities successfully targeting the Beta-CoV Spike protein.

Comput Struct Biotechnol J2020       LitCov and CORD-19
4857Perinatology clinic in the coronavirus disease-2019 pandemic: what harms, often teaches  

N/A

J Matern Fetal Neonatal Med2021       LitCov and CORD-19
4858Changes in sleep pattern, sense of time and digital media use during COVID-19 lockdown in Italy  

Italy is one of the major COVID‐19 hotspots. To reduce the spread of the infections and the pressure on Italian healthcare systems, since March 10, 2020, Italy has been under a total lockdown, forcing people into home confinement. Here we present data from 1,310 people living in the Italian territory (M (age) = 23.91 ± 3.60 years, 880 females, 501 workers, 809 university students), who completed an online survey from March 24 to March 28, 2020. In the survey, we asked participants to think about their use of digital media before going to bed, their sleep pattern and their subjective experience of time in the previous week (March 17–23, which was the second week of the lockdown) and up to the first week of February (February 3–10, before any restriction in any Italian area). During the lockdown, people increased the usage of digital media near bedtime, but this change did not affect sleep habits. Nevertheless, during home confinement, sleep timing markedly changed, with people going to bed and waking up later, and spending more time in bed, but, paradoxically, also reporting a lower sleep quality. The increase in sleep difficulties was stronger for people with a higher level of depression, anxiety and stress symptomatology, and associated with the feeling of elongation of time. Considering that the lockdown is likely to continue for weeks, research data are urgently needed to support decision making, to build public awareness and to provide timely and supportive psychosocial interventions.

J Sleep Res2020       LitCov and CORD-19
4859Molecular docking, binding mode analysis, molecular dynamics and prediction of ADMET/toxicity properties of selective potential antiviral agents against SARS-CoV-2 main protease: an effort toward drug repurposing to combat COVID-19  

The importance of the main protease (M(pro)) enzyme of SARS-CoV-2 in the digestion of viral polyproteins introduces M(pro) as an attractive drug target for antiviral drug design. This study aims to carry out the molecular docking, molecular dynamics studies, and prediction of ADMET properties of selected potential antiviral molecules. The study provides an insight into biomolecular interactions to understand the inhibitory mechanism and the spatial orientation of the tested ligands and further, identification of key amino acid residues within the substrate-binding pocket that can be applied for structure-based drug design. In this regard, we carried out molecular docking studies of chloroquine (CQ), hydroxychloroquine (HCQ), remdesivir (RDV), GS441524, arbidol (ARB), and natural product glycyrrhizin (GA) using AutoDock 4.2 tool. To study the drug-receptor complex's stability, selected docking possesses were further subjected to molecular dynamics studies with Schrodinger software. The prediction of ADMET/toxicity properties was carried out on ADMET Prediction™. The docking studies suggested a potential role played by CYS145, HIS163, and GLU166 in the interaction of molecules within the active site of COVID-19 M(pro). In the docking studies, RDV and GA exhibited superiority in binding with the crystal structure of M(pro) over the other selected molecules in this study. Spatial orientations of the molecules at the active site of M(pro) exposed the significance of S1–S4 subsites and surrounding amino acid residues. Among GA and RDV, RDV showed better and stable interactions with the protein, which is the reason for the lesser RMSD values for RDV. Overall, the present in silico study indicated the direction to combat COVID-19 using FDA-approved drugs as promising agents, which do not need much toxicity studies and could also serve as starting points for lead optimization in drug discovery. [Image: see text]

Mol Divers2021       LitCov and CORD-19
4860Estimating global and regional disruptions to routine childhood vaccine coverage during the COVID-19 pandemic in 2020: a modelling study  

BACKGROUND: The COVID-19 pandemic and efforts to reduce SARS-CoV-2 transmission substantially affected health services worldwide. To better understand the impact of the pandemic on childhood routine immunisation, we estimated disruptions in vaccine coverage associated with the pandemic in 2020, globally and by Global Burden of Disease (GBD) super-region. METHODS: For this analysis we used a two-step hierarchical random spline modelling approach to estimate global and regional disruptions to routine immunisation using administrative data and reports from electronic immunisation systems, with mobility data as a model input. Paired with estimates of vaccine coverage expected in the absence of COVID-19, which were derived from vaccine coverage models from GBD 2020, Release 1 (GBD 2020 R1), we estimated the number of children who missed routinely delivered doses of the third-dose diphtheria-tetanus-pertussis (DTP3) vaccine and first-dose measles-containing vaccine (MCV1) in 2020. FINDINGS: Globally, in 2020, estimated vaccine coverage was 76·7% (95% uncertainty interval 74·3–78·6) for DTP3 and 78·9% (74·8–81·9) for MCV1, representing relative reductions of 7·7% (6·0–10·1) for DTP3 and 7·9% (5·2–11·7) for MCV1, compared to expected doses delivered in the absence of the COVID-19 pandemic. From January to December, 2020, we estimated that 30·0 million (27·6–33·1) children missed doses of DTP3 and 27·2 million (23·4–32·5) children missed MCV1 doses. Compared to expected gaps in coverage for eligible children in 2020, these estimates represented an additional 8·5 million (6·5–11·6) children not routinely vaccinated with DTP3 and an additional 8·9 million (5·7–13·7) children not routinely vaccinated with MCV1 attributable to the COVID-19 pandemic. Globally, monthly disruptions were highest in April, 2020, across all GBD super-regions, with 4·6 million (4·0–5·4) children missing doses of DTP3 and 4·4 million (3·7–5·2) children missing doses of MCV1. Every GBD super-region saw reductions in vaccine coverage in March and April, with the most severe annual impacts in north Africa and the Middle East, south Asia, and Latin America and the Caribbean. We estimated the lowest annual reductions in vaccine delivery in sub-Saharan Africa, where disruptions remained minimal throughout the year. For some super-regions, including southeast Asia, east Asia, and Oceania for both DTP3 and MCV1, the high-income super-region for DTP3, and south Asia for MCV1, estimates suggest that monthly doses were delivered at or above expected levels during the second half of 2020. INTERPRETATION: Routine immunisation services faced stark challenges in 2020, with the COVID-19 pandemic causing the most widespread and largest global disruption in recent history. Although the latest coverage trajectories point towards recovery in some regions, a combination of lagging catch-up immunisation services, continued SARS-CoV-2 transmission, and persistent gaps in vaccine coverage before the pandemic still left millions of children under-vaccinated or unvaccinated against preventable diseases at the end of 2020, and these gaps are likely to extend throughout 2021. Strengthening routine immunisation data systems and efforts to target resources and outreach will be essential to minimise the risk of vaccine-preventable disease outbreaks, reach children who missed routine vaccine doses during the pandemic, and accelerate progress towards higher and more equitable vaccination coverage over the next decade. FUNDING: Bill & Melinda Gates Foundation.

Lancet2021       LitCov and CORD-19
4861Prevalence and Social Determinants of Food Insecurity among College Students during the COVID-19 Pandemic  

The coronavirus disease (COVID-19) pandemic has increased unemployment and food insecurity in the United States (US). Prior to the pandemic, college students exhibited higher rates of food insecurity than nonstudent households. The objectives of this study were to assess the prevalence and determinants of food insecurity among college students during the COVID-19 pandemic. We administered an online survey to 651 students on three diverse campuses at a state-funded university in Texas, US, in May 2020. Food security was assessed using a multistep approach that included the 2-item Food Sufficiency Screener and 6-Item USDA Food Security Survey Module (FSSM). Overall, 34.5% of respondents were classified as food insecure within the last 30 days. The strongest predictors of food insecurity were change in current living arrangement (OR = 2.70, 95% CI: 2.47, 2.95), being furloughed (OR = 3.22, 95% CI: 2.86, 3.64), laid off (OR = 4.07, 95% CI: 3.55, 4.66), or losing part-time work (OR = 5.73, 95% CI: 5.09, 6.46) due to the COVID-19 pandemic. These findings highlight the high prevalence of food insecurity among college students during the COVID-19 pandemic, with students who experienced housing insecurity and/or loss of income due to the pandemic being impacted the most.

