Covid19-Sources

Purpose The recent coronavirus disease (COVID-19) pandemic mainly affects the respiratory system; however, several oral and maxillofacial post-COVID-19 complications have also been observed. This series reports the growing number of osteonecrosis cases associated with post-COVID-19 patients. Materials and methods This is a retrospective, multi-center case series that reports cases with maxillary osteonecrosis after various periods of SARS-CoV-2 infection in the period between January and August 2021 based on the PROCESS guidelines. Results Twelve cases were reported with post-COVID-19 manifestation of spontaneous osteonecrosis of the maxillary jaw. Five patients were hospitalized during COVID-19 management and all of the twelve cases had at least one systematic Co-morbidity, and undertake corticosteroids prescription based on the COVID-19 disease treatment protocol. The mean onset of osteonecrosis symptoms appearance was 5.5 ± 2.43 weeks calculated from the day of the negative PCR test. The management was successfully done through surgical debridement and pre and post-operative antibiotics. No anti-fungal medications were prescribed as the fungal culture and the histopathological report were negative. Conclusion Post-COVID-related osteonecrosis of the jaw (PC-RONJ) could be now considered as one of the potential post-COVID-19 oral and maxillofacial complications that occurs unprovokedly and mainly in the maxilla.

To investigate the relationship between avascular osteonecrosis (AVN) and corticosteroid treatment given to patients with severe acute respiratory syndrome (SARS). Methods Longitudinal study of 71 former SARS patients (mainly health care workers) who had been treated with corticosteroids, with an observation time of 36 months. Magnetic resonance images (MRI) and X-rays of hips, knees, shoulders, ankles and wrists were taken as part of the post-SARS follow-up assessments. Results Thirty-nine per cent developed AVN of the hips within 3–4 months after starting treatment. Two more cases of hip necrosis were seen after 1 year and another 11 cases of AVN were diagnosed after 3 years, one with hip necrosis and 10 with necrosis in other joints. In total, 58% of the cohort had developed AVN after 3 years of observation. The sole factor explaining AVN in the hip was the total dose of corticosteroids received. Conclusion The use of corticosteroids in SARS has been debated; opinions conflict about whether the immediate benefits in terms of saving lives compensate for the adverse effects, including AVN.

Persistence of symptoms beyond the initial acute phase of coronavirus disease-2019 (COVID-19) is termed post-acute SARS-CoV-2 (PASC) and includes neurological, autonomic, pulmonary, cardiac, psychiatric, gastrointestinal, and functional impairment. PASC autonomic dysfunction can present with dizziness, tachycardia, sweating, headache, syncope, labile blood pressure, exercise intolerance and “brain fog.” A multidisciplinary team can help manage this complex syndrome with non-pharmacologic and pharmacologic interventions.

The clinical and laboratory findings in four cases of acute renal failure following the onset of influenza A viral infection (Port Chalmers/1/73) are presented. Although the pathophysiologic mechanisms affecting the kidney in these cases varied, the ensuing renal failure in each patient was severe. …

BackgroundAs face masks became mandatory in most countries during the COVID-19 pandemic, adverse effects require substantiated investigation.MethodsA systematic review of 2,168 studies on adverse medical mask effects yielded 54 publications for synthesis and 37 studies for meta-analysis (on n = 8,641, m = 2,482, f = 6,159, age = 34.8 ± 12.5). The median trial duration was only 18 min (IQR = 50) for our comprehensive evaluation of mask induced physio-metabolic and clinical outcomes.ResultsWe found significant effects in both medical surgical and N95 masks, with a greater impact of the second. These effects included decreased SpO2 (overall Standard Mean Difference, SMD = −0.24, 95% CI = −0.38 to −0.11, p 0.001) and minute ventilation (SMD = −0.72, 95% CI = −0.99 to −0.46, p 0.001), simultaneous increased in blood-CO2 (SMD = +0.64, 95% CI = 0.31–0.96, p 0.001), heart rate (N95: SMD = +0.22, 95% CI = 0.03–0.41, p = 0.02), systolic blood pressure (surgical: SMD = +0.21, 95% CI = 0.03–0.39, p = 0.02), skin temperature (overall SMD = +0.80 95% CI = 0.23–1.38, p = 0.006) and humidity (SMD +2.24, 95% CI = 1.32–3.17, p 0.001). Effects on exertion (overall SMD = +0.9, surgical = +0.63, N95 = +1.19), discomfort (SMD = +1.16), dyspnoea (SMD = +1.46), heat (SMD = +0.70), and humidity (SMD = +0.9) were significant in n = 373 with a robust relationship to mask wearing (p 0.006 to p 0.001). Pooled symptom prevalence (n = 8,128) was significant for: headache (62%, p 0.001), ac...

