Novel Aspects of COVID-19 after a Two-Year Pandemic

A special issue of Reports (ISSN 2571-841X).

Deadline for manuscript submissions: closed (15 July 2022) | Viewed by 42474

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Guest Editor
Department of Respiratory Medicine, Sendai City Hospital, Sendai 982-8502, Miyagi, Japan
Interests: HIV; infection
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Special Issue Information

Dear Colleagues,

In these two years more than 500 million peoples have been infected with SARS-CoV2 and among them more than 5 million people have died. The latest technology has been introduced and major advantages have been made in diagnosis, treatment and prevention. In this Special Issue, we will publish novel aspects of COVID-19 after a two-year pandemic as follows.

  1. Development of diagnosis methods.
  2. Therapeutic effects of new agents.
  3. Improvements of monitoring and managements of patients.
  4. Characteristics of break-through infection.
  5. Sequelae of COVID-19 infections.
  6. Development of vaccine against COVID-19 infection.
  7. Disasters caused by COVID-19 infection.

Prof. Dr. Toshio Hattori
Dr. Yugo Ashino
Guest Editors

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Keywords

  • COVID-19
  • SARS-CoV2
  • diagnosis
  • treatment
  • prevention
  • infection
  • monitoring
  • vaccine
  • sequelae
  • characteristics

Published Papers (14 papers)

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Editorial

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3 pages, 164 KiB  
Editorial
Possibility to Open Up New Areas by COVID-19 Infection
by Toshio Hattori and Yugo Ashino
Reports 2022, 5(2), 16; https://doi.org/10.3390/reports5020016 - 22 May 2022
Viewed by 1593
Abstract
The rapid increase of COVID-19 cases has brought the number of patients to 513 million [...] Full article
(This article belongs to the Special Issue Novel Aspects of COVID-19 after a Two-Year Pandemic)

