Browsing by Subject "Covid-19"
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Item A Comprehensive Summary of the Knowledge on COVID-19 Treatment(JKL International, 2021-02-01) Peng, Yu; Tao, Hongxun; Satyanarayanan, Senthil Kumaran; Jin, Kunlin; Su, HuanxingCurrently, the world is challenged by the coronavirus disease 2019 (COVID-19) pandemic. Epidemiologists and researchers worldwide are invariably trying to understand and combat this precarious new disease. Scrutinizing available drug options and developing potential new drugs are urgent needs to subdue this pandemic. Several intervention strategies are being considered and handled worldwide with limited success, and many drug candidates are yet in the trial phase. Despite these limitations, the development of COVID-19 treatment strategies has been accelerated to improve the clinical outcome of patients with COVID-19, and some countries have efficiently kept it under control. Recently, the use of natural and traditional medicine has also set the trend in coronavirus treatment. This review aimed to discuss the prevailing COVID-19 treatment strategies available globally by examining their efficacy, potential mechanisms, limitations, and challenges in predicting a future potential treatment candidate and bridging them with the effective traditional Chinese medicine (TCM). The findings might enrich the knowledge on traditional alternative medication and its complementary role with Western medicine in managing the COVID-19 epidemic.Item Acute Inflammatory Mediators in Young Adult Patients with COVID-19 in Mexico(MDPI, 2021-08-20) Maldonado-Cabrera, Anahi; Angulo-Molina, Aracely; Haque, Ubydul; Velazquez, Carlos; Alvarez-Villasenor, Andrea S.; Santacruz-Gomez, Karla J.; Gallego-Hernandez, Ana L.Young adults (18-40 years old) are an active population with high risk of infection and transmission of COVID-19. They are considered a low-risk population due to its low 1.0% case fatality rate (CFR). Despite their high clinical usefulness to prevent fatal cases, inflammatory and coagulation biomarkers studies are limited. For this reason, we performed a retrospective cohort study with COVID-19 patients in Hermosillo, Mexico, to assess inflammation, coagulopathy profile, and severity outcomes in young adults. We analyzed blood samples to determine the neutrophil/lymphocyte ratio (NLR), neutrophil/monocyte ratio (NMR), lymphocyte/monocyte ratio (LMR), platelet/lymphocyte ratio (PLR), and C-reactive protein (C-RP). We included epidemiological features and comorbidities, and compared them to the severity status. Only 359 COVID-19-confirmed young adults were included in the ambulatory (44.8%), hospitalized (42.9%), and death (12%) severity groups. Laboratory results showed an increase in NMR, LMR, and C-RP associated with the aggravated patients. Additionally, obesity, arterial hypertension, and type-2 diabetes mellitus (T2DM) were associated with the COVID-19 severity outcome. We found that 9.1% and 30.3% of young adults presented the novel COVID-19-associated coagulopathy (CAC) and the risk of CAC, respectively. These parameters can be considered independent biomarkers reflecting an enhanced inflammatory process related to the COVID-19 prognosis.Item Coronavirus disease 2019 pandemic associated with anxiety and depression among Non-Hispanic whites with chronic conditions in the US(Elsevier B.V., 2022-02-22) Wang, Hao; Paul, Jenny; Ye, Ivana; Blalock, Jake; Wiener, R. Constance; Ho, Amy F.; Alanis, Naomi; Sambamoorthi, UshaOBJECTIVES: During the coronavirus 2019 (COVID-19) pandemic, increased anxiety and depression were reported, with mixed findings among individuals of different races/ethnicities. This study examines whether anxiety and depression increased during the COVID-19 pandemic compared to the pre-COVD-19 period among different racial/ethnic groups in the US. METHODS: The Health Information National Trend Surveys 5 (HINTS 5) Cycle 4 data was analyzed. We used the time when the survey was administered as the pre-COVID-19 period (before March 11, 2020, weighted N = 77,501,549) and during the COVID-19 period (on and after March 11, 2020, weighted N = 37,222,019). The Patient Health Questionnaire (PHQ) was used to measure anxiety/depression and further compared before and during COVID-19. Separate multivariable logistic regression analyses were used to determine the association of the COVID-19 pandemic with anxiety/depression after adjusting for age, sex, insurance, income, and education. RESULT: A higher percentage of Non-Hispanic whites (NHW) with chronic conditions reported anxiety (24.3% vs. 11.5%, p = 0.0021) and depression (20.7% vs. 9.3%, p = 0.0034) during COVID-19 than pre-COVID-19. The adjusted odds ratio (AOR) of anxiety and depression for NHWs with chronic conditions during the COVID-19 pandemic was 2.02 (95% confidence interval of 1.10-3.73, p = 0.025) and 2.33 (1.17-4.65, p = 0.018) compared to NHWs who participated in the survey before the COVID-19. LIMITATIONS: Limited to the NHW US population. PHQ can only be used as the initial screening tool. CONCLUSION: The COVID-19 pandemic was associated with an increased prevalence of anxiety and depression among NHW adults with chronic conditions, but not among people of color.Item COVID-19 in India: Are Biological and Environmental Factors Helping to Stem the Incidence and Severity?