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Bibliography on: covid-19

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ESP: PubMed Auto Bibliography 18 Jun 2021 at 01:32 Created: 


Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS coronavirus 2, or SARS-CoV-2), a virus closely related to the SARS virus. The disease was discovered and named during the 2019-20 coronavirus outbreak. Those affected may develop a fever, dry cough, fatigue, and shortness of breath. A sore throat, runny nose or sneezing is less common. While the majority of cases result in mild symptoms, some can progress to pneumonia and multi-organ failure. The infection is spread from one person to others via respiratory droplets produced from the airways, often during coughing or sneezing. Time from exposure to onset of symptoms is generally between 2 and 14 days, with an average of 5 days. The standard method of diagnosis is by reverse transcription polymerase chain reaction (rRT-PCR) from a nasopharyngeal swab or sputum sample, with results within a few hours to 2 days. Antibody assays can also be used, using a blood serum sample, with results within a few days. The infection can also be diagnosed from a combination of symptoms, risk factors and a chest CT scan showing features of pneumonia. Correct handwashing technique, maintaining distance from people who are coughing and not touching one's face with unwashed hands are measures recommended to prevent the disease. It is also recommended to cover one's nose and mouth with a tissue or a bent elbow when coughing. Those who suspect they carry the virus are recommended to wear a surgical face mask and seek medical advice by calling a doctor rather than visiting a clinic in person. Masks are also recommended for those who are taking care of someone with a suspected infection but not for the general public. There is no vaccine or specific antiviral treatment, with management involving treatment of symptoms, supportive care and experimental measures. The case fatality rate is estimated at between 1% and 3%. The World Health Organization (WHO) has declared the 2019-20 coronavirus outbreak a Public Health Emergency of International Concern (PHEIC). As of 29 February 2020, China, Hong Kong, Iran, Italy, Japan, Singapore, South Korea and the United States are areas having evidence of community transmission of the disease.

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Created with PubMed® Query: "SARS-CoV-2" OR "COVID-19" OR (wuhan AND "coronavirus") AND review[SB] NOT pmcbook NOT ispreviousversion

Citations The Papers (from PubMed®)


RevDate: 2021-06-15

Keshta AS, Mallah SI, Al Zubaidi K, et al (2021)

COVID-19 versus SARS: A comparative review.

Journal of infection and public health, 14(7):967-977 pii:S1876-0341(21)00100-3 [Epub ahead of print].

The two genetically similar severe acute respiratory syndrome coronaviruses, SARS-CoV-1 and SARS-CoV-2, have each been responsible for global epidemics of vastly different scales. Although both viruses arose from similar origins, they quickly diverged due to differences in their transmission dynamics and spectrum of clinical presentations. The potential involvement of multiple organs systems, including the respiratory, cardiac, gastrointestinal and neurological, during infection necessitates a comprehensive understanding of the clinical pathogenesis of each virus. The management of COVID-19, initially modelled after SARS and other respiratory illnesses, has continued to evolve as we accumulate more knowledge and experience during the pandemic, as well as develop new therapeutics and vaccines. The impact of these two coronaviruses has been profound for our health care and public health systems, and we hope that the lessons learned will not only bring the current pandemic under control, but also prevent and reduce the impact of future pandemics.

RevDate: 2021-06-15

Almutairi AS, Abunurah H, Hadi Alanazi A, et al (2021)

The immunological response among COVID-19 patients with acute respiratory distress syndrome.

Journal of infection and public health, 14(7):954-959 pii:S1876-0341(21)00124-6 [Epub ahead of print].

Coronavirus disease 2019 (COVID-19) often results in pneumonia and can lead to acute respiratory distress syndrome (ARDS). ARDS is one of the most significant causes of death in patients with COVID-19. The development of a "cytokine storm" in patients with COVID-19 causes progression to ARDS. In this scoping review, we investigated the effect of pro-inflammatory cytokines in inducing moderate and severe ARDS outcomes. A comprehensive search was performed using PubMed and Google Scholar to implement a broad query that captured all the relevant studies published between December 2019 and September 2020.We identified seven studies that evaluated the immune response in COVID-19 patients with ARDS. The white blood cell counts (WBCs), CRP, and IL-6 were higher in the moderately presenting ARDS patients, critically ill patients, and those with more severe ARDS. This study may contribute to better patient management and outcomes if tailored immune marker interventions are implemented in the near future.

RevDate: 2021-06-15

Cox RM, RK Plemper (2021)

The impact of high-resolution structural data on stemming the COVID-19 pandemic.

Current opinion in virology, 49:127-138 pii:S1879-6257(21)00059-6 [Epub ahead of print].

The coronavirus disease 2019 (COVID-19) pandemic has had a catastrophic impact on human health and the world economy. The response of the scientific community was unparalleled, and a combined global effort has resulted in the creation of vaccines in a shorter time frame than previously unimaginable. Reflecting this concerted effort, the structural analysis of the etiological agent, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has progressed with an unprecedented pace. Since the onset of the pandemic, over 1000 high-resolution structures of a broad range of SARS-CoV-2 proteins have been solved and made publicly available. These structures have aided in the identification of numerous potential druggable targets and have contributed to the design of different vaccine candidates. This opinion article will discuss the impact of high-resolution structures in understanding SARS-CoV-2 biology and explore their role in the development of vaccines and antivirals.

RevDate: 2021-06-15

Ong JJY, Chan ACY, Bharatendu C, et al (2021)

Headache Related to PPE Use during the COVID-19 Pandemic.

Current pain and headache reports, 25(8):53.

PURPOSE OF REVIEW: Personal protection equipment (PPE)-associated headache is an unusual secondary headache disorder that predominantly occurs in healthcare workers as a consequence of the donning of protective respirators, face masks and/or eyewear. The appreciation of this entity is important given the significant ramifications upon the occupational health of healthcare workers and could additionally have an impact on persons living with pre-existing headache disorder(s).

RECENT FINDINGS: There has been a renewed interest and recognition of PPE-associated headaches amongst healthcare professionals, largely brought about by the ongoing COVID-19 pandemic which has besieged healthcare systems worldwide. De novo PPE-associated headaches may present with migrainous or tension-type features and can be viewed as a subtype of external compression headache. The prognosis of the disorder is generally favourable, given that most headaches are short-lived without long-term sequalae. Several aetiologies have been postulated to account for the development of these headaches. Notably, these headaches can affect the occupational health and work performance of healthcare workers. In this review, we discuss the epidemiology, clinical characteristics, probable etiopathogenesis, management and prognosis of PPE-associated headaches in the context of the COVID-19 pandemic. Future directions for research and PPE development are proposed.

RevDate: 2021-06-15

Iffah R, FNE Gavins (2021)

Thromboinflammation in COVID-19: The Clot Thickens.

British journal of pharmacology [Epub ahead of print].

Since the start of the coronavirus SARS-Cov-2 pandemic, a disease that has become one of the world's greatest global health challenges, the role of the immune system has been at the forefront of scientific studies. The pathophysiology of COVID-19 is complex, which is evident in those at higher risk for poor outcome. Multiple systems contribute to thrombosis and inflammation seen in COVID-19 patients, including neutrophil and platelet activation, and endothelial dysfunction. Understanding how the immune system functions in different patient cohorts (particularly given recent emerging events with the Oxford/AstraZeneca vaccine) is vital to understanding the pathophysiology of this devastating disease and for the subsequent development of novel therapeutic targets and to facilitate possible drug repurposing strategies that could benefit society on a global scale.

RevDate: 2021-06-15

Poormohammadi A, Bashirian S, Rahmani AR, et al (2021)

Are photocatalytic processes effective for removal of airborne viruses from indoor air? A narrative review.

Environmental science and pollution research international [Epub ahead of print].

A wide variety of methods have been applied in indoor air to reduce the microbial load and reduce the transmission rate of acute respiratory diseases to personnel in healthcare sittings. In recent months, with the occurrence of COVID-19 pandemic, the role of portable ventilation systems in reducing the load of virus in indoor air has received much attention. The present study delineates a comprehensive up-to-date overview of the available photocatalysis technologies that have been applied for inactivating and removing airborne viruses. The detection methods for identifying viral particles in air and the main mechanisms involving in virus inactivation during photocatalysis are described and discussed. The photocatalytic processes could effectively decrease the load of viruses in indoor air. However, a constant viral model may not be generalizable to other airborne viruses. In photocatalytic processes, temperature and humidity play a distinct role in the inactivation of viruses through changing photocatalytic rate. The main mechanisms for inactivation of airborne viruses in the photocatalytic processes included chemical oxidation by the reactive oxygen species (ROS), the toxicity of metal ions released from metal-containing photocatalysts, and morphological damage of viruses.

RevDate: 2021-06-15

Sampath U Gunathilake TM, Ching YC, Uyama H, et al (2021)

Nanotherapeutics for treating coronavirus diseases.

Journal of drug delivery science and technology pii:S1773-2247(21)00314-2 [Epub ahead of print].

Viral diseases have recently become a threat to human health and rapidly become a significant cause of mortality with a continually exacerbated unfavorable socio-economic impact. Coronaviruses, including severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome (MERS-CoV), and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), have threatened human life, with immense accompanying morbidity rates; the COVID-19 (caused by SARS-CoV-2) epidemic has become a severe threat to global public health. In addition, the design process of antiviral medications usually takes years before the treatments can be made readily available. Hence, it is necessary to invest scientifically and financially in a technology platform that can then be quickly repurposed on demand to be adequately positioned for this kind of pandemic situation through lessons learned from the previous pandemics. Nanomaterials/nanoformulations provide such platform technologies, and a proper investigation into their basic science and biological interactions would be of great benefit for potential vaccine and therapeutic development. In this respect, intelligent and advanced nano-based technologies provide specific physico-chemical properties, which can help fix the key issues related to the treatments of viral infections. This review aims to provide an overview of the latest research on the effective use of nanomaterials in the treatment of coronaviruses. Also raised are the problems, perspectives of antiviral nanoformulations, and the possibility of using nanomaterials effectively against current pandemic situations.

RevDate: 2021-06-15

Alsenani F (2021)

Potential Natural Candidates in the Treatment of Coronavirus.

Saudi journal of biological sciences pii:S1319-562X(21)00468-X [Epub ahead of print].

Many viral infections do not have treatments or resistant to existing antiviral therapeutic interventions, and a novel strategy is required to combat virus-mediated fatalities. A novel coronavirus (coronavirus disease 2019 [COVID-19]) emerged in Wuhan, China, in late 2019 and rapidly spread across the globe. COVID-19 has impacted human society with life-threatening and unprecedented health, social, and economic issues, and it continues to affect millions of people. More than 5,800 clinical trials are in place worldwide to develop treatments to eradicate COVID-19. Historically, traditional medicine or natural products, such as medicinal plants, marine organisms and microbes, have been efficacious in treating viral infections. Nevertheless, important parameters for natural products, including clinical trial information, pharmacokinetic data, potency and toxicity profiles, in vivo and in vitro data, and product safety require validation. In this review article, an evaluation is performed of the potential application of natural product-based antiviral compounds, including crude extracts and bioactive chemical compounds obtained from medicinal plants, marine organisms, and microbes, to treat the viral infections COVID-19.

RevDate: 2021-06-15

Zaidi AK, P Dehgani-Mobaraki (2021)

The mechanisms of action of Ivermectin against SARS-CoV-2: An evidence-based clinical review article.

The Journal of antibiotics [Epub ahead of print].

Considering the urgency of the ongoing COVID-19 pandemic, detection of various new mutant strains and future potential re-emergence of novel coronaviruses, repurposing of approved drugs such as Ivermectin could be worthy of attention. This evidence-based review article aims to discuss the mechanism of action of ivermectin against SARS-CoV-2 and summarizing the available literature over the years. A schematic of the key cellular and biomolecular interactions between Ivermectin, host cell, and SARS-CoV-2 in COVID-19 pathogenesis and prevention of complications have been proposed.

RevDate: 2021-06-15

Selick A, Bobbette N, Lunsky Y, et al (2021)

Virtual health care for adult patients with intellectual and developmental disabilities: A scoping review.

Disability and health journal pii:S1936-6574(21)00078-9 [Epub ahead of print].

BACKGROUND: The COVID-19 pandemic led to an abrupt shift to virtual health care for many patients, including adults with intellectual and developmental disabilities (IDD). Approaches to virtual care that are successful for people without IDD may need to be adapted for adults with IDD.

OBJECTIVE: The aim of this scoping review was to examine what is known about virtual health care for adults with IDD and in particular, the impact of virtual delivery on access to care for this population.

METHODS: A comprehensive search was conducted of the academic and grey literature. A two-stage screening process was conducted by two independent reviewers and a structured data extraction template was populated for each included study. Findings were analyzed thematically using Access to Care Framework domains.

RESULTS: In total, 22 studies met inclusion criteria. The majority were published in the past three years and focused on specialized IDD services. A subset of 12 studies reported findings on access to care for adults with IDD. Participants generally reported high acceptability of virtual care, though some preferred face-to-face encounters. Initial results on effectiveness were positive, though limited by small sample sizes. Challenges included internet quality and technical skill or comfort.

CONCLUSIONS: This review suggests that it is possible to deliver accessible, high quality virtual care for adults with IDD, however, relatively little research has been conducted on this topic. Due to COVID-19 there is currently a unique opportunity and urgency to learn when and for whom virtual care can be successful and how it can be supported.

RevDate: 2021-06-15

Hantoushzadeh S, Nabavian SM, Soleimani Z, et al (2021)

COVID-19 Disease During Pregnancy and Peripartum Period: A Cardiovascular Review.

Current problems in cardiology pii:S0146-2806(21)00103-1 [Epub ahead of print].

Pregnancy with various physiological effects on cardiovascular system, makes mothers with borderline cardiovascular reserve at significant risk for adverse events during labor and early postpartum period. Cardiac imaging modalities, have shown that Coronavrus Disease 2019 disease is associated with subclinical myocardial injury in significant numbers of infected people, even in mild or asymptomatic disease and previous healthy ones. Herein, we have discussed the cardiovascular aspects of prepartum pregnant women with Coronavrus Disease 2019, especially patients with moderate to severe illness. Also, we have proposed how to handle the hemodynamic load during labor and the first 48 hours postpartum in the hypoxemic overloaded parturients with possible subclinical myocardial injury.

RevDate: 2021-06-15

García Rodríguez J, González Ruiz de León C, Sacristán González R, et al (2021)

Changes in the ambulatory care of prostate cancer patients during the SARS-CoV-2 pandemic. Literature review and contribution of our group in telematic care.

Actas urologicas espanolas pii:S0210-4806(21)00087-5 [Epub ahead of print].

INTRODUCTION AND OBJECTIVE: The COVID-19 pandemic has brought about changes in the management of urology patients, especially those with prostate cancer. The aim of this work is to show the changes in the ambulatory care practices by individualized telematic care for each patient profile.

MATERIALS AND METHODS: Articles published from March 2020 to January 2021 were reviewed. We selected those that provided the highest levels of evidence regarding risk in different aspects: screening, diagnosis, treatment and follow-up of prostate cancer.

RESULTS: We developed a classification system based on priorities, at different stages of the disease (screening, diagnosis, treatment and follow-up) to which the type of care given, in-person or telephone visits, was adapted. We established 4 options, as follows: in priority A or low, care will be given by telephone in all cases; in priority B or intermediate, if patients are considered subsidiary of an in-person visit after telephone consultation, they will be scheduled within 3 months; in priority C or high, patients will be seen in person within a margin from 1 to 3 months and in priority D or very high, patients must always be seen in person within a margin of up to 48hours and considered very preferential.

CONCLUSIONS: Telematic care in prostate cancer offers an opportunity to develop new performance and follow-up protocols, which should be thoroughly analyzed in future studies, in order to create a safe environment and guarantee oncologic outcomes for patients.

RevDate: 2021-06-14

Pomorska-Mól M, Włodarek J, Gogulski M, et al (2021)

Review: SARS-CoV-2 infection in farmed minks - an overview of current knowledge on occurrence, disease and epidemiology.

Animal : an international journal of animal bioscience, 15(7):100272 pii:S1751-7311(21)00114-2 [Epub ahead of print].