Nutrients2020       LitCov and CORD-19
4862Drinking to Cope During COVID-19 Pandemic: The Role of External and Internal Factors in Coping Motive Pathways to Alcohol Use, Solitary Drinking and Alcohol Problems  

N/A

Alcohol Clin Exp Res2020       LitCov and CORD-19
4863Racial and ethnic disparities in SARS-CoV-2 pandemic: analysis of a COVID-19 observational registry for a diverse US metropolitan population  

INTRODUCTION: Data on race and ethnic disparities for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are limited. We analysed sociodemographic factors associated with higher likelihood of SARS-CoV-2 infection and explore mediating pathways for race and ethnic disparities in the SARS-CoV-2 pandemic. METHODS: This is a cross-sectional analysis of the COVID-19 Surveillance and Outcomes Registry, which captures data for a large healthcare system, comprising one central tertiary care hospital, seven large community hospitals and an expansive ambulatory/emergency care network in the Greater Houston area. Nasopharyngeal samples for individuals inclusive of all ages, races, ethnicities and sex were tested for SARS-CoV-2. We analysed sociodemographic (age, sex, race, ethnicity, household income, residence population density) and comorbidity (Charlson Comorbidity Index, hypertension, diabetes, obesity) factors. Multivariable logistic regression models were fitted to provide adjusted OR (aOR) and 95% CI for likelihood of a positive SARS-CoV-2 test. Structural equation modelling (SEM) framework was used to explore three mediation pathways (low income, high population density, high comorbidity burden) for the association between non-Hispanic black (NHB) race, Hispanic ethnicity and SARS-CoV-2 infection. RESULTS: Among 20 228 tested individuals, 1551 (7.7%) tested positive. The overall mean (SD) age was 51.1 (19.0) years, 62% were females, 22% were black and 18% were Hispanic. NHB and Hispanic ethnicity were associated with lower socioeconomic status and higher population density residence. In the fully adjusted model, NHB (vs non-Hispanic white; aOR, 2.23, CI 1.90 to 2.60) and Hispanic ethnicity (vs non-Hispanic; aOR, 1.95, CI 1.72 to 2.20) had a higher likelihood of infection. Older individuals and males were also at higher risk of infection. The SEM framework demonstrated a significant indirect effect of NHB and Hispanic ethnicity on SARS-CoV-2 infection mediated via a pathway including residence in densely populated zip code. CONCLUSIONS: There is strong evidence of race and ethnic disparities in the SARS-CoV-2 pandemic that are potentially mediated through unique social determinants of health.

BMJ Open2020       LitCov and CORD-19
4864Chemiluminescence Immunoassay Based Serological Immunoassays for Detection of SARS-CoV-2 Neutralizing Antibodies in COVID-19 Convalescent Patients and Vaccinated Population  

The development of rapid serological detection methods re urgently needed for determination of neutralizing antibodies in sera. In this study, four rapid methods (ACE2-RBD inhibition assay, S1-IgG detection, RBD-IgG detection, and N-IgG detection) were established and evaluated based on chemiluminescence technology. For the first time, a broadly neutralizing antibody with high affinity was used as a standard for the quantitative detection of SARS-CoV-2 specific neutralizing antibodies in human sera. Sera from COVID-19 convalescent patients (N = 119), vaccinated donors (N = 86), and healthy donors (N = 299) confirmed by microneutralization test (MNT) were used to evaluate the above methods. The result showed that the ACE2-RBD inhibition assay calculated with either ACE2-RBD binding inhibition percentage rate or ACE2-RBD inhibiting antibody concentration were strongly correlated with MNT (r ≥ 0.78, p < 0.0001) and also highly consistent with MNT (Kappa Value ≥ 0.94, p < 0.01). There was also a strong correlation between the two evaluation indices (r ≥ 0.99, p < 0.0001). Meanwhile, S1-IgG and RBD-IgG quantitative detection were also significantly correlated with MNT (r ≥ 0.73, p < 0.0001), and both methods were highly correlated with each other (r ≥ 0.95, p < 0.0001). However, the concentration of N-IgG antibodies showed a lower correlation with the MNT results (r < 0.49, p < 0.0001). The diagnostic assays presented here could be used for the evaluation of SARS-CoV-2 vaccine immunization effect and serological diagnosis of COVID-19 patients, and could also have guiding significance for establishing other rapid serological methods to surrogate neutralization tests for SARS-CoV-2.

Viruses2021       LitCov and CORD-19
4865In Silico Insights into the SARS CoV-2 Main Protease Suggest NADH Endogenous Defences in the Control of the Pandemic Coronavirus Infection  

COVID-19 is a pandemic health emergency faced by the entire world. The clinical treatment of the severe acute respiratory syndrome (SARS) CoV-2 is currently based on the experimental administration of HIV antiviral drugs, such as lopinavir, ritonavir, and remdesivir (a nucleotide analogue used for Ebola infection). This work proposes a repurposing process using a database containing approximately 8000 known drugs in synergy structure- and ligand-based studies by means of the molecular docking and descriptor-based protocol. The proposed in silico findings identified new potential SARS CoV-2 main protease (M(PRO)) inhibitors that fit in the catalytic binding site of SARS CoV-2 M(PRO). Several selected structures are NAD-like derivatives, suggesting a relevant role of these molecules in the modulation of SARS CoV-2 infection in conditions of cell chronic oxidative stress. Increased catabolism of NAD(H) during protein ribosylation in the DNA damage repair process may explain the greater susceptibility of the elderly population to the acute respiratory symptoms of COVID-19. The molecular modelling studies proposed herein agree with this hypothesis.

Viruses2020       LitCov and CORD-19
4866Mechanistic Aspects of Medicinal Plants and Secondary Metabolites against SARS-CoV-2  

N/A

Curr Pharm Des2021       LitCov and CORD-19
4867Predictors of adverse prognosis in COVID-19: A systematic review and meta-analysis  

N/A

Eur J Clin Invest2020       LitCov and CORD-19
4868Dynamics of SARS-CoV-2 Antibody Response to CoronaVac followed by Booster Dose of BNT162b2 Vaccine  

N/A

Emerg Infect Dis2022       LitCov and CORD-19
4869Occurrence, prevention and management of the psychological effects of emerging virus outbreaks on healthcare workers: rapid review and meta-analysis  

