Infection with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) leads to COVID19 disease and caused a worldwide pandemic in 2019. Since the first wave of infections, there has been significant antigenic shifts, leading to the emergence of new variants. Today, infections have shifted away from the severe, fatal infection seen in 2019.

This study aimed to assess how the plasma metabolomes from patients varied with infection with different strains and could reflect disease severity.

Patients with COVID19 not requiring intensive care were recruited between January 2021 and May 2022 from the Queen Elizabeth Hospital Birmingham; 33 patients with alpha, 13 delta and 14 omicron variants. These were compared to 26 age matched contemporaneously recruited controls. Plasma samples were extracted into chloroform/methanol/water (1:2.5/1 v/v) and assessed by flow injection electrospray mass spectrometry (FIE-MS) using an Exactive Orbitrap mass spectrometer. Derived data were assessed using the R based MetaboAnalyst platform.

Plasma metabolomes from COVID19 patients were clearly different from controls. Metabolite variation could be related to infection with different SARS-CoV2 variants. Variant showed different levels of some phospholipids, ganglioside GD1a and a dihydroxyvitamin D3 derivative. Correlations of the plasma metabolomes indicated negative correlations between selected phospholipids and the levels of C-reactive protein, creatinine, neutrophil and D-dimer.

The plasma metabolomes of COVID19 patients show changes, particularly in phospholipids, which could reflect disease severity and SARS-CoV2 variant infection.

Inborn errors of immunity (IEI) are congenital disorders of the immune system. Due to impaired immune system, they are at a higher risk to develop a more severe COVID-19 course compared to general population.

Herein, we aimed to systematically review various aspects of IEI patients infected with SARS-CoV-2. Moreover, we performed a meta-analysis to determine the frequency of COVID-19 in patients with different IEI.

Embase, Web of Science, PubMed, and Scopus were searched introducing terms related to IEI and COVID-19.

3646 IEI cases with a history of COVID-19 infection were enrolled. The majority of patients had critical infections (1013 cases, 27.8%). The highest frequency of critical and severe cases was observed in phenocopies of IEI (95.2%), defects in intrinsic and innate immunity (69.4%) and immune dysregulation (23.9%). 446 cases (12.2%) succumbed to the disease and the highest mortality was observed in IEI phenocopies (34.6%). COVID-19 frequency in immunodeficient patients was 11.9% (95% CI: 8.3 to 15.5%) with innate immunodeficiency having the highest COVID-19 frequency [34.1% (12.1 to 56.0%)]. COVID-19 case fatality rate among IEI patients was estimated as 5.4% (95% CI: 3.5-8.3%, n = 8 studies, I2 = 17.5%).

IEI with underlying defects in specific branches of the immune system responding to RNA virus infection experience a higher frequency and mortality of COVID-19 infection. Increasing awareness about these entities and underlying genetic defects, adherence to prophylactic strategies and allocating more clinical attention to these patients could lead to a decrease in COVID-19 frequency and mortality in these patients.

Objectives. To evaluate the impact of the COVID-19 pandemic on HIV mortality rates with a focus on demographic predictors and Medicaid access. Methods. Using Wide-Ranging Online Data for Epidemiologic Research, we conducted a descriptive study comparing HIV mortality in the United States 2 years before the COVID-19 pandemic (2018-2019) and the initial 2 years of the pandemic (2020-2021), and identifying HIV mortality factors during the pandemic. Results. During the first 2 years of the pandemic, crude HIV death rates increased and then decreased marginally. COVID-19 and HIV together contributed to 11% of the HIV death rate. While African Americans had a higher HIV mortality rate, there was a slight decrease during the pandemic. Nonelderly adults in Medicaid expansion states had lower HIV mortality than those in nonexpansion states. Conclusions. Contrary to initial concerns, we found no substantial increase in HIV mortality. A slight decrease was observed with persisting racial disparities in mortality and lower mortality in states that expanded Medicaid. Public Health Implications. The study findings can inform the development of policies to address demographic disparities in HIV mortality through targeted system-level interventions for vulnerable populations, such as Medicaid expansion and Ryan White Program services. (Am J Public Health. 2025;115(4):579-587. https://doi.org/10.2105/AJPH.2024.307916).

COVID-19, caused by the SARS-CoV-2 virus, has emerged as a global public health crisis. Understanding the factors associated with disease severity and outcomes is crucial for effective patient management. This study aimed to investigate the association between cycle threshold (CT) values, demographic data, medical history, clinical manifestations, and laboratory findings in hospitalized COVID-19 patients in Semnan, Iran.

A cross-sectional study was conducted on 86 patients with confirmed COVID-19 admitted to two hospitals in Semnan, Iran, between December 2022 and March 2023. Respiratory swab samples were collected RT-PCR was performed, CT values were obtained, and data were collected from medical records, including demographic information, medical history, clinical manifestations, and laboratory results. Statistical analysis was performed using SPSS software.

The study included 86 COVID-19 patients, with a slightly higher representation of females (55.8%) and a mean age of 67.43 years. Pre-existing conditions like hypertension, diabetes mellitus, and ischemic heart disease were prevalent among hospitalized patients. A majority of patients (59.3%) had severe COVID-19, as indicated by lower CT values, while 31.4% exhibited oxygen saturation levels below 90%. Significant differences were observed in FBS, CRP, WBC, Hb, Cr, and SPo2 levels between severe and non-severe patients. Correlation analysis revealed associations between age, CRP, Cr, BUN, FBS, Vitamin D, TG, LDL, HDL, AST, ALP, and SPo2. Reflecting complex interactions between inflammatory markers, organ function, and lipid metabolism in COVID-19 patients.

This study provides valuable insights into the association between CT values, clinical characteristics, and laboratory findings in hospitalized COVID-19 patients. The findings underscore the importance of CT values in assessing disease severity and potential prognostication. Further research is warranted to validate these findings in larger and more diverse patient populations.

High mutation rates in SARS-CoV-2, particularly among immunocompromised patients living with HIV, continue to complicate the current COVID-19 pandemic. The threshold for severe COVID-19 and a greater risk of mortality have increased in many immunocompromised individuals due to a weakened immune system. Low CD4+ T-cell counts in people living with both HIV and COVID-19 lead to prolonged disease duration and, therefore, an increased likelihood of viral infection with SARS-CoV-2 mutations in such individuals. These mutations could decrease the efficiency of ongoing vaccines and cause new outbreaks. Recently, the rise of new mutations in this patient population has created increasing concern; however, few data are currently available on the direct association of HIV infection with SARS-CoV-2 mutations. This review highlights the implications of SARS-CoV-2 and HIV co-infection, highlighting the need for extra caution and monitoring of the immune-compromised population during a pandemic. Access to HIV care and COVID-19 treatments, careful surveillance, and adapted health strategies are key to reducing risks and protecting these populations. Further research is required to elucidate the dynamics of mutations and develop intervention methods to manage COVID-19 among immunocompromised patients.

