The therapeutic target of COVID-19 is focused on controlling inflammation and preventing fibrosis. Collagen-polyvinylpyrrolidone (collagen-PVP) and pirfenidone both have the ability to control the cytokine storm observed in rheumatic and fibrotic disorders. In this work, our aim was to understand the benefits of treatment with each of these drugs in patients with severe COVID-19. In total, 36 patients were treated with dexamethasone and enoxaparin, but 26 were allocated collagen-PVP or pirfenidone (n = 15 and 11, respectively); the clinical and metabolic effects were compared among them. Since pirfenidone works via transcriptional mechanisms, we performed a human genome microarray assay using RNA isolated from fibroblast and monocyte cultures treated with the biodrug, with the aim of hypothesising a possible mechanism of action for collagen-PVP. Our results showed that hospital stay duration, quick COVID-19 severity index (qCSI), and admission to the intensive care unit were statistically significantly lower (p < 0.02) in patients treated with collagen-PVP or pirfenidone when compared with the control group, and that only collagen-PVP normalised serum glucose at discharge. Ingenuity Pathway Analysis showed that the cell cycle, inflammation, and cell surface-extracellular matrix interactions could be regulated with collagen-PVP via the downmodulation of proinflammatory cytokines, while Th2 anti-inflammatory response signalling could be upregulated. Furthermore, the downregulation of some of the genes involved in nitric oxide production showed a possible control for JAK in the IFN-γ pathway, allowing for the possibility of controlling inflammation through the JAK/STAT pathway, as has been observed for pirfenidone and other immunomodulators, such as ruxolitinib.

COVID-19 most often affects the respiratory system and may manifest as acute respiratory failure requiring the use of non-invasive respiratory support (NIRS). The aim of this study was to find predictors based on laboratory results and chest computed tomography (CT) scans performed on admission to the hospital indicating the need for NIRS and predicting mortality after hospital discharge.

We retrospectively analysed data from consecutive patients hospitalised in the Pulmonology Department of the Temporary COVID Hospital in Poznan from 1 February 2021 to 31 March 2022. Upon admission to the department, the patients underwent a series of laboratory blood tests and high-resolution chest CT scan.

The study group included 282 patients, with an average age of 60.0 ± 15.0 years. In total, 54 (53%) patients of 101 requiring NIRS died from various causes or required intubation. Patients who required NIRS were significantly older and had more severe changes in the lung parenchyma. They had higher white blood cell and neutrophil counts and lower lymphocyte counts, as well as higher concentrations of D-dimer, CRP, PCT, and IL-6 and greater activities of LDH and AST.

Laboratory tests and chest CT performed on hospital admission may be useful to rapidly identify patients at higher risk for severe disease.

The maintenance of public health behaviors stands as a critical issue within the realm of public health. COVID-19, a major global emergency, has profoundly impacted the sustainability of public health behaviors. However, there is currently a gap of empirical studies examining the status and influencing mechanisms of public health behavior maintenance after the pandemic, especially those adopting a multifactorial and integrated approach.

This study aims to investigate the current status of public health behavior maintenance in China after the COVID-19 pandemic. It integrates the complementary advantages of the Multi-Theory Model (MTM) and the Protective Action Decision Model (PADM) to conduct a comprehensive analysis of the multi-factorial mechanisms influencing the maintenance of public health behaviors. The findings are expected to provide empirical evidence and strategic recommendations for the formulation of public health policies and the promotion of national health.

An integrated model was developed based on the MTM and the PADM. Data were collected from the Chinese public between October and November 2023 via the online survey panel Sojump (Changsha Ranxing Information Technology Co., Ltd.). The questionnaire included items on health behavior maintenance, variables from the MTM and the PADM, sociodemographic and personal disease, and health characteristics. Univariate analysis, correlation analysis, multivariate regression analysis, and structural equation modeling were performed to explore the determinants of health behavior maintenance.

This study collected 1216 valid samples, including 726 females and 490 males, with an average age of 27.38 (SD 8.52) years, and most of them had been infected with COVID-19 at least once (1054/1216, 86.68%). The public maintenance of health behaviors was at a fairly low level (Mean 2.88, SD 0.45). Multivariate regression analysis revealed that those with high monthly incomes, married individuals, and who were more concerned about their health after the COVID-19 pandemic had higher levels of health behavior maintenance. These variables, along with others from the MTM and the PADM, accounted for 45.5% of the variance in health behavior maintenance. Structural equation modeling indicated that efficacy perception had the most significant positive influence on health behavior maintenance (β=.386, P<.001), followed by emotional transformation and practical changes (both β=.213, P<.001). Risk perception had a slightly negative effect on health behavior maintenance (β=-.099, P=.013). Variables such as social cues, warning messages, and information sources also indirectly influenced the public maintenance of health behaviors.