OBJECTIVE: To examine the psychological effects on clinicians of working to manage novel viral outbreaks, and successful measures to manage stress and psychological distress. DESIGN: Rapid review and meta-analysis. DATA SOURCES: Cochrane Central Register of Controlled Trials, PubMed/Medline, PsycInfo, Scopus, Web of Science, Embase, and Google Scholar, searched up to late March 2020. ELIGIBILITY CRITERIA FOR STUDY SELECTION: Any study that described the psychological reactions of healthcare staff working with patients in an outbreak of any emerging virus in any clinical setting, irrespective of any comparison with other clinicians or the general population. RESULTS: 59 papers met the inclusion criteria: 37 were of severe acute respiratory syndrome (SARS), eight of coronavirus disease 2019 (covid-19), seven of Middle East respiratory syndrome (MERS), three each of Ebola virus disease and influenza A virus subtype H1N1, and one of influenza A virus subtype H7N9. Of the 38 studies that compared psychological outcomes of healthcare workers in direct contact with affected patients, 25 contained data that could be combined in a pairwise meta-analysis comparing healthcare workers at high and low risk of exposure. Compared with lower risk controls, staff in contact with affected patients had greater levels of both acute or post-traumatic stress (odds ratio 1.71, 95% confidence interval 1.28 to 2.29) and psychological distress (1.74, 1.50 to 2.03), with similar results for continuous outcomes. These findings were the same as in the other studies not included in the meta-analysis. Risk factors for psychological distress included being younger, being more junior, being the parents of dependent children, or having an infected family member. Longer quarantine, lack of practical support, and stigma also contributed. Clear communication, access to adequate personal protection, adequate rest, and both practical and psychological support were associated with reduced morbidity. CONCLUSIONS: Effective interventions are available to help mitigate the psychological distress experienced by staff caring for patients in an emerging disease outbreak. These interventions were similar despite the wide range of settings and types of outbreaks covered in this review, and thus could be applicable to the current covid-19 outbreak.

BMJ2020       LitCov and CORD-19
4870The effect of age, gender, income, work and physical activity on mental health during coronavirus disease lockdown in Austria  

BACKGROUND: The impact of Coronavirus disease (COVID-19) and the governmental restrictions on mental health have been reported for different countries. This study evaluated mental health during COVID-19 lockdown in Austria and the effect of age, gender, income, work, and physical activity. METHODS: An online survey was performed through Qualtrics® after four weeks of lockdown in Austria to recruit a representative sample regarding gender, age, education, and region. Indicators of mental health were quality of life (WHO-QOL BREF), well-being (WHO-5), depression (PHQ-9), anxiety (GAD-7), stress (PSS-10), and sleep quality (ISI). RESULTS: In total, N = 1005 individuals were included (53% women). 21% scored above the cut off ≥10 points (PHQ-9) for moderate depressive symptoms, 119% scored above the cut-off ≥10 points (GAD-7) for moderate anxiety symptoms, and 16% above the cut-off ≥15 points (ISI) for clinical insomnia. ANOVAs, Bonferroni-corrected post-hoc tests, and t-tests showed highest mental health problems in adults under 35 years, women, people with no work, and low income (all p-values <.05). Comparisons with a large Austrian sample recruited within the ATHIS 2014 study showed increases of depression and decreases of quality of life in times of COVID-19 as compared to before COVID-19. CONCLUSIONS: Depressive symptoms (21%) and anxiety symptoms (19%) are higher during COVID-19 compared to previous epidemiological data. 16% rated over the cut-off for moderate or severe clinical insomnia. The COVID-19 pandemic and lockdown seems particularly stressful for younger adults (<35 years), women, people without work, and low income.

J Psychosom Res2020       LitCov and CORD-19
4871Exploring Spike Protein as Potential Target of Novel Coronavirus and to Inhibit the Viability Utilizing Natural Agents  

N/A

Curr Drug Targets2021       LitCov and CORD-19
4872Clinical characteristics and outcomes of patients undergoing surgeries during the incubation period of COVID-19 infection  

BACKGROUND: The outbreak of 2019 novel coronavirus disease (COVID-19) in Wuhan, China, has spread rapidly worldwide. In the early stage, we encountered a small but meaningful number of patients who were unintentionally scheduled for elective surgeries during the incubation period of COVID-19. We intended to describe their clinical characteristics and outcomes. METHODS: We retrospectively analyzed the clinical data of 34 patients underwent elective surgeries during the incubation period of COVID-19 at Renmin Hospital, Zhongnan Hospital, Tongji Hospital and Central Hospital in Wuhan, from January 1 to February 5, 2020. FINDINGS: Of the 34 operative patients, the median age was 55 years (IQR, 43–63), and 20 (58·8%) patients were women. All patients developed COVID-19 pneumonia shortly after surgery with abnormal findings on chest computed tomographic scans. Common symptoms included fever (31 [91·2%]), fatigue (25 [73·5%]) and dry cough (18 [52·9%]). 15 (44·1%) patients required admission to intensive care unit (ICU) during disease progression, and 7 patients (20·5%) died after admission to ICU. Compared with non-ICU patients, ICU patients were older, were more likely to have underlying comorbidities, underwent more difficult surgeries, as well as more severe laboratory abnormalities (eg, hyperleukocytemia, lymphopenia). The most common complications in non-survivors included ARDS, shock, arrhythmia and acute cardiac injury. INTERPRETATION: In this retrospective cohort study of 34 operative patients with confirmed COVID-19, 15 (44·1%) patients needed ICU care, and the mortality rate was 20·5%. FUNDING: National Natural Science Foundation of China.

EClinicalMedicine2020       LitCov and CORD-19
4873Potent SARS-CoV-2-Specific T Cell Immunity and Low Anaphylatoxin Levels Correlate With Mild Disease Progression in COVID-19 Patients  

T cells play a fundamental role in the early control and clearance of many viral infections of the respiratory system. In SARS-CoV-2-infected individuals, lymphopenia with drastically reduced CD4(+) and CD8(+) T cells correlates with Coronavirus disease 2019 (COVID-19)-associated disease severity and mortality. In this study, we characterized cellular and humoral immune responses induced in patients with mild, severe and critical COVID-19. Peripheral blood mononuclear cells of 37 patients with mild, severe and critical COVID-19 and 10 healthy individuals were analyzed by IFNγ ELISpot and multi-color flow cytometry upon stimulation with peptide pools covering complete immunodominant SARS-CoV-2 matrix, nucleocapsid and spike proteins. In addition SARS-CoV-2 antibody levels, neutralization abilities and anaphylatoxin levels were evaluated by various commercially available ELISA platforms. Our data clearly demonstrates a significantly stronger induction of SARS-CoV-2 specific CD8(+) T lymphocytes and higher IFNγ production in patients with mild compared to patients with severe or critical COVID-19. In all patients SARS-CoV-2-specific antibodies with similar neutralizing activity were detected, but highest titers of total IgGs were observed in critical patients. Finally, elevated anaphylatoxin C3a and C5a levels were identified in severe and critical COVID-19 patients probably caused by aberrant immune complex formation due to elevated antibody titers in these patients. Crucially, we provide a full picture of cellular and humoral immune responses of COVID-19 patients and prove that robust polyfunctional CD8(+) T cell responses concomitant with low anaphylatoxin levels correlate with mild infections. In addition, our data indicates that high SARS-CoV-2 antibody titers are associated with severe disease progression.

