Search Results (86)

Background/Objectives: Saliva as a diagnostic medium for COVID-19 requires fewer resources to collect and is more readily adopted across a range of testers. Our study compared an Emergency Use Authorized direct saliva-to-RT-qPCR test against an FDA-authorized nasal swab RT-qPCR assay for participants who reported symptoms of respiratory infection. Methods: We analyzed 737 symptomatic participants who self-selected to test at either a community testing facility or a walk-in clinic due to respiratory symptoms and provided matched saliva and nasal swab samples. Samples were collected between March and September of 2023, both before and after the declared end of the public health emergency. Results: A total of 120 participants tested positive in at least one of the tests. For participants testing in the first 5 days of reported symptoms, the saliva test had a 94.0 positive percent agreement (PPA; 95% C.I. 88.9–99.1%) with the nasal test and a 99.0 negative percent agreement (NPA; 95% C.I. 98.1–99.9%). The viral load decreased beyond day 1 of reported symptoms for saliva testing. Viral load increased up to day 4 for nasal swabs and then decreased. The same number of discordant positive samples (five each) occurred for both tests within 5 days of symptoms onset. Conclusions: In the endemic phase of COVID-19 and for development of new tests, testing methods that are less invasive are more likely to be adopted. The results of saliva-based versus nasal swab PCR measurements relative to days of symptom onset are needed to optimize future testing strategies. Full article

Background: Osteogenesis imperfecta (OI) is a rare genetic connective tissue disorder characterized by bone fragility, most often caused by pathogenic variants in type I collagen genes. In this context, we aimed to describe the clinical and epidemiological characteristics of patients with OI who were hospitalized for coronavirus disease (COVID)-19 in Brazil between 2020 and 2024. Methods: We conducted a retrospective descriptive analysis using data from the Brazilian Unified Health System (SUS, which stands for the Portuguese Sistema Único de Saúde) through the Open-Data-SUS platform. Patients with a confirmed diagnosis of OI and hospitalization due to COVID-19 were included. Descriptive statistical analysis was performed to evaluate demographic, clinical, and outcome-related variables. We included all hospitalized COVID-19 cases with a confirmed diagnosis of OI between 2020 and 2024. Results: Thirteen hospitalized patients with OI and COVID-19 were identified. Most were adults (9; 69.2%), male (7; 53.8%), self-identified as White (9; 69.2%), and all were residents of urban areas (13; 100.0%). The most frequent symptoms were fever (10; 76.9%), cough (9; 69.2%), oxygen desaturation (9; 69.2%), dyspnea (8; 61.5%), and respiratory distress (7; 53.8%). Two patients had heart disease, one had chronic lung disease, and one was obese. As for vaccination status, five patients (38.5%) had been vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Four patients (30.8%) required admission to an intensive care unit (ICU), and six (46.2%) required noninvasive ventilatory support. Among those admitted to the ICU, only two required invasive mechanical ventilation. The clinical outcome was death in two cases (15.4%). Both patients were male, White, and had not been vaccinated against SARS-CoV-2. One was 47 years old, was not admitted to the ICU, but required noninvasive ventilation. Despite the underlying condition most patients had favorable outcomes, consistent with an international report. Conclusions: This is the first report to describe the clinical and epidemiological profile of patients with OI hospitalized for COVID-19 in Brazil, providing initial insights into how a rare bone disorder intersects with an acute respiratory infection. The generally favorable outcomes observed—despite the underlying skeletal fragility—suggest that individuals with OI are not necessarily at disproportionate risk of severe COVID-19, particularly when appropriately monitored. The occurrence of deaths only among unvaccinated patients underscores the critical role of SARS-CoV-2 vaccination in this population. Although pharmacological treatment data were unavailable, the potential protective effects of bisphosphonates and vitamin D merit further exploration. These findings support the need for early preventive strategies, systematic vaccination efforts, and dedicated clinical protocols for rare disease populations during infectious disease outbreaks. Full article