Coronaviruses (CoVs), which are enveloped, positive-sense RNA viruses, may cause infections in mammals and birds. Apart from the respiratory manifestations, CoVs are also responsible for infections of the gastrointestinal tract and nervous systems. Their propensity to recombine allows them to easily transmit and adapt to new hosts. The emergence of a new CoV in humans, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which is attributed to a zoonotic origin, has provoked numerous studies to assess its pathogenicity for different animal species (pets, farm and wild animals). Available results indicate that numerous animal species are susceptible to infection with SARS-CoV-2. From April 2020, when the first SARS-CoV-2 infection in minks was reported in the Netherlands, to the end of January 2021, further outbreaks have been confirmed in Denmark, Italy, Spain, Sweden, the United States, Greece, France, Canada, Lithuania and Poland. It has also been established that human-to-minks and minks-to-human transmission may occur. The results obtained to date indicate that the virus was originally introduced into the minks population by humans, possibly at the start of the pandemic and had been circulating in the population for several weeks before detection. Recent data indicate that minks are highly susceptible to SARS-CoV-2 infection, but the route or routes of virus transmission between farms, other than by direct contact with infected humans, have not been identified. In minks, infection can occur in clinical and subclinical form, making it possibly difficult to detect. Therefore, minks could represent potentially dangerous, not always recognized, animal reservoir for SARS-CoV-2. The current data indicate that further studies on minks and other Mustelidae are needed to clarify whether they may be a potential reservoir for SARS-CoV-2, and if so, how and whether this can be prevented.

RevDate: 2021-06-14

Patel S, M Wadhwa (2021)

Therapeutic use of specific tumour necrosis factor inhibitors in inflammatory diseases including COVID-19.

Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie, 140:111785 pii:S0753-3322(21)00567-9 [Epub ahead of print].

Coronavirus disease 2019 (COVID-19) has caused significant devastation globally. Despite the development of several vaccines, with uncertainty around global uptake and vaccine efficacy, the need for effective therapeutic agents remains. Increased levels of cytokines including tumour necrosis factor are significant in the pathogenesis of COVID-19 and associated with poor outcomes including ventilator requirement and mortality. Repurposing tumour necrosis factor blocker therapy used in conditions such as rheumatoid arthritis and inflammatory bowel disease seems promising, with early feasibility data showing a reduction in circulation of pro-inflammatory cytokines and encouraging the evaluation of such interventions in preventing disease progression and clinical deterioration in patients with COVID-19. Here, we examine the biological activities of tumour necrosis factor inhibitors indicative of their potential in COVID-19 and briefly outline the randomised control trials assessing their benefit-risk profile in COVID-19 therapy.

RevDate: 2021-06-14

Badshah SL, Faisal S, Muhammad A, et al (2021)

Antiviral activities of flavonoids.

Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie, 140:111596 pii:S0753-3322(21)00381-4 [Epub ahead of print].

Flavonoids are natural phytochemicals known for their antiviral activity. The flavonoids acts at different stages of viral infection, such as viral entrance, replication and translation of proteins. Viruses cause various diseases such as SARS, Hepatitis, AIDS, Flu, Herpes, etc. These, and many more viral diseases, are prevalent in the world, and some (i.e. SARS-CoV-2) are causing global chaos. Despite much struggle, effective treatments for these viral diseases are not available. The flavonoid class of phytochemicals has a vast number of medicinally active compounds, many of which are studied for their potential antiviral activity against different DNA and RNA viruses. Here, we reviewed many flavonoids that showed antiviral activities in different testing environments such as in vitro, in vivo (mice model) and in silico. Some flavonoids had stronger inhibitory activities, showed no toxicity & the cell proliferation at the tested doses are not affected. Some of the flavonoids used in the in vivo studies also protected the tested mice prophylactically from lethal doses of virus, and effectively prevented viral infection. The glycosides of some of the flavonoids increased the solubility of some flavonoids, and therefore showed increased antiviral activity as compared to the non-glycoside form of that flavonoid. These phytochemicals are active against different disease-causing viruses, and inhibited the viruses by targeting the viral infections at multiple stages. Some of the flavonoids showed more potent antiviral activity than the market available drugs used to treat viral infections.

RevDate: 2021-06-14

Dong F, Liu HL, Dai N, et al (2021)

A living systematic review of the psychological problems in people suffering from COVID-19.

Journal of affective disorders, 292:172-188 pii:S0165-0327(21)00504-8 [Epub ahead of print].

OBJECTIVES: We aimed to investigate the psychological problems on people infected with SARS-CoV-2 during the pandemic.

METHODS: In this living systematic review and meta-analyses, we searched seven electronic databases for cross-sectional studies and longitudinal studies on psychological problems on COVID-19 patients from Jan 1, 2020 to Oct 7, 2020. The primary outcome was prevalence of various psychological problems such as anxiety, depression, stress, insomnia, somatization, and fear. We pooled data for prevalence with their 95% confidence interval (CI) using random effect models and assessed the study quality based on the 11-item checklist recommended by the Agency for Healthcare Research and Quality.

RESULTS: Fourty-four studies, including studies from China(35), Italy(2), Iran(2), India(1), Korea(1), Ecuador(1), Switzerland(1), Germany(1), were identified by comprising a total of 8587 completed questionnaires and 38 studies for meta-analyses. The prevalence of anxiety, depression, post-traumatic stress disorder(PTSD), insomnia, somatization, and fear in patients with COVID-19 was 16.6% (10.1%-23.1%), 37.7% (29.3%-46.2%), 41.5% (9.3%-73.7%), 68.3% (48.6%-88.0%), 36.5% (20.2%-52.8%), 47.6% (9.4%-85.7%), respectively. The prevalence of anxiety, depression, and insomnia in severe COVID-19 patients (intensive care unit inpatients) was higher than mild or clinically stable COVID-19 patients.

LIMITATIONS: A significant degree of heterogeneity in terms of populations, sampling methods, scales was noted across studies.

CONCLUSIONS: There existed high proportions of COVID-19 patients with psychological problem. The prevalence of psychological problems was closely related to the patients themselves, their surroundings and social support. It is imperative to provide ontime psychological care service for COVID-19 patients and to follow-up them for a longer period.

RevDate: 2021-06-14

Saleki K, Yaribash S, Banazadeh M, et al (2021)

Interferon therapy in patients with SARS, MERS, and COVID-19: A systematic review and meta-analysis of clinical studies.

European journal of pharmacology pii:S0014-2999(21)00401-5 [Epub ahead of print].

Concern regarding coronavirus (CoV) outbreaks has stayed relevant to global health in the last decades. Emerging COVID-19 infection, caused by the novel SARS-CoV2, is now a pandemic, bringing a substantial burden to human health. Interferon (IFN), combined with other antivirals and various treatments, has been used to treat and prevent MERS-CoV, SARS-CoV, and SARS-CoV2 infections. We aimed to assess the clinical efficacy of IFN-based treatments and combinational therapy with antivirals, corticosteroids, traditional medicine, and other treatments. Major healthcare databases and grey literature were investigated. A three-stage screening was utilized, and included studies were checked against the protocol eligibility criteria. Risk of bias assessment and data extraction were performed, followed by narrative data synthesis. Fifty-five distinct studies of SARS-CoV2, MERS-CoV, and SARS-CoV were spotted. Our narrative synthesis showed a possible benefit in the use of IFN. A good quality cohort showed lower CRP levels in Arbidol (ARB) + IFN group vs. IFN only group. Another study reported a significantly shorter chest X-ray (CXR) resolution in IFN-Alfacon-1 + corticosteroid group compared with the corticosteroid only group in SARS-CoV patients. In a COVID-19 trial, total adverse drug events (ADEs) were much lower in the Favipiravir (FPV) + IFN-α group compared with the LPV/RTV arm (P = 0.001). Also, nausea in patients receiving FPV + IFN-α regimen was significantly lower (P = 0.03). Quantitative analysis of mortality did not show a conclusive effect for IFN/RBV treatment in six moderately heterogeneous MERS-CoV studies (log OR=-0.05, 95% CI: (-0.71,0.62), I2 =44.71%). A meta-analysis of three COVID-19 studies did not show a conclusive nor meaningful relation between receiving IFN and COVID-19 severity (log OR=-0.44, 95% CI: (-1.13,0.25), I2 =31.42%). A lack of high-quality cohorts and controlled trials was observed. Evidence suggests the potential efficacy of several combination IFN therapies such as lower ADEs, quicker resolution of CXR, or a decrease in inflammatory cytokines; Still, these options must possibly be further explored before being recommended in public guidelines. For all major CoVs, our results may indicate a lack of a definitive effect of IFN treatment on mortality. We recommend such therapeutics be administered with extreme caution until further investigation uncovers high-quality evidence in favor of IFN or combination therapy with IFN.

RevDate: 2021-06-14

Whitmore HAB, LA Kim (2021)

Understanding the Role of Blood Vessels in the Neurological Manifestations of COVID-19.

The American journal of pathology pii:S0002-9440(21)00260-1 [Epub ahead of print].

SARS-CoV-2 was originally identified as an outbreak in Wuhan, China towards the end of 2019 and quickly became a global pandemic, with a large death toll. Originally identified as a respiratory disease, similar to previously discovered SARS and MERS type viruses, concern has since been raised about the effects of SARS-CoV-2 infection on the vasculature. This viral-vascular involvement is of particular concern with regards to the small vessels present in the brain, with mounting evidence demonstrating that SARS-CoV-2 is capable of crossing the blood-brain-barrier. Severe symptoms of infection, termed COVID-19, often result in neurological complications, regardless of patient age. These neurological complications range from mild to severe across all demographics, however, the long-term repercussions of neurological involvement on patient health are still unknown.

RevDate: 2021-06-14

Zhu C, He G, Yin Q, et al (2021)

Molecular biology of the SARs-CoV-2 spike protein: A review of current knowledge.

Journal of medical virology [Epub ahead of print].

The global coronavirus disease 2019 (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has led to an unprecedented worldwide public health emergency. Despite the concerted efforts of the scientific field, by April 25, 2021, SARS-CoV-2 had spread to over 192 countries/regions, causing more than 146 million confirmed cases including 31 million deaths. For now, an established treatment for patients with COVID-19 remains unavailable. The key to tackling this pandemic is to understand the mechanisms underlying its infectivity and pathogenicity. As a predominant focus, the coronavirus spike (S) protein is the key determinant of host range, infectivity, and pathogenesis. Thereby comprehensive understanding of the sophisticated structure of SARS-CoV-2 S protein may provide insights into possible intervention strategies to fight this ongoing global pandemic. Herein, we summarize the current knowledge of the molecular structural and functional features of SARS-CoV-2 S protein as well as recent updates on the cell entry mechanism of the SARS-CoV-2, paving the way for exploring more structure-guided strategies against SARS-CoV-2.

RevDate: 2021-06-15

Leal Rato M, Bandeira M, Romão VC, et al (2021)

Neurologic Manifestations of the Antiphospholipid Syndrome - an Update.

Current neurology and neuroscience reports, 21(8):41.

PURPOSE OF REVIEW: In recent years, the spectrum of neurological manifestations of antiphospholipid syndrome (APS) has been growing. We provide a critical review of the literature with special emphasis on presentation, proposed mechanisms of disease, and treatment of neurological involvement in APS.

RECENT FINDINGS: Although stroke is the most common cause of neurological manifestations in patients with APS, other neurological disorders have been increasingly associated with the disease, including cognitive dysfunction, headache, and epilepsy. Direct oral anticoagulants have failed to show non-inferiority compared to vitamin K antagonists for the prevention of major thrombotic events. Antiphospholipid antibodies are often found in patients with acute COVID-19 but clear evidence supporting an association between these antibodies and the risk of thrombotic events, including stroke and cerebral venous thrombosis, is still lacking. APS patients may present with several distinct neurological manifestations. New criteria will facilitate the classification of patients presenting with increasingly recognized non-criteria neurological manifestations.

RevDate: 2021-06-15

Armocida B, Formenti B, Missoni E, et al (2021)

Challenges in the equitable access to COVID-19 vaccines for migrant populations in Europe.

The Lancet regional health. Europe, 6:100147.

RevDate: 2021-06-15

Pacheco CAR, Hilares RT, de Jesús Colina Andrade G, et al (2021)


Bioresource technology reports [Epub ahead of print].

The current pandemic caused by SARS-CoV-2 has put public health at risk, being wastewater-based epidemiology (WBE) a potential tool in the detection, prevention, and treatment of present and possible future outbreaks, since this virus enters wastewater through various sources such as feces, vomit, and sputum. Thus, advanced technologies such as advanced oxidation processes (AOP), membrane technology (MT) are identified through a systematic literature review as an alternative option for the destruction and removal of emerging contaminants (drugs and personal care products) released mainly by infected patients. The objectives of this review are to know the implications that the new COVID-19 outbreak is generating and will generate in water compartments, as well as the new challenges faced by wastewater treatment plants due to the change in a load of contaminants and the solutions proposed based on the aforementioned technologies to be applied to preserve public health and the environment.

RevDate: 2021-06-15

Rezvani Ghomi E, Khosravi F, Mohseni-M A, et al (2021)

A collection of the novel coronavirus (COVID-19) detection assays, issues, and challenges.

Heliyon, 7(6):e07247.

The global pandemic of COVID-19 has rapidly increased the number of infected cases as well as asymptomatic individuals in many, if not all the societies around the world. This issue increases the demand for accurate and rapid detection of SARS-CoV-2. While accurate and rapid detection is critical for diagnosing SARS-CoV-2, the appropriate course of treatment must be chosen to help patients and prevent its further spread. Testing platform accuracy with high sensitivity and specificity for SARS-CoV-2 is equally important for clinical, regional, and global arenas to mitigate secondary transmission rounds. The objective of this article is to compare the current detection technology and introduce the most accurate and rapid ones that are suitable for pandemic circumstances. Hence, the importance of rapid detection in societies is discussed initially. Following this, the current technology for rapid detection of SARS-CoV-2 is explained and classified into three different categories: nucleic acid-based, protein-based, and point of care (PoC) detection testing. Then, the current issues for diagnostic procedures in laboratories are discussed. Finally, the role of new technologies in countering COVID-19 is also introduced to assist researchers in the development of accurate and timely detection of coronaviruses. As coronavirus continues to affect human lives in a detrimental manner, the development of rapid and accurate virus detection methods could promote COVID-19 diagnosis accessible to both individuals and the mass population at patient care. In this regard, rRT-PCR and multiplex RT-PCR detection techniques hold promise.

RevDate: 2021-06-14

Farkhad NK, Reihani H, Sedaghat A, et al (2021)

Are Mesenchymal Stem Cells able to manage Cytokine Storm in COVID-19 patients? A review of recent studies.

Regenerative therapy pii:S2352-3204(21)00045-6 [Epub ahead of print].

The Covid-19 disease has recently become one of the biggest challenges globally, and there is still no specific medication. Findings showed the immune system in severe Covid-19 patients loses regulatory control of pro-inflammatory cytokines, especially IL-6 production, called the "Cytokine storm" process. This process can cause injury to vital organs, including lungs, kidneys, liver, and ultimately death if not inhibited. While many treatments have been proposed to reduce cytokine storm, but the safety and effectiveness of each of them are still in doubt. Mesenchymal stem cells (MSCs) are multipotent cells with self-renewal potential capable of suppressing overactive immune responses and leading to tissue restoration and repair. These immuno-modulatory properties of MSCs and their derivatives (like exosomes) can improve the condition of Covid-19 patients with serious infectious symptoms caused by adaptive immune system dysfunction. Many clinical trials have been conducted in this field using various MSCs around the world. Some of these have been published and summarized in the present article, while many have not yet been completed. Based on these available data, MSCs can reduce inflammatory cytokines, increase oxygen saturation, regenerate lung tissue and improve clinical symptoms in Covid-19 patients. The review article aims to collect available clinical data in more detail and investigate the role of MSCs in reducing cytokine storms as well as improving clinical parameters of Covid-19 patients for use in future clinical studies.

RevDate: 2021-06-15

Singhavi H, Pai A, Mair M, et al (2021)

SARS-Cov2: a meta-analysis of symptom distribution by continent in 7310 adult COVID-19 infected patients.

Virusdisease [Epub ahead of print].

There is recent evidence that suggests that there are multiple strains of coronavirus in different parts of the world. Moreover, scientist have noted multiple mutations and postulated that these changes might increase the infective rate of the virus. However literature on varying severity of disease based on these strains is absent. In this meta-analysis, we have made an attempt to correlate the symptoms in different continents with respect to various studied strains of virus. We searched three databases, PubMed, EMBASE and EMCARE to identify studies reporting symptoms of COVID-19. All articles published between December 2019 and May 2020 was included in this meta-analysis. A total of 56 studies consisted of 7310 patients were included in the meta-analysis. Mean age of patients varied from 22 to 69.8 years. The pooled proportion of male patients was 52%. Highest incidence of fever (76%) and cough (56%) was noted in Chinese population. Sore throat (29%) was most common in Asian population. Upper respiratory tract symptom like Rhinorrhoea, Anosmia and dysgeusia (32%, 47% and 39%) were well documented in European population as compared to the other continents. Nausea and diarrhoea were more common in European (17%, 19%) and Australian (12%, 16%) population. Dyspnoea and fatigue were consistently similar in all the continents. We postulate that different mutations in COVID-19 virus may vary its pathogenicity and screening symptoms across all the continents should be not be generalised but continent-specific.

Supplementary Information: The online version contains supplementary material available at 10.1007/s13337-021-00699-y.

