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28 Sep 2021 at 01:37
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Bibliography on: covid-19


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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.

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: 2021-09-27

Simonelli G, Petit D, Delage JP, et al (2021)

Sleep in times of crises: A scoping review in the early days of the COVID-19 crisis.

Sleep medicine reviews, 60:101545 pii:S1087-0792(21)00130-1 [Epub ahead of print].

During the early days of the pandemic and in the context of a seemingly unknown global threat, several potential major sleep disruptors were identified by sleep researchers and practitioners across the globe. The COVID-19 pandemic combined several features that, individually, had been shown to negatively affect sleep health in the general population. Those features included state of crisis, restrictions on in-person social interactions, as well as financial adversity. To address the lack of a comprehensive summary of sleep research across these three distinctive domains, we undertook three parallel systematic reviews based on the following themes: 1) Sleep in times of crises; 2) Sleep and social isolation; and 3) Sleep and economic uncertainty. Using a scoping review framework, we systematically identified and summarized findings from these three separated bodies of works. Potential moderating factors such as age, sex, ethnicity, socioeconomic status, psychological predisposition, occupation and other personal circumstances are also discussed. To conclude, we propose novel lines of research necessary to alleviate the short- and long-term impacts of the COVID-19 crises and highlight the need to prepare the deployment of sleep solutions in future crises.

RevDate: 2021-09-27

Brooks SK, Weston D, N Greenberg (2021)

Social and psychological impact of the COVID-19 pandemic on people with Parkinson's disease: a scoping review.

Public health, 199:77-86 pii:S0033-3506(21)00341-3 [Epub ahead of print].

OBJECTIVES: The COVID-19 pandemic caused countries across the globe to impose restrictions to slow the spread of the virus, with people instructed to stay at home and reduce contact with others. This reduction in social contact has the potential to negatively impact mental health and well-being. The restrictions are particularly concerning for people with existing chronic illnesses such as Parkinson's disease, who may be especially affected by concerns about the pandemic and associated reduction of social contact. The aim of this review was to synthesise published literature on the impact of the COVID-19 pandemic on the social and psychological well-being of people with Parkinson's disease.

STUDY DESIGN: The design of this study is a scoping review.

METHODS: We searched five electronic databases for English language articles containing primary data on this topic.

RESULTS: Thirty-one relevant studies were found and included in the review. Six main themes were identified: impact of the pandemic on physical and mental health; COVID-19 concerns; access to health care; impact on daily and social activities; impact on physical activity and impact on caregivers. Levels of perceived risk of COVID-19 differed across studies, but most participants had adopted preventive measures such as staying at home and reducing social contacts. Participants in many studies reported a discontinuation of regular healthcare appointments and physiotherapy, as well as concerns about being able to obtain medication. Loss of daily activities and social support was noted by many participants. There was mixed evidence on the impact of the pandemic on physical exercise, with some studies finding no change in physical activity and others reporting a reduction; generally, participants with reduced physical activity had poorer mental health and greater worsening of symptoms. Caregivers of people with Parkinson's disease were more likely to be negatively affected by the pandemic if they cared for people with complex needs such as additional mental health problems.

CONCLUSIONS: The COVID-19 pandemic has had negative effects on the physical and mental health of people with Parkinson's disease, perhaps due to disruption of healthcare services, loss of usual activities and supports and reduction in physical activity. We make recommendations for policy, practice and future research.

RevDate: 2021-09-27

Ehsan G, Fateme Y, Alireza R, et al (2021)

COVID-19 and peripheral artery thrombosis: A mini review.

Current problems in cardiology pii:S0146-2806(21)00207-3 [Epub ahead of print].

For more than two years, health care systems have been floundering in a massive crisis of coronavirus disease 2019 (COVID-19) pandemic. while acute respiratory distress syndrome is the main complication in patients with COVID-19, as the pandemic continues, more data about the non-respiratory effects of the coronavirus is obtained, including developing Coagulopathy-related manifestations, in the form of venous and arterial thromboembolism. Although arterial thrombosis a rare complication of this disease, it proves to be an effective factor in the mortality and morbidity of COVID-19 patients. The pathophysiology of thrombosis reveals a complex relation between hemostasis and immune system that can be disrupted by COVID-19. Thrombectomy, anticoagulant therapy, and thrombolysis are the main treatments in these patients. In addition, appropriate thromboprophylaxis treatment should be considered in COVID-19 patients. In this article, we have successfully reviewed the arterial thrombotic events in patients reported around the world, including the diagnostic and management method of choice.

RevDate: 2021-09-27

Aguilar-Piedras MF, Porres-Aguilar M, Mukherjee D, et al (2021)

High flow nasal cannula oxygenation successfully used as bridge therapy for systemic thrombolysis in COVID-19 associated intermediate-high risk pulmonary embolism: HFNC and systemic lysis in acute PE.

Current problems in cardiology pii:S0146-2806(21)00215-2 [Epub ahead of print].

RevDate: 2021-09-27

Isachenko V, Isachenko E, Mallmann P, et al (2021)

High cryo-resistance of SARS-CoV-2 virus: Increased risk of re-contamination at transplantation of cryopreserved ovarian tissue after COVID-19 pandemic.

Cryobiology pii:S0011-2240(21)00167-X [Epub ahead of print].

Cryopreservation and re-transplantation of ovarian tissue after anticancer treatment is important medical technology. Today, during a pandemic, the risk of contamination of transplanted cells with SARS-CoV-2 virus is extremely high. Data about cryo-resistance (virulence and/or infectivity) of SARS-CoV-2 are limited. Analysis and systematization of literature data allow us to draw the following conclusions: 1) The cytoplasmic membrane of somatic cell, like envelope of corona viruses, consists of lipid bilayer and this membrane, like envelope of corona viruse, contains membrane proteins. Thus, we can consider the cytoplasmic membrane of an ordinary somatic cell as a model of the envelope membrane of SARS-CoV-2. It is expected that the response of the virus to cooling and freezing is similar to that of a somatic cell. SARS-CoV-2 is more poor-water and more protein-rich than somatic cell, and this virus is much more cryo-resistant. 2) The exposure of somatic cells at low positive temperatures increases a viability of these cells. The safety of the virus is also in direct proportion to the decrease in temperature: the positive effect of low temperatures on SARS-CoV-2 virus has been experimentally proven. 3) Resistance of SARS-CoV-2 to cryoprotectant-free cryopreservation is extremely high. The high viability rate of SARS-CoV-2 after freezing-drying confirms its high cryo-resistance. 4) The risk of SARS-CoV-2 infection after transplantation of cryopreserved ovarian tissues that have been contaminated with this virus, increases significantly. It was formulated hypothesis about increasing of viability (virulence and/or infectivity) of SARS-CoV-2 virus after cryopreservation.

RevDate: 2021-09-27

Viola TW, ML Nunes (2021)

Social and environmental effects of the COVID-19 pandemic on children.

Jornal de pediatria pii:S0021-7557(21)00122-4 [Epub ahead of print].

OBJECTIVE: This study aimed to review the literature, summarizing the existing evidence on the effects of the pandemic on children, adolescents and parents, with an emphasis on the psychological, emotional, and sleep quality consequences.

SOURCE OF DATA: Empirical studies identified in the following databases: MEDLINE, ISI Web of Knowledge/Web of Science, and preprint servers.

SYNTHESIS OF DATA: The findings point to a wide range of consequences for children and adolescents resulting from the COVID-19 pandemic, which mainly includes an increase in depressive mood symptoms. There is also an increase in anxiety symptoms, suicidal ideation, as well as potential delays in language and motor development resulting from deprivation of social interaction and the closing of schools. These effects are more severe due to previous neuropsychiatric conditions. For parents, there is an increase in anxiety, depressive and post-traumatic symptoms, which are more accentuated in those who suffered socioeconomic damage due to the pandemic. There was an important increase in situations of violence towards children by parents and caregivers during the pandemic. Also, changes in routine and fear of the pandemic have negatively impacted sleep quality, globally.

CONCLUSIONS: It is noteworthy that most studies published to date used a cross-sectional design and applied online screening questionnaires. The few studies with a longitudinal design suggest that these changes may have been transitory and more prevalent at the beginning of the pandemic.

RevDate: 2021-09-27

Soni S, Pudake RN, Jain U, et al (2021)

A systematic review on SARS-CoV-2 Associated Fungal Co-Infections.

Journal of medical virology [Epub ahead of print].

Sever pandemic of Coronavirus disease (COVID-19) has been sweeping around the globe since 2019, and this time, it did not stop at frequent mutations to transform into virulent strains for instance B.1.1.7, B.1.351, and B.1.427. In recent months, a fungal infection, mucormycosis has emerged with more fatal responses and significantly increased mortality rate. To measure the severity and potential alternative approaches against black fungus co-infection in COVID-19 patients; PubMed, Google Scholar, World Health Organization (WHO) newsletters, and other online resources based on the case reported and retrospective observational analysis were searched from the year 2015-2021. The studies reporting mucormycosis with SARS-CoV-2 co-infection and/or demonstrating potential risk factors, such as a history of diabetes mellitus or suppressed immune system were included, and reports published in non-English language were excluded. More than 20 case reports and observational studies on black fungus co-infection in COVID-19 patients were eligible for inclusion. The results indicated that diabetes mellitus, hyperglycemic, and immunocompromised COVID-19 patients with mucormycosis were at higher risks. According to our study, it is prudent to assess the potential risk factors and severity of invasive mycosis via standardized diagnostic and clinical settings. Large scale studies need to be conducted to identify early biomarkers and optimization of diagnostic methods has to establish as per population and geographical variation. It will not only help clinicians around the world to timely detect the co-infection but will also prepare them for the future outburst of other potential pandemics. This article is protected by copyright. All rights reserved.

RevDate: 2021-09-27

Guo H, Qian L, J Cui (2021)

Focused evaluation of the roles of macrophages in chimeric antigen receptor (CAR) T cell therapy associated cytokine release syndrome.

Cancer biology & medicine pii:j.issn.2095-3941.2021.0087 [Epub ahead of print].

Cytokine release syndrome (CRS) is a major obstacle to the widespread clinical application of chimeric antigen receptor (CAR) T cell therapies. CRS can also be induced by infections (such as SARS-CoV-2), drugs (such as therapeutic antibodies), and some autoimmune diseases. Myeloid-derived macrophages play key roles in the pathogenesis of CRS, and participate in the production and release of the core CRS cytokines, including interleukin (IL)-1, IL-6, and interferon-γ. In this review, we summarize the roles of macrophages in CRS and discuss new developments in macrophage activation and the related mechanisms of cytokine regulation in CRS.

RevDate: 2021-09-27

Chong WH, Saha BK, KP Neu (2021)

Comparing the clinical characteristics and outcomes of COVID-19-associate pulmonary aspergillosis (CAPA): a systematic review and meta-analysis.

Infection [Epub ahead of print].

PURPOSE: Invasive pulmonary aspergillosis has been increasingly recognized in COVID-19 patients, termed COVID-19-associate pulmonary aspergillosis (CAPA). Our meta-analysis aims to assess the clinical characteristics and outcomes of patients diagnosed with CAPA compared to those without CAPA.

METHODS: We searched the Pubmed, Cochrane Library, SCOPUS, and Web of Science databases for studies published between January 1, 2020 and August 1, 2021, containing comparative data of patients diagnosed with CAPA and those without CAPA.

RESULTS: Eight cohort studies involving 729 critically ill COVID-19 patients with comparative data were included. CAPA patients were older (mean age 66.58 vs. 59.25 years; P = 0.007) and had underlying chronic obstructive pulmonary disease (COPD) (13.7 vs. 6.1%; OR 2.75; P = 0.05). No differences in gender, body mass index (BMI), and comorbidities of diabetes and cancer were observed. CAPA patients were more likely to receive long-term corticosteroid treatment (15.0 vs. 5.3%; OR 3.53; P = 0.03). CAPA patients had greater severity of illness based on sequential organ failure assessment (SOFA) score with a higher all-cause in-hospital mortality rate (42.6 vs. 26.5%; OR 3.39; P < 0.001) and earlier ICU admission from illness onset (mean 11.00 vs. 12.00 days; P = 0.003). ICU length of stay (LOS), invasive mechanical ventilation (IMV) duration, the requirement of inotropic support and renal replacement therapy were comparable between the two groups.

CONCLUSIONS: CAPA patients are typically older with underlying COPD and received long-term corticosteroid treatment. Furthermore, CAPA is associated with higher SOFA scores, mortality, and earlier onset of ICU admission from illness onset.

RevDate: 2021-09-27

Gammone MA, N D'Orazio (2021)

COVID-19 and Obesity: Overlapping of Two Pandemics.

Obesity facts pii:000518386 [Epub ahead of print].

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has recently led to worldwide research efforts to identify subjects at greater risk of developing more severe illness: overall obesity displayed a strong correlation with critical illness and major severity of COVID-19 manifestations.

SUMMARY: Obesity and metabolic disorders are closely linked to chronic systemic inflammation. The adipose tissue constitutes a source of cytokines, which configure a low-grade inflammation and a hypercoagulation status; in addition, diagnosis and care of obese patients are often complicated by excess weight and ventilation difficulties. Key Messages: This review aims to examine the intersection between obesity and adverse outcomes of COVID-19, in order to investigate its preventive and/or therapeutic potential in the management of obesity-related COVID-19 complications.

RevDate: 2021-09-27

Cross DA, Pestka DL, White KM, et al (2021)

Business not as usual: Implementation Strategies that Support Learning during the COVID-19 Pandemic.

Mayo Clinic proceedings. Innovations, quality & outcomes pii:S2542-4548(21)00135-1 [Epub ahead of print].

Health system response to COVID-19 required drastic care delivery changes, but also a substantially altered environment in which to observe implementation of more standard quality improvement efforts. Implementation assessment during disrupted operational norms ("business not as usual") distills challenges solved by prioritization from those requiring solutions that address more fundamental barriers to change. This commentary retrospectively analyzes health system implementation of a clinical practice guideline intended to support COVID-19 treatment. We use the QUERI roadmap to reflect upon implementation strategy within the context of a nascent LHS framework. In doing so, we identify aspects of implementation that were facilitated by the COVID-19-altered environment, enduring implementation challenges with respect to fidelity and sustainability, and key areas of necessary continued investment to strengthen a responsive system for learning and improvement. Moving forward, COVID-19 response highlighted key investments that bridge learning health system structures to implementation practices. This includes structures that (1) accelerate ideas that emerge from the front lines, (2) promote "living" care guidelines that are supported by continuous review of emergent evidence, and (3) enhance analytic capacity that supports organizational learning. COVID-19 response has offered opportunities for "new norm" thinking around what's possible to build out a learning health system. Strategic application of implementation frameworks to learning health system infrastructure has highlighted necessary investments that build and sustain a more responsive, improvement-oriented organization.

RevDate: 2021-09-27

Alnagar A, Ruth N, Elsharif M, et al (2021)

Paediatric Liver Transplantation During COVID-19 Pandemic: Lessons Learned and Unanswered Questions.

SN comprehensive clinical medicine pii:1050 [Epub ahead of print].

COVID-19 pandemic has imposed many challenges on paediatric liver transplantation (PLT) services and has necessitated several adaptations in different stages of the process to ensure transplant centres can still deliver the proposed services in addition to protecting patients and staff against infection. This review article digs through the current literature to clarify the challenges imposed by SARS-CoV2 on PLT centres globally. It provides an overview of current practice as well as suggestions from experts in the field to overcome multiple obstacles. In paediatrics, the reaction to SARS-CoV2 may be less severe than that seen in the adult population, but this can change in view of newly discovered virus strains. Response of transplant centres to the current pandemic was variable depending on the anticipated risk and available resources. Telemedicine has helped PLT programmes to continue their activities while protecting patients, as well as staff against the risk of SARS-CoV2 virus. Further studies are needed to guide immunosuppression management in post-transplant infected candidates; answering this critical question will help PLT centres solve this dilemma.

RevDate: 2021-09-27

Rahman HS, Aziz MS, Hussein RH, et al (2020)

The transmission modes and sources of COVID-19: A systematic review.

International journal of surgery open, 26:125-136.

The current rampant coronavirus infection in humans, commonly known as COVID-19, a pandemic that may cause mortality in humans, has been declared a global emergency by the World Health Organization (WHO). The morbidity and mortality rates due to the pandemic are increasing rapidly worldwide, with the USA most affected by the disease. The source COVID-19 is not absolutely clear; however, the disease may be transmitted by either by COVID-19-positive individuals or from a contaminated environment. In this review, we focused on how the COVID-19 virus is transmitted in the community. An extensive literature search was conducted using specific keywords and criteria. Based on the published report, it is concluded that COVID-19 is primarily transmitted human-to-human via oral and respiratory aerosols and droplets with the virus-contaminated environment play a lesser role in the propagation of disease. Healthcare providers and the elderly with comorbidities are especially susceptible to the infection.

RevDate: 2021-09-27

Vahedian-Azimi A, Mohammadi SM, Banach M, et al (2021)

Improved COVID-19 Outcomes following Statin Therapy: An Updated Systematic Review and Meta-analysis.

BioMed research international, 2021:1901772.

Background: Although vaccine rollout for COVID-19 has been effective in some countries, there is still an urgent need to reduce disease transmission and severity. We recently carried out a meta-analysis and found that pre- and in-hospital use of statins may improve COVID-19 mortality outcomes. Here, we provide an updated meta-analysis in an attempt to validate these results and increase the statistical power of these potentially important findings.

