https://papers.ssrn.com/sol3/jeljour_results.cfm?form_name=journalBrowse&journal_id=3526432 MedRN Subject Matter eJournals Sat, 01 Apr 2023 02:34:51 GMT Since the outbreak of COVID-19 epidemic, it has brought a serious health and economic crisis worldwide. The present study aims to provide a relatively simple deep learning way to model, forecast, and evaluate the time evolutions of COVID-19 pandemic. We built a data self-driven echo state network (ESN) model to predict the evolution of COVID-19 time series. Specifically, the self-driven ESN was created to form the closed feedback loop through replacing the input with the output. According to the different temporal evolution trend (gentle or dramatical) of COVID-19 time series, we proposed an adaptive prediction scheme that the self-driven ESN could autonomously adapt its network parameters to data changes in order to improve prediction accuracy. The prediction results, which involved COVID-19 temporal evolutions of the multiple countries around the world, indicated the excellent prediction performances of the proposed model in comparison with some of the main AI prediction models from https://ssrn.com/abstract=4402844 BackgroundCOVID-19 pandemic exacerbates infections among health care workers, highlighting importance of prevention for these high-risk people. Vitamin D, as an immunomodulator, is thought likely to be to correlate with the inflammatory reaction.MethodsThis was a multicenter, open-label, randomized controlled trial. The study recruited 228 health care workers who tested negative PCR or antigen for COVID-19. Subjects were randomly allocated to 200, 000 IU vitamin D2 fortnightly or non-intervention at a ratio 1:1. PCR or antigen tests were taken at baseline and twice a week during the follow-up visit. The concentration of serum 25-hydroxyvitamin D (25(OH)D), C-reaction protein (CRP), complement component C1q and inflammatory cytokines (IL-1β, IFN-α, IFN-γ, TNF-α, MCP-1, IL-6, IL-8, IL-10, IL-12, IL-17A, IL-18, IL-23, and IL-33) were measured at baseline and on the thirtieth day of this trial. Subjects recorded the symptoms of COVID-19 and essential information in the electronic questionn https://ssrn.com/abstract=4401710 The zoonotic potential of SARS-CoV-2 is not established, therefore the dynamics of transmission, host range and ability to cross species barrier is not fully understood.This study evaluated the susceptibility of some animals having close contact with man to SARs-CoV-2, their potential to be reservoir for SARS-CoV-2 and subsequent transmissibility vis-a-vis man.ACE2 and SARs-CoV-2 protein sequences were retrieved from uniprotKB database.The sequences were aligned, evolutionary relatedness and subcellular location was examined for the ACE2 protein sequences. Structural, physiochemical and genetic variation analysis of the ACE2 proteins were carried out. Binding affinity of ACE2 proteins for SARs-CoV-2 spike glycoprotein were analyzed.The study revealed that the ACE2 protein for all the animal model are structurally similar but slight variation exist within their physiochemical properties. Docking of theACE2 protein with SARs-CoV-2 spike glycoprotein suggest that man along with the other https://ssrn.com/abstract=4402314 Backgrounds: Patients with Coronavirus Disease (COVID-19) often develop severe acute respiratory distress syndrome (ARDS) requiring prolonged mechanical ventilation (MV), and venovenous extracorporeal membrane oxygenation (VV ECMO). Mortality in COVID-19 patients on VV ECMO was exceptionally high; therefore, whether survival can be ameliorated should be investigated.<br><br>Methods: We collected data from 85 patients with severe ARDS who required ECMO support at the University Hospital Magdeburg from 2014 to 2021. The patients were divided into the COVID-19 group (52 patients) and the non-COVID-19 group (33 patients). Demographic and pre-, intra-, and post-ECMO data were retrospectively recorded. The parameters of mechanical ventilation, laboratory data before using ECMO, and during ECMO were compared.<br><br>Results: There was a significant difference between the two groups regarding survival: 38,5% of COVID-19 patients and 63,6% of non-COVID-19 patients survived intensive care (p = 0 https://ssrn.com/abstract=4402044 IntroductionBreakthrough infection by SARS-COV-2 virus among vaccinated individuals have been reported from all over the world and it has created substantial challenge in designing strategies to live with the virus in the post-pandemic era. Factors affecting the extent and nature of breakthrough infection are still not fully understood and those are known to vary depending on host and agent factors. Health Care Providers (HCPs), specially in hospital settings, are front-liners in combating the epidemic and, consequently, they are more vulnerable to breakthrough infection by SARS-COV-2. Like most of the countries of the world, Bangladesh went through several waves of COVID-19 and the last (3rd wave) was the widespread Omicron wave during the winter of 2022. HCPs in Bangladesh have been disproportionately affected by the virus. Under this context, the present study was undertaken to explore breakthrough infection and its host-related covariates pandemic among HCPs of a COVID dedicated ci https://ssrn.com/abstract=4402040 Background: Anticoagulant therapy has become a hallmark of treatment for critically ill COVID patients. Gastrointestinal and intracranial hemorrhage are known major complications of anticoagulation, but spontaneous hemothorax is a rare event, particularly in the absence of pre-existing structural lung disease, vascular malformations, or genetic bleeding diatheses. Herein is a case of spontaneous hemothorax following anticoagulation for microthrombi in a patient with acute hypoxic respiratory failure due to Covid pneumonia.