The aim of this study was to assess the prevalence and predictive factors of secondary infectionsin patients with coronavirus disease 2019 (COVID-19) and compare with influenza. A retrospective cohort study which included COVID-19 and influenza patients with samples processed at Karolinska University Hospital Laboratory between 1st March 2020 to 1st January2021 and 1st January 2015 to 1st January 2021 respectively. Blood, urine and respiratory culture results from 7 days before and 7 days after the primary diagnosis collected from laboratory information system. Chi-square and Mann-Whitney U test used for descriptive comparison. Predictive factors of secondary infections analyzed using logistic regression. Data includes 16,354 patients:7470 COVID-19 and 8884 influenza. Secondary infections were significantly fewer in COVID-19 patients (26.6%) compared to influenza patients (30%) p<0.01. Lower proportion of episodes with growth (EWG) in blood culture of COVID-19 patients (1.8%) compared to influenza (2.9%) p<0.001. Lower proportion of EWG in respiratory tract cultures of COVID-19 patients (11.1%) compared to influenza patients (24.5%) p<0.001. Higher proportionof EWG in urinary tract cultures of COVID-19 patients (24.5%) compared to influenza (20.1%)p<0.001. Staphylococcus aureus were common bacteria in blood and respiratory tract in both cohorts. Escherichia coli were the most common bacteria in urine in both cohorts. Fungi were least common with unspecified yeast being the most frequent. Likelihood of secondary infection lower in males compared to females AOR 0.70 (95%CI 0.66-0.76)), lower in other clinicalsettings AOR 0.65 (95%CI 0.56-0.76) and increased with age in both COVID-19 and influenza patients (AOR 1.03(95%CI 1.02-1.04)). Higher probability of secondary infections in young influenza patients compared to young COVID-19 patients. A lower prevalence of secondary infections in blood, respiratory tract cultures of COVID-19 patients compared to influenza. Olderage, female sex, intensive care were predictive factors for secondary infections. Findings important for planning of treatment protocols.

Background SARS-CoV-2 is the virus responsible for the current global pandemic, COVID-19. Because this virus is novel, little is known about its sensitivity to disinfection. Methods We performed suspension tests against SARS-CoV-2 using three commercially available quaternary ammonium compound (Quat) disinfectants and one laboratory-made 0.2% benzalkonium chloride solution. Findings Three of the four formulations completely inactivated the virus within 15 s of contact, even in the presence of a soil load or when diluted in hard water. Conclusion Quats rapidly inactivate SARS-CoV-2, making them potentially useful for controlling SARS-CoV-2 spread in hospitals and the community.

Enligt Socialstyrelsen (2020) anses hedersrelaterat våld vara ett allvarligt samhällsproblem i Sverige och enligt bland annat Grzyb (2016) ett socialt problem globalt. En av de särskilt sårbara grupperna som kan utsättas för det hedersrelaterade våldet är hbtqi+-personer (Regeringskansliet, 2021) där denna grupp bland annat kan utsättas för tvångsäktenskap, korrigeringsresor och omvändelseförsök (RFSL, 2018). Syftet med denna studie är att undersöka och analysera hur SARS-CoV-2 pandemin kan ha påverkat en grupp socionomer i sitt arbete med hedersrelaterat våld och förtryck riktat till hbtqi+-personer samt om det kan finnas kunskaps- och rutinbrister i den aktuella verksamheten. Ytterligare ett syfte är att försöka sammanfoga dessa två komplexa områden och se på vilket sätt man försöker arbeta med detta inom ramen för det sociala arbetet. Informanterna som intervjuades i denna studie representerar sig själva i den verksamhet där de jobbade. Den information som vår studie fick ta del av från informanterna var endast aktuell vid tidpunkten för studien. Tjugotre kommuner i Sverige tillfrågades om att delta i studien varav tre kommuner ville delta och de resterande tjugo kommunerna ville av olika anledningar inte delta eller återkopplade inte angående medverkan. En kvalitativ metod har använts för genomförande av studien. Semistrukturerade intervjuer genomfördes med tre informanter som jobbade med våld där bland annat hedersrelaterat våld riktat till hbtqi+-personer innefattades. Vidare har en tematisk analysmetod tillämpas för analys av insamlat data. I resultatet framkommer det bland annat att pandemins isolering kan ha begränsat hbtqi+-personers rörelsefrihet vilket även kan ha påverkat yrkesverksammas arbete och att verksamheter i Sverige till viss del präglas av kunskap men även till stor del av behov av kunskapsutveckling i hur verksamheterna ska stötta och skydda hbtqi+-personer som kan befinna sig i en hederskontext. En av studiens viktigaste slutsatser är att beakta hur maktordningar samverkar där individer som är utsatta för hedersrelaterat våld och förtryck ytterligare kan vara utsatta om de även tillhör en särskilt sårbar grupp. Samtliga aspekter behöver därmed tas i beaktning vid implementeringar eller åtgärder för att kunna möta den problematik som maktordningarnas samspel kan medföra för yrkesverksammas arbete med denna typ av problematik.

