Medicine and Health Sciences Commons^™

Observational Analysis For Predicting Initial Spikes In Testing Volume Of Cohorts Inside And Outside Of A Regional Covid-19 Screening Program, Adam M. Franks, Seth Bergeron, Tammy Bannister, Justin Spradling, Tamara Lowe, Paris Johnson, Rajan Lamichhane, Stephen M. Petrany

Marshall Journal of Medicine

BACKGROUND Containing the highly contagious SARs-CoV-2 pathogen requires a safe and effective screening program. The aim of this observational cohort study is to analyze a regional testing center and identify factors predicting testing rates that direct supply and staffing needs.

METHODS A drive-through SAR-CoV-2 regional testing facility was created. Number of tests and positive results were collected for eighteen months. Data for testing demand was compared to positive results, percent positive rates (PPR), known external factors, and county PPR. Dissimilarities were contrasted with dynamic time warp and a detailed agreement analysis. The Grainger’s test was utilized to assess the degree …

Ischemic Colitis In A Middle-Aged Man With Covid-19: Case Report And Review Of Literature, Lara Appiah, Subhasis Misra, Stephen Jones

HCA Healthcare Journal of Medicine

Introduction

Coronavirus disease 2019 (COVID-19) was a pandemic that began in 2019 and continues to have morbid and deadly consequences throughout the world. During the beginning of the pandemic, many considered older adults and immunocompromised younger adults to be the only populations at risk for the severe consequences of COVID-19. Throughout the pandemic, this was proven wrong with several case reports and studies showing that relatively younger adults can also suffer serious consequences from this perplexing virus.

Case Presentation

We report a rare case of ischemic colitis in a 42-year-old obese man who presented to the emergency department with quintessential …

Opioid-Related Emergency Department Visits Before And During Covid-19: Association With Community-Level Factors, Timothy F. Page, Weiwei Chen, François Sainfort, Julie A. Jacko

HCA Healthcare Journal of Medicine

Background

The purpose of the study was to investigate the relationship between community-level variables and emergency department (ED) visit rates before and during COVID-19. The focus was on opioid-related ED visits. Despite large declines in overall ED visits during COVID-19, opioid-related visits increased. While visits for avoidable conditions decreased, the opposite was true for opioid-related visits.

Methods

We combined data from Florida EDs with community-level variables from the 2020 American Community Survey. The outcome measures of the study were quarterly ZIP code tabulation-area-level ED visit rates for opioid-related ED visits as well as visit rates for all other causes. Associations …

Evaluation Of The Efficacy Of Remdesivir For The Treatment Of Coronavirus Disease 2019, Alexandra Flannery, Anastasia Knecht, Koravangala Sundaresh

HCA Healthcare Journal of Medicine

Background

Coronavirus disease 2019 (COVID-19), caused by a novel coronavirus, SARS-CoV-2, has accounted for more than 1 000 000 deaths in the United States alone. In May 2020, the Food and Drug Administration issued an Emergency Use Authorization to allow the investigational use of intravenous remdesivir for the treatment of suspected or confirmed COVID-19 in hospitalized children and adults. Several other agents, such as hydroxychloroquine, dexamethasone, and tocilizumab have been investigated as potential treatment options; however, dexamethasone is currently the only agent that has been proven to reduce mortality in patients who require supplemental oxygen. The purpose of this study …

Overview Of The Zoonotic Potential And Coinfection Of Sars-Cov-2 In Indonesia, Muhammad Khaliim Jati Kusala, Ni Luh Putu Indi Dharmayanti

Karbala International Journal of Modern Science

In the ASEAN region, Indonesia has the highest overall COVID-19 infection score. The SARS-CoV-2 pandemic first emerged in China and then transmitted sporadically throughout the world. Animals and humans can be infected with the corona virus, so this disease is classified as a zoonotic disease. This review aims to gather information regarding the potential of SARS-CoV-2 as a zoonotic disease and coinfections with several other pathogens in Indonesia. This study collected data demonstrating the potential for COVID-19 to be transmitted from humans to animals, as an evidenced by positive test results for the Bat Coronavirus Antigen in bats. Cats have …