<br><br>Case presentation: A 49 year old male with hypertension, asthma, and obesity was admitted for acute hypoxic respiratory failure due to Covid pneumonia. He was treated with dexamethasone, baricitinib, and therapeutic enoxaparin as empiric therapy for severe COVID disease. He subsequently developed a massive right hemothorax with associated hemorrhagic shock, which required initiation of massive transfusion protocol, vasopressor support and mechanical ventilatio https://ssrn.com/abstract=4401800 Background: SARS-CoV-2 emerged in late 2019 has accumulated a series of point mutations and evolved into several variants of concern (VOC), some of which are more transmissible and potentially more severe than the original strain. The most notable VOCs are Alpha, Beta, Gamma, Delta and Omicron, which have spread to various parts of the world. The study conducted in Jashore, Bangladesh aimed to investigate the effect of coinfection with Dengue virus on SARS-CoV-2 evolution and the emergence of VOC.Methods: A hospital-based COVID-19 surveillance from June to August, 2021 identified 9,453 positive patients in the surveillance area. The study enrolled 572 randomly selected COVID-19 positive patients, of which 11 (2%) had Dengue viral coinfection. Whole genome sequences of SARS-CoV-2 were analyzed and compared between coinfection positive and negative group. Additionally, we extracted 185 genome sequences from GISAID to investigate the cross-correlation function between SARS-CoV-2 mutations https://ssrn.com/abstract=4401701 Background: Both the COVID-19 pandemic and ensuing vaccine distribution campaigns have had significant health equity implications in Sub-Saharan Africa. In Ghana, the vaccine campaign included over 2.5 million doses of COVID-19 vaccines delivered using drones, or unmanned aerial vehicles (UAV), to regions both rural and urban across the country. Our aim was to evaluate the ability of UAV in transporting COVID-19 vaccines to underserved areas.Methods: In this retrospective, ecological study, we used a complete dataset of all fulfillment information for UAV-delivered vaccines in Ghana, joined with demographic, and socioeconomic data from the Ghana Statistical Service. GIS analysis and structural demographic data was used to group health facilities and distribution centers (DC) into rural and urban groups. Bivariable and multivariable regression analyses examined how vaccines were distributed across all health facilities, as well as its differential effects across rural and urban distribu https://ssrn.com/abstract=4401693 Background We previously demonstrated the safety and immunogenicity of an MF59-adjuvanted COVID-19 vaccine based on the SARS-CoV-2 spike glycoprotein stabilised in a pre-fusion conformation by a molecular clamp using HIV-1 glycoprotein 41 sequences. Here, we describe 12-month results in adults aged 18–55 years and ≥56 years.Methods Phase 1, double-blind, placebo-controlled trial conducted in Australia (July 2020–December 2021; ClinicalTrials.gov NCT04495933; active, not recruiting). Healthy adults (Part 1: 18–55 years; Part 2: ≥56 years) received two doses of placebo, 5 μg, 15 μg, or 45 μg vaccine, or one 45 μg dose of vaccine followed by placebo (Part 1 only), 28 days apart (n=216; 24 per group). Safety, humoral immunogenicity (including against virus variants), and cellular immunogenicity were assessed to day 394 (12 months after second dose). Effects of subsequent COVID-19 vaccination on humoral responses were examined.Findings All two-dose vaccine regimens were well tolerated and e https://ssrn.com/abstract=4401687 Objective: Previous studies have observed the BNT162b2 vaccine efficacy (VE) in adolescents in a short period of time, but data on the long-term effectiveness of the vaccine is sparse.<br><br>Methods: This observational study from July 2021 to June 2022 was designed to emulate a target trial. Fully vaccinated adolescents 12-15 years of age were matched to unvaccinated adolescents. Outcomes were mild (positive PCR test without hospitalization), moderate (positive PCR test with hospitalization within 30 days), or severe infection (positive PCR test with intensive therapy or death within 30 days). VE was estimated as 1-risk ratio.<br><br>Results: We compared 235 636 vaccinated adolescents with 235 636 matched unvaccinated adolescents. On mild infection, the estimated VE declined from 42.88% up to 25 days after full vaccination, to 33.86%-37.26% at 100 days and 8.85%-8.37% at 320 days. Estimated VE on moderate infection declined from 53.71% up to 25 days to 22.06%-22.73% up to 320 days. A https://ssrn.com/abstract=4399760 CT scanning has become an invaluable tool in the field of PCR. It is less expensive, faster, and more widely available than other imaging techniques, and it can provide detailed images of the internal structures of the body. Additionally, CT scans can be used to monitor the progression of diseases and conditions, and to detect the presence of certain genetic mutations or infectious agents in a sample. Therefore, CT scanning is an invaluable tool for diagnosing and monitoring a wide range of diseases and conditions. CT scanning can provide more detailed images of the internal structures of the body than other imaging techniques. For example, CT scans can detect tumors and other abnormalities in the lungs, heart, and other organs. Furthermore, CT scans can provide detailed information about the size, shape, and location of a tumor or other abnormality, which is critical for guiding treatment decisions. https://ssrn.com/abstract=4367044 Background: COVID-19 increased uncertainty for most and was especially disruptive to autistic people and their families, due in part to tendencies toward intolerance for uncertainty across this population. As such, COVID presented a natural experiment of uncertainty and its correlates in autism. Previous reports have shown associations between intolerance of uncertainty, sensory difficulty, and stress.&nbsp;<br><br>Aims: We investigated changes in sensory difficulties and stress associated with COVID-related increases in uncertainty.