(JKL International, 2020-05-09) Chakrabarti, Sankha Shubhra; Kaur, Upinder; Banerjee, Anindita; Ganguly, Upsana; Banerjee, Tuhina; Saha, Sarama; Parashar, Gaurav; Prasad, Suvarna; Chakrabarti, Suddhachitta; Mittal, Amit; Agrawal, Bimal Kumar; Rawal, Ravindra Kumar; Zhao, Robert Chunhua; Gambhir, Indrajeet Singh; Khanna, Rahul; Shetty, Ashok K.; Jin, Kunlin; Chakrabarti, SasankaThe ongoing Corona virus (COVID-19) pandemic has witnessed global political responses of unimaginable proportions. Many nations have implemented lockdowns that involve mandating citizens not to leave their residences for non-essential work. The Indian government has taken appropriate and commendable steps to curtail the community spread of COVID-19. While this may be extremely beneficial, this perspective discusses the other reasons why COVID-19 may have a lesser impact on India. We analyze the current pattern of SARS-CoV-2 transmission, testing, and mortality in India with an emphasis on the importance of mortality as a marker of the clinical relevance of COVID-19 disease. We also analyze the environmental and biological factors which may lessen the impact of COVID-19 in India. The importance of cross-immunity, innate immune responses, ACE polymorphism, and viral genetic mutations are discussed.Item Factors associated with COVID-19-related mental health among Asian Indians in the United States(Elsevier B.V., 2023-01-11) Ikram, Mohammad; Shaikh, Nazneen F.; Siddiqui, Zasim A.; Dwibedi, Nilanjana; Misra, Ranjita; Vishwanatha, Jamboor K.; Sambamoorthi, UshaBACKGROUND: In the United States, the COVID-19 pandemic has caused increased mental health symptoms and mental illness. Specific subgroups such as Asian Indians in the US have also been subject to additional stressors due to unprecedented loss of lives in their home country and increased Asian hate due to the misperception that Asians are to be blamed for the spread of the SARS-CoV-2. OBJECTIVE: We examined the various factors including discrimination associated with COVID-19-related mental health symptoms among Asian Indians. METHODS: We administered an online survey between May 2021 and July 2021 using convenient and snowball sampling methods to recruit Asian Indian adults (age > 18 years, N = 289). The survey included questions on mental health and the experience with unfair treatment in day-to-day life. Descriptive analysis and logistic regressions were performed. RESULTS: Overall, 46.0% reported feeling down, depressed, or lonely and feeling nervous, tense, or worried due to the COVID-19 pandemic; 90.0% had received at least one dose of vaccination and 74.7% reported some form of discrimination. In the fully-adjusted logistic regression, age (AOR = 0.95; 95%CI- 0.92, 0.97;p < 0.01) and general health (AOR=0.84; 95%CI- 0.73, 0.97; p < 0.015) were negatively associated with mental health symptoms. Participants who experienced discrimination were more likely (AOR=1.26; 95%CI- 1.08, 1.46; p < 0.01) to report mental health symptoms. CONCLUSION: In this highly vaccinated group of Asian Indians discriminatory behaviors were associated with mental health symptoms suggesting the need for novel institutional level policy responses to reduce anti-Asian racism.Item Feasibility Trial of an eHealth Intervention for Health-Related Quality of Life: Implications for Managing Patients with Chronic Pain during the COVID-19 Pandemic(MDPI, 2020-10-01) Licciardone, John C.; Pandya, VishrutiPURPOSE: This study was conducted to determine the feasibility of providing an eHealth intervention for health-related quality of life (HRQOL) to facilitate patient self-management. METHODS: A randomized controlled trial was conducted from 2019-2020 within the Pain Registry for Epidemiological, Clinical, and Interventional Studies and Innovation. Eligible patients included those with chronic low back pain and a SPADE (sleep disturbance, pain interference with activities, anxiety, depression, and low energy/fatigue) cluster score >/= 55 based on the relevant scales from the Patient-Reported Outcomes Measurement