Since the beginning of the pandemic, SARS-CoV-2 has shown a great genomic variability, resulting in the continuous emergence of new variants that has made their global monitoring and study a priority. This work aimed to study the genomic heterogeneity, the temporal origin, the rate of viral evolution and the population dynamics of the main circulating variants (20E.EU1, Alpha and Delta) in Italy, in August 2020-January 2022 period. For phylogenetic analyses, two datasets were evaluated for each variant, the former comprising international genomes and the latter focusing on clusters containing at least 70% of Italian sequences. The international dataset showed 26 (23% Italians, 23% singleton, 54% mixed), 40 (60% mixed, 37.5% Italians, 1 singleton) and 42 (85.7% mixed, 9.5% singleton, 4.8% Italians) clusters with at least one Italian sequence, in 20E.EU1 clade, Alpha and Delta variants, respectively. International clusters presented tMRCAs between 13/06/2020-27/07/2021. R e values showed the highest level between May-June until autumn 2020 in 20E.EU1 clade. The Alpha variant showed an increase in the R e in December 2020, when the highest mean value was estimated. Delta variant presented two peaks: the first between March-May, and the second between June-July 2021. The present work highlighted a different evolutionary dynamic of studied lineages with a high concordance between epidemiological parameters estimation and phylodynamic trends suggesting that the mechanism of replacement of the SARS-CoV-2 variants must be related to a complex of factors involving the transmissibility, as well as the implementation of control measures, and the level of cross-immunization within the population.

Objective: To explore the impact of non-pharmacological interventions on inhaled allergen sensitization in children during the COVID-19 pandemic. Methods: The positive rate of inhaled allergens, allergens sIgE grade, and multiple sensitization rates before and during the pandemic were analyzed retrospectively in this study. Logistic regression analysis was used to compare the positive rate of allergens before and after the pandemic, using OR and OR 95%CI to investigate the impact of the pandemic on allergen sensitization. Results：Positive rates of d1(49.5% vs 38.5%), d2 (50.2% vs 32.2%), e2(10.1% vs 6.1%), e1(6.2% vs 1.7%), mx2(10.1% vs 2.7%), sycamore (7.2% vs 2.1%), w1(4.0% vs 1.7%),elm(3.1% vs 0.6%), w6(3.0% vs 1.7%), and u80(1.3% vs 0.5%) increased significantly during the COVID-19 pandemic. After adjusting gender, age, season and other potential influencing factors, the COVID-19 pandemic was found to be a risk factor for the positive rate of d1( OR=1.174,95%CI=1.015~1.358), d2( OR=1.301,95%CI=1.093~1.549), e2( OR=1.499,95%CI=1.280~1.756), mx2( OR=3.959,95%CI=3.358~4.446), w1( OR=1.828, 95%CI=1.353~2.470, w6( OR=1.538, 95%CI=1.123~2.106)), u80( OR=2.521, 95%CI=1.413~4.497) ( P<0.05). What’s more, d1 and d2 allergen sIgE grades increased during the COVID-19 pandemic(d1 ：X2=9.576,P<0.05；d2 ：X2=39.063,P<0.05). The proportion of multiple allergies was significantly higher than that before the pandemic, with a statistical significance ( X2=1621.815, P<0.05). Conclusion: During the COVID-19 pandemic, non-pharmacological interventions increased the positive rate of both indoor and outdoor allergens in children. The sIgE grade of dust mite allergen and multiple sensitization rate were significantly higher than those before COVID-19.

CT imaging is often used to confirm COVID-19, playing a crucial role in the diagnosis and assessment due to its high sensitivity. The purpose of this study is to investigate results of quantitative CT analysis for CT patterns in SARS-CoV-2 infected patients, and how these relate to viral load and pathophysiological states. We recruited patients who had confirmed SARS-CoV-2 infection and undergone chest CT within 24 hours of confirmation. By quantitative CT analysis, and collecting clinical data, we explored correlations between those variables. Our research included 253 patients, after screening by exclusion criteria, 171 patients were included in final cohort. The incidence of SARS-CoV-2 associated pneumonia was 74.3%. The ROC test results showed AUCs for leukomonocyte count, and virus genes were 0.703, 0.562, 0.567, and 0.582, respectively. GGO pattern in CT was correlated PaO 2/FiO 2 ratio. Multiple linear regression results indicated GGO was associated with PaO 2/FiO 2. Meanwhile, the consolidation was correlated with PaCO 2 level. Additionally, consolidation was also associated with neutrophil–lymphocyte ratio. Conclusion: Lymphocyte count may be a potential marker for predicting SARS-CoV-2 pneumonia, independent of virus load. Additionally, GGO is correlated with hypoxia, while consolidation is associated with PaCO 2 levels and inflammation, which may affect aeration in the lungs.