&nbsp;<br><br>Methods and Procedures: Primary caregivers of 47 autistic children (ages 6-15) completed online surveys containing questions about demographics, experiences, and supports received during the pandemic. Additionally, caregivers filled out measures of intolerance of uncertainty and sensory processing for both pre- and during-COVID conditions.<br><br><br>Outscomes and Results: Eighty nine percent of children had significant sensory difficulties be https://ssrn.com/abstract=4399252 In this paper, we propose a new model to describe the blood type distribution of new Coronavirus (COVID-19) cases using the Bayesian Poisson - Hidden Markov Model (BP-HMM). With the help of the GIBBS sampler; We first identify the number of hidden states fitting European (EU) and African (AF) data sets of COVID-19 cases by blood type frequencies. The study then compares the state-dependent mean of infection within and across the two geographical areas. The study findings show that the number of hidden states and rate of infection within and across the two geographical areas differ according to blood type. https://ssrn.com/abstract=4389268 BackgroundThe efficacy of three doses of mRNA vaccine against COVID-19 has been proven, but waning immunity has necessitated boosters. The antibody response and neutralizing levels reached after the fourth dose have not been adequately described for elderly recipients, particularly those not exposed to SARS-CoV-2. The ability of elderly recipients to mount a proper immune response against new variants when repeatedly vaccinated against the original variant has been questioned.MethodsThis nested case-control study evaluated the immune response to the third and fourth doses of a COVID-19 mRNA vaccine among 46 elderly residents (median age 85 years [Q1-Q3: 81; 89]) of an assisted living facility who were not previously infected with SARS-CoV-2. Serum anti-RBD IgG levels (Abbott SARS-CoV-2 IgG II Quant assay) and neutralizing capacities (spike SARS-CoV-2 pseudovirus Wuhan and Omicron BA.1 variant) were measured.FindingsAmong participants never infected by SARS-CoV-2, the mean serum IgG lev https://ssrn.com/abstract=4399153 ABSTRACTBackground. The COVID-19 pandemic had a major impact on indigenous populations. Understanding the viral dynamics within this population is essential to create targeted protection measures.Methods . A total of 204 SARS-CoV-2 positive samples collected between May 2020 and November 2021 from an indigenous area in Mato Grosso do Sul (MS), Midwestern Brazil, were screened. Samples were submitted to whole genome sequencing using the Nanopore sequencing platform. Clinical, demographic, and phylogenetic data were analyzed.Results. We found the co-circulation of six main SARS-CoV-2 lineages in the indigenous population, with the Zeta lineage being the most prevalent, followed by B.1.1 (an ancestral strain), Gamma and Delta. The estimated indigenous population mortality rate was 1.47%.Discussion. Our results revealed that multiple independent SARS-CoV-2 introduction events had occurred through time, probably due to indigenous mobility since the villages studied here are close to urban a https://ssrn.com/abstract=4399150 BackgroundThe 2021 HIV prevalence among South African adults was 18% and over 2 million people had uncontrolled HIV, posing a risk for poor COVID-19 outcomes among those co-infected. We investigated trends in COVID-19 admissions and factors associated with in-hospital COVID-19 mortality among people living with HIV (PLWH).MethodsData collected between March 5, 2020 and May 28, 2022 from the national COVID-19 hospital surveillance system, SARS-CoV-2 case linelist, and the Electronic Vaccination Data System (EVDS) were linked and analysed. Descriptive statistics were employed for admissions and mortality trends. Post-imputation random effect multivariable logistic regression models compared (a) characteristics of PLWH and HIV-uninfected individuals, and (b) factors associated with mortality among PLWH.Results Compared to HIV uninfected, PLWH were more likely to die in hospital from COVID-19 overall (adjusted Odds Ratio [aOR] 1.14; 95% Confidence Interval [CI] 1.10-1.19) and the increased https://ssrn.com/abstract=4397820 Background: Data on paediatric SARS-CoV-2 infections are limited, especially from the early pandemic period. In addition, children are not considered to be at high risk for severe outcomes of COVID-19. This systematic review with meta-analysis estimated the SAR-CoV-2 positivity rate, identified risk factors, and described the severity and mortality outcomes of SARS-CoV-2 infections in children aged ≤18 years, until December 2021, prior to the Omicron era.Methods: We searched MEDLINE, Embase, Global Health, CINAHL, China National Knowledge Infrastructure, Wanfang, CQvip, and WHO COVID-19 global literature databases for primary studies recruiting children aged ≤18 years with a confirmed diagnosis of SARS-CoV-2 infection either by molecular or antigen tests. The Joanna Briggs Institute critical appraisal tools were used to appraise the study quality. Meta-analyses using the random effects model were conducted for all outcomes except for race/ ethnicity as risk factor of SARS-CoV-2 infecti https://ssrn.com/abstract=4397814 Public health events (PHEs) have emerged as significant threats to human life and health, as well as affecting economic growth. PHEs such as COVID-19 have led people to reflect on better regular prevention and control (RPC) for PHEs. Firstly, under the background of RPC for PHEs, a neoclassical economic growth model is established from a long-term and macro perspective with the core concept of prevention and control intensity (PCI). Secondly, we obtain the equilibrium solution of the model, with the steady state and the balanced growth path analyzed. Additionally, an algorithm for optimal PCI and marginal propensity to consume (MPC) is given. Finally, the numerical simulation results demonstrate that this model has good interpretability to explore the mechanism of RPC for PHEs on economic growth, and can provide valuable guidance and policy recommendations of RPC for PHEs. https://ssrn.com/abstract=4392921 Background Due to the increased immune escape of novel SARS-CoV-2 variants, several approved neutralizing antibodies have been paused for their usage against COVID-19. Previously, we identified an antibody cocktail A8G6. When administrated by the nasal spray delivery system, A8G6 showed broad neutralizing activities against Omicron variants in COVID-19 animal models and also showed favorable safety profile in preclinical models as well as in a first-in-human trial. The aim of this study is to evaluate the real-world efficacy of A8G6 neutralizing antibody nasal spray in post-exposure prevention of COVID-19.  