RevDate: 2021-06-15

Breikaa RM, B Lilly (2021)

The Notch Pathway: A Link Between COVID-19 Pathophysiology and Its Cardiovascular Complications.

Frontiers in cardiovascular medicine, 8:681948.

COVID-19 is associated with a large number of cardiovascular sequelae, including dysrhythmias, myocardial injury, myocarditis and thrombosis. The Notch pathway is one likely culprit leading to these complications due to its direct role in viral entry, inflammation and coagulation processes, all shown to be key parts of COVID-19 pathogenesis. This review highlights links between the pathophysiology of SARS-CoV2 and the Notch signaling pathway that serve as primary drivers of the cardiovascular complications seen in COVID-19 patients.

RevDate: 2021-06-15

Al-Kuraishy HM, Al-Gareeb AI, Alblihed M, et al (2021)

COVID-19 in Relation to Hyperglycemia and Diabetes Mellitus.

Frontiers in cardiovascular medicine, 8:644095.

Coronavirus disease 2019 (COVID-19), triggered by the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2), may lead to extrapulmonary manifestations like diabetes mellitus (DM) and hyperglycemia, both predicting a poor prognosis and an increased risk of death. SARS-CoV-2 infects the pancreas through angiotensin-converting enzyme 2 (ACE2), where it is highly expressed compared to other organs, leading to pancreatic damage with subsequent impairment of insulin secretion and development of hyperglycemia even in non-DM patients. Thus, this review aims to provide an overview of the potential link between COVID-19 and hyperglycemia as a risk factor for DM development in relation to DM pharmacotherapy. For that, a systematic search was done in the database of MEDLINE through Scopus, Web of Science, PubMed, Embase, China National Knowledge Infrastructure (CNKI), China Biology Medicine (CBM), and Wanfang Data. Data obtained underline that SARS-CoV-2 infection in DM patients is more severe and associated with poor clinical outcomes due to preexistence of comorbidities and inflammation disorders. SARS-CoV-2 infection impairs glucose homeostasis and metabolism in DM and non-DM patients due to cytokine storm (CS) development, downregulation of ACE2, and direct injury of pancreatic β-cells. Therefore, the potent anti-inflammatory effect of diabetic pharmacotherapies such as metformin, pioglitazone, sodium-glucose co-transporter-2 inhibitors (SGLT2Is), and dipeptidyl peptidase-4 (DPP4) inhibitors may mitigate COVID-19 severity. In addition, some antidiabetic agents and also insulin may reduce SARS-CoV-2 infectivity and severity through the modulation of the ACE2 receptor expression. The findings presented here illustrate that insulin therapy might seem as more appropriate than other anti-DM pharmacotherapies in the management of COVID-19 patients with DM due to low risk of uncontrolled hyperglycemia and diabetic ketoacidosis (DKA). From these findings, we could not give the final conclusion about the efficacy of diabetic pharmacotherapy in COVID-19; thus, clinical trial and prospective studies are warranted to confirm this finding and concern.

RevDate: 2021-06-15

Chan ASW, Ho JMC, Li JSF, et al (2021)

Impacts of COVID-19 Pandemic on Psychological Well-Being of Older Chronic Kidney Disease Patients.

Frontiers in medicine, 8:666973.

COVID-19 pandemic has been a major global issue, its eventual influences on the population welfare, global markets, public security, and everyday activities remain uncertain. Indeed, the pandemic has arisen a significant global threat. Its psychological impact is predicted to be severe and enduring, but the absolute magnitude is still largely unclear. Chronic kidney disease (CKD) is a complication markedly contributes to the mortality of COVID-19 cases, meanwhile several studies have demonstrated the high frequency and seriousness of the COVID-19 in CKD patients receiving dialysis. Importantly, the influence of COVID-19 among CKD patients without dialysis is still largely unexplored. Thus, we systemically summarized how mental health affects the spreading of COVID-19 to virtually worldwide, covering perspectives from several countries across a wide range of fields and clinical contexts. This review aims to provide the latest details and reveal potential concerns on the public health including psychological well-being of the older patients with CKD.

RevDate: 2021-06-15

Borrelli M, Corcione A, Castellano F, et al (2021)

Coronavirus Disease 2019 in Children.

Frontiers in pediatrics, 9:668484.

Since its appearance in Wuhan in mid-December 2019, acute respiratory syndrome coronavirus 2 (SARS-CoV-2) related 19 coronavirus disease (COVID-19) has spread dramatically worldwide. It soon became apparent that the incidence of pediatric COVID-19 was much lower than the adult form. Morbidity in children is characterized by a variable clinical presentation and course. Symptoms are similar to those of other acute respiratory viral infections, the upper airways being more affected than the lower airways. Thus far, over 90% of children who tested positive for the virus presented mild or moderate symptoms and signs. Most children were asymptomatic, and only a few cases were severe, unlike in the adult population. Deaths have been rare and occurred mainly in children with underlying morbidity. Factors as reduced angiotensin-converting enzyme receptor expression, increased activation of the interferon-related innate immune response, and trained immunity have been implicated in the relative resistance to COVID-19 in children, however the underlying pathogenesis and mechanism of action remain to be established. While at the pandemic outbreak, mild respiratory manifestations were the most frequently described symptoms in children, subsequent reports suggested that the clinical course of COVID-19 is more complex than initially thought. Thanks to the experience acquired in adults, the diagnosis of pediatric SARS-CoV-2 infection has improved with time. Data on the treatment of children are sparse, however, several antiviral trials are ongoing. The purpose of this narrative review is to summarize current understanding of pediatric SARS-CoV-2 infection and provide more accurate information for healthcare workers and improve the care of patients.

RevDate: 2021-06-15

Schlapbach LJ, Andre MC, Grazioli S, et al (2021)

Best Practice Recommendations for the Diagnosis and Management of Children With Pediatric Inflammatory Multisystem Syndrome Temporally Associated With SARS-CoV-2 (PIMS-TS; Multisystem Inflammatory Syndrome in Children, MIS-C) in Switzerland.

Frontiers in pediatrics, 9:667507.

Background: Following the spread of the coronavirus disease 2019 (COVID-19) pandemic a new disease entity emerged, defined as Pediatric Inflammatory Multisystem Syndrome temporally associated with COVID-19 (PIMS-TS), or Multisystem Inflammatory Syndrome in Children (MIS-C). In the absence of trials, evidence for treatment remains scarce. Purpose: To develop best practice recommendations for the diagnosis and treatment of children with PIMS-TS in Switzerland. It is acknowledged that the field is changing rapidly, and regular revisions in the coming months are pre-planned as evidence is increasing. Methods: Consensus guidelines for best practice were established by a multidisciplinary group of Swiss pediatric clinicians with expertise in intensive care, immunology/rheumatology, infectious diseases, hematology, and cardiology. Subsequent to literature review, four working groups established draft recommendations which were subsequently adapted in a modified Delphi process. Recommendations had to reach >80% agreement for acceptance. Results: The group achieved agreement on 26 recommendations, which specify diagnostic approaches and interventions across anti-inflammatory, anti-infectious, and support therapies, and follow-up for children with suspected PIMS-TS. A management algorithm was derived to guide treatment depending on the phenotype of presentation, categorized into PIMS-TS with (a) shock, (b) Kawasaki-disease like, and (c) undifferentiated inflammatory presentation. Conclusion: Available literature on PIMS-TS is limited to retrospective or prospective observational studies. Informed by these cohort studies and indirect evidence from other inflammatory conditions in children and adults, as well as guidelines from international health authorities, the Swiss PIMS-TS recommendations represent best practice guidelines based on currently available knowledge to standardize treatment of children with suspected PIMS-TS. Given the absence of high-grade evidence, regular updates of the recommendations will be warranted, and participation of patients in trials should be encouraged.

RevDate: 2021-06-15

Sureka B, Nag VL, Garg MK, et al (2021)

Rational use of PPE and preventing PPE related skin damage.

Journal of family medicine and primary care, 10(4):1547-1553.

On 31st December, 2019, an outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was declared in Wuhan, China. On 24 March 2020, there was a nationwide lockdown for 21 days, followed by Janata curfew on 22nd March. As the pandemic has developed and spread across continents, everyone including policy makers have realized shortage of personal protective equipment (PPE) such as N95 respirators, coverall, and face shields. This is one of the major factors putting healthcare workers not only at risk of infection but also to various side effects of prolonged use of PPE. Based on international experiences, new ideas in procuring and mass manufacturing, rational use of PPE equipment is the need of hour, especially for developing nations which lack adequate resources and infrastructure for manufacturing PPEs.

RevDate: 2021-06-15

Alabdulkarim N, Altwaijri N, Alsultan F, et al (2021)

Perspective of Covid-19 pandemic in Middle East countries.

Journal of family medicine and primary care, 10(4):1534-1539.

COVID-19 has emerged as the world's biggest challenge that has not only threatened human lives but also had an immense impact on the economy, safety and religious practices. The situation has worsened due to the lack of proper guidelines for fighting the sudden unexpected outbreaks. The world was not prepared for this situation. This review highlights some important steps the Middle East countries is taking and their impact on controlling the COVID-19 outbreak. We also discuss some hypothetical predictions for the coming months.

RevDate: 2021-06-15

Patnaik N, Bhatia V, Mishra KG, et al (2021)

Effects of COVID-19 on Pregnant women: Evidence-based review.

Journal of family medicine and primary care, 10(4):1530-1533.

Corona virus infection (COVID-19) is increasing exponentially globally. It is also affecting pregnant women among others. Complications arising during pregnancy because of COVID-19 must be considered a health issue. The objective of the study was to analyse symptoms of pregnant women affected with COVID-19 based on the available literature. The articles were searched from Medline/PubMed, Scopus which were published till June 2020 and reviewed for the determined outcomes. The review demonstrated that common symptoms were fever, cough, nausea and myalgia. Vertical transmission of Corona virus infection was not found in any of the articles reviewed. Multicenter studies are important to better understand the pathogenesis and treatment planning for COVID-19 affected pregnant women.

RevDate: 2021-06-15

Shah AK, MU Raul (2021)

(RE) currences in COVID-19: (RE)-activation or (RE)-infection?.

Journal of family medicine and primary care, 10(4):1525-1529.

The COVID-19 which started in December 2019 has spread rapidly worldwide with millions of cases out of which many have successfully recovered. Owing to novelty, COVID-19 has been a mystery in itself since the beginning. Some cases develop severe complications while some remain asymptomatic. With research being done in all parts of the world, many lacunae in the etiology and pathophysiology of the disease have been filled. As we move ahead with the pandemic new information is getting added to the existing knowledge pool. The residual damages and long-term health effects are yet to be encountered. The question that has been in the minds of many researchers and is still being explored remains that about re-infection. There are multiple cases worldwide where the discharged patients have been detected positive once again. In India, the guidelines for prophylaxis, testing strategy, quarantine, home isolation, and discharge policies have been revised time and again by the ministry and ICMR. It is difficult to label ones re-detected positive status, taking into consideration strain of coronavirus, dead viral particles, antibodies and reliability of tests. The role of vaccine and herd immunity also becomes controversial with number of such cases arising. We have tried to compile and find out the scientific causes, its effects on individual and what can be the implications on the Public Health and scope of development of strategies required for such occurrences. Efforts need to be taken in such a way that there is neither a panic situation nor should there be a false sense of security post-recovery.

RevDate: 2021-06-15

Sharma N, Vyas S, Mohapatra A, et al (2021)

Combating COVID-19 pandemic in India: Demystifying the concept of herd immunity.

Journal of family medicine and primary care, 10(4):1515-1519.

The concept of Herd immunity is a key factor for epidemic control. According to it only a proportion of entire population needs to be immune either via natural infection or vaccination. The idea of herd immunity via natural infection rather than vaccination is a bit controversial, as it is not clear how long will the antibodies last, and whether re-infection or re-activation of the virus can occur after the antibodies starts weaning from the body. It has been suggested that coronavirus will likely become similar to a seasonal flu once the herd immunity is attained. Till then, it will continue causing outbreaks year-round and there could be multiple waves of virus transmission before achieving herd immunity. Therefore, the public needs to learn to live with it, and continue practising the best prevention measures, including wearing of masks, physical distancing, hand hygiene, and avoidance of gathering.

RevDate: 2021-06-15

Sureka B, Tak V, Nag VL, et al (2021)

Suraksha Chakra: A new scoring system to protect the healthcare workers from COVID.

Journal of family medicine and primary care, 10(4):1512-1514.

Doctors, nurses, house cleaning staff and hospital ward attendants are at increased risk of acquiring coronavirus disease 2019 (COVID-19) if there is a breach in the personal protection equipment. A new simple, easy to implement scoring system has been developed by our Suraksha Chakra team which can be used by the policy makers and hospital administrators. The scoring system is not to discourage anyone but constantly reinforce the healthcare workers for safe practices during patient care.

RevDate: 2021-06-15

Forcados GE, Muhammad A, Oladipo OO, et al (2021)

Metabolic Implications of Oxidative Stress and Inflammatory Process in SARS-CoV-2 Pathogenesis: Therapeutic Potential of Natural Antioxidants.

Frontiers in cellular and infection microbiology, 11:654813.

COVID-19 is a zoonotic disease with devastating economic and public health impacts globally. Being a novel disease, current research is focused on a clearer understanding of the mechanisms involved in its pathogenesis and viable therapeutic strategies. Oxidative stress and inflammation are intertwined processes that play roles in disease progression and response to therapy via interference with multiple signaling pathways. The redox status of a host cell is an important factor in viral entry due to the unique conditions required for the conformational changes that ensure the binding and entry of a virus into the host cell. Upon entry into the airways, viral replication occurs and the innate immune system responds by activating macrophage and dendritic cells which contribute to inflammation. This review examines available literature and proposes mechanisms by which oxidative stress and inflammation could contribute to COVID-19 pathogenesis. Further, certain antioxidants currently undergoing some form of trial in COVID-19 patients and the corresponding required research gaps are highlighted to show how targeting oxidative stress and inflammation could ameliorate COVID-19 severity.

RevDate: 2021-06-15

Viansone AA, Ammari S, Dercle L, et al (2021)

Optimizing the Management of Cancer Patients Treated With Systemic Therapies During the COVID-19 Pandemic: The New Role of PCR and CT Scan.

Frontiers in oncology, 11:560585.

In late 2019 and early 2020, the world witnessed the outbreak of the SARS-CoV-2 (also referred as COVID-19) in Wuhan, China. Its rapid expansion worldwide and its contagiousness rate have forced the activation of several measures to contain the pandemic, mostly through confinement and identification of infected patients and potential contacts by testing.

RevDate: 2021-06-15

Seo JY (2021)

Pediatric Endocrinology of Post-Pandemic Era.

Chonnam medical journal, 57(2):103-107.

The COVID-19 pandemic has brought about significant changes in the global health and medical environment. In order to prevent viral transmission, governments implemented strong social distancing, even lockdowns. The closure of schools has reduced physical activity among children and adolescents. Children, especially those with chronic diseases, are often reluctant to visit or even give up visiting hospitals, resulting in delayed diagnosis or missing the right timing for treatment. New guidelines are needed for the management of patients with endocrine diseases such as diabetes or thyroid disease, as well as children with chronic diseases who need regular clinical monitoring. Therefore, it is necessary to analyze the previous research on pediatric endocrinology reported during COVID-19, guide the direction for future research, and establish guidelines to care for pediatric patients with endocrine diseases in the post-pandemic era.

RevDate: 2021-06-15

Tassinari S, Perez LC, La Riva A, et al (2021)

Virtual Residency Interviews: What Variables Can Applicants Control?.

Cureus, 13(5):e14938.

Due to the ongoing coronavirus disease 2019 (COVID-19) pandemic, almost all residency programs have adopted virtual interviewing for the National Residency Matching Program® (NRMP) or The Match® 2021. Hence, applicants have had to adapt quickly to this process, since the interviewers and the applicants were mostly inexperienced regarding this process. To date, program directors have had a successful experience on this new modality, and since the pandemic continues to limit in-person meetings and given the benefits that virtual interviews provide in terms of transportation, booking, and cost, there is a high chance that interviews for The Match 2022 will also be conducted in the same, virtual way. In light of this, we performed a review of the literature by using PubMed, Embase, Scopus, and other online resources to analyze certain critical aspects and offer recommendations for residency and fellowship applicants to improve their performance in virtual interviews. Despite the current surge of virtual interviewing in today's technology-driven era, virtual interviewing programs for residency and fellowship candidates selection are still in their infancy. We have learned that applicants can control certain aspects such as technology, settings, dress code, and behavior so that they can tailor their experience to make it more favorable and fulfilling. Ensuring proper preparation in terms of the variables that can influence the virtual experience is key for a successful interview.

RevDate: 2021-06-15

Prakash P, Meena R, Stanley ABRAHAM, et al (2021)

EVIDENCE-BASED traditional Siddha formulations for prophylaxis and management of respiratory symptoms in COVID-19 pandemic- a review.