Research

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14 pages, 995 KiB  
Article
COVID-19 Outcomes in a US Cohort of Persons Living with HIV (PLWH)
by Amanda Blair Spence, Sameer Desale, Jennifer Lee, Princy Kumar, Xu Huang, Stanley Evan Cooper, Stephen Fernandez and Seble G. Kassaye
Reports 2022, 5(4), 41; https://doi.org/10.3390/reports5040041 - 9 Oct 2022
Cited by 1 | Viewed by 2128
Abstract
Reported coronavirus disease 2019 (COVID-19) outcomes in persons living with HIV (PLWH) vary across cohorts. We examined clinical characteristics and outcomes of PLWH with COVID-19 compared with a matched HIV-seronegative cohort in a mid-Atlantic US healthcare system. Multivariate logistic regression was used to [...] Read more.
Reported coronavirus disease 2019 (COVID-19) outcomes in persons living with HIV (PLWH) vary across cohorts. We examined clinical characteristics and outcomes of PLWH with COVID-19 compared with a matched HIV-seronegative cohort in a mid-Atlantic US healthcare system. Multivariate logistic regression was used to explore factors associated with hospitalization and death/mechanical ventilation among PLWH. Among 281 PLWH with COVID-19, the mean age was 51.5 (SD 12.74) years, 63% were male, 86% were Black, and 87% had a HIV viral load <200 copies/mL. Overall, 47% of PLWH versus 24% (p < 0.001) of matched HIV-seronegative individuals were hospitalized. Rates of COVID-19 associated cardiovascular and thrombotic events, AKI, and infections were similar between PLWH and HIV-seronegative individuals. Overall mortality was 6% (n = 18/281) in PLWH versus 3% (n = 33/1124) HIV-seronegative, p < 0.0001. Among admitted patients, mortality was 14% (n = 18/132) for PLWH and 13% (n = 33/269) for HIV-seronegative, p = 0.75. Among PLWH, hospitalization associated with older age aOR 1.04 (95% CI 1.01, 1.06), Medicaid insurance aOR 2.61 (95% CI 1.39, 4.97) and multimorbidity aOR 2.98 (95% CI 1.72, 5.23). Death/mechanical ventilation associated with older age aOR 1.06 (95% CI 1.01, 1.11), Medicaid insurance aOR 3.6 (95% CI 1.36, 9.74), and multimorbidity aOR 4.4 (95% CI 1.55, 15.9) in adjusted analyses. PLWH were hospitalized more frequently than the HIV-seronegative group and had a higher overall mortality rate, but once hospitalized had similar mortality rates. Older age, multimorbidity and insurance status associated with more severe outcomes among PLWH suggesting the importance of targeted interventions to mitigate the effects of modifiable inequities. Full article
(This article belongs to the Special Issue Novel Aspects of COVID-19 after a Two-Year Pandemic)
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11 pages, 5817 KiB  
Communication
Management of the COVID-19 Pandemic in Singapore from 2020 to 2021: A Revisit
by Zehuan Liao, Devika Menon, Le Zhang, Ye-Joon Lim, Wenhan Li, Xuexin Li and Yan Zhao
Reports 2022, 5(3), 35; https://doi.org/10.3390/reports5030035 - 22 Aug 2022
Cited by 3 | Viewed by 4854
Abstract
The first coronavirus disease 2019 (COVID-19) case was detected in Singapore on 23 January 2020. Over the two years, Singapore witnessed tightening and easing of policies in response to and in anticipation of new variants, stress on the healthcare sector, and new waves [...] Read more.
The first coronavirus disease 2019 (COVID-19) case was detected in Singapore on 23 January 2020. Over the two years, Singapore witnessed tightening and easing of policies in response to and in anticipation of new variants, stress on the healthcare sector, and new waves of infection. Upon confirming the reliability of the data using Benford’s analysis, the collated COVID-19 data and trends were analyzed alongside the policies between 2020 and 2021 in Singapore. Due to the proactive nature of these policies, Singapore was largely successful in reducing the imported cases that would spill over and result in community waves of infection and death. The government has taken necessary steps to support the citizens and reduce the impact of the pandemic on the economy of the country. Furthermore, there were policies that were more responsive and there are lessons to be learned from neighboring countries on their management of the pandemic. Given the endemic approach the government has adopted, the efficacy of these policies comes down to its sustainability. Since the pandemic requires frequent revisiting of these policies, Singapore’s long-term management of the pandemic (or endemic) and its impact comes down to the ability of the government to introduce sustainable policies and update these according to new developments in treatments, variants, and vaccines, bearing in mind the socioeconomic condition of the country. Full article
(This article belongs to the Special Issue Novel Aspects of COVID-19 after a Two-Year Pandemic)
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11 pages, 1196 KiB  
Article