Background: The COVID-19 pandemic has impacted billions of people worldwide, particularly those with chronic health conditions, and has been associated with increases in substance use, including cannabis. The purpose of this study was to estimate the prevalence of cannabis use for symptom management of chronic health conditions during the COVID-19 pandemic. Methods: The COVID-19 Cannabis Health Study is an ongoing study among adults ≥18 who self-report cannabis use. Analyses included 1,466 responses received between March 21, 2020, and March 23, 2022, from participants who self-reported cannabis use and a chronic health condition. We examined comorbidities, symptoms managed with cannabis during the COVID-19 pandemic, and fear regarding COVID-19 diagnosis and transmission using the COVID-19 Cannabis Health Questionnaire. Descriptive statistics, Chi-squared, and T-tests were conducted. Results were stratified by those who reported using cannabis to manage a chronic health condition (medicinal cannabis user, n = 1,333) and those who did not use cannabis to manage chronic health condition (non-medicinal cannabis user, n = 133). Results: Most (90.9%, n = 1,333) of the total sample (mean age: 47.1 years [standard deviations {SD} = 15.0]) reported using cannabis to manage a chronic health condition, of which 46.1% (n = 615) reported having a medical card/recommendation, and 4.6% received recommendations to use cannabis to manage COVID-19 from health professionals. There were significant differences in age, gender, race/ethnicity, and education by medicinal cannabis use status. Comorbidities prevalent among medicinal cannabis consumers were mental health-related (66.1%), pain (58.5%), cardiometabolic-related (30.5%), immune-related (21.9%), and respiratory-related (20.8%). The most reported symptoms self-managed with cannabis during the pandemic were sleep (69.2%), chronic noncancer pain (49.7%), acute pain (46.5%), headaches/migraines (39.0%), muscle spasms (33.6%), nausea/vomiting (30.6%), and appetite stimulant (29.9%). There were no statistical differences in COVID-19 testing, fear of diagnosis, fear of transmission, or isolation due to COVID-19 between medicinal and nonmedicinal cannabis consumers in this sample. Conclusions: The perceived therapeutic benefit of cannabis during the COVID-19 pandemic is evident by the high prevalence of adults who reported using cannabis for medicinal reasons despite no recommendation from their health provider. Research is necessary to understand the prospective impact of cannabis use for self-management of chronic disease, especially within the context of COVID-19.

Several studies have reported a reduced risk of COVID-19-related mortality in patients taking antidiabetic medications. This is an umbrella review, meta-analysis, and Bayesian sensitivity assessment of SGLT2 inhibitors (SGLT2is) in COVID-19 patients with type 2 diabetes mellitus (T2DM).

A search was conducted on the MEDLINE (PubMed), EMBASE, Cochrane, and ClinicalTrials.gov databases on 5/12/2023. We performed an umbrella review of systematic reviews and meta-analyses on the effects of SGLT2is in T2DM patients with COVID-19 and critically appraised them using AMSTAR 2.0. Trials investigating SGLT2i use in COVID-19 patients post-hospitalisation and observational studies on prior SGLT2i use among COVID-19 patients were included in the meta-analysis, adhering to the PRISMA guidelines.

SGLT2is exhibited significantly lower odds of mortality (OR 0.67, 95% CI 0.53-0.84) and hospitalisation (OR 0.84, 0.75-0.94) in COVID-19 patients with T2DM. Bayesian sensitivity analyses corroborated most of the findings, with differences observed in hospitalisation and mortality outcomes. SGLT-2 inhibitors showed an OR of 1.20 (95% CI 0.64-2.27) for diabetic ketoacidosis. Publication bias was observed for hospitalisation, but not for mortality. The GRADE assessment indicated a low to very low quality of evidence because of the observational studies included.

The prophylactic use of SGLT2is reduces mortality and hospitalisation among COVID-19 patients, particularly in patients with diabetes. The utility of SGLT2is after hospitalisation is uncertain and warrants further investigation. A limited efficacy has been observed under critical conditions. Individualised assessment is crucial before integration into COVID-19 management.

Geospatial data science can be a powerful tool to aid the design, reach, efficiency, and impact of community-based intervention trials. The project titled Take Care Texas aims to develop and test an adaptive, multilevel, community-based intervention to increase COVID-19 testing and vaccination uptake among vulnerable populations in 3 Texas regions: Harris County, Cameron County, and Northeast Texas.

We aimed to develop a novel procedure for adaptive selections of census block groups (CBGs) to include in the community-based randomized trial for the Take Care Texas project.

CBG selection was conducted across 3 Texas regions over a 17-month period (May 2021 to October 2022). We developed persistent and recent COVID-19 burden metrics, using real-time SARS-CoV-2 monitoring data to capture dynamic infection patterns. To identify vulnerable populations, we also developed a CBG-level community disparity index, using 12 contextual social determinants of health (SDOH) measures from US census data. In each adaptive round, we determined the priority CBGs based on their COVID-19 burden and disparity index, ensuring geographic separation to minimize intervention "spillover." Community input and feedback from local partners and health workers further refined the selection. The selected CBGs were then randomized into 2 intervention arms-multilevel intervention and just-in-time adaptive intervention-and 1 control arm, using covariate adaptive randomization, at a 1:1:1 ratio. We developed interactive data dashboards, which included maps displaying the locations of selected CBGs and community-level information, to inform the selection process and guide intervention delivery. Selection and randomization occurred across 10 adaptive rounds.

A total of 120 CBGs were selected and followed the stepped planning and interventions, with 60 in Harris County, 30 in Cameron County, and 30 in Northeast Texas counties. COVID-19 burden presented substantial temporal changes and local variations across CBGs. COVID-19 burden and community disparity exhibited some common geographical patterns but also displayed distinct variations, particularly at different time points throughout this study. This underscores the importance of incorporating both real-time monitoring data and contextual SDOH in the selection process.

The novel procedure integrated real-time monitoring data and geospatial data science to enhance the design and adaptive delivery of a community-based randomized trial. Adaptive selection effectively prioritized the most in-need communities and allowed for a rigorous evaluation of community-based interventions in a multilevel trial. This methodology has broad applicability and can be adapted to other public health intervention and prevention programs, providing a powerful tool for improving population health and addressing health disparities.