Background: Studies on post-COVID-19 condition (PCC) in adults have shown deterioration in pulmonary function tests (PFTs), mainly a diffusion limitation. Among pediatric population data are scarce. Aim: To characterize PFTs of children with PCC, including changes over time. Methods: A prospective longitudinal study of children with defined PCC and respiratory complaints referred to a designated multidisciplinary clinic from 11/2020 to 12/2022. Results: 184 children at a mean age of 12.4 years (SD 4.06) were included. A mild obstructive pattern was demonstrated in 19/170 (11%) at presentation, as indicated by spirometry and/or positive exercise challenge test and/or reversibility post bronchodilators- only 3 with a previous diagnosis of asthma. Lung volumes and diffusion were normal in all but one patient (1/134, 0.7%). [Exhaled nitric oxide](https://erj.ersjournals.com/content/21/1/43)  levels were elevated in 32/144 (22%). All 33 children who had repeated PFTs had normal or near-normal PFTs on following testing, including 7 (21.2%) who had mild obstructive PFTs at presentation. Multivariate analysis identified older age [OR 1.36 (95% CI:1.07-1.75)] and specific imaging findings [prominent bronchovascular markings (OR 43.28 (95% CI: 4.50-416.49)[ and hyperinflation ](OR 28.42, 95% CI: 2.18-370.84)] as significant predictors of an obstructive pattern on PFTs. Conclusion: In children with PCC and respiratory symptoms, the most common impairment was mild obstructive pattern; most of them without a history of asthma. Improvement was witnessed in long-term follow-up. As opposed to the adult population, no diffusion limitation was found. Empirical periodic inhaler therapy may be considered in children with factors associated with PFTs abnormalities.

Molnupiravir (also known as EIDD-2801/MK-4482), which is used as an antiviral drug has its mechanism of action by incorporating into the viral genome increasing errors, mismatching, and misdirecting the viral polymerase, leading to the accumulation of deleterious errors and halting viral RNA replication of SARS-CoV-2 and other RNA viruses. Our meta-analysis aims to evaluate virology profile, and adverse effects associated with the use of molnupiravir on a large patient population. Following PRISMA guidelines performed a thorough literature search of electronic and medical databases (MEDLINE and Cochrane CENTRAL) from their establishment to January 2023 without any limitations on time, language, or sample size. The random effects model was utilized to calculate the weighted mean difference (WMD) and its associated 95% confidence intervals (CIs) to pool continuous outcomes of interest. Using a random effects model, odds ratio, and accompanying 95% confidence intervals (CIs). Molnupiravir 800 mg at day 5 is significant in creating viral RNA error rate (WMD: 4.91; 95% CI; [1.19, 8.63] p=0.01; I 2=0%). (P-value for subgroup differences = 0.05). A significant outcome was reported with 400mg molnupiravir (WMD: 2.27; 95% CI; 2.27 [0.50, 4.65] p=0.02; I 2=0%). Significant outcome for mean change in SARS-COV-2 RNA viral load from baseline in nasopharyngeal sample at 800 mg molnupiravir on day 3 (WMD: -0.22; 95% CI; [-0.35,-0.08] p=0.002; I 2=0%), day 5 (WMD: -0.32; 95% CI; [-0.53,-0.11] p=0.003; I 2=24%) and overall pooled analysis (WMD: -0.17; 95% CI; [-0.29, 0.33] p=0.003; I 2=32%). Similarly for 400 mg at DAY 5 and overall analysis comparing the molnupiravir group to the placebo group, a significant reduction in viral RNA load was seen from baseline. (WMD: -0.46; 95% CI; [-0.77,-0.15] p=0.004; I 2=0%), (WMD: -0.28; 95% CI; [-0.49,-0.07] p=0.009; I 2=0%). Molnupiravir 400mg significantly reduced the incidence of death as compared to the placebo group. (RR: 0.17; 95% CI; [0.07, 0.43] p=0.0002; I 2=0%). In our meta-analysis, we conclude that molnupiravir is effective in treating SARS-COV-2 patients with respect to eliminating the virus from the host through their mechanism of action. Thereby, widely used and appropriate to treat SARS-COV-2.