COVID-19 Signs and Symptom Clusters in Long-Term Care Facility Residents: Data from the GeroCovid Observational Study
by Alba Malara, Marianna Noale, Angela Marie Abbatecola, Gilda Borselli, Carmine Cafariello, Stefano Fumagalli, Pietro Gareri, Enrico Mossello, Caterina Trevisan, Stefano Volpato, Fabio Monzani, Alessandra Coin, Giuseppe Bellelli, Chukwuma Okoye, Stefania Del Signore, Gianluca Zia, Raffaele Antonelli Incalzi and on behalf of the GeroCovid LTCFs Working Group
Reports 2022, 5(3), 30; https://doi.org/10.3390/reports5030030 - 21 Jul 2022
Cited by 2 | Viewed by 2073
Abstract
Background: Long-term care facility (LTCF) residents often present asymptomatic or paucisymptomatic features of SARS-CoV-2 infection. We aimed at investigating signs/symptoms, including their clustering on SARS-CoV-2 infection and mortality rates associated with SARS-CoV-2 infection in LTCF residents. Methods: This is a cohort study of [...] Read more.
Background: Long-term care facility (LTCF) residents often present asymptomatic or paucisymptomatic features of SARS-CoV-2 infection. We aimed at investigating signs/symptoms, including their clustering on SARS-CoV-2 infection and mortality rates associated with SARS-CoV-2 infection in LTCF residents. Methods: This is a cohort study of 586 aged ≥ 60 year-old residents at risk of or affected with COVID-19 enrolled in the GeroCovid LTCF network. COVID-19 signs/symptom clusters were identified using cluster analysis. Cluster analyses associated with SARS-CoV-2 infection and mortality were evaluated using logistic regression and Cox proportional hazard models. Results: Cluster 1 symptoms (delirium, fever, low-grade fever, diarrhea, anorexia, cough, increased respiratory rate, sudden deterioration in health conditions, dyspnea, oxygen saturation, and weakness) affected 39.6% of residents and were associated with PCR swab positivity (OR = 7.21, 95%CI 4.78–10.80; p < 0.001). Cluster 1 symptoms were present in deceased COVID-19 residents. Cluster 2 (increased blood pressure, sphincter incontinence) and cluster 3 (new-onset cognitive impairment) affected 20% and 19.8% of residents, respectively. Cluster 3 symptoms were associated with increased mortality (HR = 5.41, 95%CI 1.56–18.8; p = 0.008), while those of Cluster 2 were not associated with mortality (HR = 0.82, 95%CI 0.26–2.56; p = 730). Conclusions: Our study highlights that delirium, fever, and low-grade fever, alone or in clusters should be considered in identifying and predicting the prognosis of SARS-CoV-2 infection in older LTCF patients. Full article
(This article belongs to the Special Issue Novel Aspects of COVID-19 after a Two-Year Pandemic)
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12 pages, 1405 KiB  
Article
Social Determinants Contribute to Disparities in Test Positivity, Morbidity and Mortality: Data from a Multi-Ethnic Cohort of 1094 GU Cancer Patients Undergoing Assessment for COVID-19
by Rebecca A. Moorhead, Jonathan S. O’Brien, Brian D. Kelly, Devki Shukla, Damien M. Bolton, Natasha Kyprianou, Peter Wiklund, Anna Lantz, Nihal Mohamed, Heather H. Goltz, Dara J. Lundon and Ashutosh Tewari
Reports 2022, 5(3), 29; https://doi.org/10.3390/reports5030029 - 20 Jul 2022
Viewed by 1849
Abstract
Background: The COVID-19 pandemic exploits existing inequalities in the social determinants of health (SDOH) that influence disease burden and access to healthcare. The role of health behaviours and socioeconomic status in genitourinary (GU) malignancy has also been highlighted. Our aim was to evaluate [...] Read more.
Background: The COVID-19 pandemic exploits existing inequalities in the social determinants of health (SDOH) that influence disease burden and access to healthcare. The role of health behaviours and socioeconomic status in genitourinary (GU) malignancy has also been highlighted. Our aim was to evaluate predictors of patient-level and neighbourhood-level factors contributing to disparities in COVID-19 outcomes in GU cancer patients. Methods: Demographic information and co-morbidities for patients screened for COVID-19 across the Mount Sinai Health System (MSHS) up to 10 June 2020 were included. Descriptive analyses and ensemble feature selection were performed to describe the relationships between these predictors and the outcomes of positive SARS-CoV-2 RT-PCR test, COVID-19-related hospitalisation, intubation and death. Results: Out of 47,379 tested individuals, 1094 had a history of GU cancer diagnosis; of these, 192 tested positive for SARS-CoV-2. Ensemble feature selection identified social determinants including zip code, race/ethnicity, age, smoking status and English as the preferred first language—being the majority of significant predictors for each of this study’s four COVID-19-related outcomes: a positive test, hospitalisation, intubation and death. Patient and neighbourhood level SDOH including zip code/ NYC borough, age, race/ethnicity, smoking status, and English as preferred language are amongst the most significant predictors of these clinically relevant outcomes for COVID-19 patients. Conclusion: Our results highlight the importance of these SDOH and the need to integrate SDOH in patient electronic medical records (EMR) with the goal to identify at-risk groups. This study’s results have implications for COVID-19 research priorities, public health goals, and policy implementations. Full article