SARS-CoV-2 infection has led to a range of long-lasting symptoms, collectively referred to as long COVID. Current research highlights the critical role of angiotensin-converting enzyme 2 (ACE2) in regulating gut microbiota diversity, vascular function, and homeostasis within the renin-angiotensin system (RAS). ACE2 is utilized by the SARS-CoV-2 virus to enter host cells, but its downregulation following infection contributes to gut microbiota dysbiosis and RAS disruption. These imbalances have been linked to a range of long COVID symptoms, including joint pain, chest pain, chronic cough, fatigue, brain fog, anxiety, depression, myalgia, peripheral neuropathy, memory difficulties, and impaired attention. This review investigates the dysregulation caused by SARS-CoV-2 infection and the long-term effects it has on various organ systems, including the musculoskeletal, neurological, renal, respiratory, and cardiovascular systems. We explored the bidirectional interactions between the gut microbiota, immune function, and these organ systems, focusing on how microbiota dysregulation contributes to the chronic inflammation and dysfunction observed in long COVID symptoms. Understanding these interactions is key for identifying effective therapeutic strategies and interventional targets aimed at mitigating the impact of long COVID on organ health and improving patient outcomes.

COVID-19 symptoms may persist beyond acute SARS-CoV-2 infection, as ongoing symptomatic COVID-19 [OSC] (symptom duration 4-12 weeks) and post-COVID syndrome [PCS] (symptom duration ≥12 weeks). Vaccination against SARS-CoV-2 decreases OSC/PCS in individuals subsequently infected with SARS-CoV-2 post-vaccination. Whether vaccination against SARS-CoV-2, or any other vaccinations (such as against influenza) affects symptoms in individuals already experiencing OSC/PCS, more than natural symptom evolution, is unknown.

Using data from the ZOE COVID Symptom Study app, two comparative analyses were carried out, both in prospectively-reporting individuals with OSC/PCS: A) symptoms in individuals receiving first vaccination against SARS-CoV-2, compared with unvaccinated individuals, matched for age, sex, BMI and week of test (n=1679 in each group); B) symptoms in individuals receiving vaccination against influenza, compared with unvaccinated individuals, matched for age, sex, BMI, week of test and number of SARS-CoV-2 vaccinations (n=692 in each group). In both analyses, vaccination date (or equivalent time from start of symptoms in the unvaccinated group) was considered as the index time, and symptom evolution was measured by comparing symptoms during the second week before and second week after vaccination. Symptoms were considered by prevalence and burden over the considered periods; all results were adjusted for multiple comparisons.

After first vaccination against SARS-CoV-2, many symptoms in individuals with OSC/PCS improved more rapidly than natural history resolution, including the commonly reported symptoms of fatigue (p<0.0001, β=--0.9 [95% CI: -1.86; -0.67]) and myalgia (p<0.001, β=-0.3 [95% CI: -0.50; -0.12]). No symptom worsened after vaccination. In contrast, there was no improvement in OSC/PCS symptoms beyond natural history resolution after vaccination against influenza.

In individuals with OSC/PCS, symptom resolution improved after vaccination against SARS-CoV-2 ; this was not observed, however, after other vaccinations.

The SARS-CoV-2-induced disease, COVID-19, remains a worldwide public health concern due to its high rate of transmission, even in vaccinated and previously infected people. In the endemic state, it continues to cause significant pathology. To elu- cidate the viral mutational changes and screen the emergence of new variants of concern, we conducted this study in Bangladesh. The viral RNA genomes extracted from 25 ran- domly collected samples of COVID-19-positive patients from March 2021 to February 2022 were sequenced using Illumina COVID Seq protocol and genomic data processing, as well as evaluations performed in DRAGEN COVID Lineage software. In this study, the percentage of Delta, Omicron, and Mauritius variants identified were 88%, 8%, and 4%, respectively. All of the 25 samples had 23,403 A>G (D614G, S gene), 3037 C>T (nsp3), and 14,408 C>T (nsp12) mutations, where 23,403 A>G was responsible for increased transmis- sion. Omicron had the highest number of unique mutations in the spike protein (i.e., sub- stitutions, deletions, and insertions), which may explain its higher transmissibility and immune-evading ability than Delta. A total of 779 mutations were identified, where 691 substitutions, 85 deletions, and 3 insertion mutations were observed. To sum up, our study will enrich the genomic database of SARS-CoV-2, aiding in treatment strategies along with understanding the virus's preferences in both mutation type and mutation site for predicting newly emerged viruses' survival strategies and thus for preparing to coun- teract them.

Coronavirus Disease 19 (COVID-19), caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), and Human Immunodeficiency Virus (HIV) are significant 21st-century pandemics with distinct virological and clinical characteristics. COVID-19 primarily presents as an acute respiratory illness, while HIV leads to chronic immune suppression. Understanding their differences can enhance public health strategies and treatment approaches.

This narrative review compares the virology, transmission, immune responses, and clinical outcomes of SARS-CoV-2 and HIV to inform treatment strategies and public health interventions.

A narrative review was conducted, synthesizing data from peer-reviewed literature and expert commentary from 2010 to 2024. Databases such as PubMed, Cochrane Library, and Google Scholar were searched for relevant studies.

SARS-CoV-2 primarily spreads through airborne droplets and contaminated surfaces, while HIV transmits through direct contact with infected bodily fluids. The immune response to SARS-CoV-2 involves both innate and adaptive systems, potentially leading to a cytokine storm in severe cases. In contrast, HIV evades the immune system by integrating into host cells, resulting in chronic infection and progressive immune deterioration. Treatment for SARS-CoV-2 focuses on symptom management and prevention, with antiviral medications and vaccines playing crucial roles. Conversely, HIV treatment relies on antiretroviral therapy (ART) to suppress viral replication and maintain immune function.

The review highlights the acute nature of SARS-CoV-2 versus the chronic progression of HIV. Tailored prevention and treatment strategies are essential for effective disease management.

Public health strategies should address the unique transmission routes and progression of both viruses. Further research into vaccine development and therapeutic interventions is critical for improving disease management.

Measuring virus in biofluids is complicated by confounding biomolecules coisolated with viral nucleic acids. To address this, we developed an affinity-based microfluidic device for specific capture of intact severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Our approach used an engineered angiotensin-converting enzyme 2 to capture intact virus from plasma and other complex biofluids. Our device leverages a staggered herringbone pattern, nanoparticle surface coating, and processing conditions to achieve detection of as few as 3 viral copies per milliliter. We further validated our microfluidic assay on 103 plasma, 36 saliva, and 29 stool samples collected from unique patients with COVID-19, showing SARS-CoV-2 detection in 72% of plasma samples. Longitudinal monitoring in the plasma revealed our device's capacity for ultrasensitive detection of active viral infections over time. Our technology can be adapted to target other viruses using relevant cell entry molecules for affinity capture. This versatility underscores the potential for widespread application in viral load monitoring and disease management.