Methods: The meta-analysis investigated the effect of observational and randomized clinical studies on intensive care unit (ICU) admission, tracheal intubation, and death outcomes in COVID-19 cases involving statin treatment, by searching the scientific literature up to April 23, 2021. Statistical analysis and random effect modeling were performed to assess the combined effects of the updated and previous findings on the outcome measures. Findings. The updated literature search led to the identification of 23 additional studies on statin use in COVID-19 patients. Analysis of the combined studies (n = 47; 3,238,508 subjects) showed no significant effect of statin treatment on ICU admission and all-cause mortality but a significant reduction in tracheal intubation (OR = 0.73, 95% CI: 0.54-0.99, p = 0.04, n = 10 studies). The further analysis showed that death outcomes were significantly reduced in the patients who received statins during hospitalization (OR = 0.54, 95% CI: 0.50-0.58, p < 0.001, n = 7 studies), with no such effect of statin therapy before hospital admission (OR = 1.06, 95% CI = 0.82-1.37, p = 0.670, n = 29 studies).

Conclusion: Taken together, this updated meta-analysis extends and confirms the findings of our previous study, suggesting that in-hospital statin use leads to significant reduction of all-cause mortality in COVID-19 cases. Considering these results, statin therapy during hospitalization, while indicated, should be recommended.

RevDate: 2021-09-27

Santos AF, Póvoa P, Paixão P, et al (2021)

Changes in Glycolytic Pathway in SARS-COV 2 Infection and Their Importance in Understanding the Severity of COVID-19.

Frontiers in chemistry, 9:685196 pii:685196.

COVID-19 is an infectious disease caused by Coronavirus 2 (SARS-CoV-2) that may lead to a severe acute respiratory syndrome. Such syndrome is thought to be related, at least in part, to a dysregulation of the immune system which involves three main components: hyperactivity of the innate immune system; decreased production of type 1 Interferons (IFN) by SARS-CoV-2-infected cells, namely respiratory epithelial cells and macrophages; and decreased numbers of both CD4+ and particularly CD8+ T cells. Herein, we describe how excessive activation of the innate immune system and the need for viral replication in several cells of the infected organism promote significant alterations in cells' energy metabolism (glucose metabolism), which may underlie the poor prognosis of the disease in severe situations. When activated, cells of the innate immune system reprogram their metabolism, and increase glucose uptake to ensure secretion of pro-inflammatory cytokines. Changes in glucose metabolism are also observed in pulmonary epithelial cells, contributing to dysregulation of cytokine synthesis and inflammation of the pulmonary epithelium. Controlling hyperglycolysis in critically ill patients may help to reduce the exaggerated production of pro-inflammatory cytokines and optimise the actions of the adaptive immune system. In this review, we suggest that the administration of non-toxic concentrations of 2-deoxy-D-glucose, the use of GLUT 1 inhibitors, of antioxidants such as vitamin C in high doses, as well as the administration of N-acetylcysteine in high doses, may be useful complementary therapeutic strategies for these patients, as suggested by some clinical trials and/ or reports. Overall, understanding changes in the glycolytic pathway associated with COVID-19 infection can help to find new forms of treatment for this disease.

RevDate: 2021-09-27

Ferrante G, Mollicone D, Cazzato S, et al (2021)

COVID-19 Pandemic and Reduced Physical Activity: Is There an Impact on Healthy and Asthmatic Children?.

Frontiers in pediatrics, 9:695703.

Physical activity (PA) has been seen to improve asthma symptoms, lung function, and quality of life, as well as to reduce airway inflammation and bronchial responsiveness. As a consequence of the COVID-19 pandemic, the minimal amount of PA recommended by the World Health Organization-i.e., about 60 min/day of moderate-to-high intensity-is difficult to achieve for many children, particularly those living in urban areas. Short-term changes in PA because of the COVID-19 pandemic may become habitual, increasing the risk of adverse asthma outcomes in children. Indeed, prolonged home confinement during the COVID-19 pandemic reduces PA levels and increases sedentary behaviors, possibly impairing immune system function and increasing susceptibility to inflammatory diseases. However, there is limited evidence regarding the effects of lockdown due to COVID-19 on PA and sedentary behaviors in asthmatic children. Given that children stay longer indoors, indoor air pollution represents a major issue to consider during home confinement. This narrative review aims to summarize the available evidence about the impact of decreased PA and increased sedentary behaviors on children with asthma during the COVID-19 pandemic. In addition, strategies for supporting PA in children with asthma during the COVID-19 pandemic are suggested, also looking at the issue of indoor air quality.

RevDate: 2021-09-27

Asgharzadeh M, Mahdavipoor B, Asgharzadeh V, et al (2021)

Why the COVID-19 Is Not Significantly Reduced in Iran?.

Iranian journal of public health, 50(7):1303-1310.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was transported from China to Iran via passengers. The virus is transmitted through droplets from coughing, sneezing, talking and contact with infected surfaces. Due to high transmissibility in places such as clinics, medical offices, buses and offices where there are large crowds, it spread rapidly in Iran and caused the mortality of a significant number of people, especially the elderly with underlying disease. Preventing travel and gatherings, as well as applying house quarantine in Apr 2020, reduced COVID-19 somewhat but then due to lack of attention to social distancing, reducing the use of masks by the people and inappropriate decisions by the national committee on combating coronavirus (NCCC), including reducing the working hours of public offices and shops, reducing the staff of government offices, monopoly on the distribution of essential materials and supplies, the presence of overcrowding in clinics of medical centers, hospitals, and private clinics caused the decline of the disease in the country to decrease. Measures can be taken to prevent the spread of the virus as much as possible, including: rapid detection of infected people, their isolation, contact tracing, quarantine of people over 65 and under 15, protection of the elderly, prevention of gatherings, forcing the use of protective equipment in possible gatherings, and electronicizing public services.

RevDate: 2021-09-27

Rastogi A, Padhi A, Syed S, et al (2021)

Mapping the footprints of COVID-19 pandemic.

Journal of family medicine and primary care, 10(7):2467-2476.

The new member of the coronavirus family created havoc in the world in few days of its discovery and was declared as a pandemic by March 2020. The enveloped, single-stranded RNA virus was first identified in a patient with dry cough, pain, and weakness for the past1 week with unknown etiology in Wuhan. The coronavirus soon spread across the globe in the next few weeks. To curb the spread of coronavirus, stringent measures such as lockdown and social distancing were enforced resulted in a declining of cases in various countries. However, unlocking, relaxation of preventive measures, and changing human behaviors led to a drastic increase in the number of COVID-19 cases resulting in the second wave of transmission. This resulted in reimposing of lockdown measures in countries such as Nepal, Italy, France, Netherland, and Germany. At present, the virus has affected over 110.7 million peoples and over 2.4 million deaths across the world, with India having the second-highest number of COVID-19 cases, following the United States of America. Furthermore, a cross-sectional view of the disease states several new strains being reported across the globe at one end and at another end there is rolling out of vaccine against COVID-19. There is still uncertainty related to curbing of the pandemic as effect of vaccine on new strains is undetermined. Thus, it is important to understand the transforming epidemiology of the virus as it helps in planning necessary steps for physicians and policymakers. The present review summarizes the updated information primarily about the epidemiology of COVID-19, from initiation to the present scenario.

RevDate: 2021-09-27

Sharma A, Sharma RP, Kaur R, et al (2021)

A comprehensive insight on the COVID-19 vaccine candidates.

Journal of family medicine and primary care, 10(7):2457-2466.

The world is currently facing a pandemic triggered by the novel corona virus (SARS - CoV2), which causes a highly infectious infection that predominantly affects the lungs, resulting in a variety of clinical symptoms some cases may be asymptomatic while others may result in to severe respiratory disorder, if the infection is left unattended it may result in multi-organ failure and eventually death of the patient. The transmission of infection is by droplet and fomites of the infected person. The incubation period of virus is from 2 to 14 days. Most common symptoms resemble flu-like but later progress to pneumonia along with dyspnoea and worsening of oxygen saturation, thus requiring ventilator support. The diagnostic modalities include Reverse transcriptase real time PCR (Quantitative Reverse transcriptase polymerase chain reaction) which is recommended method used for diagnosis of the COVID-19 infection using oro-pharyngeal or nasopharyngeal swabs of the patients. Recently serological tests for antigen and antibody detection has been approved by ICMR. Till now, nine COVID-19 vaccines are granted emergency approval for prevention and for the management of infection symptomatic and supportive measures are being adopted. Globally major pharmaceutical firms are engrossed for development of a potent vaccine candidate. This review highlights on various vaccine candidates under clinical trials.

RevDate: 2021-09-27

Parihar S, Kaur RJ, S Singh (2021)

Flashback and lessons learnt from history of pandemics before COVID-19.

Journal of family medicine and primary care, 10(7):2441-2449.

With an increasing frequency of infectious disease outbreaks, the COVID-19 pandemic causing mortality around the world and the threat of similar future events looming large, mankind is faced with the herculean task of counteracting such threats with the best possible strategies and public health decisions. It is key that such decisions should be guided by previous examples of similar health emergencies. Here we review some of the significant infectious disease outbreaks, including epidemics and pandemics occurring worldwide in the past including their impact at population and global levels, unique challenges presented by each and the measures taken by authorities worldwide as well as the crucial lessons each epidemic or pandemic provided. This review highlights that throughout history measures such as contact tracing, quarantine and isolation have been incredibly effective in limiting an outbreak in its severity, thus ensuring accurate information flow to the public is as essential as limiting the spread of misinformation. With global populations rising, surveillance for emerging and re-emerging pathogens will play an immense role in preventing future epidemics or pandemics. And finally that even though for novel strains or pathogens, although vaccines are thought to be an irreplaceable defense, but their development and distribution in time to curb an epidemic has seldom been witnessed and remains an important challenge for the future. Hence, we conclude that looking at these past examples not only highlights the important knowledge gained for the strategies to devise, but also the mistakes that can be avoided in the way forward.

RevDate: 2021-09-27

Khan WH, Hashmi Z, Goel A, et al (2021)

COVID-19 Pandemic and Vaccines Update on Challenges and Resolutions.

Frontiers in cellular and infection microbiology, 11:690621.

The coronavirus disease (COVID-19) is caused by a positive-stranded RNA virus called severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), belonging to the Coronaviridae family. This virus originated in Wuhan City, China, and became the cause of a multiwave pandemic that has killed 3.46 million people worldwide as of May 22, 2021. The havoc intensified with the emergence of SARS-CoV-2 variants (B.1.1.7; Alpha, B.1.351; Beta, P.1; Gamma, B.1.617; Delta, B.1.617.2; Delta-plus, B.1.525; Eta, and B.1.429; Epsilon etc.) due to mutations generated during replication. More variants may emerge to cause additional pandemic waves. The most promising approach for combating viruses and their emerging variants lies in prophylactic vaccines. Several vaccine candidates are being developed using various platforms, including nucleic acids, live attenuated virus, inactivated virus, viral vectors, and protein-based subunit vaccines. In this unprecedented time, 12 vaccines against SARS-CoV-2 have been phased in following WHO approval, 184 are in the preclinical stage, and 100 are in the clinical development process. Many of them are directed to elicit neutralizing antibodies against the viral spike protein (S) to inhibit viral entry through the ACE-2 receptor of host cells. Inactivated vaccines, to the contrary, provide a wide range of viral antigens for immune activation. Being an intracellular pathogen, the cytotoxic CD8+ T Cell (CTL) response remains crucial for all viruses, including SARS-CoV-2, and needs to be explored in detail. In this review, we try to describe and compare approved vaccines against SARS-CoV-2 that are currently being distributed either after phase III clinical trials or for emergency use. We discuss immune responses induced by various candidate vaccine formulations; their benefits, potential limitations, and effectiveness against variants; future challenges, such as antibody-dependent enhancement (ADE); and vaccine safety issues and their possible resolutions. Most of the current vaccines developed against SARS-CoV-2 are showing either promising or compromised efficacy against new variants. Multiple antigen-based vaccines (multivariant vaccines) should be developed on different platforms to tackle future variants. Alternatively, recombinant BCG, containing SARS-CoV-2 multiple antigens, as a live attenuated vaccine should be explored for long-term protection. Irrespective of their efficacy, all vaccines are efficient in providing protection from disease severity. We must insist on vaccine compliance for all age groups and work on vaccine hesitancy globally to achieve herd immunity and, eventually, to curb this pandemic.

RevDate: 2021-09-27

Al-Kuraishy HM, Al-Gareeb AI, Faidah H, et al (2021)

Testosterone in COVID-19: An Adversary Bane or Comrade Boon.

Frontiers in cellular and infection microbiology, 11:666987.

COVID-19 is a pandemic disease caused by severe acute respiratory coronavirus 2 (SARS-CoV-2), which leads to pulmonary manifestations like acute lung injury (ALI) and acute respiratory distress syndrome (ARDS). In addition, COVID-19 may cause extra-pulmonary manifestation such as testicular injury. Both high and low levels of testosterone could affect the severity of COVID-19. Herein, there is substantial controversy regarding the potential role of testosterone in SARS-CoV-2 infection and COVID-19 severity. Therefore, the present study aimed to review and elucidate the assorted view of preponderance regarding the beneficial and harmful effects of testosterone in COVID-19. A related literature search in PubMed, Scopus, Web of Science, Google Scholar, and Science Direct was done. All published articles related to the role of testosterone and COVID-19 were included in this mini-review. The beneficial effects of testosterone in COVID-19 are through inhibition of pro-inflammatory cytokines, augmentation of anti-inflammatory cytokines, modulation of the immune response, attenuation of oxidative stress, and endothelial dysfunction. However, its harmful effects in COVID-19 are due to augmentation of transmembrane protease serine 2 (TMPRSS2), which is essential for cleaving and activating SARS-CoV-2 spike protein during acute SARS-CoV-2 infection. Most published studies illustrated that low testosterone levels are linked to COVID-19 severity. A low testosterone level in COVID-19 is mainly due to testicular injury, the primary source of testosterone.

RevDate: 2021-09-27

Lyu M, Fan G, Xiao G, et al (2021)

Traditional Chinese medicine in COVID-19.

Acta pharmaceutica Sinica. B pii:S2211-3835(21)00350-6 [Epub ahead of print].

COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread across the globe, posing an enormous threat to public health and safety. Traditional Chinese medicine (TCM), in combination with Western medicine (WM), has made important and lasting contributions in the battle against COVID-19. In this review, updated clinical effects and potential mechanisms of TCM, presented in newly recognized three distinct phases of the disease, are summarized and discussed. By integrating the available clinical and preclinical evidence, the efficacies and underlying mechanisms of TCM on COVID-19, including the highly recommended three Chinese patent medicines and three Chinese medicine formulas, are described in a panorama. We hope that this comprehensive review not only provides a reference for health care professionals and the public to recognize the significant contributions of TCM for COVID-19, but also serves as an evidence-based in-depth summary and analysis to facilitate understanding the true scientific value of TCM.

RevDate: 2021-09-27

Khurshid H, Qureshi IA, Jahan N, et al (2021)

A Systematic Review of Fibromyalgia and Recent Advancements in Treatment: Is Medicinal Cannabis a New Hope?.

Cureus, 13(8):e17332.

Fibromyalgia syndrome (FMS) is a pain disorder characterized by chronic widespread pain, fatigue, and sleep disturbance, in the absence of any well-defined underlying organic disease. The exact pathophysiology and the mechanism which links different factors related to the disease is still unknown. Due to unknown precise pathogenesis, the coexistence of other diseases, and overlapping clinical features, FMS diagnosis may be laborious. Various treatment strategies are used, only a few Food and Drug Administration (FDA) approved, still we are facing challenges regarding effective treatment. Recently, medicinal cannabis has proven to be effective in chronic pain conditions such as osteoarthritis, neuropathic pain, and other non-cancer chronic pain. However, further research is needed about how the cannabinoid system works with the pain pathway. Using the fact that medicinal cannabis is effective in the treatment of chronic pain and certain rheumatic diseases, in this review, we aim to analyze the role of the cannabinoid system in fibromyalgia syndrome. We followed Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines in searching PubMed, MEDLINE (through PubMed), PubMed Central, and Google Scholar using keywords "fibromyalgia, chronic pain, cannabis, cannabinoids, pharmacotherapy, alternative therapy" and Medical Subject Heading (MeSH) words. After applying inclusion/exclusion criteria and checking for the quality assessment, 22 articles were retrieved and used for the analysis of the role of cannabis in the treatment of fibromyalgia. The two main compounds of cannabis with analgesic and anti-inflammatory properties are cannabidiol (CBD) and delta-9-tetrahydrocannabinol (THC), and their ratio determines the effect on various symptoms of FMS. We included studies regarding the use of cannabinoids in the treatment of fibromyalgia, investigating the use of nabilone, dronabinol (a synthetic analog of THC), Bedrocan (22.4 mg THC, <1 mg CBD), Bediol (13.4 mg THC, 17.8 mg CBD), and Bedrolite (18.4 mg CBD, <1 mg THC). In the era of the coronavirus disease 2019 (COVID-19) pandemic and opioid crisis, many adverse outcomes are observed in the patients suffering from FMS due to lack of any definitive treatment and promising outcomes from the known treatment options, which led to the need for effective and safer treatment alternatives. Although the studies reviewed in this article suggest that medical cannabis is a safe and effective treatment for fibromyalgia pain, several limitations regarding dosage, length of treatment, adverse effects, long-term follow-up, and dependence needs further investigation.

RevDate: 2021-09-27

Manjunath SH, RK Thimmulappa (2021)

Antiviral, immunomodulatory, and anticoagulant effects of quercetin and its derivatives: Potential role in prevention and management of COVID-19.

Journal of pharmaceutical analysis pii:S2095-1779(21)00110-6 [Epub ahead of print].

