A scientometric analysis of the effect of COVID-19 on the spread of research outputs

The spread of the COVID-19 pandemic in 2020 had a huge impact on the life course of all of us. This rapid spread has also caused an increase in the research production in topics related to different aspects of COVID-19. Italy has been one of the first countries to be massively involved in the outbreak of the disease. In this paper, we present an extensive scientometric analysis of the research production both at global (entire literature produced in the first 2 years after the beginning of the pandemic) and local level (COVID-19 literature produced by authors with an Italian affiliation). Our results showed that US and China are the most active countries in terms of number of publications and that the number of collaborations between institutions varies depending on geographical distance. Moreover, we identified the medical-biological as the field with the greatest growth in terms of literature production. As regards the analysis focused on Italy, we have shown that most of the collaborations follow a geographical pattern, both externally (with a preference for European countries) and internally (two clusters of institutions, north versus center-south). Furthermore, we explored the relationship between the number of citations and variables obtained from the data set (e.g. number of authors). Using multiple correspondence analysis and quantile regression we shed light on the role of journal topics and impact factor, the type of article, the field of study and how these elements affect citations

COVIDrugNet: a network-based web tool to investigate the drugs currently in clinical trial to contrast COVID-19

The COVID-19 pandemic poses a huge problem of public health that requires the implementation of all available means to contrast it, and drugs are one of them. In this context, we observed an unmet need of depicting the continuously evolving scenario of the ongoing drug clinical trials through an easy-to-use, freely accessible online tool. Starting from this consideration, we developed COVIDrugNet (http://compmedchem.unibo.it/covidrugnet), a web application that allows users to capture a holistic view and keep up to date on how the clinical drug research is responding to the SARS-CoV-2 infection. Here, we describe the web app and show through some examples how one can explore the whole landscape of medicines in clinical trial for the treatment of COVID-19 and try to probe the consistency of the current approaches with the available biological and pharmacological evidence. We conclude that careful analyses of the COVID-19 drug-target system based on COVIDrugNet can help to understand the biological implications of the proposed drug options, and eventually improve the search for more effective therapies

A synthesis of evidence for policy from behavioural science during COVID-19

Scientific evidence regularly guides policy decisions1, with behavioural science increasingly part of this process2. In April 2020, an influential paper3 proposed 19 policy recommendations (‘claims’) detailing how evidence from behavioural science could contribute to efforts to reduce impacts and end the COVID-19 pandemic. Here we assess 747 pandemic-related research articles that empirically investigated those claims. We report the scale of evidence and whether evidence supports them to indicate applicability for policymaking. Two independent teams, involving 72 reviewers, found evidence for 18 of 19 claims, with both teams finding evidence supporting 16 (89%) of those 18 claims. The strongest evidence supported claims that anticipated culture, polarization and misinformation would be associated with policy effectiveness. Claims suggesting trusted leaders and positive social norms increased adherence to behavioural interventions also had strong empirical support, as did appealing to social consensus or bipartisan agreement. Targeted language in messaging yielded mixed effects and there were no effects for highlighting individual benefits or protecting others. No available evidence existed to assess any distinct differences in effects between using the terms ‘physical distancing’ and ‘social distancing’. Analysis of 463 papers containing data showed generally large samples; 418 involved human participants with a mean of 16,848 (median of 1,699). That statistical power underscored improved suitability of behavioural science research for informing policy decisions. Furthermore, by implementing a standardized approach to evidence selection and synthesis, we amplify broader implications for advancing scientific evidence in policy formulation and prioritization

A synthesis of evidence for policy from behavioural science during COVID-19

Scientific evidence regularly guides policy decisions 1, with behavioural science increasingly part of this process 2. In April 2020, an influential paper 3 proposed 19 policy recommendations (‘claims’) detailing how evidence from behavioural science could contribute to efforts to reduce impacts and end the COVID-19 pandemic. Here we assess 747 pandemic-related research articles that empirically investigated those claims. We report the scale of evidence and whether evidence supports them to indicate applicability for policymaking. Two independent teams, involving 72 reviewers, found evidence for 18 of 19 claims, with both teams finding evidence supporting 16 (89%) of those 18 claims. The strongest evidence supported claims that anticipated culture, polarization and misinformation would be associated with policy effectiveness. Claims suggesting trusted leaders and positive social norms increased adherence to behavioural interventions also had strong empirical support, as did appealing to social consensus or bipartisan agreement. Targeted language in messaging yielded mixed effects and there were no effects for highlighting individual benefits or protecting others. No available evidence existed to assess any distinct differences in effects between using the terms ‘physical distancing’ and ‘social distancing’. Analysis of 463 papers containing data showed generally large samples; 418 involved human participants with a mean of 16,848 (median of 1,699). That statistical power underscored improved suitability of behavioural science research for informing policy decisions. Furthermore, by implementing a standardized approach to evidence selection and synthesis, we amplify broader implications for advancing scientific evidence in policy formulation and prioritization

