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Background: Understanding COVID-19's impact on children is vital for public health policy, yet age-specific data is scarce, especially in Uganda. This study examines SARS-CoV-2 seroprevalence and risk factors among Ugandan children at two timepoints, along with COVID-19-related knowledge and practices in households, including adult vaccination status. Methods: Baseline surveys were conducted in 12 communities from April to May 2021 (post-Alpha wave) and follow-up surveys in 32 communities from November 2021 to March 2022 (Omicron wave). Household questionnaires and blood samples were collected to test for malaria by microscopy and for SARS-CoV-2 using a Luminex assay. Seroprevalence was estimated at both the survey and community level. Mixed-effects logistic regression models assessed the association between individual and household factors and SARS-CoV-2 seropositivity in children, adjusting for household clustering. Results: More households reported disruptions in daily life at baseline compared to follow-up, though economic impacts lingered. By the follow-up survey, 52.7% of adults had received at least one COVID-19 vaccine dose. Overall seroprevalence in children was higher at follow-up compared to baseline (71.6% versus 19.2%, p < 0.001). Seroprevalence in children ranged across communities from 6-37% at baseline and 50-90% at follow-up. At baseline, children from the poorest households were more likely to be infected. Increasing age remained the only consistent risk factor for SARS-CoV-2 seroconversion at both timepoints. Conclusions: Results indicate that a larger number of children were infected by the Delta and Omicron waves of COVID-19 compared to the Alpha wave. This study is the largest seroprevalence survey in children in Uganda, providing evidence that most children were infected with SARS-CoV-2 before the vaccine was widely available to pediatric populations. Pediatric infections were vastly underreported by case counts, highlighting the importance of seroprevalence surveys in assessing disease burden when testing and reporting rates are limited and many cases are mild or asymptomatic.

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BACKGROUND: Child malnutrition risk factors are globally recognized, but the specific impact of the COVID-19 pandemic on the prevalence of child malnutrition, considering socioeconomic burdens and changes in family lifestyles, remains underexplored. This study aims to identify the significance of COVID-19-related factors in relation to the prevalence of child malnutrition in Selangor, Malaysia. METHODS: Purposive sampling was employed in this pilot study to select the households with under-5 children and, a structured questionnaire was developed to gather data. Chi-squared tests, logistic regression modelling and World Health Organisation AnthroPlus software-based visualization were used for analyses. RESULTS: The present study's findings indicate that demographic and social factors, including 'Citizenship,' 'Type of House,' 'Number of Earning Members,' 'Father's Highest Educational Level,' and 'Number of Children in a Family,' have a statistically significant association with Wasting. Additionally, the mother's 'Highest Educational Level' is found to be linked to underweight prevalence. Within COVID-19 factors, "COVID-19 Impact on Employment/Business" demonstrated significance for both stunting and wasting. Multivariate analysis revealed disparities in childhood malnutrition by gender, age, and factors such as "COVID-19 impact on children's physical activity" and "COVID-19 impact on children's decrease in health over the last two weeks." CONCLUSIONS: This study identified COVID-19 factors alongside sociodemographic variables with statistically significant relationships impacting childhood malnutrition in Selangor, Malaysia. The results underscored the substantial influence of the COVID-19 pandemic on child malnutrition prevalence. Decision-makers at family and community levels can benefit by considering these factors in their actions. However, the study's limitation lay in its dataset, urging larger-scale analyses to explore further sub-categories of the examined variables.

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Elevated C-reactive protein (CRP) levels have been associated with poorer COVID-19 outcomes. While baseline CRP levels are higher in women, obese individuals, and older adults, the relationship between CRP, sex, body mass index (BMI), age, and COVID-19 outcomes remains unknown. To investigate, we performed a retrospective analysis on 824 adult patients with COVID-19 admitted during the first pandemic wave, of whom 183 (22.2%) died. The maximum CRP value over the first five hospitalization days better predicted hospitalization outcome than the CRP level at admission, as a maximum CRP > 10 mg/dL independently quadrupled the risk of death (p < 0.001). Males (p < 0.001) and patients with a higher BMI (p = 0.001) had higher maximum CRP values, yet CRP levels did not impact their hospitalization outcome. While CRP levels did not statistically mediate any relation between sex, age, or BMI with clinical outcomes, age impacted the association between BMI and the risk of death. For patients 60 or over, a BMI < 25 kg/m2 increased the risk of death (p = 0.017), whereas the reverse was true for patients <60 (p = 0.030). Further impact of age on the association between BMI, CRP, and the risk of death could not be assessed due to a lack of statistical power but should be further investigated.

