Search Research

Longitudinal impact of the coronavirus disease pandemic on pediatric adenoidectomy volume and referrals in Japan: A 6-year retrospective study.

OBJECTIVES: To evaluate the impact of the coronavirus disease (COVID-19) pandemic and public health measures, including emergency declarations and reclassification of COVID-19, on pediatric adenoidectomy (Ad) volume and referrals diagnosed with adenoidal hypertrophy (AH) accompanied by obstructive sleep apnea (OSA) and/or otitis media with effusion (OME) in Japan. METHODS: Monthly case volumes from January 2019 to December 2024 were analyzed at a regional tertiary hospital. Trends were assessed for pediatric Ad, new referrals, general anesthesia surgeries (all departments and ENT), and regional COVID-19 cases. Ad cases were classified according to the presence of concomitant tonsillectomy (T) or tympanostomy tube insertion (TTI); referrals based on the presence of OSA or OME symptoms. The annual age trends were also evaluated. RESULTS: General anesthesia surgeries across the hospital and in the adult ENT department declined temporarily during the emergency declarations but rapidly recovered afterward, whereas those in the pediatric ENT department remained below the baseline even after each declaration. Notably, Ad volumes showed no apparent post-declaration recoveries and remained suppressed until 2023, except for a transient increase in summer 2021, followed by a sharp rebound after the COVID-19 reclassification. In 2024, the volumes of Ad with concurrent T and referrals for AH with OSA or OME symptoms both exceeded the pre-pandemic baseline. Surgical age declined during the pandemic, while referral age remained stable until 2023. Both ages increased in 2024. CONCLUSION: The total Ad volume-especially Ad with concurrent T-and referrals for AH with OSA symptoms showed an abrupt decline immediately after the pandemic onset, followed by a sharp recovery exceeding pre-pandemic levels. These findings suggest that public health crises can disrupt elective care for chronic pediatric conditions and that the post-pandemic surge reflects behavioral changes and pent-up demand as well as possible epidemiological alterations in tonsillar tissue dynamics.

Ogawa M, Maruta T, Kamakura T, Otami Y, Sudo T, Fujita H, Fujisawa N, Okamoto S, Yamashita M, Okazaki S, Hosokawa K, Mishiro Y, International journal of pediatric otorhinolaryngology

Jan 1, 2026

Biochemical Markers as Predictors of Coronavirus Disease-2019 Severity and Intensive Care Unit Admission: A Retrospective Study in Saudi Arabia.

BACKGROUND AND AIMS: Coronavirus disease-2019 (COVID-19) is an emerging infectious disease that can present with a wide range of symptoms and lead to increased mortality by causing extreme respiratory failure, multiple organ dysfunction, and death. Several biochemical markers have been proposed to predicting the severity of COVID-19 and the consequent need for intensive care unit (ICU) admission. This study provides insight into the role of different laboratory parameters as a minimally invasive method in the prediction of COVID-19 severity and the need for ICU admission. MATERIALS AND METHODS: This retrospective observational study included all patients with positive real-time polymerase chain reaction (RT-PCR) results for COVID-19 who were hospitalized at the Ministry of Health South Al-Qunfudah General Hospital between March and September 30, 2020. Laboratory parameters (white blood cell [WBC] count, lymphocytes, lactate dehydrogenase [LDH], and erythrocyte sedimentation rate [ESR]) levels were evaluated. RESULTS: Biochemical parameters were analyzed in 342 COVID-19 patients, comprising 206 males and 136 females, with a mean age of 54 years. 97 patients had critical illnesses, while 245 had noncritical illnesses. Critical illness was defined as a condition that required intensive care or that resulted in death. Noncritical illnesses did not require intensive care, resulting in recovery. High LDH levels were significantly associated with critical COVID-19 cases compared with noncritical cases. WBC and lymphocyte parameter analyses included 287 patients. Of these, 170 were male and 117 were female. These analyses were conducted under severe conditions. The mean WBC count was significantly higher in the critical cases than in the noncritical cases (11.15 vs. 6.96, P = 0.001). The mean lymphocyte count (LC) was significantly lower in critical cases than in noncritical cases (1.11 vs. 1.89, P = 0.007). Age and sex were not significantly associated with the disease severity or mortality. The ESR parameter analysis included 161 patients. Based on the severity of the condition, there were 63 women. These patients' critical outcomes included 15 patients, while the noncritical outcomes included 146 patients; however, it was not significant to compare critical and noncritical patients, indicating that these parameters cannot be used as biomarkers to predict the severity of COVID-19. CONCLUSIONS: We studied the effects of various biochemical markers on the prognosis of COVID-19. Our findings concluded critical COVID-19 is associated with significantly increased WBCs counts, LDH, and decreased LC. The ESR is not a potential biomarker for predicting the severity of COVID-19. It is important to note that the use of biochemical markers to assess severity has been reported in the literature, and further research is required to validate their effectiveness.