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has caused a devastating health crisis worldwide. In this review, we have discussed that prophylactic phytochemical quercetin supplementation in the form of foods or nutraceuticals may help manage the COVID-19 pandemic. The following evidence supports our argument: first, nuclear factor erythroid-derived 2-like 2 (NRF2) agonists abrogated replication of SARS-CoV-2 in lung cells, and quercetin is a potent NRF2 agonist; second, quercetin exerts antiviral activity against several zoonotic coronaviruses, including SARS-CoV-2, mainly by inhibiting the entry of virions into host cells; third, inflammatory pathways activated by nuclear factor kappa B (NF-κB), inflammasome, and interleukin-6 (IL-6) signals elicit cytokine release syndrome that promotes acute respiratory distress syndrome in patients with COVID-19, and quercetin inhibits these pro-inflammatory signals; fourth, patients with COVID-19 develop thrombosis, and quercetin mitigates coagulation abnormalities by inhibiting plasma protein disulfide isomerase. This review provides a strong rationale for testing quercetin for the management of COVID-19.

RevDate: 2021-09-27

Zhang LS, Yu Y, Yu H, et al (2021)

Therapeutic prospects of mesenchymal stem/stromal cells in COVID-19 associated pulmonary diseases: From bench to bedside.

World journal of stem cells, 13(8):1058-1071.

The ongoing outbreak of coronavirus disease 2019 (COVID-19) caused by the novel severe acute respiratory syndrome coronavirus 2 has become a sudden public emergency of international concern and seriously threatens millions of people's life health. Two current studies have indicated a favorable role for mesenchymal stem/stromal cells (MSCs) in clinical remission of COVID-19 associated pulmonary diseases, yet the systematical elaboration of the therapeutics and underlying mechanism is far from satisfaction. In the present review, we summarize the therapeutic potential of MSCs in COVID-19 associated pulmonary diseases such as pneumonia induced acute lung injury, acute respiratory distress syndrome, and pulmonary fibrosis. Furthermore, we review the underlying mechanism of MSCs including direct- and trans-differentiation, autocrine and paracrine anti-inflammatory effects, homing, and neovascularization, as well as constitutive microenvironment. Finally, we discuss the prospects and supervision of MSC-based cytotherapy for COVID-19 management before large-scale application in clinical practice. Collectively, this review supplies overwhelming new references for understanding the landscapes of MSCs in the remission of COVID-19 associated pulmonary diseases.

RevDate: 2021-09-27

Oluwasola TAO, OO Bello (2021)

COVID-19 and its implications for obstetrics and gynecology practice in Africa.

The Pan African medical journal, 38:15 pii:PAMJ-38-15.

Having to cope with corona virus disease 2019 (COVID-19) is likely to create imbalances in health care provision in the obstetrics and gynecology practices in Africa where most countries still battle with high rate of maternal morbidities and mortalities as well as poor or inadequate quality gynecological care. COVID-19 has spread to the continents of the world including all African nations since it was first reported in Wuhan, China in December 2019. Its impact and implications on the obstetrics and gynecology practice in Africa are yet to be fully explored. Routine essential services are being disrupted; therefore, giving rise to the need to redeploy the already limited health personnel across health services in Africa. This is an attempt to discuss the potential implications for obstetrics and gynecologic practice in Africa.

RevDate: 2021-09-27

Prajapati S, S Kaur (2021)

Safety Recommendations for Forensic Laboratory Staff During COVID-19 Pandemic.

Academic forensic pathology, 11(2):94-102.

In the 21st century, the crime rate and viral infectious diseases are on peak and seems to be the real enemies of humanity. Forensic science and its various branches especially biology have a key role in modern-day justice. Forensic scientists and laboratory staffs are of great significance for elucidating the biological exhibits and generating the biological evidence which are required for criminal justice. Owing to the profession and like other medical health workers, forensic laboratory staffs are also at a greater risk in the era of COVID-19. Therefore, the safety of forensic laboratory staff is of utmost importance during this pandemic. The article emphasizes on the safety guidelines and regulations that need to be adopted by the forensic staff in connection with daily laboratory practices. Thus, the article may offer a reference or help one to implement COVID-19 advisory to forensic scientists and other laboratory staff working in forensic institutions and laboratories during the current pandemic.

RevDate: 2021-09-27

Cihakova D, Streiff MB, Menez SP, et al (2021)

High-value laboratory testing for hospitalized COVID-19 patients: a review.

Future virology.

We present here an evidence-based review of the utility, timing, and indications for laboratory test use in the domains of inflammation, cardiology, hematology, nephrology and co-infection for clinicians managing the care of hospitalized COVID-19 patients. Levels of IL-6, CRP, absolute lymphocyte count, neutrophils and neutrophil-to-lymphocyte ratio obtained upon admission may help predict the severity of COVID-19. Elevated LDH, ferritin, AST, and d-dimer are associated with severe illness and mortality. Elevated cardiac troponin at hospital admission can alert clinicians to patients at risk for cardiac complications. Elevated proBNP may help distinguish a cardiac complication from noncardiac etiologies. Evaluation for co-infection is typically unnecessary in nonsevere cases but is essential in severe COVID-19, intensive care unit patients, and immunocompromised patients.

RevDate: 2021-09-27

Julsrigival J, Sirisa-Ard P, Julsrigival S, et al (2021)

Antiviral medicinal plants found in Lanna traditional medicine.

Chinese herbal medicines pii:S1674-6384(21)00101-5 [Epub ahead of print].

Traditional medicine uses a multitude of plants to create medicinal formulations, some of which show antiviral properties that may be of benefit in treating emerging viral diseases, including Covid-19. Lanna, an ancient Kingdom in northern Thailand, with a thriving culture that continues to this day and has a rich history of traditional medicine using local plants that is still practiced today. To find potential antiviral medicinal candidates, we examined ancient manuscripts, interviewed traditional healers practicing today, and inventoried current traditional medicines to catalogue 1400 medicinal formulations used in Lanna traditional medicine. We then narrowed this list to find those traditionally used to treat diseases that in their original use and descriptions most likely map to those we know today to be viral diseases. We identified the plants used in these formulations to create a list of 64 potential antiviral herbal candidates drawn from this ancient Lanna wisdom and matched these to the scientific literature to see which of these plants had already been shown to possess antiviral properties, generating a list of 64 potential antiviral medicinal candidates from Lanna traditional medicine worth further investigation for treating emerging viral diseases.

RevDate: 2021-09-27

Boni C, Cavazzini D, Bolchi A, et al (2021)

Degenerate CD8 Epitopes Mapping to Structurally Constrained Regions of the Spike Protein: A T Cell-Based Way-Out From the SARS-CoV-2 Variants Storm.

Frontiers in immunology, 12:730051.

There is an urgent need for new generation anti-SARS-Cov-2 vaccines in order to increase the efficacy of immunization and its broadness of protection against viral variants that are continuously arising and spreading. The effect of variants on protective immunity afforded by vaccination has been mostly analyzed with regard to B cell responses. This analysis revealed variable levels of cross-neutralization capacity for presently available SARS-Cov-2 vaccines. Despite the dampened immune responses documented for some SARS-Cov-2 mutations, available vaccines appear to maintain an overall satisfactory protective activity against most variants of concern (VoC). This may be attributed, at least in part, to cell-mediated immunity. Indeed, the widely multi-specific nature of CD8 T cell responses should allow to avoid VoC-mediated viral escape, because mutational inactivation of a given CD8 T cell epitope is expected to be compensated by the persistent responses directed against unchanged co-existing CD8 epitopes. This is particularly relevant because some immunodominant CD8 T cell epitopes are located within highly conserved SARS-Cov-2 regions that cannot mutate without impairing SARS-Cov-2 functionality. Importantly, some of these conserved epitopes are degenerate, meaning that they are able to associate with different HLA class I molecules and to be simultaneously presented to CD8 T cell populations of different HLA restriction. Based on these concepts, vaccination strategies aimed at potentiating the stimulatory effect on SARS-Cov-2-specific CD8 T cells should greatly enhance the efficacy of immunization against SARS-Cov-2 variants. Our review recollects, discusses and puts into a translational perspective all available experimental data supporting these "hot" concepts, with special emphasis on the structural constraints that limit SARS-CoV-2 S-protein evolution and on potentially invariant and degenerate CD8 epitopes that lend themselves as excellent candidates for the rational development of next-generation, CD8 T-cell response-reinforced, COVID-19 vaccines.

RevDate: 2021-09-27

Chen Z (2021)

Sharing Employee: B2B Employment Model in the Era of Coronavirus Disease 2019 and Implication for Human Resource Management.

Frontiers in psychology, 12:714704.

With the explosion of coronavirus disease 2019 (COVID-19), the concept of "Sharing Employees" has emerged in China. This study will discuss the background of the formation of the "Sharing Employees," how the "Sharing Employees" model is implemented, the relative risks, and the impact on human resource management. Currently, this virus is spreading worldwide, affecting the economy and increasing the unemployment rate. This study will help other countries to learn from this model and provide suggestions for adopting flexible employment policies to ease employment pressure and increase employment channels through the "Sharing Employees" B2B model.

RevDate: 2021-09-27

Bottemanne H, Delaigue F, C Lemogne (2021)

SARS-CoV-2 Psychiatric Sequelae: An Urgent Need of Prevention.

Frontiers in psychiatry, 12:738696.

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), responsible for COVID-19 pandemic, caused catastrophic health and social effects, but little is known about its consequences on mental health. Other viral infections have been associated with psychiatric sequelae: infection-triggered disturbing of the immune system and the stressful intensive unit care can cause psychological and psychiatric complications. Moreover, SARS-CoV-2 can potentially induce neuronal injuries, leading to neurocognitive disabilities. Previous studies during the COVID-19 pandemic reported a high occurrence rate of psychopathological and neurocognitive conditions among COVID-19 survivors, highlighting the need for screening for these impairments in order to implement early interventions and secondary prevention. However, many psychiatric disorders can take several years to develop, and it is still difficult to differentiate between factors linked to the infection itself or to the global context of the pandemic. In this review, we describe the effects of SARS-CoV-2 infection on mental health, the mechanisms involved in psychiatric and neurocognitive sequelae, and the strategies of prevention and management. More studies are needed to investigate the effects of a range of factors including clinical, sociodemographic, and inflammatory predictors. These efforts could be useful to identify high-risk individuals and inform targeted preventive actions.

RevDate: 2021-09-27

Büttiker P, Weissenberger S, Stefano GB, et al (2021)

SARS-CoV-2, Trait Anxiety, and the Microbiome.

Frontiers in psychiatry, 12:720082.

During the COVID-19 pandemic, research on the relationships between the virus and its human host has become fundamental to understand this pathology and its effects. Attaining this profound understanding is critical for the effective containment and treatment of infections caused by the virus. In this review, we present some possible mechanisms by which psychopathological symptoms emerge following viral infections of the central nervous system (CNS). These proposed mechanisms are based on microbial communication and the induced priming of microglial antibody activation within the CNS through Toll-like receptor signaling. In this process, chronic microglial activation causes increased glutamate release in virally-altered, high-density neuronal structures, thereby modulating cognitive networks and information integration processes. This modulation, in turn, we suggest, affects the accuracy of sensory integration and connectivity of major control networks, such as the default mode network. The chronic activation of immunological responses and neurochemical shifts toward an elevated glutamate/gamma-aminobutyric acid ratio lead to negative reinforcement learning and suboptimal organismic functioning, for example, maintaining the body in an anxious state, which can later become internalized as trait anxiety. Therefore, we hypothesize that the homeostatic relationship between host, microbiome, and virome, would be decisive in determining the efficiency of subsequent immunological responses, disease susceptibility, and long-term psychopathological effects of diseases that impact the CNS, such as the COVID-19.

RevDate: 2021-09-27

Mui L, Martin CM, Tschirhart BJ, et al (2021)

Therapeutic Potential of Annexins in Sepsis and COVID-19.

Frontiers in pharmacology, 12:735472 pii:735472.

Sepsis is a continuing problem in modern healthcare, with a relatively high prevalence, and a significant mortality rate worldwide. Currently, no specific anti-sepsis treatment exists despite decades of research on developing potential therapies. Annexins are molecules that show efficacy in preclinical models of sepsis but have not been investigated as a potential therapy in patients with sepsis. Human annexins play important roles in cell membrane dynamics, as well as mediation of systemic effects. Most notably, annexins are highly involved in anti-inflammatory processes, adaptive immunity, modulation of coagulation and fibrinolysis, as well as protective shielding of cells from phagocytosis. These discoveries led to the development of analogous peptides which mimic their physiological function, and investigation into the potential of using the annexins and their analogous peptides as therapeutic agents in conditions where inflammation and coagulation play a large role in the pathophysiology. In numerous studies, treatment with recombinant human annexins and annexin analogue peptides have consistently found positive outcomes in animal models of sepsis, myocardial infarction, and ischemia reperfusion injury. Annexins A1 and A5 improve organ function and reduce mortality in animal sepsis models, inhibit inflammatory processes, reduce inflammatory mediator release, and protect against ischemic injury. The mechanisms of action and demonstrated efficacy of annexins in animal models support development of annexins and their analogues for the treatment of sepsis. The effects of annexin A5 on inflammation and platelet activation may be particularly beneficial in disease caused by SARS-CoV-2 infection. Safety and efficacy of recombinant human annexin A5 are currently being studied in clinical trials in sepsis and severe COVID-19 patients.

RevDate: 2021-09-27

Roviello V, Gilhen-Baker M, Vicidomini C, et al (2021)

Forest-bathing and physical activity as weapons against COVID-19: a review.

Environmental chemistry letters pii:1321 [Epub ahead of print].

Strengthening the immune system in order to better withstand the threat of COVID-19 is an important way to ensure the protection of our health against the current pandemic associated with SARS-CoV-2. There are many ways to achieve this, but with current circumstances, certain modalities stand out as being the most valid and are certainly worth greater consideration. Here we review the effects that particular immuno-strengthening activities can have on limiting the severity of COVID-19 disease as well as preventing virus infection. Physical activity, in particular, should not be discounted as an important method of prevention of viral diseases as it triggers many biological processes within the human body which in turn lead to heightened natural defences against viral infections. When exercise is performed in forested areas, these protective health benefits may be increased since many plant species emit biogenic volatile compounds (VOCs) which, when inhaled, have many protective properties. These VOCs have been shown in particular to have immunostimulatory effects on the human body and, thus, they could be of use in the prevention and/or treatment of COVID-19. Being amongst trees may also help to alleviate stress and anxiety, lowering cortisol levels and consequently helping the proper functioning of the immune system. In the following work, we have performed an analysis of the available scientific literature which looks at the effects of physical exercise as well as 'forest-bathing' on the immune system's ability to fight disease, especially of course as it relates to COVID-19. Our review aims at shedding light on the benefits of exercising outdoors in green areas and suggests reforestation as a protective measure against future outbreaks.

RevDate: 2021-09-27

Lozar T, Nagvekar R, Rohrer C, et al (2021)

Cervical Cancer Screening Postpandemic: Self-Sampling Opportunities to Accelerate the Elimination of Cervical Cancer.

International journal of women's health, 13:841-859 pii:288376.

The persisting burden of cervical cancer in underserved populations and low-resource regions worldwide, worsened by the onset of the COVID-19 pandemic, requires proactive strategies and expanded screening options to maintain and improve screening coverage and its effects on incidence and mortality from cervical cancer. Self-sampling as a screening strategy has unique advantages from both a public health and individual patient perspective. Some of the barriers to screening can be mitigated by self-sampling, and resources can be better allocated to patients at the highest risk of developing cervical cancer. This review summarizes the implementation options for self-sampling and associated challenges, evidence in support of self-sampling, the available devices, and opportunities for expansion beyond human papillomavirus testing.

RevDate: 2021-09-27

Chahar S, PK Roy (2021)

COVID-19: A Comprehensive Review of Learning Models.

Archives of computational methods in engineering : state of the art reviews pii:9641 [Epub ahead of print].

Coronavirus disease is communicable and inhibits the infected person's immune system. It belongs to the Coronaviridae family and has affected 213 nations and territories so far. Many kinds of studies are being carried out to filter advice and provide oversight to monitor this outbreak. A comparative and brief review was carried out in this paper on research concerning the early identification of symptoms, estimation of the end of the pandemic, and examination of user-generated conversations. Chest X-ray images, abdominal computed tomography scan, tweets shared on social media are several of the datasets used by researchers. Using machine learning and deep learning methods such as K-means clustering, Random Forest, Convolutional Neural Network, Long Short-Term Memory, Auto-Encoder, and Regression approaches, the above-mentioned datasets are processed. The studies on COVID-19 with machine learning and deep learning models with their results and limitations are outlined in this article. The challenges with open future research directions are discussed at the end.

RevDate: 2021-09-27

Elsaid AM, Mohamed HA, Abdelaziz GB, et al (2021)

A critical review of heating, ventilation, and air conditioning (HVAC) systems within the context of a global SARS-CoV-2 epidemic.

Process safety and environmental protection : transactions of the Institution of Chemical Engineers, Part B pii:S0957-5820(21)00487-0 [Epub ahead of print].

The Coronavirus disease (COVID-19) has spread over the world, resulting in more than 225 million patients, and 4.7 million deaths in September 2021. It also caused panic and terror, halted numerous activities, and resulted in the world economy deteriorates. It altered human behavior and compelled people to alter their lifestyles to avoid infection. Air conditioning systems are one of the most important sectors that must be considered because of the pandemic SARS-CoV-2 all over the world. Air is used as a heat transfer medium in heating, ventilation, and air conditioning (HVAC) systems. The air contains a variety of pollutants, viruses, and bacteria, all of which have an impact on and destroy human life. Significantly in summer, people spend more time in air conditioners which results in lower levels of vitamin D and melatonin which may affect the functioning of their immune system and are susceptible to receiving SARS-CoV-2 from other individuals. As an important component of air conditioning and ventilation systems, the air filter plays a significant role. As a result, researchers must work harder to improve its design to prevent the ultra-small particles loaded with COVID-19. This paper contributes to the design of existing HVAC systems in terms of their suitability and impact on the spread of the hybrid SARS-CoV-2 epidemic, as well as efforts to obtain a highly efficient air filter to remove super-sized particles for protection against epidemic infection. In addition, important guideline recommendations have been extracted to limit the spread of the SARS-CoV-2 throughout the world and to get the highest quality indoor air in air-conditioned places.