The main proteases (M pro) are highly conserved cysteine-rich proteins that can be covalently modified by numerous natural and synthetic compounds. Herein, we constructed an integrative approach to efficiently discover covalent inhibitors of M pro from complex herbal matrices. This work begins with biological screening of sixty clinically used antiviral herbal medicines, among which Lonicera japonica (LJ) demonstrated the strongest anti-M pro effect (IC 50 = 37.82 μg/mL). Mass spectrometry-based chemical analysis and chemoproteomic profiling revealed that LJ extract contains at least 50 constituents, of which 22 exhibited the capability to covalently modify M pro. We subsequently verified the anti-M pro effects of these covalent binders. Gallic acid and quercetin were found to potently inhibit SARS-CoV-2 M pro in dose- and time- dependent manners, with the IC 50 values below 10 µM. The inactivation kinetics, binding affinity and binding mode of gallic acid and quercetin were further characterized by fluorescence resonance energy transfer, surface plasmon resonance, and covalent docking simulations. Overall, this study established a practical approach for efficiently discovering the covalent inhibitors of M pro from herbal medicines by integrating target-based high-throughput screening and mass spectrometry-based assays, which would greatly facilitate the discovery of key anti-viral constituents from medicinal plants.

Molecular assays from nasopharyngeal swabs are the current reference method to diagnose COVID-19. As an alternative, we evaluated the performance of the iFlash-2019-nCoV Antigen® (YHLO, Shenzhen, China), developed for SARS-CoV-2 N-antigen detection in serum samples. Specificity, determined on 50 pre-pandemic samples, was 100%. Overall sensitivity, evaluated on 40 sera from patients with RT-PCR confirmed infection, was 67.5%. However, sensitivity reached 73% in symptomatic patients, 80% in patients with high and medium nasopharyngeal (NP) viral loads (samples with Ct≤33) and, 90% in samples collected within the first week after symptoms onset. These sera were further analyzed with the COV-QUANTO® ELISA and COVID-VIRO® LFIA assays (AAZ, Boulogne-Billancourt, France). EIA Ag assays from Yhlo and AAZ had comparable performances, and both were more sensitive than the LFIA. These findings suggest that SARS-CoV-2 N-antigen detection in serum could be an alternative to PCR from NP swabs, at least early after onset of symptoms. Further studies are required to confirm these results.

Convalescent plasma samples that can be collected from individuals after the resolution of infection and vaccination are an invaluable source of neutralization antibodies against the virus. Although plaque reduction assay with replicative virus is the gold standard of analyzing neutralization potency of convalescent plasma, it is a technically demanding procedure requiring high biosafety level (BSL-3/4) laboratory and equipment. The abundance of neutralizing antibodies varies among individuals, therefore fast and reliable methods to identify neutralization potency of plasma samples are needed. In this paper, G-protein deficient vesicular stomatitis virus (VSV-ΔG) carrying a C-terminal 21 amino acid truncated severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Spike protein was generated for pseudovirus neutralization assay. We analyzed SARS-CoV-2 neutralizing potency of vaccinated human convalescent plasma samples (n=13) and plasma samples of healthy people (n=2). Human convalescent plasma samples were examined against the ancestral Wuhan strain and two SARS-CoV-2 variants (B.1.1.7, and B.1.351) using a VSV-ΔG-Sdel21 pseudovirus and Vero E6 cell line. Neutralization values against pseudotyped virus were compared to those of plaque reduction assay against authentic virus. The serum neutralizing titer of convalescent plasma measured by pseudovirus assay has a good correlation with that measured by plaque reduction assay (R 2= 0.7). The pseudovirus assay is safer and timesaving than the replicative virus-based plaque reduction assay, and has several advantages in evaluating a new vaccine, newly emergent variants, and approved vaccine efficacy against variants of concern as well as in viral fusion-focused treatment analysis that can be performed under BSL-2 conditions.

Vaccination against coronavirus disease 2019 (COVID-19) in Spain began in the year 2020, starting by groups with high exposure, including biomedical students with clinical practices. It is suggested that these students could have a lower incidence of COVID-19 than other students of the same age group due to early vaccination, different exposure, and disease awareness. A cross-sectional observational study was conducted through a questionnaire distributed in February 2022. 536 people answered the questionnaire and 53 were excluded, making 483 evaluable (320 biomedical and 163 non-biomedical), 73.71% women, 98.55% vaccinated and 52.59% never infected. 67.81% of biomedical students had clinical practices. No differences were found in the incidence between biomedical and non-biomedical students (54.06% versus 53.99%, p=0. 952); nor when classifying it specifically by periods, although there is a tendency towards significance in the third (July 2021-November 2021) period (9.20% non-biomedical and 4.38% biomedical, p=0.051). The students receiving the vaccine earlier than their age group have a lower incidence in this period (2.90% vs 8.18%, p=0.014). The booster dose reduced the incidence during period 4 (24% versus 34.4%, p=0.017). These data suggest that biomedical students are not at increased risk for COVID-19, but that early vaccination reduces the incidence of infection.