Han trascurrido dieciocho meses desde que se declaró como pandemia la infección COVID-19 ocasionada por el SARS-CoV-2. No existe aún tratamiento contra el virus, salvo el sintomático y recuperativo. El rápido reconocimiento del nuevo coronavirus permitió la elaboración de vacunas que están siendo usadas de emergencia y han permitido disminuir los casos graves, hospitalizaciones, uso de unidades de cuidados intensivos, ventilación mecánica y muertes. Pero aún quedan incógnitas sobre las modificaciones genéticas y variantes que el virus utiliza para una mejor invasión y adaptación a las defensas del ser humano, así como sobre sus consecuencias inmediatas y a largo plazo en el hombre, la mujer y su niño. Parece distante alcanzar la inmunización de rebaño, porque desconocemos la inmunidad proporcionada por la infección y por las vacunas, así como su duración, y por la importante parte de la población que no desea vacunarse. Además, existe insuficiente capacidad de oferta de vacunas, accesibilidad limitada a los servicios de salud, situación económica desfavorable, incremento de la pobreza y sus consecuencias, disminución temporal de la expectativa de vida y otras complicaciones secundarias a la infección por el virus. La presente revisión es un recuento breve de lo avanzado recientemente en el conocimiento y manejo del COVID-19, en momentos en que el Perú celebra el Bicentenario de la Independencia del país del dominio español, un 28 de julio de 1821, y que encuentra a los peruanos en medio de una pandemia agresiva, elusiva y mortal, y con aspectos humanos, poblacionales, económicos y políticos a resolver.

The COVID-19 pandemic caused by SARS-CoV-2 infection poses a serious threat to public health. An explicit investigation of COVID-19 immune responses, particularly the host immunity in recovered subjects, will lay a foundation for the rational design of therapeutics and/or vaccines against future coronaviral outbreaks. Here, we examined virus-specific T cell responses and identified T cell epitopes using peptides spanning SARS-CoV-2 structural proteins. These peptides were used to stimulate peripheral blood mononuclear cells (PBMCs) derived from COVID-19-recovered subjects, followed by an analysis of IFN-γ-secreting T cells by enzyme-linked immunosorbent spot (ELISpot). We also evaluated virus-specific CD4 or CD8 T cell activation by flow cytometry assay. By screening 52 matrix pools (comprised of 315 peptides) of the spike (S) glycoprotein and 21 matrix pools (comprised of 102 peptides) spanning the nucleocapsid (N) protein, we identified 28 peptides from S protein and 5 peptides from N protein as immunodominant epitopes. The immunogenicity of these epitopes was confirmed by a second ELISpot using single peptide stimulation in memory T cells, and they were mapped by HLA restrictions. Notably, SARS-CoV-2 specific T cell responses positively correlated with B cell IgG and neutralizing antibody responses to the receptor-binding domain (RBD) of the S protein. Our results demonstrate that defined levels of SARS-CoV-2 specific T cell responses are generated in some, but not all, COVID-19-recovered subjects, fostering hope for the protection of a proportion of COVID-19-exposed individuals against reinfection. These results also suggest that these virus-specific T cell responses may induce protective immunity in unexposed individuals upon vaccination, using vaccines generated based on the immune epitopes identified in this study. However, SARS-CoV-2 S and N peptides are not potently immunogenic, and none of the single peptides could universally induce robust T cell responses, suggesting the necessity of using a multi-epitope strategy for COVID-19 vaccine design.

The novel coronavirus disease 2019 (COVID-19), appeared in the United States over 1 year ago. This virus has a wide range of presentations, from being asymptomatic to causing severe acute respiratory syndrome, which can lead to death. It has led to a worldwide effort to find effective treatments, from repurposed medications to new discoveries, as well as the push to develop effective vaccines. As the race to fight this pandemic unfolds, this column provides what is currently available to combat this virus, how it has been utilized in the pregnant population, and what data have been made available about how these treatments affect fetal development and the neonate.