Objective: This study aims to investigate the feasibility of an online music therapy protocol for individuals previously diagnosed with COVID-19, focusing on their perceptions of their respiratory symptoms and the intervention’s impact on psychosocial measures. Methods: A within-subject experimental design was applied to examine an eight-week weekly online music therapy protocol, including singing, wind instrument playing, and music visualizations. All self-report data were collected bi-weekly throughout the 16-weeks study period, including baseline and post-tests. The measures for respiratory symptoms included the Medical Research Council’s Dyspnea Scale (MRC Dyspnea), Chronic Respiratory Questionnaire-Mastery Scores (CRQ Mastery), and Visual Analogue Scale for breathlessness. The measures for the secondary psychosocial outcomes were the Beck Depression Inventory-Short Form, the Generalized Anxiety Disorder 7-item, the Hospital Anxiety and Depression Scale, the Fatigue Severity Scale, the Epworth Sleepiness Scale, the EuroQol 5-Dimension 5-Level, and the Connor-Davidson Resilience Scale. Results: Twenty-four participants were enrolled. The participants perceived a reduction in respiratory symptoms, and shortness of breath (MRC Dyspnea). Planned comparisons showed significant decreases in MRC from baseline to post-treatment (p = 0.008). The mixed-effects model, including pre-baseline and post-treatment, was significant (p < 0.001). Significant changes in Breathing VAS were consistent with improvements in MRC Dyspnea, showing a significant baseline-to-post difference (p = 0.01). The CRQ Mastery showed significant improvements from baseline to Week 12 (p < 0.001). No significant changes were observed in other secondary measures. Conclusions: Our preliminary findings suggest that this protocol is feasible, and as a result, may help individuals previously diagnosed with COVID-19 to cope with lasting respiratory symptoms and improve their perception of shortness of breath. Live music-making, including playing accessible wind instruments and singing, may contribute to an increase sense of control over breathing. As this was a feasibility study, we conducted multiple uncorrected statistical comparisons to explore potential effects. While this approach may increase the risk of Type I error, the findings are intended to inform hypotheses for future confirmatory studies rather than to draw definitive conclusions. Full article

Algal blooms produced by cyanobacteria liberate microcystins and other toxins that create a public health hazard. During the 2018 bloom of Microcystis aeruginosa in Florida, USA, residential and recreational exposures were associated with an increased risk of self-reporting respiratory, gastrointestinal, or ocular symptoms for 125 participants. Subsequently, 207 persons were interviewed between 2019 and 2024 in the absence of large-scale algal blooms and were considered non-exposed. Analyses of cyanotoxins and brevetoxins in water and air showed only intermittent, background levels of toxins during the non-bloom period. The purpose of this report was to compare symptom reporting between active bloom and non-bloom periods. The assessment of information bias from self-reported symptoms is an important issue in epidemiologic studies of harmful algal blooms. During the non-bloom period, no statistically significant associations with residential, recreational, or occupational exposures were found for any symptom group. Estimated risks for respiratory, gastrointestinal, and ocular symptoms, headache, and skin rash were significantly higher for persons sampled during the bloom than the non-bloom period with odds ratios (ORs) of 2.3 to 8.3. ORs for specific respiratory symptoms were also significantly elevated. After adjustment for confounders and multiple exposures in multivariable analyses, the differences in symptom reporting between bloom and non-bloom periods remained statistically significant. In summary, the use of self-reported symptoms in this epidemiologic study of exposure to a cyanobacterial algal bloom did not appear to introduce substantial information bias. Full article

All parts of Alocasia × amazonica (A. amazonica, Araceae) pose a toxicological risk due to oxalate production. Ingestion of the plant extract may cause multi-organ damage and fatal outcomes. Given the rarity of poisoning cases, its toxicological profile and systemic effects remain insufficiently characterized. This study aimed to investigate and report an appropriate approach to managing a patient intoxicated with A. amazonica (Araceae). A case of intentional self-poisoning with A. amazonica is presented. The patient, a 63-year-old woman, ingested approximately 200–300 mL of liquid prepared from the grated root of the plant. The initial clinical presentation involved localized injuries to the oral cavity and gastrointestinal tract, including severe pain, hoarseness, aphonia, dysphagia, mucosal erosions, and necrosis. Additional symptoms included hematinic vomiting, hemorrhagic diarrhea, and abdominal discomfort. These superficial and mucosal lesions resolved without the development of adhesions. Systemic effects comprised impaired consciousness indicative of encephalopathy, early metabolic acidosis, pulmonary edema with acute respiratory insufficiency, mild liver dysfunction, and hematuria. The therapeutic protocol for oral poisoning management was appropriate, leading to the patient’s discharge after 20 days of hospitalization. Full article