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INTRODUCTION: Three years into the pandemic, there remains significant uncertainty about the true infection and mortality burden of COVID-19 in the World Health Organization Africa region. High quality, population-representative studies in Africa are rare and tend to be conducted in national capitals or large cities, leaving a substantial gap in our understanding of the impact of COVID-19 in rural, low-resource settings. Here, we estimated the spatio-temporal morbidity and mortality burden associated with COVID-19 in a rural health district of Madagascar until the first half of 2021. METHODS: We integrated a nested seroprevalence study within a pre-existing longitudinal cohort conducted in a representative sample of 1600 households in Ifanadiana District, Madagascar. Socio-demographic and health information was collected in combination with dried blood spots for about 6500 individuals of all ages, which were analysed to detect IgG and IgM antibodies against four specific proteins of SARS-CoV-2 in a bead-based multiplex immunoassay. We evaluated spatio-temporal patterns in COVID-19 infection history and its associations with several geographic, socio-economic and demographic factors via logistic regressions. RESULTS: Eighteen percent of people had been infected by April-June 2021, with seroprevalence increasing with individuals' age. COVID-19 primarily spread along the only paved road and in major towns during the first epidemic wave, subsequently spreading along secondary roads during the second wave to more remote areas. Wealthier individuals and those with occupations such as commerce and formal employment were at higher risk of being infected in the first wave. Adult mortality increased in 2020, particularly for older men for whom it nearly doubled up to nearly 40 deaths per 1000. Less than 10% of mortality in this period would be directly attributed to COVID-19 deaths if known infection fatality ratios are applied to observed seroprevalence in the district. CONCLUSION: Our study provides a very granular understanding on COVID-19 transmission and mortality in a rural population of sub-Saharan Africa and suggests that the disease burden in these areas may have been substantially underestimated.

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Background: At the end of 2019, the coronavirus disease 2019 (COVID-19) pandemic increased the hospital burden of COVID-19 caused by the SARS-Cov-2 and became the most significant health challenge for nations worldwide. The severity and high mortality of COVID-19 have been correlated with various demographic characteristics and clinical manifestations. Prediction of mortality rate, identification of risk factors, and classification of patients played a crucial role in managing COVID-19 patients. Our purpose was to develop machine learning (ML)-based models for the prediction of mortality and severity among patients with COVID-19. Identifying the most important predictors and unraveling their relationships by classification of patients to the low-, moderate- and high-risk groups might guide prioritizing treatment decisions and a better understanding of interactions between factors. A detailed evaluation of patient data is believed to be important since COVID-19 resurgence is underway in many countries. Results: The findings of this study revealed that the ML-based statistically inspired modification of the partial least square (SIMPLS) method could predict the in-hospital mortality among COVID-19 patients. The prediction model was developed using 19 predictors including clinical variables, comorbidities, and blood markers with moderate predictability (Q2 = 0.24) to separate survivors and non-survivors. Oxygen saturation level, loss of consciousness, and chronic kidney disease (CKD) were the top mortality predictors. Correlation analysis showed different correlation patterns among predictors for each non-survivor and survivor cohort separately. The main prediction model was verified using other ML-based analyses with a high area under the curve (AUC) (0.81-0.93) and specificity (0.94-0.99). The obtained data revealed that the mortality prediction model can be different for males and females with diverse predictors. Patients were classified into four clusters of mortality risk and identified the patients at the highest risk of mortality, which accentuated the most significant predictors correlating with mortality. Conclusion: An ML model for predicting mortality among hospitalized COVID-19 patients was developed considering the interactions between factors that may reduce the complexity of clinical decision-making processes. The most predictive factors related to patient mortality were identified by assessing and classifying patients into different groups based on their sex and mortality risk (low-, moderate-, and high-risk groups).