Introduktion. Coronavirus disease 19 (COVID-19) är en virussjukdom som orsakar mild till allvarlig respiratorisk sjukdom, med symtom som andnöd, feber, hosta och trötthet. Risken att bli allvarligt sjuk är hög, med risk för komplikationer som sepsis, tromboembolismer och lungpåverkan. Viruset orsakar en kraftig inflammatorisk respons i kroppen som i svåra fall kan orsaka cellskador. Diagnos ställs via RT-PCR-test och/eller lungröntgen. Behandlingen är framför allt symtomatisk med syrgasbehandling och trombosprofylax. Melatonin är ett kroppseget hormon som används som läkemedel vid sömnstörning. Det har även visat sig ha anti-inflammatoriska och anti-oxidativa egenskaper, vilka tros vara lämpliga vid tilläggsbehandling av COVID-19. Metod. Detta examensarbete är en litteraturstudie med syfte att undersöka om tilläggsbehandling med melatonin kan förbättra prognosen för patienter drabbade av COVID-19. Vetenskapliga studier söktes i olika databaser med sökorden melatonin och COVID-19. Inklusionskriterierna var att studien skulle vara en orginalstudie, patienterna skulle vara diagnostiserade med COVID-19 samt fått tilläggsbehandling med melatonin utöver standardbehandling. Exklusionskriterierna var om peer-review saknades samt om studien var inriktad på en specifik målgrupp eller mot cellulära mekanismer. Sökningen resulterade i sex utvalda studier, varav fyra randomiserade och två icke randomiserade. Resultat. Melatonin ger en bättre sömnkvalitet, minskad trötthet och längre sömnduration. Gällande symtomlindring sågs ingen förbättring av symtom förutom de kopplade till respirationsapparaten, till exempel hosta och andnöd. De som fått behandling återhämtade sig snabbare och hade kortare sjukhusvistelse. Melatonin gav även en positiv inverkan på graden lungpåverkan av ground-glass-förändringar samt att de behandlade patienterna behövde mekanisk ventilation mer sällan än kontrollgruppen. Resultatet gav ingen entydig bild huruvida de inflammatoriska markörerna i blodprov förbättrats vid behandling. Inte heller sågs tillräckliga bevis för att dödligheten minskat. Dock sågs en förbättring gällande förekomsten av sepsis, delirium och tromboembolismer. Melatonin verkar vara ett säkert och väl tolererat läkemedel, även i höga doser, då inga allvarliga biverkningar rapporterats. Slutsats. Melatonin kan ha viss effekt för att mildra COVID-19-infektion och korta ner sjukdomstiden, framför allt med avseende på respiratoriska symtom. Det går inte att avgöra om melatonin minskar dödligheten utifrån resultatet. Fler och samstämmiga studier inom området behövs. / Coronavirus disease 19 (COVID-19) is an infectious viral disease that causes mild to severe respiratory disease, with symptoms such as shortness of breath, fever, cough and fatigue. The risk of becoming seriously ill is high, with the risk of complications such as sepsis, thromboembolisms and lung damage. The virus causes a strong inflammatory response in the body that in severe cases can cause cell damage. Diagnosis is made via RT-PCR test and/or chest X-ray, where COVID-19 typical ground-glass changes and consolidation can be seen. Treatment in Sweden is primarily symptomatic with oxygen therapy and thrombosis prophylaxis. Melatonin is an endogenous hormone used as a medicine for sleep disorder. It has also demonstrated anti-inflammatory and antioxidative properties, which are believed to be fitting as adjunct therapy in COVID-19. This thesis is a literature study with the aim of investigating whether supplemental therapy with melatonin can improve the prognosis for patients with COVID-19. Scientific studies were searched in various databases with the keywords melatonin and COVID-19. The inclusion criteria were that the study would be an original study, patients were diagnosed with COVID-19 and received adjunct melatonin in addition to standard treatment. The exclusion criteria were whether peer-review was missing and whether the study was focused on a specific target group or cellular mechanisms. The search resulted in six selected studies, four randomized and two non-randomized. All investigated whether melatonin as a supplemental therapy could affect the outcome of COVID-19, but with different outcome variables. When reviewing the studies, five showed good quality, while one showed low quality. The results of this literature study show that melatonin as an adjuvant therapy provides a better sleep quality, reduced fatigue and longer sleep duration. Regarding symptom relief, no improvement in symptoms was seen except those linked to the respiratory apparatus, such as cough and shortness of breath. Those who received treatment recovered more quickly and had a shorter hospital stay. Melatonin also had a positive impact on the degree of lung impact of ground-glass changes and that the treated patients needed mechanical ventilation less often than the control group. The results did not give a definite picture of whether the inflammatory markers in blood tests improved during treatment. There was also insufficient evidence that the mortality rate had decreased. However, an improvement was seen in the incidence of sepsis, delirium and thromboembolisms. Melatonin appears to be a safe and well-tolerated drug, even in high doses, as no serious side effects have been reported. The conclusion is that melatonin may have some effect in mitigating the COVID-19 infection and shortening the duration of the disease, especially with regard to respiratory symptoms. It is not possible to determine whether melatonin reduces mortality based on the result. More and consistent studies in this area are needed.