Abstract Objectives: Olfactory dysfunction can expose individuals to day-to-day safety hazards. We sought to investigate the perceptions of safety in individuals affected with olfactory dysfunction, quantify the incidence of hazardous events, and how safety scares/incidents manifest through patient stories. Methods: A survey that included questions to capture quantitative and qualitative data was created. Responses were collected from 25th February 2022 to 28th September 2022. The survey was distributed through Fifth Sense media channels and open to anyone who claimed to suffer from olfactory dysfunction. Results: Our survey collected responses from 432 individuals. The majority were female (79.6%), ages 41-70. Around a fifth (16.7%) were non-UK residents, encompassing 21 different countries. Covid-19 was the commonest cause of olfactory dysfunction (22%). Majority (85.9%) were worried about any form of safety due to their smell dysfunction. Gas, smoke and food were major concerns. Specifically, 32.2%, 14.8%, 34.5%, 18.5% of participants have experienced at least one food incident, gas incident, gas scare, and work scare, respectively. Affected individuals have taken preventative measures at home (60.2%). Conclusion: There is an unmet need in mitigating safety concerns/events for individuals with olfactory dysfunction. We suggest educating the public sector and high-risk sectors such as gas companies, and introduction of safety ‘scratch and sniff’ cards as a screening method. Regular assessment of an individual’s olfactory ability, similar to routine assessments for other sensory systems (sight, hearing) would allow proactive identification of at-risk people, and allow corrective measures to take place.

This study assesses the effects of COVID-19 control measures on the resilience of economic growth. We applied the ordinary least squares method on a sample of 11 Central African countries with daily data from 2020 to 2021. According to the results, measures to combat COVID-19 (income support, fiscal debt relief, closure of schools and workplaces, cancellation of public events, quarantine, handwashing and lockdown) decrease the ability of economic growth to withstand the COVID-19 shock and to return to equilibrium after the shock. Furthermore, the results of the mediation analysis show that the effects of COVID-19 control measures (income support and debt relief) on the resilience of economic growth is mediated by corruption. From a policy perspective, we suggest strengthening political, economic and health institutions to combat future shocks.

The diagnosis of clinically significant prostate cancer is often challenging. The 4K® score test may assist in evaluating the risk of significant malignancy and avoid biopsies in non-significant disease. The COVID-19 pandemic caused a remarkable disruption in managing patients with suspected prostate cancer. The aim of this study is to evaluate the effect of the COVID-19 pandemic on 4K ®score test results by comparing tests performed in Israel between April to July 2020 to a control group of the same period in 2019. During the COVID-19 era there were few quarantine periods in which citizens were allowed to leave their homes for specific reasons only (eg, medical consultations). Meanwhile, medical clinics were operating in limited schedule with intention to treat emergent cases only. We assumed that focusing on coping with the pandemic and its implications will decrease prostate MRI tests and prostate biopsies and as a result, there will an increase in the 4K score blood tests as well as a change in the pre-biopsies prostate risk stratification.

Background: Understanding the SARS-COV-2 reinfection rate and its potential influencing factors is essential for further improvement and development of prevention and control strategies and measures to reduce the reinfection rate of SARS-CoV-2. This study aimed to quantitatively summarize the evidence of current reinfection studies. Methods: We reviewed all English studies published up to Dec 4, 2022. Information extracted from each selected articles and quality assessment of these articles was used to evaluate the risk for bias in studies. The meta-analysis was performed to examine the rate and influencing factors of SARS-CoV-2 reinfection and protective effect of primary infection on reinfection in our study. Sources of heterogeneity were identified using a subgroup analysis defined by the minimum time interval of days to reinfection and variant strains. Results: The weighted pooled rate of reinfection for SARS-CoV-2 was 1.08% ([95% CI, 0.77%-1.52%], I2 = 100%, P < 0.001). Subgroup-analysis of the minimum time interval definition for reinfection showed that rates of reinfection are 0.71%, 0.75%, 1.46% and 1.62% in less than 90 days, 90 days, greater than 90 days, unknown groups, respectively and 0.64%,1.8%,3.08%,0.95% in Alpha, Delta, Omicron, unknown groups. The weighted pooled RR value of the protective effect of primary infection on reinfection was 0.09 ([95% CI, 0.06-0.13], I2 = 92%, P < 0.01). Conclusions: Overall, the reinfection rate of SARS-CoV-2 is relatively low and appears to be on the rise as duration from the first infection to the second infection and the novel coronavirus strain mutates.

