bluuebunny/crossref_metadata_2025_split huggingface dataset:
An Evaluation of Liver Function Tests in SARS-CoV-2 infection in the backdrop of chronic kidney disease
Authors: Kumar Rajeev , Jana Pratip , Priyadarshini Indu , Roy Smita , Datta Pritha , Das Saswati 
Published: July 2021

ABSTRACTINTRODUCTIONThe SARS-CoV-2 pandemic has emerged as perhaps the most challenging global health problem of this century. The concomitant presence of co-morbidities like chronic kidney disease (CKD), diabetes, chronic heart disease etc. makes the task of patient management difficult.AIMS AND OBJECTIVESTo assess the patterns of liver test abnormalities in patients of COVID-19 infection with and without CKD and evaluate the probable outcomes.MATERIALs and METHODSA cross-sectional retrospective observational study done on 600 patient samples (Group 1 COVID-19 without CKD, Group 2 COVID-19 with CKD and Group 3 non COVID-19 with CKD) which were processed for Liver function test (AST, ALT and ALP) and Renal function test (Urea and Creatinine) in the Department of Biochemistry, Dr. RML Hospital New Delhi.RESULTSAST and ALT levels were significantly higher (P < 0.05) in all COVID-19 positive patients - group 1 mean ± 2 SD, (63.63 ± 42.89 U/L & 50.25 ± 46.53 U/L respectively) and group 2 (90.59 ± 62.51 U/L & 72.09 ± 67.24 U/L respectively) as compared to Group 3 (25.24 ± 7.47 U/L & 24.93 ± 11.44 U/L respectively) and also a statistically significant elevation is seen in these two parameters (AST & ALT) in Group 2 as compared to Group 1 (P< 0.05). There was a negative significant correlation between eGFR and AST/ALT levels in Group 1 (p < 0.05). In Group 2, a weak positive correlation was seen with ALT (p < 0.01).No significant correlation existed between eGFR and ALP in groups 1 and 2. In Group 3, eGFR’s showed strong correlations with AST and ALT levels (p < 0.01) and reduction in kidney function correlated well with increase in serum ALP levels, (p < 0.01).CONCLUSIONSThis study most comprehensively describes that SARS-CoV-2 positive CKD patients show more elevations in serum aminotransferase levels as compared to their non-CKD counterparts, in contrast to non-COVID-19 CKD cases. Serum ALT values in SARS-CoV-2 patients show significant correlation with calculated eGFR values. Elevated ALP values in CKD patients may be used as an indicator of declining kidney function. However, more studies in this direction are needed.
Virlaza™ Inhibits Sars-COV-2-induced Inflammatory Response of Bronchial Epithelial Cells and Pulmonary Fibroblast
Authors: Brandao-Rangel Maysa Alves Rodrigues , Melamed Dobroslav , Silva-Reis Anamei , Brill Boris , Santos Zamarioli Lucas dos , Oliveira Carlos Rocha , Vieira Rodolfo P 
Published: July 2021

AbstractCoronavirus disease 2019 (COVID-19), which is currently a global public health emergency and beyond vaccines as a prophylactic treatment, no specific and effective therapeutical treatments are available. COVID-19 induces a massive release of proinflammatory cytokines, which drives COVID-19 progression, severity, and mortality. In addition, bronchial epithelial cells are the first pulmonary cells activated by coronavirus-2 (SARS-Cov-2) leading to massive cytokine release, which can hyperactivate lung fibroblasts, resulting in pulmonary fibrosis, a phenomenon observed even in moderate COVID-19 survivors. This in vitro study tested the hypothesis that Virlaza™, a herbal medicine, could inhibit the hyperactivation of human bronchial epithelial cells (BEAS-2B) and pulmonary fibroblasts (MRC-5) induced by SARS-Cov-2. BEAS-2B (5×104/mL/well) and MRC-5 (5×104/mL/well) cells were co-cultivated with 1ml of blood of a Sars-Cov-2 infected patient for 4 hours and Virlaza™ (1ug/mL) was added in the first minute of the co-culture. After 4 hours, the cells were recovered and used for analysis of cytotoxicity by MTT and for mRNA expression of P2X7 receptor E iNOS. The supernatant was used to measure ATP and cytokines. Sars-Cov-2 incubation resulted in increased release of ATP, IL-1beta, IL-6, IL-8, and TNF-alpha by BEAS-2B and MRC-5 cells (p<0.001). Treatment with Virlaza™ resulted in reduction of ATP, IL-1beta, IL-6, IL-8, and TNF-alpha release (p<0.001). In addition, Sars-Cov-2 incubation resulted in increased expression of P2X7 receptor and iNOS (p<0.001), which has been reversed by Virlaza™ (p<0.001). In conclusion, Virlaza™ presents important anti-inflammatory effects in the context of Sars-Cov-2 infection.
Salivary molecular testing for SARS-CoV-2: simplifying the diagnosis without losing accuracy
Authors: Saluzzo Francesca , Mantegani Paola , de Chaurand Valeria Poletti , Cugnata Federica , Rovere-Querini Patrizia , Cilla Marta , Erba Patrizia , Racca Sara , Tresoldi Cristina , Uberti-Foppa Caterina , Di Serio Clelia , Cirillo Daniela Maria 
Published: July 2021