RevDate: 2021-09-27

Santos RPD, Lordani TVA, Peres LAB, et al (2021)

[Occurrence of acute kidney injury in adult patients hospitalized with COVID-19: A systematic review and meta-analysis].

Nefrologia : publicacion oficial de la Sociedad Espanola Nefrologia pii:S0211-6995(21)00199-5 [Epub ahead of print].

BACKGROUND AND AIM: The knowledge about the acute kidney injury (AKI) incidence in patients with coronavirus disease 2019 (COVID-19) can help health teams to carry out a targeted care plan. This study aimed to determine the AKI incidence in patients hospitalized with COVID-19.

METHODS: The electronic search covered research published until June 20, 2020, and included five databases, PubMed, Embase, Web of Science, Scopus, and Lilacs (Latin American and Caribbean Health Sciences Library). Eligible studies were those including data from AKI occurrence in adult patients hospitalized with COVID-19. The primary outcome was AKI incidence, and the secondary outcome assessed was the AKI mortality. Additionally, the estimated incidence of renal replacement therapy (RRT) need also was verified. Using a standardized form prepared in Microsoft Excel, data were extracted by two independents authors, regarding the description of studies, characteristics of patients and clinical data on the AKI occurrence.

RESULTS: We included 30 studies in this systematic review, of which 28 were included in the meta-analysis. Data were assessed from 18,043 adult patients with COVID-19. The AKI estimate incidence overall and at the ICU was 9.2% (4.6 - 13.9) and 32.6% (8.5 - 56.6), respectively. AKI estimate incidence in the elderly patients and those with acute respiratory disease syndrome was 22.9% (-4.0 - 49.7) and 4.3% (1.8 - 6.8), respectively. Patients with secondary infection, AKI estimate incidence was 31.6% (12.3 - 51.0). The estimate incidence of patients that required RRT was 3.2% (1.1 - 5.4) and estimate AKI mortality was 50.4% (17.0 - 83.9).

CONCLUSION: The occurrence of AKI is frequent among adult patients hospitalized with COVID-19, and affects on average, up to 13.9% of these patients. It is believed that AKI occurs early and in parallel with lung injury.

RevDate: 2021-09-27

Barone G, Levaltier V, Capaldi A, et al (2021)

[Evaluation of professional practice in the context of Covid-19].

Revue de l'infirmiere, 70(274):40-41.

An evaluation of professional practices was carried out in a cancer centre in the wake of the management of the health crisis linked to the severe acute respiratory syndrome coronavirus 2 pandemic. Hospital teams questioned the relevance of the measures adopted, internally and during home care, to manage suspected or confirmed Covid-19 patients and prevent contagion for all.

RevDate: 2021-09-27

Begemann M, Gross O, Wincewicz D, et al (2021)

Addressing the 'hypoxia paradox' in severe COVID-19: literature review and report of four cases treated with erythropoietin analogues.

Molecular medicine (Cambridge, Mass.), 27(1):120.

BACKGROUND: Since fall 2019, SARS-CoV-2 spread world-wide, causing a major pandemic with estimated ~ 220 million subjects affected as of September 2021. Severe COVID-19 is associated with multiple organ failure, particularly of lung and kidney, but also grave neuropsychiatric manifestations. Overall mortality reaches > 2%. Vaccine development has thrived in thus far unreached dimensions and will be one prerequisite to terminate the pandemic. Despite intensive research, however, few treatment options for modifying COVID-19 course/outcome have emerged since the pandemic outbreak. Additionally, the substantial threat of serious downstream sequelae, called 'long COVID' and 'neuroCOVID', becomes increasingly evident. Among candidates that were suggested but did not yet receive appropriate funding for clinical trials is recombinant human erythropoietin. Based on accumulating experimental and clinical evidence, erythropoietin is expected to (1) improve respiration/organ function, (2) counteract overshooting inflammation, (3) act sustainably neuroprotective/neuroregenerative. Recent counterintuitive findings of decreased serum erythropoietin levels in severe COVID-19 not only support a relative deficiency of erythropoietin in this condition, which can be therapeutically addressed, but also made us coin the term 'hypoxia paradox'. As we review here, this paradox is likely due to uncoupling of physiological hypoxia signaling circuits, mediated by detrimental gene products of SARS-CoV-2 or unfavorable host responses, including microRNAs or dysfunctional mitochondria. Substitution of erythropoietin might overcome this 'hypoxia paradox' caused by deranged signaling and improve survival/functional status of COVID-19 patients and their long-term outcome. As supporting hints, embedded in this review, we present 4 male patients with severe COVID-19 and unfavorable prognosis, including predicted high lethality, who all profoundly improved upon treatment which included erythropoietin analogues.

SHORT CONCLUSION: Substitution of EPO may-among other beneficial EPO effects in severe COVID-19-circumvent downstream consequences of the 'hypoxia paradox'. A double-blind, placebo-controlled, randomized clinical trial for proof-of-concept is warranted.

RevDate: 2021-09-27

Sorokin II, Vassilenko KS, Terenin IM, et al (2021)

Non-Canonical Translation Initiation Mechanisms Employed by Eukaryotic Viral mRNAs.

Biochemistry. Biokhimiia, 86(9):1060-1094.

Viruses exploit the translation machinery of an infected cell to synthesize their proteins. Therefore, viral mRNAs have to compete for ribosomes and translation factors with cellular mRNAs. To succeed, eukaryotic viruses adopt multiple strategies. One is to circumvent the need for m7G-cap through alternative instruments for ribosome recruitment. These include internal ribosome entry sites (IRESs), which make translation independent of the free 5' end, or cap-independent translational enhancers (CITEs), which promote initiation at the uncapped 5' end, even if located in 3' untranslated regions (3' UTRs). Even if a virus uses the canonical cap-dependent ribosome recruitment, it can still perturb conventional ribosomal scanning and start codon selection. The pressure for genome compression often gives rise to internal and overlapping open reading frames. Their translation is initiated through specific mechanisms, such as leaky scanning, 43S sliding, shunting, or coupled termination-reinitiation. Deviations from the canonical initiation reduce the dependence of viral mRNAs on translation initiation factors, thereby providing resistance to antiviral mechanisms and cellular stress responses. Moreover, viruses can gain advantage in a competition for the translational machinery by inactivating individual translational factors and/or replacing them with viral counterparts. Certain viruses even create specialized intracellular "translation factories", which spatially isolate the sites of their protein synthesis from cellular antiviral systems, and increase availability of translational components. However, these virus-specific mechanisms may become the Achilles' heel of a viral life cycle. Thus, better understanding of the unconventional mechanisms of viral mRNA translation initiation provides valuable insight for developing new approaches to antiviral therapy.

RevDate: 2021-09-26

Beltrami M, Bartolini S, Milli M, et al (2021)

The relevance of specific heart failure outpatient programs in the COVID era: an appropriate model for every disease.

Reviews in cardiovascular medicine, 22(3):677-690.

Heart Failure (HF) is characterized by an elevated readmission rate, with almost 50% of events occurring after the first episode over the first 6 months of the post-discharge period. In this context, the vulnerable phase represents the period when patients elapse from a sub-acute to a more stabilized chronic phase. The lack of an accurate approach for each HF subtype is probably the main cause of the inconclusive data in reducing the trend of recurrent hospitalizations. Most care programs are based on the main diagnosis and the HF stages, but a model focused on the specific HF etiology is lacking. The HF clinic route based on the HF etiology and the underlying diseases responsible for HF could become an interesting approach, compared with the traditional programs, mainly based on non-specific HF subtypes and New York Heart Association class, rather than on detailed etiologic and epidemiological data. This type of care may reduce the 30-day readmission rates for HF, increase the use of evidence-based therapies, prevent the exacerbation of each comorbidity, improve patient compliance, and decrease the use of resources. For all these reasons, we propose a dedicated outpatient HF program with a daily practice scenario that could improve the early identification of symptom progression and the quality-of-life evaluation, facilitate the access to diagnostic and laboratory tools and improve the utilization of financial resources, together with optimal medical titration and management.

RevDate: 2021-09-26

Jakobsson J, Cotgreave I, Furberg M, et al (2021)

Potential Physiological and Cellular Mechanisms of Exercise That Decrease the Risk of Severe Complications and Mortality Following SARS-CoV-2 Infection.

Sports (Basel, Switzerland), 9(9): pii:sports9090121.

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has unmasked mankind's vulnerability to biological threats. Although higher age is a major risk factor for disease severity in COVID-19, several predisposing risk factors for mortality are related to low cardiorespiratory and metabolic fitness, including obesity, cardiovascular disease, diabetes, and hypertension. Reaching physical activity (PA) guideline goals contribute to protect against numerous immune and inflammatory disorders, in addition to multi-morbidities and mortality. Elevated levels of cardiorespiratory fitness, being non-obese, and regular PA improves immunological function, mitigating sustained low-grade systemic inflammation and age-related deterioration of the immune system, or immunosenescence. Regular PA and being non-obese also improve the antibody response to vaccination. In this review, we highlight potential physiological, cellular, and molecular mechanisms that are affected by regular PA, increase the host antiviral defense, and may determine the course and outcome of COVID-19. Not only are the immune system and regular PA in relation to COVID-19 discussed, but also the cardiovascular, respiratory, renal, and hormonal systems, as well as skeletal muscle, epigenetics, and mitochondrial function.

RevDate: 2021-09-26

Plowman T, D Lagos (2021)

Non-Coding RNAs in COVID-19: Emerging Insights and Current Questions.

Non-coding RNA, 7(3): pii:ncrna7030054.

The highly infectious severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged as the causative agent of coronavirus disease 2019 (COVID-19) in late 2019, igniting an unprecedented pandemic. A mechanistic picture characterising the acute immunopathological disease in severe COVID-19 is developing. Non-coding RNAs (ncRNAs) constitute the transcribed but un-translated portion of the genome and, until recent decades, have been undiscovered or overlooked. A growing body of research continues to demonstrate their interconnected involvement in the immune response to SARS-CoV-2 and COVID-19 development by regulating several of its pathological hallmarks: cytokine storm syndrome, haemostatic alterations, immune cell recruitment, and vascular dysregulation. There is also keen interest in exploring the possibility of host-virus RNA-RNA and RNA-RBP interactions. Here, we discuss and evaluate evidence demonstrating the involvement of short and long ncRNAs in COVID-19 and use this information to propose hypotheses for future mechanistic and clinical studies.

RevDate: 2021-09-26

Guarnera A, Santini E, P Podda (2021)

Idiopathic Interstitial Pneumonias and COVID-19 Pneumonia: Review of the Main Radiological Features and Differential Diagnosis.

Tomography (Ann Arbor, Mich.), 7(3):397-411 pii:tomography7030035.

COVID-19 pneumonia represents a challenging health emergency, due to the disproportion between the high transmissibility, morbidity, and mortality of the virus and healthcare systems possibilities. Literature has mainly focused on COVID-19 pneumonia clinical-radiological diagnosis and therapy, and on the most common differential diagnoses, while few papers investigated rare COVID-19 pneumonia differential diagnoses or the overlapping of COVID-19 pneumonia on pre-existing lung pathologies. This article presents the main radiological characteristics of COVID-19 pneumonia and Idiopathic Interstitial Pneumonias (IIPs) to identify key radiological features for a differential diagnosis among IIPs, and between IIPs and COVID-19 pneumonia. COVID-19 pneumonia differential diagnosis with IIPs is challenging, since these entities may share common radiological findings as ground glass opacities, crazy paving patterns, and consolidations. Multidisciplinary discussion is crucial to reach a final and correct diagnosis. Radiologists have a pivotal role in identifying COVID-19 pneumonia patterns, reporting possible overlapping with long-lasting lung diseases, and suggesting potential differential diagnoses. An optimal evaluation of HRTC may help in containing the disease, in promoting better treatment for patients, and in providing an efficient allocation of human and economic resources.

RevDate: 2021-09-26

Plavec Z, Pöhner I, Poso A, et al (2021)

Virus structure and structure-based antivirals.

Current opinion in virology, 51:16-24 pii:S1879-6257(21)00103-6 [Epub ahead of print].

Structure-based antiviral developments in the past two years have been dominated by the structure determination and inhibition of SARS-CoV-2 proteins and new lead molecules for picornaviruses. The SARS-CoV-2 spike protein has been targeted successfully with antibodies, nanobodies, and receptor protein mimics effectively blocking receptor binding or fusion. The two most promising non-structural proteins sharing strong structural and functional conservation across virus families are the main protease and the RNA-dependent RNA polymerase, for which design and reuse of broad range inhibitors already approved for use has been an attractive avenue. For picornaviruses, the increasing recognition of the transient expansion of the capsid as a critical transition towards RNA release has been targeted through a newly identified, apparently widely conserved, druggable, interprotomer pocket preventing viral entry. We summarize some of the key papers in these areas and ponder the practical uses and contributions of molecular modeling alongside empirical structure determination.

RevDate: 2021-09-26

Yakhchali M, Taghipour Z, Mirabzadeh Ardakani M, et al (2021)

Cinnamon and its possible impact on COVID-19: The viewpoint of traditional and conventional medicine.

Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie, 143:112221 pii:S0753-3322(21)01005-2 [Epub ahead of print].

The COVID-19 global epidemic caused by coronavirus has affected the health and other aspects of life for more than one year. Despite the current pharmacotherapies, there is still no specific treatment, and studies are in progress to find a proper therapy with high efficacy and low side effects. In this way, Traditional Persian Medicine (TPM), due to its holistic view, can provide recommendations for the prevention and treatment of new diseases such as COVID-19. The muco-obstruction of the airway, which occurs in SARS-CoV-2, has similar features in TPM textbooks that can lead us to new treatment approaches. Based on TPM and pharmacological studies, Cinnamomum verum (Darchini)'s potential effective functions can contribute to SARS-CoV-2 infection treatment and has been known to be effective in corona disease in Public beliefs. From the viewpoint of TPM theories, Cinnamon can be effective in SARS-CoV-2 improvement and treatment through its anti-obstructive, diuretic, tonic and antidote effects. In addition, there is pharmacological evidence on anti-viral, anti-inflammatory, antioxidant, organ-o-protective and anti-depression effects of Cinnamon that are in line with the therapeutic functions mentioned in TPM.Overall, Cinnamon and its ingredients can be recommended for SARS-CoV2 management due to multi-targeting therapies. This review provides basic information for future studies on this drug's effectiveness in preventing and treating COVID-19 and similar diseases.

RevDate: 2021-09-26

Yang M, Wang Q, Song Y, et al (2021)

A critical assessment of the potential vertical transmission hypotheses: Implications for research on the early-life infection with COVID-19.

Placenta, 115:78-86 pii:S0143-4004(21)00584-1 [Epub ahead of print].

The risk of potential vertical transmission in SARS-CoV-2 infected pregnant women is currently a topic of debate. To explore the correlation between the two, we searched PubMed, Embase®, and Web of Science for studies on vertical transmission of COVID-19. The quality of the studies was evaluated by the Cochrane risk of bias tool. Detailed information of each included case including methods of delivery, protection measures for mothers and neonates at birth, types of specimens, inspection time, results of testing and feeding patterns was collected to assess the possibility of vertical transmission. The results showed that of the 390 neonates reported in 36 studies, 23 were infected with SARS-CoV-2 by potential vertical transmission. From the perspective of virology and pathology, vertical transmission of SARS-CoV-2 was possible via uterus or breastmilk. Some reported potential vertically transmitted neonates could be attributed to horizontal transmission. It is extremely vital to fully elucidate the potential routes of transmission of SARS-CoV-2, implicating clinical practice and nursing to reduce the risk of not only horizontal transmission but also vertical transmission, thus protecting neonates from COVID-19 infection.

RevDate: 2021-09-26

Buchy P, Buisson Y, Cintra O, et al (2021)

COVID-19 pandemic: lessons learned from more than a century of pandemics and current vaccine development for pandemic control.

International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases pii:S1201-9712(21)00752-9 [Epub ahead of print].

Pandemic dynamics and health care responses are markedly different during the COVID-19 pandemic than in earlier outbreaks. Compared with established infectious disease such as influenza, we currently know relatively little about the origin, reservoir, cross-species transmission and evolution of SARS-CoV-2. Health care services, drug availability, laboratory testing, research capacity and global governance are more advanced than during 20th century pandemics, although COVID-19 has highlighted significant gaps. The risk of zoonotic transmission and an associated new pandemic is rising substantially. COVID-19 vaccine development has been done at unprecedented speed, with the usual sequential steps done in parallel. The pandemic has illustrated the feasibility of this approach and the benefits of a globally coordinated response and infrastructure. Some of the COVID-19 vaccines recently developed or currently in development might offer flexibility or sufficiently broad protection to swiftly respond to antigenic drift or emergence of new coronaviruses. Yet many challenges remain, including the large-scale production of sufficient quantity of vaccines, delivery of vaccines to all countries and ensuring vaccination of relevant age groups. This wide vaccine technology approach will be best employed in tandem with active surveillance for emerging variants or new pathogens using antigen mapping, metagenomics and next generation sequencing.

RevDate: 2021-09-26

Felsenstein S, AO Reiff (2021)

A hitchhiker's guide through the COVID-19 galaxy.

Clinical immunology (Orlando, Fla.) pii:S1521-6616(21)00186-8 [Epub ahead of print].