New Onset Positive Autoantibodies Following Covid-19 Infection, David Hernandez, Adnaan Sheikh, Shakira Laing, Mariana Adieb, Omar Siddiqui, Rohail Baig, Annabel Antonini, James Vienneau, Camden Burns

Advances in Clinical Medical Research and Healthcare Delivery

The World Health Organization (WHO) declared the novel coronavirus (COVID-19) outbreak a global pandemic on March 11, 2020. Since the original outbreak in December 2019, over 100 million people have been confirmed to have been infected by COVID-19 and over two million people have died. The presentation seen in patients may vary widely based on multiple factors. Fever has been reported in up to 99% of patients, while other common symptoms seen are dyspnea, fatigue, anosmia, and myalgia. Around 80% of COVID-19 patients present with a mild respiratory illness that can be managed at home, while around 15% need basic …

Significance Of Chronic Kidney Disease On Morbidity And Mortality In Hospitalized Patients With Covid-19, Varsha Suresh, Alexis Finer, Aarushi Varshney, Kay Thi Khine, Ishak Mansi, Abdo Asmar

HCA Healthcare Journal of Medicine

Background

Patients with comorbid illnesses are at risk for worse outcomes with a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2; COVID-19). Our research examined patients with chronic kidney disease (CKD) to establish whether it remains an independent risk factor for mortality and morbidity in patients with COVID-19.

Methods

We conducted a retrospective cohort study using an electronic patient database in 2020. An observational dataset from 149 hospitals comprising a United States-based health system (HCA Healthcare) was analyzed. Hospitalized patients (N=11 086), aged 18 and above, with a COVID-19 polymerase chain reaction positive result between January 1, 2020, and September 1, …

A Retrospective Cohort Study Assessing The Impact Of Statin Therapy On Hospital Length Of Stay And Inpatient Mortality In Covid-19 Patients, Huy V. Ho, Hamish Patel, Mohammed Ahmed, Ahmed Eddib, Fagunkumar Modi, Domenick Sorresso, Rahul Mhaskar, David Phrathep, Olugbenga Oyesanmi

HCA Healthcare Journal of Medicine

Background

Coronaviruses, known for their crown-like appearance, cause mild gastrointestinal and respiratory diseases. Some cause outbreaks of respiratory diseases, most recently, SARS-CoV-2, the coronavirus disease 2019 (COVID-19). Individuals with COVID-19 are reported to be in both arterial and venous prothrombotic states. In addition to a lipid-lowering effect, statin also has an anti-inflammatory effect, which addresses one of the underlying causes of thrombosis. An in-silico study revealed that statins could directly interact with the main protease enzyme of SARS-CoV-2 and prevent infectivity. Due to these pleiotropic properties, statins may positively impact the outcome of hospitalized patients with COVID-19 infections.

Methods

A …

Sars-Cov-2: Tale Of A Microscopic Murderer, Josiah P. Garner

Quest

Independent Study

Research in progress for BIOL1406: Biology for Science Majors I

Faculty Mentor: Amina Tassa, Ph.D.

I am delighted to introduce Josiah Garner’s “SARS-CoV-2: Tale of a Microscopic Murderer.” This independent study assignment explores the impact of a novel, deadly, and worldwide virus. The assignment also examines the fast development of vaccines to control the spread and reduce the symptoms of the virus.

Josiah’s paper focuses on the early history of the emergence of COVID-19, the world response, and vaccine development. He demonstrates critical thinking skills and effectively utilizes various research methods to obtain and communicate his information. Josiah …

Who Left The Hospital Against Medical Advice During The Early Covid-19 Pandemic?, Bryan Werner, Se Won Lee

HCA Healthcare Journal of Medicine

Background

Patients leaving against medical advice (AMA) presents a challenge to hospitals as they try to manage costs and improve patient outcomes in an ever-increasing competitive market. Investigating AMA discharges that occurred during the early COVID-19 pandemic presents a unique opportunity to better understand this phenomenon and be better prepared for the future.

