Annals of medicine
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COVID-19 counts 46 million people infected and killed more than 1.2 million. Hypoxaemia is one of the main clinical manifestations, especially in severe cases. HIF1α is a master transcription factor involved in the cellular response to oxygen levels. The immunopathogenesis of this severe form of COVID-19 is poorly understood. ⋯ The up-regulation and participation of HIF1α in events such as inflammation, immunometabolism, and TLR make it a potential molecular marker for COVID-19 severity and, interestingly, could represent a potential target for molecular therapy. Key messages Critically ill COVID-19 patients show emergency myelopoiesis. HIF1α and its transcriptionally regulated genes are expressed in immature myeloid cells which could serve as molecular targets. HIF1α and its transcriptionally regulated genes is also expressed in lung cells from critically ill COVID-19 patients which may partially explain the hypoxia related events.
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The COVID-19 pandemic has compelled all educational institutions from the conventional campus-based education system to e-learning worldwide. However, adapting to this new platform, e-learning readiness may cause perceived stress among students. This study aimed to examine the association between e-learning readiness and perceived e-learning stress and the relationship between sociodemographic and e-learning related factors. ⋯ A sudden introduction of e-learning during the COVID-19 catastrophe has brought about challenges, including the students' readiness, that might exacerbate the perceived stress level in different ways. This study reported that most of the students were at sub-optimal levels of readiness and suffered from moderate to high levels of perceived e-learning stress. The findings should integrate into the education monitoring system to enhance students' coping strategies, incite readiness, straighten, and nourish existing policies.Key messagesThe moderate and higher level of e-learning stress was 76% and 15%, respectively.Here, 58% of students were at the sub-optimum level of e-learning readiness.Students' sub-optimum level of e-learning readiness was significantly associated with the perceived moderate and high level of e-learning stress.
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To appraise effective predictors for COVID-19 mortality in a retrospective cohort study. ⋯ We proposed the disease severity, age, serum levels of hs-CRP, LDH, ferritin, and IL-10 as significant predictors for death risk of COVID-19, which may help to identify the high-risk COVID-19 cases. KEY MESSAGES A machine learning method is used to build death risk model for COVID-19 patients. Disease severity, age, hs-CRP, LDH, ferritin, and IL-10 are death risk factors. These findings may help to identify the high-risk COVID-19 cases.
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Hospitalizations for severe injection-related infections (SIRI), such as endocarditis, osteomyelitis, and skin and soft tissue infections (SSTI) are increasingly common. People who inject drugs (PWID) experiencing SIRIs often receive inadequate substance use disorder (SUD) treatment and lack of access to harm reduction services. This translates into lengthy hospitalizations with high rates of patient-directed discharge, readmissions, and post-hospitalization mortality. The purpose of this study was to describe the development of an integrated "SIRI Team" and its initial barriers and facilitators to success. ⋯ A model of integrated infectious disease and SUD care for the treatment of SIRIs has the potential to improve infection and addiction outcomes. Providing attentive, patient-centered care, using a harm reduction approach can facilitate engagement of this marginalized population with the healthcare system.KEY MESSAGESIntegrated infectious disease and addiction treatment is a novel approach to treating severe injection-related infections.Harm reduction should be applied to treating patients with severe injection-related infections with a goal of facilitating antibiotic completion, remission from substance use disorder, and reducing hospital readmissions.
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The objective was to evaluate the clinical characteristics, management and two-year outcomes of patients with newly diagnosed non-valvular atrial fibrillation at risk for stroke in Nordic countries. ⋯ Nordic countries had significantly higher major bleeding than Non-Nordic-European countries. Rates of mortality and non-haemorrhagic stroke/SE were similar .