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Background-Previous studies on coronavirus disease 2019 (COVID-19) were limited to specific geographical locations and small sample sizes. Therefore, we used the National Inpatient Sample (NIS) 2020 database to determine the risk factors for severe outcomes and mortality in COVID-19. Methods-We included adult patients with COVID-19. Univariate and multivariate logistic regression was performed to determine the predictors of severe outcomes and mortality in COVID-19. Results-1,608,980 (95% CI 1,570,803-1,647,156) hospitalizations with COVID-19 were included. Severe complications occurred in 78.3% of COVID-19 acute respiratory distress syndrome (ARDS) and 25% of COVID-19 pneumonia patients. The mortality rate for COVID-19 ARDS was 54% and for COVID-19 pneumonia was 16.6%. On multivariate analysis, age > 65 years, male sex, government insurance or no insurance, residence in low-income areas, non-white races, stroke, chronic kidney disease, heart failure, malnutrition, primary immunodeficiency, long-term steroid/immunomodulatory use, complicated diabetes mellitus, and liver disease were associated with COVID-19 related complications and mortality. Cardiac arrest, septic shock, and intubation had the highest odds of mortality. Conclusions-Socioeconomic disparities and medical comorbidities were significant determinants of mortality in the US in the pre-vaccine era. Therefore, aggressive vaccination of high-risk patients and healthcare policies to address socioeconomic disparities are necessary to reduce death rates in future pandemics.

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Background and Objectives: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection represents a pathology with primary pulmonary involvement and multisystemic impact, including cardiovascular injuries. The present study aimed to assess the value of clinical, biochemical, and imaging factors in COVID-19 patients in determining the severity of myocardial involvement, and to create a model that can be used toevaluate myocardial injury risk based on clinical, biochemical and imaging factors. Materials and Methods: We performed an observational cohort study on 150 consecutive patients, evaluating their age, sex, hospitalization period, peripheral oxygen saturation (SpO2) in ambient air, systolic and diastolic blood pressure, heart rate, respiratory rate, biochemical markers of cardiac dysfunction (TnI, and NT-proBNP), inflammatory markers (C reactive protein (CRP), fibrinogen, serum ferritin, interleukin-6 (IL-6), tumor necrosis factor alpha (TNFα)), D-dimers, lactate dehydrogenase (LDH), myoglobin and radio-imaging parameters. All patients underwent computerized tomography chest scan in the first two days following admission. Results: We observed elevated heart and respiratory rates, higher systolic blood pressure, and a lower diastolic blood pressure in the patients with cardiac injury; significant differences between groups were registered in TnI, NT-proBNP, LDH, CRP, and D-dimers. For the radiological parameters, we found proportional correlations with the myocardial injury for the severity of lung disease, number of pulmonary segments with alveolar consolidation, number of pulmonary lobes with pneumonia, crazy paving pattern, type of lung involvement, the extent of fibroatelectatic lesions and the mediastinal adenopathies. Conclusions: Myocardial injury occurred in 12% of patients in the study group. Ground glass opacities, interstitial interlobular septal thickening (crazy paving pattern), fibroatelectasic lesions and alveolar consolidations on CT scan were correlated with myocardial injury. Routine lung sectional imaging along with non-specific biomarkers (LDH, D-dimers, and CRP) can be further valuable in the characterization of the disease burden, thus impacting patient care.

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Introducción. Introducción. La pandemia por SARS-CoV-2 en pediatría ha tenido un bajo impacto en niños y niñas adolescentes (NNA) debido a que un gran porcentaje son asintomáticos o desarrollan síntomas leves. No obstante, se han reportado casos de síndrome inflamatorio multisistémico pediátrico (SIM) por este virus, el cual afecta a múltiples órganos y sus manifestaciones se asemejan a la enfermedad de Kawasaki. La mayoría ha requerido hospitalización en unidades críticas (UCI). A pesar de la vigilancia epidemiológica de esta enfermedad, no se han reportado factores de riesgo (FR) para hospitalización. Objetivo. Explorar en la literatura los FR asociados a hospitalización en camas básicas y críticas de NNA con SIM relacionado a COVID-19. Métodos. Revisión sistemática exploratoria de bases de datos Pubmed, Epistemonikos, Lilacs y Scielo desde el año 2020, con un rango etario de 0 a 19 años, con estrategia de búsqueda sensible para FR de hospitalización en camas básicas y críticas por SIM. Resultados. De 84 artículos se seleccionaron 7. Las manifestaciones clínicas incluyeron fiebre persistente, síntomas gastrointestinales y parámetros inflamatorios severos. También se reporta asociación a comorbilidades y estrato socioeconómico bajo. El ingreso mediano a UCI fue de un 60%, y la mortalidad por SIM fue menor a un 2%, pero de mayor magnitud comparado con los ingresos por COVID-19 en este grupo etario. Los FR de ingreso a UCI fueron asociados a dolor abdominal [OR 1,7 (IC95% 1,2; 2,7)] y a mayor edad, con OR ajustado de 1,9 [IC95%1,4; 6] para edad de 6 a 12 años, OR ajustado de 2,6 [IC95% 1,8; 3,8] para edad de 13 a 20 años. La elevación de proteína C reactiva, troponina, ferritina, dímero D, péptido natriurético cerebral (BNP), BNP N-terminal pro tipo B o interleucina-6, y/o recuentos reducidos de plaquetas, linfocitos o albúmina se asociaron a ingreso a UCI. La etnia afroamericana se asoció a mayor ingreso a UCI con OR de 1,6 [IC95% 1,0; 2,4]. Conclusión. Los FR para hospitalización de NNA con SIM, reportados y seleccionados en la literatura, son edad sobre los 6 años, etnia afroamericana, presencia de comorbilidades y nivel socioeconómico bajo. Para el ingreso a UCI, se suma a esto, compromiso clínico respiratorio y/o gastrointestinal, y presencia de parámetros inflamatorios elevados. La mortalidad fue inferior al 2%, pero significativamente mayor que la mortalidad por infección COVID-19 exclusiva.