Biocatalysis and agricultural biotechnology [Epub ahead of print].

The recent outbreak of COVID-19 is attributed to Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). This viral disease is rapidly spreading across the globe, including India. The mainstay in managing the disease is supportive care, nutrition, and preventing further progression in the absence of proven antiviral drugs. Currently two vaccines Covishield and Covaxin are administered in India. Long-term plans of developing most reliable mRNA-based vaccines are also underway for the future method of prophylaxis. The Siddha system of medicine's holistic approach emphasizes lifestyle modification, prophylactic interventions, and dietary management to boost the host immunity and treatment with herbal medicines and higher-order medicines as the case may be. In this review, a brief outline of the disease COVID-19, Coronavirus, evidence-based traditional Siddha interventions for respiratory ailments, immune boosters highlighting the relevant published research on individual herbs are dealt, which pave way for further research on drug repurposing for COVID-19. Historical evidence on the prevention and treatment of infections in Siddha classics is studied. Web search in databases such as Embase, Biomed Central Articles, Pub med, NLM, Web of Science CrossRef, Google scholar, AYUSH research portal, google search engine related to antiviral properties of herbs used in the preparation of Siddha drugs was also carried out.

RevDate: 2021-06-15

Richter K, Kellner S, Hillemacher T, et al (2021)

Sleep quality and COVID-19 outcomes: the evidence-based lessons in the framework of predictive, preventive and personalised (3P) medicine.

The EPMA journal [Epub ahead of print].

Sleep quality and duration play a pivotal role in maintaining physical and mental health. In turn, sleep shortage, deprivation and disorders are per evidence the risk factors and facilitators of a broad spectrum of disorders, amongst others including depression, stroke, chronic inflammation, cancers, immune defence insufficiency and individual predisposition to infection diseases with poor outcomes, for example, related to the COVID-19 pandemic. Keeping in mind that COVID-19-related global infection distribution is neither the first nor the last pandemic severely affecting societies around the globe to the costs of human lives accompanied with enormous economic burden, lessons by predictive, preventive and personalised (3P) medical approach are essential to learn and to follow being better prepared to defend against global pandemics. To this end, under extreme conditions such as the current COVID-19 pandemic, the reciprocal interrelationship between the sleep quality and individual outcomes becomes evident, namely, at the levels of disease predisposition, severe versus mild disease progression, development of disease complications, poor outcomes and related mortality for both - population and healthcare givers. The latter is the prominent example clearly demonstrating the causality of severe outcomes, when the long-lasting work overload and shift work rhythm evidently lead to the sleep shortage and/or deprivation that in turn causes immune response insufficiency and strong predisposition to the acute infection with complications. This article highlights and provides an in-depth analysis of the concerted risk factors related to the sleep disturbances under the COVID-19 pandemic followed by the evidence-based recommendations in the framework of predictive, preventive and personalised medical approach.

RevDate: 2021-06-15

Chen F, Liu Z, F Jiang (2021)

Prospects of Neutralizing Nanobodies Against SARS-CoV-2.

Frontiers in immunology, 12:690742.

Since December 2019, the SARS-CoV-2 has erupted on a large scale worldwide and spread rapidly. Passive immunization of antibody-related molecules provides opportunities for prevention and treatment of high-risk patients and children. Nanobodies (Nbs) have many strong physical and chemical properties. They can be atomized, administered by inhalation, and can be directly applied to the infected site, with fast onset, high local drug concentration/high bioavailability, and high patient compliance (no needles). It has very attractive potential in the treatment of respiratory viruses. Rapid and low-cost development of Nbs targeting SARS-CoV-2 can quickly be achieved. Nbs against SARS-CoV-2 mutant strains also can be utilized quickly to prevent the virus from escaping. It provides important technical supports for the treatment of the SARS-CoV-2 and has the potential to become an essential medicine in the toolbox against the SARS-CoV-2.

RevDate: 2021-06-15

Alam S, Sarker MMR, Afrin S, et al (2021)

Traditional Herbal Medicines, Bioactive Metabolites, and Plant Products Against COVID-19: Update on Clinical Trials and Mechanism of Actions.

Frontiers in pharmacology, 12:671498.

SARS-CoV-2 is the latest worldwide pandemic declared by the World Health Organization and there is no established anti-COVID-19 drug to combat this notorious situation except some recently approved vaccines. By affecting the global public health sector, this viral infection has created a disastrous situation associated with high morbidity and mortality rates along with remarkable cases of hospitalization because of its tendency to be high infective. These challenges forced researchers and leading pharmaceutical companies to find and develop cures for this novel strain of coronavirus. Besides, plants have a proven history of being notable wellsprings of potential drugs, including antiviral, antibacterial, and anticancer therapies. As a continuation of this approach, plant-based preparations and bioactive metabolites along with a notable number of traditional medicines, bioactive phytochemicals, traditional Chinese medicines, nutraceuticals, Ayurvedic preparations, and other plant-based products are being explored as possible therapeutics against COVID-19. Moreover, the unavailability of effective medicines against COVID-19 has driven researchers and members of the pharmaceutical, herbal, and related industries to conduct extensive investigations of plant-based products, especially those that have already shown antiviral properties. Even the recent invention of several vaccines has not eliminated doubts about safety and efficacy. As a consequence, many limited, unregulated clinical trials involving conventional mono- and poly-herbal therapies are being conducted in various areas of the world. Of the many clinical trials to establish such agents as credentialed sources of anti-COVID-19 medications, only a few have reached the landmark of completion. In this review, we have highlighted and focused on plant-based anti-COVID-19 clinical trials found in several scientific and authenticated databases. The aim is to allow researchers and innovators to identify promising and prospective anti-COVID-19 agents in clinical trials (either completed or recruiting) to establish them as novel therapies to address this unwanted pandemic.

RevDate: 2021-06-15

Cheng B, Ma J, Yang Y, et al (2021)

Systemic Corticosteroid Administration in Coronavirus Disease 2019 Outcomes: An Umbrella Meta-Analysis Incorporating Both Mild and Pulmonary Fibrosis-Manifested Severe Disease.

Frontiers in pharmacology, 12:670170.

Background: Effective treatments for coronavirus disease 2019 (COVID-19) are urgently needed. The real role of corticosteroid use in COVID-19 has long been of interest and is disputable. Methods: We aimed to quantitatively reevaluate the efficacy of corticosteroids on COVID-19. Databases were searched for eligible meta-analyses/systematic reviews with available outcome data. For each association, we estimated the summary effect size with fixed- and random-effects models, 95% confidence intervals, and 95% prediction intervals. Heterogeneity, Egger's test, evidence of small-study effects and excess significance bias, and subgroup analyses were rigorously evaluated. Results: Intended outcomes of 12 eligible studies were mortality, clinical improvement, hospitalization, mechanical ventilation (MV), adverse events (AEs), intensive care unit (ICU) stay, hospital stay, virus clearance time (VCT), and negative conversion. Corticosteroid administration was associated with a 27% risk reduction in MV [hazard ratio (HR): 0.73 (0.64-0.83)] and a 20% reduction in mortality of critically ill/severe COVID-19 patients [HR: 0.80 (0.65-0.98)]. Interestingly, shorter ICU stays and, conversely, potentially longer hospital stays, a longer VCT, and a longer time to negative conversion were associated with corticosteroid use. There was no significant impact of different corticosteroid doses on mortality. Only one study showed slightly excess significant bias. Caution should be applied given the weak nature of the evidence, and it has been confirmed by sensitivity analyses too. Conclusion: This umbrella study found benefits from corticosteroids on MV and especially the mortality of critically ill/severe patients with shorter ICU stays but prolonged hospital stays and VCT. The benefits and harms should be reevaluated and balanced before corticosteroids are cautiously prescribed in clinical practice.

RevDate: 2021-06-15

Li P, Hu S, Qian C, et al (2021)

The Therapeutic Effect of Traditional Chinese Medicine on Inflammatory Diseases Caused by Virus, Especially on Those Caused by COVID-19.

Frontiers in pharmacology, 12:650425.

Inflammasomes are large multimolecular complexes best recognized because of their ability to control activation of caspase-1, which in turn regulates the maturation of interleukin-18 (IL-18) and interleukin-1 β (IL-1β). IL-1β was originally identified as a pro-inflammatory cytokine, capable of inducing local and systemic inflammation as well as a fever response reaction in response to infection or injury. Excessive production of IL-1β is related to inflammatory and autoimmune diseases. Both coronavirus disease 2019 (COVID-19) and severe acute respiratory syndrome (SARS) are characterized by excessive inflammatory response. For SARS, there is no correlation between viral load and worsening symptoms. However, there is no specific medicine which is available to treat the disease. As an important part of medical practice, TCM showed an obvious therapeutic effect in SARS-CoV-infected patients. In this article, we summarize the current applications of TCM in the treatment of COVID-19 patients. Herein, we also offer an insight into the underlying mechanisms of the therapeutic effects of TCM, as well as introduce new naturally occurring compounds with anti-coronavirus activity, in order to provide a new and potential drug development strategy for the treatment of COVID-19.

RevDate: 2021-06-15

Kim CH (2021)

Anti-SARS-CoV-2 Natural Products as Potentially Therapeutic Agents.

Frontiers in pharmacology, 12:590509.

Severe acute respiratory syndrome-related coronavirus-2 (SARS-CoV-2), a β-coronavirus, is the cause of the recently emerged pandemic and worldwide outbreak of respiratory disease. Researchers exchange information on COVID-19 to enable collaborative searches. Although there is as yet no effective antiviral agent, like tamiflu against influenza, to block SARS-CoV-2 infection to its host cells, various candidates to mitigate or treat the disease are currently being investigated. Several drugs are being screened for the ability to block virus entry on cell surfaces and/or block intracellular replication in host cells. Vaccine development is being pursued, invoking a better elucidation of the life cycle of the virus. SARS-CoV-2 recognizes O-acetylated neuraminic acids and also several membrane proteins, such as ACE2, as the result of evolutionary switches of O-Ac SA recognition specificities. To provide information related to the current development of possible anti-SARS-COV-2 viral agents, the current review deals with the known inhibitory compounds with low molecular weight. The molecules are mainly derived from natural products of plant sources by screening or chemical synthesis via molecular simulations. Artificial intelligence-based computational simulation for drug designation and large-scale inhibitor screening have recently been performed. Structure-activity relationship of the anti-SARS-CoV-2 natural compounds is discussed.

RevDate: 2021-06-14

Kumar R, Haresh KP, Sharma DN, et al (2021)

Low-dose radiotherapy for COVID 19: A radioimmunological perspective.

Journal of cancer research and therapeutics, 17(2):295-302.

The world is fighting the onslaught of COVID 19 for the last 10 months, ever since the first case was reported in December 2019 in Wuhan, China. Now, it has spread to over 200 countries. COVID 19-associated respiratory syndrome is causing a lot of mortality and morbidity. There are reports suggesting that the complications and ARDS associated with COVID 19 is an immune response reaction. The cytokine storm associated with severe cases of COVID 19 acts as a cause of death in many sick patients. It has been shown that COVID 19 is associated with a peculiar immune profile: Decrease in CD3, CD4, CD8, natural killer cell and B-cells; Rise in interleukin (IL)-4, IL-6 and tumor necrosis factor (TNF) alpha; Decrease in IL-10; Decrease in interferon-gamma. Low-dose radiotherapy (LDRT) immunosuppressive features resulting from M2 macrophage phenotype activation, increase in IL-10, transforming growth factor beta, a decrease in IL-6, TNF alpha and an increase in CD3, CD4, and CD8 T cell counts may negate the harmful effects of cytokine release syndrome. Literature review shows that radiation was previously used to treat viral pneumonia with a good success rate. This practice was discontinued in view of the availability of effective antibiotics and antivirals. As there are no scientifically proven treatment for severe COVID 19-associated respiratory distress today, it is prudent that we understand the benefits of LDRT at this critical juncture and take rational decisions to treat the same. This article provides an radioimmunological rationale for the treatment of immune crisis mediated complications in severe cases of COVID 19.

RevDate: 2021-06-14

Buso G, Becchetti C, A Berzigotti (2021)

Acute splanchnic vein thrombosis in patients with COVID-19: A systematic review.

Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver pii:S1590-8658(21)00272-3 [Epub ahead of print].

There is increasing evidence that coronavirus disease 2019 (COVID-19) is associated with a significant risk of venous thromboembolism. While information are mainly available for deep vein thrombosis of the lower limb and pulmonary embolism, scarce data exist regarding acute splanchnic vein thrombosis (SVT) in this setting. PubMed, EMBASE and Google Scholar English-language articles published up to 30 January 2021 on SVT in COVID-19 were searched. Overall, 21 articles reporting equal number of patients were identified. 15 subjects presented with portal vein thrombosis, 11 with mesenteric vein thrombosis, four with splenic vein thrombosis, and two with Budd-Chiari syndrome. Male sex was prevalent (15 patients), and median age was 43 years (range 26-79 years). Three patients had a history of liver disease, while no subject had known myeloproliferative syndrome. Clinical presentation included mainly gastrointestinal symptoms. Anticoagulation was started in 16 patients. Three patients underwent bowel resection. Ten subjects developed gastric or bowel ischemia, seven of whom underwent bowel resection, and four died after SVT diagnosis. Although rare, SVT should be seen as a complication of COVID-19. Patients with severe gastrointestinal symptoms should be screened for SVT, as rapid recognition and correct management are essential to improve the outcome of these patients.

RevDate: 2021-06-14

Iloanusi S, Mgbere O, EJ Essien (2021)

Polypharmacy among COVID-19 patients: A systematic review.

Journal of the American Pharmacists Association : JAPhA pii:S1544-3191(21)00188-6 [Epub ahead of print].

BACKGROUND: Polypharmacy, the concomitant use of 5 or more medications, is highly prevalent among older adults and individuals with multimorbid conditions and has been linked to suboptimal clinical outcomes in various diseases. However, little is known about the impact of polypharmacy on clinical outcomes among coronavirus disease 2019 (COVID-19) patients.

OBJECTIVE: This systematic review summarizes the available literature on the association between polypharmacy and specific drug classes, and clinical outcomes among COVID-19 patients.

METHODS: We conducted an electronic database search on Embase, Medline, Cochrane, Scopus, Google Scholar,, LITCOVID, PubMed, PubMed Central (PMC), and China national knowledge infrastructure for studies on Polypharmacy among COVID-19 patients using relevant combinations of the keywords. Only studies published between November 2019 to September 2020 were included. Seven articles out of 1502 unique articles met the inclusion criteria and were used for the current study. We adopted the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline in conducting and reporting this systematic review.

RESULTS: The total sample size of all studies was 474,342, out of which 10,519 patients were COVID-19 positive, and 4818 COVID-19 positive patients experienced polypharmacy. Five out of the 7 included studies found associations between polypharmacy and negative clinical outcomes among COVID-19 patients. Polypharmacy was associated with increase in the relative risk of a positive COVID-19 test result (P < 0.01), death among male COVID-19 patients (P < 0.001), increase in the rate of acute kidney injury (P = 0.003), and adverse drug reactions (P < 0.001). Antipsychotic drugs were associated with severe COVID-19 morbidity (OR = 2.79; 95% CI 2.23-3.49) and increased risk of death among COVID-19 infected men (OR = 1.71; 95% CI 1.18-2.48) and women (OR = 1.96; 95% CI 1.41-2.73).

CONCLUSION: Polypharmacy and selected drug classes are associated with increased risk of adverse clinical outcomes among COVID-19 patients. Understanding these relationships can enhance risk stratification and evidence-based decision-making that may improve care and clinical outcomes of COVID-19 patients.

RevDate: 2021-06-14

Cordie A, Gaber Y, AbdAllah M, et al (2021)

Gastrointestinal manifestations of human immunodeficiency virus and coronavirus disease 2019: Understanding the intersecting regions between the two epidemics.

Arab journal of gastroenterology : the official publication of the Pan-Arab Association of Gastroenterology pii:S1687-1979(21)00036-8 [Epub ahead of print].

In March 2020, the World Health Organization declared coronavirus disease (COVID-19) a pandemic. As of February 2021, there were 107 million COVID-19 cases worldwide. As a comparison, there are approximately 38 million people living with human immunodeficiency virus (PLHIV) worldwide. The coexistence of both epidemics, and the syndemic effect of both viruses could lead to a delirious impact both at individual and community levels. Many intersecting points were found between severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the causative agent of COVID-19, and HIV; among which, gastrointestinal (GI) manifestations are the most notable. GI manifestations represent a common clinical presentation in both HIV and SARS-CoV-2. The emergence of GI symptoms as a result of SARS-CoV-2 infection provides a new dynamic to COVID-19 diagnosis, management, and infection control measures, and adds an additional diagnostic challenge in case of coinfection with HIV. The presence of GI manifestations in PLHIV during the COVID-19 pandemic could be referred to HIV enteropathy, presence of opportunistic infection, adverse effect of antiretrovirals, or coinfection with COVID-19. Thus, it is important to exclude SARS-CoV-2 in patients who present with new-onset GI manifestations, especially in PLHIV, to avoid the risk of disease transmission during endoscopic interventions. Structural similarities between both viruses adds a valuable intersecting point, which has mutual benefits in the management of both viruses. These similarities led to the hypothesis that antiretrovirals such as lopinavir/Rironavir have a role in the management of COVID-19, which was the target of our search strategy using the available evidence. These similarities may also facilitate the development of an efficient HIV vaccine in the future using the advances in COVID-19 vaccine development.