Hakami AM, Annals of African medicine

Jan 1, 2026

Association between eosinophil counts and outcomes of severe coronavirus disease 2019 in elderly asthma patients: a prospective cohort study.

BACKGROUND: Given effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on the respiratory system and epidemiological burden of asthma worldwide, coronavirus disease 2019 (COVID-19) in asthma patients caused reasonable concern to be a "dangerous" combination in early pandemic. This is especially pertinent to elderly patients with asthma since older age, diabetes, cardiovascular disease, and hypertension, is associated with more serious complications of COVID-19 and higher mortality. Blood eosinopenia occurs as a part of the total cytopenia at the early stage of severe COVID-19 due to an effect of SARS-CoV-2 virus on the immunity and severe inflammation. Therefore, blood cell count monitoring could be useful for the diagnosis and outcome prediction in COVID-19. The aim of this study was to investigate a relationship between blood eosinophil count and outcomes of COVID-associated lung injury in elderly patients with asthma. METHODS: This was a prospective cohort study involving elderly patients with asthma (>60 years of age, n=131). All patients were admitted to a hospital for COVID-19 from October 1, 2020, to September 30, 2021. Those patients who completed their hospital treatment (were discharged or died) by December, 30, 2021, were enrolled in the study. All the patients were previously diagnosed with asthma according to Global Initiative for Asthma (GINA) criteria. The diagnosis of COVID-19 was confirmed by positive polymerase chain reaction (PCR) test, typical clinical symptoms, and radiological signs of multifocal pneumonia. Survived patients were followed up by weekly phone calls for 90 days after discharge. The complete blood count was measured in the whole blood samples obtained at admission. Hazard ratio was calculated using univariable and multivariable Cox proportional hazards regression models. RESULTS: In total, 131 patients were enrolled in the study. Eighty-six patients survived, 30 patients died in the hospital, and 15 patients died post-discharge. Common independent predictors of death were the Charlson Comorbidity Index and eosinopenia. Survived patients had higher blood eosinophil count compared to patients who died in the hospital or post-discharge (P=0.001 and P=0.04, respectively). The cut-off eosinophil count was estimated as 100 cells/L; higher eosinophil count was seen in 24% of survivors and in none of non-survivors (P=0.002 and P=0.04, respectively). The absolute eosinophil count was a significant predictor of in-hospital death [odds ratio (OR), 0.64; 95% confidence interval (CI): 0.49-0.84; P=0.002] and death post-discharge (OR, 0.78; 95% CI: 0.65-0.95; P=0.01). Median survival, in-hospital and post-discharge, was shorter in patients with eosinophil count ≤100 cells/L (P<0.001 and P=0.04, respectively). CONCLUSIONS: Blood eosinophil count could be used as a prognostic marker of outcome in elderly patients with asthma and COVID-associated lung injury. Eosinophil level ≤100 cells/µL could be used as a threshold for predicting poor outcome, both in-hospital and 90-day post-discharge.

Avdeev SN, Gaynitdinova VV, Chikina SY, Merzhoeva ZM, Nuralieva GS, Gneusheva TY, Sokolova ES, Bogatyreva TU, Berikkhanov ZG, Ma Q, Journal of thoracic disease

Dec 28, 2025

Incidence of Severe Acute Respiratory Syndrome Coronavirus 2 Neutralizing Antibodies in a Rural Community in Western Kenya during the First 24 Months of the Coronavirus Disease 2019 Pandemic.

Seroreactivity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigens was commonly reported in African settings during the early stages of the coronavirus disease 2019 pandemic. Severe acute respiratory syndrome coronavirus 2 neutralizing antibodies (nAbs) are not only correlated with functional protection from disease but also are highly specific responses to the virus. These responses were used to investigate the evolution of virus exposure in a community-based, longitudinal cohort of 504 individuals in rural Western Kenya. Eluates from dried blood spots collected every 3 months from January 2020 to September 2021 were tested for nAbs using a commercial kit. Only 10 individuals developed SARS-CoV-2 nAbs, all of which were clustered in December 2020 (wildtype virus) and September 2021 (delta variant). After seroconversion, all patients seroreverted within 2 months. Despite reports of widespread viral exposure in Western Kenya from 2020 to 2021, the paucity of nAbs highlights the limited natural immunity present when vaccines became available in late 2021 in Kenya.

Gaston DD, Markwalter CF, Grassia JT, Freedman B, Wang LF, Obala AA, O'Meara WP, Taylor SM, The American journal of tropical medicine and hygiene

Nov 5, 2025

Greater fatigue is more strongly associated with reduced reward sensitivity in the long-term phase of coronavirus disease (COVID-19) than in the early phase.