Background. SARS-CoV-2 pandemic in pediatrics population (children and adolescents) has low impact in due to large percent of asymptomatic or mild symptoms. However, since March 2020, cases of pediatric multisystemic inflammatory syndrome (PMIS) have been reported, which affects multiple organs and its main manifestations resemble Kawasaki disease. This group frequently required hospitalization in critical care units (ICU), and despite epidemiological surveillance of this disease, no risk factors (RF) for hospitalization of these children has been reported. Objetive. To explore RF in literature associated with pediatric hospitalization in basic and critical care beds from children and adolescents with PMIS related to COVID-19. Methodology. exploratory systematic review of Pubmed, Epistemonikos, Lilacs and Scielo databases, with limits: publication date from 2020 until now, and age range from 0 to 19 years. We made a sensitive search strategy for RF of pediatric hospitalization in basic and critical beds by PMIS. Results. clinical manifestations of hospitalized patients included persistent fever (3 to 5 days), gastrointestinal symptoms (vomiting, nausea, diarrhea and abdominal pain), and inflammatory laboratory parameters in highly ranges. It is also reported an association with presence of comorbidities and low socioeconomic status. The median admission to ICU was 60%, and mortality less than 2%, but greater magnitude compared to COVID-19 mortality. RF for ICU admission were associated with older age, with adjusted OR of 1.9 [CI95% 1.4; 6] for age 6 to 12 years, adjusted OR of 2.6 [CI95% 1.8; 3.8] for age 13 to 20 years, and abdominal pain [OR 1.7 (CI95% 1.2; 2.7)]. Among laboratory tests, elevated C-reactive protein, troponin, ferritin, D-dimer, brain natriuretic peptide (BNP), N-terminal pro-B-type BNP or interleukin-6, and/or reduced platelet, lymphocyte or albumin counts were associated with ICU admission. African-American ethnicity was also associated with higher ICU admission with OR of 1.6 [CI95% 1.0; 2.4]. Conclusion. RFs for hospitalization of children with PMIS reported and selected in the literature were: age over 6 years, Afro-American ethnicity, presence of comorbidities and low socioeconomic level. In addition to this, for ICU admission, it is reported respiratory and/or gastrointestinal clinical involvement, and elevated inflammatory parameters presence. Mortality was less than 2%, but significantly higher than mortality due to exclusive COVID-19 infection.

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Cancer patients, specifically lung cancer patients, show heightened vulnerability to severe COVID-19 outcomes. The immunological and inflammatory pathophysiological similarities between lung cancer and COVID-19-related ARDS might explain the predisposition of cancer patients to severe COVID-19, while multiple risk factors in lung cancer patients have been associated with worse COVID-19 outcomes, including smoking status, older age, etc. Recent cancer treatments have also been urgently evaluated during the pandemic as potential risk factors for severe COVID-19, with conflicting findings regarding systemic chemotherapy and radiation therapy, while other therapies were not associated with altered outcomes. Given this vulnerability of lung cancer patients for severe COVID-19, the delivery of cancer care was significantly modified during the pandemic to both proceed with cancer care and minimize SARS-CoV-2 infection risk. However, COVID-19-related delays and patients' aversion to clinical settings have led to increased diagnosis of more advanced tumors, with an expected increase in cancer mortality. Waning immunity and vaccine breakthroughs related to novel variants of concern threaten to further impede the delivery of cancer services. Cancer patients have a high risk of severe COVID-19, despite being fully vaccinated. Numerous treatments for early COVID-19 have been developed to prevent disease progression and are crucial for infected cancer patients to minimize severe COVID-19 outcomes and resume cancer care. In this literature review, we will explore the lessons learned during the COVID-19 pandemic to specifically mitigate COVID-19 treatment decisions and the clinical management of lung cancer patients.