Front Immunol2021       LitCov and CORD-19
4874A Comparative Analysis of In-Hospital Mortality per Disease Groups in Germany Before and During the COVID-19 Pandemic From 2016 to 2020  

IMPORTANCE: Throughout the ongoing SARS-CoV-2 pandemic, it has been critical to understand not only the viral disease itself but also its implications for the overall health care system. Reports about excess mortality in this regard have mostly focused on overall death counts during specific pandemic phases. OBJECTIVE: To investigate hospitalization rates and compare in-hospital mortality rates with absolute mortality incidences across a broad spectrum of diseases, comparing 2020 data with those of prepandemic years. DESIGN, SETTING, AND PARTICIPANTS: Retrospective, cross-sectional, multicentric analysis of administrative data from 5 821 757 inpatients admitted from January 1, 2016, to December 31, 2020, to 87 German Helios primary to tertiary care hospitals. EXPOSURES: Exposure to SARS-CoV-2. MAIN OUTCOMES AND MEASURES: Administrative data were analyzed from January 1, 2016, to March 31, 2021, as a consecutive sample for all inpatients. Disease groups were defined according to International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10; German modification) encoded main discharge diagnoses. Incidence rate ratios (IRRs) for hospital admissions and hospital mortality counts, as well as relative mortality risks (RMRs) comparing 2016-2019 with 2020 (exposure to the SARS-CoV-2 pandemic), were calculated with Poisson regression with log-link function. RESULTS: Data were examined for 5 821 757 inpatients (mean [SD] age, 56.4 [25.3] years; 51.5% women), including 125 807 in-hospital deaths. Incidence rate ratios for hospital admissions were associated with a significant reduction for all investigated disease groups (IRR, 0.82; 95% CI, 0.79-0.86; P < .001). After adjusting for age, sex, the Elixhauser Comorbidity Index score, and SARS-CoV-2 infections, RMRs were associated with an increase in infectious diseases (RMR, 1.28; 95% CI, 1.21-1.34; P < .001), musculoskeletal diseases (RMR, 1.19; 95% CI, 1.04-1.36; P = .009), and respiratory diseases (RMR, 1.09; 95% CI, 1.05-1.14; P < .001) but not for the total cohort (RMR, 1.00; 95% CI, 0.99-1.02; P = .66). Regarding in-hospital mortality, IRR was associated with an increase within the ICD-10 chapter of respiratory diseases (IRR, 1.28; 95% CI, 1.13-1.46; P < .001) in comparing 2020 with 2016-2019, in contrast to being associated with a reduction in IRRs for the overall cohort and several other subgroups. After exclusion of patients with SARS-CoV-2 infections, IRRs were associated with a reduction in absolute in-hospital mortality for the overall cohort (IRR, 0.78; 95% CI, 0.72-0.84; P < .001) and the subgroup of respiratory diseases (IRR, 0.83; 95% CI, 0.74-0.92; P < .001). CONCLUSIONS AND RELEVANCE: This cross-sectional study of inpatients from a multicentric German database suggests that absolute in-hospital mortality for 2020 across disease groups was not higher compared with previous years. Higher IRRs of in-hospital deaths observed in patients with respiratory diseases were likely associated with individuals with SARS-CoV-2 infections.

JAMA Netw Open2022       LitCov and CORD-19
4875Impact of COVID-19 on Children's and Adolescent's Mental Health in Saudi Arabia  

Background COVID-19 outbreak was sudden and unexpected in most countries. It has spread globally between January and March 2020. The World Health Organization (WHO) first declared the outbreak as a global pandemic on 11 March 2020. While this lockdown has proven to be an important and successful method of social distancing to counter the growing spread of the highly contagious COVID-19 virus, it has also created a degree of psychological impact on the public. Children may be strongly exposed to pandemic-generated biopsychosocial stressors, and once the containment measures of the population are needed to minimize the spread of viruses, they may be negatively impacted by the disturbance of everyday life as a result of social isolation. During school closures, children's routines may change, and healthy behaviors, such as physical activity, adequate diet, or good sleeping habits, may be less likely to happen. Method A cross-sectional study was conducted in Saudi Arabia from 20 March 2021 to 30 March 2021, targeted at children's parents and adolescents. Our concentration was on the impact of COVID-19 on the psychiatric wellbeing of children and adolescents. The data was collected through an online self-administered questionnaire which contains 56 close-ended questions for parents of children and 46 close-ended questions for adolescents. Statistical analysis was performed using R v 3.6.3 (R Foundation, Vienna, Austria). Counts and percentages were used to summarize the distribution of categorical variables. Results The questionnaire was completed by 1141 respondents, 454 were < 18 years old. Thus, these respondents completed the questionnaire on behalf of themselves. The remaining 688 respondents were adults and completed the questionnaire on behalf of their children. Results showed that higher children's age was associated with less increase in worrying, restlessness, and a higher increase in sadness. Higher age was associated with a higher increase in the frequency of waking up, sleeping little, and uneasiness, and nervousness. Having relatives who were infected with COVID-19 was associated with higher increases in most of the negative behaviors such as anxiety, sadness, sleeping little, indecisiveness, and irritability. Punishment threats, screaming, and hitting were associated with a higher increase in negative behaviors during the pandemic compared to before the pandemic. Results showed that neither the gender of the parent nor the child was associated with any of the domains of the child's behavior. Children whose parents were divorced had higher scores on anxiety, restlessness, and sleep disorders than children whose parents were not divorced Conclusion COVID-19 has caused increased stress on families, especially children and adolescents who are vulnerable populations. Our results show that the COVID-19 pandemic can affect the mental health of children and adolescents in Saudi Arabia. We showed that parental stress is a predictor of psychiatric problems, which, if unaddressed, can cause child maltreatment and greater psychological distress.

Cureus2021       LitCov and CORD-19
4876A cross-sectional investigation of SARS-CoV-2 seroprevalence and associated risk factors in children and adolescents in the United States  

BACKGROUND: Pediatric SARS-CoV-2 data remain limited and seropositivity rates in children were reported as <1% early in the pandemic. Seroepidemiologic evaluation of SARS-CoV-2 in children in a major metropolitan region of the US was performed. METHODS: Children and adolescents ≤19 years were enrolled in a cross-sectional, observational study of SARS-CoV-2 seroprevalence from July-October 2020 in Northern Virginia, US. Demographic, health, and COVID-19 exposure information was collected, and blood analyzed for SARS-CoV-2 spike protein total antibody. Risk factors associated with SARS-CoV-2 seropositivity were analyzed. Orthogonal antibody testing was performed, and samples were evaluated for responses to different antigens. RESULTS: In 1038 children, the anti-SARS-CoV-2 total antibody positivity rate was 8.5%. After multivariate logistic regression, significant risk factors included Hispanic ethnicity, public or absent insurance, a history of COVID-19 symptoms, exposure to person with COVID-19, a household member positive for SARS-CoV-2 and multi-family or apartment dwelling without a private entrance. 66% of seropositive children had no symptoms of COVID-19. Secondary analysis included orthogonal antibody testing with assays for 1) a receptor binding domain specific antigen and 2) a nucleocapsid specific antigen had concordance rates of 80.5% and 79.3% respectively. CONCLUSIONS: A much higher burden of SARS-CoV-2 infection, as determined by seropositivity, was found in children than previously reported; this was also higher compared to adults in the same region at a similar time. Contrary to prior reports, we determined children shoulder a significant burden of COVID-19 infection. The role of children’s disease transmission must be considered in COVID-19 mitigation strategies including vaccination.

PLoS One2021       LitCov and CORD-19
4877The effect of large-scale anti-contagion policies on the COVID-19 pandemic  

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Nature2020       LitCov and CORD-19
4878An ACE2 Triple Decoy that neutralizes SARS-CoV-2 shows enhanced affinity for virus variants  

The SARS-CoV-2 variants replacing the first wave strain pose an increased threat by their potential ability to escape pre-existing humoral protection. An angiotensin converting enzyme 2 (ACE2) decoy that competes with endogenous ACE2 for binding of the SARS-CoV-2 spike receptor binding domain (S RBD) and inhibits infection may offer a therapeutic option with sustained efficacy against variants. Here, we used Molecular Dynamics (MD) simulation to predict ACE2 sequence substitutions that might increase its affinity for S RBD and screened candidate ACE2 decoys in vitro. The lead ACE2(T27Y/H34A)-IgG(1)F(C) fusion protein with enhanced S RBD affinity shows greater live SARS-CoV-2 virus neutralization capability than wild type ACE2. MD simulation was used to predict the effects of S RBD variant mutations on decoy affinity that was then confirmed by testing of an ACE2 Triple Decoy that included an additional enzyme activity-deactivating H374N substitution against mutated S RBD. The ACE2 Triple Decoy maintains high affinity for mutated S RBD, displays enhanced affinity for S RBD N501Y or L452R, and has the highest affinity for S RBD with both E484K and N501Y mutations, making it a viable therapeutic option for the prevention or treatment of SARS-CoV-2 infection with a high likelihood of efficacy against variants.