Background: A significant number of COVID-19 survivors around the world have been reporting persistent symptoms following their recovery. Long COVID is recognized as a condition affecting not only the respiratory but also the gastrointestinal, cardiovascular, neurological, immune, and hematopoietic systems. Objective: This study aimed to describe persistent symptoms in COVID-19 survivors six months post-infection in Minia, Upper Egypt, and investigate associated risk factors. Methods: This observational cross-sectional study included 189 hospitalized and non-hospitalized patients previously diagnosed with COVID-19. Demographic data, symptom severity, comorbidities, and persistent symptoms were collected. A logistic regression analysis was used to identify risk factors associated with long COVID, with statistical significance set at p < 0.05. Results: In total, 68.8% of participants were women, and 83.5% of patients reported at least one ongoing symptom. The most self-reported symptoms were fatigue (73.5%) and myalgia (45.5%), followed by dyspnea (43.3%). Age was associated with an increased risk of developing long COVID (OR 1.028, 95% CI 1.003–1.054, p = 0.030). Patients who were hospitalized during the acute phase had more than twice the risks of having persistent symptoms (OR 2.384, 95% CI 1.055–5.387, p = 0.037). Conclusions: A substantial proportion of COVID-19 survivors in Minia, Upper Egypt, continues to experience persistent symptoms, primarily constitutional and neurological manifestations. Many patients reported self-medicating with unprescribed antibiotics, highlighting a need for public awareness regarding viral infections and the risks associated with improper antibiotic use. Full article

Long COVID, also known as post-acute sequelae of SARS-CoV-2 infection (PASC), is increasingly recognized as a condition affecting not only adults but also children and adolescents. While children often experience milder acute COVID-19 symptoms compared to adults, some develop persistent physical, psychological, and neurological symptoms lasting for weeks or months after initial infection. The most commonly reported symptoms include debilitating fatigue, respiratory issues, headaches, muscle pain, gastrointestinal disturbances, and cognitive difficulties, which significantly impact daily activities, schooling, and social interactions. Additionally, many children with long COVID experience psychological symptoms, such as anxiety, depression, mood swings, and irritability, likely exacerbated by prolonged illness and lifestyle disruptions. Risk factors for long COVID in children include pre-existing health conditions such as asthma, obesity, and neurological disorders, with adolescents and females seemingly more affected. Hypothesized mechanisms underlying long COVID include chronic immune dysregulation, persistent viral particles stimulating inflammation, autonomic nervous system dysfunction, and mitochondrial impairment, which may collectively contribute to the variety of observed symptoms. Long-term outcomes remain uncertain; however, long COVID can lead to school absenteeism, social withdrawal, and psychological distress, potentially affecting cognitive development. Severe cases may develop chronic conditions such as postural orthostatic tachycardia syndrome (POTS) and reduced exercise tolerance. This review synthesizes the existing literature on long COVID in children, examining its prevalence, symptomatology, risk factors, and potential mechanisms, with an emphasis on the need for further clinical studies. While existing research largely relies on surveys and self-reported data, clinical assessments are essential to accurately characterize long COVID in pediatric populations and to guide effective management strategies. Full article