Numerous reviews have summarized the epidemiology, pathophysiology and the various therapeutic aspects of Coronavirus disease 2019 (COVID-19), but a practical guide on "how to treat whom with what and when" based on an understanding of the immunological background of the disease stages remains missing. This review attempts to combine the current knowledge about the immunopathology of COVID-19 with published evidence of available and emerging treatment options. We recognize that the information about COVID-19 and its treatment is rapidly changing, but hope that this guide offers those on the frontline of this pandemic an understanding of the host response in COVID-19 patients and supports their ongoing efforts to select the best treatments tailored to their patient's clinical status.

RevDate: 2021-09-26

Battina HL, Alentado VJ, Srour EF, et al (2021)

The Interaction of the Inflammatory Response and Megakaryocytes in COVID-19 Infection.

Experimental hematology pii:S0301-472X(21)00328-3 [Epub ahead of print].

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly across the world and has resulted in over 4.2 million global deaths as of July 30, 2021. For reasons that remain unknown, the coronavirus disease 2019 (COVID-19) clinically manifests itself in various severities, with a majority of COVID-19 positive patients being asymptomatic or having only mild symptoms. However, clinical studies in severely ill patients have implicated that manifestations of this infection are due, in part, to abnormal megakaryocyte (MK) behavior. Additionally, COVID-19 associated cytokine storms have been identified to induce aberrant MK formation, primarily through IL-6 and JAK-STAT signaling. Autopsy reports have demonstrated significantly higher rates of MKs in the pulmonary and cardiac systems, which may be responsible for the high rate of thrombotic complications and abnormal coagulopathies in patients with severe forms of COVID-19. This review examines MKs and their potential function in the clinical manifestations of the SARS-CoV-2 infection.

RevDate: 2021-09-26

Garofolo M, Aragona M, Rodia C, et al (2021)

Glycaemic control during the lockdown for COVID-19 in adults with type 1 diabetes: A meta-analysis of observational studies.

Diabetes research and clinical practice pii:S0168-8227(21)00425-3 [Epub ahead of print].

AIMS: To assess the effects of lockdown due to COVID-19 pandemic on glucose metrics, measured by glucose monitoring systems, in adult individuals with type 1 diabetes.

METHODS: We conducted a systematic literature search for English language articles from MEDLINE, Scopus and Web of Science up to February 28, 2021, using "diabetes", "lockdown", and "glucose" as key search terms. Time in range (TIR) was the main outcome; other metrics were time above range (TAR), time below range (TBR), mean blood glucose (MBG) and its variability (%CV), estimated HbA1c (eA1c) or glucose management indicator (GMI).

RESULTS: Seventeen studies for a total of 3,441 individuals with type 1 diabetes were included in the analysis. In the lockdown period, TIR 70-180 mg/dl increased by 3.05% (95% CI 1.67-4.43%; p < 0.0001) while TAR (>180 mg/dL and >250 mg/dL) declined by 3.39% (-5.14 to -1.63%) and 1.96% (-2.51 to -1.42%), respectively (p < 0.0001 for both). Both TBR <70 and <54 mg/dL remained unchanged. MBG slightly decreased by 5.40 mg/dL (-7.29 to - 3.51 mg/dL; p < 0.0001) along with a reduction in %CV. Pooled eA1c and GMI decreased by 0.18% (-0.24 to -0.11%; p < 0.0001) and a similar reduction was observed when GMI alone was considered (0.15%, -0.23 to -0.07%; p < 0.0001). Sensor use was only slightly but not significantly reduced during lockdown.

CONCLUSIONS: This meta-analysis shows that well-controlled people with type 1 diabetes on both MDI and CSII with continuous or flash glucose monitoring did not experience a deterioration in glucose control throughout the COVID-19 lockdown, showing a modest, though statistically significant improvement in many glucose control parameters.

RevDate: 2021-09-26

Tomidokoro D, Y Hiroi (2021)

Cardiovascular implications of the COVID-19 pandemic.

Journal of cardiology pii:S0914-5087(21)00243-4 [Epub ahead of print].

The COVID-19 pandemic has rapidly emerged as one of the biggest public health concerns of the 21st century. Although it was initially reported as a cluster of pneumonia cases, it quickly became apparent that COVID-19 is not merely a respiratory tract infection. Its clinical course is often complicated by cardiovascular manifestations including venous and arterial thrombosis, electrical disturbances, and myocardial damage. In addition, the cardiovascular system is involved not only during infection but also preceding the contraction of the virus; having cardiovascular comorbidities indicates significant vulnerability to the pathogen. As longer-term data continue to accumulate, we now have concerns over its lasting cardiovascular effects after recovery. Moreover, there have been substantial collateral effects on the epidemiology of cardiovascular diseases. Reports of adverse cardiovascular events from vaccination have emerged as new hurdles to our efforts to bring an end to the pandemic. As such, the association between COVID-19 and the cardiovascular system and cardiovascular practice in general is expansive. In this review, we provide an overview of the knowledge and considerations in this field, based on the evidence available at the time of this writing.

RevDate: 2021-09-26

Bhujel N, Zaheer K, RP Singh (2021)

Oral mucosal lesions in patients with COVID-19: a systematic review.

The British journal of oral & maxillofacial surgery pii:S0266-4356(21)00243-6 [Epub ahead of print].

COVID-19 is a new disease that presents mainly with respiratory symptoms. However, it can present with a multitude of signs and symptoms that affect various body systems and several oral manifestations have also been reported. We carried out a systematic review to explore the types of oral mucosal lesions that have been reported in the COVID-19-related literature up to 25 March 2021. A structured electronic database search using Medline, Embase, and CINAHL, as well as a grey literature search using Google Scholar, revealed a total of 322 studies. After the removal of duplicates and completion of the primary and secondary filtering processes, 12 studies were included for final appraisal. In patients with COVID-19 infection, we identified several different types of oral mucosal lesions at various locations within the oral cavity. Most of the studies appraised had a high risk of bias according to the Joanna Briggs Institute checklist. The current published literature does not allow differentiation as to whether the oral lesions were caused by the viral infection itself, or were related to oral manifestations secondary to existing comorbidities or the treatment instigated to combat the disease. It is important for healthcare professionals to be aware of the possible link between COVID-19 and oral mucosal lesions, and we hereby discuss our findings.

RevDate: 2021-09-27
CmpDate: 2021-09-23

Huang CL (2021)

[Impact of Nurse Practitioners and Nursing Education on COVID-19 Pandemics: Innovative Strategies of Authentic Technology-Integrated Clinical Simulation].

Hu li za zhi The journal of nursing, 68(5):4-6.

Taiwan Nurses Association and the International Council of Nurses recognize nurse practitioners (NPs) as advanced-practice nurses. A total of 11,266 registered nurses held NP certificates in April 2021 in Taiwan (Tsay, 2021). While international organizations recognize NPs with graduate degrees, over 85% of NPs in Taiwan hold a bachelor degree only. Tsay and Wang (2007) emphasized that NP education in Taiwan should be in step with international trends. Therefore, nursing schools must recruit PhD faculty who hold NP certificates. In addition, complicated and simulation-based learning procedures and teaching plans must be incorporated into the graduate curriculum and clinical practicum to promote the clinical reasoning competences and advanced nursing capabilities of NPs in light of professional training, qualifying examinations, and occupational practice. With the evolution of virtual technology, the strategies for teaching core competences in nursing education have shifted from traditional classroom lectures to online format simulation. Recently, scholars have begun using authentic technology-enhanced clinical simulation to develop and integrate nursing competence to reconceptualize the gap between theory and practice (Weeks et al., 2019). It is increasingly important to teach patient safety, clinical reasoning, and decision-making skills to nursing students using the assistive methods of clinical simulation technology (Aebersold, 2016; Johnsen et al., 2016). Since 2019, the COVID-19 pandemic has had a global impact. In May 2021, clinical practice settings and university campuses in Taiwan were closed following the announcement of a nationwide, level-3 epidemic alert. The Ministry of Education and Taiwan Nurses Association approved the replacement of up to 50% of clinical practicum hours with alternative learning activities. Therefore, faculties require innovative strategies to teach requisite skills and deliver clinical practica online. The faculty members of California State University use virtual clinical education and standardized patient-based telehealth simulations (Shea & Rovera, 2021). In Taiwan, there is a lack of studies in the literature examining the effect of replacing 50% of traditional face-to-face clinical activities with educational alternatives. Prior survey results have demonstrated the efficacy of transitioning to virtual clinical experiences in an online environment for undergraduate and graduate students (Fogg et al., 2020). Moreover, a systematic review provided evidence that virtual simulations support learning outcomes (Foronda et al., 2020). To promote clinical-reasoning competence in graduate students with NP certificates and prepare alternative, virtual-based teaching plans to meet the remaining clinical hours required of students, Fooyin University's School of Nursing has recently established the multi-functional iNursing-Innovative Learning Center. The hardware devices provide interactive virtual patients with character creator 3D, augmented realty (AR) hospital, operating room, intensive care unit, and virtual reality (VR) simulation plans for different nursing divisions as well as editors of electronic book and AR/VR teaching plans. The simulation plans include commercial products and self-design produced by well-trained faculty members. A group of seeding faculty members supported by the Ministry of Education's Higher Education Sprout Project and university funding was tapped to develop a large number of virtual simulation plans. In addition, when developing virtual simulation, it is necessary to follow teaching team discussion and learning objective setting procedures, pre-brief teachers and students, enact plans, conduct debriefing, and collect and evaluate data to explore the learning and teaching process and outcomes (Verkuyl et al., 2021). The nursing clinical practicum continues to be impacted by the ongoing COVID-19 pandemic. In a further study, nursing academic faculty cooperated with clinical preceptors to develop and design education strategies using authentic technology-integrated clinical simulations to promote advanced and comprehensive care competences in nurse practitioners.

RevDate: 2021-09-27
CmpDate: 2021-09-27

Wiedenmann M, Goutaki M, Keiser O, et al (2021)

The role of children and adolescents in the SARS-CoV-2 pandemic: a rapid review.

Swiss medical weekly, 151:w30058 pii:Swiss Med Wkly. 2021;151:w30058.

BACKGROUND: There has been much discussion about coronavirus disease 2019 (COVID-19) and the virus that causes it, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children and adolescents, since the pandemic was recognised in early 2020. Understanding their role in this pandemic is important for the development of appropriate prevention measures.

OBJECTIVE: To summarise evidence about three aspects of SARS-CoV-2 and COVID-19 in children and adolescents: (1) severity of SARS-CoV-2 presentation, (2) risk of SARS-CoV-2 infection and (3) risk of transmitting SARS-CoV-2.METHODS: We searched PubMed and MedRxiv for studies on SARS-CoV-2 and COVID-19 in children and adolescents from January 2020 to 21 January 2021. The electronic search was supplemented by papers found in a manual search or suggested by experts up to 29 March 2021. We included case reports, cross-sectional studies, cohort studies, narrative reviews or viewpoints, systematic reviews and modelling studies. We synthesised the information descriptively and attempted to report findings separately for: infants and small children (0-5 years) who are mostly pre-school; school children (6-12 years) broadly covering primary school years; and adolescents (13-17 years).

RESULTS: Of 2778 screened articles, we included 63 (20 case reports, 18 cross-sectional studies, 8 cohort studies, 6 narrative reviews or viewpoints, 10 systematic reviews and 1 modelling study). Children (≤12 years of age) and adolescents (13-17 years of age) usually present with mild disease, with few requiring intensive care treatment. A minority of children of all ages (<18 years) remains asymptomatic throughout the course of infection. In serological studies, reported symptoms are similar in children with and without SARS-CoV-2 antibodies. Children and adolescents can acquire and transmit SARS-CoV-2. The risks of acquiring and transmitting SARS-CoV-2 seems to increase with age. There was limited information about SARS-CoV-2 variants of concern. Poor reporting of age groups and contextual factors such as levels of community transmission, school closures and other non-pharmaceutical interventions make synthesis of findings across studies difficult.

CONCLUSIONS: The clinical presentation and role of children and adolescents in SARS-CoV-2 susceptibility and transmission needs further investigation, particularly with regard to variants of concern. Large, prospective studies that attempt to minimise biases in design, are analysed appropriately and reported comprehensively should be conducted.

RevDate: 2021-09-27
CmpDate: 2021-09-27

Anonymous (2021)

Casirivimab and imdevimab (REGEN-COV) for post-exposure prophylaxis of COVID-19.

The Medical letter on drugs and therapeutics, 63(1631):130-131.

RevDate: 2021-09-27
CmpDate: 2021-09-23

Collins J, Westerveld R, Nelson KA, et al (2021)

'Learn from the lessons and don't forget them': identifying transferable lessons for COVID-19 from meningitis A, yellow fever and Ebola virus disease vaccination campaigns.

BMJ global health, 6(9):.

INTRODUCTION: COVID-19 vaccines are now being distributed to low- and middle-income countries (LMICs), with global urgency surrounding national vaccination plans. LMICs have significant experience implementing vaccination campaigns to respond to epidemic threats but are often hindered by chronic health system challenges. We sought to identify transferable lessons for COVID-19 vaccination from the rollout of three vaccines that targeted adult groups in Africa and South America: MenAfriVac (meningitis A); 17D (yellow fever) and rVSV-ZEBOV (Ebola virus disease).

METHODS: We conducted a rapid literature review and 24 semi-structured interviews with technical experts who had direct implementation experience with the selected vaccines in Africa and South America. We identified barriers, enablers, and key lessons from the literature and from participants' experiences. Interview data were analysed thematically according to seven implementation domains.

RESULTS: Participants highlighted multiple components of vaccination campaigns that are instrumental for achieving high coverage. Community engagement is an essential and effective tool, requiring dedicated time, funding and workforce. Involving local health workers is a key enabler, as is collaborating with community leaders to map social groups and tailor vaccination strategies to their needs. Vaccination team recruitment and training strategies need to be enhanced to support vaccination campaigns. Although recognised as challenging, integrating vaccination campaigns with other routine health services can be highly beneficial if well planned and coordinated across health programmes and with communities.

CONCLUSION: As supplies of COVID-19 vaccines become available to LMICs, countries need to prepare to efficiently roll out the vaccine, encourage uptake among eligible groups and respond to potential community concerns. Lessons from the implementation of these three vaccines that targeted adults in LMICs can be used to inform best practice for COVID-19 and other epidemic vaccination campaigns.

RevDate: 2021-09-27
CmpDate: 2021-09-22

Elhiny R, Al-Jumaili AA, MJ Yawuz (2021)

An overview of post-COVID-19 complications.

International journal of clinical practice, 75(10):e14614.

RevDate: 2021-09-27
CmpDate: 2021-09-16

Lim CC, Saniasiaya J, J Kulasegarah (2021)

Croup and COVID-19 in a child: a case report and literature review.

BMJ case reports, 14(9): pii:14/9/e244769.

Croup (laryngotracheitis) is frequently encountered in the emergency department in a young child presenting with stridor. We describe a rare case of croup secondary to SARS-CoV-2 in an 18-month-old child who presented with stridor and respiratory distress and required urgent intubation. Subsequently, the child developed multisystem inflammatory syndrome in children (MIS-C). The child was monitored in paediatric intensive care unit. We would like to highlight that COVID-19 croup in children may be an indicator for MIS-C, and close monitoring is warranted as MIS-C is a life-threatening condition. Our limited experience suggests that COVID-19 croup especially if associated with MIS-C has an underlying more severe pathology and may require prolonged treatment in comparison with the typical croup or even COVID-19 croup. It is important to recognise this clinical entity during a time when most countries are in a third wave of COVID-19 pandemic.

RevDate: 2021-09-27

Zezza A, Martuscelli A, Wollburg P, et al (2021)

Viewpoint: High-frequency phone surveys on COVID-19: Good practices, open questions.

Food policy, 105:102153.

Following the onset of the COVID-19 pandemic, face-to-face survey data collection efforts came to a halt due to lockdowns, limitations on mobility and social distancing requirements. What followed was a surge in phone surveys to fulfill rapidly evolving needs for timely and policy-relevant microdata for understanding the socioeconomic impacts of and responses to the pandemic. Even as the face-to-face survey data collection efforts are resuming in different parts of the world with COVID-19 safety protocols, the rapidly-acquired experience with phone surveys on the part of national statistical offices and survey practitioners in low- and middle-income countries appears to have formed the foundation for phone surveys to be more commonly implemented in the post-pandemic era, in response to other shocks and as complementary efforts to face-to-face surveys. Informed by the practical experience with the high-frequency phone surveys that have been implemented with support from the World Bank Living Standards Measurement Study (LSMS) to monitor the socioeconomic impacts of the COVID-19 pandemic, this paper provides an overview of options for the design and implementation of phone surveys to collect representative data from households and individuals. Further, the discussion identifies the requirements for phone surveys to be a mainstay in the toolkits of national statistical offices and the directions for future research on the design and implementation of phone surveys.

RevDate: 2021-09-27
CmpDate: 2021-09-27

Mash R, Christian C, RV Chigwanda (2021)

Alternative mechanisms for delivery of medication in South Africa: A scoping review.

South African family practice : official journal of the South African Academy of Family Practice/Primary Care, 63(1):e1-e8.

BACKGROUND: The number of people in South Africa with chronic conditions is a challenge to the health system. In response to the coronavirus infection, health services in Cape Town introduced home delivery of medication by community health workers. In planning for the future, they requested a scoping review of alternative mechanisms for delivery of medication to patients in primary health care in South Africa.

METHODS: Databases were systematically searched using a comprehensive search strategy to identify studies from the last 10 years. A methodological guideline for conducting scoping reviews was followed. A standardised template was used to extract data and compare study characteristics and findings. Data was analysed both quantitatively and qualitatively.