(This article belongs to the Special Issue Novel Aspects of COVID-19 after a Two-Year Pandemic)
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8 pages, 210 KiB  
Article
Strategies Addressing the Challenges of the COVID-19 Pandemic in Long-Term, Palliative and Hospice Care: A Qualitative Study on the Perspectives of Patients’ Family Members
by Latife Pacolli, Diana Wahidie, Ilknur Özger Erdogdu, Yüce Yilmaz-Aslan and Patrick Brzoska
Reports 2022, 5(3), 26; https://doi.org/10.3390/reports5030026 - 8 Jul 2022
Viewed by 1886
Abstract
Patients in long-term, palliative, and hospice care are at increased risk of a severe course of COVID-19. For purposes of infection control, different strategies have been implemented by the respective health care facilities, also comprising visitation and other forms of contact restrictions. The [...] Read more.
Patients in long-term, palliative, and hospice care are at increased risk of a severe course of COVID-19. For purposes of infection control, different strategies have been implemented by the respective health care facilities, also comprising visitation and other forms of contact restrictions. The aim of the present study was to examine how these strategies are perceived by family members of patients in these settings. An exploratory, qualitative approach was used to examine perceptions of policies and strategies using partially standardized guided interviews analyzed by means of a thematic approach. Interviews were conducted with 10 family members of long-term, palliative, and hospice care patients. Interviewees were between 30 and 75 years old. Because of the pandemic-related measures, respondents felt that their basic rights were restricted. Results indicate that perceptions of strategies and interventions in long-term, palliative, and hospice care facilities are particularly influenced by the opportunity to visit and the number of visitors allowed. Strict bans on visits, particularly during end-of-life care, are associated with a strong emotional burden for patients and family members alike. Aside from sufficient opportunities for visits, virtual communication technologies need to be utilized to facilitate communication between patients, families, and caregivers. Full article
(This article belongs to the Special Issue Novel Aspects of COVID-19 after a Two-Year Pandemic)
6 pages, 214 KiB  
Article
Diagnostic Accuracy of Routine Laboratory Tests for COVID-19
by Joshua Davis and Gina Gilderman
Reports 2022, 5(3), 25; https://doi.org/10.3390/reports5030025 - 22 Jun 2022
Cited by 2 | Viewed by 1875
Abstract
Objectives: COVID-19 has ravaged healthcare systems across the globe. Availability of and timely results for PCR testing have made diagnosis in the Emergency Department challenging. Therefore, we sought to determine if routine serum laboratory tests could be diagnostic of COVID-19. Methods: All patients [...] Read more.
Objectives: COVID-19 has ravaged healthcare systems across the globe. Availability of and timely results for PCR testing have made diagnosis in the Emergency Department challenging. Therefore, we sought to determine if routine serum laboratory tests could be diagnostic of COVID-19. Methods: All patients tested for COVID-19 at an academic hospital in Pennsylvania between 1 March 2020–28 April 2020, were retrospectively analyzed. Results of COVID-19 PCR testing and laboratory tests were recorded. Mean difference was used to determine which tests demonstrated a significant difference, with p < 0.01 used, due to multiple observations. The tests that met these criteria had ROC curves and sensitivity and specificity determined. Results: Of the patients identified, 553 had had any laboratory test. All tests that showed a statistically significant mean difference were lower in COVID-19 positive patients. These included white blood cell count, platelets, absolute neutrophil count, absolute lymphocyte count, absolute eosinophil count, alkaline phosphatase, albumin, troponin T, lactic acid, D-DIMER, and procalcitonin. D-Dimer was excluded for only having four tests completed in COVID-19 positive patients. The remaining tests had a specificity of 88–96%, with a sensitivity of 5–50%. Discussion: No single serum laboratory test demonstrated sensitivity for COVID-19. Some tests might be moderately specific, but this was of limited clinical use. Future research should focus on a combination of tests to diagnose COVID-19, and healthcare systems should work to obtain rapid and accurate PCR tests to diagnose COVID-19. Full article