AbstractBackgroundQuantitative RT-PCR on NasoPharyngeal Swab (NPS) is still considered the standard for the diagnosis of SARS-CoV-2 infection, even if saliva has been evaluated in several studies as a possible alternative. The use of point of care (POC) platforms, providing highly specific results performed on saliva could simplify the diagnosis of COVID-19 and contribute to contain the spreading of SARS-CoV-2.MethodsWe assess the sensitivity and specificity of molecular testing performed on saliva in comparison to NPS using two different POC platforms (DiaSorin Simplexa™ and Cepheid Xpert®). NPS and saliva were collected prospectically from asymptomatic health care workers and mildly symptomatic patients. Moreover, the stability of saliva samples after storage at -80°C for up to 45 days was tested.ResultsThe obtained results in comparison to NPS demonstrated for both DiaSorin Simplexa™ and Xpert® Xpress a specificity of 100% and a sensitivity of 90.24%. The overall agreement between the tests performed on saliva was 98%. A positive correlation in Ct values detected on saliva and on NPS was identified for all the targets shared by the tests in analysis (Orf1ab, E and N2). Both S Ct values and Orf1ab Ct values were not significantly different before and after the freezing in the tested saliva samples.ConclusionThe obtained results demonstrated an overall performance of saliva comparable to NPS, confirming that RT-PCR performed using POCs on saliva could represent a valid public health solution for controlling SARS-CoV-2 pandemic.
Real-Time SARS-CoV-2 Genotyping by High-Throughput Multiplex PCR Reveals the Epidemiology of the Variants of Concern in Qatar
Authors: Hasan Mohammad R. , Kalikiri Mahesh K. R. , Mirza Faheem , Sundararaju Sathyavathi , Sharma Anju , Lorenz Stephan , Chemaitelly Hiam , El-Kahlout Reham A. , Tsui Kin Ming , Yassine Hadi M. , Coyle Peter V. , Khal Abdullatif Al , Bertollini Roberto , Al Thani Mohamed H. , Abu-Raddad Laith J. , Tang Patrick ,   National Study Group for COVID-19 Epidemiology in Qatar
Published: July 2021

AbstractComplementing whole genome sequencing strategies with high-throughput multiplex RT-qPCR genotyping allows for more comprehensive and real-time tracking of SARS-CoV-2 variants of concern. During the second and third waves of COVID-19 in Qatar, PCR genotyping, combined with Sanger sequencing of un-typeable samples, was employed to describe the epidemiology of the Alpha, Beta and Delta variants. A total of 9792 nasopharyngeal PCR-positive samples collected between April-June 2021 were successfully genotyped, revealing the importation and transmission dynamics of these three variants in Qatar.
Irremediable psychiatric suffering in the context of physician assisted death: a Delphi-study
Authors: van Veen Sisco M.P. , Evans Natalie , Ruissen Andrea M. , Vandenberghe Joris , Beekman Aartjan T.F. , Widdershoven Guy A.M. 
Published: July 2021

AbstractBackgroundPatients with a psychiatric disorder (PPD) are eligible to request physician assisted death (PAD) in a small but growing number of jurisdictions, including the Netherlands and Belgium. For this request to be granted, most of these jurisdictions demand that the patient is competent in her request, and that the suffering experienced is unbearable and irremediable. Especially the criterion of irremediability is challenging to establish in patients with psychiatric disorders.AimsTo establish what criteria Dutch and Belgian experts agree to be essential in characterising irremediable psychiatric suffering (IPS) in the context of PAD.MethodA two round Delphi procedure among psychiatrists with relevant experience.ResultsThirteen consensus-criteria were established: five diagnostic and eight treatment-related criteria. Diagnostically, the participants deem a narrative description and attention to contextual and systemic elements necessary. Also, a mandatory second opinion is required. The criteria concerning treatment show that extensive biopsychosocial treatment is needed, and the suffering must be present for several years. Finally, in the case of treatment refusal, the participants agree that there are limits to the number of diagnostic procedures or treatments a patient must undergo.ConclusionsConsensus was found among a Dutch and Belgian expert group on essential criteria for establishing IPS in the context of PAD. These criteria can be used in clinical decision making and can inform future procedural demands and research.
Assessing COVID prevention strategies to permit the safe opening of college campuses in fall 2021
Authors: David Paltiel A. , Schwartz Jason L. 
Published: July 2021