Studies have noted the connection between Mycobacterium avium subspecies paratuberculosis (MAP) and autoimmunity. MAP is an intracellular pathogen that infects and multiplies in macrophages. To overcome the hostile environment elicited by the macrophage, MAP secretes a battery of virulence factors to neutralize the toxic effects of the macrophage. One of the virulence factors is the Protein Tyrosine Phosphatase A (PtpA), a protein secreted by MAP that interferes in the phago-lysosome fusion, rendering the pathogen unnoticed in the cytoplasm of the macrophage. This study aimed to assess the presence of PtpA antibodies in the sera of Mexican individuals with rheumatoid arthritis (RA) and investigate its possible use as a biomarker for disease activity. We compared RA patients (n = 100) to control subjects (CS) (n = 100) by assessing specific immune responses to PtpA (the antigen) by an indirect ELISA method. Results showed a significant difference in PtpA levels between RA and CS, with RA patients having a median OD of 0.4645 compared to 0.1372 in CS. Antibodies against PtpA were present in 95% of RA patients and 16% of CS (AUC = 0.9163, p = 0.0001). Male control subjects showed higher PtpA reactivity than female CS. The Disease Activity Score (DAS-28) analysis showed that individuals with moderate to high disease activity had lower levels of PtpA reactivity. The results suggest a potential connection between RA and MAP infection.

To evaluate the impact of absolute cardiovascular risk counselling on quality-of-life indices within a chest pain clinic.

Primary data was collected at the Royal Hobart Hospital, Australia, between 2014 and 2020.

Patients attending an Australian chest pain clinic were randomised into a prospective, open-label, blinded-endpoint study over a minimum 12-months follow-up.

The SF-36 questionnaire was completed at baseline/follow-up and SF-6D multi-attribute utility instrument's health state utilities (HSU) were generated using SF-36 responses and the SF-6D's Australian tariff. SF-6D minimal important difference was 0.04 points. Absolute cardiovascular risk was also stratified into high/intermediate/low-risk categories for exploratory analysis of summary HSUs and dimensional scores. ANZCTR registration number 12617000615381 (registered 28/4/17).

Of n = 189 patients enrolled, HSUs were generated for 96% at baseline (intervention n = 93, usual care n = 88) and 61% at follow-up. There were no statistical differences in age, sex, absolute cardiovascular risk or mean HSU between groups at baseline. Summary HSUs improved more for the intervention group and the median between-group difference exceeded the minimal important difference threshold (intervention 0.16 utility points, control 0.10 utility points). For Intervention patients with high absolute risk (≥ 15%), HSU did not significantly change.

Absolute cardiovascular risk counselling in a chest pain clinic yielded clinically meaningful improvement in health-related quality of life.

Background and Objectives: Coinfection with SARS-CoV-2 and extrapulmonary tuberculosis (extraPTB) presents unique clinical challenges due to dual inflammatory responses and potential differences in patient profiles compared to those with SARS-CoV-2 infection alone. This study uniquely contributes to the underexplored interaction between extraPTB and SARS-CoV-2, focusing on systemic inflammation as a critical determinant of outcomes. Materials and Methods: This retrospective, cross-sectional study included 123 patients aged 19-91 years, hospitalized at Victor Babeș Hospital in Timișoara from March 2020 to March 2022. We compared 23 extraPTB and SARS-CoV-2 coinfected patients with 100 age-matched SARS-CoV-2-only patients. Clinical records were examined for demographic, clinical, and laboratory data. Results: The coinfected group was younger, with 65% under 40 years, and presented significantly higher IL-6, PCT, and transaminase levels. Coexisting COPD and type 2 diabetes were independent predictors of coinfection. A higher SpO2 at diagnosis was positively associated with coinfection likelihood (OR = 5.37), while CT scores indicated less pulmonary involvement in coinfected patients. Non-fatal outcomes were more frequent in the coinfection group (95.7% sensitivity), and only one coinfected patient had a fatal outcome versus 17 in the SARS-CoV-2-only group. Low SpO2 and elevated IL-6 were significant predictors of mortality, with severe symptoms tripling fatality odds. Conclusions: Coinfection with extraPTB and SARS-CoV-2 is associated with younger age, heightened systemic inflammation, and longer hospital stays but does not significantly increase mortality risk compared to SARS-CoV-2 alone. These findings underscore the importance of monitoring systemic inflammatory markers and developing tailored management strategies to improve long-term care outcomes for coinfected patients, especially in resource-limited settings.

Angiotensin-converting enzyme 2 (ACE2) receptors facilitate the entry of the causative virus severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) into target cells. Some ACE gene variants have been suggested to be involved in COVID-19 pathogenesis. So, the aim was to assess the association between ACE1 rs4646994 and ACE2 rs2285666 genes polymorphisms and the susceptibility and severity of COVID-19. This case-control study was conducted on 197 patients with COVID-19 and 197 healthy controls. ACE-1 insertion/deletion (I/D) (rs4646994) and ACE2 rs2285666 genes polymorphisms were determined by the amplification refractory mutation system- polymerase chain reaction (ARMS-PCR) technique. The DD genotype of ACE1 I/D polymorphism was associated with increased susceptibility to COVID-19 infection (p = 0.012), whereas the ID genotype of this polymorphism was associated with decreased susceptibility (p = 0.003) (significance level = 0.017). There was no significant association in allele and genotype distribution of ACE2 rs2285666 polymorphism between cases and controls. The ACE1 I/D polymorphism may be considered as a risk factor for COVID-19 susceptibility.

Tracheostomy is often performed in patients with a prolonged course of endotracheal intubation. This study sought to examine the clinical utility of tracheostomy during severe Coronavirus disease 2019 (COVID-19) infection.

A retrospective single-system, multicenter observational cohort study was performed on patients intubated for COVID-19 infection. Patients who received intubation alone were compared with patients who received intubation and subsequent tracheostomy. Patient demographics, comorbidities, and hospital courses were analyzed.

The University of Pennsylvania Health System from 2020 to 2021.

Logistic regression analysis was performed on patient demographics and comorbidities. Kaplan-Meier survival curves were generated depending on whether patients received a tracheostomy.