Background and Objectives: Despite the significant impacts of cognitive impairment on patients with chronic obstructive pulmonary disease (COPD), there is limited information available on healthcare workers’ (HCWs) perceptions, current practice, and barriers to managing COPD patients with cognitive impairment. Materials and Methods: A cross-sectional questionnaire was distributed to HCWs in Saudi Arabia between April and December 2023. The collected responses were analysed using descriptive statistics and logistic regression models. Results: A total of 890 participants, including nursing, physical, and respiratory therapists, completed the online questionnaire. Over two-thirds of the study participants indicated not having sufficient knowledge or adequate training in managing cognitive impairment in patients with COPD. The majority of HCWs perceive cognitive impairment to underdiagnose COPD (83%), underestimate COPD severity (81%), exacerbate COPD symptoms (80%), and interfere with self-management (81%) and pulmonary rehabilitation (81%). However, less than 45% (n = 394) reported having the potential to recognise signs of cognitive impairment during patient encounters. Logistic regression analysis revealed that male healthcare practitioners were more likely to recognise cognitive impairment than females (OR: 1.48; 95% CI: 1.13 to 1.95; p < 0.001). Physical and respiratory therapists were more likely to identify cognitive impairment compared to nurses. Additionally, having more years of experience (≥10 years, OR: 1.63; 95% CI: 1.02 to 2.61; p = 0.001) and adequate knowledge of cognitive impairment (OR: 6.23; 95% CI: 4.18 to 9.29; p = 0.001) were strongly associated with better recognition. Confidence in managing cognitively impaired COPD patients was low, attributed to poor training (64%), inadequate knowledge (64%), and the absence of standardised procedures (58%). Conclusions: HCWs agreed upon the negative impacts associated with cognitive impairment in patients with COPD. However, the potential of recognising signs of cognitive impairment and confidently dealing with the existence of cognitive impairment in COPD is not optimal, owing to poor training and limited knowledge. A focus should be given to managing comorbidities alongside COPD. Full article

Objectives of the study: The aim of this study was to assess the impact of the COVID-19 pandemic on the epidemiology and clinical course of chickenpox in children based on 6 years of self-reported observations. MATERIAL AND METHODS: The medical records of 350 patients under 18 years of age hospitalised in the Department of Paediatrics, Infectious Diseases, and Hepatology between 1 January 2018 to 31 December 2023 were analysed retrospectively. RESULTS: During the analysed period, 350 children were hospitalised due to chickenpox, the fewest in the pandemic period, the greatest number in 2023. Complications of chickenpox were diagnosed in 297 children (84.86%). The most commonly diagnosed complications were bacterial dermatitis (168, 48%) and lower respiratory tract infections (13.42%). After the pandemic period, a generalised inflammatory reaction was observed significantly more often (p ≤ 0.01069). Among children hospitalised in 2023, 5.90% of patients with bacterial dermatitis required surgical intervention due to skin abscess or fasciitis. In 2023, 41.46% of cultures from swabs taken from skin lesions grew Streptococcus pyogenes. After the pandemic, children with chickenpox and gastrointestinal symptoms were hospitalised significantly less frequently (p ≤ 0.00001). CONCLUSIONS: In the post-pandemic period, there were more hospitalisations of patients with chickenpox complicated by bacterial skin infection progressing to a generalised inflammatory reaction or septicaemia, related to the increase in invasive group A streptococcal infections observed in Europe. On the other hand, thanks to the widespread adaption of hygiene practices and infection prevention measures, the number of patients with gastrointestinal symptoms significantly decreased. Full article

Background: Over the last few decades, the efficacy of biological therapies for COPD has been evaluated by different randomized controlled trials (RCTs). Still, the evaluation of real-world data and patient-reported outcome measures (PROMs) have not been performed in this field before. In the current work, we present a systematic literature review of the real-world data and PROMs of biological treatments for COPD. Methods: Three large databases (MEDLINE/PubMed, Scopus, and ScienceDirect) were utilized for the systematic literature review. Clinical studies (RCT, cohorts, case series/reports) assessing patients with COPD treated by any biological therapy were included. Results: The review resulted in twelve eligible studies (nine randomized controlled trials and three “real-world” case series/reports). The evaluation of PROMs in the included studies was mainly limited to the severity and burden of respiratory symptoms. Most biological therapies were associated with improved PROMs compared to the baseline, although not for the placebo. Dupilumab was the only biologic therapy with proven efficacy in RCT for both objective and subjective measures. One prior study reported patients’ self-perceived drug effects, and none evaluated patients’ perceived disease status. Only 25 patients were assessed in a real-world setting for all biologic therapies combined. Real-world data were retrospective in the form of case reports or series. Conclusions: There are limited data on patients’ experience with biological therapies for COPD. While real-world data and PROMs are missing, biases such as a placebo effect must be considered, requiring their incorporation with objective outcomes from prospective controlled trials. Full article

