Impact of Coinfection With SARS-CoV-2 and Influenza on Disease Severity: A Systematic Review and Meta-Analysis

Background: Although coinfection with influenza in COVID-19 patients has drawn considerable attention, it is still not completely understood whether simultaneously infected with these two viruses influences disease severity. We therefore aimed to estimate the impact of coinfected with SARS-CoV-2 and influenza on the disease outcomes compared with the single infection of SARS-CoV-2.Materials and Methods: We searched the PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure Database (CNKI) to identify relevant articles up to July 9, 2021. Studies that assessed the effect of SARS-CoV-2 and influenza coinfection on disease outcomes or those with sufficient data to calculate risk factors were included. Risk effects were pooled using fixed or random effects model.Results: We ultimately identified 12 studies with 9,498 patients to evaluate the risk effects of SARS-CoV-2 and influenza coinfection on disease severity. Results indicated that coinfection was not significantly associated with mortality (OR = 0.85, 95%CI: 0.51, 1.43; p = 0.55, I2 = 76.00%). However, mortality was found significantly decreased in the studies from China (OR = 0.51, 95%CI: 0.39, 0.68; I2 = 26.50%), while significantly increased outside China (OR = 1.56, 95%CI: 1.12, 2.19; I2 = 1.00%). Moreover, a lower risk for critical outcomes was detected among coinfection patients (OR = 0.64, 95%CI: 0.43, 0.97; p = 0.04, I2 = 0.00%). Additionally, coinfection patients presented different laboratory indexes compared with the single SARS-CoV-2 infection, including lymphocyte counts and APTT.Conclusion: Our study revealed that coinfection with SARS-CoV-2 and influenza had no effect on overall mortality. However, risk for critical outcomes was lower in coinfection patients and different associations were detected in the studies from different regions and specific laboratory indexes. Further studies on influenza strains and the order of infection were warranted. Systematic testing for influenza coinfection in COVID-19 patients and influenza vaccination should be recommended.

Methodological Investigation for Hydrogen Addition to Small Cage Carbon Fullerenes

Hydrogenated small fullerenes (Cn, n < 60) are of interest as potential astrochemical species, and as intermediates in hydrogen-catalysed fullerene growth. However, the computational identification of key stable species is difficult due to the vast configurationally space of structures. In this study, we explored routes to predict stable hydrogenated small fullerenes. We showed that neither local fullerene geometry nor local electronic structure analysis was able to correctly predict subsequent low-energy hydrogenation sites, and sequential stable addition searches also sometimes failed to identify most stable hydrogenated fullerene isomers. Of the empirical and semi-empirical methods tested, GFN2-xTB consistently gave highly accurate energy correlations (r > 0.99) to full DFT-LDA calculations at a fraction of the computational cost. This allowed identification of the most stable hydrogenated fullerenes up to 4H for four fullerenes, namely two isomers of C28 and C40, via “brute force” systematic testing of all symmetry-inequivalent combinations. The approach shows promise for wider systematic studies of smaller hydrogenated fullerenes.

Does the data tell the true story? A modelling assessment of early COVID-19 pandemic suppression and mitigation strategies in Ghana

This paper uses publicly available data and various statistical models to estimate the basic reproduction number (R0) and other disease parameters for Ghana’s early COVID-19 pandemic outbreak. We also test the effectiveness of government imposition of public health measures to reduce the risk of transmission and impact of the pandemic, especially in the early phase. R0 is estimated from the statistical model as 3.21 using a 0.147 estimated growth rate [95% C.I.: 0.137–0.157] and a 15-day time to recovery after COVID-19 infection. This estimate of the initial R0 is consistent with others reported in the literature from other parts of Africa, China and Europe. Our results also indicate that COVID-19 transmission reduced consistently in Ghana after the imposition of public health interventions—such as border restrictions, intra-city movement, quarantine and isolation—during the first phase of the pandemic from March to May 2020. However, the time-dependent reproduction number (Rt) beyond mid-May 2020 does not represent the true situation, given that there was not a consistent testing regime in place. This is also confirmed by our Jack-knife bootstrap estimates which show that the positivity rate over-estimates the true incidence rate from mid-May 2020. Given concerns about virus mutations, delays in vaccination and a possible new wave of the pandemic, there is a need for systematic testing of a representative sample of the population to monitor the reproduction number. There is also an urgent need to increase the availability of testing for the general population to enable early detection, isolation and treatment of infected individuals to reduce progression to severe disease and mortality.

