51
|
Chan KG, Ang GY, Yu CY, Yean CY. Harnessing CRISPR-Cas to Combat COVID-19: From Diagnostics to Therapeutics. Life (Basel) 2021; 11:1210. [PMID: 34833086 PMCID: PMC8623262 DOI: 10.3390/life11111210] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 10/31/2021] [Accepted: 11/03/2021] [Indexed: 12/24/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), remains a global threat with an ever-increasing death toll even after a year on. Hence, the rapid identification of infected individuals with diagnostic tests continues to be crucial in the on-going effort to combat the spread of COVID-19. Viral nucleic acid detection via real-time reverse transcription polymerase chain reaction (rRT-PCR) or sequencing is regarded as the gold standard for COVID-19 diagnosis, but these technically intricate molecular tests are limited to centralized laboratories due to the highly specialized instrument and skilled personnel requirements. Based on the current development in the field of diagnostics, the programmable clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated proteins (Cas) system appears to be a promising technology that can be further explored to create rapid, cost-effective, sensitive, and specific diagnostic tools for both laboratory and point-of-care (POC) testing. Other than diagnostics, the potential application of the CRISPR-Cas system as an antiviral agent has also been gaining attention. In this review, we highlight the recent advances in CRISPR-Cas-based nucleic acid detection strategies and the application of CRISPR-Cas as a potential antiviral agent in the context of COVID-19.
Collapse
Affiliation(s)
- Kok Gan Chan
- International Genome Centre, Jiangsu University, Zhenjiang 212013, China;
- Institute of Marine Sciences, Shantou University, Shantou 515063, China
- Division of Genetics and Molecular Biology, Institute of Biological Sciences, Faculty of Science, University of Malaya, Kuala Lumpur 50603, Malaysia
| | - Geik Yong Ang
- Faculty of Sports Science and Recreation, Universiti Teknologi MARA, Shah Alam 40450, Malaysia
| | - Choo Yee Yu
- Laboratory of Vaccine and Biomolecules, Institute of Bioscience, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Chan Yean Yean
- Department of Medical Microbiology and Parasitology, School of Medical Sciences, Universiti Sains Malaysia, Kota Bharu 16150, Malaysia
| |
Collapse
|
52
|
Lucaciu O, Aghiorghiesei O, Petrescu NB, Mirica IC, Benea HRC, Apostu D. In quest of a new therapeutic approach in COVID-19: the endocannabinoid system. Drug Metab Rev 2021; 53:478-490. [PMID: 33683968 PMCID: PMC7989954 DOI: 10.1080/03602532.2021.1895204] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/21/2021] [Indexed: 01/08/2023]
Abstract
The SARS-Cov-2 virus caused a high morbidity and mortality rate disease, that is the COVID-19 pandemic. Despite the unprecedented research interest in this field, the lack of specific treatments leads to severe complications in a high number of cases. Current treatment includes antivirals, corticosteroids, immunoglobulins, antimalarials, interleukin-6 inhibitors, anti-GM-CSF, convalescent plasma, immunotherapy, antibiotics, circulation support, oxygen therapy, and circulation support. Due to the limited results, until specific treatments are available, other therapeutic approaches need to be considered. The endocannabinoid system is found in multiple systems within the human body, including the immune system. Its activation can lead to beneficial results such as decreased viral entry, decreased viral replication, and a decrease in pro-inflammatory cytokines such as IL-2, IL-4, IL-6, IL-12, TNF-α, or IFN-γ. Moreover, endocannabinoid system activation can lead to an increase in anti-inflammatory cytokines, mainly represented by IL-10. Overall, the cannabinoid system can potentially reduce pulmonary inflammation, increase the immunomodulatory effect, decrease PMN infiltration, reduce fibrosis, and decrease viral replication, as well as decrease the 'cytokine storm'. Although the cannabinoid system has many mechanisms to provide certain benefits in the treatment of SARS-CoV-2 infected patients, research in this field is needed for a better understanding of the cannabinoid impact in this situation.