Of 777 intubated patients, 452 were male (58.2%) and 325 were female (41.8%) with a median age of 63 (interquartile range [IQR]: 54-73) years. One-hundred and eighty-five (23.8%) patients underwent tracheostomy. The mean time from intubation to tracheostomy was (17.3 ± 9.7) days. Patients who underwent tracheostomy were less likely to expire during their hospitalization than those who did not undergo tracheostomy (odds ratio [OR] = 0.31, P < 0.001), and patient age was positively associated with mortality (OR = 1.04 per year, P < 0.001). Likelihood of receiving tracheostomy was positively associated with being on extra-corporeal membranous oxygenation (ECMO) (OR = 101.10, P < 0.001), immunocompromised status (OR = 3.61, P = 0.002), and current tobacco smoking (OR = 4.81, P = 0.041). Tracheostomy was also associated with a significantly longer hospital length of stay ([57.5 ± 32.2] days vs. [19.9 ± 18.1] days, P < 0.001).

Tracheostomy was associated with reduced in-hospital mortality, despite also being associated with increased comorbidities. Tracheostomy should not be held back from patients with comorbidities for this reason alone and may even improve survival in high-risk patients.

Identification of risk factors for severe COVID-19 can help to inform case management in resource-constrained settings. We aimed to rigorously but retroactively address data issues to identify risk factors for COVID-19 morbidity and mortality among cases seeking care in Liberia.

Chart data on confirmed cases were extracted at the national COVID-19 treatment unit. Due to the use of paper charts, assignment of non-unique identifiers and incomplete documentation, data required cleaning to remove duplicates per three sets of predefined criteria. Associations between epidemiological, clinical and demographic variables and indicators of disease severity were assessed using multivariable logistic regression.

The raw data set for patients classified between 15 March and 1 September 2020 included 2703 cases or 107% more than the 1303 cases reported by the national surveillance system during the same period. The median age of cases was found to be 38 years (IQR: 27-50); most cases were men (65%). The rates of continuous positive airway pressure (CPAP) use for breathing support and of case fatality were 5% (71/1330) and 5% (52/981), respectively. Increased odds of breathing assistance with CPAP use were associated with self-reported diabetes (aOR: 4.37; 95% CI: 1.72 to 10.4) and/or hypertension (aOR: 4.86; 95% CI: 1.81 to 12.2) and increasing age (aOR: 1.06; 95% CI: 1.04 to 1.08). Recent travel history (aOR: 5.13; 95% CI: 1.13 to 19.3) and residence outside of urban Montserrado County (aOR: 22.7; 95% CI: 8.08 to 76.4) were associated with increased odds of death.

Results from this retrospective analysis highlight self-reported non-communicable diseases as well as residence outside of largely urbanised Montserrado County as factors associated with COVID-19 severity among presenting cases in Liberia. The findings, both in terms of analytical results and data quality concerns, offer insight into how access to the highly centralised health systems and processes in Liberia may have affected populations distant from the central response in terms not only of COVID-19 disease outcomes but also care-seeking behaviour and surveillance effectiveness. This has implications for surveillance and response across priority diseases.

During the course of the coronavirus disease 2019 (COVID-19) pandemic, numerous comorbidities were identified as risk factors for increased morbidity and mortality. Few studies have examined human immunodeficiency virus (HIV) and COVID-19 co-infection and the impact of HIV on COVID-19 outcomes. In this study, we compared outcomes of people living with HIV with COVID-19 with a control group to examine outcomes.

We identified 45 people living with HIV admitted with COVID-19 to one of three large healthcare systems in Memphis, Tennessee, between March 1 and October 31, 2020. We matched the people living with HIV in a 1:1 fashion to a control group of COVID-19-positive patients without a recorded history of HIV and compared clinical outcomes. Nine pairs were not able to be optimally matched, so a sensitivity analysis was completed by repeating the same analyses in the primary analysis while excluding the nine mismatched pairs.

Patients did not differ significantly in demographic variables due to the matching algorithm, and there was no significant difference in measured outcomes between people living with HIV and controls. A CD4 count of <200 cells per microliter was not significantly associated with increased morbidity or mortality. Controlling for HIV status, an elevated Charlson Comorbidity Index score of >3 was associated with increased intubation (P = 0.02), vasopressor use (odds ratio [OR] 4.81, P = 0.04), intensive care unit level of care (OR 4.37, P = 0.007), mortality (OR 7.14, P = 0.02), and length of overall hospital stay in days (P = 0.004).

We found no difference in outcomes of people living with HIV in comparison to matched controls based on HIV status but found that an increased Charlson Comorbidity Index score led to increased morbidity and mortality regardless of HIV status.

A review of key learnings from the response to the COVID-19 pandemic in nursing homes in Ireland can inform planning for future pandemics. This study describes barriers and facilitators contributing to COVID-19 outbreak management from the perspective of frontline teams.

A qualitative study involving ten online focus group meetings was conducted. Data was collected between April and June 2023. The focus group discussions explored the views, perceptions and experiences of COVID-19 Response Team (CRT) members, clinical/public health experts who worked with them, and care professionals who worked in frontline managerial roles during the pandemic. All nine Community Healthcare Organisations and six Public Health Areas in Ireland were represented. Inductive reflexive thematic analysis was carried out using NVivo Pro 20.

In total, 54 staff members participated in focus group meetings. Five themes were developed from a thematic analysis that covered topics related to (1) infection prevention and control challenges and response to the pandemic, (2) social model of care and the built environment of nursing homes, (3) nursing home staffing, (4) leadership and staff practices, and (5) support and guidance received during the pandemic.

The response to the COVID-19 pandemic has resulted in a steep learning curve, internationally and in Ireland. Preparing better for future pandemics not only requires changes to infection control and outbreak response but also to the organisation and operation of nursing homes. There is a great need to strengthen the long-term care sector's regulations and support around staffing levels, nursing home facilities, governance, use of technology, infection prevention and control, contingency planning, and maintaining collaborative relationships and strategic leadership. Key findings and recommendations from the Irish example can be used to improve the quality of care and service delivery at local, national, and policy levels and improve preparedness for future pandemics, in Ireland and internationally.

Nirmatrelvir plus ritonavir received Emergency Use Authorization for treating mild to moderate COVID-19 in high-risk patients. Its efficacy against the Omicron variant of SARS-CoV-2 remains uncertain. This retrospective cohort study assessed the effect of nirmatrelvir-ritonavir in preventing severe disease progression and long COVID symptoms after acute COVID-19 in non-hospitalized adults. SALAMA medical records from Dubai's COVID-19 healthcare centers between May 22, 2022, and April 30, 2023, were used to identify 7290 eligible patients, 9.6% of whom received nirmatrelvir-ritonavir. Treatment was associated with a notable reduction in COVID-19-related hospitalizations (adjusted hazard ratio [HR] of 0.39; 95% CI, 0.18-0.85) by day 28 of symptom onset. Moreover, nirmatrelvir-ritonavir was associated with fewer long COVID symptoms (adjusted HR of 0.42; 95% CI, 0.19-0.95). This suggests the significant effectiveness of nirmatrelvir-ritonavir against the Omicron variant, reducing both severe and long-term COVID-19 symptoms.