(This article belongs to the Special Issue Novel Aspects of COVID-19 after a Two-Year Pandemic)
18 pages, 8778 KiB  
Article
Deep Learning Methods to Reveal Important X-ray Features in COVID-19 Detection: Investigation of Explainability and Feature Reproducibility
by Ioannis D. Apostolopoulos, Dimitris J. Apostolopoulos and Nikolaos D. Papathanasiou
Reports 2022, 5(2), 20; https://doi.org/10.3390/reports5020020 - 31 May 2022
Cited by 5 | Viewed by 3329
Abstract
X-ray technology has been recently employed for the detection of the lethal human coronavirus disease 2019 (COVID-19) as a timely, cheap, and helpful ancillary method for diagnosis. The scientific community evaluated deep learning methods to aid in the automatic detection of the disease, [...] Read more.
X-ray technology has been recently employed for the detection of the lethal human coronavirus disease 2019 (COVID-19) as a timely, cheap, and helpful ancillary method for diagnosis. The scientific community evaluated deep learning methods to aid in the automatic detection of the disease, utilizing publicly available small samples of X-ray images. In the majority of cases, the results demonstrate the effectiveness of deep learning and suggest valid detection of the disease from X-ray scans. However, little has been investigated regarding the actual findings of deep learning through the image process. In the present study, a large-scale dataset of pulmonary diseases, including COVID-19, was utilized for experiments, aiming to shed light on this issue. For the detection task, MobileNet (v2) was employed, which has been proven very effective in our previous works. Through analytical experiments utilizing feature visualization techniques and altering the input dataset classes, it was suggested that MobileNet (v2) discovers important image findings and not only features. It was demonstrated that MobileNet (v2) is an effective, accurate, and low-computational-cost solution for distinguishing COVID-19 from 12 various other pulmonary abnormalities and normal subjects. This study offers an analysis of image features extracted from MobileNet (v2), aiming to investigate the validity of those features and their medical importance. The pipeline can detect abnormal X-rays with an accuracy of 95.45 ± 1.54% and can distinguish COVID-19 with an accuracy of 89.88 ± 3.66%. The visualized results of the Grad-CAM algorithm provide evidence that the methodology identifies meaningful areas on the images. Finally, the detected image features were reproducible in 98% of the times after repeating the experiment for three times. Full article
(This article belongs to the Special Issue Novel Aspects of COVID-19 after a Two-Year Pandemic)
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8 pages, 1345 KiB  
Communication
Comparison of Allplex™ 2019-nCoV and TaqPath™ COVID-19 Assays
by Manuela Colosimo, Pasquale Minchella, Rossana Tallerico, Ilenia Talotta, Cinzia Peronace, Luca Gallelli, Giulio Di Mizio and Erika Cione
Reports 2022, 5(2), 14; https://doi.org/10.3390/reports5020014 - 26 Apr 2022
Cited by 3 | Viewed by 2142
Abstract
The clinical presentation of COVID-19 is non-specific, and to improve and limit the spread of the SARS-CoV-2 virus, an accurate diagnosis with a robust method is needed. A total of 500 nasopharyngeal swab specimens were tested for SARS-CoV-2. Of these, 184 samples were [...] Read more.
The clinical presentation of COVID-19 is non-specific, and to improve and limit the spread of the SARS-CoV-2 virus, an accurate diagnosis with a robust method is needed. A total of 500 nasopharyngeal swab specimens were tested for SARS-CoV-2. Of these, 184 samples were found to be positive with Allplex™ 2019-nCoV Assay, which is fully automated. All the positive samples were retested with TaqPath™ COVID-19 CE-IVD RT-PCR Kit (after this, referred to as TaqPath™ COVID-19), semi-automated. The comparison of RT-qPCR for SARS-CoV-2 genes target points shows only one target point in common, the N gene. Therefore, the N gene was used to compare both assays. We noticed different Ct values between the tests. Therefore, samples were divided into four groups depending to the Ct value results: (1) Ct < 25, (2) Ct 25–30, (3) Ct 30–35, (4) Ct > 35. TaqPath™ COVID-19 Kit reconfirmed the results obtained from Allplex™ 2019-nCoV Assay. In conclusion, both the Allplex™ 2019-nCoV assay and TaqPath™ COVID-19 tests accurately confirm the diagnosis of SARS-CoV-2 infection. Even if TaqPath™ COVID-19 has a semi-automated workflow, it does not introduce bias in the diagnostic screening of SARS-CoV-2, and it supports the indirect identification of variants of concern to undergo sequencing. Full article
(This article belongs to the Special Issue Novel Aspects of COVID-19 after a Two-Year Pandemic)
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Review