RESULTS: A total of 4253 publications were identified and 26 included. Most publications were from the last 5 years (n = 21), research (n = 24), Western Cape (n = 15) and focused on adherence clubs (n = 17), alternative pick-up-points (n = 14), home delivery (n = 5) and HIV (n = 17). The majority of alternative mechanisms were supported by a centralised dispensing and packaging system. New technology such as smart lockers and automated pharmacy dispensing units have been piloted. Patients benefited from these alternatives and had improved adherence. Available evidence suggests alternative mechanisms were cheaper and more beneficial than attending the facility to collect medication.

CONCLUSION: A mix of options tailored to the local context and patient choice that can be adequately managed by the system would be ideal. More economic evaluations are required of the alternatives, particularly before going to scale and for newer technology.

RevDate: 2021-09-27
CmpDate: 2021-09-27

Allen ES, Cohn CS, Bakhtary S, et al (2021)

Current advances in transfusion medicine 2020: A critical review of selected topics by the AABB Clinical Transfusion Medicine Committee.

Transfusion, 61(9):2756-2767.

BACKGROUND: The AABB Clinical Transfusion Medicine Committee (CTMC) compiles an annual synopsis of the published literature covering important developments in the field of transfusion medicine (TM), which has been made available as a manuscript published in Transfusion since 2018.

METHODS: CTMC committee members reviewed original manuscripts including TM-related topics published electronically (ahead) or in print from December 2019 to December 2020. The selection of topics and manuscripts was discussed at committee meetings and chosen based on relevance and originality. Next, committee members worked in pairs to create a synopsis of each topic, which was then reviewed by two additional committee members. The first and senior authors of this manuscript assembled the final manuscript. Although this synopsis is extensive, it is not exhaustive, and some papers may have been excluded or missed.

RESULTS: The following topics are included: COVID-19 effects on the blood supply and regulatory landscape, COVID convalescent plasma, adult transfusion practices, whole blood, molecular immunohematology, pediatric TM, cellular therapy, and apheresis medicine.

CONCLUSIONS: This synopsis provides easy access to relevant topics and may be useful as an educational tool.

RevDate: 2021-09-27
CmpDate: 2021-09-23

Laigle V, Postma MJ, Pavlovic M, et al (2021)

Vaccine market access pathways in the EU27 and the United Kingdom - analysis and recommendations for improvements.

Vaccine, 39(39):5706-5718.

BACKGROUND: Vaccine market access (VMA) pathways across the European Union (EU) and the United Kingdom (UK) are complex, lengthy, and heterogeneous, particularly when compared with pharmaceuticals. The knowledge base to inform recommendations for optimization of VMA is lacking. We therefore conducted a comprehensive evaluation of EU VMA pathways.

METHODS: Research in two phases included: (1) mapping VMA pathways in each EU member state (including the UK) based on a literature review, expert interviews, and mathematical archetyping; and (2) interviews with vaccine experts to identify barriers, drivers, and recommendations for regional VMA alignments.

RESULTS: Key steps in VMA across the EU include horizon scanning, early advice, National Immunization Technical Advisory Group (NITAG) recommendation for inclusion in national immunization programs, health technology assessment (HTA), final decision and procurement. We found significant complexity and heterogeneity, particularly for early advice, and in the roles, decision-making criteria, and transparency of NITAGs and HTA bodies. The most important drivers for rapid VMA included demonstration of disease burden and vaccine benefit (e.g., efficacy, safety, economic). Key barriers were budget limitations and complexity/clarity of VMA processes (e.g., need for national-regional consensus, clarity on process initiation, and clarity on the role of HTA). Recommendations for alignment at EU and member-state levels include information sharing, joint clinical assessment, initiatives to address funding and political barriers, and improved transparency by decision-making bodies. Early engagement with vaccine stakeholders was a key recommendation for manufacturers.

CONCLUSIONS: There is significant potential for alignment, collaboration, and improvement of VMA across the EU. Roles, responsibilities, and transparency of key bodies can be clarified. The COVID-19 pandemic response should stimulate policies to improve access to all vaccines, including routine ones, and form the foundation upon which a consistent vaccine ecosystem can be created for the EU, one that is resilient, consistent between member states, and fit for purpose.

RevDate: 2021-09-27
CmpDate: 2021-09-27

Zhou R, Liu L, Y Wang (2021)

Viral proteins recognized by different TLRs.

Journal of medical virology, 93(11):6116-6123.

Virus invasion activates the host's innate immune response, inducing the production of numerous cytokines and interferons to eliminate pathogens. Except for viral DNA/RNA, viral proteins are also targets of pattern recognition receptors. Membrane-bound receptors such as Toll-like receptor (TLR)1, TLR2, TLR4, TLR6, and TLR10 relate to the recognition of viral proteins. Distinct TLRs perform both protective and detrimental roles for a specific virus. Here, we review viral proteins serving as pathogen-associated molecular patterns and their corresponding TLRs. These viruses are all enveloped, including respiratory syncytial virus, hepatitis C virus, measles virus, herpesvirus human immunodeficiency virus, and coronavirus, and can encode proteins to activate innate immunity in a TLR-dependent way. The TLR-viral protein relationship plays an important role in innate immunity activation. A detailed understanding of their pathways contributes to a novel direction for vaccine development.

RevDate: 2021-09-27
CmpDate: 2021-09-27

Barman A, Sahoo J, Viswanath A, et al (2021)

Clinical Features, Laboratory, and Radiological Findings of Patients With Acute Inflammatory Myelopathy After COVID-19 Infection: A Narrative Review.

American journal of physical medicine & rehabilitation, 100(10):919-939.

ABSTRACT: The objective of this review was to analyze the existing data on acute inflammatory myelopathies associated with coronavirus disease 2019 infection, which were reported globally in 2020. PubMed, CENTRAL, MEDLINE, and online publication databases were searched. Thirty-three acute inflammatory myelopathy cases (among them, seven cases had associated brain lesions) associated with coronavirus disease 2019 infection were reported. Demyelinating change was seen in cervical and thoracic regions (27.3% each, separately). Simultaneous involvement of both regions, cervical and thoracic, was seen in 45.4% of the patients. Most acute inflammatory myelopathy disorders reported sensory motor and bowel bladder dysfunctions. On cerebrospinal fluid analysis, pleocytosis and increased protein were reported in 56.7% and 76.7% of the patients, respectively. Cerebrospinal fluid severe acute respiratory syndrome coronavirus 2 reverse transcriptase-polymerase chain reaction was positive in five patients. On T2-weighted imaging, longitudinally extensive transverse myelitis and short-segment demyelinating lesions were reported in 76% and 21%, respectively. Among the patients with longitudinally extensive transverse myelitis, 61% reported "moderate to significant" improvement and 26% demonstrated "no improvement" in the motor function of lower limbs. Demyelinating changes in the entire spinal cord were observed in three patients. Most of the patients with acute inflammatory myelopathy (including brain lesions) were treated with methylprednisolone (81.8%) and plasma-exchange therapy (42.4%). An early treatment, especially with intravenous methylprednisolone with or without immunoglobulin and plasma-exchange therapy, helped improve motor recovery in the patients with acute inflammatory myelopathy associated with coronavirus disease 2019.

RevDate: 2021-09-27
CmpDate: 2021-09-27

Weng CC, Lin TY, Yang YP, et al (2021)

Modifications of intravitreal injections in response to the COVID-19 pandemic.

Journal of the Chinese Medical Association : JCMA, 84(9):827-832.

The Coronavirus disease 2019 (COVID-19) pandemic has caused unprecedented disruption to the normal operation of the healthcare system. On a worldwide scale, hospitals suspended nonurgent surgeries and outpatient visits to downsize clinical loadings to redistribute manpower to counteract the pandemic's impact. So far, there is no evidence-based guideline defining a clear line between urgent and nonurgent indications of intravitreal injections (IVI). Herein, we aimed to summarize IVI algorithm modifications and discuss the patient prioritization according to medical needs in the hostile environment in the COVID crisis. Assessing current literature, we found that neovascular age-related macular degeneration is considered the utmost priority among conditions that require IVI. Other conditions assigned with a high priority include monocular or quasi-monocular patients (only one eye > 20/40), neovascular glaucoma, and new patients with significant vision loss. Although patients with central retinal vein occlusion and proliferative diabetic retinopathy are not advised to delay treatments, we found no consistent evidence that correlated with a worse outcome. Diabetic macular edema and branch retinal vein occlusion patients undertaking treatment delay should be regularly followed up every 2 to 3 months. Serving as the principle of management behind the algorithm modifications, the reduction of both patient visit and IVI therapy counts should be reckoned together with the risk of permanent visual loss and COVID infection.

RevDate: 2021-09-27
CmpDate: 2021-09-27

Lai YJ, Chang HS, Yang YP, et al (2021)

The role of micronutrient and immunomodulation effect in the vaccine era of COVID-19.

Journal of the Chinese Medical Association : JCMA, 84(9):821-826.

Different dietary nutrients have distinct effects, including enhancing immune response activity and supporting mucous membrane integrity. These effects are critical in fighting against pathogenic agents, which cover coronavirus disease 2019 (COVID-19), the coronavirus disease that shuts down globally. Recent researches have shown that micronutrient deficiency is commonly associated with compromised immune responses, respiratory tract infections, or even susceptibility to COVID-19. The relationship between Vit A and infection is its role in mucosal epithelium integrity (skin and mucous membrane), the supplementation could be an option for assisted-treating the SARS-CoV-2 virus and a possible prevention of lung infection. Vit C/ascorbic acid stimulates oxygen radical scavenging activity of the skin and enhances epithelial barrier function. Ascorbic acid alone or with other natural compounds (baicalin and theaflavin) may inhibit the expression of angiotensin-converting enzyme II in human small alveolar epithelial cells and limited the entry of SARS-CoV-2. Vitamin D receptors can be expressed by immune cells, and different immune cells (macrophages, monocytes, dendritic cells, T cells, and B cells) can convert Vit D into its active form 1,25-(OH)2 D. Oral vitamin D intake can be a readily way to restrict the viral infection through downregulation of ACE2 receptor and to attenuate the disease severity by decreasing the frequency of cytokine storm and pulmonary pro-inflammatory response. Vit E supports T-cell mediated functions, optimization of Th1 response, and suppression of Th2 response. Vitamin E supplementation can lower the production of superoxides and may favors the antioxidants and benefit the progress of COVID-19 treatment. Zinc plays an essential role in both innate and adaptive immune systems and cytokine production, and Zinc-dependent viral enzymes to initiate the infectious process have proved the Zinc levels are directly associated with symptoms relieved of COVID-19. Iron is an essential component of enzymes involved in the activation of immune cells, lower iron levels predispose to severe symptoms of SARS-CoV-2, and monitoring the status can predict the disease severity and mortality. Selenium participates in the adaptive immune response by supporting antibody production and development. Deficiency can reduce antibody concentration, decreased cytotoxicity of NK cells, compromised cellular immunity, and an attenuated response to vaccination. The COVID-19 vaccines including three broad categories, protein-based vaccines, gene-based vaccines (mRNA vaccines and DNA vaccines), combination of gene and protein-based vaccines. Micronutrients are involved in immunity from the virus entering the human to innate immune response and adaptive immune response. Micronutrients are indispensable in immune response of vaccination.

RevDate: 2021-09-25

Guerra O, E Eboreime (2021)

The Impact of Economic Recessions on Depression, Anxiety, and Trauma-Related Disorders and Illness Outcomes-A Scoping Review.

Behavioral sciences (Basel, Switzerland), 11(9): pii:bs11090119.

In the wake of a global economic recession secondary to the COVID-19 pandemic, this scoping review seeks to summarize the current quantitative research on the impact of economic recessions on depression, anxiety, traumatic disorders, self-harm, and suicide. Seven research databases (PsycINFO, MEDLINE, Embase, Web of Science: Core Collection, National Library of Medicine PubMed, PubMed Central, and Google Scholar) were searched for keywords returning 3412 preliminary results published since 2008 in Organisation for Economic Coordination and Development (OECD)nations. These were screened by both authors for inclusion/exclusion criteria resulting in 127 included articles. Articles included were quantitative studies in OECD countries assessing select mental disorders (depression, anxiety, and trauma-/stress-related disorders) and illness outcomes (self-harm and suicide) during periods of economic recession. Articles were limited to publication from 2008 to 2020, available online in English, and utilizing outcome measures specific to the disorders and outcomes specified above. A significant relationship was found between periods of economic recession and increased depressive symptoms, self-harming behaviour, and suicide during and following periods of recession. Results suggest that existing models for mental health support and strategies for suicide prevention may be less effective than they are in non-recession times. It may be prudent to focus public education and medical treatments on raising awareness and access to supports for populations at higher risk, including those vulnerable to the impacts of job or income loss due to low socioeconomic status preceding the recession or high levels of financial strain, those supporting others financially, approaching retirement, and those in countries with limited social safety nets. Policy makers should be aware of the potential protective nature of unemployment safeguards and labour program investment in mitigating these negative impacts. Limited or inconclusive data were found on the relationship with traumatic disorders and symptoms of anxiety. In addition, research has focused primarily on the working-age adult population with limited data available on children, adolescents, and older adults, leaving room for further research in these areas.

RevDate: 2021-09-25

Fabiani L, Caratelli V, Fiore L, et al (2021)

State of the Art on the SARS-CoV-2 Toolkit for Antigen Detection: One Year Later.

Biosensors, 11(9): pii:bios11090310.

The recent global events of COVID-19 in 2020 have alerted the world to the risk of viruses and their impacts on human health, including their impacts in the social and economic sectors. Rapid tests are urgently required to enable antigen detection and thus to facilitate rapid and simple evaluations of contagious individuals, with the overriding goal to delimitate spread of the virus among the population. Many efforts have been achieved in recent months through the realization of novel diagnostic tools for rapid, affordable, and accurate analysis, thereby enabling prompt responses to the pandemic infection. This review reports the latest results on electrochemical and optical biosensors realized for the specific detection of SARS-CoV-2 antigens, thus providing an overview of the available diagnostics tested and marketed for SARS-CoV-2 antigens as well as their pros and cons.

RevDate: 2021-09-25

Hsiao WW, Le TN, Pham DM, et al (2021)

Recent Advances in Novel Lateral Flow Technologies for Detection of COVID-19.

Biosensors, 11(9): pii:bios11090295.

The development of reliable and robust diagnostic tests is one of the most efficient methods to limit the spread of coronavirus disease 2019 (COVID-19), which is caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). However, most laboratory diagnostics for COVID-19, such as enzyme-linked immunosorbent assay (ELISA) and reverse transcriptase-polymerase chain reaction (RT-PCR), are expensive, time-consuming, and require highly trained professional operators. On the other hand, the lateral flow immunoassay (LFIA) is a simpler, cheaper device that can be operated by unskilled personnel easily. Unfortunately, the current technique has some limitations, mainly inaccuracy in detection. This review article aims to highlight recent advances in novel lateral flow technologies for detecting SARS-CoV-2 as well as innovative approaches to achieve highly sensitive and specific point-of-care testing. Lastly, we discuss future perspectives on how smartphones and Artificial Intelligence (AI) can be integrated to revolutionize disease detection as well as disease control and surveillance.

RevDate: 2021-09-25

Ghasemiyeh P, Mohammadi-Samani S, Firouzabadi N, et al (2021)

A focused review on technologies, mechanisms, safety, and efficacy of available COVID-19 vaccines.

International immunopharmacology, 100:108162 pii:S1567-5769(21)00798-0 [Epub ahead of print].

>20 months has been passed since the detection of the first cases of SARS-CoV-2 infection named COVID-19 from Wuhan city of China. This novel coronavirus spread rapidly around the world and became a pandemic. Although different therapeutic options have been considered and approved for the management of COVID-19 infection in different stages of the disease, challenges in pharmacotherapy especially in patients with moderate to severe COVID-19 and with underlying diseases have still remained. Prevention of infection through public vaccination would be the only efficient strategy to control the morbidity and mortality caused by COVID-19. To date, several COVID-19 vaccines using different platforms including nucleic acid-based vaccines, adenovirus-based vaccines, protein-based vaccines, and inactivated vaccines have been introduced among which many have received approval for prevention against COVID-19. In this comprehensive review, available COVID-19 vaccines have been discussed. The mechanisms, safety, efficacy, dosage, dosing intervals, possible adverse reactions, storage, and coverage of these four different vaccine platforms against SARS-CoV-2 variants have been discussed in detail and summarized in tabular format for ease of comparison and conclusion. Although each COVID-19 vaccine has various advantages and disadvantages over the others, accessibility and affordability of approved vaccines by the official health organizations, especially in developing countries, would be essential to terminate this pandemic. The main limitation of this study was the lack of access to the clinical data on available COVID-19 vaccines developed in Eastern countries since the data on their efficacy, safety, and adverse reactions were limited.

RevDate: 2021-09-25

Khan A, Khan T, Ali S, et al (2021)

SARS-CoV-2 new variants: Characteristic features and impact on the efficacy of different vaccines.

Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie, 143:112176 pii:S0753-3322(21)00960-4 [Epub ahead of print].

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its new variants reported in different countries have posed a serious threat to human health and social fabrics worldwide. In addition, these new variants hindered the efforts of vaccines and other therapeutic developments. In this review article, we explained the emergence of new variants of SARS-CoV-2, their transmission risk, mortality rate, and, more importantly, the impact of each new variant on the efficacy of the developed vaccines reported in different literature and findings. The literature reported that with the emergence of new variants, the efficacy of different vaccines is declined, hospitalization and the risk of reinfection is increased. The reports concluded that the emergence of a variant that entirely evades the immune response triggered by the vaccine is improbable. The emergence of new variants and reports of re-infections are creating a more distressing situation and therefore demands further investigation to formulate an effective therapeutic strategy.

RevDate: 2021-09-25

Chen Y, Zhang X, Chen S, et al (2021)

Bibliometric analysis of mental health during the COVID-19 pandemic.