Background: Fatigue and depressive mood is inherent to acute disease, but a substantial group of people report persisting disabling fatigue and depressive symptoms long after a COVID-19 infection. Infections have been shown to change decisions about engaging in effortful and rewarding activities, but it is currently unclear whether fatigue and depressive symptoms are similarly associated with decision making during early and persistent phases after a COVID-19 infection. Here, we investigated whether fatigue and depressive mood are associated with altered weighting of reward and effort in decision making at different timepoints after COVID-19 infection. Methods: We conducted an online cross-sectional study between March 2021 and March 2022, in which 242 participants (18-65 years) with COVID-19 < 4 weeks ago (n = 62), COVID-19 > 12 weeks ago (n = 81), or no prior COVID-19 (n = 90; self-reported) performed an effort-based decision-making task. In this task, participants accepted or rejected offers in which they could exert physical effort (ticking boxes on screen, 5 levels) to gain rewards (money to be gained in a voucher-lottery, 5 levels). State fatigue and depressive mood were measured with the Profile of Mood States (POMS) prior to the task. We used mixed binomial regression analysis to test whether fatigue and depressive mood were related to acceptance rates for reward and effort levels and whether this differed between the groups. Results: Compared with no COVID-19 and COVID-19 < 4 weeks groups, the COVID-19 > 12 weeks group reported higher state fatigue (mean ± SD: 20 ± 7 vs. 14 ± 7 and 12 ± 6 POMS-score, respectively; both p < 0.001) and was less sensitive to rewards (Reward∗Group: OR: 0.35 (95 %CI 0.20, 0.62), p < 0.001 and OR: 0.38 (95 %CI 0.20, 0.72), p = 0.003). In the COVID-19 > 12 weeks group, fatigue was more negatively associated with reward sensitivity compared to the COVID-19 < 4 weeks group (Reward∗Fatigue∗Group: OR 0.47 (95 %CI 0.25, 1.13), p = 0.022) and the no COVID-19 group (OR 0.48 (95 %CI 4.01, 0.92), p = 0.029). No group differences were observed for the relationship between fatigue and effort sensitivity. There were also no group differences for the relationship between depressive mood and effort or reward sensitivity. Higher age, lower BMI, unhealthy lifestyle, and worrying during the early phase of COVID-19 each predicted lower reward sensitivity in the > 12 weeks group (Age∗Reward: OR 0.30 (95 %CI 0.19, 0.48), p < 0.001; BMI∗Reward: OR 1.43 (95 %CI 1.01, 2.00), p = 0.047); Lifestyle∗Reward: OR 1.50 (95 %CI 1.06, 2.14), p = 0.022; Worrying∗Reward: OR 0.59 (95 %CI 0.38, 0.94), p = 0.025, respectively). Conclusion: The finding that fatigue is related to lower reward sensitivity > 12 weeks after COVID-19 suggests potential reward deficits in post-COVID-19 fatigue. Moreover, higher age, unhealthy lifestyle, and worrying during the early phase of COVID-19 are potential risk factors for developing lower reward sensitivity. These findings are in line with previous observations that long-term inflammation induces dysregulations in neural reward processing, which should be investigated in future studies.

GreenMedInfo, Brain, behavior, & immunity - health

Oct 1, 2025

Surveying Association Between Moral Injury and Quality of Work Life of Emergency Nurses During the Coronavirus Disease 2019 Pandemic.

INTRODUCTION: The emergency department is an environment with a high volume of workload pressure and stressors accompanied by various moral problems and challenges. Thus, the current research examined the association between moral injury and the quality of work life of the nurses. METHODS: In this descriptive-correlational study done in 2022, 168 nurses working in the emergency department of the referral hospitals of Mazandaran University of Medical Sciences participated via census sampling. The demographic questionnaire, moral injury questionnaire (Moral Injury Symptom Scale-Healthcare Professionals version), and Brooks' Quality of Nursing Work Life scale were used to collect the data, which were analyzed by SPSS 25 and used descriptive and inferential statistics with Spearman's rank correlation coefficient and Mann-Whitney and Kruskal-Wallis tests. RESULTS: The mean moral injury and the mean quality of nursing work life resulted as 9.58 ± 46.69 and 129.92 ± 15.76, respectively. Moral injury displayed a significant and indirect relationship with the quality of nursing work life (r = -0.433, P<0.05). In addition, moral injury was meaningfully associated with age, work record, work shift, job rank, and the number of patients (P = .05). The quality of work life was also significantly associated with gender, education, and marital status (P<.05). DISCUSSION: In the current study, a significant relationship was discovered between moral injury and the quality of work life of nurses during the coronavirus disease 2019 pandemic. As moral injury increases, the nurses' quality of work life decreases.