Indiana University-Purdue University Indianapolis (IUPUI) / The emergence of the global SARS-CoV-2 pandemic created tremendous impact on humanity beginning in late 2019. Public health researchers at Indiana University Richard M. Fairbanks School of Public Health responded by conducting research into the etiological profile of the virus, including a large Indiana state-wide population-based prevalence study in early 2020. Methods Data on demographics, tobacco use, health status, and reasons for participating in the population prevalence study were used to conduct three retrospective cross-sectional studies. The first study assessed the association of self-reported health and tobacco behaviors with COVID-19 infection (n=8,241). The second study used successive wave analysis to assess nonresponse bias (n=3,658). Finally, participants demographics were characterized by who responded to text, email, phone calls, or postcards and by the number of prompts needed to elicit participation (n= 3,658). Results The first study found self-identified health status of those reporting “poor, “fair” or good” had a higher risk of past or current infections compared to “very good” or “excellent” health status (P <0.02). Positive smoking status was inversely associated with SARS-CoV-2 infection (p <0.001). When assessing the sample for non-response bias (n=3,658), 40.9% responded in wave 1 of recruitment, 34.1% in wave 2 and 25.0% in wave 3 for an overall participation rate of 23.6%. There were no significant differences in response by waves and demographics, being recently exposed or reasons for participating. In the final study, compared to males, females made up 54.6% of the sample and responded at a higher rate to postcards (8.2% vs. 7.5%) and text/emails (28.1 vs. 24.6%, 2= 7.43, p 0.025); and responded at a higher percentage after 1 contact (21.4 vs. 17.9%, 2 = 7.6, p 0.023). Conclusion This research contributed to the scientific understanding of the etiological picture of SARS-CoV-2. Additionally, the current study used a novel method that public health practitioners can easily implement to detect non-response bias in primary data collection without advanced statistical methods. Finally, the current study allows researchers to focus not only on the modality of inviting participants, but the frequency of invitations needed to secure specific populations, reducing time and resources.

We report severe acute respiratory syndrome coronavirus 2 antibody positivity among market and city bus depot workers in Lima, Peru. Among 1285 vendors from 8 markets, prevalence ranged from 27% to 73%. Among 488 workers from 3 city bus depots, prevalence ranged from 11% to 47%. Self-reported symptoms were infrequent. / National Institute of Allergy and Infectious Diseases / Revisión por pares

Background: COVID-19 is an ongoing pandemic. As of 11 May 2020, there are 4 013 728confirmed cases and 278 993 deaths. Smoking has been named as one possible factor regardingillness progression and severity. Aim: The aim of this systematic literature review is to examine if smokers are more at riskconsidering disease severity. Methods: This is a systematic literature study using the PubMed database. Inclusion andexclusion criteria were specified by using the PICOS format. Free text words and MeSH wordswere combined to create a search plan. The search was conducted twice, 26 April 2020 and 12May 2020. Full text articles were examined for eligibility by using inclusion and exclusioncriteria. An estimation of bias was conducted by using the MINORS criteria. Result: A total of seven articles were included. Of those, 5 reported a statistically significantrelationship between smoking and disease progression or death. Of these, 4 articles foundstatistical significance when correcting for confounders (hypertension, COPD, ischemic heartdisease, cardiac insufficiency). Conclusions: The result of this systematic literature review suggests that smoking enhancesthe severity of COVID-19. Due to the limited number of patients combined with a narrowgeographic area being studied, more research is needed to further evaluate and establish therelationship between smoking and COVID-19.