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BACKGROUND: As vaccine supply and access remain limited in many parts of the world, understanding the duration of protection from reinfection after natural infection is important. METHODS: Distinct individuals testing positive and negative for SARS-CoV-2 between March 6, 2020, and August 31, 2020, in Kentucky, USA, were identified using the Kentucky National Electronic Disease Surveillance System. Individuals were followed for occurrence of a positive test for SARS-CoV-2 from 91 days after their initial test result through December 31, 2020. Protection from reinfection provided by a prior infection was calculated and additional analyses evaluated impact of age, sex, symptom status, long-term care facility connection, testing occurrence and frequency, and time from initial infection. RESULTS: The protective effect from prior infection was 80.3% (95% CI, 78.2%-82.2%) for those aged 20-59 years and 67.4% (95% CI, 62.8%-71.4%) for those aged ≥60 years. At 30-day time periods through 270 days (with limited exceptions), protection was estimated to be >75% for those aged 20-59 years and >65% for those aged ≥60 years. Factors associated with repeat positive testing included a connection to a long-term care facility, duration of potential exposure, and absence of symptoms during initial infection. CONCLUSIONS: Natural infection provides substantial and persistent immunologic protection for a period of several months for most individuals, although subpopulations may be at greater risk of repeat positive testing and potential poor outcomes associated with reinfection. These subgroups include individuals aged ≥60 years, residents and staff of long-term care facilities, and those who have mild or asymptomatic illness with initial infection. Continued emphasis on vaccination and infection prevention and control strategies remains critically important in reducing the risk of reinfection and associated severe outcomes for these groups.

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Coronavirus disease 2019 (COVID-19) distresses the pulmonary system causing acute respiratory distress syndrome, which might lead to death. There is no cure for COVID-19 infection. COVID-19 is a self-limited infection, and the methods that can enhance immunity are strongly required. Enhancing oxygenation is one safe and effective intervention to enhance immunity and pulmonary functions. This review deliberates the probable influences of enhancing oxygenation on immunity and other health-connected conditions in patients with COVID-19. An extensive search was conducted through Web of Science, Scopus, Medline databases, and EBSCO for the influence of enhancing oxygenation on immunity, pulmonary functions, psycho-immune hormones, and COVID-19 risk factors. This search included clinical trials and literature and systematic reviews. This search revealed that enhancing oxygenation has a strong effect on improving immunity and pulmonary functions and psycho-immune hormones. Also, enhancing oxygenation has a self-protective role counter to COVID-19 risk factors. Lastly, this search revealed the recommended safe and effective exercise protocol to enhance oxygenation in patients with COVID-19. Enhancing oxygenation should be involved in managing patients with COVID-19 because of its significant effects on immunity, pulmonary functions, and COVID-19 risk factors. A mild to moderate cycling or walking with 60%-80% Vo2max for 20-60 min performed 2-3 times per week could be a safe and effective aerobic exercise program in patients with COVID-19 to enhance their immunity and pulmonary functions.

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This paper presents the results of a new approach to discover related health and social factors during the COVID-19 pandemic. The approach leverages a knowledge graph of related concepts mined from a corpus of published evidence (PubMed) prior to the pandemic. Population trends from online searches were used to identify social determinants of health (SDoH) concepts that trended high at the outset of the pandemic from a list of SDoH topics from the World Health Organization (WHO). The trending concepts were then mapped to the knowledge graph and a subsequent analysis of the derived insights, spanning two years, was conducted. This paper suggests an approach to derive new related health and social factors that may have either played a role in, or been affected by, the onset of the global COVID-19 pandemic. In particular, our results show how, from a list of SDoH topics, Food Security, Unemployment trended the highest at the start of the pandemic. Further work is needed to continue to ascertain the validity of the derived relations in a population health context and to improve mining insights from published evidence.