Incidence and Risk Factors of COVID-19-Associated Pulmonary Aspergillosis in Intensive Care Unit —A Monocentric Retrospective Observational Study

Coronavirus disease 2019 (COVID-19)-associated pulmonary aspergillosis (CAPA) is an increasingly recognized complication of COVID-19 and is associated with significant over-mortality. We performed a retrospective monocentric study in patients admitted to the intensive care unit (ICU) for respiratory insufficiency due to COVID-19 from March to December 2020, in order to evaluate the incidence of CAPA and the associated risk factors. We also analysed the diagnostic approach used in our medical centre for CAPA diagnosis. We defined CAPA using recently proposed consensus definitions based on clinical, radiological and microbiological criteria. Probable cases of CAPA occurred in 9 out of 141 patients included in the analysis (6.4%). All cases were diagnosed during the second wave of the pandemic. We observed a significantly higher realization rate of bronchoalveolar lavage (BAL) (51.1% vs. 28.6%, p = 0.01) and Aspergillus testing (through galactomannan, culture, PCR) on BAL samples during the second wave (p < 0.0001). The testing for Aspergillus in patients meeting the clinical and radiological criteria of CAPA increased between the two waves (p < 0.0001). In conclusion, we reported a low but likely underestimated incidence of CAPA in our population. A greater awareness and more systematic testing for Aspergillus were necessary to assess the real incidence and characteristics of CAPA.

Preparing for COVID-2x: Urban Planning Needs to Regard Urological Wastewater as an Invaluable Communal Public Health Asset and Not as a Burden

Prior to the COVID-19 pandemic, the analysis of urological wastewater had been a matter of academic curiosity and community-wide big-picture studies looking at drug use or the presence of select viruses such as Hepatitis. The COVID-19 pandemic saw systematic testing of urological wastewater emerge as a significant early detection tool for the presence of SARS-CoV-2 in a community. Even though the pandemic still rages in all continents, it is time to consider the post-pandemic world. This paper posits that urban planners should treat urological wastewater as a communal public health asset and that future sewer design should allow for stratified multi-order sampling.

Methodological Investigation for Hydrogen Addition to Small Cage Carbon Fullerenes

Hydrogenated small fullerenes (Cn, n&lt;60) are of interest as potential astrochemical species, and as intermediates in hydrogen catalysed fullerene growth. However computational identification of key stable species is difficult due to the vast combinatorial space of structures. In this study we explore routes to predict stable hydrogenated small fullerenes. We show that neither local fullerene geometry nor local electronic structure analysis are able to correctly predict subsequent low energy hydrogenation sites, and indeed sequential stable addition searches also sometimes fail to identify most stable hydrogenated fullerene isomers. Of the empirical and semi-empirical methods tested, GFN2-xTB consistently gives highly accurate energy correlation (r&gt;0.99) to full DFT-LDA calculations at a fraction of the computational cost. This allows identification of the most stable hydrogenated fullerenes up to 4H for four fullerenes, namely two isomers of C28 and C40, via &ldquo;brute force&rdquo; systematic testing of all symmetry inequivalent combinations. The approach shows promise for wider systematic studies of smaller hydrogenated fullerenes.

Observer Design for a Variable Moment of Inertia System

Variable moment of inertia systems are common, and a popular laboratory system of this type is the “ball-and-beam”. Such systems are, however, nonlinear and often unstable. Efficient control requires full state information (or at least partial velocities), which are generally difficult to measure. That is why the design of state observers is a relevant problem. In this paper, a new design of an observer is proposed. This new nonlinear observer uses partial output injection and the circle criterion to ensure semiglobal stability. Moreover, we present a complete modeling of the system and systematic testing of the observer in comparison to a baseline in the form of a linear observer. The results show that the designed observer outperforms its linear counterpart and does not impede control.