Information System instrument with 29 items (PROMIS-29). Patients were randomized to the eHealth treatment group, which received a tailored HRQOL report and interpretation guide, or to a wait-list control group. The primary outcome was change in the SPADE cluster score, including its five component scales, over 3 months. Secondary outcomes were changes in low back pain intensity and back-related disability. Treatment effects were measured using the standardized mean difference (SMD) in change scores between groups. The eHealth intervention was also assessed by a survey of the experimental treatment group 1 month following randomization. RESULTS: A total of 102 patients were randomized, including 52 in the eHealth treatment group and 50 in the wait-list control group, and 100 (98%) completed the trial. A majority of patients agreed that the HRQOL report was easy to understand (86%), provided new information (79%), and took actions to read or learn more about self-management approaches to improve their HRQOL (77%). Although the eHealth intervention met the criteria for a small treatment effect in improving the overall SPADE cluster score (SMD = 0.24; p= 0.23) and anxiety (SMD = 0.24; p = 0.23), and for a small-to-medium treatment effect in improving depression (SMD = 0.37; p = 0.06) and back-related disability (SMD = 0.36; p = 0.07), none of these results achieved statistical significance because of limited sample size. CONCLUSION: Given the feasibility of rapid online deployment, low cost, and low risk of adverse events, this eHealth intervention for HRQOL may be useful for patients with chronic pain during the COVID-19 pandemic.Item Impact of Environmental Indicators on the COVID-19 Pandemic in Delhi, India(MDPI, 2021-08-09) Mangla, Sherry; Pathak, Ashok Kumar; Arshad, Mohd; Ghosh, Doyel; Sahoo, Prafulla Kumar; Garg, Vinod Kumar; Haque, UbydulCurrently, there is a massive debate on whether meteorological and air quality parameters play a crucial role in the transmission of COVID-19 across the globe. With this background, this study aims to evaluate the impact of air pollutants (PM2.5, PM10, CO, NO, NO2, and O3) and meteorological parameters (temperature, humidity, wind speed, and rainfall) on the spread and mortality due to the COVID-19 outbreak in Delhi from 14 Mar 2020 to 3 May 2021. The Spearman's rank correlation method employed on secondary data shows a significant correlation between the COVID-19 incidences and the PM2.5, PM10, CO, NO, NO2, and O3 concentrations. Amongst the four meteorological parameters, temperature is strongly correlated with COVID-19 infections and deaths during the three phases, i.e., pre-lockdown (14 March 2020 to 24 March 2020) (r = 0.79), lockdown (25 March 2020 to 31 May 2020) (r = 0.87), and unlock (1 June 2020 to 3 May 2021) (r = -0.75), explaining the variability of about 20-30% in the lockdown period and 18-19% in the unlock period. NO2 explained the maximum variability of 10% and 7% in the total confirmed cases and deaths among the air pollutants, respectively. A generalized linear model could explain 80% and 71% of the variability in confirmed cases and deaths during the lockdown and 82% and 81% variability in the unlock phase, respectively. These findings suggest that these factors may contribute to the transmission of the COVID-19 and its associated deaths. The study results would enhance the ongoing research related to the influence of environmental factors. They would be helpful for policymakers in managing the outbreak of COVID-19 in Delhi, India.Item Leading Predictors of COVID-19-Related Poor Mental Health in Adult Asian Indians: An Application of Extreme Gradient Boosting and Shapley Additive Explanations(MDPI, 2023-01-09) Ikram, Mohammad; Shaikh, Nazneen F.; Vishwanatha, Jamboor K.; Sambamoorthi, UshaDuring the COVID-19 pandemic, an increase in poor mental health among Asian Indians was observed in the United States. However, the leading predictors of poor mental health during the COVID-19 pandemic in Asian Indians remained unknown. A cross-sectional online survey was administered to self-identified Asian Indians aged 18 and older (N = 289). Survey collected information on demographic and socio-economic characteristics and the COVID-19 burden. Two novel machine learning techniques-eXtreme Gradient Boosting and Shapley Additive exPlanations (SHAP) were used to identify the leading predictors and explain their associations with poor mental health. A majority of the study participants were female (65.1%), below 50 years of age (73.3%), and had income >/= $75,000 (81.0%). The six leading predictors of poor mental health among Asian Indians were sleep disturbance, age, general health, income, wearing a mask, and