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BACKGROUND: Comprehensive, nationwide data regarding Parkinson's disease (PD) hospitalizations, coronavirus disease 2019 (COVID-19) in-hospital frequency, and COVID-19-associated inpatient mortality during the first wave of the COVID-19 pandemic are not available. OBJECTIVE: To provide a nationwide analysis on hospitalized PD patients in Germany and evaluate the impact of the COVID-19 pandemic. METHODS: We conducted a cross-sectional study using an administrative claims database covering 1468 hospitals and 5,210,432 patient hospitalizations including a total of 30,872 COVID-19+ cases between January 16 and May 15, 2020. RESULTS: Compared to 2019, hospitalizations for PD transiently decreased by up to 72.7% in 2020. COVID-19 frequency was significantly higher in the population of 64,434 PD patients (693 being COVID-19+ ) than in non-PD patients (1.1% vs. 0.6%, P < 0.001), especially in subjects with advanced age (≥ 65 years). Regarding established COVID-19 risk comorbidities, COVID-19+ inpatients with PD showed higher incidences than non-PD COVID-19+ subjects, particularly hypertension and chronic kidney disease. Advanced age and male sex were significantly more frequent in COVID-19+ than in COVID-19- PD patients. The COVID-19 inpatient mortality rate was much higher in PD patients than in non-PD patients (35.4% vs. 20.7%, P < 0.001), especially in patients aged 75-79 years. Of note, overall inpatient mortality of PD patients was significantly higher in 2020 than in 2019 (5.7% vs. 4.9%, P < 0.001). CONCLUSIONS: PD inpatients are more frequently affected by COVID-19 and suffer from increased COVID-19-associated mortality in comparison to non-PD patients. More comprehensive studies are needed to assess the significance of associated comorbidities for COVID-19 risk and mortality in PD. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

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Background: Women with polycystic ovary syndrome (PCOS) often have vitamin D deficiency, a known risk factor for severe COVID-19 disease. Alveolar macrophage-derived cytokines contribute to the inflammation underlying pulmonary disease in COVID-19. We sought to determine if basal macrophage activation, as a risk factor for COVID-19 infection, was present in PCOS and, if so, was further enhanced by vitamin D deficiency. Methods: A cross-sectional study in 99 PCOS and 68 control women who presented sequentially. Plasma levels of a macrophage-derived cytokine panel were determined by Slow Off-rate Modified Aptamer (SOMA)-scan plasma protein measurement. Vitamin D was measured by tandem mass spectroscopy. Results: Vitamin D was lower in PCOS women (p<0.0001) and correlated negatively with body mass index (BMI) in PCOS (r=0.28, p=0.0046). Basal macrophage activation markers CXCL5, CD163 and MMP9 were elevated, whilst protective CD200 was decreased (p<0.05); changes in these variables were related to, and fully accounted for, by BMI. PCOS and control women were then stratified according to vitamin D concentration. Vitamin D deficiency was associated with decreased CD80 and IFN-γ in PCOS and IL-12 in both groups (p<0.05). These factors, important in initiating and maintaining the immune response, were again accounted for by BMI. Conclusion: Basal macrophage activation was higher in PCOS with macrophage changes related with increased infection risk associating with vitamin D; all changes were BMI dependent, suggesting that obese PCOS with vitamin D deficiency may be at greater risk of more severe COVID-19 infection, but that it is obesity-related rather than an independent PCOS factor.

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BACKGROUND: The current COVID-19 outbreak is seriously affecting the lives and health of people across the globe. While gender remains a key determinant of health, attempts to address the gendered dimensions of health face complex challenges. METHODS: In a cross-sectional study 482 participants (men=237, women=245) completed questionnaires on precautionary behaviour, perceived knowledge about COVID-19 risk factors, emotional reactions toward COVID-19 and perceived susceptibility. We examined gender differences in perceived knowledge about COVID-19 risk factors, healthy behaviours, threat perceptions and emotional responses, as well as the role of gender as a moderating factor. RESULTS: Women reported higher levels of precautionary behaviour (t(475)=3.91, p<0.001) and more negative emotional reactions toward COVID-19 (t(475)=6.07, p<0.001). No gender differences emerged in perceived susceptibility or knowledge about COVID-19. The multiple regression model is significant and explains 30% of the variance in precautionary behaviour, which was found to be higher among women and older participants, those with higher perceived knowledge about COVID-19 risk factors and those with higher emotional reactions. Gender exhibited a significant moderating role in the relationship between perceived knowledge and precautionary behaviour (B=0.16, SE=0.07, ß=0.13, p=0.02, 95% CI 0.03 to 0.30). CONCLUSION: Women exhibited higher levels of precautionary behaviour and emotional responses.

