Aim: The evolution of coagulation factors in pregnant patients infected with SARS-CoV-2 during the pandemic is still debated. However, few studies have been carried out to evaluate the silent alterations of blood values in mild forms of the disease. Methods:A total of 153 pregnant patients with an asymptomatic form of COVID-19 and 306 healthy pregnant patients, who were admitted for delivery in our hospital between April 1, 2020 and March 1, 2022, were studied. The blood values harvested closest to the time of delivery were considered. Results:There was a significant variability in values of fibrinogen, prothrombin time, though these were still within normal limits. Conclusions:Pregnant patients with mild forms of COVID-19 displayed some blood alterations, even if they were asymptomatic for COVID-19.

Even though the Covid-19 pandemic seems to be stagnating or decreasing across the world, a resurgence of the disease or the occurrence of other epidemics caused by the aerial dissemination of pathogenic biological agents cannot be ruled out. These agents, in particular the virions of the Covid-19 disease, are found in the particles originating from the sputum of infected symptomatic or asymptomatic people. In previous research, we made use of a three-dimensional Computational Fluid Dynamics (CFD) model to simulate particle transport and dispersion in ventilated semi-confined spaces. By way of illustration, we considered a commuter train coach in which an infected passenger emitted droplets (1 and 10 µm) and drops (100 and 1000 µm) while breathing and coughing. Using an Eulerian approach and a Lagrangian approach, we modelled the dispersion of the particles in the turbulent flow generated by the ventilation of the coach. The simulations returned similar results from both approaches and clearly demonstrated the very distinct aerodynamics of the aerosol of airborne droplets and, at the other end of the spectrum, of drops falling or behaving like projectiles depending on their initial velocity. That numerical study considered passengers without protective masks. In this new phase of research, we first used literature data to develop a model of a typical surgical mask for use on a digital manikin representing a human. Next, we resumed the twin experiment of the railway coach, but this time, the passengers (including the infected one) were provided with surgical masks. We compared the spatial and temporal distributions of the particles depending on whether the spreader passenger wore a mask at all, and whether the mask was perfectly fitted (without leaks) or worn loosely (with leaks). Beyond demonstrating the obvious value of wearing a mask in limiting the dissemination of particles, our model and our simulations allow a quantification of the ratio of particles suspended in the coach depending on whether the infected passenger wears a mask or not. Moreover, the calculations carried out constitute only one illustrative application among many others, not only in public transport, but in any other public or private ventilated space on the basis of the same physical models and digital twins of the places considered. CFD therefore makes it possible to estimate the criticality of the occupation of places by people with or without a mask and to recommend measures in order to limit aerial contamination by any kind of airborne pathogen, such as the virions of Covid-19.

Intraorbital lymphatic-venous malformations are rare lesions that represent a therapeutic challenge given their location and high rate of recurrence, with only a few cases in adult patients having been published in the literature. We present the case of a 30-year-old male with a right intraorbital lymphatic-venous malformation treated with sirolimus at a dose of 4 mg/day with complete clinical and radiologic remission. Mild cold-like symptoms ensued during the first week of treatment and elevation of liver function enzymes and D-dimer occurred in the context of acute SARS-CoV-2 pneumonia. No major adverse effects were documented. After 18 months of treatment, the patient remains asymptomatic and ophthalmologic examinations including optical coherence tomography and visual field test are within normal values.

Streptococcus suis is a Gram-positive, facultative anaerobic bacterium and has its natural reservoir in pigs. Infection by this microorganism usually manifests in humans as meningitis, endocarditis, sepsis, and/or arthritis after contact with pigs or pork. Meningitis is a very common manifestation and Streptococcus suis may be considered its second most common cause. A clinical course may manifest acutely or with a more chronic course. Streptococcus suis is endemic in pork-consuming and pig-rearing countries, but may occur all over the world, especially in individuals with occupational exposure to pigs and/or pork, such as abattoir workers, butchers, and farmers. Most infections are observed in adults without preexisting diseases. We report a case of Streptococcus suis meningitis in a healthy patient with occupational exposure and with an asymptomatic infection by severe acute respiratory syndrome coronavirus 2, who was admitted to an intensive care unit in a tertiary hospital in the North of Portugal.