Background Global COVID-19 vaccination programs effectively contain the fast spread of the SARS-CoV-2. Characteristic the immunity status of returned populations will favor for understanding the achievement of herd immunity and long-term management of COVID-19 in China. Methods Returning travellers were recruited from 7 quarantine stations in Guangzhou, China. The immunity statuses of participants were determined through Competitive ELISA, Micro-Neutralization Assay and Enzyme-Linked FluoroSpot Assay. Results A total of 272 subjects were involved in questionnaire survey, in which 235 (86.4%) were returning ex-patriot Chinese and 37 (13.6%) were foreigners. Blood and throat swabs specimens were collected from each of 108 returning ex-patriot Chinese. The neutralizing antibody against SARS-CoV-2 was detected in ~90% of returning ex-patriot Chinese, either in the primary or the homologous and heterologous booster vaccination group. The serum NAb titers of them were significantly decreased against SARS-CoV-2 Omicron BA.5, BF.7, BQ.1 and XBB.1 compare with prototype virus. However, memory T cell responses including specific IFN-γ and IL-2 were no differences in either group. Smoking, drinking, SARS-CoV-2 infection, COVID-19 vaccination, and the time interval between last vaccination and the sampling were independent influencing factors for NAb titers against prototype SARS-CoV-2 and variants of concerns. The dose of vaccination was the unique common influencing factor for Omicron variants. Conclusions The herd immunity was established in returning ex-patriot Chinese who exposure to the complicated infection and vaccination circumstance. Domestic residents will benefit from booster of COVID-19 vaccines either in homologous and heterologous vaccination after re-opening of China, as well as breakthrough infection.

A retrospective observational study was conducted among healthcare workers (HCWs) in a tertiary paediatric hospital. The study covered the period before and after implementation of the vaccination programme and evaluated the incidence of new SARS-CoV-2 infections in both periods. Risk factors of the new SARS-CoV-2 infection and COVID-19 vaccine effectiveness was also assessed in a real-world setting. The overall incidence of SARS-CoV-2 infections among HCWs in the study period was 19.4% with a high proportion of asymptomatic individuals (45.1%). The incidence before vaccination was 16.6% and nurses had a higher risk of infection, while physicians had a reduced risk (OR 1.80, 95% CI 1.29–2.52; and OR 0.45, 95% CI 0.30–0.68). Within two months of implementation, the programme achieved a high (88.9%) vaccination coverage in our cohort, although some disparities in vaccination rates were observed. In particular, older individuals, physicians, those working in clinical settings, and those previously uninfected were more likely to be vaccinated. The overall incidence of SARS-CoV-2 infection after vaccination deployment was 6.3% (40.0% in unvaccinated individuals and 3.2% in individuals vaccinated with at least one dose). The estimated vaccine efficacy was high (95.0%) in fully vaccinated HCWs and similar to those observed previously in clinical trials and real-world settings.

Background and Aim To assess the outcomes of children born with esophageal atresia/tracheoesophageal fistula (EA-TEF) with concomitant SARS-CoV-2 infection. Methods An international survey was circulated to the International Network of Esophageal Atresia (INoEA) members from April 2020 to May 2022. Information on demography, type of EA-TEF, co-morbidities, complications, hospitalization, and therapies administered for SARS-CoV-2 infection was collected for all patients. Results Forty-two patients from April 2020-May 2022, with a mean age of 6.8 years were reported from Argentina, Switzerland, Netherlands, Canada, France, Italy, Australia and Turkey. 34 patients (81%) had a type C, EA-TEF. 30 had respiratory comorbidities, 14 had associated cardiac malformations and 14 had a history of recurrent anastomotic stricture. Reported medications included proton-pump inhibitors (n=14), inhaled bronchodilators (n=3) and inhaled corticosteroids (n=4). Six patients (14%) were hospitalised. Three required respiratory support and one required extra-corporal membranous oxygenation. There were no deaths. Respiratory, cardiac and gastrointestinal comorbidities were not associated with increased risk of hospitalization. Concomitant medication at time of infection was associated with increased risk for hospitalization with SARS-CoV-2 infection (p=0.0035), however PPI alone was not significantly associated with increased risk for hospitalization (p=0.16). Conclusion Rates of hospitalization with SARS-CoV-2 are higher for patients with EA-TEF than the general pediatric population, with increased risk in those on medication in patients. 67% of those admitted required respiratory support. Infection likely does not represent a risk for severe respiratory complications or severe outcome.