RevDate: 2021-06-15

van de Leemput J, Z Han (2021)

Drosophila, a powerful model to study virus-host interactions and pathogenicity in the fight against SARS-CoV-2.

Cell & bioscience, 11(1):110.

The COVID-19 pandemic is having a tremendous impact on humanity. Although COVID-19 vaccines are showing promising results, they are not 100% effective and resistant mutant SARS-CoV-2 strains are on the rise. To successfully fight against SARS-CoV-2 and prepare for future coronavirus outbreaks, it is essential to understand SARS-CoV-2 protein functions, their host interactions, and how these processes convey pathogenicity at host tissue, organ and systemic levels. In vitro models are valuable but lack the physiological context of a whole organism. Current animal models for SARS-CoV-2 research are exclusively mammals, with the intrinsic limitations of long reproduction times, few progeny, ethical concerns and high maintenance costs. These limitations make them unsuitable for rapid functional investigations of virus proteins as well as genetic and pharmacological screens. Remarkably, 90% of the SARS-CoV-2 virus-host interacting proteins are conserved between Drosophila and humans. As a well-established model system for studying human diseases, the fruit fly offers a highly complementary alternative to current mammalian models for SARS-CoV-2 research, from investigating virus protein function to developing targeted drugs. Herein, we review Drosophila's track record in studying human viruses and discuss the advantages and limitations of using fruit flies for SARS-CoV-2 research. We also review studies that already used Drosophila to investigate SARS-CoV-2 protein pathogenicity and their damaging effects in COVID-19 relevant tissues, as well as studies in which the fly was used as an efficient whole animal drug testing platform for targeted therapeutics against SARS-CoV-2 proteins or their host interacting pathways.

RevDate: 2021-06-13

Riches S, Azevedo L, Bird L, et al (2021)

Virtual reality relaxation for the general population: a systematic review.

Social psychiatry and psychiatric epidemiology [Epub ahead of print].

PURPOSE: Relaxation has significant restorative properties and implications for public health. However, modern, busy lives leave limiting time for relaxation. Virtual reality (VR) experiences of pleasant and calming virtual environments, accessed with a head-mounted display (HMD), appear to promote relaxation. This study aimed to provide a systematic review of feasibility, acceptability, and effectiveness of studies that use VR to promote relaxation in the general population (PROSPERO 195,804).

METHODS: Web of Science, PsycINFO, Embase, and MEDLINE were searched until 29th June 2020. Studies were included in the review if they used HMD technology to present virtual environments that aimed to promote or measure relaxation, or relaxation-related variables. The Effective Public Health Practice Project (EPHPP) quality assessment tool was used to assess methodological quality of studies.

RESULTS: 6403 articles were identified through database searching. Nineteen studies published between 2007 and 2020, with 1278 participants, were included in the review. Of these, thirteen were controlled studies. Studies predominantly used natural audio-visual stimuli to promote relaxation. Findings indicate feasibility, acceptability, and short-term effectiveness of VR to increase relaxation and reduce stress. Six studies received an EPHPP rating of 'strong', seven were 'moderate', and six were 'weak'.

CONCLUSIONS: VR may be a useful tool to promote relaxation in the general population, especially during the COVID-19 pandemic, when stress is increasing worldwide. However, methodological limitations, such as limited randomised controlled trials and longer-term evidence, mean that these conclusions should be drawn with caution. More robust studies are needed to support this promising area of VR relaxation.

RevDate: 2021-06-15
CmpDate: 2021-06-15

Maródi L (2021)

SARS-CoV-2 infection and COVID‒19 in Gaucher disease: indications for vaccination.

Orvosi hetilap, 162(24):938-942.

Összefoglaló. Az új típusú koronavírus (SARS-CoV-2) okozta pandémia kezdetén a szakmai közvélemény általános vélekedése a Gaucher-kóros betegek fokozott érzékenységét vetítette elő, magas morbiditási és mortalitási mutatókkal. Meglepő módon azonban az eddigi, nagyszámú betegen, az Egyesült Államokban, Európában és Izraelben végzett klinikai tanulmányok azt mutatják, hogy ezen súlyos anyagcsere-betegségben sem a fertőzésnek kitett betegek morbiditási adatait, sem a ritkán kialakult fertőzések súlyosságát tekintve nem áll fenn csökkent immunvédekezés a SARS-CoV-2-vel szemben. Ezen immunológiai és infektológiai paradoxon lehetséges magyarázata, hogy a betegek makrofágjaiban és más sejtjeiben felhalmozódó glükocerebrozid gyulladásos állapotot tart fenn, amely hátrányos a kórokozó vírus intracelluláris túlélése szempontjából. A közleményben összefoglaljuk a témakörben eddig megjelent tanulmányok adatait, az általános prevencióval és a vakcinációval kapcsolatos ajánlásokat, és kitérünk az 1-es típusú interferonok (IFNα és IFNω) közelmúltban megismert szerepére a SARS-CoV-2-vel szembeni immunitásban. Orv Hetil. 2021; 162(24): 938-942. Summary. At the start of the pandemic caused by the novel coronavirus (SARS-CoV-2), the Gaucher disease community anticipated that infection with this emerging viral pathogen would be associated with high morbidity and mortality in individuals with this chronic metabolic disorder. Surprisingly, however, preliminary studies suggest that Gaucher disease does not confer a higher risk of severe, life-threatening effects of SARS-CoV-2 infection, and no severe cases have been reported in large cohorts of patients from the United States, Europe and Israel. It is thought that the accumulation of glucocerebroside in the cells of Gaucher patients may promote immune tolerance rather than inflammation on exposure to SARS-CoV-2. We review here the current concepts of Gaucher disease and SARS-CoV-2 infection, focusing particularly on general prevention and vaccination. We also discuss the susceptibility to COVID-19 of patients with inborn errors of type 1 interferon (IFNα and IFNω) immunity. Orv Hetil. 2021; 162(24): 938-942.

RevDate: 2021-06-15

Mishra A, Basumallick S, Lu A, et al (2021)

The healthier healthcare management models for COVID-19.

Journal of infection and public health, 14(7):927-937 pii:S1876-0341(21)00131-3 [Epub ahead of print].

The worldwide pandemic situation of COVID-19 generates a situation in which healthcare resources such as diagnostic kits, drugs and basic healthcare infrastructure were on shortage throughout the period, along with negative impact on socio-economic system. Standardized public healthcare models were missing in pandemic situation, covering from hospitalized patient care to local resident's healthcare managements in terms of monitoring, assess to diagnosis and medicines. This exploratory and intervention-based study with the objective of proposing COVID-19 Care Management Model representing comprehensive care of society including patients (COVID-19 and other diseases) and healthy subjects under integrated framework of healthier management model. Shifting policy towards technology-oriented models with well-aligned infrastructure can achieve better outcomes in COVID-19 prevention and care. The planned development of technical healthcare models for prognosis and improved treatment outcomes that take into account not only genomics, proteomics, nanotechnology, materials science perspectives but also the possible contribution of advanced digital technologies is best strategies for early diagnosis and infections control. In view of current pandemic, a Healthier Healthcare Management Model is proposed here as a source of standardized care having technology support, medical consultation, along with public health model of sanitization, distancing and contact less behaviours practices. Effective healthcare managements have been the main driver of healthier society where, positive action at identified research, technology and management segment more specifically public health, patient health, technology selection and political influence has great potential to enhanced the global response to COVID-19. The implementation of such practices will deliver effective diagnosis and control mechanism and make healthier society.

RevDate: 2021-06-15

Soliman NA (2021)

COVID-19 infection and the kidneys: Learning the lesson.

Journal of infection and public health, 14(7):922-926 pii:S1876-0341(21)00126-X [Epub ahead of print].

The novel coronavirus 2019 pandemic has become a global health crisis. In an attempt to decipher how kidneys are affected by COVID-19 infection, this review focuses on pathogenic and clinical links between COVID-19 infection and the kidneys. SARS-CoV-2 infected patients are target for kidney affection, renal tropism, among other multiorgan complications. COVID-19 related kidney affection is reported not only in infected chronic kidney disease patients but also in those with no prior history of kidney disease. As nephrologists try to keep up with the rapidly evolving, sometimes hasty, reports on renal affection in COVID-19, kidneys continue to be deleteriously affected particularly in critical care settings. This review aims to briefly portray renal involvement in COVID-19 amid this unprecedented deluge of scientific data. Based on gained knowledge and expertise, it is prudent to develop and regularly update preventive, diagnostic and therapeutic strategies to improve clinical outcome and reduce mortality.

RevDate: 2021-06-15

Goyal M, Tewatia N, Vashisht H, et al (2021)

Novel corona virus (COVID-19); Global efforts and effective investigational medicines: A review.

Journal of infection and public health, 14(7):910-921 pii:S1876-0341(21)00112-X [Epub ahead of print].

Coronavirus disease-2019 (COVID-19), associated with the outbreak of deadly virus originating in Wuhan, China, is now a global health emergency and a matter of serious concern. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is rapidly spreading worldwide, and WHO declared the outbreak of this disease a pandemic on March 11, 2020. Though some of the countries have succeeded in slowing down the rate of the spread of this pandemic, most the countries across the globe are still continuing to experience an increasing trend in the growth and spread of this deadly disease. Hence, in the current scenario, is has now become essential to control and finally irradicate this deadly disease using an effective vaccine. One can expect the prominent role of already available antivirals, antibodies and anti-inflammatory drugs in the market, in this pandemic. Immunomodulatory and biological therapeutics are also in the high expectations to combat COVID-19. RNA based vaccines might be more advantageous over traditional vaccines, to deal with the pandemic threat. Aiming towards this direction, clinical trials for SARS-CoV-2 vaccine are currently underway all across the globe. Currently, about 150 health related organizations and research labs are in the progress for the evolution of COVID-19 vaccines, globally. The initial aim of these clinical trials is to assess vaccine's safety, which is tested in Phase I/II/III studies where the primary outcomes typically examine the frequency of adverse effects. The vaccine is about to undergo phase III testing in several countries such as India, USA, South Africa, Brazil and England. US Government, under Operation Wrap Speed is even ready to sponsor three candidates, namely-The University of Oxford and AstraZeneca's AZD1222; Moderna's mRNA-1273; and Pfizer and BioNTech's BNT162 for Phase III trials.

RevDate: 2021-06-13

Cross KM, Landis DM, Sehgal L, et al (2021)

Melatonin in Early Treatment for COVID-19: A Narrative Review of Current Evidence and Possible Efficacy.

Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists pii:S1530-891X(21)01079-X [Epub ahead of print].

OBJECTIVE: To date, there are no FDA approved medications for treatment of early COVID-19 infection. Recently, use of melatonin, a naturally occurring tryptophan-derivative synthesized in the pineal gland and immune cells, has been suggested as an early treatment option for COVID-19. Melatonin has known anti-inflammatory, immunomodulatory, and protective antioxidant mechanisms that may attenuate the severity of COVID-19 symptoms. The objective of the present narrative review is to discuss the use of melatonin as an early treatment option on the first day of diagnosis for COVID-19.

METHODS: The MeSH terms "COVID-19" and "viral diseases" were manually searched on PubMed and relevant articles were included.

RESULTS: Results showed that melatonin acts to reduce reactive-oxygen-species mediated damage, cytokine-induced inflammation, and lymphopenia in viral diseases similar to COVID-19.

CONCLUSIONS: These conclusions provide evidence for potential benefits in melatonin use for COVID-19 treatment as early as the day of diagnosis.

RevDate: 2021-06-13

Pranata R, Henrina J, Raffaello WM, et al (2021)

Diabetes and COVID-19: The Past, The Present, and The Future.

Metabolism: clinical and experimental pii:S0026-0495(21)00114-1 [Epub ahead of print].

Diabetes, one of the most prevalent chronic diseases in the world, is strongly associated with a poor prognosis in COVID-19. Scrupulous blood sugar management is crucial, since the worse outcomes are closely associated with higher blood sugar levels in COVID-19 infection. Although recent observational studies showed that insulin was associated with mortality, it should not deter insulin use in hospitalized patients requiring tight glucose control. Back and forth dilemma in the past with regards to continue/discontinue certain medications used in diabetes have been mostly resolved. The initial fears of consequences related to continuing certain medications have been largely dispelled. COVID-19 also necessitates the transformation in diabetes care through the integration of technologies. Recent advances in health-related technologies, notably telemedicine and remote continuous glucose monitoring, have become essential in the management of diabetes during the pandemic. Today, these technologies have changed the landscape of medicine and become more important than ever. Being a high-risk population, patients with type 1 or type 2 diabetes, should be prioritized for vaccination. In the future, as the pandemic fades, the prevalence of non-communicable diseases is expected to rise due to lifestyle changes and medical issues/dilemma encountered during the pandemic.

RevDate: 2021-06-13

Das P, Mondal S, Pal S, et al (2021)

COVID diagnostics by molecular methods: A systematic review of nucleic acid based testing systems.

Indian journal of medical microbiology pii:S0255-0857(21)04114-1 [Epub ahead of print].

BACKGROUND: The selection of appropriate kit and PCR equipment for the detection of SARS CoV-2 is critically important in view of many options available in the diagnostic market. Since last year many molecular products are available for COVID-19 diagnostics., some of these diagnostics have become commercially available for healthcare workers and clinical laboratories. However, the diagnostic technologies have specific limitations and reported several false-positive and false-negative cases, especially during the early stages of kit development and use. The current article addresses these and other relevant questions important to the medical microbiologists running or aspiring to run COVID diagnostic services using PCR and related technologies.

METHODS: In this Systematic Review we follow Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA). A total of 258 citations retrieved, among those 77 peer reviewed articles was assessed for eligibility, and 181 studies were excluded. Based on inclusion criteria final data extraction was done.

RESULTS: The question of diagnostic dilemma has also been addressed in view of discordant results between assays, inter-test variability, repeat testing requirements in specific settings and inconclusive or indeterminate results. Kit efficiency was satisfactory for all assays and the estimates varied within sample types and technology. Using clinical samples, we observed some variations in detection rate between kits. Importantly, none of the assays showed cross-reactivity with other respiratory (corona) viruses, except as expected for the SARS-CoV-1 E-gene.

CONCLUSIONS: We conclude SARS CoV-2 related molecular assays differed considerably in performance. Hence we need to understand importance of molecular diagnostics test interpretation in light of the latest pandemic virus.

RevDate: 2021-06-13

Margos NP, Meintanopoulos AS, Filioglou D, et al (2021)

Intracerebral hemorrhage in COVID-19: A narrative review.

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia, 89:271-278.

Coronavirus Disease 19 (COVID-19) pandemic affects the worldwide healthcare system and our understanding of this disease grows rapidly. Although COVID-19 is a mainly respiratory disease, neurological manifestations are not uncommon. The aim of this review is to report on the etiology, clinical profile, location, and outcome of patients with intracerebral hemorrhage (ICH) and COVID-19. This review includes 36 studies examining ICH in the clinical presentation of COVID-19. Overall, 217 cases with intracranial hemorrhage, of which 188 ICHs, were reported. Generally, a low incidence of both primary and secondary ICH was found in 8 studies [106 (0.25%) out of 43,137 hospitalized patients with COVID-19]. Available data showed a median age of 58 years (range: 52-68) and male sex 64%, regarding 36 and 102 patients respectively. Furthermore, 75% of the patients were on prior anticoagulation treatment, 52% had a history of arterial hypertension, and 61% were admitted in intensive care unit. Location of ICH in deep structures/basal ganglia was ascertained in only 7 cases making arterial hypertension an improbable etiopathogenetic mechanism. Mortality was calculated at 52.7%. Disease related pathophysiologic mechanisms support the hypothesis that SARS-CoV2 can cause ICH, however typical ICH risk factors such as anticoagulation treatment, or admission to ICU should also be considered as probable causes. Physicians should strongly suspect the possibility of ICH in individuals with severe COVID-19 admitted to ICU and treated with anticoagulants. It is not clear whether ICH is related directly to COVID-19 or reflects expected comorbidity and/or complications observed in severely ill patients.

RevDate: 2021-06-13

Lin B, Dietrich ML, Senior RA, et al (2021)

A better classification of wet markets is key to safeguarding human health and biodiversity.