The emergence of the SARS-CoV-2 virus, an unknown strain of coronavirus, has resulted in severe acute respiratory syndrome with high mortality rates worldwide. Due to the possibility of asymptomatic carriers, late diagnosis of infected individuals can lead to uncontrollable transmission of the disease, making early and accurate detection crucial in controlling the spread of the virus. In this study we identified high-binding-affinity aptamers targeting various strains of the SARS-CoV2 (COVID-19) virus, using the GO-Cell-SELEX (Graphene Oxide- Systematic Evolution of Ligands by Exponential Enrichment) strategy. A total of 96 aptamers were developed through 11 rounds of GO-Cell-SELEX from a random 40 nucleotide single-strand DNA (ssDNA) aptamer library. Using the surface plasmon resonance (SPR) method, the dissociation constant (Kd) values of all aptamers were calculated and two aptamers 52 and 91 with Kd 50 and 61 were selected for enzyme-linked apta-sorbent assay (ELASA). Aptamer 91 could detect various strains of the virus in above 97% of clinical samples obtained from nasopharyngeal swaps (NPS) specimens kept in viral transport media (VTM), confirmed by real-time PCR assay at COVID-19 Reference Diagnostic Laboratory of Iran, Pasture Institute. Aptamer 52 could detect the SARS-CoV2 virus in a competitive lateral flow assay (LFA) to be considered for a future designed kit. These two simple, specific, and sensitive tests can be used in combination for rapid and early diagnosis of various strains of the COVID-19 virus. Our results suggest that these two discovered aptamers present an opportunity for developing a new rapid aptamer-based coronavirus diagnostic kit.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a contagious respiratory virus that is the cause of the coronavirus disease 2019 (COVID-19) pandemic which has posed a serious threat to public health. COVID-19 is characterized by a wide spectrum of clinical manifestations, ranging from asymptomatic infection to mild cold-like symptoms, severe pneumonia or even death. Inflammasomes are supramolecular signaling platforms that assemble in response to danger or microbial signals. Upon activation, inflammasomes mediate innate immune defense by favoring the release of proinflammatory cytokines and triggering pyroptotic cell death. Nevertheless, abnormalities in inflammasome functioning can result in a variety of human diseases such as autoimmune disorders and cancer. A growing body of evidence has showed that SARS-CoV-2 infection can induce inflammasome assembly. Dysregulated inflammasome activation and consequent cytokine burst have been associated with COVID-19 severity, alluding to the implication of inflammasomes in COVID-19 pathophysiology. Accordingly, an improved understanding of inflammasome-mediated inflammatory cascades in COVID-19 is essential to uncover the immunological mechanisms of COVID-19 pathology and identify effective therapeutic approaches for this devastating disease. In this review, we summarize the most recent findings on the interplay between SARS-CoV-2 and inflammasomes and the contribution of activated inflammasomes to COVID-19 progression. We dissect the mechanisms involving the inflammasome machinery in COVID-19 immunopathogenesis. In addition, we provide an overview of inflammasome-targeted therapies or antagonists that have potential clinical utility in COVID-19 treatment.

