SARS COV 2 infection affects primarily the respiratory system and various organs in humans is responsible for higher mortality secondary to cytokine storm during the COVID-19 pandemic. It affects the internal auditory system is responsible for Sensory neural hearing loss in adults as well as children born to COVID-19 infected mothers. This study was aimed to detect the pattern of hearing loss in COVID-19 infected adults and pattern of hearing loss in children born to gestational COVID-19 infected mothers. Fifty asymptomatic RT-PCR COVID-19 infected adults and age, sex matched healthy controls were evaluated for audiological profile using Pure Tone Audiometry (PTA). Children born to COVID-19 infected mothers were tested using Transient product otoacoustic emissions and click-evoked auditory brainstem responses (ABRs) compared with children born to non-COVID mothers. PTA auditory profile of COVID-19 infected adults on day 7 had 30% (16 out of 50) significant high frequency sensory neural hearing impairment for 4000 Hz (p value 0.003), 6000 Hz (p value 0.001), 8000 Hz (p value 0.001). Repeat PTA testing on day 30 showed normal hearing. Whereas in children, 40% (n = 20) born to COVID-19 infected mothers had OAE as \"Refer\". BERA (ABRs) testing of that OAE \"Refer\" children revealed 30% (n = 6) hearing impairment. COVID-19 infection cause transient type of high frequency sensory neural hearing loss in adults. Whereas in children born to COVID-19 infected mothers there is risk of developing permanent, progressive or long-standing transient type of sensory neural hearing loss.

COVID-19 infection has been found to precipitate hypercoagulability and transiently increase antiphospholipid antibodies. However, it is yet to be determined how likely these transient changes contribute to thrombotic events and antiphospholipid syndrome. We present a case in which antiphospholipid antibodies were detected in the presence of significant thromboses. The patient was subsequently treated for suspected catastrophic antiphospholipid syndrome following COVID-19 infection.

Severe liver injury is an uncommon condition caused by non-traumatic rhabdomyolysis. This rare correlation is more commonly seen in the aspartate aminotransferase (AST) than in the alanine transaminase (ALT) level elevation. We report a case of a 27-year-old male with a history of McArdle disease who presented with generalized muscle aches associated with dark urine. His workup showed SARS-CoV-2 positive, severe rhabdomyolysis (creatinine kinase [CK] > 40000 U/L) and acute kidney injury (AKI) followed by severe liver injury (AST/ALT: 2122/383 U/L). He was started on aggressive intravenous hydration. After multiple boluses, he became overloaded, fluids were re-adjusted and continued, his renal function, CK, and liver enzymes improved, and the patient was discharged; during his visit at the post-discharge, the patient was asymptomatic and no clinical or laboratory abnormalities were found. The glycogen storage diseases are challenging, but prompt and accurate assessment is determinant in recognizing potential life-threatening complications of SARS-CoV-2. The failure to identify complicated rhabdomyolysis could lead to the patient\'s rapid deterioration, ending in multiorgan failure.

Coronavirus disease 2019 (COVID-19) has been a pandemic disease reported in almost every country and causes life-threatening, severe respiratory symptoms. Recent studies showed that various environmental selection pressures challenge the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infectivity and, in response, the virus engenders new mutations, leading to the emergence of more virulent strains of WHO concern. Advance prediction of the forthcoming virulent SARS-CoV-2 strains in response to the principal environmental selection pressures like temperature and solar UV radiation is indispensable to overcome COVID-19. To discover the UV-solar radiation-driven genomic adaption of SARS-CoV-2, a curated dataset of 2,500 full-grade genomes from five different UVindex regions (25 countries) was subjected to in-depth downstream genome-wide analysis. The recurrent variants that best respond to UV-solar radiations were extracted and extensively annotated to determine their possible effects and impacts on gene functions. This study revealed 515 recurrent single nucleotide variants (rcntSNVs) as SARS-CoV-2 genomic responses to UV-solar radiation, of which 380 were found to be distinct. For all discovered rcntSNVs, 596 functional effects (rcntEffs) were detected, containing 290 missense, 194 synonymous, 81 regulatory, and 31 in the intergenic region. The highest counts of missense rcntSNVs in spike (27) and nucleocapsid (26) genes explain the SARS-CoV-2 genomic adjustment to escape immunity and prevent UV-induced DNA damage, respectively. Among all, the most commonly observed rcntEffs were four missenses (RdRp-Pro327Leu, N-Arg203Lys, N-Gly204Arg, and Spike-Asp614Gly) and one synonymous (ORF1ab-Phe924Phe) functional effects. The highest number of rcntSNVs found distinct and were uniquely attributed to the specific UVindex regions, proposing solar-UV radiation as one of the driving forces for SARS-CoV-2 differential genomic adaptation. The phylogenetic relationship indicated the high UVindex region populating SARS-CoV-2 as the recent progenitor of all included samples. Altogether, these results provide baseline genomic data that may need to be included for preparing UVindex region-specific future diagnostic and vaccine formulations.