Background/Objectives: There has been limited evidence on the long-term impacts of coffee intake on health. We aimed to investigate the association between coffee intake and the incidence of diseases and mortality risk over 20 years among community-dwelling Chinese adults. Methods: Participants were from the Hong Kong Osteoporosis Study who attended baseline assessments during 1995–2010. Coffee intake was self-reported through a food frequency questionnaire and was previously validated. Disease diagnoses, which were mapped into 1795 distinct phecodes, and mortality data were obtained from linkage with territory-wide electronic health records. Cox models were used to estimate the association between coffee intake and the incidence of each disease outcome and mortality among individuals without a history of the respective medical condition at baseline. All models were adjusted for age, sex, body mass index, smoking, alcohol drinking, and education. Results: Among the 7420 included participants (mean age 53.2 years, 72.2% women), 54.0% were non-coffee drinkers, and only 2.7% consumed more than one cup of coffee per day. Over a median follow-up of 20.0 years, any coffee intake was associated with a reduced risk of dementia, atrial fibrillation, painful respirations, infections, atopic dermatitis, and dizziness at a false discovery rate (FDR) of <0.05. Furthermore, any coffee intake was associated with an 18% reduced risk of all-cause mortality (95% confidence interval = 0.73–0.93). Conclusion: In a population with relatively low coffee consumption, any coffee intake is linked to a lower risk of several neurological, circulatory, and respiratory diseases and symptoms, as well as mortality. Full article

Olea europaea L. pollen is one of the main causes of pollinosis and respiratory diseases in the Iberian Peninsula (IP). The aim of this study was to provide a pollen calendar in different regions of the IP, which could help allergists and allergic patients in the management of Olea europaea allergic diseases, and to update/complement what has already been reported on olive trees’ aeropalynology in this region. Airborne Olea pollen dynamics were analyzed over a period of 8 years in a total of 21 localities, 7 in Portugal and 14 in Spain. Airborne pollen monitoring was carried out using the Hirst-type spore trap method and following the recommendations of the Quality Control Working Group of the European Aerobiology Society. The daily pollen count, the annual pollen profile, the Annual Pollen Integral (APIn), the Seasonal Pollen Integral (SPIn) and the Pollen Peak, all expressed in number of pollen grains per cubic metre of air, together with the main pollen season and its characteristics, the Start Day, the End Day and the length of the pollen season, were calculated for each sampling station. Differences in mean Olea pollen concentration between odd and even years were also analyzed. On average, the main pollen season (MPS) started in April/May and ended in June, with Pollen Peaks recorded in May, except in Burgos, where it was recorded in June. The longest MPS occurred in Lisbon, Oviedo and Valencia (53 days) and the shortest in Vitoria (25 days). A high daily pollen concentration (i.e., >200 grains/m³) was recorded between 1 and 38 days along the year in all sampling stations of the southwest quadrant of the IP and in Jaén. A biannual pattern, characterized by alternating years of high and low pollen production, was found in the southwest of the IP. In conclusion, the study provided a deeper understanding of the pollination behaviour of olive trees in the IP and allowed the establishment of a representative Olea pollen calendar for this region. In addition, our results suggest the usefulness of investigating more detailed relationships between annual Olea pollen, allergen sensitization and symptoms, both for allergists involved in the study and management of allergic respiratory diseases caused by this species and for the self-management of disease in allergic subjects. Full article

The emergence of COVID-19 caused by SARS-CoV-2 prompted an unprecedented global response to develop vaccines at an accelerated pace. Messenger RNA (mRNA) and adenovirus vector vaccines emerged as the frontrunners in global immunization efforts, significantly reducing hospitalization, severity, and mortality, supplemented by inactivated virus-based vaccines in developing countries. However, concerns regarding adverse effects, including allergic reactions, have been raised. This study aimed to investigate the adverse effects following COVID-19 vaccination, particularly in atopic and non-atopic individuals. A cohort of 305 volunteers receiving BNT162, ChAdOx1, or CoronaVac vaccines were assessed based on a Skin Prick Test (SPT), specific IgE levels, and clinical history of asthma and rhinitis. Adverse effects were self-reported and scored across the different vaccination shots. The results indicated a notable presence of mild adverse effects following the first and third doses, regardless of vaccine type. ChAdOx1 recipients experienced more adverse effects compared to those receiving BNT162 and CoronaVac, including headaches, muscle pain, fever, chills, nausea, and flu-like symptoms. Atopic individuals receiving ChAdOx1 reported more adverse effects, such as muscle pain, fever, and chills, compared to non-atopic individuals. Conversely, headaches were more frequently reported in non-atopic individuals receiving BNT162 compared to atopic individuals. No anaphylaxis or allergic reactions were reported, indicating valuable evidence supporting the safety of COVID-19 vaccination in individuals with respiratory allergies. This study highlights the importance of understanding vaccine-related adverse effects, particularly in vulnerable populations, to inform vaccination strategies and address safety concerns in global immunization campaigns. Full article