The severe shortfall in testing supplies during the initial COVID-19 outbreak and ensuing struggle to manage the pandemic have affirmed the critical importance of optimal supply-constrained resource allocation strategies for controlling novel disease epidemics. To address the challenge of constrained resource optimization for managing diseases with complications like pre- and asymptomatic transmission, we develop an integro partial differential equation compartmental disease model which incorporates realistic latent, incubation, and infectious period distributions along with limited testing supplies for identifying and quarantining infected individuals. Our model overcomes the limitations of typical ordinary differential equation compartmental models by decoupling symptom status from model compartments to allow a more realistic representation of symptom onset and presymptomatic transmission. To analyze the influence of these realistic features on disease controllability, we find optimal strategies for reducing total infection sizes that allocate limited testing resources between 'clinical' testing, which targets symptomatic individuals, and 'non-clinical' testing, which targets non-symptomatic individuals. We apply our model not only to the original, delta, and omicron COVID-19 variants, but also to generically parameterized disease systems with varying mismatches between latent and incubation period distributions, which permit varying degrees of presymptomatic transmission or symptom onset before infectiousness. We find that factors that decrease controllability generally call for reduced levels of non-clinical testing in optimal strategies, while the relationship between incubation-latent mismatch, controllability, and optimal strategies is complicated. In particular, though greater degrees of presymptomatic transmission reduce disease controllability, they may increase or decrease the role of non-clinical testing in optimal strategies depending on other disease factors like transmissibility and latent period length. Importantly, our model allows a spectrum of diseases to be compared within a consistent framework such that lessons learned from COVID-19 can be transferred to resource constrained scenarios in future emerging epidemics and analyzed for optimality.

The novel coronavirus 2019 (COVID-19) which is caused by severe acute respiratory syndrome coronavirus-2 was first reported from Wuhan, China in December 2019. Since then, it has caused global crisis and it still continues to be a Public Health Emergency of International Concern. Although it primarily involves respiratory system with symptoms ranging from mild to severe acute respiratory distress syndrome, extrapulmonary involvement including gastrointestinal manifestations is increasingly reported. There are few reported cases of acute pancreatitis following severe acute respiratory syndrome coronavirus-2 infection; however, little is known on true prevalence of acute pancreatitis or other extrapulmonary manifestations. More data and research on pathophysiology and organ-specific extrapulmonary manifestations would aid clinicians to monitor and recognise these wide spectra of manifestations so that organ-specific therapeutic strategies and management pathways could be developed. We report a case of acute pancreatitis in an otherwise asymptomatic severe acute respiratory syndrome coronavirus-2 infection. He developed acute upper abdominal pain on day 13th of severe acute respiratory syndrome coronavirus-2 infection detection. Diagnosis of acute pancreatitis was made after his serum amylase level was raised by more than five times the normal and the computed tomography abdomen showed oedematous pancreas. He was successfully managed and discharged after 12 days of diagnosis of acute pancreatitis. On follow-up after 1 year, there were no recurrent attacks of pancreatitis. Our case highlights that acute pancreatitis can occur even in asymptomatic and milder form of COVID-19 and the onset of such complications could be delayed. Abdominal pain in COVID-19 should be carefully assessed because prompt diagnosis and management of acute pancreatitis in COVID-19 patient is crucial in preventing multi-organ dysfunction leading to subsequent morbidity and mortality.

Presymptomatic plasma samples from 1596 donors reporting coronavirus disease 2019 infection or symptoms after blood donation were tested for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA and anti-S and anti-N antibodies. Prior infection and vaccination both protected from developing SARS-CoV-2 RNAemia and from symptomatic infection. RNAemia rates did not differ in the Delta and Omicron variant eras.

Owing to coronavirus disease 2019 (COVID-19), lung damage is seen as an important problem in patients after recovery. In this study, evaluation of respiratory symptoms and lung ultrasonography (LUS) findings of those who have had symptomatic and asymptomatic COVID-19 disease in children was aimed. A total of 81 patients with positive and 18 healthy children with negative COVID-19 antibodies were included to the study. The most common late presentation symptoms were cough (85.2%), shortness of breath (77.8%), and chest pain (60.5%). In LUS, 2 or less B lines, 3 or more B lines, and Z line were seen in 66.7%, 33.3%, and 9.9% of patients, respectively. There was no significant difference between control and patients in terms of these parameters (P > .05). Pleural effusion was detected in 2 patients in the late period. Respiratory system findings may develop in the late period in patients infected with COVID-19. Therefore, patients should be followed closely.