ABSTRACTBackgroundEffective vaccines, improved testing technologies, and declines in COVID-19 incidence prompt an examination of the choices available to college administrators to safely resume in-person campus activities in fall 2021.ObjectiveTo develop a decision support tool that assists college administrators in designing and evaluating customized COVID vaccination, screening, and prevention plans.DesignDecision analysis linked to a compartmental epidemic model, quantifying the interaction of policy instruments (e.g., vaccination promotion, asymptomatic testing, physical distancing, and other non-pharmaceutical interventions), institutional priorities (e.g., risk tolerance, desire to resume activities), and assumptions about vaccine performance and background epidemic severity.ParticipantsHypothetical cohort of 5000 individuals (students, faculty, and staff) living and working in the close environs of a residential college campus.Main Outcome(s) and Measure(s)Cumulative infections over a 120-day semester.ResultsUnder Base Case assumptions, if 90% coverage with an 85%-effective vaccine can be attained, the model finds that campus activities can be fully resumed while holding cumulative cases below 5% of the population without the need for routine, asymptomatic testing. With 50% population coverage using such a vaccine, a similar “return to normalcy” would require daily asymptomatic testing of unvaccinated individuals. The effectiveness of vaccination in reducing susceptibility to infection is a critical uncertainty.Conclusions & RelevanceVaccination coverage is the most powerful tool available to college administrators to achieve a safe return to pre-pandemic operations this fall. Given the breadth of potential outcomes in the face of uncontrollable and uncertain factors, even colleges that achieve high vaccination coverage should be prepared to reinstitute testing and distancing policies on short notice.
Effectiveness of Covishield vaccine in preventing Covid-19 – A test-negative case-control study
Authors: Pramod Stuti , Govindan Dhanajayan , Ramasubramani Premkumar , Kar Sitanshu Sekhar , Aggarwal Rakesh ,   JIPMER vaccine effectiveness study group, Manoharan Nandhini , Chinnakali Palanivel , Thulasingam Mahalakshmy , Sarkar Sonali , Thabah Molly Mary 
Published: July 2021

AbstractIntroductionThis study was aimed at assessing the vaccine effectiveness (VE) of Covishield, which is identical to the AstraZeneca vaccine, in preventing laboratory-confirmed Covid-19.MethodsUsing a test-negative case-control design, information on vaccination status of cases with Covid-19 among healthcare workers in our institution in Puducherry, India, and an equal number of matched controls, i.e., positive and negative for SARS-CoV-2 by RT-PCR, was obtained. The cases and controls were matched for age (±3 years) and date of testing (±3 days). The groups were compared using multivariable conditional logistic regression to calculate odds ratios (OR), with adjustment for gender, occupational role, presence of symptoms and presence of a comorbidity condition. Per cent vaccine effectiveness (VE) was calculated as 100 x (1-adjusted odds ratio).ResultsUsing data from 360 case-control pairs, VE of one dose and of two doses, in providing protection against Covid-19 was 49% (95% CI: 17%-68%) and 54% (27%-71%), respectively. In view of a difference in the proportion of cases and controls who had symptoms, a separate analysis of data from 203 pairs where both the case and the control had symptoms was done, which showed VE of 58% (28%-75%) and 64% (38%-78%) after one dose and two doses, respectively. Among cases with moderately severe disease that required oxygen therapy, VE following any number of vaccine doses was 95% (44%-100%).ConclusionCovishield vaccine protected significantly against Covid-19, with the protection after two doses being slightly higher than after one dose, and a particularly high protection rate against severe forms of disease.
Development and validation of a prognostic model for COVID-19: a population-based cohort study in Iceland
Authors: Eythorsson Elias , Bjarnadottir Valgerdur , Runolfsdottir Hrafnhildur Linnet , Helgason Dadi , Ingvarsson Ragnar Freyr , Bjornsson Helgi K , Olafsdóttir Lovisa Bjork , Bjarnadottir Solveig , Agustsson Arnar Snaer , Oskarsdottir Kristin , Thorvaldsson Hrafn Hliddal , Kristjansdottir Guðrun , Bjornsson Aron Hjalti , Emilsdottir Arna R , Armannsdottir Brynja , Guðlaugsson Olafur , Hansdottir Sif , Gottfredsson Magnus , Bjarnason Agnar , Sigurdsson Martin I , Indridason Olafur S , Palsson Runolfur 
Published: July 2021