This study indicates a slight decline in public health behavior maintenance following the COVID-19 pandemic, and our analysis has explored some of its influencing factors. Attention should be given to broadening information channels and appropriately explaining the risks of unhealthy behaviors. In addition, integrating external support and bolstering the public's efficacy in maintaining health behaviors can promote sustainable healthy practices.

In this study, we establish a multi-population model that counting the number of reinfection and obtain the intrinsic relationship between the time-dependent transmission rates and reported case data. Using a Gaussian convolution-based approach on reported cases, we derive explicit expressions for first-infection and reinfection transmission rates and the compatibility conditions for parameters. Through computational analysis and numerical simulations, we compare the variations of these transmission rates over the same time period and explore the long-term transmissibility of COVID-19 in New York state. Our results indicate that the transmission pattern of COVID-19 is shifting from being primarily driven by initial infections to a "cyclical reinfection" pattern, a trend that became particularly evident after the spread of the Omicron variant. This study provides theoretical support for the estimation of time-dependent transmission rates and can contribute to long-term epidemic monitoring and control strategies.

Obstructive sleep apnea syndrome is the most common sleep disordered breathing. In recent years, literature has focused on the anatomical and functional factors in the pathophysiology of patients to better understand their clinical and polysomnographic features, aiming for personalized treatment. Studies suggest that sleep-disorders breathing in women are underestimated and associated with cardiovascular and metabolic disorders. Women tend to experience more mood disorders and behavioral symptoms, leading to a reduced quality of life. The sleep and respiratory pathophysiology in women are complex and varies with age and hormonal status. This review summarizes recent knowledge on this topic, emphasizing the pathophysiological mechanisms to explain the typical clinical and polysomnographic patterns observed in females. In sleep respiratory medicine, gender- specific approaches are now essential for personalized patient care.

While some studies suggest an elevated risk of obstructive sleep apnea (OSA) in sarcoidosis, comprehensive research remains limited. This study aims to assess the prevalence of OSA among sarcoidosis patients, compare its occurrence with the general population, and evaluate the clinical and polysomnographic features of sarcoidosis patients diagnosed with OSA.

This prospective observational study identified 150 out of 290 sarcoidosis-diagnosed patients with OSA symptoms. Of these, 52 underwent polysomnography (PSG), and 45 patients with an Apnea-Hypopnea Index (AHI) ≥ 5 events/hour were included. The control group consisted of 48 OSA patients without lung disease history who had previously undergone PSG. Demographic, anthropometric, clinical, and polysomnographic parameters were compared between groups. Respiratory function test results and pulmonary involvement were also analyzed for sarcoidosis patients.

Ninety-three patients (45 sarcoidosis, 48 controls) were included. Sarcoidosis patients had a mean age of 50.7 ± 9.5 years, with 68.8% female and 55.5% obese. Pulmonary involvement was observed in 20%, and 62.5% of actively treated patients received corticosteroids. The median AHI and ODI values for sarcoidosis patients were 17.9 and 13.5, respectively. Supine apnea count was significantly higher in sarcoidosis patients (p = 0.003). N3 sleep stage proportion was significantly lower in severe OSA (p = 0.006). Pulmonary involvement increased with OSA severity: 2.2% in mild, 6.6% in moderate, and 11.1% in severe cases.

OSA is a common comorbidity in sarcoidosis; warranting further investigation to optimize management in this population.

Evidence on the risk of adverse respiratory outcomes associated with gabapentinoids in patients with chronic obstructive pulmonary disease (COPD) remains limited. Thus, we aimed to assess the risk of severe COPD exacerbation associated with gabapentinoids. We assembled a base cohort of patients aged ≥ 55 years newly diagnosed with COPD between 1993 and 2021 using the UK's Clinical Practice Research Datalink, linked to the Hospital Episode Statistics, and Office for National Statistics datasets. Using a time-conditional propensity score (TCPS)-matched, new-user design, patients prescribed gabapentinoids with an indication of epilepsy, neuropathic pain, or other chronic pain were matched 1:1 with non-users with the same indication on age, sex, calendar year, COPD duration, and TCPS. Cox proportional hazards models were used to estimate the hazard ratios (HR) and 95% confidence intervals (CIs) of severe exacerbation associated with gabapentinoid use compared to non-use in the overall cohort, and by indication. The study cohort comprised 29,882 gabapentinoid users, including 1,256 with epilepsy, 19,155 patients with neuropathic pain, and 9,471 with other chronic pain matched 1:1 with non-users. Compared with non-use, gabapentinoid use was associated with an increased risk of severe exacerbation in the overall cohort (HR 1.43; 95% CI: 1.35-1.52), and among patients with epilepsy (HR 1.39; 95% CI: 1.11-1.74), neuropathic pain (HR 1.43; 95% CI: 1.32-1.54), and other chronic pain (HR 1.45; 95% CI: 1.31-1.60). These findings suggest that gabapentinoid use is associated with an increased risk of severe exacerbation among patients with COPD, consistent among patients with neuropathic pain, epilepsy, and other chronic pain.