Abdominal aortic aneurysm (AAA) is a common medical condition with the feared, and often fatal, complication of rupture. The risk of rupture has been well documented to correlate with aneurysm size. It is exceedingly rare for an AAA less than 5 cm to rupture. This case report demonstrates an asymptomatic 4.3 cm AAA that ruptured while admitted to the hospital with COVID-19 pneumonia. The patient was successfully managed with an endovascular aortoiliac stent graft. Although rare, in patients with small AAA, rupture must remain in the differential diagnosis in the setting of acute onset abdominal or back pain. Furthermore, when quickly recognized, these patients can be safely managed with an endovascular approach.

Coronavirus disease 2019 (COVID-19) in children can be compounded by concurrent diseases and immunosuppressants. For the first time, we aimed to report the clinical features of concurrent COVID-19 and pediatric rheumatic disease (PRD) in Japan. Pediatric Rheumatology Association of Japan members were surveyed between 1 April 2020 and 31 August 2022. Outcome measurements included the clinical features of concurrent PRD and COVID-19. Questionnaire responses were obtained from 38 hospitals. Thirty-one hospitals (82%) had children with PRD and COVID-19. The female-to-male ratio in these children (n = 156) was 7:3, with half aged 11-15 years. The highest proportion of children with PRD and COVID-19 was accounted for by juvenile idiopathic arthritis (52%), followed by systemic lupus erythematosus (24%), juvenile dermatomyositis (5%), scleroderma (4%), and Takayasu arteritis (3%). Of children with PRD, a significant majority (97%) were found to be asymptomatic (10%) or presented with mild symptoms (87%) of the COVID-19 infection. No severe cases or deaths were observed. Regarding the use of glucocorticoids, immunosuppressants, or biologics for PRD treatment before COVID-19, no significant difference was found between asymptomatic/mild and moderate COVID-19 in children with PRD. Therefore, COVID-19 is not a threat to children with PRD in Japan.

COVID-19, which broke out globally in 2019, is an infectious disease caused by a novel strain of coronavirus, and its spread is highly contagious and concealed. Environmental vectors play an important role in viral infection and transmission, which brings new difficulties and challenges to disease prevention and control. In this paper, a type of differential equation model is constructed according to the spreading functions and characteristics of exposed individuals and environmental vectors during the virus infection process. In the proposed model, five compartments were considered, namely, susceptible individuals, exposed individuals, infected individuals, recovered individuals, and environmental vectors (contaminated with free virus particles). In particular, the re-positive factor was taken into account (i.e., recovered individuals who have lost sufficient immune protection may still return to the exposed class). With the basic reproduction number R0 of the model, the global stability of the disease-free equilibrium and uniform persistence of the model were completely analyzed. Furthermore, sufficient conditions for the global stability of the endemic equilibrium of the model were also given. Finally, the effective predictability of the model was tested by fitting COVID-19 data from Japan and Italy.

To face the COVID-19 outbreak, a wide range of non-pharmaceutical interventions (NPIs) aimed at limiting the spread of the virus in communities, such as mask-wearing, hand hygiene, social distancing, travel restrictions, and school closures, were introduced in most countries. Thereafter, a significant reduction of new asymptomatic and symptomatic COVID-19 cases occurred, although there were differences between countries according to the type and duration of the NPIs. In addition, the COVID-19 pandemic has been accompanied by significant variations in the global incidence of diseases due to the most common non-SARS-CoV-2 respiratory viruses and some bacteria. In this narrative review, the epidemiology of the most common non-SARS-CoV-2 respiratory infections during the COVID-19 pandemic is detailed. Moreover, factors that could have had a role in modifying the traditional circulation of respiratory pathogens are discussed. A literature analysis shows that NPIs were the most important cause of the general reduction in the incidence of influenza and respiratory syncytial virus infection in the first year of the pandemic, although the different sensitivity of each virus to NPIs, the type and duration of measures used, as well as the interference among viruses may have played a role in modulating viral circulation. Reasons for the increase in the incidences of Streptococcus pneumoniae and group A Streptococcus infections seem strictly linked to immunity debt and the role played by NPIs in reducing viral infections and limiting bacterial superimposed infections. These results highlight the importance of NPIs during pandemics, the need to monitor the circulation of infectious agents that cause diseases similar to those caused by pandemic agents, and the need to make efforts to improve coverage with available vaccines.