Jump to: Editorial, Research, Other

13 pages, 1066 KiB  
Review
Seminar Lessons: Infectious Diseases Associated with and Causing Disaster
by Toshio Hattori, Haorile Chagan-Yasutan, Shin Koga, Yasutake Yanagihara and Issei Tanaka
Reports 2022, 5(1), 7; https://doi.org/10.3390/reports5010007 - 28 Feb 2022
Cited by 2 | Viewed by 3476
Abstract
Disasters such as the magnitude-9 Great East Japan Earthquake occur periodically. We considered this experience while developing measures against a predicted earthquake in the Nankai Trough. This report includes a summary of 10 disastrous infectious diseases for which a countermeasures seminar was held. [...] Read more.
Disasters such as the magnitude-9 Great East Japan Earthquake occur periodically. We considered this experience while developing measures against a predicted earthquake in the Nankai Trough. This report includes a summary of 10 disastrous infectious diseases for which a countermeasures seminar was held. Thirty-five speakers from twenty-one organizations performed the lectures. Besides infectious diseases, conference topics also included disaster prevention and mitigation methods. In addition, the development of point-of-care tests, biomarkers for diagnosis, and severity assessments for infectious diseases were introduced, along with epidemics of infectious diseases affected by climate. Of the 28 pathogens that became a hot topic, 17 are viruses, and 14 out of these 17 (82%) are RNA viruses. Of the 10 seminars, the last 2 targeted only COVID-19. It was emphasized that COVID-19 is not just a disaster-related infection but a disaster itself. The first seminar on COVID-19 provided immunological and epidemiological knowledge and commentary on clinical practices. During the second COVID-19 seminar, vaccine development, virological characteristics, treatment of respiratory failure, biomarkers, and human genetic susceptibility for infectious diseases were discussed. Conducting continuous seminars is important for general infectious controls. Full article
(This article belongs to the Special Issue Novel Aspects of COVID-19 after a Two-Year Pandemic)
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Other