Methods

This retrospective analysis of 34 379 patients from a nationwide private healthcare system across 20 states analyzed patients during the early stages of the pandemic who chose to leave against medical advice (AMA) after being admitted with COVID-19 infection and identified several patient characteristics associated with …

Covid-19 Disease Characterization And Outcomes Comparison In Pediatrics, Rachel Rowland, Abigail Schauble, Brendon Cornett

HCA Healthcare Journal of Medicine

Background

It has been reported that children experience less severe COVID-19 symptoms than adults; however, the literature that supports this idea is evolving. The purpose of this study was to retrospectively characterize hospitalized COVID-19-positive pediatric patients with a focus on the assessment of risk factors for poorer outcomes, mortality, and evaluation of interventions utilized and associated clinical outcomes.

Methods

We conducted a multi-center retrospective chart review of patients 18 years old or younger who were COVID-19 positive and admitted to any US HCA Healthcare Pediatric service line between January 1, 2020, and November 30, 2020. We identified 6081 children across …

Why The West Should Help China Reduce Unrecognized And Preventable Covid-19 Deaths, George A. Gellert

Journal of Health Ethics

In an era marked by a ruinous war between a democratic state and a totalitarian regime, political volatility, rightward looking isolationism and nationalism, and heightened competition and disputes between China and the West, it is perhaps difficult to discern why the West should supply China with COVID-19 vaccines and therapeutics, as well as epidemiological assistance in order to mitigate a potentially unrecognized COVID-19 crisis in that nation. This commentary considers three arguments against Western and international indifference to the plight of China as it transitions to COVID-19 endemicity.

Prevalence And Impact Of Gastrointestinal Manifestations In Covid-19 Patients: A Systematic Review, Bassam Hossain, Shoreh Qazi, Sumair Ahmad, Atif Saleem, Amanke Oranu, Fahad Malik

Journal of Community Hospital Internal Medicine Perspectives

Background and Objective: The aim of this study is to systematically analyze and summarize the implications of COVID-19 on the digestive system by quantitatively evaluating the prevalence of gastrointestinal symptoms such as nausea, vomiting, abdominal pain, constipation, diarrhea, anorexia. reported in COVID-19 cases. We simultaneously investigated other variables to determine the association of such symptoms in COVID-19 patients which can potentially influence the disease prognosis and outcome. This systematic review presents an updated literature on the issue as it requires more scientific discussion in order to better inform the medical community and authorities so that appropriate measures can be taken …

Impact Of Inhaled Epoprostenol In Patients On Covid-19 Acute Respiratory Distress Syndrome (Ards), Stacey Nguyen, Stephen Chromi, Mark Decerbo, Surajit Dey, Joseph Mccoy, Jeffrey Murawsky

HCA Healthcare Journal of Medicine

Background

Coronavirus disease 2019 (COVID-19), a novel respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), can progress to critical illness and the development of acute respiratory distress syndrome (ARDS). Variability in clinical presentation has led to 2 distinct theoretical classifications of COVID-19 ARDS based on different phenotypical presentations. The first of which follows closely to traditional ARDS presenting as severe hypoxemia with markedly reduced lung compliance, whereas the second presents as severe hypoxemia with preserved to high lung compliance. With uncertainty surrounding the specific pathological and mechanistic nature of COVID-19, we designed this study to elucidate the …

You Can Lead A Horse To Water, Paul B. Freeman, Od

Optometric Clinical Practice

Letter from the Editor

Exploring The Possible Phenomenon Of Viral Interference Between The Novel Coronavirus And Common Respiratory Viruses, Spencer Deleveaux, Alexandria Clarke-Kregor, Xavier Fonseca-Fuentes, Essam Mekhaiel

Journal of Patient-Centered Research and Reviews

At the peak of the 2021 wave of the SARS-CoV-2 alpha variant in North America, there was concern for a superimposed wave of viral respiratory infections. There was, however, an apparent shift in the usual epidemiology of these pathogens, especially during the traditional influenza season from approximately October 2020 to March 2021. This article seeks to briefly describe the epidemiology of notable respiratory pathogens during the first wave of the COVID-19 pandemic and to focus on one possible factor for the trends observed. There are many contributory elements to the observed viral trends, but in particular, we present a synopsis …