The Lancet. Planetary health, 5(6):e386-e394.

Wet markets have been implicated in multiple zoonotic outbreaks, including COVID-19. They are also a conduit for legal and illegal trade in wildlife, which threatens thousands of species. Yet wet markets supply food to millions of people around the world, and differ drastically in their physical composition, the goods they sell, and the subsequent risks they pose. As such, policy makers need to know how to target their actions to efficiently safeguard human health and biodiversity without depriving people of ready access to food. Here, we propose a taxonomy of wet markets, oriented around the presence of live or dead animals, and whether those animals are domesticated or wild (either captive-reared or wild-caught). We assess the dimensions and levels of risk that different types of wet markets pose to people and to biodiversity. We identify six key risk factors of wet markets that can affect human health: (1) presence of high disease-risk animal taxa, (2) presence of live animals, (3) hygiene conditions, (4) market size, (5) animal density and interspecies mixing, and (6) the length and breadth of animal supply chains. We also identify key factors informing risk to biodiversity. Finally, we recommend targeted, risk-adjusted policies to more efficiently and humanely address the dangers posed by wet markets.

RevDate: 2021-06-14

Sung PS, SL Hsieh (2021)

C-type lectins and extracellular vesicles in virus-induced NETosis.

Journal of biomedical science, 28(1):46.

Dysregulated formation of neutrophil extracellular traps (NETs) is observed in acute viral infections. Moreover, NETs contribute to the pathogenesis of acute viral infections, including those caused by the dengue virus (DV) and severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Furthermore, excessive NET formation (NETosis) is associated with disease severity in patients suffering from SARS-CoV-2-induced multiple organ injuries. Dendritic cell-specific intercellular adhesion molecule-3-grabbing non-integrin (DC-SIGN) and other members of C-type lectin family (L-SIGN, LSECtin, CLEC10A) have been reported to interact with viral glycans to facilitate virus spreading and exacerbates inflammatory reactions. Moreover, spleen tyrosine kinase (Syk)-coupled C-type lectin member 5A (CLEC5A) has been shown as the pattern recognition receptor for members of flaviviruses, and is responsible for DV-induced cytokine storm and Japanese encephalomyelitis virus (JEV)-induced neuronal inflammation. Moreover, DV activates platelets via CLEC2 to release extracellular vesicles (EVs), including microvesicles (MVs) and exosomes (EXOs). The DV-activated EXOs (DV-EXOs) and MVs (DV-MVs) stimulate CLEC5A and Toll-like receptor 2 (TLR2), respectively, to enhance NET formation and inflammatory reactions. Thus, EVs from virus-activated platelets (PLT-EVs) are potent endogenous danger signals, and blockade of C-type lectins is a promising strategy to attenuate virus-induced NETosis and intravascular coagulopathy.

RevDate: 2021-06-15
CmpDate: 2021-06-15

Alfarouk KO, Alhoufie STS, Hifny A, et al (2021)

Of mitochondrion and COVID-19.

Journal of enzyme inhibition and medicinal chemistry, 36(1):1258-1267.

COVID-19, a pandemic disease caused by a viral infection, is associated with a high mortality rate. Most of the signs and symptoms, e.g. cytokine storm, electrolytes imbalances, thromboembolism, etc., are related to mitochondrial dysfunction. Therefore, targeting mitochondrion will represent a more rational treatment of COVID-19. The current work outlines how COVID-19's signs and symptoms are related to the mitochondrion. Proper understanding of the underlying causes might enhance the opportunity to treat COVID-19.

RevDate: 2021-06-15
CmpDate: 2021-06-15

Molaee H, Allahyari F, Emadi SN, et al (2021)

Cutaneous manifestations related to the COVID-19 pandemic: a review article.

Cutaneous and ocular toxicology, 40(2):168-174.

BACKGROUND: Skin lesions are either caused by COVID-19 disease or they can be due to other driving forces related to the COVID-19 pandemic.

AIM: Considering the fact that the reported data in different articles for the type and prevalence of skin manifestations related to the COVID-19 pandemic are inconsistent, we have described the mechanism and type of skin lesions related to the COVID-19 pandemic.

METHODS: In this review article, we have searched the Medline database (PubMed) for the combination of the following key terms "Dermatological Manifestation", "cutaneous Manifestation", "Skin Manifestation", "COVID-19", "SARS-CoV-2".

RESULTS: The prevalence of skin manifestations related to COVID-19 ranged from 0.2% to 20%. The majority of these skin lesions are maculopapular eruptions. The skin presentations related to the COVID-19 pandemic are described below. Traumatic skin conditions such as dermatitis in individuals, especially those with allergies, might initiate secondary to over-washing or rinsing with inappropriate detergents. Also, inappropriate use of personal protective equipment (mask-gloves-shield) can trigger skin lesions on the face and hands or aggravate the lesions of acne, seborrhoeic dermatitis, eczema, etc. Furthermore, cutaneous adverse drug reactions may occur during hospitalization or outpatient treatment of COVID-19 patients. Also, psychocutaneous disorders due to acute stress can trigger or deteriorate several skin manifestations. Moreover, COVID-19 prevalence and course may be changed in patients with autoimmune or chronic inflammatory underlying skin disorders such as psoriasis, lupus erythematosus, pemphigus, scleroderma who are on immunosuppressive or biological medications to control their disorders.

CONCLUSION: Due to the various dimensions of skin organ involvement and the large population affected, long-term skin conditions following this pandemic can be a lot more problematic than it appears. Serious preventive measures and medical supports are necessary to avoid skin disorders from becoming permanent or even chronic.

RevDate: 2021-06-14
CmpDate: 2021-06-14

Ruta F, Dal Mas F, Biancuzzi H, et al (2021)

[Covid-19 and front-line nurses' mental health: a literature review].

Professioni infermieristiche, 74(1):41-47.

INTRODUCTION: The Coronavirus (Covid-19) pandemic caused a severe health crisis that has affected millions of people and quarantined half of the world's population. The health emergency from Covid-19 has seen health workers on the front line face all the difficulties related to the burden of care and the reorganization of procedures, roles, and tools at the hospital level. One of the most significant and probably underestimated aspects is the psychological stress of frontline nurses. The article aims to analyze the literature relating to the impact on the mental health of nurses engaged in the management and care of Covid-19 patients.

METHODS: A systematic review of the published articles on the subject was conducted from January 2020 to November 2020. The search for papers was conducted on scientific databases like PubMed, Scopus and Embase.

RESULTS: The results show the onset of anxiety, depression and stress and insomnia in healthcare workers. These aspects are closely related to numerous factors, including the fear of contracting the disease and infecting family members, stressful shifts and little rest, leading to a state of psychological and physical tension capable of activating pathological behaviours. The literature highlights the importance of support interventions for frontline personnel to avoid the onset of psycho-pathophysical severe problems.

CONCLUSION: The review suggests that frontline nurses during the emergency phase of Covid- 19 may be prone to psychological disorders that can compromise mental health. Therefore, the surveillance and monitoring of symptoms, together with targeted support interventions, should be guaranteed daily to all professionals involved to prevent the onset of psychological disorders.

RevDate: 2021-06-15
CmpDate: 2021-06-15

Kaba AJ, AN Kaba (2020)

COVID-19 in African Countries versus other World Regions: A Review.

African journal of reproductive health, 24(s1):125-141.

This review examines the spread of COVID-19 (coronavirus) in Africa. By May 15, 2020, while the COVID-19 infections were 1,741,129 in Europe, 1,632,167 in North America, 757,924 in Asia, 401,072 in South America, there were only 79,780 infections in Africa, a continent with 1.34 billion people. During this same date, of the total COVID-19 deaths of 308,154 worldwide, Europe accounted for 160,482 (52.1%) deaths; North America accounted for 99,633 (32.3%) deaths; Asia accounted for 23,963 (7.8%) deaths; South America accounted for 21,303 (6.9%) deaths; and Africa accounted for only 2,639 (0.9%) deaths. Among the factors cited for this phenomenon (Africa's low figures) are: low volumes of international tourism to most African nations; a relatively young African population, with 533.5 (39.8%) million under the age of 15; low obesity rates in Africa; low rates of urbanization in most African nations; hot or high temperatures and high humidity in most African nations; low levels of testing, which continues to be the case in countries all across the world and proactive measures by African governments and people to slow the spread of the coronavirus. It is recommended that African countries continue to pursue proactive measures such as use of facemasks, hand sanitizers, regular hand washing and immediate partial or full lockdown when necessary.

RevDate: 2021-06-14
CmpDate: 2021-06-14

Mak V, Fitzgerald J, Holle L, et al (2021)

Meeting pharmacy educational outcomes through effective use of the virtual simulation MyDispense.

Currents in pharmacy teaching & learning, 13(7):739-742.

INTRODUCTION: One of the challenges of pharmacy schools worldwide is the need to link theoretical training with the mastery of practical skills. A virtual pharmacy simulation, MyDispense, developed by the Faculty of Pharmacy and Pharmaceutical Sciences at Monash University, enables students to practice the skills of a professional pharmacist, from novice to highly advanced, in a safe virtual environment that is web-based and highly accessible. The free online simulation allows students to undertake scenarios where patients can present with prescription or self-care requirements, and are also challenged with validation tasks requiring them to check the work of virtual colleagues for accuracy, legality, and medicine safety.

COMMENTARY: This commentary describes the use of a virtual simulation, MyDispense, in enhancing didactic instruction, complementing experiential education, and the challenges of the virtual simulation to pharmacy educators. MyDispense is now deployed to 186 schools of pharmacy across 34 countries to over 25,000 students worldwide who have completed over 963,000 exercises globally.

IMPLICATIONS: The severe acute respiratory syndrome 2 (aka COVID-19) pandemic presents challenges to pharmacy education requiring many educators to switch to remote online learning. Simulation programs, such as MyDispense, help to replicate aspects of pharmacy practice and can be used creatively to meet course needs. The use of MyDispense is an excellent example of pharmacy educators collaborating globally and learning from each other to improve student learning.

RevDate: 2021-06-15

Karges J, SM Cohen (2021)

Metal Complexes as Antiviral Agents for SARS-CoV-2.

Chembiochem : a European journal of chemical biology [Epub ahead of print].

The severe acute respiratory syndrome - coronavirus 2 (SARS-CoV-2), the infectious agent responsible for COVID-19 - has caused more than 2.5 million deaths worldwide and triggered a global pandemic. Even with successful vaccines being delivered, there is an urgent need for novel treatments to combat SARS-CoV-2, and other emerging viral diseases. While several organic small molecule drug candidates are in development, some effort has also been devoted towards the application of metal complexes as potential antiviral agents against SARS-CoV-2. Herein, the metal complexes that have been reported to show antiviral activity against SARS-CoV-2 or one of its target proteins are described and their proposed mechanisms of action are discussed.

RevDate: 2021-06-14
CmpDate: 2021-06-14

Moutsopoulos HM (2021)

A recommended paradigm for vaccination of rheumatic disease patients with the SARS-CoV-2 vaccine.

Journal of autoimmunity, 121:102649.

Autoimmune and autoinflammatory rheumatic disorders (ARD) are treated with antimetabolites, calcineurin inhibitors and biologic agents either neutralizing cytokines [Tumor Necrosis Factor (TNF), Interleukin (IL)-1, IL-6, IL-17, B-cell activating factor] or being directed against B-cells (anti-CD-20), costimulatory molecules or JAK kinases. Similarly for the influenza or pneumococcal vaccines, there is limited data on the effectiveness of vaccination against SARS-CoV-2 infection and COVID-19 prevention for this susceptible patient population. Moreover, preliminary data from vaccinated organ transplanted, inflammatory bowel and connective tissue disease patients suggests only limited immunogenicity after the first vaccine dose, particularly in patients on immunosuppressive regimens. Herein a set of recommendations for the vaccination of immune suppressed patients with the SARS-CoV-2 vaccines is proposed aimed at achieving optimal vaccine benefit without interfering with disease activity status. Moreover, rare autoimmune adverse events related to vaccinations are discussed.

RevDate: 2021-06-15
CmpDate: 2021-06-15

Windisch W, Schönhofer B, Majorski DS, et al (2021)

[Role of Non-Invasive Strategies in the Treatment of Acute Hypoxemic Respiratory Failure Related to COVID-19].

Pneumologie (Stuttgart, Germany), 75(6):424-431.

Non-invasive strategies such as HFOT (high-flow oxygen therapy), CPAP (continuous positive airway pressure) and NIV (non-invasive ventilation) are increasingly being used during the COVID-19 pandemics in order to treat acute hypoxemic respiratory failure related to COVID-19, and this is aimed at avoiding intubation. This review article summarizes the current evidence by also emphasizing its heterogeneity. Importantly, current evidence suggests that these non-invasive strategies can be successfully used even in case of severe respiratory failure and are, thus, indeed capable of avoiding intubation, and consequently, tube-related complications. In contrast, it also remains to be emphasized that prolonged spontaneous breathing supported by non-invasive treatment strategies is also prone to complications. In particular, late NIV failure is associated with substantially deteriorated outcome, which is suggested to be meaningful in view of NIV failure rates still being high in Germany. Finally, the current article also refers to a parallel article that addresses the discussion being held in the public media in Germany concerning this topic. Here, its textual questionability, but also its negative consequences for both the research community and the general society are elaborated. In this context, the importance of national and regularly updated guidelines is emphasized.

RevDate: 2021-06-14
CmpDate: 2021-06-14

Sajid MI, Moazzam M, Cho Y, et al (2021)

siRNA Therapeutics for the Therapy of COVID-19 and Other Coronaviruses.

Molecular pharmaceutics, 18(6):2105-2121.

The ongoing pandemic of global concern has killed about three million humans and affected around 151 million people worldwide, as of April 30, 2021. Although recently approved vaccines for COVID-19 are engendering hope, finding new ways to cure the viral pandemic is still a quest for researchers worldwide. Major pandemics in history have been of viral origin, such as SARS, MERS, H1NI, Spanish flu, and so on. A larger emphasis has been on discovering potential vaccines, novel antiviral drugs, and agents that can mitigate the viral infection symptoms; however, a relatively new area, RNA interference (RNAi), has proven effective as an antiviral agent. The RNAi phenomenon has been largely exploited to cure cancer, neurodegenerative diseases, and some rare diseases. The U.S. Food and Drug Administration has recently approved three siRNA products for human use that garner significant hope in siRNA therapeutics for coronaviruses. There have been some commentaries and communications addressing this area. We have summarized and illustrated the significance and the potential of the siRNA therapeutics available as of April 30, 2021 to combat the ongoing viral pandemic and the emerging new variants such as B.1.1.7 and B.1.351. Numerous successful in vitro studies and several investigations to address the clinical application of siRNA therapeutics provide great hope in this field. This seminal Review describes the significance of siRNA-based therapy to treat diverse viral infections in addition to the current coronavirus challenge. In addition, we have thoroughly reviewed the patents approved for coronaviruses, the major challenges in siRNA therapy, and the potential approaches to address them, followed by innovation and prospects.

RevDate: 2021-06-14
CmpDate: 2021-06-14

Bertho N, F Meurens (2021)

The pig as a medical model for acquired respiratory diseases and dysfunctions: An immunological perspective.

Molecular immunology, 135:254-267.

By definition no model is perfect, and this also holds for biology and health sciences. In medicine, murine models are, and will be indispensable for long, thanks to their reasonable cost and huge choice of transgenic strains and molecular tools. On the other side, non-human primates remain the best animal models although their use is limited because of financial and obvious ethical reasons. In the field of respiratory diseases, specific clinical models such as sheep and cotton rat for bronchiolitis, or ferret and Syrian hamster for influenza and Covid-19, have been successfully developed, however, in these species, the toolbox for biological analysis remains scarce. In this view the porcine medical model is appearing as the third, intermediate, choice, between murine and primate. Herein we would like to present the pros and cons of pig as a model for acquired respiratory conditions, through an immunological point of view. Indeed, important progresses have been made in pig immunology during the last decade that allowed the precise description of immune molecules and cell phenotypes and functions. These progresses might allow the use of pig as clinical model of human respiratory diseases but also as a species of interest to perform basic research explorations.

RevDate: 2021-06-14
CmpDate: 2021-06-14

Lemaitre J, Naninck T, Delache B, et al (2021)

Non-human primate models of human respiratory infections.

Molecular immunology, 135:147-164.

Respiratory pathogens represent a great burden for humanity and a potential source of new pandemics, as illustrated by the recent emergence of coronavirus disease 2019 (COVID-19). In recent decades, biotechnological advances have led to the development of numerous innovative therapeutic molecules and vaccine immunogens. However, we still lack effective treatments and vaccines against many respiratory pathogens. More than ever, there is a need for a fast, predictive, preclinical pipeline, to keep pace with emerging diseases. Animal models are key for the preclinical development of disease management strategies. The predictive value of these models depends on their ability to reproduce the features of the human disease, the mode of transmission of the infectious agent and the availability of technologies for monitoring infection. This review focuses on the use of non-human primates as relevant preclinical models for the development of prevention and treatment for human respiratory infections.