Methods An open-label, non-randomized, two-arm, blank-controlled, investigator-initiated trial was conducted in Chongqing, China. High-risk healthy participants (18-65 years) within 72-hour close contact to SARS-CoV-2 infected individuals were recruited and received a three-dose (1·4 mg/dose) A8G6 nasal spray treatment daily or no treatment (blank control) for seven consecutive days https://ssrn.com/abstract=4397031 COVID-19 has challenged the world’s public health and led to over 6.7 million deaths. A rapid, sensitive, and cost-effective point-of-care virus detection device is crucial to the control and surveillance of the contagious severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic. Here we demonstrate a solid phase isothermal recombinase polymerase amplification coupled CRISPR-based (spRPA-CRISPR) assay for on-chip multiplexed, sensitive and visual COVID-19 DNA detection. By targeting the SARS-CoV-2 structure protein encoded genomes, two specific genes were simultaneously detected with the control sample without cross-interaction with other sequences. The endpoint signal can be directly visualized for rapid detection of COVID-19. The amplified target sequences were immobilized on the one-pot device surface and detected using the mixed Cas12a-crRNA collateral cleavage of reporter-released fluorescent signal when specific genes were recognized. The system was tested with sampl https://ssrn.com/abstract=4396939 BackgroundIncreased paediatric Covid-19 occurrence due to the SARS-CoV-2 0micron variant raised concerns about the effectiveness of existing vaccines.MethodsIn September 2021, the Cuban Ministry of Health launched a nationwide mass paediatric immunisation campaign with the recombinant SOBERANA COVID-19 vaccines. At the end of the campaign in early December, shortly before the Omicron outbreak, 95.4% of the 2 to 18-year-old population was fully vaccinated (2 doses of conjugated SOBERANA-02 followed by a heterologous SOBERANA-Plus dose). We assessed the real-world effectiveness of the SOBERANA-02+SOBERANA-Plus scheme against symptomatic and severe SARS-CoV-2 infection during the complete course of the Omicron wave. We conducted a post vaccination case-population study using a regression discontinuity design with 24 months of age as cut-off. Vaccine effectiveness was calculated for children without previously documented SARS-CoV-2 infection.ResultsWe included 1,098,817 fully vaccinated 2- https://ssrn.com/abstract=4397049 At the end of 2019, a novel coronavirus spread around the world. The automatic detection of infected lung areas from CT images of patients with COVID-19 is essential to help doctors make accurate diagnoses and analyzes. The method based on deep learning can quickly segment the target region and has become a popular way. However, the success of most current medical images segmentation methods depend on a large number of labeled data, and performs poorly on training datasets lacking large-scale good annotation. Especially for medical images, segmentation labels usually require manual segmentation by professional doctors, which is difficult to obtain. Therefore, semi-supervised learning has become a promising solution. In order to effectively to use unlabeled data, this paper designs a method by using contrastive learning to guide CNN and Transformer to conduct consistent training. CNN and Transformer are respectively used to capture the local and global features of the image, and generat https://ssrn.com/abstract=4396473 Background:&nbsp;There is growing hesitancy among parents concerning COVID-19 vaccines. Understanding the factors driving parental hesitancy is critical to addressing the COVID-19 public health crisis. This qualitative study explored parental perspectives of COVID-19 vaccines, specifically for children ages 5-11 years, immediately after the vaccine’s authorization by the U.S. Food and Drug Administration in October 2021.<br><br>Methods:&nbsp;We conducted semi-structured interviews with a purposive sample of 15 mothers of children ages 5-11 years in Atlanta, GA, between October-December 2021. Thematic analysis was performed using NVivo 12.<br><br>Results:&nbsp;Mothers were white, college-educated, homeowners, and fully vaccinated against COVID-19. Key findings included: Lack of trust in pediatrician’s recommendations for COVID-19 vaccines, distrust in public health authorities, high risk-perception of COVID-19 vaccines, and low risk-perception of COVID-19 disease. Factors related to vac https://ssrn.com/abstract=4396166 Background: To evaluate antibody responses against the primary series of vaccination of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) vaccines in the staff and residents of Japanese geriatric intermediate care facilities.<br><br>Methods: All subjects (159 staff and 96 residents) received two doses of the BNT162b2 mRNA vaccine 3 weeks apart. Baseline data of subject were collected using a structured form. Serum samples were collected three times: before vaccination, 3 weeks after the first dose, and 4 weeks after the second dose, and anti-receptor binding domain of the spike protein of SARS-CoV-2 [anti-RBD] IgG was measured using two immunoassays.