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Background: Longitudinal studies are crucial for identifying potential risk factors for infection with, and consequences of, COVID-19, but relationships can be biased if they are associated with invitation and response to data collection. We describe factors relating to questionnaire invitation and response in COVID-19 questionnaire data collection in a multigenerational birth cohort (the Avon Longitudinal Study of Parents and Children, ALSPAC). Methods: We analysed online questionnaires completed between the beginning of the pandemic and easing of the first UK lockdown by participants with valid email addresses who had not actively disengaged from the study. We assessed associations of pre-pandemic sociodemographic, behavioural, anthropometric and health-related factors with: i) being sent a questionnaire; ii) returning a questionnaire; and iii) item response (for specific questions). Analyses were conducted in three cohorts: the index children born in the early 1990s (now young adults; 41 variables assessed), their mothers (35 variables) and the mothers' partners (27 variables). Results: Of 14,849 young adults, 41% were sent a questionnaire, of whom 57% returned one. Item response was >95%. In this cohort, 78% of factors were associated with being sent a questionnaire, 56% with returning one, and, as an example of item response, 20% with keyworker status response. For instance, children from mothers educated to degree-level had greater odds of being sent a questionnaire (OR=5.59; 95% CI=4.87-6.41), returning one (OR=1.60; 95% CI=1.31-1.95), and responding to items (e.g., keyworker status OR=1.65; 95% CI=0.88-3.04), relative to children from mothers with fewer qualifications. Invitation and response rates and associations were similar in all cohorts. Conclusions: These results highlight the importance of considering potential biases due to non-response when using longitudinal studies in COVID-19 research and interpreting results. We recommend researchers report response rates and factors associated with invitation and response in all COVID-19 observational research studies, which can inform sensitivity analyses.

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Social determinants of health (SDoH) are the factors which lie outside of the traditional health system, such as employment or access to nutritious foods, that influence health outcomes. Some efforts have focused on identifying vulnerable populations during the COVID-19 pandemic, however, both the short- and long-term social impacts of the pandemic on individuals and populations are not well understood. This paper presents a pipeline to discover health outcomes and related social factors based on trending SDoH at population-level using Google Trends. A knowledge graph was built from a corpus of research literature (PubMed) and the social determinants that trended high at the start of the pandemic were examined. This paper reports on related social and health concepts which may be impacted by the COVID-19 outbreak and may be important to monitor as the pandemic evolves. The proposed pipeline should have wider applicability in surfacing related social or clinical characteristics of interest, outbreak surveillance, or to mine relations between social and health concepts that can, in turn, help inform and support citizen-centred services.

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SARS-CoV-2 infection has led to a global health crisis, and yet our understanding of the disease and potential treatment options remains limited. The infection occurs through binding of the virus with angiotensin converting enzyme 2 (ACE2) on the cell membrane. Here, we established a screening strategy to identify drugs that reduce ACE2 levels in human embryonic stem cell (hESC)-derived cardiac cells and lung organoids. Target analysis of hit compounds revealed androgen signaling as a key modulator of ACE2 levels. Treatment with antiandrogenic drugs reduced ACE2 expression and protected hESC-derived lung organoids against SARS-CoV-2 infection. Finally, clinical data on COVID-19 patients demonstrated that prostate diseases, which are linked to elevated androgen, are significant risk factors and that genetic variants that increase androgen levels are associated with higher disease severity. These findings offer insights on the mechanism of disproportionate disease susceptibility in men and identify antiandrogenic drugs as candidate therapeutics for COVID-19.

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COVID-19 is a severe infectious disease that has claimed >150,000 lives and infected millions in the United States thus far, especially the elderly population. Emerging evidence has shown the virus to cause hemorrhagic and immunologic responses, which impact all organs, including lungs, kidneys, and the brain, as well as extremities. SARS-CoV-2 also affects patients', families', and society's mental health at large. There is growing evidence of re-infection in some patients. The goal of this paper is to provide a comprehensive review of SARS-CoV-2-induced disease, its mechanism of infection, diagnostics, therapeutics, and treatment strategies, while also focusing on less attended aspects by previous studies, including nutritional support, psychological, and rehabilitation of the pandemic and its management. We performed a systematic review of >1,000 articles and included 425 references from online databases, including, PubMed, Google Scholar, and California Baptist University's library. COVID-19 patients go through acute respiratory distress syndrome, cytokine storm, acute hypercoagulable state, and autonomic dysfunction, which must be managed by a multidisciplinary team including nursing, nutrition, and rehabilitation. The elderly population and those who are suffering from Alzheimer's disease and dementia related illnesses seem to be at the higher risk. There are 28 vaccines under development, and new treatment strategies/protocols are being investigated. The future management for COVID-19 should include B-cell and T-cell immunotherapy in combination with emerging prophylaxis. The mental health and illness aspect of COVID-19 are among the most important side effects of this pandemic which requires a national plan for prevention, diagnosis and treatment.