Sci Rep2021       LitCov and CORD-19
4879Antibody Responses after Two Doses of COVID-19 mRNA Vaccine in Dialysis and Kidney Transplantation Patients Recovered from SARS-CoV-2 Infection  

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Medicina (Kaunas)2022       LitCov
4880Predictors of COVID-19 vaccine acceptability among health professions students in Vietnam  

BACKGROUND: The COVID-19 vaccine hesitancy or refusal has actually been a threat to global health. In the current situation, health professions students are at risk for SARS-CoV-2 infection during their internship at healthcare facilities. Furthermore, those future healthcare workers will advise people to accept the COVID-19 vaccination. Therefore, the attitude of students towards vaccine acceptance and the predicting factors needs to be elucidated. This study applied the Health Belief Model to determine predictors of COVID-19 vaccine acceptability among health professions students. METHODS: Nine hundred eleven students participated in a cross-sectional online survey in Vietnam. Data were collected from 1st April to 30th June 2021. Data analysis was performed using SPSS software version 20.0 with Chi-square and Kruskal-Wallis tests before executing multinomial logistic regression to identify predictors of the COVID-19 vaccine acceptability RESULTS: The overall vaccine acceptance, hesitancy, and refusal rates were 58% (95% CI: 54.7% - 61.3%), 40.4% (95% CI: 37.2% - 43.7%) and 1.5% (95% CI: 0.8% - 2.6%), respectively. Regarding vaccination hesitancy, a predictor such as Receiving recent flu shots” had a negative correlation, whereas Vaccines have little efficacy & serious adverse effects” (Perceived barriers), nationality, and majors were positive correlates. For refusal, Unvaccinated students feasibly infected COVID-19 during hospital internship” (Perceived susceptibility) was a negative correlate. For predicting both hesitancy and refusal, Mass media appreciating effectiveness and safety of vaccines (Cues to action), and Health professions students get serious complications of COVID-19 if not vaccinated (Perceived severity) were negative predictors. In contrast, Manufacturers do not disclose adverse effects of vaccines (Cues to action), and Adverse effect causes death (Perceived barrier) were recognized as positive predictors. Strong Health Belief Model predictors of vaccine refusal were Manufacturers do not disclose adverse effects of vaccines (Cues to action) with OR= 5.299(95% CI: 1.687-16.641, p= 0.004), and Adverse effect causes death (Perceived barrier) with OR= 10.255 (95% CI = 3.528-29.814, p= 0.0005). CONCLUSION: Health professions students' acceptability of COVID-19 vaccination might be based on the perceived susceptibility to and severity of COVID-19, concerns about vaccine efficacy and safety, and the influence levels of information from various sources. Health education and measures to prevent the harmful effects of COVID-19 vaccine misinformation could potentially improve the acceptance rate of the COVID-19 vaccine

BMC Public Health2022       LitCov and CORD-19
4881Teaching Strategies During the COVID-19 Pandemic: Tailoring Virtual Learning for Public Health and Cancer Health Disparities Education  

The COVID-19 pandemic has dramatically impacted higher education institutions in the United States (US). Given the dangers of close social interaction in spreading COVID-19, colleges and universities closed their campuses to minimize and often restrict face-to-face instruction of any kind, including supplemental skill development training and experiential learning. In exchange, higher education institutions implemented online learning strategies to continue education for students, including in-person experiential field experiences. This paper describes the adaptation of an in-person experiential field experience into an eight-day virtual workshop as a result of COVID-19 restrictions along with results from participant surveys evaluating pre-and post-test changes in knowledge and their overall assessment of the virtual workshop. This workshop, the Public Health and Cancer Research Workshop (PHCRW), was tailored for students from health-related graduate programs with the primary goal of introducing students to the causes and impacts of cancer disparities in the US/Mexico border region and research related to mitigating those disparities. The course facilitators added a professional development curriculum necessary for student success and the pursuit of advanced degrees such as academic/job interviewing skills and scientific and grant writing. The objectives were for students to (1) understand introductory and intermediate curriculum on public health, cancer, and cancer research; (2) examine the interrelationships among factors impacting public health problems; (3) describe the components of the research process; (4) describe various components of scientific writing; and (5) demonstrate professional strategies associated with school admission and employment. Students completed pre-and post- self-assessments that indicated gains in knowledge about cancer topics, particularly cancer prevention strategies (M(pre) = 3.43; M(post) = 4.43), social determinants associated with cancer (M(pre) = 3.29; M(post) = 4.43), and cancer rates by characteristics (M(pre) = 3.43; M(post) = 4.43). Additionally, students overwhelmingly stated that they appreciated the opportunity to supplement their educational experience in a virtual format. Though the virtual format proved challenging in some respects, students expressed high satisfaction with the workshop. In addition to achieving the goals, the workshop successfully increased students' skills, knowledge, and self-confidence. Despite the last-minute adaptation of the PHCRW, students' satisfaction indicated that this program was an overall success.

Front Public Health2022       LitCov and CORD-19
4882Low-threshold SARS-CoV-2 testing facility for hospital staff: Prevention of COVID-19 outbreaks?  

BACKGROUND: The ongoing global SARS-CoV-2 pandemic has caused over 4.7 million infections greatly challenging healthcare workers (HCW) and medical institutions worldwide. The SARS-CoV-2 pandemic has shown to significantly impact mental and physical health of HCW. Thus, implementation of testing facilities supporting HCW are urgently needed. METHODS: A low-threshold SARS-CoV-2 testing facility was introduced at the University Hospital Bonn, Germany, in March 2020. Irrespective of clinical symptoms employees were offered a voluntary and free SARS-CoV-2 test. Furthermore, employees returning from SARS-CoV-2 risk regions and employees after risk contact with SARS-CoV-2 infected patients or employees were tested for SARS-CoV-2 infection. Pharyngeal swabs were taken and reverse transcription polymerase chain reaction for detection of SARS-CoV-2 was performed, test results being available within 24 hours. Profession, symptoms and reason for SARS-CoV-2 testing of employees were recorded. RESULTS: Between 9th March and 30th April 2020, a total of 1,510 employees were tested for SARS-CoV-2 infection. 1,185 employees took advantage of the low-threshold testing facility. One percent (n=11) were tested positive for SARS-CoV-2 infection, 18% being asymptomatic, 36% showing mild and 36% moderate/severe symptoms (missing 10%). Furthermore, of 56 employees returning from SARS-CoV-2 risk regions, 18% (10/56) were tested SARS-CoV-2 positive. After risk contact tracking by the hospital hygiene 6 patient-to-employee transmissions were identified in 163 employees with contact to 55 SARS-CoV-2 positive patients. CONCLUSION: In the absence of easily accessible public SARS-CoV-2 testing facilities low-threshold SARS-CoV-2 testing facilities in hospitals with rapid testing resources help to identify SARS-CoV-2 infected employees with absent or mild symptoms, thus stopping the spread of infection in vulnerable hospital environments. High levels of professional infection prevention training and implementation of specialized wards as well as a perfectly working hospital hygiene network identifying and tracking risk contacts are of great importance in a pandemic setting.