The SARS-CoV-2 outbreak has resulted in a considerable number of deaths worldwide. The virus damages the pulmonary artery endothelium, leading to a condition known as microvascular pulmonary inflammatory thrombotic syndrome (MPITS), which can be fatal and cause multiple organ failure. The presence of preexisting comorbidities has been shown to significantly impact the severity and prognosis of patients with SARS-CoV-2 infection. The objective of this study was to compare the age groups of patients with coronavirus disease 2019 (COVID-19) and to identify the prevalence of comorbidities associated with death and survival in an area of southern Italy. The data set consisted of 1985 patients with confirmed cases of SARS-CoV-2 infection who were admitted to the A.O.U. San Giovanni di Dio e Ruggi d'Aragona Hospital in Salerno between January 2021 and December 2022. The results were presented for the overall population and stratified by outcome and age group. All analyses were performed using the XLSTAT (Lumivero, 2024, Paris, France) and STATA software (release 16.1, StataCorp LLG, College Station, TX, USA, 2019) packages. In the study, population, 636 cases (32%) resulted in death, with a higher prevalence in the 60-79 age group, followed by the ≥80 and 30-59 age groups. The most prevalent diseases among deceased and surviving patients with confirmed cases of SARS-CoV-2 infection were those affecting the circulatory system (61.5% vs. 55.5%), the respiratory system (55.8% vs. 26.2%), and the metabolic system (25.9% vs. 25.4%). In patients aged 30-79, respiratory diseases were the primary cause of mortality, whereas in those aged ≥80, circulatory system diseases were more prevalent. Among survivors, cardiovascular diseases were the most common comorbidities across all age groups, followed by respiratory diseases and endocrine, metabolic, and immune disorders. Moreover, these comorbidities were associated with an elevated risk of mortality. The study emphasizes the substantial influence of age and comorbidities on the mortality associated with SARS-CoV-2 infection. These findings highlight the necessity for targeted interventions to manage comorbid conditions in patients with SARS-CoV-2 infection, particularly in older adults.

Cancer patients face a greater risk of complications and death after contracting the SARS-CoV-2 virus. Booster doses of the COVID-19 vaccine were suggested to provide additional protection. This study aimed to assess how cancer patients' immune systems respond to the booster shots and categorize their responses.

We analyzed 735 samples from 422 individuals, including patients followed at the Portuguese Oncology Institute of Porto (IPO-Porto). Three cohorts were recruited, and blood samples were collected 3- and 6-months post-booster dose: cohort 1 cancer patients (also collected before the booster); cohort 2 cancer patients; and cohort 3 (healthy individuals). Humoral immune response was evaluated by analyzing IgG levels against the SARS-CoV-2 Spike (S) protein. IgG levels against the SARS-CoV-2 Nucleocapsid(N) protein was also analyzed in order to address previous contact with the virus.

Among Cohort 1 patients with solid tumors, when compared to pre-boost, IgG S levels increased 3 months after the boost and remained high after 6 months. Patients with hematologic tumors demonstrated lower IgG S levels at both timepoints. Comparing the IgG S levels among hematological tumors, solid tumors, and healthy individuals in both timepoints we observed that the healthy individuals had the strongest IgG S response, followed by the solid, and, lastly, the hematologic tumors. Solid tumor patients undergoing chemotherapy had reduced IgG S levels, especially those on high febrile neutropenia risk regimens.

In conclusion, cancer patients have a weaker immune response to the SARS-CoV-2 vaccine, especially those with hematological cancers. Chemotherapy and febrile neutropenia risk further reduce booster effectiveness. Further research is needed to optimize vaccine timing for cancer patients undergoing chemotherapy.

Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) is a chronic debilitating condition with no cure that shares commonality with long-COVID. This review examines current understanding of long-COVID symptoms, characteristics of the affected population, the connection with ME/CFS, and the potential for salubrinal, an agent known for its influence on cellular stress pathways, to mitigate these disorders It also describes the historical development and mechanism of action of salubrinal, to mitigate endoplasmic reticulum (ER)/cellular stress responses, that could potentially contribute to symptom improvement in both ME/CFS and long-COVID patients. Further research and clinical trials are warranted to advance our understanding of the potential role of salubrinal in improving the quality of life for individuals with long-COVID-related ME/CFS symptoms as well as ME/CFS patients.

Poverty is one of the macro factors that has been little studied in terms of its effect on death from COVID-19 since most studies have focused only on investigating whether the pandemic increased poverty or not. With that on mind, the present study aims to analyze how the social deprivations that comprise the measurement of municipal poverty in interaction with health comorbidities and sociodemographic characteristics, increased the probability of death from COVID-19.

The study is cross-sectional and covers daily reports on the conditions of COVID-19 in the Mexican population for almost 2 years. Using data from the National Epidemiological Surveillance System and the National Council for Evaluation of the Social Development Policy (N = 5,387,981), we employ a Generalized Linear Mixed Model (GLMM), specifically a binomial generalized linear mixed model.

The findings indicate that, besides comorbidities, sociodemographic traits, and clinical aspects, living in a municipality where one or more of the social deprivations exist increases the probability of death. Specifically, in those municipalities where there is deprivation in education, social security, and food, as well as deprivation due to access to health services and deprivation in household services, the probability of death was greater.

Living in a municipality with one or more of the social deprivations that compose poverty generated a greater probability of death. Each one of them or together, shows that poverty is a substantial factor for a pandemic like COVID-19 to worsen contagion and death, becoming a circle from which it is difficult to escape.

We analyzed the changes in the top 10 non-communicable diseases (NCDs) over the past century across the World Health Organization (WHO) regions.

The data were extracted from the Global Burden of Disease (GBD) studies. After we accessed this source, all NCDs were sorted according to their prevalence in 2019, and the 10 most common NCDs were selected. Then, the incidence, prevalence, and mortality rates of these 10 NCDs were compared to the rates in 2000.

Diabetes and kidney disease had the highest increase in incidence (49.4%) and prevalence (28%) in the Eastern Mediterranean region. Substance use disorders had a huge increase (138%) in the mortality rates among women in the Americas region. On the other hand, women in Southeast Asia experienced the greatest decrease in incidence (-19.8%), prevalence (-15.8%), and mortality rates (-66%).

In recent years, nearly all NCDs have shown an increase, yet mortality rates have declined across all regions. Lifestyle can be a major cause of this increase, but advancements in health and medical services, such as screening and treatment, have played a crucial role in improving survival rates.