Asian journal of psychiatry, 65:102846 pii:S1876-2018(21)00302-6 [Epub ahead of print].

BACKGROUND: As a global pandemic, coronavirus disease 2019 (COVID-19) has had a profound effect on public mental health.

METHODS: Publications related to mental health during the COVID-19 pandemic from December 1, 2019, to November 13, 2020, were extracted from the Web of Science database. Bibliometric indicator analysis was performed using VOSviewer 1.6.15.

RESULTS: In total, 1233 documents from 2020 were retrieved, of which 680 were original articles. The United States contributed the largest publication output (285, 23.1%). Huazhong University of Science and Technology published the most articles in this field (35), while Wuhan University received the most citations (1149). The United Kingdom had the strongest collaboration network. Four keyword clusters representing hotspots in this field were identified.

CONCLUSIONS: In addition to developed countries, countries seriously affected by the COVID-19 pandemic also made significant contributions to mental health research during the COVID-19 pandemic. This study focused on various aspects, such as mental health during isolation, mental health in healthcare workers, and public mental health issues during the COVID-19 pandemic. In the future, countries should strengthen global cooperation and pay more attention to the mental health of vulnerable groups during pandemics.

RevDate: 2021-09-25

Thakur V, Thakur P, RK Ratho (2021)

Nipah Outbreak: Is it the Beginning of another Pandemic in the Era of COVID-19 and Zika.

Brain, behavior, and immunity pii:S0889-1591(21)00559-6 [Epub ahead of print].

RevDate: 2021-09-25

Abu-Eid R, FJ Ward (2021)

Targeting the PI3K/Akt/mTOR pathway: A therapeutic strategy in COVID-19 patients.

Immunology letters pii:S0165-2478(21)00146-2 [Epub ahead of print].

Some COVID-19 patients suffer complications from anti-viral immune responses which can lead to both a dangerous cytokine storm and development of blood-borne factors that render severe thrombotic events more likely. The precise immune response profile is likely, therefore, to determine and predict patient outcomes and also represents a target for intervention. Anti-viral T cell exhaustion in the early stages is associated with disease progression. Dysregulation of T cell functions, which precedes cytokine storm development and neutrophil expansion in alveolar tissues heralds damaging pathology.T cell function, cytokine production and factors that attract neutrophils to the lung can be modified through targeting molecules that can modulate T cell responses. Manipulating T cell responses by targeting the PI3K/Akt/mTOR pathway could provide the means to control the immune response in COVID-19 patients. During the initial anti-viral response, T cell effector function can be enhanced by delaying anti-viral exhaustion through inhibiting PI3K and Akt. Additionally, immune dysregulation can be addressed by enhancing immune suppressor functions by targeting downstream mTOR, an important intracellular modulator of cellular metabolism. Targeting this signalling pathway also has potential to prevent formation of thrombi due to its role in platelet activation. Furthermore, this signalling pathway is essential for SARS-cov-2 virus replication in host cells and its inhibition could, therefore, reduce viral load. The ultimate goal is to identify targets that can quickly control the immune response in COVID-19 patients to improve patient outcome. Targeting different levels of the PI3K/Akt/mTOR signalling pathway could potentially achieve this during each stage of the disease.

RevDate: 2021-09-25

Beyer DK, A Forero (2021)

Mechanisms of Antiviral Immune Evasion of SARS-CoV-2.

Journal of molecular biology pii:S0022-2836(21)00501-5 [Epub ahead of print].

Coronavirus disease (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is characterized by a delayed interferon (IFN) response and high levels of proinflammatory cytokine expression. Type I and III IFNs serve as a first line of defense during acute viral infections and are readily antagonized by viruses to establish productive infection. A rapidly growing body of work has interrogated the mechanisms by which SARS-CoV-2 antagonizes both IFN induction and IFN signaling to establish productive infection. Here, we summarize these findings and discuss the molecular interactions that prevent viral RNA recognition, inhibit the induction of IFN gene expression, and block the response to IFN treatment. We also describe the mechanisms by which SARS-CoV-2 viral proteins promote host shutoff. A detailed understanding of the host-pathogen interactions that unbalance the IFN response is critical for the design and deployment of host-targeted therapeutics to manage COVID-19.

RevDate: 2021-09-25

Upham NS, Poelen JH, Paul D, et al (2021)

Liberating host-virus knowledge from biological dark data.

The Lancet. Planetary health pii:S2542-5196(21)00196-0 [Epub ahead of print].

Connecting basic data about bats and other potential hosts of SARS-CoV-2 with their ecological context is crucial to the understanding of the emergence and spread of the virus. However, when lockdowns in many countries started in March, 2020, the world's bat experts were locked out of their research laboratories, which in turn impeded access to large volumes of offline ecological and taxonomic data. Pandemic lockdowns have brought to attention the long-standing problem of so-called biological dark data: data that are published, but disconnected from digital knowledge resources and thus unavailable for high-throughput analysis. Knowledge of host-to-virus ecological interactions will be biased until this challenge is addressed. In this Viewpoint, we outline two viable solutions: first, in the short term, to interconnect published data about host organisms, viruses, and other pathogens; and second, to shift the publishing framework beyond unstructured text (the so-called PDF prison) to labelled networks of digital knowledge. As the indexing system for biodiversity data, biological taxonomy is foundational to both solutions. Building digitally connected knowledge graphs of host-pathogen interactions will establish the agility needed to quickly identify reservoir hosts of novel zoonoses, allow for more robust predictions of emergence, and thereby strengthen human and planetary health systems.

RevDate: 2021-09-25

Song Y, Liu J, Zhao K, et al (2021)

Cholesterol-induced toxicity: An integrated view of the role of cholesterol in multiple diseases.

Cell metabolism pii:S1550-4131(21)00420-4 [Epub ahead of print].

High levels of cholesterol are generally considered to be associated with atherosclerosis. In the past two decades, however, a number of studies have shown that excess cholesterol accumulation in various tissues and organs plays a critical role in the pathogenesis of multiple diseases. Here, we summarize the effects of excess cholesterol on disease pathogenesis, including liver diseases, diabetes, chronic kidney disease, Alzheimer's disease, osteoporosis, osteoarthritis, pituitary-thyroid axis dysfunction, immune disorders, and COVID-19, while proposing that excess cholesterol-induced toxicity is ubiquitous. We believe this concept will help broaden the appreciation of the toxic effect of excess cholesterol, and thus potentially expand the therapeutic use of cholesterol-lowering medications.

RevDate: 2021-09-25

Kim HU, HS Jung (2021)

Cryo-EM as a powerful tool for drug discovery: recent structural based studies of SARS-CoV-2.

Applied microscopy, 51(1):13.

The novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has arisen as a global pandemic affecting the respiratory system showing acute respiratory distress syndrome (ARDS). However, there is no targeted therapeutic agent yet and due to the growing cases of infections and the rising death tolls, discovery of the possible drug is the need of the hour. In general, the study for discovering therapeutic agent for SARS-CoV-2 is largely focused on large-scale screening with fragment-based drug discovery (FBDD). With the recent advancement in cryo-electron microscopy (Cryo-EM), it has become one of the widely used tools in structural biology. It is effective in investigating the structure of numerous proteins in high-resolution and also had an intense influence on drug discovery, determining the binding reaction and regulation of known drugs as well as leading the design and development of new drug candidates. Here, we review the application of cryo-EM in a structure-based drug design (SBDD) and in silico screening of the recently acquired FBDD in SARS-CoV-2. Such insights will help deliver better understanding in the procurement of the effective remedial solution for this pandemic.

RevDate: 2021-09-25

Memon B, EM Abdelalim (2021)

ACE2 function in pancreatic islet: Implications for relationship between SARS-CoV-2 and diabetes.

Acta physiologica (Oxford, England) [Epub ahead of print].

The molecular link between SARS-CoV-2 infection and susceptibility is not well understood. Nonetheless, a bi-directional relationship between SARS-CoV-2 and diabetes has been proposed. The angiotensin converting enzyme 2 (ACE2) is considered as the primary protein facilitating SARS-CoV and SARS-CoV-2 attachment and entry into the host cells. Studies suggested that ACE2 is expressed in the endocrine cells of the pancreas including beta cells, in addition to the lungs and other organs; however, its expression in the islets, particularly beta cells, has been met with some contradiction. Importantly, ACE2 plays a crucial role in glucose homeostasis and insulin secretion by regulating beta cell physiology. Given the ability of SARS-COV-2 to infect human pluripotent stem cell-derived pancreatic cells in vitro and the presence of SARS-CoV-2 in pancreatic samples from COVID-19 patients strongly hints that SARS-CoV-2 can invade the pancreas and directly cause pancreatic injury and diabetes. However, more studies are required to dissect the underpinning molecular mechanisms triggered in SARS-COV-2-infected islets that lead to aggravation of diabetes. Regardless, it is important to understand the function of ACE2 in the pancreatic islets to design relevant therapeutic interventions in combatting the effects of SARS-CoV-2 on diabetes pathophysiology. Herein, we detail the function of ACE2 in pancreatic beta cells crucial for regulating insulin sensitivity, secretion, and glucose metabolism. Also, we discuss the potential role played by ACE2 in aiding SARS-COV-2 entry into the pancreas and the possibility of ACE2 cooperation with alternative entry factors as well as how that may be linked to diabetes pathogenesis.

RevDate: 2021-09-25

Takeda M (2021)

Proteolytic activation of SARS-CoV-2 spike protein.

Microbiology and immunology [Epub ahead of print].

Spike (S) protein cleavage is a crucial step in coronavirus infection. In this review, we discuss this process, with particular focus on the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Compared with influenza virus and paramyxovirus membrane fusion proteins, the cleavage activation mechanism of coronavirus S protein is much more complex. The S protein has two cleavage sites (S1/S2 and S2'), and the cleavage motif for furin protease at the S1/S2 site that results from a unique four-amino acid insertion is one of the distinguishing features of SARS-CoV-2. The viral particle incorporates the S protein, which has already undergone S1/S2 cleavage by furin, and then undergoes further cleavage at the S2' site, mediated by the type II transmembrane serine protease TMPRSS2, after binding to the receptor ACE2 to facilitate membrane fusion at the plasma membrane. In addition, SARS-CoV-2 can enter the cell by endocytosis and be proteolytically activated by cathepsin L, although this is not a major mode of SARS-CoV-2 infection. SARS-CoV-2 variants with enhanced infectivity have been emerging throughout the ongoing pandemic, and there is a close relationship between enhanced infectivity and changes in S protein cleavability. All four variants of concern carry the D614G mutation, which indirectly enhances S1/S2 cleavability by furin. The P681R mutation of the delta variant directly increases S1/S2 cleavability, enhancing membrane fusion and SARS-CoV-2 virulence. Changes in S protein cleavability can significantly impact viral infectivity, tissue tropism, and virulence. Understanding these mechanisms is critical to counteracting the coronaviral pandemic. This article is protected by copyright. All rights reserved.

RevDate: 2021-09-25

Powelson I, Kaufmann RA, Chida NM, et al (2021)

A New Consideration for Corticosteroid Injections: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2/COVID-19) Vaccination.

The Journal of hand surgery pii:S0363-5023(21)00403-2 [Epub ahead of print].

Corticosteroid injection (CSI) is a commonly used tool in hand surgery that is often given little consideration as a potential detriment to vaccination efficacy. The authors reviewed guidelines issued by relevant societies for the timing of CSI around the severe acute respiratory syndrome coronavirus 2 vaccination period and the evidence used to support them. Ultimately, providers and patients should be adequately educated on the theoretical risks and benefits before proceeding with CSI immediately before, during, or immediately after coronavirus disease 2019 vaccination.

RevDate: 2021-09-25

Arkin LM, Moon JJ, Tran JM, et al (2021)

From Your Nose to Your Toes: A Review of Severe Acute Respiratory Syndrome Coronavirus 2 Pandemic‒Associated Pernio.

The Journal of investigative dermatology pii:S0022-202X(21)01351-8 [Epub ahead of print].

Despite thousands of reported patients with pandemic-associated pernio, low rates of seroconversion and PCR positivity have defied causative linkage to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Pernio in uninfected children is associated with monogenic disorders of excessive IFN-1 immunity, whereas severe COVID-19 pneumonia can result from insufficient IFN-1. Moreover, SARS-CoV-2 spike protein and robust IFN-1 response are seen in the skin of patients with pandemic-associated pernio, suggesting an excessive innate immune skin response to SARS-CoV-2. Understanding the pathophysiology of this phenomenon may elucidate the host mechanisms that drive a resilient immune response to SARS-CoV-2 and could produce relevant therapeutic targets.

RevDate: 2021-09-24

Zou H, Ye H, Kamaraj R, et al (2021)

A review on pharmacological activities and synergistic effect of quercetin with small molecule agents.

Phytomedicine : international journal of phytotherapy and phytopharmacology, 92:153736 pii:S0944-7113(21)00279-8 [Epub ahead of print].

BACKGROUND: Quercetin is a natural flavonoid, which widely exists in nature, such as tea, coffee, apples, and onions. Numerous studies have showed that quercetin has multiple biological activities such as anti-oxidation, anti-inflammatory, and anti-aging. Hence, quercetin has a significant therapeutic effect on cancers, obesity, diabetes, and other diseases. In the past decades, a large number of studies have shown that quercetin combined with other agents can significantly improve the overall therapeutic effect, compared to single use.

PURPOSE: This work reviews the pharmacological activities of quercetin and its derivatives. In addition, this work also summarizes both in vivo and in vitro experimental evidence for the synergistic effect of quercetin against cancers and metabolic diseases.

METHODS: An extensive systematic search for pharmacological activities and synergistic effect of quercetin was performed considering all the relevant literatures published until August 2021 through the databases including NCBI PubMed, Scopus, Web of Science, and Google Scholar. The relevant literatures were extracted from the databases with following keyword combinations: "pharmacological activities" OR "biological activities" OR "synergistic effect" OR "combined" OR "combination" AND "quercetin" as well as free-text words.

RESULTS: Quercetin and its derivatives possess multiple pharmacological activities including anti-cancer, anti-oxidant, anti-inflammatory, anti-cardiovascular, anti-aging, and neuroprotective activities. In addition, the synergistic effect of quercetin with small molecule agents against cancers and metabolic diseases has also been confirmed.

CONCLUSION: Quercetin cooperates with agents to improve the therapeutic effect by regulating signal molecules and blocking cell cycle. Synergistic therapy can reduce the dose of agents and avoid the possible toxic and side effects in the treatment process. Although quercetin treatment has some potential side effects, it is safe under the expected use conditions. Hence, quercetin has application value and potential strength as a clinical drug. Furthermore, quercetin, as the main effective therapeutic ingredient in traditional Chinese medicine, may effectively treat and prevent coronavirus disease 2019 (COVID-19).

RevDate: 2021-09-26

Oo WM, Giri P, A de Souza (2021)

AstraZeneca COVID-19 vaccine and Guillain- Barré Syndrome in Tasmania: A causal link?.

Journal of neuroimmunology, 360:577719 [Epub ahead of print].

The emergence of the coronavirus 2019 (COVID-19) pandemic has presented an unprecedented global challenge. Vaccines against COVID have been developed to date. Covid-19 has been linked with the development of Guillain-Barre Syndrome (GBS), a rare immune-mediated demyelinating neuropathy. We report three cases of Guillain-Barre Syndrome and one case of Chronic Inflammatory Demyelinating Polyneuropathy (CIDP), presenting to a Tasmanian hospital, and review 15 other reported cases and discuss likely immunopathology. Nearly all reported cases of post-COVID-19 vacciation inflammatory demyelinating polyneuropathy are linked to AstraZeneca vaccination and a variant with bifacial weakness is the most reported form of GBS globally.

RevDate: 2021-09-24

Zuo T, Wu X, Wen W, et al (2021)

Gut Microbiome Alterations in COVID-19.

Genomics, proteomics & bioinformatics pii:S1672-0229(21)00206-0 [Epub ahead of print].

Since the outset of the coronavirus disease 2019 (COVID-19) pandemic, the gut microbiome in COVID-19 has garnered substantial interest, given its significant roles in human health and pathophysiology. Accumulating evidence is unveiling that the gut microbiome is broadly altered in COVID-19, including the bacterial microbiome, mycobiome, and virome. Overall, the gut microbial ecological network is significantly weakened and becomes sparse in patients with COVID-19, together with a decrease in gut microbiome diversity. Beyond the existence of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2), the gut microbiome of patients with COVID-19 is also characterized by enrichment of opportunistic bacteria, fungi, and eukaryotic viruses, which are also associated with disease severity and presentation. Meanwhile, a multitude of symbiotic bacteria and bacteriophages are decreased in abundance in patients with COVID-19. Such gut microbiome features persist in a significant subset of patients with COVID-19 even after disease resolution, coinciding with 'long COVID' (also known as post-acute sequelae of COVID-19). The broadly-altered gut microbiome is largely a consequence of SARS-CoV-2 infection and its downstream detrimental effects on the systemic host immunity and the gut milieu. The impaired host immunity and distorted gut microbial ecology, particularly loss of low-abundance beneficial bacteria and blooms of opportunistic fungi including Candida, may hinder the re-assembly of the gut microbiome post COVID-19. Future investigation is necessary to fully understand the role of the gut microbiome in host immunity against SARS-CoV-2 infection, as well as the long-term effect of COVID-19 on the gut microbiome in relation to the host health after the pandemic.

RevDate: 2021-09-26

Pizzol D, Shin JI, Trott M, et al (2021)

Social environmental impact of COVID-19 and erectile dysfunction: an explorative review.

Journal of endocrinological investigation [Epub ahead of print].