Background: Global awareness of ambient air pollution has heightened due to its detrimental impact on health, particularly in regions with elevated PM_2.5 levels. Chiang Mai has emerged as an area experiencing the highest PM_2.5 levels in Thailand. Objectives: to examine the prevalence of respiratory allergies and assess the impact of air pollution on the health-related quality of life (QoL) among university students in Chiang Mai. Methods: Chiang Mai University (CMU) and Maejo University (MJU) students were recruited. The Global Asthma Network (GAN) questionnaire screened for respiratory allergies (RAs). The disease-specific QoL questionnaire (Rcq-36) was administered twice during low-PM_2.5 and high-PM_2.5 seasons to evaluate air pollution’s impact on health-related QoL. Those showing potential RAs underwent a skin prick test (SPT) to investigate allergic sensitization. Results: Out of 406 participants, 131 (32%) reported respiratory allergies. Among those undergoing SPT, a high rate (82.54%) had positive results. Across both universities, students reported significantly lower QoL in multiple domains, particularly respiratory, eye, sleep, and emotional well-being, during the high-PM_2.5 season. This aligned with their poorer self-reported health on a visual analog scale (VAS; p-value < 0.01). PM_2.5 levels significantly impacted social functioning for CMU students (p-value = 0.001) and role limitations for MJU students (p-value < 0.001). Notably, participants without respiratory allergies (non-RAs) were more significantly affected by PM_2.5 than RA participants in almost all parameters, despite experiencing fewer baseline symptoms. Conclusions: Respiratory allergies, particularly allergic rhinitis, are prevalent among university students in Chiang Mai. This study underscores the substantial negative impact of ambient air pollution on QoL for both allergic and non-allergic students. Full article

Severe respiratory infections are characterised by depleted vitamin C and elevated inflammation and oxidative stress. The aim of this study was to recruit people with a history of severe respiratory infections to undergo a six-week intervention with SunGold kiwifruit to determine if this could restore adequate vitamin C status. Secondary outcomes included changes in inflammatory and oxidative stress biomarkers, self-reported fatigue and subjective mood, and the incidence, duration and severity of respiratory symptoms. The total cohort comprised 20 adults (65% female, age range 31–84 years). The participants had a low median fruit and vegetable intake of 2.3 servings/day and a correspondingly low vitamin C intake of 46 mg/day. Circulating vitamin C status was a median of 45 µmol/L and was in the hypovitaminosis range in 25% of the cohort. Following intervention with two SunGold kiwifruit/day (equivalent to ~300 mg vitamin C), there was an increase in plasma vitamin C concentrations to >60 µmol/L (p < 0.05). Approximately 20% of the participants were unable to reach adequate vitamin C status (≥50 µmol/L), possibly due to current smoking, which enhances vitamin C turnover, and a strong inverse correlation between body weight and vitamin C status (r = −0.734, p < 0.05). Following the intervention, there were indications towards decreases in the inflammatory biomarkers C-reactive protein and TNFα (p > 0.05), but no changes in oxidative stress biomarkers (F₂isoprostanes, protein carbonyls). There were decreases in fatigue and depression (p < 0.05) and a lower number of individual respiratory symptoms reported during the kiwifruit intervention phase (8.5 vs. 10, p = 0.05). Overall, the consumption of two SunGold kiwifruit per day for six weeks was able to restore adequate to saturating vitamin C status in ~80% of the participants. Smokers and people with higher body weight may need larger doses and/or longer duration of supplementation. The contribution of vitamin C to reducing fatigue, depression, and number of respiratory symptoms warrants further investigation. Full article