Performance Of A Sars-Cov-2 Rt-Pcr Assay With Non-Traditional Specimen Types, Subathra Marimuthu, Holly Aliesky, Heather Ness, Daniya Sheikh, Sathya Rashmit, Dawn Balcom, Leslie A. Wolf

The University of Louisville Journal of Respiratory Infections

During the first two years of the coronavirus disease 2019 (COVID-19) pandemic, nasopharyngeal (NP) specimens were the gold standard for clinical diagnostic testing. As information about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing the pandemic continued to be shared, it was clear that the virus could be detected in other specimen types during an active infection. The University of Louisville Infectious Diseases Laboratory accepted non-traditional specimen types, most without a paired, positive NP result, for research purposes only to support local epidemiology efforts. A real-time reverse transcription-polymerase chain reaction (RT-PCR) assay originally validated for NP specimens was used …

Therapeutic Options For Covid-19: Drug Repurposing Of Serine Protease Inhibitor Against Tmprss2, Mohammad Wildan Abiyyi, Surya Dwira, Arleni Bustami, Linda Erlina

Indonesian Journal of Medical Chemistry and Bioinformatics

The SARS-Coronavirus 2 (SARS-CoV-2) outbreak is a serious global public health threat. Researchers around the world are conducting mass research to control this epidemic, starting from the discovery of vaccines, to new drugs that have specific activities as antivirals. Drug repurposing is a potential method of using drugs with known activity for reuse as COVID-19 therapy. This method has the advantage that it can reduce costs and also the duration in the development of potential drugs. The initial step in drug repurposing can be done computationally to determine the effectiveness and specificity of the drug on the target protein. Molecular …

Investigating Stigma During The Early Stages Of A Pandemic Through The Lens Of Covid-19, Zach Thornton, Bethany Hodge, Sheridan Langford

The University of Louisville Journal of Respiratory Infections

Background: Individuals face stigma associated with numerous health conditions. Stigma can arise rapidly during the early spread of a new disease, adding to the burden felt by those affected. COVID-19 can be used as an example to study stigma during the early phases of a pandemic. This narrative review is a descriptive analysis that tracks the ways in which COVID-19 stigma was discussed in the scholarly literature during the first year of the pandemic to understand how stigma was viewed in the context of a rapidly spreading pandemic.

Methods: PubMed was used as a non-exhaustive sample of the literature. Searches …

Acute Thrombotic Thrombocytopenic Purpura: Rare And Life-Threatening Side Effect Of Recent Bnt-162b2 Covid-19 Vaccination, Jay Patel, Muhammad Umair Jahngir, Ahmad Abdulzahir, Ismael Rodriguez

HCA Healthcare Journal of Medicine

Thrombotic thrombocytopenic purpura (TTP) is a rare, potentially life-threatening disorder characterized by uncontrolled and spontaneous clot formation throughout the body. Known secondary causes of TTP include malignancy, bone marrow transplantation, pregnancy, various medications, and HIV infection. TTP in the setting of COVID-19 vaccination is rare and not well reported. Reported cases have been confined primarily to the AstraZeneca and Johnson and Johnson COVID-19 Vaccines. TTP in the setting of Pfizer BNT-162b2 vaccination has only recently been reported. We present a patient with no obvious risk factors for TTP who presented with acute altered mental status and was found to have …

A Phase 1a/1b Clinical Trial Design To Assess Safety, Acceptability, Pharmacokinetics And Tolerability Of Intranasal Q-Griffithsin For Covid-19 Prophylaxis, Henry W. Nabeta, Maryam Zahin, Joshua L. Fuqua, Elizabeth D. Cash, Ingrid Leth, Michael Strauss, Jeanne Novak, Lin Wang, Angela Siegwald, Rachel A. Sheppard, Shesh N. Rai, Lisa C. Rohan, Sharon Hillier, Gerald W. Dryden, Kevin L. Potts, Kenneth E. Palmer

The University of Louisville Journal of Respiratory Infections

Background: The COVID-19 pandemic remains an ongoing threat to global public health. Q-Griffithsin (Q-GRFT) is a lectin that has demonstrated potent broad-spectrum inhibitory activity in preclinical studies in models of Nipah virus and the beta coronaviruses SARS-CoV, MERS-CoV, and SARS-CoV-2.