<br><br>Results: After the second dose, geometric mean titers (GMT) of anti-RBD with both the Abbott and Roche assay were significantly lower in residents than staff (2282 AU/mL vs. 8505 AU/mL, and 258 U/mL vs. 948 U/mL, respectively). Multivariate analysis of characteristics affecting antibody responses (≥1280 AU/mL for Abbott a https://ssrn.com/abstract=4396163 Background: The Centers for Disease Control and Prevention (CDC) has been a major source of information during the COVID-19 pandemic, guiding policies and practices in many aspects of life. As such, it is imperative that the information be free of errors, or, if errors are made, that they are corrected quickly. <br><br>Methods: We sought to compile instances of numerical and statistical errors made by the CDC during the COVID-19 pandemic by reviewing CDC publications, press releases, interviews, meetings, and Twitter accounts. Further, we catalogued mortality data from both the National Center for Health Statistics and the CDC COVID Data Tracker and compared reported results. <br><br>Results: We documented 25 instances when the CDC reported statistical or numerical errors. Twenty (80%) of these instances exaggerated the severity of the COVID-19 situation, 3 (12%) instances simultaneously exaggerated and downplayed the severity of the situation, one error was neutral, and one error exag https://ssrn.com/abstract=4381627 Background: During the SARS-CoV-2 pandemic, nurses of primary health care has been an important role in Spain. Even so, the data obtained in the tracing have been scarcely used to investigate the possible mechanisms of transmission. Few studies focused on community transmission, evaluating the effectiveness of individual protective measures and exposure environment.<br><br>Objective: The main aim of the study was to evaluate the association between individual protective measures and SARS-CoV-2 transmission in the community and to compare secondary attack rates in different exposure settings.Methods: A case-control study from contact tracing of SARS-CoV-2 index patients. COVID-19 contact tracing was led by nurses at the COVID-19 Coordinating Centre in Majorca (Spain). During the systematic tracing, additional information for this study was collected from the index patient (social-demographic variables, symptoms, the number of close contacts). And also the following variables from their https://ssrn.com/abstract=4395325 Assessing the health status of critically ill patients with COVID-19 and predicting their outcome are highly challenging problems and one of the reasons for poor management of ICU resources worldwide. A better pathophysiological understanding of patients’ state evolution in the ICU can enhance effective medical interventions. Therefore, there is a need to monitor and analyze the pulmonary function of a ICU patient with COVID-19 and its impact on cardiovascular and other systems. To achieve this, chest X-rays (CXRs), respiratory sounds and all the routinely monitored parameters, scores and metrics in the COVID-19 ICU were recorded from 171 ICU patients with COVID-19 from June 2020 until December 2021. Features were extracted from respiratory sounds, deep learning analysis was conducted on CXRs, and logistic regression analysis was performed on routine ICU clinical variables. Deep learning pipelines were established to classify patients’ outcomes (survival or death) at two time points (I https://ssrn.com/abstract=4395317 Background: Various SARS-CoV-2 variants of concerns (VOCs) characterized by higher transmissibility and immune evasion have emerged. Despite reduced vaccine efficacy against VOCs, currently available vaccines provide protection. Real-world evidence on the humoral immune response after booster vaccination is crucial to guide future vaccination strategies and in preparation for imminent COVID-19 waves.<br><br>Methods: This multicenter, population-based cohort study included 4,697 individuals &gt;18 years of age who received a booster vaccination. Antibody levels against SARS-CoV-2 receptor binding domain (RBD) and neutralizing antibodies against wild-type (WT) virus and Omicron variants were assessed at baseline (day of booster vaccination) and after four weeks. Safety was evaluated daily within the first week using a participant-completed electronic diary. Antibody levels were compared across different vaccination strategies, taking into account individual host factors.<br><br>Results: https://ssrn.com/abstract=4394991 In August 2021, a physician in Alabama made headlines when he refused to treat patients who had not received COVID-19 vaccinations. He stated that, while he “will not force anyone to take the vaccine, [he] also cannot continue to watch [his] patients suffer and die from an eminently preventable disease.” This Essay examines whether such a refusal to treat unvaccinated patients is legally justified and further notes what potential exceptions exist. Finally, pragmatic arguments for and against the practice are presented for consideration. https://ssrn.com/abstract=3912275 Background: COVID-19 vaccines have been essential for reducing the impact of the pandemic, nevertheless, population-based data under real-life conditions are needed to compare their effectiveness in various contexts. The objective of this study was to estimate the effectiveness of vaccines in preventing hospitalization and death from COVID-19 in Colombia under real-life conditions among people aged 18 years and older, according to sex, age, confirmed history of COVID-19 and vaccination series, including the effects of boosters. <br><br>Methods: This investigation was an observational, retrospective, population-based study based on the Colombian cohort “Esperanza” (what means hop in Spanish). A total of 14,213,409 individuals aged 18 years and older were analyzed, who were matched in a 1:1 ratio of vaccinated to unvaccinated. The study groups consisted of unvaccinated individuals, those with a complete series (CS) and individuals with a CS plus booster. The vaccinated individuals receiv https://ssrn.com/abstract=4381545 Purpose: The study aim to construct an effective model for predicting the survival period of COVID-19 patients.<br><br>Methods: Clinical data of 389 COVID-19 patients were collected from December 2022 to January 2023.