The increasing mortality rate of COVID-19 has remained an international public health concern. Limited studies on clinical treatment and morbidity in hospital settings are available in Indonesia. This present study aims to analyse demographic characteristics, clinical signs and treatment in COVID-19 patients and their association to the mortality case in Sulianti Saroso Infectious Disease Hospital.

The study applied a retrospective cohort approach to all COVID-19 inpatients confirmed by polymerase chain reaction (PCR) testing in Sulianti Saroso Infectious Disease Hospital from 1 June 2020 to 30 September 2021. Overall survival rates until the end of the study were calculated using the Kaplan-Meier method and compared using the log-rank test. A Cox regression model was used to evaluate the crude and adjusted hazard ratios for associated factors.

We collected 1,970 inpatient data that met our inclusion and exclusion criteria. Most of them were 19 years old-59 years old (73.2%) and male (52.6%), and 966 (49%) patients had comorbidities. Approximately 63.9%, 89.2%, 89.8%, 82%, and 14.1% of the patients had ferritin levels ≤ 800, received antiviral treatment, were treated in non-intensive wards, had a moderate or mild clinical stage and did not survive, respectively. In the adjusted analysis, mortality was associated with sex (hazard ratio [HR]: 1.12; 95% CI: 1.02, 1.23), presence of comorbidity (HR: 1.19; 95% CI: 1.08, 1.30) and favipiravir (FPV) plus azithromycin treatment (HR: 1.21; 95% CI: 1.06,1.39). FPV treatment (HR: 1.35; 95% CI: 1.04, 1.75) was associated with higher mortality.

Tailored approaches to treatment, considering individual risk factors and comorbidities, are crucial in improving patient outcomes.

The presence of prolonged symptoms after COVID infection worsens the workability and quality of life. 200 adults with long COVID syndrome were enrolled after medical, physical, and mental screening, and were divided into two groups based on their performance. The intervention group (n = 100) received supervised rehabilitation at Department of Pulmonology, Semmelweis University with the registration number 160/2021 between 01/APR/2021-31/DEC/2022, while an age-matched control group (n = 100) received a single check-up. To evaluate the long-term effects of the rehabilitation, the intervention group was involved in a 2- and 3-month follow-up, carrying out cardiopulmonary exercise test. Our study contributes understanding long COVID rehabilitation, emphasizing the potential benefits of structured cardiopulmonary rehabilitation in enhancing patient outcomes and well-being. Significant difference was found between intervention group and control group at baseline visit in pulmonary parameters, as forced vital capacity, forced expiratory volume, forced expiratory volume, transfer factor for carbon monoxide, transfer coefficient for carbon monoxide, and oxygen saturation (all p < 0.05). Our follow-up study proved that a 2-week long, patient-centered pulmonary rehabilitation program has a positive long-term effect on people with symptomatic long COVID syndrome. Our data showed significant improvement between two and three months in maximal oxygen consumption (p < 0.05). Multidisciplinary, individualized approach may be a key element of a successful cardiopulmonary rehabilitation in long COVID conditions, which improves workload, quality of life, respiratory function, and status of patients with long COVID syndrome.

The non-invasive and inexpensive predictive indicators seem to be essential for the evaluation of coronavirus disease-19 (COVID-19) prognosis. Uric acid to high-density lipoprotein-cholesterol ratio (UHR) have been known as inflammatory and metabolic biomarker in some disorders. This study aimed to evaluate the usefulness of serum uric acid (UA) and UHR values on admission as prognostic indicators for the severity and mortality of COVID-19. Regression models were accomplished to assess the association between UA and UHR with the severity and mortality of COVID-19.

This study was performed with 424 confirmed COVID-19 patients. The mean UA and UHR values of the severe group and deceased group were statistically higher than those mild group and survivor group, respectively (P < 0.05). Compared to the survivor cases, deceased subjects had lower serum concentrations of HDL-c (p < 0.05). Multivariate logistic regression analysis showed that UHR and UA values statistically are correlated with the severity (OR = 1.20 CI:1.07-1.35, OR = 1.19 CI:1.023-1.381 respectively) and mortality (OR = 10.04 CI:1.50-67.30, OR = 10.73 CI:1.47-87.11, respectively) of COVID-19. Compared with a reference range, serum UA levels ≥ 7.3 mg/dl and a UHR value greater than 0.185 increase the risk of critical care of COVID-19 almost 2.5 and 3.5 times, respectively. In summary, our results revealed that UHR index value and serum UA levels are useful biochemical indicators for predicting the severity and mortality of COVID-19.

This review discusses the prevention and treatment of coronavirus disease 2019 (COVID-19) caused by infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Mutations in its spike glycoprotein have driven the emergence of variants with high transmissibility and immune escape capabilities. Some antiviral drugs are ineffective against the BA.2 subvariant at the authorized dose. Recently, 150 natural metabolites have been identified as potential candidates for development of new anti-COVID-19 drugs with higher efficacy and lower toxicity than those of existing therapeutic agents. Botanical drug-derived bioactive molecules have shown promise in dampening the COVID-19 cytokine storm and thus preventing pulmonary fibrosis, as they exert a strong binding affinity for viral proteins and inhibit their activity. The Health Ministry of Thailand has approved Andrographis paniculata (Jap. Senshinren) extracts to treat COVID-19. In China, over 85% of patients infected with SARS-CoV-2 receive treatments based on traditional Chinese medicine. A comprehensive map of the stages and pathogenetic mechanisms related to the disease and effective natural products to treat and prevent COVID-19 are presented. Approximately 10% of patients with COVID-19 are affected by long COVID, and COVID-19 infection impairs mitochondrial DNA. As the number of agents to treat COVID-19 is limited, adjuvant botanical drug treatments including vitamin C and E supplementation may reduce COVID-19 symptoms and inhibit progression to long COVID.

The 2019 outbreak of SARS-CoV-2 has caused a major worldwide health crisis with high rates of morbidity and death. Interestingly, it has also been linked to cancer, which begs the issue of whether it plays a role in carcinogenesis. Recent studies have revealed various mechanisms by which SARS-CoV-2 can influence oncogenic pathways, potentially promoting cancer development. The virus encodes several proteins that alter key signaling pathways associated with cancer hallmarks. Unlike classical oncogenic viruses, which transform cells through viral oncogenes or by activating host oncogenes, SARS-CoV-2 appears to promote tumorigenesis by inhibiting tumor suppressor genes and pathways while activating survival, proliferation, and inflammation-associated signaling cascades. Bioinformatic analyses and experimental studies have identified numerous interactions between SARS-CoV-2 proteins and cellular components involved in cancer-related processes. This review explores the intricate relationship between SARS-CoV-2 infection and cancer, focusing on the regulation of key hallmarks driving initiation, promotion and progression of cancer by viral proteins. By elucidating the underlying mechanisms driving cellular transformation, the potential of SARS-CoV-2 as an oncovirus is highlighted. Comprehending these interplays is essential to enhance our understanding of COVID-19 and cancer biology and further formulating strategies to alleviate SARS-CoV-2 influence on cancer consequences.