AbstractBackgroundThe severity of SARS-CoV-2 infection varies from asymptomatic state to severe respiratory failure and the clinical course is difficult to predict. The aim of the study was to develop a prognostic model to predict the severity of COVID-19 at the time of diagnosis and determine risk factors for severe disease.MethodsAll SARS-CoV-2-positive adults in Iceland were prospectively enrolled into a telehealth service at diagnosis. A multivariable proportional-odds logistic regression model was derived from information obtained during the enrollment interview with those diagnosed before May 1, 2020 and validated in those diagnosed between May 1 and December 31, 2020. Outcomes were defined on an ordinal scale; no need for escalation of care during follow-up, need for outpatient visit, hospitalization, and admission to intensive care unit (ICU) or death. Risk factors were summarized as odds ratios (OR) adjusted for confounders identified by a directed acyclic graph.ResultsThe prognostic model was derived from and validated in 1,625 and 3,131 individuals, respectively. In total, 375 (7.9%) only required outpatient visits, 188 (4.0%) were hospitalized and 50 (1.1%) were either admitted to ICU or died due to complications of COVID-19. The model included age, sex, body mass index (BMI), current smoking, underlying conditions, and symptoms and clinical severity score at enrollment. Discrimination and calibration were excellent for outpatient visit or worse (C-statistic 0.75, calibration intercept 0.04 and slope 0.93) and hospitalization or worse (C-statistic 0.81, calibration intercept 0.16 and slope 1.03). Age was the strongest risk factor for adverse outcomes with OR of 75-compared to 45-year-olds, ranging from 5.29-17.3. Higher BMI consistently increased the risk and chronic obstructive pulmonary disease and chronic kidney disease correlated with worse outcomes.ConclusionOur prognostic model can accurately predict the outcome of SARS-CoV-2 infection using information that is available at the time of diagnosis.
Children with SARS-CoV-2 in the National COVID Cohort Collaborative (N3C)
Authors: Martin Blake , DeWitt Peter E. , Russell Seth , Anand Adit , Bradwell Katie R. , Bremer Carolyn , Gabriel Davera , Girvin Andrew T. , Hajagos Janos G. , McMurry Julie A. , Neumann Andrew J. , Pfaff Emily R. , Walden Anita , Wooldridge Jacob T. , Yoo Yun Jae , Saltz Joel , Gersing Ken R. , Chute Christopher G. , Haendel Melissa A. , Moffitt Richard , Bennett Tellen D. 
Published: July 2021