We aimed to assess the association of household and classroom determinants with students’ school absence due to respiratory tract infections (RTI) among 253 students (4-11 years) of 20 classrooms. We collected 71 absences; RTI incidence was very high during the study period, 17.5-33.1 cases per 100 population. Having someone else at home with respiratory symptoms was the most significant epidemiological factor (OR=9.12, CI 95%=2.54-33.39), suggesting that households are crucial for the transmission of RTI to the children. A positive but not statistically significant association was observed between higher median levels of CO2 and respiratory-related absences (OR=1.2, CI 95%=0.98-1.46).

Background We used data from a prospective cohort to explore two-year trajectories of “long COVID” (persistent symptoms after SARS-CoV-2 infection) and their association with illness perception. Methods RECoVERED participants (adults; prospectively enrolled following laboratory-confirmed SARS-CoV-2 infection, May 2020-June 2021) completed symptom questionnaires at months 2-12, 18 and 24, and the Brief Illness Perception Questionnaire (B-IPQ) at months 1, 6, and 12. Using group-based trajectory models (GBTM), we modelled symptoms (mean total numbers and proportion with 4 specific complaints), including age, sex, BMI and timing of infection as covariates. In a multivariable linear mixed-effects model, we assessed the association between symptom trajectories and repeated B-IPQ scores. Results Among 292 participants (42% female; median age 51 [IQR=36-62]), four trajectories were identified, ranging from Trajectory 4 (8.9%; 6+ symptoms) to Trajectory 1 (24.8%; no symptoms). The occurrence of fatigue and myalgia increased among 23% and 12% of participants, respectively. Individuals in Trajectory 4 experienced more negative adjusted B-IPQ scores over time than those in Trajectories 1-3. Conclusions We observed little fluctuation in the total number of symptoms but individual symptoms may develop as others resolve. Reporting a greater number of symptoms was congruent with more negative illness perception over time.

Objectives: to evaluate the effectiveness of treatment options for post-COVID-19 olfactory dysfunction. Design: This is a retrospective cohort study. Setting: …………………………………….. Participants: 120 patients between January 2020 and December 2022 with post-COVID-19 olfactory dysfunction (anosmia or hyposmia). Main outcome measures: Initial smell scores and on weeks 1,2,3,4 of treatment regimens. Results: 43.3% of patients were males and 56.6% were females aged from 18 to 62 years (median age was 38.5 years). 38 patients (36.3%) were hospitalized while 82 patients (68.3%) managed at home. There was a significant difference in the average time for complete recovery in group B was 25.7 ± 9.20 days and group C was 24.8± 6.67 days and group D was 23.5± 7.13 days compared to 28.97 ± 4.29 days in control group A (P = 0.02*). There is no significant association between age, sex, place of management, severity of COVID-19 illness, obesity, and the duration of COVID-19 illness with smell scores and the duration of anosmia/hyposmia but there was a highly significant association with diabetes, hypertension, smoking, and asthma (P-Value=<0.001***). Conclusion: This study suggests that combining the usage of topical mometasone furoate or topical vitamin A or intranasal theophylline with olfactory training shortens the duration of post-COVID- 19 anosmia/hyposmia but offers no superiority regarding smell scores over olfactory training alone after 4 weeks.