Int J Hyg Environ Health2020       LitCov and CORD-19
4883Low Sensitivity of Admission Lung US Compared to Chest CT for Diagnosis of Lung Involvement in a Cohort of 82 Patients with COVID-19 Pneumonia  

Background and Objectives: The potential role of lung ultrasound (LUS) in characterizing lung involvement in Coronavirus disease 2019 (COVID-19) is still debated. The aim of the study was to estimate sensitivity of admission LUS for the detection of SARS-CoV-2 lung involvement using Chest-CT (Computed Tomography) as reference standard in order to assess LUS usefulness in ruling out COVID-19 pneumonia in the Emergency Department (ED). Methods: Eighty-two patients with confirmed COVID-19 and signs of lung involvement on Chest-CT were consecutively admitted to our hospital and recruited in the study. Chest-CT and LUS examination were concurrently performed within the first 6–12h from admission. Sensitivity of LUS was calculated using CT findings as a reference standard. Results: Global LUS sensitivity in detecting COVID-19 pulmonary lesions was 52%. LUS sensitivity ranged from 8% in case of focal and sporadic ground-glass opacities (mild disease), to 52% for a crazy-paving pattern (moderate disease) and up to 100% in case of extensive subpleural consolidations (severe disease), although LUS was not always able to detect all the consolidations assessed at Chest-CT. LUS sensitivity was higher in detecting a typical Chest-CT pattern (60%) and abnormalities showing a middle-lower zone predominance (79%). Conclusions: As admission LUS may result falsely negative in most cases, it should not be considered as a reliable imaging tool in ruling out COVID-19 pneumonia in patients presenting in ED. It may at least represent an expanded clinical evaluation that needs integration with other diagnostic tests (e.g., nasopharyngeal swab, Chest-CT).

Medicina (Kaunas)2021       LitCov and CORD-19
4884RBD-VLP Vaccines Adjuvanted with Alum or SWE Protect K18-hACE2 Mice against SARS-CoV-2 VOC Challenge  

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mSphere2022       LitCov
4885Mental distress and influencing factors in nurses caring for patients with COVID-19  

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Nurs Crit Care2021       LitCov and CORD-19
4886Profiling Early Humoral Response to Diagnose Novel Coronavirus Disease  

BACKGROUND: The emergence of coronavirus disease 2019 (COVID-19) is a major healthcare threat. The current method of detection involves a quantitative polymerase chain reaction (qPCR)–based technique, which identifies the viral nucleic acids when present in sufficient quantity. False-negative results can be achieved and failure to quarantine the infected patient would be a major setback in containing the viral transmission. We aim to describe the time kinetics of various antibodies produced against the 2019 novel coronavirus (SARS-CoV-2) and evaluate the potential of antibody testing to diagnose COVID-19. METHODS: The host humoral response against SARS-CoV-2, including IgA, IgM, and IgG response, was examined by using an ELISA-based assay on the recombinant viral nucleocapsid protein. 208 plasma samples were collected from 82 confirmed and 58 probable cases (qPCR negative but with typical manifestation). The diagnostic value of IgM was evaluated in this cohort. RESULTS: The median duration of IgM and IgA antibody detection was 5 (IQR, 3–6) days, while IgG was detected 14 (IQR, 10–18) days after symptom onset, with a positive rate of 85.4%, 92.7%, and 77.9%, respectively. In confirmed and probable cases, the positive rates of IgM antibodies were 75.6% and 93.1%, respectively. The detection efficiency by IgM ELISA is higher than that of qPCR after 5.5 days of symptom onset. The positive detection rate is significantly increased (98.6%) when combining IgM ELISA assay with PCR for each patient compared with a single qPCR test (51.9%). CONCLUSIONS: The humoral response to SARS-CoV-2 can aid in the diagnosis of COVID-19, including subclinical cases.

Clin Infect Dis2020       LitCov and CORD-19
4887Coronavirus Disease Associated Mucormycosis (CAM): Case Report and Systematic Review of Literature  

Severe coronavirus disease (COVID-19) is currently managed with systemic glucocorticoids. Opportunistic fungal infections are of concern in such patients. While COVID-19 associated pulmonary aspergillosis is increasingly recognized, mucormycosis is rare. We describe a case of probable pulmonary mucormycosis in a 55-year-old man with diabetes, end-stage kidney disease, and COVID-19. The index case was diagnosed with pulmonary mucormycosis 21 days following admission for severe COVID-19. He received 5 g of liposomal amphotericin B and was discharged after 54 days from the hospital. We also performed a systematic review of the literature and identified seven additional cases of COVID-19 associated mucormycosis (CAM). Of the eight cases included in our review, diabetes mellitus was the most common risk factor. Three subjects had no risk factor other than glucocorticoids for COVID-19. Mucormycosis usually developed 10–14 days after hospitalization. All except the index case died. In two subjects, CAM was diagnosed postmortem. Mucormycosis is an uncommon but serious infection that complicates the course of severe COVID-19. Subjects with diabetes mellitus and multiple risk factors may be at a higher risk for developing mucormycosis. Concurrent glucocorticoid therapy probably heightens the risk of mucormycosis. A high index of suspicion and aggressive management is required to improve outcomes.

Mycopathologia2021       LitCov and CORD-19
4888The Integral Membrane Protein ZMPSTE24 Protects Cells from SARS-CoV-2 Spike-Mediated Pseudovirus Infection and Syncytia Formation  

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mBio2022       LitCov
4889The Emotional Path to Action: Empathy Promotes Physical Distancing and Wearing of Face Masks During the COVID-19 Pandemic  

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Psychol Sci2020       LitCov and CORD-19
4890Transfer learning-based ensemble support vector machine model for automated COVID-19 detection using lung computerized tomography scan data  

The novel discovered disease coronavirus popularly known as COVID-19 is caused due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and declared a pandemic by the World Health Organization (WHO). An early-stage detection of COVID-19 is crucial for the containment of the pandemic it has caused. In this study, a transfer learning–based COVID-19 screening technique is proposed. The motivation of this study is to design an automated system that can assist medical staff especially in areas where trained staff are outnumbered. The study investigates the potential of transfer learning–based models for automatically diagnosing diseases like COVID-19 to assist the medical force, especially in times of an outbreak. In the proposed work, a deep learning model, i.e., truncated VGG16 (Visual Geometry Group from Oxford) is implemented to screen COVID-19 CT scans. The VGG16 architecture is fine-tuned and used to extract features from CT scan images. Further principal component analysis (PCA) is used for feature selection. For the final classification, four different classifiers, namely deep convolutional neural network (DCNN), extreme learning machine (ELM), online sequential ELM, and bagging ensemble with support vector machine (SVM) are compared. The best performing classifier bagging ensemble with SVM within 385 ms achieved an accuracy of 95.7%, the precision of 95.8%, area under curve (AUC) of 0.958, and an F1 score of 95.3% on 208 test images. The results obtained on diverse datasets prove the superiority and robustness of the proposed work. A pre-processing technique has also been proposed for radiological data. The study further compares pre-trained CNN architectures and classification models against the proposed technique. [Image: see text]

Med Biol Eng Comput2021       LitCov and CORD-19
4891Trust in government, intention to vaccinate and COVID-19 vaccine hesitancy: A comparative survey of five large cities in the United States, United Kingdom and Australia  