Charati FG, Heidari Gorji MA, Keramat F, Mohammadpour RA, Shafipour V, Journal of emergency nursing

Sep 1, 2025

Risk of bias and low reproducibility in meta-analytic evidence from fast-tracked publications during the coronavirus disease 2019 pandemic.

The fast-tracked publication of coronavirus disease 2019 (COVID-19)-related meta-analytic evidence has undeniably facilitated rapid public health policymaking; however, concerns are mounting that this publication policy may compromise research quality and scientific integrity. To investigate this, we conducted a meta-research study systematically evaluating risk of bias (ROB), transparency, and reproducibility in pandemic-era meta-analyses synthesizing COVID-19-derived mental health problem epidemics. From 98 identified studies-including data from 18.6 million individuals across 94 countries-we observed significant ROBs in publication, with one new meta-analysis published approximately every 5 days at peak output. Despite apparent sample diversity, nearly half of participants were from China, and only 8.9% originated from less economically developed countries. Of these meta-analyses, a substantial proportion (70.6%) showed discrepancies between Preferred Reporting Items for Systematic Reviews and Meta-Analyses-guided reporting and actual research conducts, while 57.1% exhibited high methodological ROBs due to insufficient data sources and lack of sensitivity analysis. Alarmingly, none achieved full computational reproducibility, and fewer than one-fifth were fully replicable. Furthermore, neither publication in high-impact journals, citation performance, nor fast-track publication mode correlated with lower ROBs that we identified above. To address these limitations, we re-estimated global COVID-19-derived mental health epidemics using their individual participant data after minimizing identified ROBs. Our recalibrated meta-analytic findings provide more reliable benchmarks for understanding the pandemic's mental health impact. This study demonstrated that rigorous methodology and scientific integrity must remain central priorities-even under urgent, crisis-driven conditions-establishing a foundation for transparent, reproducible, and unbiased global mental health surveillance during public health emergencies.

GreenMedInfo, PNAS nexus

Aug 1, 2025

The incidence and epidemiology of necrotising otitis externa in England before, during and after the coronavirus disease 2019 pandemic: an updated analysis of Hospital Episode Statistics data 2002-2024.

OBJECTIVES: Necrotising otitis externa is a serious infective condition with significant risk of complications and a profound impact on patients' quality of life. METHODS: A quantitative descriptive study was undertaken using epidemiological data from the National Health Service Hospital Episode Statistics database and other national databases. Data correlating with reported cases 2002-2024 were compiled and analysed. RESULTS: The national incidence of necrotising otitis externa has demonstrated a sustained increase 2002-2024. The 30 per cent incidence drop during the coronavirus disease 2019 pandemic may be attributable to reduced exposure to risk factors, reduced contact between susceptible patients and health professionals and pandemic-related deaths of at-risk populations. There remains a strong correlation between growths in necrotising otitis externa incidence, the ageing population and national incidence of diabetes mellitus. These are all projected to continue to rise. Antibiotic resistance is not a significant contributing factor. CONCLUSION: This study demonstrates several significant trends, offering a strong foundation for deeper exploration in future studies.

GreenMedInfo, The Journal of laryngology and otology

Jul 28, 2025

Are Coronavirus Disease 2019 Vaccinations Causing Fatal Adverse Event? A Comprehensive Case Discussion Based on WHO Adverse Events Following Immunization Causality Criteria.

ABSTRACT: The coronavirus disease 2019 (COVID-19) pandemic has led to a global health crisis, with mass vaccination being a pivotal strategy in mitigating its impact. However, adverse events following immunization/vaccination have raised concerns, although most are mild. This case report details a 33-year-old male who developed fatal acute respiratory distress syndrome, congestive cardiac failure, and multi-organ failure after receiving the second dose of the COVID-19 vaccine. Autopsy revealed underlying mitral stenosis complicated by infective endocarditis, which likely contributed to the patient's death. Cytological, biochemical, and microbiological examinations of pleural, pericardial, and peritoneal fluids were inconclusive in identifying a specific cause. The temporal association between vaccination and death warrants further investigation, although definitive evidence linking the vaccine to the adverse event remains unclear. The findings emphasize the importance of continuous monitoring and further research into vaccine safety, whereas reinforcing the critical role of mass vaccination in controlling the pandemic.

GreenMedInfo, Annals of African medicine

Jun 27, 2025

Enhanced and Sexually Transmitted Infections and Associated Risk Factors in Fiji Following the Coronavirus Disease 2019 Pandemic.