AbstractImportanceSARS-CoV-2ObjectiveTo determine the characteristics, changes over time, outcomes, and severity risk factors of SARS-CoV-2 affected children within the National COVID Cohort Collaborative (N3C)DesignProspective cohort study of patient encounters with end dates before May 27th, 2021.Setting45 N3C institutionsParticipantsChildren <19-years-old at initial SARS-CoV-2 testingMain Outcomes and MeasuresCase incidence and severity over time, demographic and comorbidity severity risk factors, vital sign and laboratory trajectories, clinical outcomes, and acute COVID-19 vs MIS-C contrasts for children infected with SARS-CoV-2.Results728,047 children in the N3C were tested for SARS-CoV-2; of these, 91,865 (12.6%) were positive. Among the 5,213 (6%) hospitalized children, 685 (13%) met criteria for severe disease: mechanical ventilation (7%), vasopressor/inotropic support (7%), ECMO (0.6%), or death/discharge to hospice (1.1%). Male gender, African American race, older age, and several pediatric complex chronic condition (PCCC) subcategories were associated with higher clinical severity (p≤0.05). Vital signs (all p≤0.002) and many laboratory tests from the first day of hospitalization were predictive of peak disease severity. Children with severe (vs moderate) disease were more likely to receive antimicrobials (71% vs 32%, p<0.001) and immunomodulatory medications (53% vs 16%, p<0.001).Compared to those with acute COVID-19, children with MIS-C were more likely to be male, Black/African American, 1-to-12-years-old, and less likely to have asthma, diabetes, or a PCCC (p<0.04). MIS-C cases demonstrated a more inflammatory laboratory profile and more severe clinical phenotype with higher rates of invasive ventilation (12% vs 6%) and need for vasoactive-inotropic support (31% vs 6%) compared to acute COVID-19 cases, respectively (p<0.03).ConclusionsIn the largest U.S. SARS-CoV-2-positive pediatric cohort to date, we observed differences in demographics, pre-existing comorbidities, and initial vital sign and laboratory test values between severity subgroups. Taken together, these results suggest that early identification of children likely to progress to severe disease could be achieved using readily available data elements from the day of admission. Further work is needed to translate this knowledge into improved outcomes.
Effectiveness of the ChAdOx1 vaccine in the elderly during SARS-CoV-2 Gamma variant transmission in Brazil
Authors: Hitchings Matt D.T. , Ranzani Otavio T. , Dorion Murilo , D’Agostini Tatiana Lang , de Paula Regiane Cardoso , de Paula Olivia Ferreira Pereira , de Moura Villela Edlaine Faria , Scaramuzzini Torres Mario Sergio , de Oliveira Silvano Barbosa , Schulz Wade , Almiron Maria , Said Rodrigo , de Oliveira Roberto Dias , da Silva Patricia Vieira , de Araújo Wildo Navegantes , Gorinchteyn Jean Carlo , Andrews Jason R. , Cummings Derek A.T. , Ko Albert I. , Croda Julio 
Published: July 2021

AbstractBackgroundA two-dose regimen of ChAdOx1 coronavirus disease 19 (Covid-19) vaccine with an inter-dose interval of three months has been implemented in many countries with restricted vaccine supply. However, there is limited evidence for the effectiveness of ChAdOx1 by dose in elderly populations in countries with high prevalence of the Gamma variant of severe acute respiratory syndrome 2 (SARS-CoV-2).MethodsWe conducted a test-negative case-control study to estimate the effectiveness of ChAdOx1 vaccine in adults aged 60 years or older during a Gamma-variant-associated epidemic in São Paulo state, Brazil, between 17 January and 2 July 2021. Cases and matched test-negative controls were individuals, identified from surveillance databases, who experienced an acute respiratory illness and underwent SARS-CoV-2 RT-PCR testing. We used conditional logistic regression to estimate the effectiveness by dose against RT-PCR-confirmed Covid-19, Covid-19 hospitalization, and Covid-19-related death.Results61,164 individuals were selected into matched case-control pairs. Starting ≥28 days after the first dose, adjusted effectiveness of a single dose of ChAdOx1 was 33.4% (95% CI, 26.4 to 39.7) against Covid-19, 55.1% (95% CI, 46.6 to 62.2) against hospitalization, and 61.8% (95% CI, 48.9 to 71.4) against death. Starting ≥14 days after the second dose, the adjusted effectiveness of the two-dose schedule was 77.9% (95% CI, 69.2 to 84.2) against Covid-19, 87.6% (95% CI, 78.2 to 92.9) against hospitalization, and 93.6% (95% CI, 81.9 to 97.7) against death.ConclusionsCompletion of the ChAdOx1 vaccine schedule afforded significantly increased protection over a single dose against mild and severe Covid-19 outcomes in elderly individuals during widespread Gamma variant transmission.
Forward planning driven by context-dependent conflict processing in anterior cingulate cortex
Authors: Ott Florian , Legler Eric , Kiebel Stefan J. 
Published: July 2021

AbstractForward planning is often essential to achieve goals over extended time periods. However, forward planning is typically computationally costly for the brain and should only be employed when necessary. The explicit calculation of how necessary forward planning will be, is in itself computationally costly. We therefore assumed that the brain generates a mapping from a particular situation to a proxy of planning value to make fast decisions about whether to use forward planning, or not. Moreover, since the state space of real world decision problems can be large, we hypothesized that such a mapping will rely on mechanisms that generalize sets of situations based on shared demand for planning. We tested this hypothesis in an fMRI study using a novel complex sequential task. Our results indicate that participants abstracted from the set of task features to more generalized control contexts that govern the balancing between forward planning and a simple response strategy. Strikingly, we found that correlations of conflict with response time and with activity in the dorsal anterior cingulate cortex were dependent on context. This context-dependency might reflect that the cognitive control system draws on category-based cognition, harnessing regularities in control demand across task space to generate control contexts that help reduce the complexity of control allocation decisions.