Methods: Here, we propose a clinical trial design to test the safety, pharmacokinetics (PK), and tolerability of intranasally administered Q-GRFT for the prevention of SARS-CoV-2 infection as a prophylaxis strategy. The initial Phase 1a study will assess the safety and PK of a single dose of intranasally administered Q-GRFT. If found safe, the safety, PK, and tolerability of multiple doses …

An Algorithm For Indoor Sars-Cov-2 Transmission, Daniel Maxin, Spencer Gannon

Journal of Mind and Medical Sciences

We propose a computer modeling approach for SARS-CoV-2 transmission that can be preferable to a purely mathematical framework. It is illustrated its functionality in a specific case of indoor transmission. Based on literature, we assume that infection is due to aerosols with viral particles that persist and accumulate for hours in the air even after the persons who produced them left the space. We incorporate also restricted opening hours as a mitigation measure and one possible behavioral change in response to this measure. It is shown via several examples how this algorithmic modeling approach can be used to run various …

Development And Optimization Of An Immunoassay For The Detection Of Antibodies Against Sars-Cov-2 With In-House Recombinant Rbd Protein, Safira Pinaka Pramestika Ratu, Silmi Mariya, Rachmitasari Noviana, Uus Saepuloh, Huda Salahudin Darusman

Makara Journal of Science

COVID-19 caused by SARS-CoV-2 poses a major threat to the global community, particularly in Indonesia. Countermeasures to prevent the spread of this disease have also been implemented, including the implementation of a vaccination program. An immunoassay technique that can be used to analyze antibodies that might develop following vaccination is the indirect enzyme-linked immunosorbent assay (ELISA). We produced the recombinant spike protein used in this study. The optimization comprised adjusted concentrations of spike recombinant protein (5 and 10 ng/mL), blocking agent (2.5% and 5%), and conjugate (1:1000 and 1:5000). The optimal conditions in this study included a spiked concentration of …

Threats Of Covid-19 Reinfection: A Review Of The Evidence From The Literature, Muhammad Luthfi Adnan, Ana Fauziyati

Jurnal Penyakit Dalam Indonesia

Case of COVID-19 reinfection are related to immune factors in patients who have recovered by the natural course of the infecting pathogen. However, the chance of COVID-19 reinfection are still not well established. This review aimed to discuss about reinfection-related studies, including causes and clinical manifestations, and reinfection management. Reinfection happens when a patient is infected by the SARS-CoV-2 virus, which has a different genome from previous infection. Although the comparison of clinical manifestation between reinfection and the previous infection is not clear, it is believed that vulnerable populations may have worse outcomes. Vaccination is the main option to reduce …

Attitudes Toward Covid-19 And Covid-19 Vaccinations Among Athletic Trainers, Stephen A. Cage, Paul Mcgaha, Monica Matocha, Michelle Crum, Phd, Cathy Fieseler, Laurel Trail, Brandon J. Warner, Diana M. Gallegos

Internet Journal of Allied Health Sciences and Practice

Purpose: Following the beginning of the pandemic brought about by the novel coronavirus which causes COVID-19, the first COVID-19 vaccination received emergency use authorization in the United States of America in December of 2020. Current research has shown the authorized COVID-19 vaccines are safe and effective at preventing severe illness, hospitalizations and death have a good safety profile. Additionally, the side effects associated with these vaccines are typically mild to moderate while the protection against hospitalization and severe disease is substantial. (https://www.cdc.gov/coronavirus/2019-ncov/vaccines/safety/adverse-events.html). At the time of this study, there appears to be a paucity in the research related …