Opposites in Reasoning Processes: Do We Use Them More Than We Think, but Less Than We Could?

Our aim in this paper is to contribute toward acknowledging the general role of opposites as an organizing principle in the human mind. We support this claim in relation to human reasoning by collecting evidence from various studies which shows that “thinking in opposites” is not only involved in formal logical thinking, but can also be applied in both deductive and inductive reasoning, as well as in problem solving. We also describe the results of a series of studies which, although they have been developed within a number of different theoretical frameworks based on various methodologies, all demonstrate that giving hints or training reasoners to think in terms of opposites improves their performance in tasks in which spontaneous thinking may lead to classic biases and impasses. Since we all possess an intuitive idea of what opposites are, prompting people to “think in opposites” is something which is undoubtedly within everyone's reach and in the final section, we discuss the potential of this strategy and suggest possible future research directions of systematic testing the benefits that might arise from the use of this technique in contexts beyond those tested thus far. Ascertaining the conditions in which reasoners might benefit will also help in terms of clarifying the underlying mechanisms from the point of view, for instance, of analytical, conscious processing vs. automatic, unconscious processing.

STRIP: Systematic Testing using Robotics and Innovation during Pandemics v1

STRIP is a start-to-end streamlined and automated procedure for COVID-19 testing, centering on a single Tecan Fluent liquid-handling robot that can process over 14,000 samples per day. The sensitivity, specificity, and practical implementation of STRIP have been validated in a clinical study on 1128 individuals, meeting the standards set by the Dutch National Institute for Public Health and the Environment (Dutch CDC). Automation throughout the testing procedure dramatically reduces the workload of diagnostic laboratory personnel and potentially allows the placement of multiple STRIP liquid-handling robots per testing facility, further increasing testing capacity. The entire test procedure also requires only 3 pipet tips per sample, as well as reduced testing reagents due to process miniaturization, which is important given scarcity of testing consumables during the COVID-19 pandemic. Furthermore, STRIP is compatible with reagents from any supplier, and thus less sensitive to supply chain bottlenecks. Finally, the system is open and modular, facilitating adaptation of future developments in diagnostics. Overall, the system enabled substantial savings in personnel and reagents requirements compared with conventional diagnostic testing; when STRIP runs at full capacity, it is possible to rapidly recoup the initial outlay in the liquid-handling system from savings in personnel costs, reagents and materials.

Prevalence and effect of bacterial co-infections on clinical outcomes in hospitalized COVID-19 patients at a tertiary care centre of India

Background: Bacterial co-infections are a leading cause of morbidity and mortality during viral infections including COVID-19. Systematic testing of COVID-19 patients having bacterial co-infections is essential to select the correct antibiotic for treatment in order to reduce mortality and also prevent spread of antimicrobial resistance (AMR). The present study aims to evaluate the prevalence, demographic parameters, antibiotic sensitivity patterns and outcomes in hospitalized COVID-19 patients with bacterial co-infections. Methods: A total of 1019 COVID-19 patients were selected for the study. We analyzed the prevalence, antibiotic sensitivity pattern and clinical outcomes in COVID-19 patients having bacterial co-infections. Results: Out of a total 1019 COVID-19 patients screened, 5.2% of patients demonstrated clinical signs of bacterial co-infection. Bacteremia was found in majority of the patients followed by respiratory and urinary infections. Escherichia coli, Pseudomonas aeruginosa and Klebsiella spp. were most common isolates among the Gram-negative and Coagulase-negative Staphylococci (CONS) and Staphylococcus aureus among the Gram-positive bacterial infections. Antibiotic sensitivity profiling revealed that colistin, imipenem and fosfomycin were the most effective drugs against the Gram-negative isolates while vancomycin, teicoplanin and doxycycline against the Gram-positive isolates. Analysis of clinical outcomes revealed that the mortality rate was higher (39%) among the patients with bacterial co-infections as compared to the group without co-infection (17%). Conclusions: This study reveals that the rate of bacterial co-infections is significantly increasing among COVID-19 patients and leading to increase in mortality. Systematic testing of bacterial co-infections is therefore essential in COVID-19 patients for better clinical outcomes and to reduce AMR.