The main objective of this study was to investigate the dynamic of SARS-CoV-2 viral excretion in rectal swab (RS), saliva, and nasopharyngeal swab (NS) samples from symptomatic patients and asymptomatic contacts. In addition, in order to evaluate the replication potential of SARS-CoV-2 in the gastrointestinal (GI) tract and the excretion of infectious SARS-CoV-2 from feces, we investigated the presence of subgenomic nucleoprotein gene (N) mRNA (sgN) in RS samples and cytopathic effects in Vero cell culture. A prospective cohort study was performed to collect samples from symptomatic patients and contacts in Rio de Janeiro, Brazil, from May to October 2020. One hundred and seventy-six patients had samples collected at home visits and/or during the follow up, resulting in a total of 1633 RS, saliva, or NS samples. SARS-CoV-2 RNA was detected in 130 (73.9%) patients who had at least one sample that tested positive for SARS-CoV-2. The presence of replicating SARS-CoV-2 in RS samples, measured by the detection of sgN mRNA, was successfully achieved in 19.4% (6/31) of samples, whilst infectious SARS-CoV-2, measured by the generation of cytopathic effects in cell culture, was identified in only one RS sample. Although rare, our results demonstrated the replication capacity of SARS-CoV-2 in the GI tract, and infectious viruses in one RS sample. There is still a gap in the knowledge regarding SARS-CoV-2 fecal-oral transmission. Additional studies are warranted to investigate fecal or wastewater exposure as a risk factor for transmission in human populations.

China is relaxing COVID-19 measures from the "dynamic zero tolerance" (DZT) level. The "flatten-the-curve" (FTC) strategy, which decreases and maintains the low rate of infection to avoid overwhelming the healthcare system by adopting relaxed nonpharmaceutical interventions (NPIs) after the outbreak, has been perceived as the most appropriate and effective method in preventing the spread of the Omicron variant. Hence, we established an improved data-driven model of Omicron transmission based on the age-structured stochastic compartmental susceptible-latent-infectious-removed-susceptible model constructed by Cai to deduce the overall prevention effect throughout China. At the current level of immunity without the application of any NPIs, more than 1.27 billion (including asymptomatic individuals) were infected within 90 days. Moreover, the Omicron outbreak would result in 1.49 million deaths within 180 days. The application of FTC could decrease the number of deaths by 36.91% within 360 days. The strict implementation of FTC policy combined with completed vaccination and drug use, which only resulted in 0.19 million deaths in an age-stratified model, will help end the pandemic within about 240 days. The pandemic would be successfully controlled within a shorter period of time without a high fatality rate; therefore, the FTC policy could be strictly implemented through enhancement of immunity and drug use.

The study aims to describe the frequency of COVID-19 in healthcare workers (HCWs) in a designated hospital for COVID-19 treatment in Bucharest, Romania, and to explore COVID-19 vaccination and other factors associated with the clinical outcome. We actively surveyed all HCWs from 26 February 2020 to 31 December 2021. Cases were laboratory-confirmed with RT-PCR or rapid test antigen. Epidemiological, demographic, clinical outcomes, vaccination status, and co-morbidities data were collected. Data were analyzed using Microsoft Excel, SPSS, and MedCalc. A total of 490 cases of COVID-19 in HCWs were diagnosed. The comparison groups were related to the severity of the clinical outcome: the non-severe group (279, 64.65%) included mild and asymptomatic cases, and the potentially severe group included moderate and severe cases. Significant differences between groups were registered for high-risk departments (p = 0.0003), exposure to COVID-19 patients (p = 0.0003, vaccination (p = 0.0003), and the presence of co-morbidities (p < 0.0001). Age, obesity, anemia, and exposure to COVID-19 patients predicted the severity of the clinical outcomes (χ2 (4, n = 425) = 65.69, p < 0.001). The strongest predictors were anemia and obesity (OR 5.82 and 4.94, respectively). In HCWs, mild COVID-19 cases were more frequent than severe cases. Vaccination history, exposure, and individual risk influenced the clinical outcome suggesting that measures to protect HCWs and occupational medicine are important for pandemic preparedness.