Frontline healthcare workers (FHCWs) responding to the COVID-19 pandemic develop posttraumatic stress disorder (PTSD), major depressive disorder (MDD) and generalized anxiety disorder (GAD) symptoms. Such symptoms are associated with burnout, occupational and relational difficulties. In the current study, we examined the prospective association between acute transdiagnostic COVID-19-related PTSD, MDD, and GAD symptoms at pandemic outset, and burnout and functional difficulties several months later in FHCWs in New York City.
Wave 1 symptoms of COVID-19-related PTSD, MDD, and GAD, were assessed in 787 FHCWs from April 14 to May 11th, 2020. Burnout and occupational difficulties were assessed at wave 1 and wave 2, approximately 7 months later.
After adjusting for wave 1 burnout, wave 1 MDD symptoms, particularly sleep difficulties, loss of interest, and feeling tired/having little energy, collectively explained 42% incremental variance in this outcome. After adjusting for wave 1 work difficulties, MDD and PTSD symptoms, particularly feeling tired/having little energy, loss of interest, and negative expectations of self/world, collectively explained 42% incremental variance in this outcome. After adjusting for wave 1 relationship difficulties, MDD, GAD, and PTSD symptoms, particularly depressed mood, irritability, and appetite disturbance, explained 26% incremental variance in this outcome.
Results highlight psychiatric symptoms assessed during the acute phase of the COVID-19 pandemic that may help predict burnout and work and relationship difficulties in FHCWs. Early interventions aimed at ameliorating transdiagnostic symptoms of MDD, PTSD, and GAD may help mitigate risk for burnout and functional difficulties in this population.

UNASSIGNED: Severe acute respiratory syndrome-Coronavirus 2 pandemic has brought the world to a halt. We performed a questionnaire-based survey to know more about these issues which affected them due to this pandemic and resultant lockdown.
UNASSIGNED: A questionnaire-based survey (53 questions) was conducted online among Indian ophthalmologists with a 2-week response time. The invitation to participate was also circulated widely among various ophthalmologists as members on different social media platforms and emails. It was mandatory to answer all the questions in the questionnaire to make it a valid response.
UNASSIGNED: A total of 903 responses were received across the country. A majority of these responses, 403 (44.6%), were from private practitioners. Almost 876 (97%) of the responders had either kept the daily working hours as same as pre-COVID-19 era or had reduced the actual working hours. Overall, 547 (60.6%) responders did not downsize their staff and 569 (63%) did not reduce the staff salary. Consultation charges were not revised by a majority (659, 73%) of responders. Total of 663 (73.4%) were following the appointment system and 702 (77.7%) responders had reduced the number of patients to less than 6 an hour. Only 106 (11.7%) were doing a mandatory RT-PCR test before surgery, whereas 567 (62.8%) did on the basis of suspicious symptoms.
UNASSIGNED: Our survey gives valuable inputs regarding the changes made by different ophthalmologist groups during the times of COVID-19 and lockdown.

UNASSIGNED: Esophagectomy for esophageal cancer is one of the most challenging surgical procedures, with high rates of morbidity, especially from respiratory complications. SARS-COVID19 represents a health threat nowadays. Peri-operative SARS-COVID19 infection after esophagectomy might negatively affect the postoperative outcomes. The use of tocilizumab as an alternative to reduce the inflammatory response in SARS-COVID19 is an option that has not been described in the literature after esophagectomy.
METHODS: A SARS-COVID19-vaccinated (CORONAVAC) 73-year-old man with pulmonary emphysema, coronary artery disease, previous asymptomatic pulmonary embolism, and adenocarcinoma of the esophagogastric junction tumor was submitted to laparoscopic transhiatal esophagectomy (ypT2N0M0) after perioperative neoadjuvant chemotherapy. He was also infected with SARS-COVID19, confirmed by PCR test at the 14th postoperative day. During follow-up, mild hypoxemia persisted without evidence of infection except for SARS-COVID19, and a high-flow cannula was required to maintain oxygenation. Tocilizumab was administered following high parameters of a high-flow cannula, and invasive mechanical ventilation was avoided.
CONCLUSIONS: Besides of the risk of secondary infection, after administration of tocilizumab, the parameters of oxygen supplementation were systematically reduced, and he stayed in the ICU for seven days. He was discharged from the ward six days later. He developed late cervical anastomotic leakage, which was treated with conservative therapy.
CONCLUSIONS: Although the patient had high-risk comorbidities, esophagectomy, and SARS-COVID19 infection, the use of tocilizumab was safe and improved the pulmonary recovery.

Coronaviruses (CoV) are RNA viruses that cause endemic infections in various species of mammals and avian birds. There are seven known human CoVs, each of which causes respiratory diseases: together account for about one third of common colds. Some CoVs have recently entered humans from infected animals and lastly we have SARS COVID-19, (CoV), which causes severe acute, often fatal respiratory syndromes. The prevalence of CoV, the easy zoonotic transmission and the potential to cause serious respiratory diseases, lead to urgent research to discover the mechanisms of CoV infection. Our study has identified a possible way to eliminate the danger of this virus by analyzing the structures by which it enters the host cell. This study indicates that the neuroaminidase interrupts the infection.

The current Covid-19 pandemic is a significant global health threat. The outbreak has profoundly affected all healthcare professionals, including heart surgeons. To adapt to these exceptional circumstances, cardiac surgeons had to change their practice significantly. We herein discuss the challenges and broad implications of the Covid-19 pandemic from the perspective of the heart surgeons.