Background: The coronavirus disease 2019 pandemic impact on sexually transmitted infections in countries practicing syndromic management remains unknown. We conducted cross-sectional surveys in Fiji to assess increases and risk factors for (NG) and (CT) infections pre- and postpandemic. Methods: We enrolled women, men who have sex only with women (MSW), and men who have sex with men (MSM) aged 18-40 years, collected sociodemographic/behavioral data, and tested vaginal, urethral, and rectal samples using Xpert-CT/NG. Risk factors were evaluated using regression models. Results: Of 1955 participants, 6.4% (95% confidence interval [CI], 5.4%-7.6%) had gonorrhea, increasing significantly postpandemic >2-fold among women aged 25-40 years and >4-fold among MSM, MSW, and men aged 18-24 and 25-40 years; 20.0% (95% CI, 18.3%-21.8%) had chlamydia, increasing significantly postpandemic among younger women and approximately 2- to 4-fold among MSW and younger and older men. Increases were driven by urethral/vaginal infections. Coinfections increased significantly postpandemic among older women. Postpandemic gonorrhea was associated with difficulty obtaining condoms (adjusted relative risk [aRR], 2.7 [95% CI, 1.0-8.0]) and ≥2 partners (aRR, 2.6 [95% CI, 1.0-7.1]) among younger women, and iTaukei ethnicity (aRR, 4.7 [95% CI, 1.4-16.5]) and heavy alcohol use (aRR, 7.1 [95% CI, 2.5-19.7]) among older women. Postpandemic chlamydia was associated with having a casual sex partner among younger (aRR, 1.7 [95% CI, 1.0-2.9]) and older (aRR, 1.9 [95% CI, 1.1-3.4]) women and with being unmarried (aRR, 1.7 [95% CI, 1.0-2.7]). iTaukei men had increased risk postpandemic for gonorrhea (aRR, 3.7 [95% CI, 1.3-10.6]) and chlamydia (aRR, 2.5 [95% CI, 1.3-4.9]). More than 50% of infected participants did not meet syndromic treatment criteria and would have remained untreated. Conclusions: Postpandemic increases in gonorrhea and chlamydia-with risk factors varying by pathogen, gender, and age-require immediate interventions to reduce infection and transmission in Fiji.

GreenMedInfo, Open forum infectious diseases

Mar 1, 2025

[Relationship between changes in lifestyle and sleep duration due to the spread of coronavirus disease (COVID-19) in older adults: A cross-sectional study].

Objectives　In response to the spread of COVID-19, a state of emergency was declared on April 7, 2020. People were asked to stay at home unless necessary, and studies conducted in Japan and other countries have investigated the impact of these restrictions on the lives and health of older adults. While some studies have focused on sleep, a crucial aspect of the health of older adults, little is known about the relationship between sleep and various lifestyle changes experienced by older adults in Japan during the COVID-19 pandemic. Herein, we aimed to investigate the factors associated with changes in sleep duration among older adults before and after the spread of COVID-19.Methods　A random sample of 1,808 men and women aged 65-84 years who lived in Fukushima City, Fukushima Prefecture, Japan was selected. A self-administered anonymous survey was mailed to the participants. Logistic regression analysis was used to identify the factors associated with decreased sleep duration compared to the COVID-19 pre-pandemic. Factors such as basic attributes, lifestyle changes compared with that during pre-pandemic period, stress levels, and involvement with the community were considered in the analysis.Results　Of the 1,808 distributed surveys, 1,305 were returned (response rate: 72.2%). After excluding participants with missing data (n＝108), 1,197 responses were included in the final analysis (valid response rate: 66.2%). Among these, 155 participants (12.9%) reported decreased sleep duration. Decreased "social activities/connectedness" (odds ratio [OR]: 2.55, 95% confidence interval [CI]: 1.54-4.22), reduced "average duration of exercise on exercise days" (OR: 2.69, 95% CI: 1.38-5.24), and self-reported "stress in the past month" (OR: 2.41, 95% CI: 1.43-4.06) were significantly associated with decreased sleep duration.Conclusion　The spread of COVID-19 was associated with decreased sleep duration among older adults. This decrease was linked to reduced social activity and participation, decreased exercise, and increased stress. To mitigate these effects, maintaining social participation and activities, scheduling regular and manageable exercise routines, and implementing effective stress management strategies while adhering to infection control practices are important.

Yamada H, Moriyama N, Okamoto N, Nakayama C, Sato K, Iwasa H, Yasumura S, [Nihon koshu eisei zasshi] Japanese journal of public health

Jan 9, 2025

Prognosis of patients with coronavirus disease with or without anosmia: A systematic review.