RevDate: 2021-06-14
CmpDate: 2021-06-14

Lippi G, Henry BM, EJ Favaloro (2021)

Mean Platelet Volume Predicts Severe COVID-19 Illness.

Seminars in thrombosis and hemostasis, 47(4):456-459.

RevDate: 2021-06-14
CmpDate: 2021-06-14

Prasun P (2021)

COVID-19: A Mitochondrial Perspective.

DNA and cell biology, 40(6):713-719.

Coronavirus disease 2019 (COVID-19) is the worst public health crisis of the century. Although we have made tremendous progress in understanding the pathogenesis of this disease, a lot more remains to be learned. Mitochondria appear to be important in COVID-19 pathogenesis because of its role in innate antiviral immunity, as well as inflammation. This article examines pathogenesis of COVID-19 from a mitochondrial perspective and tries to answer some perplexing questions such as why the prognosis is so poor in those with obesity, metabolic syndrome, or type 2 diabetes. Although effective vaccines and antiviral drugs will be the ultimate solution to this crisis, a better understanding of disease mechanisms will open novel avenues for treatment and prevention.

RevDate: 2021-06-14
CmpDate: 2021-06-14

Risma KA, Edwards KM, Hummell DS, et al (2021)

Potential mechanisms of anaphylaxis to COVID-19 mRNA vaccines.

The Journal of allergy and clinical immunology, 147(6):2075-2082.e2.

Anaphylaxis to vaccines is historically a rare event. The coronavirus disease 2019 pandemic drove the need for rapid vaccine production applying a novel antigen delivery system: messenger RNA vaccines packaged in lipid nanoparticles. Unexpectedly, public vaccine administration led to a small number of severe allergic reactions, with resultant substantial public concern, especially within atopic individuals. We reviewed the constituents of the messenger RNA lipid nanoparticle vaccine and considered several contributors to these reactions: (1) contact system activation by nucleic acid, (2) complement recognition of the vaccine-activating allergic effector cells, (3) preexisting antibody recognition of polyethylene glycol, a lipid nanoparticle surface hydrophilic polymer, and (4) direct mast cell activation, coupled with potential genetic or environmental predispositions to hypersensitivity. Unfortunately, measurement of anti-polyethylene glycol antibodies in vitro is not clinically available, and the predictive value of skin testing to polyethylene glycol components as a coronavirus disease 2019 messenger RNA vaccine-specific anaphylaxis marker is unknown. Even less is known regarding the applicability of vaccine use for testing (in vitro/vivo) to ascertain pathogenesis or predict reactivity risk. Expedient and thorough research-based evaluation of patients who have suffered anaphylactic vaccine reactions and prospective clinical trials in putative at-risk individuals are needed to address these concerns during a public health crisis.

RevDate: 2021-06-10
CmpDate: 2021-06-10

Jones SA, CA Hunter (2021)

Is IL-6 a key cytokine target for therapy in COVID-19?.

Nature reviews. Immunology, 21(6):337-339.

RevDate: 2021-06-15
CmpDate: 2021-06-15

Miličić Stanić B, Maddox S, de Souza AMA, et al (2021)

Male bias in ACE2 basic science research: missed opportunity for discovery in the time of COVID-19.

American journal of physiology. Regulatory, integrative and comparative physiology, 320(6):R925-R937.

Throughout the world, including the United States, men have worse outcomes from COVID-19 than women. SARS-CoV-2, the causative virus of the COVID-19 pandemic, uses angiotensin-converting enzyme 2 (ACE2) to gain cellular entry. ACE2 is a member of the renin-angiotensin system (RAS) and plays an important role in counteracting the harmful effects mediated by the angiotensin type 1 receptor. Therefore, we conducted Ovid MEDLINE and Embase database searches of basic science studies investigating the impact of the biological variable of sex on ACE2 expression and regulation from 2000, the year ACE2 was discovered, through December 31, 2020. Out of 2,131 publications, we identified 853 original research articles on ACE2 conducted in primary cells, tissues, and/or whole mammals excluding humans. The majority (68.7%) of these studies that cited the sex of the animal were conducted in males, while 11.2% were conducted solely in females; 9.26% compared ACE2 between the sexes, while 10.8% did not report the sex of the animals used. General findings are that sex differences are tissue-specific and when present, are dependent upon gonadal state. Renal, cardiac, and adipose ACE2 is increased in both sexes under experimental conditions that model co-morbidities associated with worse COVID-19 outcomes including hypertension, obesity, and renal and cardiovascular diseases; however, ACE2 protein was generally higher in the males. Studies in Ace2 knockout mice indicate ACE2 plays a greater role in protecting the female from developing hypertension than the male. Studying the biological variable of sex in ACE2 research provides an opportunity for discovery in conditions involving RAS dysfunction and will shed light on sex differences in COVID-19 severity.

RevDate: 2021-06-14
CmpDate: 2021-06-14

Tsiftsoglou SA (2021)

SARS-CoV-2 associated Complement genetic variants possibly deregulate the activation of the Alternative pathway affecting the severity of infection.

Molecular immunology, 135:421-425.

RevDate: 2021-06-14
CmpDate: 2021-06-14

Tomfohr-Madsen LM, Racine N, Giesbrecht GF, et al (2021)

Depression and anxiety in pregnancy during COVID-19: A rapid review and meta-analysis.

Psychiatry research, 300:113912.

The study rapidly reviewed and meta-analyzed the worldwide prevalence of depression and anxiety among pregnant women during the COVID-19 pandemic. A systematic search of the literature and meta-analyses were conducted from December 2019 - February 2021 with a total of 46 studies meeting inclusion criteria. Depression was assessed in 37 studies (N = 47,677), with a pooled prevalence of 25.6%. Anxiety was assessed in 34 studies (N = 42,773), with a pooled prevalence of 30.5%; moderation by time showed that prevalence of anxiety was higher in studies conducted later in the pandemic.

RevDate: 2021-06-14
CmpDate: 2021-06-14

Diolaiuti F, Marazziti D, Beatino MF, et al (2021)

Impact and consequences of COVID-19 pandemic on complicated grief and persistent complex bereavement disorder.

Psychiatry research, 300:113916.

Mourning is a coping-with-loss stage that prevents grief from becoming pathologic, i.e., complicated grief (CG) syndrome and persistent complex bereavement disorder (PCBD), recently included in international classification systems. During the COVID-19 pandemic, to contain virus spread, several countries adopted/adopt the prohibition of mourning rituals (funeral ceremonies/visiting to cemeteries), so that people were/are unable to give their hospitalized relatives the latest goodbye. Such measures can lead vulnerable individuals to develop CG and PCBD. We critically discuss literature-based risk factors for and protective resources against the onset of these conditions since the start of the pandemic and analyze prevention strategies to inform public health programs.

RevDate: 2021-06-15
CmpDate: 2021-06-10

Anand U, Cabreros C, Mal J, et al (2021)

Novel coronavirus disease 2019 (COVID-19) pandemic: From transmission to control with an interdisciplinary vision.

Environmental research, 197:111126.

There a lot of review papers addressing specific COVID-19 research sectors, then devoted to specialists. This review provides an in-depth summary of the available information about SARS-CoV-2 and the corresponding disease (also known as COVID-19), with a multi-disciplinary approach. After the paper introduction, the first section treats the virological characteristics of SARS-CoV-2, the medical implications of the infection, and the human susceptivity. Great attention is devoted to the factor affecting the infection routes, distinguishing among the possible human-to-human, environmental-to-human, and pollution-to-human transmission mechanisms. The second section is devoted to reporting the impact of SARS-CoV-2 not only on the healthcare systems but also on the economy and society. The third section is devoted to non-pharmaceutical behaviours against COVID-19. In this context, this review section presents an analysis of the European second wave allowing not only to focalize the importance of some restrictions, but also the relevance of social acceptance of some measures. The data reassumed in this work are very useful for interdisciplinary researchers that work in a team to find the basic available information about all the aspects connected with this pandemic (from virus diffusion mechanism to health information, from economic and social impacts to measures to reduce the pandemic spread), with great attention to social acceptance of restriction measures and of vaccines (that currently results to be insufficient to achieve community immunity). Then, this review paper highlights the fundamental role of the trans-multi-disciplinary research that is devoted not only to understand the basics of the pandemic to propose solutions but has also the commitment to find strategies to increase population resilience. For this aim, the authors strongly suggest the establishment of an international health-care trans-multi-disciplinary workforce devoted to investigate, mitigate, and control also future viral events.

RevDate: 2021-06-15
CmpDate: 2021-06-10

Iyer M, Tiwari S, Renu K, et al (2021)

Environmental survival of SARS-CoV-2 - A solid waste perspective.

Environmental research, 197:111015.

The advent of COVID-19 has kept the whole world on their toes. Countries are maximizing their efforts to combat the virus and to minimize the infection. Since infectious microorganisms may be transmitted by variety of routes, respiratory and facial protection is required for those that are usually transmitted via droplets/aerosols. Therefore this pandemic has caused a sudden increase in the demand for personal protective equipment (PPE) such as gloves, masks, and many other important items since, the evidence of individual-to-individual transmission (through respiratory droplets/coughing) and secondary infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). But the disposal of these personal protective measures remains a huge question mark towards the environmental impact. Huge waste generation demands proper segregation according to waste types, collection, and recycling to minimize the risk of infection spread through aerosols and attempts to implement measures to monitor infections. Hence, this review focuses on the impact of environment due to improper disposal of these personal protective measures and to investigate the safe disposal methods for these protective measures by using the safe, secure and innovative biological methods such as the use of Artificial Intelligence (AI) and Ultraviolet (UV) lights for killing such deadly viruses.

RevDate: 2021-06-14
CmpDate: 2021-06-14

Jain A, Prajapati SK, Tripathi M, et al (2021)

Exploring the room for repurposed hydroxychloroquine to impede COVID-19: toxicities and multipronged combination approaches with pharmaceutical insights.

Expert review of clinical pharmacology, 14(6):715-734.

Introduction: SARS-CoV-2 has fatally affected the whole world with millions of deaths. Amidst the dilemma of a breakthrough in vaccine development, hydroxychloroquine (HCQ) was looked upon as a prospective repurposed candidate. It has confronted numerous controversies in the past few months as a chemoprophylactic and treatment option for COVID-19. Recently, it has been withdrawn by the World Health Organization for its use in an ongoing pandemic. However, its benefit/risk ratio regarding its use in COVID-19 disease remains poorly justified. An extensive literature search was done using Scopus, PubMed, Google Scholar,,, and covered: Toxicity vexations of HCQ; pharmaceutical perspectives on new advances in drug delivery approaches; computational modeling (PBPK and PD modeling) overtures; multipronged combination approaches for enhanced synergism with antiviral and anti-inflammatory agents; immuno-boosting effects.Expertcommentary: Harnessing the multipronged pharmaceutical perspectives will optimistically help the researchers, scientists, biotech, and pharmaceutical companies to bring new horizons in the safe and efficacious utilization of HCQ alone or in combination with remdesivir and immunomodulatory molecules like bovine lactoferrin in a fight against COVID-19. Combinational therapies with free forms or nanomedicine based targeted approaches can act synergistically to boost host immunity and stop SARS-CoV-2 replication and invasion to impede the infection.

RevDate: 2021-06-14
CmpDate: 2021-06-14

Crawford AM, Lightsey HM, Xiong GX, et al (2021)

Interventional procedure plans generated by telemedicine visits in spine patients are rarely changed after in-person evaluation.

Regional anesthesia and pain medicine, 46(6):478-481.

BACKGROUND AND OBJECTIVES: The role of telemedicine in the evaluation and treatment of patients with spinal disorders is rapidly expanding, brought on largely by the COVID-19 pandemic. Within this context, the ability of pain specialists to accurately diagnose and plan appropriate interventional spine procedures based entirely on telemedicine visits, without an in-person evaluation, remains to be established. In this study, our primary objective was to assess the relevance of telemedicine to interventional spine procedure planning by determining whether procedure plans established solely from virtual visits changed following in-person evaluation.

METHODS: We reviewed virtual and in-person clinical encounters from our academic health system's 10 interventional spine specialists. We included patients who were seen exclusively via telemedicine encounters and indicated for an interventional procedure with documented procedural plans. Virtual plans were then compared with the actual procedures performed following in-person evaluation. Demographic data as well as the type and extent of physical examination performed by the interventional spine specialist were also recorded.

RESULTS: Of the 87 new patients included, the mean age was 60 years (SE 1.4 years) and the preprocedural plan established by telemedicine, primarily videoconferencing, did not change for 76 individuals (87%; 95% CI 0.79 to 0.94) following in-person evaluation. Based on the size of our sample, interventional procedures indicated solely during telemedicine encounters may be accurate in 79%-94% of cases in the broader population.

CONCLUSIONS: Our findings suggest that telemedicine evaluations are a generally accurate means of preprocedural assessment and development of interventional spine procedure plans. These findings clearly demonstrate the capabilities of telemedicine for evaluating spine patients and planning interventional spine procedures.

RevDate: 2021-06-11
CmpDate: 2021-06-11

Marel C, Mills KL, M Teesson (2021)

Substance use, mental disorders and COVID-19: a volatile mix.

Current opinion in psychiatry, 34(4):351-356.

PURPOSE OF REVIEW: The COVID-19 pandemic and associated restrictions have uniquely and disproportionately affected vulnerable populations. This review summarizes recent evidence on the relationship between psychiatric disorders, substance use disorders and COVID-19, highlighting acute and long-term risks, pharmacotherapy interactions and implications regarding appropriate and timely evidence-based treatment.

RECENT FINDINGS: Evidence points to a complex relationship between psychiatric and substance use disorders and COVID-19. A range of risk factors associated with psychiatric and substance use disorders increases the risk of exposure to, and complications arising from, the COVID-19 virus. COVID-19 infection has been indicated as having acute and potential long-term impacts on both psychiatric and substance use disorders. Social disruption associated with restrictions imposed to curb transmission has also been identified as a risk factor for new onset of disorders and recurrence and exacerbation of existing conditions.

SUMMARY: Early recognition and intervention are key to preventing chronic disability associated with psychiatric disorders, substance use disorders, and their co-occurrence. It is critical that those most in need of services do not fall through the cracks of our healthcare systems. The pandemic has fast tracked the opportunity for widespread implementation of digital health interventions but ensuring these are accessible and available to all, including our most vulnerable, will be a critical task for our future health and social ecosystems.

RevDate: 2021-06-09
CmpDate: 2021-06-09

Gaszyński T, Fedorczak M, J Pondel (2021)

A proposal of a cheap and simple method of medical personnel protection for endotracheal intubation of patients with a suspected or confirmed COVID-19 infection.

International journal of occupational medicine and environmental health, 34(2):301-305.

OBJECTIVES: The COVID-19 pandemic has created additional risks to healthcare providers, especially those who perform aerosol generating procedures (AGPs) like endotracheal intubation. Endotracheal intubation is one of the procedures mostly generating aerosol and, therefore, requiring full protection of medical personnel against the infection.

MATERIAL AND METHODS: In this paper, basing on a literature review, the recommended intubation procedure is presented together with recommendations for personal protection during intubation. Additionally, a proposal of a simple and cheap protective barrier is described against spreading aerosol outside the intubation area. The aim was to propose a simple and cheap method to increase the safety of medical personnel performing AGPs in patients infected or suspected of being infected with COVID-19, which could be easily introduced into clinical practice.

RESULTS: The presented method is the authors' own idea, based on their experience gathered from working in an operating room. Judging from their clinical experience, the presented method is effective and safe for patients.

CONCLUSIONS: Endotracheal intubation is one of the most common AGPs and adequate actions must be taken in order to protect medical personnel against the infection and to prevent the spreading of aerosol around the intubation area. The proposed barrier is easy to set with disposable materials and standard equipment available in every operating room. Int J Occup Med Environ Health. 2021;34(2):301-5.

RevDate: 2021-06-11
CmpDate: 2021-06-11

Harboe KM, NC Brun (2021)

[Vaccine approval during an epidemic].

Ugeskrift for laeger, 183(10):.

Efficacious and safe vaccines are important tools in handling the corona pandemic. As summarised in this review, the European approval system has undergone a tuning, streamlining and increase in efficiency in order to be able to quickly evaluate and hopefully approve corona vaccines, without compromising the assessment quality.

RevDate: 2021-06-14

Ullah I, Khan KS, Tahir MJ, et al (2021)

Myths and conspiracy theories on vaccines and COVID-19: Potential effect on global vaccine refusals.

Vacunas, 22(2):93-97.