On September 1, 2022, the Moderna and Pfizer–BioNTech bivalent vaccines against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) containing equal amounts of spike messenger RNA from the ancestral and omicron BA.4–BA.5 subvariants replaced their monovalent counterparts as booster doses for persons who are 12 years of age or older in the United States. We previously reported surveillance data from North Carolina on the effectiveness of these two bivalent boosters against coronavirus disease 2019 (Covid-19) during the first 3 months after deployment (September 1 to December 8, 2022); the BA.4–BA.5 subvariants were predominant during the first 2.5 months of this period.1 Here, we present two additional months of data that were obtained during a period when the omicron BQ.1–BQ.1.1 and XBB–XBB.1.5 subvariants had become predominant to show the durability of protection conferred by these two bivalent boosters against a wider range of clinical outcomes than were included in our previous report.

Long COVID patients who experienced severe acute SARS-CoV-2 infection can present with humoral autoimmunity. However, whether mild SARS-CoV-2 infection provokes autoantibody responses and whether vaccination can decrease these responses in long COVID patients is unknown. Here, we demonstrate that mild SARS-CoV-2 infection increases autoantibodies associated with systemic lupus erythematosus (SLE) and inflammatory myopathies in long COVID patients with persistent neurologic symptoms to a greater extent than convalescent controls at more than 8 months post-infection. Furthermore, high titers of SLE-associated autoantibodies in long COVID patients are associated with impaired cognitive performance and greater symptom severity, and subsequent vaccination does not decrease autoantibody titers. In summary, we found that mild SARS-CoV-2 infection can induce long-term humoral autoimmunity in both long COVID patients and healthy COVID convalescents, suggesting that a reappraisal of vaccination and mitigation strategies is warranted. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement L.V. is supported by grant B48 from the philanthropic COVID research fund through Balvi Ops. P.P.M is supported by grants from the National Institute on Drug Abuse (NIDA, DP2DA051912) and from the National Institute of Biomedical Imaging and Bioengineering (NIBIB, U54EB027049). I.K. is supported by a grant from the National Institute of Aging (NIA, R01AG059291). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This study was approved by the Northwestern University Institutional Review Board, protocol number STU00212583. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The full datasets generated in the current study are available from the corresponding author upon requests.

Nature - A self-taught Indiana man is among a cadre of community scientists who scour the SARS-CoV-2 genome for problematic mutations.

Prior to vaccine availability, indoor mask mandates were associated with lower SARS-CoV-2 cases during the 12 weeks following policy adoption in high-, critical

Introduction: Post-COVID-19 syndrome (PCS) is characterized by a wide range of symptoms, predominantly fatigue and exertional intolerance. While disease courses during the first year post infection have been repeatedly described, little is known about long-term health consequences. Methods: We assessed symptom severity and various biomarkers at three time points post infection (3-8 months (mo), 9-16mo, 17-20mo) in 106 PCS patients with moderate to severe fatigue and exertional intolerance. A subset of patients fulfilled diagnostic criteria of myalgic encephalomyelitis/chronic fatigue syndrome (PCS-ME/CFS) based on the Canadian Consensus Criteria. Results: While PCS-ME/CFS patients showed persisting symptom severity and disability up to 20mo post infection, PCS patients reported an overall health improvement. Inflammatory biomarkers equally decreased in both groups. Lower hand grip force at onset correlated with symptom persistence especially in PCS-ME/CFS. Discussion: Debilitating PCS may persist beyond 20mo post infection, particularly in patients fulfilling diagnostic criteria for ME/CFS. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement This work is supported by a grant from the Weidenhammer-Zoebele Foundation. The work of F. K. was supported by the Volkswagen Foundation. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethics committee of Charite in accordance with the 1964 Declaration of Helsinki and its later amendments (EA2/006/20) gave ethical approval for this work I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors

Here are our diagrams as can be seen in the paper. pic.twitter.com/9vnu4LGgPS— Resia Pretorius (@resiapretorius) April 19, 2023

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Long covid follows 10-20% of first-time SARS-CoV-2 infections, but the societal burden of long covid and risk factors for the condition are not well-understood. Here, we report findings about self-reported sick leave and risk factors thereof from a hybrid survey and register study, which included 37,482 RT- PCR confirmed SARS-CoV-2 cases and 51,336 test-negative controls who were tested during the index and alpha waves. An additional 33 individuals per 1000 took substantial sick leave following acute infection compared to persons with no known history of infection, where substantial sick leave was defined as 1 month of sick leave within the period 1-9 months after the RT-PCR test date. Being female, ≥50 years, and having certain pre-existing conditions such as fibromyalgia increased risks for taking substantial sick leave. Further research exploring this heterogeneity is urgently needed and may provide important evidence for more targeted preventative strategies. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement No specific funding was received for this work. The study was conducted as part of the advisory tasks of the governmental institution Statens Serum Institut for the Danish Ministry of Health. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethics approval This study was performed as a surveillance study as part of the advisory tasks conducted by the governmental institution Statens Serum Institut (SSI) for the Danish Ministry of Health. The purpose of Statens Serum institut is to monitor and fight the spread of disease in accordance with section 222 of the Danish Health Act. According to Danish law, national surveillance activities carried out by SSI do not require approval from an ethics committee. Participation in the study was voluntary. The invitation letter to participants contained information about their rights under the Danish General Data Protection Regulation (rights to access data, rectification, deletion, restriction of processing and objection). After reading this information, it was considered informed consent if participants agreed and clicked on the link to fill in the questionnaires. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes The datasets used in this study comprise sensitive, individual-level information from completed questionnaires and national register data. According to the Danish data protection legislation, the authors are not permitted to share these sensitive data directly upon request. However, the data are available for research purposes upon request to the Danish Health Authority (register data, email: kontakt@sundhedsdata.dk) and Statens Serum Institut (questionnaire data, email: aii@ssi.dk), as well as within the framework of the Danish data protection legislation and any required permission from authorities. Data request processing can take an expected three to six months.

1/ Es wird gerade verbreitet, dass "Covid zu Krebs führt" oder gar zu "Turbokrebs". Man beruft sich hierbei auf diese Studie aus dem Journal of Virology. Kurze Erklärung, was die Studie eigentlich untersucht und gefunden hat. ➡️https://t.co/eCFRGYot8o pic.twitter.com/NmWT9vIWfD— Jan Hartmann (@pelagicbird) April 20, 2023

scheinen Long COVID zugrunde zu liegen, darunter virale Faktoren (Persistenz, Reaktivierung und bakteriophage Wirkung von #SARSCoV2), Wirtsfaktoren (chronische Entzündung, Stoffwechsel- und endokrine Dysregulation, Immundysregulation und Autoimmunität) und nachgeschaltete pic.twitter.com/lT5h2QHgeP— Ralf Wittenbrink (@RWittenbrink) April 20, 2023

This cohort study examines the patient characteristics and maternal outcomes associated with COVID-19 infection among pregnant patients at delivery during the early pandemic period in the US.

Unsere monatliche Statistik wertet alle über eine Krankmeldung registrierten Fehltage von beschäftigten Mitgliedern der teilnehmenden Betriebskrankenkassen für den jeweiligen Berichtsmonat aus. Über eine interaktive Oberfläche haben Sie die Möglichkeit, sich Zeitverläufe der Krankenstände differenziert nach ausgewählten Merkmalen filtern und anzeigen zu lassen.