INTRODUCTION: According to numerous research, anosmia has been reported more frequently as one of coronavirus disease (COVID-19) symptoms. However, whether anosmia is a relevant prognostic factor of COVID-19 outcomes is still unknown. A systematic review and meta-analysis were conducted to evaluate the relationship between anosmia and COVID-19 prognosis. METHODS: PubMed, PubMed Central, Google Scholar and the WHO COVID-19 Research Database were scanned for published literature from September 2021 to December 2022 about the prognosis of patients positive for COVID-19 with anosmia. 'COVID-19' and 'prognosis' were among the search terms used. Pooled estimates of odds ratios (ORs) were then calculated by comparing patients with and without anosmia in terms of intensive care unit (ICU) admission and death. RESULTS: A total of 16 full-text articles were included in this systematic review. There were a total of 40 deaths among the patients with olfactory dysfunction and 1681 deaths among those without olfactory dysfunction, with an OR of 0.19 (95% confidence interval: 0.10, 0.34; P<0.0001), indicating that the patients with COVID-19 with olfactory dysfunction had a decreased mortality rate. CONCLUSION: The good prognosis of patients with COVID-19 with anosmia is demonstrated in our study by the low mortality rate in those with anosmia. However, there is no association between the prognosis and ICU admission among patients with COVID-19 with anosmia.

Albazah NIJ, Tiong JS, Yoshana M, Aishath A, Yeo YT, Elhariri S, Malaysian family physician : the official journal of the Academy of Family Physicians of Malaysia

Jan 1, 2025

Telogen Effluvium Following Coronavirus Disease-2019 Infection: A Retrospective Study of 113 Cases.

Background: Telogen effluvium (TE) is self limiting diffuse hair loss occurring 3-4 months after a triggering event. There is scarcity of data on TE as possible sequelae of COVID-19. Methods: We assessed 113 cases of TE occurring after SARS-CoV-2 infection as a retrospective study. Results: Most of the patients belonged to the age group 18-30 years and were females (85.8%). Most of the patients (92%) had acute TE. The median duration of hair loss was 2 months. Trichodynia and pruritus were the common associated complaints. Hair pull test was positive in 54.9% patients. Trichoscopy showed short regrowing hairs in 61.2% patients and empty hair follicles in 77.9% patients. Ferritin, vitamin D and Vitamin B12 deficiency was seen in 27.4%, 38.1% and 20.4% patients respectively. TE was seen more commonly with symptomatic COVID infection (93% patients). Conclusion: TE occurring after SARS-CoV-2 infection calls for assessment of micronutrient deficiency, as there appears to be an association between COVID-19 infection and nutritional deficiency. Although acute TE is the most common presentation, relapse in chronic TE might also occur as sequelae of COVID-19 infection.

GreenMedInfo, International journal of trichology

Jan 1, 2025

A surge in fulminant idiopathic intracranial hypertension cases within 1 year from the coronavirus disease 2019 pandemic lockdown: A case series.

PURPOSE: A surge in the number of cases of fulminant idiopathic intracranial hypertension (IIH) was observed within 1 year of the lockdown due to coronavirus disease 2019 (COVID-19) in March 2020. This study aims to describe the characteristics, outline of management, and final visual outcome for six cases diagnosed with fulminant IIH. METHODS: We reviewed the medical records of six adult patients diagnosed with fulminant IIH, between May and November 2021, based on their presentation at the University of Ottawa, Eye Institute. RESULTS: All six patients were diagnosed with fulminant IIH (five females and one male). Five out of six patients were obese and one patient was overweight. Medical treatment included the administration of acetazolamide (2-4 g/day) to all patients and intravenous methylprednisolone in four patients. Surgical treatment (optic nerve sheath fenestration) was performed for all patients. Visual function improved for three out of the six patients, two patients remained stable, and one patient got worse. CONCLUSION: There has been a recent surge in the number of cases of fulminant IIH in the COVID-19 lockdown period. The negative impact of COVID-19 on health led to an increase in weight, which is thought to have played a role in this recent increase in fulminant IIH cases. Urgent surgery, coupled with acetazolamide administration, is recommended for such patients. Patient compliance and close follow-up are recommended for early detection of relapse.

Aldhahwani B, Gupta A, Badeeb N, Jordan D, Albreiki D, Saudi journal of ophthalmology : official journal of the Saudi Ophthalmological Society

Jan 1, 2025

Exceptional heatwaves and mortality in Europe: Greater impacts since the coronavirus disease 2019 outbreak.