self-reported discrimination. SHAP plots indicated that higher age, wearing a mask, and maintaining social distancing all the time were negatively associated with poor mental health while having sleep disturbance and imputed income levels were positively associated with poor mental health. The model performance metrics indicated high accuracy (0.77), precision (0.78), F1 score (0.77), recall (0.77), and AUROC (0.87). Nearly one in two adults reported poor mental health, and one in five reported sleep disturbance. Findings from our study suggest a paradoxical relationship between income and poor mental health; further studies are needed to confirm our study findings. Sleep disturbance and perceived discrimination can be targeted through tailored intervention to reduce the risk of poor mental health in Asian Indians.Item The association of COVID-19 vaccine availability with mental health among adults in the United States(Frontiers Media S.A., 2022-08-09) Shen, Chen; Rashiwala, Lucy; Wiener, R. Constance; Findley, Patricia A.; Wang, Hao; Sambamoorthi, UshaObjective: To assess whether COVID-19 vaccine approval and availability was associated with reduction in the prevalence of depression and anxiety among adults in the United States. Methods: We adopted cross sectional and quasi-experimental design with mental health measurements before vaccine availability (June 2020, N = 68,009) and after vaccine availability (March 2021, N = 63,932) using data from Census Pulse Survey. Depression and anxiety were derived from PHQ-2 and GAD-2 questionnaires. We compared rates of depression and anxiety between June 2020 and March 2021. Unadjusted and adjusted analysis with replicate weights were conducted. Results: Depression prevalence was 25.0% in June 2020 and 24.6% in March 2021; anxiety prevalence was 31.7% in June 2020 and 30.0% in March 2021 in the sample. In adjusted analysis, there were no significant differences in likelihood of depression and anxiety between June 2020 and March 2021. Conclusion: Depression and anxiety were not significantly different between June 2020 and March 2021, which suggests that the pandemic effect continues to persist even with widespread availability of vaccines.Item The Many Faces of Innate Immunity in SARS-CoV-2 Infection(MDPI, 2021-06-04) Hanan, Nicholas; Doud, Ronnie L., Jr.; Park, In-Woo; Jones, Harlan P.; Mathew, Stephen O.The innate immune system is important for initial antiviral response. SARS-CoV-2 can result in overactivity or suppression of the innate immune system. A dysregulated immune response is associated with poor outcomes; with patients having significant Neutrophil-to-Lymphocyte ratios (NLR) due to neutrophilia alongside lymphopenia. Elevated interleukin (IL)-6 and IL-8 leads to overactivity and is a prominent feature of severe COVID-19 patients. IL-6 can result in lymphopenia; where COVID-19 patients typically have significantly altered lymphocyte subsets. IL-8 attracts neutrophils; which may play a significant role in lung tissue damage with the formation of neutrophil extracellular traps leading to cytokine storm or acute respiratory distress syndrome. Several factors like pre-existing co-morbidities, genetic risks, viral pathogenicity, and therapeutic efficacy act as important modifiers of SARS-CoV-2 risks for disease through an interplay with innate host inflammatory responses. In this review, we discuss the role of the innate immune system at play with other important modifiers in SARS-CoV-2 infection.Item Traditional Chinese Medicine and Western Medicine Share Similar Philosophical Approaches to Fight COVID-19(JKL International, 2021-08-01) Zhao, Fangfang; Yang, Zhenhong; Wang, Ningqun; Jin, Kunlin; Luo, YuminThough disciplines in the same field, modern medicine (Western medicine) and traditional medicine (Traditional Chinese medicine, TCM) have been viewed as two distinct and divergent fields of medicine and thus differ greatly in their ways of diagnosing, treating, and preventing disease. In brief, Western medicine is primarily an evidence (laboratory)-based science, whereas TCM is more of a healing art based on the theory of Yin and Yang and the five elements in the human body. Therefore, whether TCM and Western medicine could use similar philosophical approaches to treat disease remains unclear. It is well-known that vitamin D enhances immune function and reduces the spread of some viruses. Indeed, recent evidence shows that the blood calcium level is strongly associated with COVID-19 severity, and vitamin D supplementation has shown favorable effects in viral infections. According to TCM theory, the pathogenesis of COVID-19 is closely associated with cold-dampness, an etiological factor in