BACKGROUND: There is widespread hesitancy towards COVID-19 vaccines in the United States, United Kingdom, and Australia. OBJECTIVE: To identify predictors of willingness to vaccinate against COVID-19 in five cities with varying COVID-19 incidence in the US, UK, and Australia. DESIGN: Online, cross-sectional survey of adults from Dynata’s research panel in July-September 2020 PARTICIPANTS, SETTING: Adults aged 18 and over in Sydney, Melbourne, London, New York City, or Phoenix MAIN OUTCOMES AND MEASURES: Willingness to receive a COVID-19 vaccine; reason for vaccine intention STATISTICAL METHODS: To identify predictors of intention to receive a COVID-19 vaccine, we used Poisson regression with robust error estimation to produce prevalence ratios. RESULTS: The proportion willing to receive a COVID-19 vaccine was 70% in London, 71% NYC, 72% in Sydney, 76% in Phoenix, and 78% in Melbourne. Age was the only sociodemographic characteristic that predicted willingness to receive a COVID-19 vaccine in all five cities. In Sydney and Melbourne, participants with high confidence in their current government had greater willingness to receive the vaccine (PR = 1.24; 95% CI = 1.07-1.44 and PR = 1.38; 95% CI = 1.74-1.62), while participants with high confidence in their current government in NYC and Phoenix were less likely to be willing to receive the vaccine (PR = 0.78; 95% CI = 0.72 - 0.85 and PR = 0.85; 95% CI = 0.76-0.96). LIMITATIONS: Consumer panels can be subject to bias and may not be representative of the general population CONCLUSIONS: Success for COVID-19 vaccination programs requires high levels of vaccine acceptance. Our data suggests more than 25% of adults may not be willing to receive a COVID-19 vaccine, but many of them were not explicitly anti-vaccination and thus may become more willing to vaccinate over time. Among the three countries surveyed, there appears to be cultural differences, political influences, and differing experiences with COVID-19 that may affect willingness to receive a COVID-19 vaccine.

Vaccine2021       LitCov and CORD-19
4892A Virtual Wellness and Learning Communities Program for Medical Students during the COVID-19 Pandemic  

OBJECTIVES: Numerous studies have demonstrated the high risk for burnout and mental illness in medical students. Because of the coronavirus disease 2019 (COVID-19) pandemic, our medical school transitioned to an all-virtual learning environment from March to June 2020, which raised concerns among student leaders and administrators, as reduced interpersonal attachments have known associations with decreased mental health. In an effort to facilitate student well-being during the pandemic, the Virtual Wellness and Learning Communities (VWLC) program was established. VWLC consisted of hour-long events that offered students the opportunity to engage with their peers online. METHODS: More than 20 events and workshops were conducted from March to June 2020, including trivia nights, song and guitar performances, sketching, video editing tutorials, chess lessons, yoga, and personal investing tips. An institutional review board–approved survey to assess the efficacy of the VWLC program was sent to medical student participants and nonparticipants. RESULTS: The overall response rate of this study was 43% (53/123). The response rate for students who attended a VWLC event was 51% (33/65), and the response rate for students who did not attend a VWLC event was 34% (20/58). Of all of the respondents, 85% (45/53) reported a decreased sense of connectivity with peers because of the pandemic, and 40% (21/53) reported a decrease in their sense of wellness. After attending a VWLC event, 79% (26/33) reported an increased sense of peer connectivity, 61% (20/33) reported improved wellness, and 55% (18/33) believed that these events should continue postpandemic to supplement in-person programming. Those who did not attend a virtual event stated that the main barriers to attending were unfamiliarity with attendees and screen fatigue. CONCLUSIONS: The COVID-19 pandemic has worsened medical student well-being and sense of community. VWLC programming may be an effective strategy for promoting medical student wellness and community while social distancing during the COVID-19 pandemic. To our knowledge, this is the first virtual wellness program for promotion of medical student mental health during the COVID-19 pandemic to be described in the literature.

South Med J2021       LitCov and CORD-19
4893Transmission of SARS-CoV-2 on mink farms between humans and mink and back to humans  

Animal experiments have shown that nonhuman primates, cats, ferrets, hamsters, rabbits, and bats can be infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). In addition, SARS-CoV-2 RNA has been detected in felids, mink, and dogs in the field. Here, we describe an in-depth investigation using whole-genome sequencing of outbreaks on 16 mink farms and the humans living or working on these farms. We conclude that the virus was initially introduced by humans and has since evolved, most likely reflecting widespread circulation among mink in the beginning of the infection period, several weeks before detection. Despite enhanced biosecurity, early warning surveillance, and immediate culling of animals in affected farms, transmission occurred between mink farms in three large transmission clusters with unknown modes of transmission. Of the tested mink farm residents, employees, and/or individuals with whom they had been in contact, 68% had evidence of SARS-CoV-2 infection. Individuals for which whole genomes were available were shown to have been infected with strains with an animal sequence signature, providing evidence of animal-to-human transmission of SARS-CoV-2 within mink farms.

Science2020       LitCov and CORD-19
4894Health anxiety, perceived stress and coping styles in the shadow of the COVID-19  

BACKGROUND: In the case of people who carry an increased number of anxiety traits and maladaptive coping strategies, psychosocial stressors may further increase the level of perceived stress they experience. In our research study, we aimed to examine the levels of perceived stress and health anxiety as well as coping styles among university students amid the COVID-19 pandemic. METHODS: A cross-sectional study was conducted using an online-based survey at the University of Debrecen during the official lockdown in Hungary when dormitories were closed, and teaching was conducted remotely. Our questionnaire solicited data using three assessment tools, namely, the Perceived Stress Scale (PSS), the Ways of Coping Questionnaire (WCQ), and the Short Health Anxiety Inventory (SHAI). RESULTS: A total of 1320 students have participated in our study and 31 non-eligible responses were excluded. Among the remaining 1289 participants, 948 (73.5%) and 341 (26.5%) were Hungarian and international students, respectively. Female students predominated the overall sample with 920 participants (71.4%). In general, there was a statistically significant positive relationship between perceived stress and health anxiety. Health anxiety and perceived stress levels were significantly higher among international students compared to domestic ones. Regarding coping, wishful thinking was associated with higher levels of stress and anxiety among international students, while being a goal-oriented person acted the opposite way. Among the domestic students, cognitive restructuring as a coping strategy was associated with lower levels of stress and anxiety. Concerning health anxiety, female students (domestic and international) had significantly higher levels of health anxiety compared to males. Moreover, female students had significantly higher levels of perceived stress compared to males in the international group, however, there was no significant difference in perceived stress between males and females in the domestic group. CONCLUSION: The elevated perceived stress levels during major life events can be further deepened by disengagement from home (being away/abroad from country or family) and by using inadequate coping strategies. By following and adhering to the international recommendations, adopting proper coping methods, and equipping oneself with the required coping and stress management skills, the associated high levels of perceived stress and anxiety could be mitigated.