To evaluate the changes in the rates and indications of eye removal procedures during the recent COVID-19 pandemic.

The medical records of all patients who underwent eye removal from 2007 to 2022 were retrospectively reviewed. The patient demographic data and indications for surgery were collected. Data from two groups of patients (prepandemic surgery and postpandemic surgery) were compared. Statistical significance was set at p<0.05.

Fifty-nine patients underwent enucleation (69%), evisceration (27%), or exenteration (3%). The mean (SD) age of the patients was 55.9 (19.4) years, and most (69%) of the patients were males. Most (47%) of the study population were Black. The common indications for eye removal were trauma (41%), painful blind eye (34%), and infection/inflammation (24%). The types of trauma were assault (55%), accidental (39%), and self-inflicted (6%). The mean (SD) monthly rates of eye removal increased from 0.25 (0.50) in the prepandemic period to 0.77 (0.91) during the pandemic (p<0.001). These increases were noted in both males (p=0.003) and females (p=0.001) and were the highest among Black patients [0.42 (0.76); p<0.001]. Among the indications of eye removal, painful blind eyes [0.35 (0.75); p<0.001] and ocular trauma [0.31 (0.47); p=0.051] exhibited the greatest increases following the pandemic.

The rate of eye removal procedures increased during the recent pandemic. Although delayed care of chronic eye conditions may have contributed to the increased rates of painful blind eyes, the increased trauma-related eye removals may be attributed to the simultaneous spike in violent assaults in New York City.

Vaccine-hesitant parents delay or refuse their children's immunization and constitute a significant public health concern. Our study aims to measure parental vaccination hesitancy and its associated factors in parents residing in Campo Grande, Mato Grosso do Sul State, Brazil. From September 2022 to October 2023, a cross-sectional study aligned to a household survey was carried out to measure vaccination coverage in Campo Grande. The two-stage cluster sampling proposed by the World Health Organization to estimate vaccination coverage was adopted in this study. All residing parents of children aged under 12 years were included. Data were collected by face-to-face interviews using the SAGE Working Group questionnaire to assess parental vaccine hesitancy. We classified the reasons for hesitancy under the 3C conceptual model of vaccine hesitancy determinants. Descriptive statistics characterized the study population and a univariate and multivariate logistic regression assessed the association between hesitancy and other study variables. This study included 158 parents, 39.2% of whom hesitated to get their children immunized. COVID-19 vaccines produced the greatest hesitancy (77.4%). Participants mentioned lack of confidence as the most common motive for their hesitancy (85.5%). Hesitant parents resided in bigger households (aOR = 1.31; 95%CI: 1.02; 1.72), believed there were reasons for not immunizing children (aOR = 4.02; 95%CI: 1.41; 12.77), and hesitated to get their own vaccines (aOR = 3.74; 95%CI: 1.80; 8.16). Results suggest an association of parental hesitancy with socioeconomical and behavioral factors.

The assessment of lymphocyte populations allows the monitoring, follow-up and treatment of patients with various infectious diseases. Acute respiratory syndrome caused by coronavirus (SARS-CoV-2), can lead to a decrease in circulating lymphocytes and cause disease progression and severity. We evaluated the association of CD4+/CD8+ T lymphocyte with COVID-19 disease severity in moderate and severe patients. 136 patients with COVID-19 from the moderate group (MG) and severe group (SG) were compared with a healthy group or control group (CG). CD3+, CD4+ and CD8+ T lymphocytes were quantified by flow cytometry and correlated to CD4+/CD8+ with sex, age, markers of inflammation (ferritin, C-reactive protein and D-dimer), lung damage and oxygen saturation. CD4+ and CD8+ T lymphocytes were significantly decreased in MG and SG (p<0.0001). The CD4+/CD8+ ratio showed association in MG with age (r=0.31; p=0.056), with lung damage (r=0.4; p=0.03) and in SG with total proteins (r=0.59; p=0.04) and D-dimer (r=0.57; p=0.03). The CD4+/CD8+ ratio is associated with disease severity, significantly affecting the cellular immune response.