Record-breaking hot weather (exceptional heatwaves) has been increasingly common worldwide, posing a significant threat to human health. However, little is known about the effect of these exceptional heatwaves on mortality in Europe, especially since the coronavirus disease 2019 (COVID-19) outbreak, which converges with climate change to affect healthcare systems and human lives. We collected mortality data of 967 regions in 30 European countries over the last decade (2014-2023) from the Eurostat. A standard time-series analysis was used to estimate the effect of exceptional heatwaves by quasi-Poisson regression model, including the main effect (effect from heatwave intensity) and the added effect (effect from heatwave duration), on mortality for each region during two periods (before and since the COVID-19 outbreak). We used random effects meta-analysis to pool the mortality risk (i.e., relative risk [RR]) and burden (i.e., attributable fraction [AF]) associated with exceptional heatwaves, at the country level and for Europe as a whole. In Europe, the mortality burden attributable to main and added effects increased from 0.492% (95% CI: 0.488%-0.496%) to 1.276% (95% CI: 1.266%-1.285%) and from 0.307% (95% CI: 0.294%-0.318%) to 0.428% (95% CI: 0.407%-0.448%), respectively. Furthermore, substantial variations across countries were observed, with some countries such as France and Spain experiencing a large increase in the mortality burden attributable to exceptional heatwaves since the COVID-19 outbreak. Our findings underscore the urgent need for heat-health actions to consider the multi-effects of exceptional heatwaves amidst a warming climate.

Li Z, Fan Y, Xu Z, Ho HC, Tong S, Huang C, Bai Z, Gai Y, Cheng W, Hu J, Feng Y, Zheng H, Wang N, Ni J, Pan G, Hossain MZ, Su H, Cheng J, Environmental pollution (Barking, Essex : 1987)

Dec 15, 2024

Nebulized alteplase in coronavirus disease 2019 pneumonia: a case series.

BACKGROUND: Many patients with severe coronavirus disease 2019 pneumonia exhibit signs of microthrombosis. Previous studies discussed intravenous fibrinolytic agents as potential add-on therapy in these patients. Therefore, we propose the inhalative administration of fibrinolytics as a possible safer alternative. CASE PRESENTATION: This case series describes five white male patients, aged 51-78 years, treated with off-label inhalation of alteplase between November and December 2020. All patients suffered from severe severe acute respiratory syndrome coronavirus 2 infection with respiratory failure. Pulmonary embolism was ruled out by pulmonary angiogram in computed tomography scans, and all patients showed signs of coronavirus disease 2019 pneumonia. Four patients improved clinically, while one patient with advanced chronic diseases died due to multiple organ failure. No directly associated adverse effects were observed following inhalation of alteplase. CONCLUSION: This case series warrants further attention to investigate inhalative alteplase as an additional treatment in patients with severe coronavirus disease 2019 infection.

Milacek C, Stefan AN, Bal C, Geist M, Guttmann C, Idzko M, Antoniewicz L, Journal of medical case reports

Nov 28, 2024

Impact of the Coronavirus Disease 2019 [COVID-19] Pandemic on Post-Acute Care of Patients with Heart Failure and the Effectiveness of Vaccine Prevention.

BACKGROUND: The Heart Failure Post-Acute Care [HF-PAC] program is a specialized healthcare program aimed at providing comprehensive care and support for patients with heart failure [HF] as they transition from acute hospital settings to home. But the impact of the coronavirus disease 2019 [COVID-19] pandemic on the HF-PAC program remains unknown. Furthermore, the effects of the comprehensive COVID-19 vaccination program on these patients with HF-PAC warrants further investigation. METHODS: A total of 265 patients with acute decompensated HF were admitted to the hospital between May 2020 and October 2022. Of these, 159 patients underwent planned HF-PAC follow-up for 6 months, followed by scheduled follow-up visits every 3 months and unscheduled telephone randomized visits for at least another 6 months. RESULTS: The program completion rate was nearly 92%. COVID-19 significantly impacted patients with HF-PAC, leading to an increased mortality [13.3%] compared to before the pandemic [6.5%]. In our patient cohort, 83% had received at least 1 dose of vaccine and 61% had received > 3 doses. Of these patients with HF-PAC, 34% contracted COVID-19 infection post discharge, and 8.8% died owing to the infection. Of the mortality group, 42.9% patients were not vaccinated, and 28.6% received 1 vaccine dose, and their vaccination rate was lower than in the survival group [ = 0.01]. CONCLUSIONS: The COVID-19 pandemic had a significant impact on patients enrolled in the HF-PAC program; receiving more than 3 doses of the COVID-19 vaccine was associated with a significant reduction in mortality rates among these patients.

GreenMedInfo, Healthcare (Basel, Switzerland)

Oct 28, 2024

Coronavirus disease 2019 status and related anxiety levels in cases undergoing total laryngectomy.