BMC Psychol2021       LitCov and CORD-19
4895Mental health of people in Australia in the first month of COVID-19 restrictions: a national survey  

OBJECTIVES: To estimate the population prevalence of clinically significant symptoms of depression, generalised anxiety, thoughts of being better off dead, irritability, and high optimism about the future, and of direct experience of COVID‐19, loss of employment caused by COVID‐19 restrictions, worry about contracting COVID‐19, or major disadvantage because of the restrictions; to examine the relationship between these experiences and reporting mental symptoms. DESIGN, SETTING, PARTICIPANTS: Anonymous online survey of adult Australian residents, 3 April – 2 May 2020. MAIN OUTCOME MEASURES: Self‐reported psychological status during the preceding fortnight assessed with the Patient Health Questionnaire 9 (PHQ‐9; symptoms of depression) and the Generalised Anxiety Disorder Scale (GAD‐7). Optimism about the future was assessed with a 10‐point study‐specific visual analogue scale. RESULTS: 13 829 respondents contributed complete response data. The estimated prevalence of clinically significant symptoms of depression (PHQ‐9 ≥ 10) was 27.6% (95% CI, 26.1–29.1%) and of clinically significant symptoms of anxiety (GAD‐7 ≥ 10) 21.0% (95% CI, 19.6–22.4%); 14.6% of respondents (95% CI, 13.5–16.0%) reported thoughts of being better off dead or self‐harm (PHQ‐9, item 9) on at least some days and 59.2% (95% CI, 57.6–60.7%) that they were more irritable (GAD‐7, item 6). An estimated 28.3% of respondents (95% CI, 27.1–29.6%) reported great optimism about the future (score ≥ 8). People who had lost jobs, were worried about contracting COVID‐19, or for whom the restrictions had a highly adverse impact on daily life were more likely to report symptoms of depression or anxiety, and less likely to report high optimism than people without these experiences. CONCLUSIONS: Mental health problems were widespread among Australians during the first month of the stage two COVID‐19 restrictions; in addition, about one‐quarter of respondents reported mild to moderate symptoms of depression or anxiety. A public mental health response that includes universal, selective and indicated clinical interventions is needed.

Med J Aust2020       LitCov and CORD-19
4896Modification of a vaccine hesitancy scale for use in adult vaccinations in the United States and China  

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Hum Vaccin Immunother2021       LitCov and CORD-19
4897Protecting older people living in care homes from COVID-19: a protocol for a mixed-methods study to understand the challenges and solutions to implementing social distancing and isolation  

INTRODUCTION: Older people living in residential and nursing care homes often have complex needs and are at high risk of poor health outcomes and mortality, especially if they contract COVID-19. Care homes use infection prevention and control measures such as social distancing and isolating residents to protect them from COVID-19. The care home sector has stated that implementing social distancing and isolation when caring for residents is a significant challenge. This paper presents the protocol of a mixed-methods study to explore and understand the real-life experiences of implementing social distancing and isolation of residents in care homes for older people from the perspective of residents, families/friends and staff working in and with care homes. The study aims to develop a toolkit of resources for health and care delivery now and for future outbreaks of infectious diseases. METHODS AND ANALYSIS: The study will be conducted in three phases. Phase 1 is a rapid review of evidence to collate knowledge on the mechanisms and measures used by care homes and long-term facilities to socially distance and isolate older people or control the spread of other infectious and contagious diseases. The review results will contribute to participant interviews in phase 2 and toolkit development in phase 3. Phase 2 will involve case studies with six care homes in England, involving the conduct of individual interviews with residents, families and friends, and staff, collection of care home policies and protocols related to social distancing and isolation for residents, and routinely collected care home data. A focus group with a purposive sample of external key informants will also be conducted. Phase 3, synthesising findings from phases 1 and 2, will inform the codesign of a toolkit of resources for residents, families/friends and care homes. ETHICS AND DISSEMINATION: The study has been approved by Coventry and Warwick Research Ethics Committee (20/WM/0318). To maximise impact, we will work closely with the Study Committees and the Patient and Public Involvement group to ensure the findings reach key stakeholders, including residents, families/friends, care homes, commissioners and organisations representing care home providers. We will disseminate the study outputs in peer-reviewed and professional journals, at professional conferences and via other knowledge transfer activities with the care home sector, and resident and carer organisations. The toolkit comprising evidence-informed guidance and resources and a mosaic film will be hosted on a project webpage. REGISTRATION DETAILS: This project is funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research Programme (Project reference NIHR132541). The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care. PROSPERO REGISTRATION NUMBER: CRD42021226734.

BMJ Open2021       LitCov and CORD-19
4898Differences in Motivating Factors for SARS-CoV-2 Vaccination and Perceptions of Infection Risk among Healthcare and EMS Personnel in South Carolina  

N/A

South Med J2022       LitCov
4899No evidence of severe acute respiratory syndrome-coronavirus 2 in semen of males recovering from COVID-19  

Abstract Objective To describe detection of SARS-CoV-2 in seminal fluid of patients recovering from COVID-19 and describe the expression profile of ACE2 and TMPRSS2 within the testicle. Design observational, cross-sectional study Setting Tertiary referral center Patients Thirty-four adult Chinese males diagnosed with COVID-19 through confirmatory quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR) from pharyngeal swab samples Intervention None Main Outcome Measures Identification of SARS-CoV-2 on qRT-PCR of single ejaculated semen samples. Semen quality was not assessed. Expression patterns of ACE2 and TMPRSS2 in the human testis are explored through previously published single-cell transcriptome datasets. Results Six patients (19%) demonstrated scrotal discomfort concerning for viral orchitis around the time of COVID-19 confirmation. SARS-CoV-2 was not detected in semen after a median of 31 days (IQR: 29-36 days) from COVID-19 diagnosis. Single-cell transcriptome analysis demonstrates sparse expression of ACE2 and TMPRSS2, with almost no overlapping gene expression. Conclusions SARS-CoV-2 was not detected in the semen of patients recovering from COVID-19 one month after COVID-19 diagnosis. ACE2-mediated viral entry of SARS-CoV-2 into target host cells is unlikely to occur within the human testicle based on ACE2 and TMPRSS2 expression. The long-term effects of SARS-CoV-2 on male reproductive function remain unknown.

Fertil Steril2020       LitCov and CORD-19
4900A deep learning algorithm using CT images to screen for coronavirus disease  

OBJECTIVE: The outbreak of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) has caused more than 26 million cases of Corona virus disease (COVID-19) in the world so far. To control the spread of the disease, screening large numbers of suspected cases for appropriate quarantine and treatment are a priority. Pathogenic laboratory testing is typically the gold standard, but it bears the burden of significant false negativity, adding to the urgent need of alternative diagnostic methods to combat the disease. Based on COVID-19 radiographic changes in CT images, this study hypothesized that artificial intelligence methods might be able to extract specific graphical features of COVID-19 and provide a clinical diagnosis ahead of the pathogenic test, thus saving critical time for disease control. METHODS: We collected 1065 CT images of pathogen-confirmed COVID-19 cases along with those previously diagnosed with typical viral pneumonia. We modified the inception transfer-learning model to establish the algorithm, followed by internal and external validation. RESULTS: The internal validation achieved a total accuracy of 89.5% with a specificity of 0.88 and sensitivity of 0.87. The external testing dataset showed a total accuracy of 79.3% with a specificity of 0.83 and sensitivity of 0.67. In addition, in 54 COVID-19 images, the first two nucleic acid test results were negative, and 46 were predicted as COVID-19 positive by the algorithm, with an accuracy of 85.2%. CONCLUSION: These results demonstrate the proof-of-principle for using artificial intelligence to extract radiological features for timely and accurate COVID-19 diagnosis. KEY POINTS: • The study evaluated the diagnostic performance of a deep learning algorithm using CT images to screen for COVID-19 during the influenza season. • As a screening method, our model achieved a relatively high sensitivity on internal and external CT image datasets. • The model was used to distinguish between COVID-19 and other typical viral pneumonia, both of which have quite similar radiologic characteristics.

Eur Radiol2021       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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