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Objetivo: apresentar os desafios e estratégias de cuidado ao paciente diabético em serviços especializados frente à pandemia por Covid- 19. Método: Estudo de reflexão teórica sobre os desafios e estratégias do cuidado ao paciente diabético frente à pandemia. Tais reflexões surgem a partir de leituras sobre a temática, tendo como eixos orientadores, os postulados teóricos sobre o Covid-19 e o cuidado especializado ao paciente diabético, além das nossas vivências pessoais e profissionais. Resultados: Pacientes diabéticos não parecem apresentar risco aumentado de se contaminar pelo Covid-19, todavia, uma vez infectado, tem mais chances de evoluir para forma mais grave e maior risco de morte. O bom controle glicêmico pode diminuir o risco de complicações nesse grupo. Assegurar o cuidado ao paciente diabético, com exposição mínima aos serviços de saúde, tem sido um dos grandes desafios das unidades de saúde, que precisaram implementar estratégias, tais como alterações no fluxo de atendimento, triagem de risco para todos os pacientes, redução das consultas presenciais, uso obrigatório de máscara, confecção de cartilhas informativas, orientações remotas e sobre monitoramento dos níveis glicêmicos, dispensação de medicamentos sob agendamento, dentre outros. Conclusão: A complexidade da pandemia pela Covid-19 e as medidas de distanciamento social trouxeram desafios no cuidado ao paciente diabético, que variam desde a repercussão do isolamento no cotidiano desses indivíduos, a necessidade de alterações na rotina dos serviços, além da exposição e condições de trabalho dos profissionais de saúde.

Objective: to present the challenges and strategies of care for diabetic patients in specialized services in the face of the Covid- 19 pandemic. Method: Study of theoretical reflection on the challenges and strategies of care for diabetic patients in the face of the pandemic. Such reflections arise from readings on the theme, having as guiding axes, the theoretical postulates about Covid-19 and specialized care for diabetic patients, in addition to our personal and professional experiences. Results: Diabetic patients do not seem to have an increased risk of becoming infected with Covid-19, however, once infected, they are more likely to evolve to a more severe form and greater risk of death. Good glycemic control can decrease the risk of complications in this group. Ensuring the care of diabetic patients, with minimal exposure to health services, has been one of the great challenges of health units, which needed to implement strategies, such as changes in the flow of care, risk screening for all patients, reduced consultations face-to-face, mandatory use of a mask, preparation of information booklets, remote guidance and monitoring of blood glucose levels, dispensing medications on schedule, among others. Conclusion: The complexity of the Covid-19 pandemic and the measures of social distance brought challenges in the care of diabetic patients, ranging from the repercussion of isolation in the daily lives of these individuals, the need for changes in the routine of services, in addition to exposure and conditions of health professionals.

Objetivo: Presentar los desafíos y estrategias de atención médica para pacientes diabéticos en servicios especializados durante la pandemia de Covid-19. Método: Este es un estudio de reflexión teórica sobre los desafíos y estrategias de atención médica para pacientes diabéticos, basado en la literatura científica. Los ejes rectores del estudio fueron postulados teóricos sobre Covid-19 y atención especializada para pacientes diabéticos, además de experiencias personales y profesionales. Resultados: Los pacientes diabéticos no parecen tener un mayor riesgo de contaminación por Covid-19. Sin embargo, si están infectados, pueden progresar severamente y morir. Por lo tanto, un buen control glucémico puede disminuir el riesgo de complicaciones. Garantizar la atención del paciente con una exposición mínima a los servicios ha sido un desafío para las unidades de atención médica, que han implementado cambios en el flujo de atención y en la detección de riesgos, con reducción de las consultas presenciales, uso obligatório de máscaras, elaboración de folletos, orientación remota y dispensación programada de medicamentos. Conclusión: La complejidad de la pandemia de Covid-19 y las medidas de distanciamiento social trajeron desafíos para la atención médica de los pacientes diabéticos, que van desde la repercusión del aislamiento en la vida cotidiana de los pacientes y los cambios en los servicios hasta el cuidado de la exposición y las condiciones laborales de los profesionales de salud.

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