Wastewater-Informed Public Health Intervention Playbook

Sustain Magazine

As the SARS-CoV-2 pandemic quickly spread from country to country and continent to continent in 2020, governments and scientists needed a way to track COVID-19 through populations in order to position public health interventions in the most impactful locations. Having a decision-based risk framework may help to guide policy creation that could minimize or prevent possible outbreaks and surges of infection within communities. The University of Louisville in partnership with Louisville’s Department of Public Health and Wellness tested this strategy in 2021 and 2022. This Wastewater-Informed Public Health Intervention Playbook describes the decisions and actions of that academic and public …

Covid-19 And Lung Cavitation: A Clue To Pathogenesis?, Tanner W. Norris, Blake M. Snyder, Patryk Purta, Ryan P. Spilman, Vanessa J. Craig

HCA Healthcare Journal of Medicine

Lung cavitation as a complication of COVID-19 is rare. A 56-year-old male presented with lung cavitation, small volume hemoptysis, and violaceous discoloration of the right great toe, 5 weeks after diagnosis with COVID-19 pneumonia. The digital changes were consistent with previously described microvascular changes called "COVID toe." CT angiography of the chest was negative for pulmonary embolism but showed a 2.5 x 3.1 x 2.2 cm cavitation within the right lung. Extensive evaluation for commonly implicated infectious and autoimmune causes was negative. We concluded that the cavitary lung lesions were likely a complication of COVID-19 pneumonia and may implicate microangiopathy …

Co2 Levels Behind And In Front Of Different Protective Mask Types, Hossein Akhondi, Sassan Kaveh, Kimball Kaufman, Tina Danai, Napatkamon Ayutyanont

HCA Healthcare Journal of Medicine

Objectives

Many individuals have difficulty adapting to face mask use and report symptoms while using masks. Our primary objective was to determine whether continuous mask-wearing causes elevated levels of carbon dioxide (CO₂) behind the facemasks.

Methods

CO₂ concentrations were measured behind 3 different types of face masks and were compared to CO^₂ concentrations at the mask front in 261 subjects who continuously wore masks for at least 5 minutes. These CO₂ concentrations were also measured in several randomly selected subjects after a 5-minute walk.

Results

There were significantly higher CO₂ concentrations behind the mask …

Discovery Of Sars-Cov-2 Rna-Dependent-Rna-Polymerase (Rdrp) Inhibitor From Sambiloto (Andrographis Paniculata) Based On Molecular Docking And Admet Prediction Approach, Dina Ahsana, Rizki Rahmadi Pratama, Alfisyahriatunnida Meily, Andika Andika

Pharmaceutical Sciences and Research

The rapid spread of the coronavirus disease 2019 (COVID-19) has led to the development of therapeutic inhibitor drug of SARS-CoV-2, which can inhibit the viral enzyme RNA-dependent-RNA-polymerase (RdRp), thereby preventing the replication, transcription, and synthesis of RNA virus in the host cells. Previous in-vitro studies revealed that Andrographis paniculata has the potential to inhibit the virus. Therefore, this study aims to isolate the specific compounds of Andrographis paniculata, which play a role in inhibiting SARS-CoV-2 RdRp using molecular docking. A total of 19 compounds were identified in previous literature studies, while remdesivir and favipiravir were used as the positive …

Real-World Third Covid-19 Vaccine Dosing And Antibody Response In Patients With Hematologic Malignancies, Michael A. Thompson, Sigrun Hallmeyer, Veronica E. Fitzpatrick, Yunqi Liao, Michael P. Mullane, Stephen C. Medlin, Kenneth Copeland, James L. Weese

Journal of Patient-Centered Research and Reviews

Purpose: This study sought to describe the changes in immune response to a third dose of either Pfizer’s or Moderna’s COVID-19 mRNA vaccine (3V) among patients with hematologic malignancies, as well as associated characteristics

Methods: This retrospective cohort study analyzed pre-3V and post-3V data on 493 patients diagnosed with hematologic malignancies across a large Midwestern health system between August 28, 2021, and November 1, 2021. For antibody testing, S1 spike antigen of the SARS-CoV-2 virus titer was used to determine serostatus.

Results: Among 493 participants, 274 (55.6%) were seropositive both pre- and post-3V (+/+) while 115 (23.3%) seroconverted to positive …