Syndromic molecular testing in adults hospitalized for suspected community-acquired pneumonia

Den mikrobielle etiologien hos pasienter med samfunnservervet lungebetennelse (CAP) blir ofte ikke avklart på grunn av utilstrekkelige mikrobiologiske metoder og vanskeligheter med å skaffe prøver fra nedre luftveier. Rask påvisning av luftveismikrober kan potensielt redusere unødvendig bruk av empirisk antimikrobiell behandling og øke andelen pasienter som får mikrobiologistyrt behandling. Moderne syndrombaserte PCR-paneler muliggjør rask deteksjon av både virale- og bakterielle luftveismikrober. CAPNOR Feasibility studien undersøkte gjennomførbarheten av flere viktige ledd fra vår planlagte CAPNOR RCT (Paper I). Studien viste at det var mulig å skaffe nedre luftveisprøver fra CAP pasienter allerede i akuttmottaket. Ved bruk av et syndrombasert PCR-panel, fant vi betydelig flere luftveismikrober på kortere tid, sammenliknet med bruk av standard metoder, noe som indikerer at det er mulig å oppnå mikrobiologiske resultater allerede i akuttmottaket. Vår CAPNOR RCT fokuserer på andelen som mottar mikrobiologistyrt behandling og tiden det tar. Prøver fra nedre luftveier ble randomisert til testing med kun standardmetoder eller med tillegg av et syndrombasert PCR-panel (Paper II). COVID-19 pandemien traff Norge da vi skulle starte vår RCT, noe som resulterte i forsinket start av studien og behov for justeringer av protokollen. I denne unike situasjonen valgte vi å undersøke pandemiens potensielle implikasjoner på både antall sykehusinnleggelser og detekterte mikrober hos pasienter med mistenkt CAP, ved å sammenlikne pasienter inkludert før og etter utbruddet av COVID-19 (Paper III). Smitteverntiltak relatert til COVID-19 forverret utfordringene med prøvetakning fra nedre luftveier ytterligere. Dette bidro til en studie som viste at testing av halsprøver med et syndrombasert PCR-panel oppdaget de vanligste bakterielle luftveismikrober med høy positiv og negativ prosentvis overensstemmelse sammenlignet med testing av nedre luftveisprøver (Paper IV). Dette antyder at halsprøver analysert av et syndrombasert PCR-panel kan representere en alternativ metode for rask mikrobiologisk testing i akuttmottaket. Oppsummert har våre studier demonstrert at det er mulig å oppnå omfattende mikrobiologiske resultater hos en stor andel CAP pasienter få timer etter innleggelse. Fremtidige studier av syndrombaserte PCR-paneler bør fokusere videre på kliniske endepunkter, kostnadseffektivitet og utvikling av implementeringsstrategier for innføring i klinisk praksis.The microbial etiology of patients with community-acquired pneumonia (CAP) is often not established due to insufficient methods for microbial detection and difficulties in obtaining lower respiratory tract (LRT) samples. Early microbial detections could potentially reduce unnecessary empirical antimicrobial treatment and improve the proportion of patients receiving pathogen-directed treatment. Recently introduced syndromic PCR-based panels enable rapid detection of both viral- and bacterial pathogens. The CAPNOR Feasibility study (Paper I) was initiated with a view to informing the design of a planned RCT and demonstrated that obtaining LRT samples from CAP patients in the emergency department (ED) was feasible. The microbial yield and time to results improved significantly by using a syndromic PCR-based panel compared to standard methods, indicating that it is possible to obtain microbiological results already in the ED. In the CAPNOR RCT, LRT samples were randomized to testing by either standard methods alone or with the addition of syndromic PCR-based testing, focusing on the time to, and provision of pathogen-directed treatment in CAP patients (Paper II). When we were about to initiate the CAPNOR RCT, Norway faced the COVID-19 pandemic, resulting in a delayed start, with mandatory adjustments needed in the protocol. Faced with this unprecedented situation, we evaluated the pandemic’s potential implications on both hospital admissions and microbial detections in patients with suspected CAP, i.e., before and after the outbreak of COVID-19 and the subsequent strict infection control measures (Paper III). Moreover, the COVID-19-related infection control measures further hampered the difficulties of LRT sampling. This fostered a study where we demonstrated that syndromic PCR-based testing of oropharyngeal (OP) swabs could detect the most common bacterial CAP pathogens with high positive and negative percent agreement compared with testing of LRT samples (Paper IV). These findings suggest that OP swabs analyzed by a syndromic panel could represent an alternative approach for rapid microbiological testing in the ED. In conclusion, our studies have demonstrated an ability to provide close to real-time microbiological results for CAP patients. Future studies should focus on the impact of rapid syndromic testing in terms of clinical outcomes, cost-effectiveness, and the development of implementation strategies to facilitate integration into clinical practice.Doktorgradsavhandlin