BACKGROUND: To date, no attempt has been made to collate literature on the relationship between the social environmental impact of COVID-19 and erectile dysfunction. The aim of this explorative review was to assess and compare the prevalence of erectile dysfunction (ED) in male healthcare workers and males during the COVID-19 pandemic.

METHODS: A systematic review of major databases from inception to February 2021 was conducted. Prevalence data were extracted, and a random-effects meta-analysis was undertaken.

OUTCOMES: The pooled prevalence of ED amongst healthcare workers working in COVID-19 specific environments, and non-healthcare during the COVID-19 pandemic.

RESULTS: Of 52 initial studies, six were included for the final analysis. The pooled prevalence of ED in healthcare workers working in a COVID-19 environment was 63.6% (95% CI 20.3-92.3%), and in non-healthcare workers during the COVID-19 pandemic was 31.9% (95% CI 19.5-47.6%).

CONCLUSION: The prevalence of ED in healthcare workers working in COVID-19 environments was higher than representative samples and is of concern. Sexual health (and by extension, overall health), should be a priority when considering ways to care for this population. Considering the social environmental impact of COVID-19 on sexual health and in particular on ED, it is important to provide adequate psychological support systems and to promote quality of life with particular attention to sexual health.

RevDate: 2021-09-26

Bandeira L, Lazaretti-Castro M, N Binkley (2021)

Clinical aspects of SARS-CoV-2 infection and vitamin D : COVID-19 and the endocrine system: special issue for reviews in endocrine and metabolic disorders (Felipe Casaneuva, Editor in Chief) A. Giustina and JP Bilezikian, Guest Editors.

Reviews in endocrine & metabolic disorders [Epub ahead of print].

In December 2019, the first cases of severe acute respiratory syndrome due to a new coronavirus (SARS-Cov-2), later designated as Covid-19, were described in China. With rapid advance of the infection to several continents, in March 2020, WHO declared this to be a pandemic. In April 2020, the first papers suggesting a possible role of Vitamin D deficiency in the severity of this infection began to appear and dozens of articles evaluating a potential relationship of vitamin D with COVID have emerged subsequntly. This possibility was raised based on pre-existing evidence of the effects of Vitamin D on the immune system, and more specifically on acute respiratory viral infections. In addition, most Covid-19 victims belong to groups at risk for vitamin D deficiency such as the elderly, obese, chronically ill, and specific ethnic groups. Although with some contradictory reports exist, most observational and cohort studies find a relationship of low vitamin D status with greater Covid severity, others, including the few interventional studies available show inconsistent results. This paper aims to present the rapidly expanding literature to date regarding the clinical relevance of vitamin D in Covid-19 and, consequently, the reasonableness of avoiding its deficiency to keep the immune system able to respond in the best way to this acute viral infection. In the meantime, we wait for publication of several prospective randomized controlled studies that are underway, evaluating the effects of treatment with vitamin D or metabolites on the severity of Covid-19 outcomes.

RevDate: 2021-09-26

Sedlaczek O, Wagner W, CE Dempfle (2021)

[COVID-19-induced coagulopathy and thrombosis manifestations].

Der Radiologe [Epub ahead of print].

CLINICAL ISSUE: Clinically, COVID-19 (coronavirus disease 2019) is increasingly seen as a systemic disease associated with multiorgan involvement through a hypercoagulatory condition in the sense of vasculopathy.

STANDARD TREATMENT: Treatment with antiplatelet drugs or heparins appears to be indicated. The current evidence, at least for acetylsalicylic acid (ASA), is lacking.

DIAGNOSTIC WORK-UP: Corresponding to the significant proportion of primarily microstructural vascular changes, the radiological diagnosis showed not only macrovascular pathologies, but also diffuse perfusion disorders.

PERFORMANCE: Regional hypoperfusion in the lungs can be detected with and without pulmonary arterial embolism. Similar findings can be found in almost all organ systems.

PRACTICAL RECOMMENDATIONS: A therapeutic intervention using low molecular weight heparins in hospitalized patients in situation-adapted dosage is indicated and is discussed in detail. In the detection of micro- and macrovascular thrombosis in the context of COVID-19, extended radiological diagnostics play a central role and are the basis of adapted therapy and secondary prevention.

RevDate: 2021-09-24

Peng J, Fu M, Mei H, et al (2021)

Efficacy and secondary infection risk of tocilizumab, sarilumab and anakinra in COVID-19 patients: A systematic review and meta-analysis.

Reviews in medical virology [Epub ahead of print].

As the pandemic progresses, the pathophysiology of coronavirus disease 2019 (COVID-19) is becoming clearer and the potential for immunotherapy is increasing. However, clinical efficacy and safety of immunosuppressants (including tocilizumab, sarilumab and anakinra) treatment in COVID-19 patients are not yet known. We searched PubMed, Embase Medline, Web of Science and MedRxiv using specific search terms in studies published from 1 January 2020 to 20 December 2020. In total, 33 studies, including 3073 cases and 6502 controls, were selected for meta-analysis. We found that immunosuppressant therapy significantly decreased mortality in COVID-19 patients on overall analysis (odds ratio = 0.71, 95% confidence interval = 0.57-0.89, p = 0.004). We also found that tocilizumab and anakinra significantly decreased mortality in patients without any increased risk of secondary infection. In addition, we found similar results in several subgroups. However, we found that tocilizumab therapy significantly increased the risk of fungal co-infections in COVID-19 patients. This represents the only systematic review and meta-analysis to investigate the efficacy and secondary infection risk of immunosuppressant treatment in COVID-19 patients. Overall, immunosuppressants significantly decreased mortality but had no effect on increased risk of secondary infections. Our analysis of tocilizumab therapy showed a significantly increased risk of fungal co-infections in these patients.

RevDate: 2021-09-24

Kumari P, Gupta UD, SS Bhagyawant (2021)

Bacillus calmette-guerin as a quick and temporary solution to coronavirus disease-2019.

International journal of mycobacteriology, 10(2):105-110.

The coronavirus disease-2019 (COVID-19) pandemic is one of the most devastating things that happened in the world which has taken the lives of millions of people and has brutally shattered the world economy. This pandemic has instigated an urgent need for a vaccine to reduce the ongoing morbidity and mortality. Bacillus Calmette-Guerin (BCG) apart from being used as an effective and old vaccine against tuberculosis has some known off-target protection effect and is getting more attention in this scenario. BCG confers nonspecific innate immune-boosting effects called trained immunity against secondary infection. Various recent publications have proposed the inverse relationship between the COVID-19 morbidity and mortality with that of BCG coverage of that country on the basis of epidemiological studies. However, these studies have not considered the confounding factors, and a lot of recent articles are contradicting these epidemiological and observational data. Several random control trials for BCG on health-care workers and elderly people are ongoing worldwide and could depict the actual relation between COVID-19 and BCG protection. Although a recent trial has found a protective function of BCG against COVID-19 in health-care workers, more results of the trials can only give approval on this. There has been a shortage of BCG worldwide due to its use in bladder cancer and vaccination in neonates, and hence, its use should be carefully regulated. In this review, we have tried to summarize the various issue and conflicts on BCG to be used as a temporary solution to COVID-19.

RevDate: 2021-09-24

Aliyu AA (2021)

Public health ethics and the COVID-19 pandemic.

Annals of African medicine, 20(3):157-163.

Health is a human right anchored in values as a basic necessity of life. It promotes the well-being of persons, communities, economic prosperity, and national development. The coronavirus disease-2019 (COVID-19) pandemic caught the world unaware and unprepared. It presented a huge challenge to the health and economic systems of every country. Across the spectrum of human endeavor and liberty, several ethical questions have been raised with regard to its management, particularly the public health control measures. Decisions for pandemic control measures are made under difficult circumstances driven by urgency and panic, with uncertainties and complexities for public goods over individual rights. Global solidarity in controlling the pandemic is being tested. National governments have the responsibility to protect public health on the grounds of common good. Political considerations should not be the basis for decision-making against the best available epidemiological data from pandemic disease dynamics. Hence, the need to adhere to the values of honesty, trust, human dignity, solidarity, reciprocity, accountability, transparency, and justice are major considerations. A literature search was conducted for the publications from academic databases and websites of health-relevant organizations. I discuss the ethical questions and challenges of the COVID-19 pandemic in the context of public health control measures using the standard ethical principles of respect for autonomy, beneficence, nonmaleficence, and social (distributive) justice. It is observed that, at the country level, the World Health Organization (WHO) guidelines are used to control the pandemic. As WHO through the COVAX strategy distributes the vaccines to less developed countries, a lot still needs to be done to address the complex bottlenecks of allocation and distribution. There is a need to ensure acceptable and transparent system that promotes cooperation, equitable access, and fair distribution of vaccines on a global scale.

RevDate: 2021-09-24

Abdrabbo M, Birch CM, Brandt M, et al (2021)

Vitamin D and COVID-19: A Review on the Role of Vitamin D in Preventing and Reducing the Severity of COVID-19 Infection.

Protein science : a publication of the Protein Society [Epub ahead of print].

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is a pathogenic coronavirus causing COVID-19 infection. The interaction between the SARS-CoV-2 spike protein and the human receptor angiotensin-converting enzyme 2, both of which contain several cysteine residues, is impacted by the disulfide-thiol balance in the host cell. The host cell redox status is affected by oxidative stress due to the imbalance between the reactive oxygen/nitrogen species and antioxidants. Recent studies have shown that Vitamin D supplementation could reduce oxidative stress. It has also been proposed that vitamin D at physiological concentration has preventive effects on many viral infections, including COVID-19. However, the molecular-level picture of the interplay of vitamin D deficiency, oxidative stress, and the severity of COVID-19 has remained unclear. Herein, we present a thorough review focusing on the possible molecular mechanism by which vitamin D could alter host cell redox status and block viral entry, thereby preventing COVID-19 infection or reducing the severity of the disease. This article is protected by copyright. All rights reserved.

RevDate: 2021-09-24

Akinbolade S, Coughlan D, Fairbairn R, et al (2021)

Combination therapies for COVID-19: an overview of the clinical trials landscape.

British journal of clinical pharmacology [Epub ahead of print].

The COVID-19 pandemic has driven an unprecedented level of global activity in drug discovery and clinical development for effective therapeutics targeting the coronavirus disease. There are currently 744 therapeutics being tested in 2879 clinical trials globally. Almost 90% of these clinical trials are focused on monotherapies. Combination therapies are the mainstay of antiviral therapeutics to increase the potency of the individual compounds and to combat the rapid evolution of resistance, although combination therapies have inherently complex clinical and regulatory development challenges. Increased understanding of the SARS-CoV-2 lifecycle and COVID-19 pathology provides a scientific rationale for evaluating the effectiveness of different combinations. In this paper, we provide an overview of the current clinical trial landscape for combination therapeutics targeting COVID-19 through weekly scanning of national and international clinical trial registries. Our analysis delves specifically into dual combination therapies in what can be defined as 'pivotal clinical trials' (active, randomised, controlled and at least phase II), with a focus on new and repurposed therapeutic candidates that have shown positive signals and/or been granted authorisation for emergency use based on positive efficacy and safety data.

RevDate: 2021-09-26

D Atoufi H, Lampert DJ, M Sillanpää (2021)

COVID-19, a double-edged sword for the environment: a review on the impacts of COVID-19 on the environment.

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

This review paper discusses the most relevant impacts of the COVID-19 pandemic on the environment. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) originated in Wuhan, China, in December 2019. The disease has infected 70 million people and caused the death of 1.58 million people since the US Food and Drug Administration issued an Emergency Use Authorization to develop a vaccine to prevent COVID-19 on December 11, 2020. COVID-19 is a global crisis that has impacted everything directly connected with human beings, including the environment. This review discusses the impacts of COVID-19 on the environment during the pandemic and post-COVID-19 era. During the first months of the COVID pandemic, global coal, oil, gas, and electricity demands declined by 8%, 5%, 2%, and 20%, respectively, relative to 2019. Stay-at-home orders in countries increased the concentrations of particles in indoor environments while decreasing the concentrations of PM2.5 and NOX in outdoor environments. Remotely working in response to the COVID-19 pandemic increased the carbon, water, and land footprints of Internet usage. Microplastics are released into our environment from the mishandling and mismanagement of personal protective equipment that endanger our water, soils, and sediments. Since the COVID-19 vaccine cannot be stored for a long time and spoils rapidly, more awareness of the massive waste of unused doses is needed. So COVID-19 is a double-edged sword for the environment.

RevDate: 2021-09-26

Islam A, Kalam MA, Sayeed MA, et al (2021)

Escalating SARS-CoV-2 circulation in environment and tracking waste management in South Asia.

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

The novel coronavirus disease of 2019 (COVID-19) pandemic has caused an exceptional drift of production, utilization, and disposal of personal protective equipment (PPE) and different microplastic objects for safety against the virus. Hence, we reviewed related literature on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) RNA detected from household, biomedical waste, and sewage to identify possible health risks and status of existing laws, regulations, and policies regarding waste disposal in South Asian (SA) countries. The SARS-CoV-2 RNA was detected in sewage and wastewater samples of Nepal, India, Pakistan, and Bangladesh. Besides, this review reiterates the enormous amounts of PPE and other single-use plastic wastes generated from healthcare facilities and households in the SA region with inappropriate disposal, landfilling, and/or incineration techniques wind-up polluting the environment. Consequently, the Delta variant (B.1.617.2) of SARS-CoV-2 has been detected in sewer treatment plant in India. Moreover, the overuse of non-biodegradable plastics during the pandemic is deteriorating plastic pollution condition and causes a substantial health risk to the terrestrial and aquatic ecosystems. We recommend making necessary adjustments, adopting measures and strategies, and enforcement of the existing biomedical waste management and sanitation-related policy in SA countries. We propose to adopt the knowledge gaps to improve COVID-19-associated waste management and legislation to prevent further environmental pollution. Besides, the citizens should follow proper disposal procedures of COVID-19 waste to control the environmental pollution.

RevDate: 2021-09-25

Gaunt ER, NA Mabbott (2021)

The clinical correlates of vaccine-induced immune thrombotic thrombocytopenia after immunisation with adenovirus vector-based SARS-CoV-2 vaccines.

Immunotherapy advances, 1(1):ltab019.

We are at a critical stage in the COVID-19 pandemic where vaccinations are being rolled out globally, in a race against time to get ahead of the SARS-CoV-2 coronavirus and the emergence of more highly transmissible variants. A range of vaccines have been created and received either emergency approval or full licensure. To attain the upper hand, maximum vaccine synthesis, deployment, and uptake as rapidly as possible is essential. However, vaccine uptake, particularly in younger adults is dropping, at least in part fuelled by reports of rare complications associated with specific vaccines. This review considers how vaccination with adenovirus vector-based vaccines against the SARS-CoV-2 coronavirus might cause rare cases of thrombosis and thrombocytopenia in some recipients. A thorough understanding of the underlying cellular and molecular mechanisms that mediate this syndrome may help to identify methods to prevent these very rare, but serious side effects. This will also help facilitate the identification of those at highest risk from these outcomes, so that we can work towards a stratified approach to vaccine deployment to mitigate these risks.


RJR Experience and Expertise


Robbins holds BS, MS, and PhD degrees in the life sciences. He served as a tenured faculty member in the Zoology and Biological Science departments at Michigan State University. He is currently exploring the intersection between genomics, microbial ecology, and biodiversity — an area that promises to transform our understanding of the biosphere.


Robbins has extensive experience in college-level education: At MSU he taught introductory biology, genetics, and population genetics. At JHU, he was an instructor for a special course on biological database design. At FHCRC, he team-taught a graduate-level course on the history of genetics. At Bellevue College he taught medical informatics.


Robbins has been involved in science administration at both the federal and the institutional levels. At NSF he was a program officer for database activities in the life sciences, at DOE he was a program officer for information infrastructure in the human genome project. At the Fred Hutchinson Cancer Research Center, he served as a vice president for fifteen years.


Robbins has been involved with information technology since writing his first Fortran program as a college student. At NSF he was the first program officer for database activities in the life sciences. At JHU he held an appointment in the CS department and served as director of the informatics core for the Genome Data Base. At the FHCRC he was VP for Information Technology.


While still at Michigan State, Robbins started his first publishing venture, founding a small company that addressed the short-run publishing needs of instructors in very large undergraduate classes. For more than 20 years, Robbins has been operating The Electronic Scholarly Publishing Project, a web site dedicated to the digital publishing of critical works in science, especially classical genetics.


Robbins is well-known for his speaking abilities and is often called upon to provide keynote or plenary addresses at international meetings. For example, in July, 2012, he gave a well-received keynote address at the Global Biodiversity Informatics Congress, sponsored by GBIF and held in Copenhagen. The slides from that talk can be seen HERE.


Robbins is a skilled meeting facilitator. He prefers a participatory approach, with part of the meeting involving dynamic breakout groups, created by the participants in real time: (1) individuals propose breakout groups; (2) everyone signs up for one (or more) groups; (3) the groups with the most interested parties then meet, with reports from each group presented and discussed in a subsequent plenary session.


Robbins has been engaged with photography and design since the 1960s, when he worked for a professional photography laboratory. He now prefers digital photography and tools for their precision and reproducibility. He designed his first web site more than 20 years ago and he personally designed and implemented this web site. He engages in graphic design as a hobby.


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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

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Collection of publications by R J Robbins

Reprints and preprints of publications, slide presentations, instructional materials, and data compilations written or prepared by Robert Robbins. Most papers deal with computational biology, genome informatics, using information technology to support biomedical research, and related matters.

Research Gate page for R J Robbins

ResearchGate is a social networking site for scientists and researchers to share papers, ask and answer questions, and find collaborators. According to a study by Nature and an article in Times Higher Education , it is the largest academic social network in terms of active users.

Curriculum Vitae for R J Robbins

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Curriculum Vitae for R J Robbins

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RJR Picks from Around the Web (updated 11 MAY 2018 )