TCM. Cold-dampness could be attenuated by sun exposure and Wenyang herbs, both of which can restore the vitamin D level in the blood in Western medicine. Therefore, TCM and Western medicine could share similar philosophical methods to fight COVID-19 and understanding their philosophical theories could achieve the maximum benefits for treatment of COVID-19 and other diseases.Item Transplantation of ACE2(-) Mesenchymal Stem Cells Improves the Outcome of Patients with COVID-19 Pneumonia(JKL International, 2020-03-09) Leng, Zikuan; Zhu, Rongjia; Hou, Wei; Feng, Yingmei; Yang, Yanlei; Han, Qin; Shan, Guangliang; Meng, Fanyan; Du, Dongshu; Wang, Shihua; Fan, Junfen; Wang, Wenjing; Deng, Luchan; Shi, Hongbo; Li, Hongjun; Hu, Zhongjie; Zhang, Fengchun; Gao, Jinming; Liu, Hongjian; Li, Xiaoxia; Zhao, Yangyang; Yin, Kan; He, Xijing; Gao, Zhengchao; Wang, Yibin; Yang, Bo; Jin, Ronghua; Stambler, Ilia; Lim, Lee Wei; Su, Huanxing; Moskalev, Alexey; Cano, Antonio; Chakrabarti, Sasanka; Min, Kyung-Jin; Ellison-Hughes, Georgina; Caruso, Calogero; Jin, Kunlin; Zhao, Robert ChunhuaA coronavirus (HCoV-19) has caused the novel coronavirus disease (COVID-19) outbreak in Wuhan, China. Preventing and reversing the cytokine storm may be the key to save the patients with severe COVID-19 pneumonia. Mesenchymal stem cells (MSCs) have been shown to possess a comprehensive powerful immunomodulatory function. This study aims to investigate whether MSC transplantation improves the outcome of 7 enrolled patients with COVID-19 pneumonia in Beijing YouAn Hospital, China, from Jan 23, 2020 to Feb 16, 2020. The clinical outcomes, as well as changes of inflammatory and immune function levels and adverse effects of 7 enrolled patients were assessed for 14 days after MSC injection. MSCs could cure or significantly improve the functional outcomes of seven patients without observed adverse effects. The pulmonary function and symptoms of these seven patients were significantly improved in 2 days after MSC transplantation. Among them, two common and one severe patient were recovered and discharged in 10 days after treatment. After treatment, the peripheral lymphocytes were increased, the C-reactive protein decreased, and the overactivated cytokine-secreting immune cells CXCR3+CD4+ T cells, CXCR3+CD8+ T cells, and CXCR3+ NK cells disappeared in 3-6 days. In addition, a group of CD14+CD11c+CD11b(mid) regulatory DC cell population dramatically increased. Meanwhile, the level of TNF-alpha was significantly decreased, while IL-10 increased in MSC treatment group compared to the placebo control group. Furthermore, the gene expression profile showed MSCs were ACE2(-) and TMPRSS2(-) which indicated MSCs are free from COVID-19 infection. Thus, the intravenous transplantation of MSCs was safe and effective for treatment in patients with COVID-19 pneumonia, especially for the patients in critically severe condition.Item Vaping and COVID-19 Risk: Perceived link and its correlates among at-risk adolescents(Elsevier Inc., 2021-10-11) Cai, Xioamei; Zhao, Xiaquan; Rossheim, Matthew E.; Xue, HongResearch shows that a significant number of adolescents and young adults quit vaping or reduced the amount of nicotine consumed since the beginning of the COVID-19 pandemic. However, there is a lack of evidence on adolescent risk perceptions regarding the link between vaping and susceptibility to contracting COVID-19. This study examined the level of perceived COVID-19 risk due to vaping among at-risk adolescents. A sample (N = 1,251) of adolescents aged 13 to 17 and susceptible to future vaping were recruited through Qualtrics to participate in an online survey. More than two thirds of the sample (68.34%) reported that vaping would increase one's risk of contracting COVID-19. Ordinal logistic regression showed that this risk perception was positively associated with perceived prevalence of vaping among peers (AOR = 1.186, 95%CI = 1.019-1.382) and prior exposure to vaping product advertising (AOR = 1.371, 95%CI = 1.221-1.539), and negatively associated with past 30-day vaping (AOR = 0.579, 95%CI = 0.406-0.825) and number of closest friends who vaped (AOR = 0.873, 95%CI = 0.779-0.978). Further analysis stratified by past 30-day vaping showed that, among those who vaped in the past 30 days, vaping-related covid risk perception was positively associated with susceptibility to future vaping (AOR = 1.562, 95%CI = 1.161-2.101) and sensation-seeking (AOR = 1.212, 95%CI = 1.003-1.463). These results are open to different interpretations because of the cross-sectional nature of the data. Additional research is needed to better understand the observed relationships and their implications for vaping prevention during the pandemic.