&nbsp;The patients were randomly divided into training and validation cohorts in a 7:3 ratio.&nbsp;LASSO regression and multivariate Cox regression analyses were used to identify prognostic factors,and a nomogram was constructed. Nomogram was evaluated using decision curve analysis, receiver operating characteristic curve, consistency index(c-index), and calibration curve. <br><br>Results: 86 patients (22.3%) died. A new nomogram for predicting the survival was established based on age, resting oxygen saturation, Blood urea nitrogen(BUN), c-reactive protein-to-albumin ratio(CAR), and pneumonia visual score. The decision curve indicated high clinical applicability. The nomogram c-indexes in the training and validation cohorts were 0.846 and 0.81, respectively. The AUCs for https://ssrn.com/abstract=4391995 BackgroundThe current coronavirus disease 2019 (COVID-19) pandemic that is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has a significant threat to public health. Although vaccines based on the mRNA of the SARS-CoV-2 spike protein have been developed to induce both cellular and humoral immunity against SARS-CoV-2, there have been some concerns raised about the cross-reactivity of antibodies against the SARS-CoV-2 spike protein to human tissue antigens. In the present study, we aim to identify an immunogenic peptide in the SARS-CoV-2 spike protein to activate cellular immunity, particularly CD4+ helper T lymphocytes (HTLs), which are a commander of immune system.MethodsSARS-CoV-2 spike protein-derived peptides Spike448-477 and Spike489-513(N501Y) -specific HTL lines were generated by repetitive stimulation of healthy donor-derived CD4+ T-cells with each peptide. Their HLA-restrictions were addressed by using blocking antibodies against HLA and HLA-transfect https://ssrn.com/abstract=4391983 The presence of infectious viral particles in bioaerosols generated during laparoscopic surgery places surgical staff at significant risk of infection and represents a major cause of nosocomial infection. These factors contributed to the postponement and cancellation of countless surgical procedures during the early stages of the ongoing COVID-19 pandemic, causing backlogs, increased waiting times for surgical procedures and excess deaths indirectly related to the pandemic. The development and implementation of devices that effectively inactivate viral particles from bioaerosols would be beneficial in limiting or preventing the spread of infections from such bioaerosols. Here, we sought to evaluate whether electrostatic precipitation (EP) is a viable means to capture and inactivate both non-enveloped (Adenovirus) and enveloped (SARS-CoV-2 Pseudotyped Lentivirus) viral particles present in bioaerosols. We developed a closed-system model to mimic the release of bioaerosols during laparos https://ssrn.com/abstract=4381681 SummaryBackgroundChildren and young people (CYP) may experience prolonged symptoms following COVID-19, commonly termed ‘Long-COVID’. The nature of this in CYP is unclear, as are the sequalae of acute COVID-19. We aimed to systematically synthesise evidence of the long-term outcomes of COVID-19 in CYP.Methods13 databases were searched until January 2022. Inclusion criteria: Observational studies reporting outcomes occurring four-weeks or more after COVID-19 in children <18 years old. Exclusion criteria: Outcomes of Paediatric Inflammatory Multisystem Syndrome. Title, abstract and full text screening were conducted independently by two reviewers. Data extraction and risk of bias assessment was by one reviewer with independent verification. Critical appraisal tools appropriate for study type were employed. Results were narratively synthesised with meta-analysis to generate summary estimates of risk of prolonged symptoms in CYP.Findings94 studies were included. 66 recruited from hospital s https://ssrn.com/abstract=4393677 While the multifaceted social, economic, and public health impacts associated with the COVID-19 pandemic are known, little is known about its effects on non-target aquatic ecosystems and organisms. Thus, we aimed to evaluate the potential ecotoxicity of SARS-CoV-2 lysate protein (SARS.CoV2/SP02.2020.HIAE.Br) in adult zebrafish (Danio rerio) at predicted environmentally relevant concentrations (0.742 and 2.226 pg/L), by 30 days. Although our data did not show locomotor alterations or anxiety-like or/and anxiolytic-like behavior, we noticed that exposure to SARS-CoV-2 negatively affected habituation memory and social aggregation of animals in response to a potential aquatic predator (Geophagus brasiliensis). An increased frequency of erythrocyte nuclear abnormalities was also observed in animals exposed to SARS-CoV-2. Furthermore, our data suggest that such changes were associated with a redox imbalance (↑ROS, ↑H2O2, ↓SOD, and ↓CAT), cholinesterasic effect (↑AChE activity), as well as th https://ssrn.com/abstract=4381391 No abstract available. https://ssrn.com/abstract=4391498 This study performs a systematic review of studies to clarify factors of diffusion of respiratory pandemic of CoronaVirus Disease 2019 (COVID-19) and shows pros and cons of epidemiological models of prevision. Results suggest lessons learned to design effective health policies to face next pandemic diseases and mitigate negative effects in society. https://ssrn.com/abstract=4377102 Background: Disruptions in food, health, and economic systems during the COVID-19 pandemic may have adversely affected child health but such effects are poorly understood. <br><br><br>Methods: We examined the short-term effect of the pandemic on anthropometric outcomes of under-5 children in India, using data from the fifth round of the National Family Health Survey which was conducted in two phases from June 2019 to January 2020, and January 2020 to April 2021 (no data collection occurred from April to October 2020 due to a nationwide lockdown). Children surveyed after October 2020 were considered as COVID-19 affected, while those surveyed before were considered unaffected. Differences in