Managing the COVID-19 pandemic has required the implementation of public health mitigation measures to limit the transmission of SARS-CoV-2. Airborne transmission via particles of different sizes, generally called droplets and aerosols, was recognized very late by public health organizations in part due to limited direct evidence of infectious virus in air samples. SARS-CoV-2 RNA has been detected in indoor air samples in various settings, but to this day only a few studies reported infectious virus particles in bioaerosols. Well-defined methods to monitor indoor air remain essential to inform on the risks of acquisition in the community and occupational environments and to evaluate mitigation methods. The quantity and infectivity of viral particles collected from air is strongly influenced by the samplers, the environmental context, the time of sampling and sample storage before cell culture requiring level 3 containment laboratory. In this study, we sought to assess the possibility of isolating infectious SARS-CoV-2 virus particles in a retrospective analysis of aerosol samples. We collected air samples in individual airborne isolation hospital rooms with negative pressure and 12 air changes/hour occupied by patients with acute COVID-19 in fall 2020 in Quebec, Canada when the Alpha variant was circulating but not yet detected in Quebec and before vaccines were available. Thirty samples were collected in 10 different rooms using two types of samplers selected based on previous reports, namely 37mm closed-face cassettes with 0.8μm polycarbonate filters (SKC, Eighty Four) with a flow rate of 10L air/min or a condensation growth tube (CGT) air sampler (Series 110A Liquid Spot Sampler, Aerosol Devices) with a nominal flow rate of 1.5L air/min, located at 2-3m from the patient's bed with sampling duration of 4.75-20h to cover sporadic events generating viral aerosols (Fig. 1A and B). Samples eluted in Viral Transport Media (VTM) were stored at -80°C. SARS-CoV-2 RNA (ORF1b) was detected by quantitative RT-PCR (RT-qPCR) in 9/22 (40.9%) cassettes and 2/8 (25%) Spot Sampler samples with concentration ranging from 129 to 2056 genomes equivalent/m3 air (Fig. 1B). We interrogated for the presence of replicating virus in four samples (two Spot Sampler and two cassettes) collected from the same patient room among the highest RNA concentrations detected (Fig. 1B). The samples had been stored 14 months before carrying out the cell culture experiments. We first confirmed that our cell culture design clearly differentiated between replicating and non-replicating virus. VERO E6 cells were inoculated with 150 pfu (chosen based on the mean copy number of the air samples analyzed) of replicating or β-propiolactone (BPL)-inactivated SARS-CoV-2/SB2 isolate (obtained from Dr. Samira Mubareka, Sunnybrook Research Institute, Toronto, Canada). Signs of cytopathic effects (CPE) attributable to SARS-CoV-2 replication (Fig. 1C), cellular expression of spike (S) and nucleocapsid (N) proteins (Fig. 1D), and production of de novo virions quantified via the median tissue culture infectious dose (TCID50) were observed at 3 days of infection with the replicating virus (Fig. 1E), while none of these parameters turned positive 2 hours after inoculation, or when using BPL-inactivated SARS-CoV-2. Having confirmed that only actively replicating virus led to positive read-outs, we proceeded with the analysis of air samples. As air samples contained low SARS-CoV-2 RNA levels (Fig. 1B), two successive cycles of infection of VERO E6 cells were carried out to maximize the amplification of the virus and therefore the detection of viable particles (Fig. 1F). One sample (#23), collected using the Spot Sampler, induced detectable CPE, with destruction of the monolayer inferior to that observed after infection with 150 pfu of SARS-CoV-2/SB2 isolate (Fig. 1G), cellular S and N expression (Fig. 1H) and de novo production of infectious virions (Fig. 1I). The titer of virions after 2 cycles of infection was of 6.32 × 107 TCID50/mL, which is 5.67 times lower than the titer observed after infection with 150 pfu of SARS-CoV-2/SB2 isolate (Fig. 1I). TCID50 analysis also allowed the detection of virions (3.57 × 102 TCID50/mL) in the supernatant of cells infected with sample #22 after 2 rounds of infection, while neither CPE nor S and N expression were observed (Fig. 1G–I). Neither of the two samples collected with the cassette produced detectable CPE, viral proteins expression or de novo virions (Fig. 1G–I). We combined measurement of virus-induced CPE, immunoblotting of viral proteins and titration of infectious virions as read-outs to provide clear demonstration of the infectivity of the virus. Immunoblotting against viral proteins confirmed the identity of SARS-CoV-2 in sample #23. RT-qPCR of N performed on the supernatant at day 3 of the second inoculation (not shown), further confirmed the presence of SARS-CoV-2. No SARS-CoV-2 N RNA was detected in sample #22 making it impossible to infer on the presence of SARS-CoV-2 in this sample. The only sample from which we successfully retrieved virus capable of replicating in cell culture was collected using the Spot Sampler. This is consistent with previous reports suggesting that CGT samplers allow collection of airborne SARS-CoV-2 and at least partially preserve virion infectivity. Patient's (45-year-old female known only for diabetes) characteristics that may have influenced aerosolization of SARS-CoV-2 were no immunization against COVID-19, symptomatic for 7 days including severe cough, and requirement of oxygen administration by nasal canula (2L/min) on the day of air sampling. No aerosol generating procedure occurred during air sampling. A nasopharyngeal swab collected 48h prior to the air sampling was positive for SARS-CoV-2 (Fig. 1B). In conclusion, we provide much needed additional evidence for the presence of replicating SARS-CoV-2 virions in bioaerosols. Our results highlight the possibility to recover replicative virus particles in air samples after freezing at -80°C in VTM and storage for several months. Our results are important as they provide rationale for retrospective evaluation of the presence of infectious SARS-CoV-2 in samples collected during the different waves since 2020.