Abstract Global crises exhibit common patterns and interlinkages, from which critical lessons can be learned. In particular, the ongoing COVID-19 pandemic offers an unprecedented moment for unearthing insights helpful for climate change response. This research aims to systematically identify, assess, and prioritize such relevant lessons. To this end, we adopted a Horizon Scanning (HS) approach to collect 553 related lessons from multiple sources, including reviewing 108 peer-reviewed journal articles and two surveys. A total of 372 respondents contributed and ranked relevant lessons, of which 31 experts across countries, sectors, and disciplines had ranked the same lessons ranked in the second survey. Adopting the HS approach was not only helpful to collect relevant lessons, but also effective in promoting the general public’s engagement in scientific research, which is essential to amplify its voice regarding two major crises that are directly affecting the lives and livelihoods of people. Results of this research indicate that both participant groups (experts and non-experts) perceived climate change to be more threatening than COVID-19. However, they expressed different areas of concern regarding the two crises. Among all thematic areas, “Research and innovation” and “Policy and governance” are of supreme importance for COVID-19 and climate change. This research provides invaluable information for actors who are at the frontline of fighting both crises.1. IntroductionWith millions of confirmed cases and deaths, the ongoing COVID-19 pandemic is an unprecedented global crisis in the recent history of humanity (Fan et al., 2020). The pandemic has triggered extraordinary social measures (Cole and Dodds, 2021; Hepburn et al., 2020) and heavily affected the global economy (Kumar and Ayedee, 2021) and imposed serious implications for CO2 emissions and the Paris Agreement on climate change (Shan et al., 2021). The implications of COVID-19 on climate change action are enormous, including putting on hold many climate actions (Loureiro and Alló, 2021). For instance, this includes postponing the 26th conference of parties (COP26) in Glasgow (United Kingdom), an important milestone for committing more ambitious Nationally Determined Contributions (NDCs), for one year due to the challenges of holding an inclusive and ambitious gathering of climate change actors. The outbreak of this pandemic seems to be related to several global problems, for instance, climate change, urbanization, and global travel (Barouki et al., 2021). Despite the fundamental differences between the COVID-19 pandemic and climate change (Manzanedo and Manning, 2020), there are interlinkages (e.g. both are global crises), shared patterns (e.g. serious implications on multiple sectors), and commonalities (e.g. multiple root causes and complex interactions) that are typical for the Anthropocene era (Fuentes et al., 2020; Heyd, 2021; Lancet, 2021). Both, COVID-19 and climate change have interferences with development, research, global cooperation, and resilience (Hepburn et al., 2020; Manzanedo and Manning, 2020). To combat the COVID-19 pandemic, global societies have witnessed massive changes in all life aspects, and governments committed to radical measures to control the spread of COVID-19 and reduce losses of lives (Baldwin and Lenton, 2020). On the other hand, the world has been experiencing climate change effects for decades (IPCC, 2021), yet few such drastic measures have been taken, reflecting the urgency of the climate emergency (Coates et al., 2020). This has raised numerous critical questions on comparable global efforts in fighting climate change (Salas et al., 2020), a threatening crisis that moved down the top global agenda because of the pressing urgency to deal with COVID-19 (Lancet, 2021).Delayed action on both climate change and COVID-19 is threatening. Therefore, policymakers and the global community concerned about such global crises must be able to make informed decisions, based on sound scientific findings (Baldwin and Lenton, 2020; Jin, 2020; Manzanedo and Manning, 2020). The current pandemic outbreak offers an exceptional window into a global crisis and provides invaluable insights and profound lessons into how this crisis may be addressed and which policy approaches are considered favorable(8). Reflecting from the COVID-19 pandemic, these lessons can be of political, social, economic, and policy nature, among others. Examples of such lessons that can be found in the literature stress the importance of global solidarity and international cooperation (Cole and Dodds, 2021; Klenert et al., 2020), emphasize how costly a delayed intervention can be (Fan et al., 2020; Fuentes et al., 2020; Heyd, 2021; Jin, 2020), underline the importance of crisis prevention (Cole and Dodds, 2021; Manzanedo and Manning, 2020), highlight how inequality can be exacerbated without timely action (Klenert et al., 2020; Salas et al., 2020), and draw attention to the centrality of research and innovation in facing new challenges (Ching and Kajino, 2020; Jin, 2020). The term lesson used in the current research, thus, refers to the insights that can be drawn from the COVID-19 pandemic and potentially applied to climate change policy making and implementation. Given the wide-spectrum of potential lessons, we are aiming mainly to provide policy-makers at different levels with up-to-date and evidence-based knowledge that can help in making the right decisions regarding climate change, reflecting from the ongoing COVID-19 pandemic.Although several previous studies have contributed to collecting and analyzing such lessons (Andrieu et al., 2021; Baldwin and Lenton, 2020; Botzen et al., 2021; El Zowalaty et al., 2020; Herrero and Thornton, 2020; Hochachka, 2020; Howarth et al., 2020; Kakderi et al., 2021; Manzanedo and Manning, 2020; Negev et al., 2021; Perkins et al., 2021; Prideaux et al., 2020; Ruiu et al., 2020; Salas, 2020; Sarkis et al., 2020; Sheehan and Fox, 2020), no systematic review of these lessons has been conducted. In addition, the number of collected lessons in these studies was limited and, in many cases, confined to limited thematic areas. Employing the Horizon Scanning (HS) approach enables a more comprehensive overview by expanding the information sources across regions, disciplines, and professions, which can be quite helpful to inform and support decision-making (Hines et al., 2019). Enlarging the information sources through the HS has the potential to allow investigating opportunities, threats signs, and outlooks of phenomena. Concerning the aim of the current research, it allows identifying important lessons that might be missed if a single source of information (e.g., literature) is used. As of the date of writing this paper, this is the first research with this scale to collect a magnitude of lessons from COVID-19 that addresses a wide spectrum of thematic areas from published literature, the public, and experts. Therefore, the ultimate goal is to gather, analyze, rank, and reflect on the most critical lessons that, if addressed, would advance climate change action. This research provides recent, useful information for successfully navigating the challenges of climate change reflecting from the ongoing COVID-19 pandemic.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may be associated with long-term health problems termed Long COVID or post COVID-19 syndrome. Symptoms can include fatigue, cognitive dysfunction, pain, anxiety, depression and sleep disturbances. There are few treatments available. Cannabis-based medicinal products (CBMPs) may reduce some of the common symptoms associated with Long COVID as they are known to ameliorate these symptoms occurring in other conditions. We conducted a single arm open label feasibility trial of the safety and tolerability of a full spectrum cannabidiol (CBD)-dominant CBMP for treating the symptoms of Long COVID. The treatment phase ran for a total of 21 weeks, followed by ~3 weeks without the study drug. Participants received up to 3 mL of MediCabilis 5% CBD Oil (50 mg CBD/mL, <2 mg THC/mL) per day orally. We recruited 12 (1 male, 11 female) individuals diagnosed with Long COVID into the trial. Monthly patient reported outcome measures (PROMs) of common symptoms and daily self-report of symptoms were collected via a smartphone app. Key measures of heart rate, activity, sleep, and oxygen saturation were assessed using wearable technology. All patients adhered to the treatment protocol for the duration of the study and there were no serious adverse events. Response rates for the research assessments were high with over 90% completion of PROMs and daily self-report. CBD-dominant CBMPs are safe and well tolerated in individuals diagnosed with Long COVID. Future work with larger samples and incorporating a control group should test the efficacy of this treatment.