individual, family, and community level characteristics between the two groups were mitigated by using propensity score matching methods. <br><br><br>Findings: COVID-affected children had 1.2% (95% CI: 0.4%-1.9%, p&lt;0.01) higher underweight rates, 1.2% (0.5%-1.9%, p&lt;0.01) lower wasting rates, 0. https://ssrn.com/abstract=4373480 Background: The WHO announced COVID-19 as a pandemic on 12 March 2020, and has become a major public health around the world. Objectives: The study aimed to evaluate clinical presentation and outcomes of COVID-19 cases after wide distribution of COVID vaccine. Methods: Cross sectional study, retrospective file review of the children aged less than 14 years, and confirmed by positive swab test to have COVID 19, from May 2021 to May 2022. Results: A total of 125 patients with positive tests were included in this study. Males made up 52.8% (66/125) of the population, while females made up 47.2% (59/125). The age group of 5–10 years was the most affected, with 46.2%. The common symptoms noted were fever 90.4%, followed by abdominal pain 45.6%, vomiting 44%, diarrhea 41.6%, running nose 39.2%, cough 36%, and headache 25%. Conjunctivitis (4%) and skin rash (1.6%) were the least common symptoms. Only four patients needed PICU admission. No mortality was reported in this study. Conclusions: Th https://ssrn.com/abstract=4204120 Objectives: Using self-reported vaccination record and COVID-19 infection status, this study is aimed to analyze the protection effectiveness provided by heterologous mRNA vaccine boosters during the 2022 Omicron Wave in Macao (China).Methods: Utilizing observational data collected through a representative online survey among Macao residents, this study examined whether mixed vaccination is associated with better protection from COVID-19 infection and milder symptoms if infected.Results: Compared with those having 3-dose inactivated vaccine, respondents with mixed vaccination (GGB, GGGB, GGMB, GGM, GGGM and GGMM) had significantly lower likelihood of reporting confirmed infection, or fever if infected, and shorter days testing positive. The protection effects of 3-does inactivated vaccine with 1-does mRNA (GGGM) are especially strong, being equivalent with 2 doses of mRNA with 1-dose bivalent booster (MMB0), and only weaker than 3 doses of mRNA with 1-dose bivalent booster (MMMB).Concl https://ssrn.com/abstract=4388145 Background: Olfactory dysfunction (OD) has been regarded as one of the major sequalae of SARS-CoV-2 infection. Previous studies showed the smell loss of COVID-19 patients could be lasting, one or two years after onset of the disease. It remains uncertain whether SARS-CoV-2-caused dysosmia may last for a longer time.Methods: We collected the epidemiological, demographic, clinical, and odors tests data in a multi-center group of 155 COVID-19 recovered patients and 170 healthy controls as a three-year follow-up study. We used Toyota‐Takagi (T&T) olfactometry scores system as an auxiliary diagnosis of dysosmia. We analyzed the emotional status and sleep condition of the included cases. Besides, we did correlation analysis and logistic regression of any influential factors on OD.Results: The median duration of COVID-19 from symptom onset to hospital discharge was 30 days. Only 7 cases (4.5%) still had smell loss and all of them were older than 50 years. The results showed more than 30% of t https://ssrn.com/abstract=4389596 Background: The prone position was reported in many non-ventilated hypoxemic patients with coronavirus disease 2019 (COVID-19). We aimed to investigate the effects of different prone position times on gas exchange in patients with mild to moderate COVID-19.Methods: In this cohort study, patients with a confirmed diagnosis of COVID-19-related pneumonia receiving supplemental oxygen were recruited from Taizhou Hospital, Zhejiang, China. Baseline data on the demographics, anthropometrics, and arterial blood gas were collected. The patients were helped to a prone position, and the primary outcome indicator, pulse oxygen saturation (SpO2) was measured. Clinical data were collected 30 minutes before placing the patients in the prone position and 30 minutes after returning them to the supine position. This study received Ethics Committee approval (K20230210).Findings: Between January 9 and 19, 2022, we enrolled 104 patients with mild to moderate COVID-19. There was a significant difference in https://ssrn.com/abstract=4387212 Background: Solid organ transplant recipients (SOTRs) are susceptible to severe coronavirus disease 2019 (COVID-19); however, the risk in children with SOT has not been well established. Herein, we compared the relative risk of severe COVID-19 infection between paediatric SOTRs and non-SOT children.Methods: This retrospective cohort study was performed with the newly constructed K-COV-N cohort (Korea Disease Control and Prevention Agency (KDCA)-COVID-19-National Health Insurance Service (NHIS)). Children with COVID-19 (< 18 years of age) who had undergone SOT between January 2008 and January 2022 were included. Non-SOT children with COVID-19 were selected in a ratio of 1:4 using propensity score matching. The occurrence of severe COVID-19 was evaluated between SOT and non-SOT children. Three definitions of severe COVID-19 were established: Severe I, requiring respiratory support over a high-flow nasal cannula or ≥ 6 days of hospitalisation; Severe II, requiring respiratory support with https://ssrn.com/abstract=4387208 BackgroundNon-pharmaceutical interventions to mitigate SARS-CoV-2 spread affected the circulation and illness due to other endemic respiratory pathogens early in the COVID-19 pandemic. We undertook an observational study to investigate the incidence of hospitalization for overall and selected pathogen-specific causes of lower respiratory tract infection (LRTI) during the COVID-19 pandemic and compared this with incidence in the pre-pandemic period.MethodsSurveillance data from the two public hospitals in Soweto, South Africa, serving a low-middle income black-African