10 pages, 1569 KiB  
Systematic Review
Clinical Outcomes after Immunotherapies in Cancer Setting during COVID-19 Era: A Systematic Review and Meta-Regression
by Mona Kamal, Massimo Baudo, Jacinth Joseph, Yimin Geng and Aiham Qdaisat
Reports 2022, 5(3), 31; https://doi.org/10.3390/reports5030031 - 25 Jul 2022
Viewed by 1837
Abstract
Background: This study aims to describe COVID-19–related clinical outcomes after immunotherapies (ICIs) for cancer patients. Methods: In this meta-analysis, we searched databases to collect data that addressed outcomes after immunotherapies (ICIs) during the COVID-19 pandemic. The primary endpoint was COVID-19–related mortality. Secondary endpoints [...] Read more.
Background: This study aims to describe COVID-19–related clinical outcomes after immunotherapies (ICIs) for cancer patients. Methods: In this meta-analysis, we searched databases to collect data that addressed outcomes after immunotherapies (ICIs) during the COVID-19 pandemic. The primary endpoint was COVID-19–related mortality. Secondary endpoints included COVID-related hospital readmission, emergency room (ER) visits, opportunistic infections, respiratory complications, need for ventilation, and thrombo-embolic events. Pooled event rates (PERs) were calculated and a meta-regression analysis was performed. Results: A total of 262 studies were identified. Twenty-two studies with a total of forty-four patients were eligible. The PER of COVID-19–related mortality was 39.73%, while PERs of COVID-19–related ER visits, COVID-19–related pulmonary complications, and COVID-19–related ventilator needs were 40.75%, 40.41%, and 34.92%, respectively. The PER of opportunistic infections was 34.92%. The PERs of the use of antivirals, antibiotics, steroids, prophylactic anticoagulants, and convalescent plasma were 62.12%, 57.12%, 51.36%, 41.90%, and 26.48%, respectively. There was a trend toward an association between previous respiratory diseases and COVID-19–related mortality. Conclusion: The rates of COVID-19–related mortality, ER visits, pulmonary complications, need for a ventilator, and opportunistic infections are still high after ICIs during the COVID-19 pandemic. There was a trend toward an association between previous respiratory diseases and COVID-19–related mortality. Full article
(This article belongs to the Special Issue Novel Aspects of COVID-19 after a Two-Year Pandemic)
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9 pages, 1495 KiB  
Case Report
A Case of COVID-19 with Acute Exacerbation after Anti-Inflammatory Treatment
by Yugo Ashino, Yoichi Shirato, Masahiro Yaegashiwa, Satoshi Yamanouchi, Noriko Miyakawa, Kokichi Ando, Yumiko Sakurada, Haorile Chagan Yasutan and Toshio Hattori
Reports 2022, 5(2), 24; https://doi.org/10.3390/reports5020024 - 20 Jun 2022
Viewed by 2034
Abstract
A COVID-19 patient (53-year-old woman from Japan) was admitted to our hospital. She had a high fever (38.3 °C), cough, fatigue, and loss of appetite. She was a smoker and took migraine medication. A thoracic computed tomography (CT) scan showed no evidence of [...] Read more.
A COVID-19 patient (53-year-old woman from Japan) was admitted to our hospital. She had a high fever (38.3 °C), cough, fatigue, and loss of appetite. She was a smoker and took migraine medication. A thoracic computed tomography (CT) scan showed no evidence of pneumonia. She was treated with antibiotics, protease inhibitors, inhalant corticosteroids, and antivirals. Anti-interleukin-6 receptor antibody tocilizumab (TCZ 400 mg) was added on day 2. On day 4, her temperature decreased, but her vital signs suddenly worsened, with an SpO2 of 70% in ambient air, a blood pressure of 70 mmHg (systolic), loss of consciousness, and tachypnea. Her CT showed bilateral lung consolidation and no pulmonary embolism. She was connected to the ventilator. On day 11, her respiratory condition improved (PaO2/FIO2 400), and she was able to withdraw from the ventilator. Her laboratory data (white cell count, ferritin, d-Dimer, C-reactive protein, and β2-microglobulin) did not increase even at the time of exacerbation, except for Galectin-9 (Gal-9). The plasma Gal-9 levels increased 2.3 times from before the administration of TCZ, followed by a swift decrease associated with improvements in respiratory status. She was discharged on day 16. Patients with TCZ-treated COVID-19 require careful observation. Full article
(This article belongs to the Special Issue Novel Aspects of COVID-19 after a Two-Year Pandemic)
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20 pages, 1779 KiB  
Perspective
Neuronal and Non-Neuronal GABA in COVID-19: Relevance for Psychiatry
by Adonis Sfera, Karina G. Thomas, Sarvin Sasannia, Jonathan J. Anton, Christina V. Andronescu, Michael Garcia, Dan O. Sfera, Michael A. Cummings and Zisis Kozlakidis
Reports 2022, 5(2), 22; https://doi.org/10.3390/reports5020022 - 8 Jun 2022
Cited by 4 | Viewed by 9307
Abstract
Infection with SARS-CoV-2, the causative agent of the COVID-19 pandemic, originated in China and quickly spread across the globe. Despite tremendous economic and healthcare devastation, research on this virus has contributed to a better understanding of numerous molecular pathways, including those involving γ-aminobutyric [...] Read more.
Infection with SARS-CoV-2, the causative agent of the COVID-19 pandemic, originated in China and quickly spread across the globe. Despite tremendous economic and healthcare devastation, research on this virus has contributed to a better understanding of numerous molecular pathways, including those involving γ-aminobutyric acid (GABA), that will positively impact medical science, including neuropsychiatry, in the post-pandemic era. SARS-CoV-2 primarily enters the host cells through the renin–angiotensin system’s component named angiotensin-converting enzyme-2 (ACE-2). Among its many functions, this protein upregulates GABA, protecting not only the central nervous system but also the endothelia, the pancreas, and the gut microbiota. SARS-CoV-2 binding to ACE-2 usurps the neuronal and non-neuronal GABAergic systems, contributing to the high comorbidity of neuropsychiatric illness with gut dysbiosis and endothelial and metabolic dysfunctions. In this perspective article, we take a closer look at the pathology emerging from the viral hijacking of non-neuronal GABA and summarize potential interventions for restoring these systems. Full article
(This article belongs to the Special Issue Novel Aspects of COVID-19 after a Two-Year Pandemic)
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5 pages, 1202 KiB  
Case Report
Spontaneous Post-COVID-19 Pneumothorax in a Patient with No Prior Respiratory Tract Pathology: A Case Report
by Vladimir Grigorov, Mladen Grigorov, Evgeni Grigorov and Hristina Nocheva
Reports 2022, 5(1), 11; https://doi.org/10.3390/reports5010011 - 21 Mar 2022
Cited by 1 | Viewed by 2515
Abstract
Spontaneous pneumothorax in the setting of coronavirus disease 19 (COVID-19) has been first described as an unlikely complication, mainly occurring in critically ill patients or as a consequence of mechanical ventilation. We report a case with COVID-19 pneumonia followed by a spontaneous pneumothorax [...] Read more.
Spontaneous pneumothorax in the setting of coronavirus disease 19 (COVID-19) has been first described as an unlikely complication, mainly occurring in critically ill patients or as a consequence of mechanical ventilation. We report a case with COVID-19 pneumonia followed by a spontaneous pneumothorax in a young non-smoker without any predisposing pathology. Full article
(This article belongs to the Special Issue Novel Aspects of COVID-19 after a Two-Year Pandemic)
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