A document by Franca Rusconi. Click on the document to view its contents.

Acinetobacter baumannii is a crucial pathogen of nosocomial infection and an alarming threat to the medical community due to the high rate of mortality worldwide. Because of its highly contagious, biofilm-forming nature, virulence characteristics, and multi-drug resistance (MDR), it has been recognized as a red-alert pathogen on a global scale. The main components which strengthen the pathogenicity of A. baumannii are complex gram-negative cell wall structure and specialized virulence factors which facilitate its adhesion and infection spread in the host cells. Higher incidents of infections have been reported in hospitalized patients undergoing treatment with Intensive Care Unit aids and medical devices majorly causing Catheter-Associated Urinary Tract Infection (CAUTI) and Ventilator-associated pneumonia (VAP). This makes the biofilm-forming multi-drug resistant A. baumannii, the most hazardous pathogen in Device Associated Hospital Acquired Infections (DA-HAI). Several investigations unveiled that the outer membrane proteins (OMP) and other adhesion-associated virulence have an anchoring role in biofilm formation which majorly contributes to DA-HAI. Moreover, during the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic, the infection spread was further aggravated in DA-HAI. Hence, it is important to search for novel therapeutic approaches that will improve the treatment strategy and prevent device-associated infection. This review explores the relationship between adhesion-associated virulence and biofilm formation further it highlights the correlation between antibacterial resistance, and biofilm characterization to elucidate a novel therapeutic approach against this threatful pathogen.

Angiotensin converting enzyme-2 (ACE2), a key component in renin-angiotensin system (RAS) has been identified as the functional receptor for mediating the entry into the cell of SARS-CoV-2. The correlation between anti-ACE2 antibodies and COVID-19 outcome is less well-defined. Herein, serum sample were collected from 134 inpatients, 22 outpatients, 40 convalesces and 12 healthy individuals, with real-time PCR-confirmed SARS-COV-2 infections. The anti-ACE2 antibodies were tested by ELASA and anti-SARS-COV-2 antibodies were analyzed by chemiluminescent immunoassay.We found that patients with COVID-19 show a high prevalence of autoantibodies against ACE2 and exhibit marked increases level compared to healthy control. The highest level of anti-ACE2 was observed in death, male, and longer time of admission group. Thus, significant negative association between serum anti-ACE2 antibodies levels and anti-SARS-COV-2 in different severity group was observed. We conclude that patients with a history of SARS-CoV-2 infection had a high prevalence of Anti-ACE2 antibodies. Its negative correlation with anti-SARS-COV-2 antibodies may lead to pro-inflammatory responses and weaken the protective power of humoral immunity by enhancing RAS pro-inflammatory axis.