The current coronavirus disease 2019 (COVID-19) pandemic is one of the international crises and researchers are working collaboratively to develop a safe and effective COVID-19 vaccine. The World Health Organization recognizes vaccine hesitancy as the world's top threat to public health safety, particularly in low middle-income countries. Vaccine hesitancy can be due to a lack of knowledge, false religious beliefs, or anti-vaccine misinformation. The current situation regarding anti-vaccine beliefs is pointing towards dreadful outcomes. It raises the concern that will people believe and accept the new COVID-19 vaccines despite all anti-vaccine movements and COVID-19-related myths and conspiracy theories. This review discusses the possible detrimental impacts of myths and conspiracy theories related to COVID-19 and vaccine on COVID-19 vaccine refusals as well as other vaccine programs.

RevDate: 2021-06-15
CmpDate: 2021-06-15

Ashbury FD (2021)

COVID-19 and supportive cancer care: key issues and opportunities.

Current opinion in oncology, 33(4):295-300.

PURPOSE OF REVIEW: The disruption to people's lives, including financial impacts, morbidity and loss of life caused by the Coronavirus disease (COVID-19) pandemic requires a dramatic transformation of cancer care delivery, including supportive care. This paper focuses on issues of supportive care in the context of the pandemic, and the extent to which these issues will impact supportive cancer care post-COVID-19.

RECENT FINDINGS: Cancer care, including supportive care delivery, has had to be dramatically altered during the COVID-19 pandemic, including reallocation of human resources, repurposing of existing physical space, amplified use of telehealth and other remote patient monitoring technologies, changes to treatment and follow-up care patient schedules, among others. These changes have resulted in psychosocial sequelae for cancer patients (including anxiety, stress, loss of control), financial toxicity, and risk of disengagement from treatment and follow-up care.

SUMMARY: COVID-19 has seriously disrupted cancer treatment and supportive care for patients and survivors. This paper highlights implications for clinical practice during and post-COVID-19, including the durability of practice adaptations and opportunities for research into mechanisms to support supportive care post the pandemic, including the advancement of eHealth technologies and alternative models of care that integrate community resources, primary care and allied health disciplines.

RevDate: 2021-06-11
CmpDate: 2021-06-11

Rahman S, Montero MTV, Rowe K, et al (2021)

Epidemiology, pathogenesis, clinical presentations, diagnosis and treatment of COVID-19: a review of current evidence.

Expert review of clinical pharmacology, 14(5):601-621.

INTRODUCTION: The COVID-19 pandemic has created a public health crisis, infected millions of people, and caused a significant number of deaths. SARS-CoV-2 transmits from person to person through several routes, mainly via respiratory droplets, which makes it difficult to contain its spread into the community. Here, we provide an overview of the epidemiology, pathogenesis, clinical presentation, diagnosis, and treatment of COVID-19.

AREAS COVERED: Direct person-to-person respiratory transmission has rapidly amplified the spread of coronavirus. In the absence of any clinically proven treatment options, the current clinical management of COVID-19 includes symptom management, infection prevention and control measures, optimized supportive care, and intensive care support in severe or critical illness. Developing an effective vaccine is now a leading research priority. Some vaccines have already been approved by the regulatory authorities for the prevention of COVID-19.

EXPERT OPINION: General prevention and protection measures regarding the containment and management of the second or third waves are necessary to minimize the risk of infection. Until now, four vaccines reported variable efficacies of between 62-95%, and two of them (Pfizer/BioNTech and Moderna) received FDA emergency use authorization. Equitable access and effective distribution of these vaccines in all countries will save millions of lives.

RevDate: 2021-06-07
CmpDate: 2021-06-07

Kanne JP, Bai H, Bernheim A, et al (2021)

COVID-19 Imaging: What We Know Now and What Remains Unknown.

Radiology, 299(3):E262-E279.

Infection with SARS-CoV-2 ranges from an asymptomatic condition to a severe and sometimes fatal disease, with mortality most frequently being the result of acute lung injury. The role of imaging has evolved during the pandemic, with CT initially being an alternative and possibly superior testing method compared with reverse transcriptase-polymerase chain reaction (RT-PCR) testing and evolving to having a more limited role based on specific indications. Several classification and reporting schemes were developed for chest imaging early during the pandemic for patients suspected of having COVID-19 to aid in triage when the availability of RT-PCR testing was limited and its level of performance was unclear. Interobserver agreement for categories with findings typical of COVID-19 and those suggesting an alternative diagnosis is high across multiple studies. Furthermore, some studies looking at the extent of lung involvement on chest radiographs and CT images showed correlations with critical illness and a need for mechanical ventilation. In addition to pulmonary manifestations, cardiovascular complications such as thromboembolism and myocarditis have been ascribed to COVID-19, sometimes contributing to neurologic and abdominal manifestations. Finally, artificial intelligence has shown promise for use in determining both the diagnosis and prognosis of COVID-19 pneumonia with respect to both radiography and CT.

RevDate: 2021-06-07
CmpDate: 2021-06-07

Netters S, Dekker N, van de Wetering K, et al (2021)

Pandemic ICU triage challenge and medical ethics.

BMJ supportive & palliative care, 11(2):133-137.

The COVID-19 pandemic has made unprecedented global demands on healthcare in general and especially the intensive care unit (ICU). the virus is spreading out of control. To this day, there is no clear, published directive for doctors regarding the allocation of ICU beds in times of scarcity. This means that many doctors do not feel supported by their government and are afraid of the medicolegal consequences of the choices they have to make. Consequently, there has been no transparent discussion among professionals and the public. The thought of being at the mercy of absolute arbitrariness leads to fear among the population, especially the vulnerable groups.

RevDate: 2021-05-20
CmpDate: 2021-05-20

Bhise V, S Dhib-Jalbut (2021)

Potential Risks and Benefits of Multiple Sclerosis Immune Therapies in the COVID-19 Era: Clinical and Immunological Perspectives.

Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics, 18(1):244-251.

Coronavirus SARS-CoV2 has emerged as one of the greatest infectious disease health challenges in a century. Patients with multiple sclerosis (MS) have a particular vulnerability to infections through their use of immunosuppressive disease-modifying therapies (DMTs). Specific DMTs pose particular risk based on their mechanisms of action (MOA). As a result, patients require individualized approaches to starting new treatments and continuation of therapy. Additionally, vaccinations must be considered carefully, and individuals on long-term B cell-depleting therapies may have diminished immune responses to vaccination, based on preserved T cells and diminished but present antibody titers to influenza vaccines. We review the immunology behind these treatments and their impact on COVID-19, as well as the current recommendations for best practices for use of DMTs in patients with MS.

RevDate: 2021-06-06
CmpDate: 2021-05-27

Kakarla V, Kaneko N, Nour M, et al (2021)

Pathophysiologic mechanisms of cerebral endotheliopathy and stroke due to Sars-CoV-2.

Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism, 41(6):1179-1192.

Cerebrovascular events have emerged as a central feature of the clinical syndrome associated with Sars-CoV-2 infection. This increase in infection-related strokes is marked by atypical presentations including stroke in younger patients and a high rate of hemorrhagic transformation after ischemia. A variety of pathogenic mechanisms may underlie this connection. Efforts to identify synergism in the pathophysiology underlying stroke and Sars-CoV-2 infection can inform the understanding of both conditions in novel ways. In this review, the molecular cascades connected to Sars-CoV-2 infection are placed in the context of the cerebral vasculature and in relationship to pathways known to be associated with stroke. Cytokine-mediated promotion of systemic hypercoagulability is suggested while direct Sars-CoV-2 infection of cerebral endothelial cells may also contribute. Endotheliopathy resulting from direct Sars-CoV-2 infection of the cerebral vasculature can modulate ACE2/AT1R/MasR signaling pathways, trigger direct viral activation of the complement cascade, and activate feed-forward cytokine cascades that impact the blood-brain barrier. All of these pathways are already implicated as independent mechanisms driving stroke and cerebrovascular injury irrespective of Sars-CoV-2. Recognizing the overlap of molecular pathways triggered by Sars-CoV-2 infection with those implicated in the pathogenesis of stroke provides an opportunity to identify future therapeutics targeting both Sars-CoV-2 and stroke thereby reducing the impact of the global pandemic.

RevDate: 2021-06-01
CmpDate: 2021-06-01

Persson C (2021)

Early humoral defence: Contributing to confining COVID-19 to conducting airways?.

Scandinavian journal of immunology, 93(6):e13024.

Early airway responses to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection are of interest since they could decide whether coronavirus disease-19 (COVID-19) will proceed to life-threatening pulmonary disease stages. Here I discuss endothelial-epithelial co-operative in vivo responses producing first-line, humoral innate defence opportunities in human airways. The pseudostratified epithelium of human nasal and tracheobronchial airways are prime sites of exposure and infection by SARS-CoV-2. Just beneath the epithelium runs a profuse systemic microcirculation. Its post-capillary venules respond conspicuously to mucosal challenges with autacoids, allergens and microbes, and to mere loss of epithelium. By active venular endothelial gap formation, followed by transient yielding of epithelial junctions, non-sieved plasma macromolecules move from the microcirculation to the mucosal surface. Hence, plasma-derived protein cascade systems and antimicrobial peptides would have opportunity to operate jointly on an unperturbed mucosal lining. Similarly, a plasma-derived, dynamic gel protects sites of epithelial sloughing-regeneration. Precision for this indiscriminate humoral molecular response lies in restricted location and well-regulated duration of plasma exudation. Importantly, the endothelial responsiveness of the airway microcirculation differs distinctly from the relatively non-responsive, low-pressure pulmonary microcirculation that non-specifically, almost irreversibly, leaks plasma in life-threatening COVID-19. Observations in humans of infections with rhinovirus, coronavirus 229E, and influenza A and B support a general but individually variable early occurrence of plasma exudation in human infected nasal and tracheobronchial airways. Investigations are warranted to elucidate roles of host- and drug-induced airway plasma exudation in restriction of viral infection and, specifically, whether it contributes to variable disease responses following exposure to SARS-CoV-2.

RevDate: 2021-06-12

Kumar R, Yeni CM, Utami NA, et al (2021)

SARS-CoV-2 infection during pregnancy and pregnancy-related conditions: Concerns, challenges, management and mitigation strategies-a narrative review.

Journal of infection and public health, 14(7):863-875 pii:S1876-0341(21)00097-6 [Epub ahead of print].

The ongoing coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is a global public health problem. The SARS-CoV-2 triggers hyper-activation of inflammatory and immune responses resulting in cytokine storm and increased inflammatory responses on several organs like lungs, kidneys, intestine, and placenta. Although SARS-CoV-2 affects individuals of all age groups and physiological statuses, immune-compromised individuals such as pregnant women are considered as a highly vulnerable group. This review aims to raise the concerns of high risk of infection, morbidity and mortality of COVID-19 in pregnant women and provides critical reviews of pathophysiology and pathobiology of how SARS-CoV-2 infection potentially increases the severity and fatality during pregnancy. This article also provides a discussion of current evidence on vertical transmission of SARS-CoV-2 during pregnancy and breastfeeding. Lastly, guidelines on management, treatment, preventive, and mitigation strategies of SARS-CoV-2 infection during pregnancy and pregnancy-related conditions such as delivery and breastfeeding are discussed.

RevDate: 2021-06-12

Srivastava V, A Ahmad (2021)

New perspective towards therapeutic regimen against SARS-CoV-2 infection.

Journal of infection and public health, 14(7):852-862 pii:S1876-0341(21)00127-1 [Epub ahead of print].

The ongoing enormous loss of human life owing to Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), has led to a global crisis ranging from the collapse of health - care systems to socio-economic instability. As SARS-CoV-2 is a novel virus, very little information is available from researchers and therefore, a rigorous effort is required to decode its pathogenicity. There are no licenced treatment options available for treating SARS-CoV-2 infections and the development of a new antiviral drug targeting coronavirus cannot happen soon. Consequently, drug repurposing is a promising solution for combating the present pandemic. In this review, we have thoroughly discussed all the proteins encoded by the SARS-CoV-2 genome; their importance in pathogenicity and their potential role in drug discovery. Also, the budding threat of co-infections by other pathogenic microbes has been highlighted. Furthermore, the advances made in the medicinal field for the treatment and prevention of this viral infection is explained. Altogether, this review will provide some insightful discussions about this infectious disease and will meet certain of the knowledge gaps which exist by presenting an exhaustive and extensive scientific report on the ongoing mission for COVID-19 drug discovery.

RevDate: 2021-06-12

Cunningham NR, Ely SL, Garcia BNB, et al (2021)

Addressing pediatric mental health using telehealth during COVID-19 and beyond: A narrative review.

Academic pediatrics pii:S1876-2859(21)00305-3 [Epub ahead of print].

The pediatrician continues to serve as a frontline provider addressing patients' medical and mental health needs, yet COVID-19 is reshaping the way physicians deliver such care. Pediatricians are increasingly faced with the challenge of delivering healthcare, including mental health care, remotely. Given the rapidly evolving literature, we performed a narrative review of the use of telehealth for mental health care for pediatric populations during the COVID-19 pandemic. Areas of focus included 1) pediatric primary care settings, 2) special pediatric populations (e.g., eating disorders, autism), 3) access and engagement in telehealth care, and 4) training opportunities available for mental health providers. Themes that emerged across studies included the importance of meeting patients' needs (e.g., access to technological resources) to optimize success in using telehealth tools and challenges around provider access to evidence-based tools for use during telehealth. Thus, we offered evidence-based tools (including COVID-19 specific resources) for improving the delivery of mental health care by pediatricians via telehealth. We also reviewed future directions including trials currently underway that will enhance understanding of future telehealth applications for pediatric mental health care.


ESP Quick Facts

ESP Origins

In the early 1990's, Robert Robbins was a faculty member at Johns Hopkins, where he directed the informatics core of GDB — the human gene-mapping database of the international human genome project. To share papers with colleagues around the world, he set up a small paper-sharing section on his personal web page. This small project evolved into The Electronic Scholarly Publishing Project.

ESP Support

In 1995, Robbins became the VP/IT of the Fred Hutchinson Cancer Research Center in Seattle, WA. Soon after arriving in Seattle, Robbins secured funding, through the ELSI component of the US Human Genome Project, to create the original ESP.ORG web site, with the formal goal of providing free, world-wide access to the literature of classical genetics.

ESP Rationale

Although the methods of molecular biology can seem almost magical to the uninitiated, the original techniques of classical genetics are readily appreciated by one and all: cross individuals that differ in some inherited trait, collect all of the progeny, score their attributes, and propose mechanisms to explain the patterns of inheritance observed.

ESP Goal

In reading the early works of classical genetics, one is drawn, almost inexorably, into ever more complex models, until molecular explanations begin to seem both necessary and natural. At that point, the tools for understanding genome research are at hand. Assisting readers reach this point was the original goal of The Electronic Scholarly Publishing Project.

ESP Usage

Usage of the site grew rapidly and has remained high. Faculty began to use the site for their assigned readings. Other on-line publishers, ranging from The New York Times to Nature referenced ESP materials in their own publications. Nobel laureates (e.g., Joshua Lederberg) regularly used the site and even wrote to suggest changes and improvements.

ESP Content

When the site began, no journals were making their early content available in digital format. As a result, ESP was obliged to digitize classic literature before it could be made available. For many important papers — such as Mendel's original paper or the first genetic map — ESP had to produce entirely new typeset versions of the works, if they were to be available in a high-quality format.

ESP Help

Early support from the DOE component of the Human Genome Project was critically important for getting the ESP project on a firm foundation. Since that funding ended (nearly 20 years ago), the project has been operated as a purely volunteer effort. Anyone wishing to assist in these efforts should send an email to Robbins.

ESP Plans

With the development of methods for adding typeset side notes to PDF files, the ESP project now plans to add annotated versions of some classical papers to its holdings. We also plan to add new reference and pedagogical material. We have already started providing regularly updated, comprehensive bibliographies to the ESP.ORG site.


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With the world now in the middle of a new and rapidly spreading pandemic, now is the time to read this book, originally published in 2012, that describes animal infections and the next human pandemic (that's actually the book's subtitle). You would be hard pressed to find a more relevant explanation of how this got started and why there will be more after this one. R. Robbins

Electronic Scholarly Publishing
961 Red Tail Lane
Bellingham, WA 98226

E-mail: RJR8222 @

Papers in Classical Genetics

The ESP began as an effort to share a handful of key papers from the early days of classical genetics. Now the collection has grown to include hundreds of papers, in full-text format.

Digital Books

Along with papers on classical genetics, ESP offers a collection of full-text digital books, including many works by Darwin (and even a collection of poetry — Chicago Poems by Carl Sandburg).


ESP now offers a much improved and expanded collection of timelines, designed to give the user choice over subject matter and dates.


Biographical information about many key scientists.

Selected Bibliographies

Bibliographies on several topics of potential interest to the ESP community are now being automatically maintained and generated on the ESP site.

ESP Picks from Around the Web (updated 07 JUL 2018 )