Introduction: Aesthetic surgery procedures are generally done in a relatively healthy population and carry a rather low risk compared to other surgical specialties. The incidence of complications in aesthetic surgery varies greatly depending on the type, wound cleanliness regarding the anatomical site, complexity of the surgery, patient's age, and comorbidities but is generally considered low. The overall incidence of surgical site infections (SSIs) in all aesthetic surgical procedures is around 1% in most of the literature while cases of necrotizing soft tissue infections are mostly found as individual reports. In contrast, treating COVID-19 patients is still challenging with many diverse outcomes. Surgical stress and general anesthesia are known mediators of cellular immunity impairment while studies regarding COVID-19 infection unquestionably have shown the deterioration of adaptive immunity by SARS-CoV-2. Adding COVID-19 to the modern surgical equation raises the question of immunocompetence in surgical patients. The main question of the modern post-lockdown world is: what could be expected in the postoperative period of perioperatively asymptomatic COVID-19 patients after aesthetic surgery? Case report: Here, we present a purulent, complicated, necrotizing skin and soft tissue infection (NSTI) after gluteal augmentation most likely triggered by SARS-CoV-2-induced immunosuppression followed by progressive COVID-19 pneumonia in an otherwise healthy, young patient. To the best of our knowledge, this is the first report of such adverse events in aesthetic surgery related to COVID-19. Conclusion: Aesthetic surgery in patients during the incubation period of COVID-19 or in asymptomatic patients could pose a significant risk for surgical complications, including severe systemic infections and implant loss as well as severe pulmonary and other COVID-19-associated complications.

Background and Objectives: The aim was to explore the interventional effect of the traditional Chinese medicine (TCM) exercise of Tian Dan Shugan Tiaoxi on the emotions of patients with mild novel coronavirus (COVID-19). Materials and Methods: A total of 110 asymptomatic and mildly symptomatic COVID-19 patients from Hongkou Memorial Road Temporary Cabin Hospital and South Renji Hospital were selected between April 2022 and June 2022, and randomly divided into two groups: a control group and an intervention group. There were 55 participants in each group. The control group was treated with Lianhua Qingwen granules, and members of the intervention group were made to practice Tian Dan Shugan Tiaoxi (an exercise that soothes the liver and regulates emotions) every day for 5 days. The Patient Health Questionnaire-9 (PHQ-9), the Generalized Anxiety Disorder questionnaire (GAD-7), and the Symptom Checklist 90 (SCL-90) were used to evaluate the data collected before and after the trial. Results: The incidence of anxiety and depression was high in the patients included in this study, at 73.64% and 69.09%, respectively. After intervention, the scores of the Patient Health Questionnaire-9 (PHQ-9) and the Generalized Anxiety Disorder questionnaire (GAD-7) in the two groups had decreased in comparison with those recorded before intervention (p < 0.05). The PHQ-9 and GAD-7 scores in the intervention group were significantly better than those of the control group (p < 0.05). The factors of somatization, depression, anxiety, hostility, and fear in the SCL-90 in the intervention group were significantly improved after intervention, and generally, better than those in the control group (p < 0.05). Conclusions: Patients infected with novel coronavirus in shelter hospitals have different degrees of emotional abnormalities. Tian Dan Shugan Tiaoxi can reduce the anxiety and depression of people with mild novel coronavirus, and it can be practiced clinically to improve the recovery rate among infected people.