Efficacy and safety of therapies for COVID-19 in pregnancy: a systematic review and meta-analysis

Background: Clinical evidence suggests that pregnant women are more vulnerable to COVID-19, since they are at increased risk for disease progression and for obstetric complications, such as premature labor, miscarriage, preeclampsia, cesarean delivery, fetal growth restriction and perinatal death. Despite this evidence, pregnant women are often excluded from clinical trials, resulting in limited knowledge on COVID-19 management. The aim of this systematic review and meta-analysis is to provide better evidence on the efficacy and safety of available COVID-19 treatment in pregnant women. Methods: Four authors searched major electronic databases from inception until 1 st November-2022 for controlled trials/observational studies, investigating outcomes after the administration of anti-SARS-CoV-2 treatments in pregnant women affected by COVID-19. The analyses investigated the cumulative incidence of delivery and maternal outcomes in pregnant women, comparing those taking active medication vs standard care. Risk ratios (RRs) with 95% confidence intervals were calculated. Statistical significance was assessed using the random effects model and inverse-variance method. This systematic review and meta-analysis was conducted in accordance with the updated 2020 Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The protocol has been registered in Prospero (number registration: CRD42023397445). Results: From initially 937 non duplicate records, we assessed the full texts of 40 articles, finally including ten studies. In six studies, including 1627 patients, the use of casirivimab/imdevimab (CAS/IMD), remdesivir, and IFN-alpha 2b significantly decreased the need of cesarean section ((RR = 0.665; 95%CI: 0.491–0.899; p = 0.008; I 2 = 19.5%;) (Table 1, (Fig. 1). Treatments did not decrease the risk of preterm delivery, admission to neonatal ICU, or stillbirth/perinatal loss (p-values > 0.50 for all these outcomes) and did not prevent the progression of disease towards severe degrees (k = 8; 2,374 pregnant women; RR = 0.778; 95%CI: 0.550–1.099; p = 0.15; I 2 = 0%). Moreover, the use of medications during pregnancy did not modify the incidence of maternal death in two studies (Table 2). Conclusions: To our analysis, CAS/IMD, remdesivir, and IFN alpha 2b reduced the number of cesarean sections but demonstrated no effect on disease progression and other obstetric and COVID-19 related outcomes. The inability to evaluate the influence of viral load on illness development in pregnant women was attributed to lack of data. In our systematic review, no major side effects were reported. Though, it is essential for the medical community to focus more on clinical trials and less on episodic case reports and case series, with standardization of fetal and maternal outcomes

The implementation of a rapid sample preparation method for the detection of SARS-CoV-2 in a diagnostic laboratory in South Africa

The SARS-CoV-2 pandemic has resulted in shortages of both critical reagents for nucleic acid purification and highly trained staff as supply chains are strained by high demand, public health measures and frequent quarantining and isolation of staff. This created the need for alternate workflows with limited reliance on specialised reagents, equipment and staff. We present here the validation and implementation of such a workflow for preparing samples for downstream SARS-CoV-2 RT-PCR using liquid handling robots. The rapid sample preparation and inactivation technique evaluated, which included sample centrifugation and heating prior to RT-PCR, showed a 97.37% (95% CI: 92.55-99.28%) positive percent agreement and 97.30% (95% CI: 90.67-99.52%) negative percent agreement compared to nucleic acid purification-based testing. A total of 195 samples were tested as part of the validation. This method was subsequently adopted as the primary sample preparation method in the Groote Schuur Hospital Virology Diagnostic Laboratory in Cape Town, South Africa

An old confusion: Entomophthoromycosis versus mucormycosis and their main differences

Fungal diseases were underestimated for many years. And the global burden of fungal infections is substantial and has increased in recent years. Invasive fungal infections have been linked to several risk factors in humans which basically depend on the individual homeostasis of the patients. However, many fungi can infect even apparently healthy people. Knowledge of these pathogens is critical in reducing or stopping morbidity and/or mortality statistics due to fungal pathogens. Successful therapeutic strategies rely on rapid diagnosis of the causative fungal agent and the underlying disease. However, the terminology of the diseases was updated to existing phylogenetic classifications and led to confusion in the definition of mucormycosis, conidiobolomycosis, and basidiobolomycosis, which were previously grouped under the now-uncommon term zygomycosis. Therefore, the ecological, taxonomic, clinical, and diagnostic differences are addressed to optimize the understanding and definition of these diseases. The term “coenocytic hyphomycosis” is proposed to summarize all fungal infections caused by Mucorales and species of Basidiobolus and Conidiobolus