Patients recovering from severe COVID-19 infections have experienced prolonged cognitive, physical, and psychological sequelae, including cardiorespiratory and motor deconditioning, neurological deterioration, anxiety, and depression. The impact of rehabilitation post-acute COVID-19 infection was recognized in the literature, but studies assessing and quantifying specific functional outcomes were lacking. This study aims to describe the characteristics and quantify the changes in functional outcomes of patients admitted to Qatar Rehabilitation Institute (QRI) for inpatient rehabilitation (IPR) post-COVID-19 infection during a 10-month period in 2021.

This is a retrospective observational cohort study, which included individuals over 18 years of age with a documented COVID-19-positive diagnosis who were admitted to QRI for IPR due to COVID-19 complications. Data was collected by the investigators from January 1, 2021, until October 30, 2021. A total of 243 patients were included in this study. The changes in functional rehabilitation outcomes were assessed and quantified at both the patient's baseline (on admission to QRI) and after completion of IPR (on discharge). The duration of the IPR program varied based on each patient's baseline assessment. Patients were given a total of 8-12 weeks to achieve their rehabilitation goals and were discharged once those goals were met. Several validated tools were utilized in this study including Functional Independence Measure (FIM), Berg Balance Scale (BBS), Dynamic Gait Index (DGI), Modified Medical Research Council (mMRC) Dyspnea Scale, Mini-Mental State Examination (MMSE), and Right- and left-Hand Grip Strength. In addition, patients' diet, the need for respiratory support, and the presence of a tracheostomy tube before and after IPR were also recorded.

In total, 84.4% of the included patients were males (n = 205); with a mean age of 52.44 ± 12.99 years. The most commonly reported comorbidities were type 2 diabetes (62.1%) and hypertension (49.8%) with 83.5% of patients experiencing critical illness neuromyopathy. The average patients' length of stay in QRI was 33.92 ± 27.72 days. A statistically significant improvement in all functional outcome scales was noted following the completion of the IPR program (p = 0.001). The number of patients requiring modification to their diet or feeding via nasogastric tube (NGT) significantly decreased by 35% and 93%, respectively (p = 0.001). Patients requiring respiratory support decreased by 98% (p = 0.001) and the need for a tracheostomy tube among patients was reduced by 95% (p = 0.001).

IPR following COVID-19 infection was associated with significant functional, motor, and cardiorespiratory improvement. Dedicating clinics for post-COVID-19 rehabilitation would ensure improved patient outcomes and enhanced recovery.

Coinfection of dengue virus and SARS-CoV-2 infections in dengue-endemic areas is a significant public health concern. Coinfections can result in severe illness. Hence, this study determines the incidence of dengue and COVID-19 coinfection for a better understanding of the clinical presentation, laboratory parameters, and outcomes including mortality.

The patients admitted to two tertiary hospitals with RT PCR-proven COVID-19 infection and dengue positive by NS1 rapid antigen or IgM dengue ELISA for two years between January 2020 and December 2022 were considered. Clinical data were retrieved from medical records including the laboratory findings and outcomes of these patients. The categorical data were analyzed in the form of frequency and proportion. The quantitative data were analyzed in the form of mean, median, and proportion.

Out of 2301 confirmed dengue samples and 3718 confirmed COVID-19 samples, there were 14 cases of coinfection with the presence of COVID-19 and dengue infection at the same time. ICU admission of 14.2% and mean hospital stay of 7 days were noted. Mainly the symptoms reported were fever at 92.9%, myalgia at 35.7%, and headache, vomiting, and cough at 28.6%. The laboratory findings were elevated lactate dehydrogenase and C-reactive protein in 100% of patients, elevated ferritin in 92.9%, thrombocytopenia in 71.4%, elevated AST and ALT in 71.4%, and elevated D-dimer in 57.1% of patients. There was no effect on morbidity and mortality seen among coinfection.

COVID-19 and dengue share similar clinical features and laboratory findings. Diagnosis of one disease cannot rule out the presence of other infections. There might be chances of misdiagnosis or missed diagnosis. Hence, it is important to stress about early detection using specific methods and confirmation of disease with timely management, as it is a potentially new dimension for public health concern and management.

The safety of the mRNA and inactivated SARS-CoV-2 vaccine has been demonstrated for people living with HIV (PLHIV). However, vaccine studies in PLHIV are limited, and there is a gap in which vaccine type provides the best response in PLHIV. Thus, PLHIV may benefit from mRNA vaccine types compared to inactivated vaccines. This study aims to assess the immune responses to vaccination by measuring specific antibodies (IgG) targeting the receptor binding sites (RBDs) of the SARS-CoV-2 virus and the levels of IL-2 and IFN-γ in plasma. A total of 41 PLHIV who regularly take antiretroviral therapy (ART) over a period of six months, along with 31 individuals in a healthy control group (HC), were administered either two mRNA or inactivated vaccines. Data regarding demographics and clinical information were gathered from the medical records. An analysis was conducted on the neutralisation antibody IgG specific to RBD using the chemiluminescence microparticle assay (CMIA). The levels of IL-2 and IFN-γ were quantified using the Luminex assay method from plasma samples. Data were collected in the laboratory 28 days after each vaccination. After the first vaccination, the level of anti-SARS-CoV-2 RBD IgG was higher in PLHIV who received the mRNA vaccines than those who received inactivated vaccines (p = 0.006). The levels of mRNA in the PLHIV group showed a significant correlation with IL-2 and IFN-γ after the second vaccination (r = 0.51, p = 0.0035; r = 0.68, p = 0.002). The group of PLHIV who received the inactivated vaccine showed increased IL-2 and IFN-γ after the initial vaccination, compared to PLHIV who received the mRNA vaccine (p = 0.04; p = 0.08). Administering a two-dose vaccination is essential to increase the levels of neutralising antibodies significantly (p = 0.013) in PLHIV who have received inactivated vaccines; further study is needed to make this a recommendation. The responses observed after vaccination in PLHIV were not affected by their CD4 cell counts. PLHIV showed higher levels of SARS-CoV-2 IgG and increased IL-2 and IFN-γ levels. Our study encourages SARS-CoV-2 vaccination in PLHIV regardless of its CD4 cell counts. Furthermore, the mRNA vaccine may give robust high antibody responses in PLHIV.