OBJECTIVE: This study aimed to evaluate rate of the COVID-19 disease, its severity, mortality rate and anxiety levels in subjects who underwent total laryngectomy. METHODS: The subjects who underwent total laryngectomy were included in the study. The data were first obtained retrospectively and then a telephone survey was applied. Anxiety levels was evaluated by the Coronavirus Anxiety Scale (CAS). RESULTS: A total of 54 subjects were included in the study. Nine (16.7%) males were reported to be infected with SARS-CoV-2. Five (55%) of them were hospitalized; 2 of them (22%) were taken to intensive care units, and one subject (11%) died. Although a tendency to increase risk of COVID-19 disease in the tracheoesophageal voice prosthesis users (23.1% vs 14.63%) was observed, statistically difference was not significant. The average total CAS score was significantly higher in those who had COVID-19. CONCLUSION: The data documented that people who underwent total laryngectomy developed more frequent and more severe COVID-19 disease and had a higher mortality rate. Although no obvious variable was found, our data suggest that using a tracheoesophageal voice prosthesis may be somewhat effective. Besides, our subjects presented very low anxiety about COVID-19.

Hazir B, Kemaloğlu YK, Eker A, Düzlü M, The Journal of laryngology and otology

Sep 1, 2024

Theoretical biological activities and docking studies of new derivatives of acyclovir for the treatment of coronavirus disease 2019.

Acyclovir is an established antiviral agent. The global emergence of the coronavirus disease 2019 (COVID-19) pandemic brought forth the necessity to investigate potential therapeutic attributes of existing drugs, including acyclovir, to combat this novel virus. The primary focus of this research was to assess the theoretical bioactivities of acyclovir derivatives and to evaluate their molecular docking capacities, thereby determining their prospective application in treating COVID-19. A set of 22 ligand molecules derived from acyclovir were carefully selected for this study. Using the one-click docking technique, these derivatives underwent molecular interactions with specific proteins sourced from the Protein Data Bank, identified by IDs 1R4L, 1S49, 1AJ6, and 1PVG. The molecular docking analysis revealed that acyclovir derivatives no. 3, 5, 8, and 14 displayed the highest docking scores and could be potential candidates as therapeutic agents against COVID-19 based on these scores. Further experimental validations are essential to establish their efficacy in clinical settings.

Farhan MS, Journal of medicine and life

Sep 1, 2024

Coronavirus Disease 2019 Infections Among Emergency Health Care Personnel: Impact on Delivery of United States Emergency Medical Care, 2020.

STUDY OBJECTIVE: In the early months of the coronavirus disease 2019 (COVID-19) pandemic and before vaccine availability, there were concerns that infected emergency department (ED) health care personnel could present a threat to the delivery of emergency medical care. We examined how the pandemic affected staffing levels and whether COVID-19 positive staff were potentially infectious at work in a cohort of US ED health care personnel in 2020. METHODS: The COVID-19 Evaluation of Risks in Emergency Departments (Project COVERED) project was a multicenter prospective cohort study of US ED health care personnel conducted from May to December 2020. During surveillance, health care personnel completed weekly electronic surveys and underwent periodic serology and nasal reverse transcription polymerase chain reaction testing for SARS-CoV-2, and investigators captured weekly data on health care facility COVID-19 prevalence and health care personnel staffing. Surveys asked about symptoms, potential exposures, work attendance, personal protective equipment use, and behaviors. RESULTS: We enrolled 1,673 health care personnel who completed 29,825 person weeks of surveillance. Eighty-nine (5.3%) health care personnel documented 90 (0.3%; 95% confidence interval [CI] 0.2% to 0.4%) person weeks of missed work related to documented or concerns for COVID-19 infection. Health care personnel experienced symptoms of COVID-19 during 1,256 (4.2%) person weeks and worked at least one shift whereas symptomatic during 1,042 (83.0%) of these periods. Seventy-five (4.5%) participants tested positive for SARS-CoV-2 during the surveillance period, including 43 (57.3%) who indicated they never experienced symptoms; 74 (98.7%; 95% CI 90.7% to 99.9%) infected health care personnel worked at least one shift during the initial period of infection, and 71 (94.7%) continued working until laboratory confirmation of their infection. Physician staffing was not associated with the facility or community COVID-19 levels within any time frame studied (Kendall tau's 0.02, 0.056, and 0.081 for no shift, one-week time shift, and 2-week time shift, respectively). CONCLUSIONS: During the first wave of the pandemic, COVID-19 infections in ED health care personnel were infrequent, and the time lost from the workforce was minimal. Health care personnel frequently reported for work while infected with SARS-CoV-2 before laboratory confirmation. The ED staffing levels were poorly correlated with facility and community COVID-19 burden.

Weber KD, Mower W, Krishnadasan A, Mohr NM, Montoy JC, Rodriguez RM, Giordano PA, Eyck PT, Harland KK, Wallace K, McDonald LC, Kutty PK, Hesse EM, Talan DA, Project COVERED Emergency Department Network, Annals of emergency medicine

Jul 1, 2024