NIH-funded study suggests need to boost CD8+ T cell response after infection.

The evidence continues to point to the Huanan Market. The ongoing debate, though, is fueling bad policy.

Das Coronavirus dringt über die Schleimhäute in den Körper – ein neuer Impfstoff soll es genau dort bekämpfen. Appliziert wird er direkt in die Nase. In Tierversuchen wirkt das Vakzin besonders gut.

The term “lockdown” has become a powerful and perverted word in the infodemic about democracies’ responses to the COVID-19 pandemic. Lockdown, as used in public discourse, has expanded to include any public health measure, even if it places little to no restriction on social mobility or

We read with interest the article by Zhong et al.1

XBB.1.5 will likely increase the frequency of COVID eye infections

Interessante Statistik von der Toronto School of Cities zur #Normalitätssimulation: Während die meisten Menschen „mit dem Virus leben“, zeigt sich, dass die Innenstädte in den USA und Kanada im Herbst 2022 immer noch viel weniger Aktivität verzeichnen als vor der Pandemie. pic.twitter.com/CXKjIji0Ww— @dm_ms@mstdn.science (@dm_ms) April 17, 2023

Is the tendency to share with other people linked to political orientation? And in which way? In a new study, researchers from the IMT School for Advanced Studies Lucca, Ca' Foscari University of Venice, ...

Rekordmange blir sykmeldt fordi de er for slappe og trette til å jobbe. I fjor gikk 1,3 millioner dagsverk tapt, ifølge tall fra NAV. Årsaken er trolig senvirkninger av covid-19.

Nature Reviews Rheumatology - The full picture of post-COVID-19 autoimmune diseases and their prevalence is lacking despite numerous case reports and small series. Two studies that use large...

Nature Communications - There is limited data on within-host SARS-CoV-2 genetic diversity and how it is affected by vaccination. The authors analysed intra-host sequence diversity and found that...

Different SARS-CoV-2 variants can differentially affect the prevalence of Post Covid-19 Condition (PCC). This prospective study assesses prevalence and severity of symptoms three months after an Omicron infection, compared to Delta, test-negative and population controls. This study also assesses symptomology after reinfection and breakthrough infections . Methods: After a positive SARS-CoV-2 test, cases were classified as Omicron or Delta based on ≥ 85% surveillance prevalence. Population controls were representatively invited and symptomatic test- negative controls enrolled after a negative SARS-CoV-2 test. Three months after enrolment, participants indicated point prevalence for 41 symptoms and severity of four symptoms. Permutation tests identified significantly elevated symptoms in cases compared to controls. PCC prevalence was estimated as the difference in prevalence of at least one elevated symptom in cases compared to population controls. Findings: At three months follow-up, five symptoms and severe dyspnea were significantly elevated in Omicron cases (n = 4138) compared to test-negative (n= 1672) and population controls (n= 2762). PCC prevalence was 10·4% for Omicron cases and 17·7% for Delta cases (n = 6855). Prevalence of severe fatigue and dyspnea were higher in reinfected compared to primary infected Omicron cases, while severity of symptoms did not significantly differ between Omicron cases with a booster or primary vaccination course. Interpretation: Three months after Omicron, prevalence of PCC is 41% lower than after Delta. Reinfection seems associated with more prevalent severe long-term symptoms compared to a first infection. A booster prior to infection does not seem to improve the outcome of long-term symptoms.