community for all-cause LRTI; including LRTI-associated with respiratory syncytial virus (RSV), influenza, human metapneumovirus (hMPV) and Bordetella pertussis, were analyzed for children younger than 5 years from January 1, 2015 to December 31, 2022. Incidence rates during each of the COVID-19 pandemic years (2020, 2021, and 2022) were compared with the incidence from the pre-pandemic period (2015 to 2019).FindingsCompar https://ssrn.com/abstract=4368078 BackgroundRacial and ethnic minorities have borne a disproportionate burden from COVID-19. Certain essential occupations, including food processing and farm work, employ large numbers of Hispanic migrant workers and have been shown to carry an especially high risk of infection.MethodsWe conducted an observational cohort study measuring the seroprevalence of SARS-CoV-2 and assessing risk factors for seropositivity among North Carolina (NC) food processing and farm workers and members of their households. Participants completed questionnaires and we collected blood samples and used an enzyme-linked immunosorbent assay to assess SARS-CoV-2 seropositivity. Univariate and multivariate analyses were carried out to identify risk factors associated with seropositivity, using generalized estimating equations to account for household clustering.FindingsAmong the 218 participants, 94.5% were Hispanic, and SARS-CoV-2 seropositivity was 50.0%. Most seropositive individuals did not report a history https://ssrn.com/abstract=4362126 The coronavirus disease of 2019 (COVID-19) pandemic created a variety of symptoms from mild to acute in the general population. Additional disease burden was experienced in high-risk populations, such as older adults, people with disabilities or overweight, those from racial and ethnic minority groups, and patients with cancer, chronic kidney, lung or liver disease, or diabetes. Although it is well-known that SARS-CoV-2 mostly affects the respiratory tract, studies have revealed the presence of gastrointestinal (GI) symptoms in those patients diagnosed with COVID-19. The best protection against infection is through receipt of the COVID-19 vaccine, which is associated with a low incidence of adverse events. However, there is limited research on the lesser-known side effects experienced following receipt of the COVID-19 vaccination, amongst healthy and special needs populations.This study investigated the association between the COVID-19 vaccination and, when it occurred, infection and r https://ssrn.com/abstract=4386865 Background: With the irruption of the COVID-19 pandemic, several neglected disease control strategies were suspended, probably compromising the eradication goals of numerous diseases, including schistosomiasis. Herein, we aimed to assess the impact of the COVID-19 pandemic on Schistosomiasis Control Program (PCE) actions in all endemic states of Brazil.<br><br>Methods: The PCE variables assessed were the population surveyed, number of Kato-Katz tests, positive cases of schistosomiasis and percentage of cases treated with Praziquantel between 2015 and 2021. The percentage of change was calculated to verify if there was an increase or decrease in 2020 and 2021, along with time trend analyses given by Joinpoint regression model. Additionally, spatial distribution maps were elaborated, considering the % change of each Brazilian state.<br><br>Results: A significant decrease in the population surveyed in 2020 (% change: -65.38%) and 2021 (-37.94%) was observed in Brazil. Likewise, there was https://ssrn.com/abstract=4385971 Highlights• A single Ad26.COV2.S booster given 45-75 or 90-240 days after 2 BBIBP-CorV doses was well tolerated• Robust humoral and cell-mediated immune responses were measured at day 28 in both interval groups• Humoral responses were strongest against ancestral virus, followed by delta then omicron variants• T-cell–produced IFNγ increased ≈10-fold in both groups after this heterologous booster dose https://ssrn.com/abstract=4387512 Background: Pulmonary fibrosis (PF) is a serious lung disease associated with significant morbidity. Data are scarce on the link between COVID-19 and PF. We aimed to assess the association between COVID-19 and its severity with PF.<br><br>Methods: We conducted a nested case-control study in a cohort of 2,894,801 adults without a diagnosis of PF. The underlying cohort consisted of members of the largest healthcare provider in Israel aged 18 years or older as of May 1, 2020. Subjects were followed up from cohort entry until June 30, 2022 for the occurrence of PF. Ten randomly selected controls were matched to each case of PF on age, sex and calendar time. To account for surveillance bias a lag-time of 60 days was used for ascertainment of prior COVID-19 and COVID-severity.<br><br>Results: During follow-up 1,284 patients were newly diagnosed with PF and matched with 12,840 controls. Multivariable conditional logistic-regression models showed that the OR for PF was 1.80 (95% CI, 1.47-2.19) https://ssrn.com/abstract=4385523 Background: Post COVID-19 syndrome (PCS) is a complex condition with partly substantial impact on patients’ social and professional life and overall life quality. Currently, the underlying cause(s) of PCS are unknown. Since PCS-specific symptoms could be associated with systemic alterations in tissue oxygen supply, we aimed to investigate changes in tissue oxygenation in patients with PCS.Methods: A case-control study including 30 PCS patients (66.6 % males, 48.6 ± 11.2 years, mean time after (first) acute infection: 324 days), 16 cardiologic patients (CVD) (65.5 % males, 56.7 ± 6.3 years) and 11 young healthy controls (55 % males, 28.5 ± 7.4 years) was conducted. Near infrared spectroscopy (NIRS) was used to assess changes in tissue oxygenation during an arterial occlusion protocol on the non-dominant forearm (brachioradialis, 760/850 nm, 5 Hz). The protocol included 10-min rest, a 2-min baseline measurement followed by a 3-min ischemic period (upper-arm cuff, 50 mmHg above resting sy https://ssrn.com/abstract=4385446