Collapse
Affiliation(s)
- Ondine Lucaciu
- Department of Oral Rehabilitation, University of Medicine and Pharmacy ‘Iuliu Hatieganu’, Cluj-Napoca, Romania
| | - Ovidiu Aghiorghiesei
- Department of Oral Rehabilitation, University of Medicine and Pharmacy ‘Iuliu Hatieganu’, Cluj-Napoca, Romania
| | - Nausica Bianca Petrescu
- Department of Oral Rehabilitation, University of Medicine and Pharmacy ‘Iuliu Hatieganu’, Cluj-Napoca, Romania
| | - Ioana Codruta Mirica
- Department of Oral Rehabilitation, University of Medicine and Pharmacy ‘Iuliu Hatieganu’, Cluj-Napoca, Romania
| | - Horea Rareș Ciprian Benea
- Department of Orthopedics-Traumatology and Pediatric Orthopedics, University of Medicine and Pharmacy ‘Iuliu Hatieganu’, Cluj-Napoca, Romania
| | - Dragoș Apostu
- Department of Orthopedics-Traumatology and Pediatric Orthopedics, University of Medicine and Pharmacy ‘Iuliu Hatieganu’, Cluj-Napoca, Romania
| |
Collapse
|
53
|
Alwazeer D, Liu FFC, Wu XY, LeBaron TW. Combating Oxidative Stress and Inflammation in COVID-19 by Molecular Hydrogen Therapy: Mechanisms and Perspectives. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2021; 2021:5513868. [PMID: 34646423 PMCID: PMC8505069 DOI: 10.1155/2021/5513868] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 09/20/2021] [Indexed: 02/07/2023]
Abstract
COVID-19 is a widespread global pandemic with nearly 185 million confirmed cases and about four million deaths. It is caused by an infection with the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which primarily affects the alveolar type II pneumocytes. The infection induces pathological responses including increased inflammation, oxidative stress, and apoptosis. This situation results in impaired gas exchange, hypoxia, and other sequelae that lead to multisystem organ failure and death. As summarized in this article, many interventions and therapeutics have been proposed and investigated to combat the viral infection-induced inflammation and oxidative stress that contributes to the etiology and pathogenesis of COVID-19. However, these methods have not significantly improved treatment outcomes. This may partly be attributable to their inability at restoring redox and inflammatory homeostasis, for which molecular hydrogen (H2), an emerging novel medical gas, may complement. Herein, we systematically review the antioxidative, anti-inflammatory, and antiapoptotic mechanisms of H2. Its small molecular size and nonpolarity allow H2 to rapidly diffuse through cell membranes and penetrate cellular organelles. H2 has been demonstrated to suppress NF-κB inflammatory signaling and induce the Nrf2/Keap1 antioxidant pathway, as well as to improve mitochondrial function and enhance cellular bioenergetics. Many preclinical and clinical studies have demonstrated the beneficial effects of H2 in varying diseases, including COVID-19. However, the exact mechanisms, primary modes of action, and its true clinical effects remain to be delineated and verified. Accordingly, additional mechanistic and clinical research into this novel medical gas to combat COVID-19 complications is warranted.
Collapse
Affiliation(s)
- Duried Alwazeer
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Igdir University, 76000 Igdır, Turkey
- Research Center for Redox Applications in Foods (RCRAF), Igdir University, 76000 Igdır, Turkey
- Innovative Food Technologies Development, Application, and Research Center, Igdir University, 76000 Igdır, Turkey
| | - Franky Fuh-Ching Liu
- Advanced Pharmaceutics and Drug Delivery Laboratory, Leslie L. Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada M5S 3M2
| | - Xiao Yu Wu
- Advanced Pharmaceutics and Drug Delivery Laboratory, Leslie L. Dan Faculty of Pharmacy, University of Toronto, Toronto, ON, Canada M5S 3M2
| | - Tyler W. LeBaron
- Center of Experimental Medicine, Institute for Heart Research, Slovak Academy of Sciences, Bratislava, Slovakia
- Molecular Hydrogen Institute, Enoch, Utah, USA
- Department of Kinesiology and Outdoor Recreation, Southern Utah University, Cedar City, 84720 Utah, USA
| |
Collapse
|
54
|
High Prevalence of Pre-Existing Liver Abnormalities Identified Via Autopsies in COVID-19: Identification of a New Silent Risk Factor? Diagnostics (Basel) 2021; 11:diagnostics11091703. [PMID: 34574044 PMCID: PMC8467907 DOI: 10.3390/diagnostics11091703] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 09/07/2021] [Accepted: 09/09/2021] [Indexed: 12/23/2022] Open
Abstract
A high prevalence of hepatic pathology (in 17 of 19 cases) was reported in post-mortem (PM) examinations of COVID-19 patients, undertaken between March 2020 and February 2021 by a single autopsy pathologist in two English Coronial jurisdictions. The patients in our cohort demonstrated high levels of recognised COVID-19 risk factors, including hypertension (8/16, 50%), type 2 diabetes mellitus (8/16, 50%) and evidence of arteriopathy 6/16 (38%). Hepatic abnormalities included steatosis (12/19; 63%), moderate to severe venous congestion (5/19; 26%) and cirrhosis (4/19; 21%). A subsequent literature review indicated a significantly increased prevalence of steatosis (49%), venous congestion (34%) and cirrhosis (9.3%) in COVID-19 PM cases, compared with a pre-pandemic PM cohort (33%, 16%, and 2.6%, respectively), likely reflecting an increased mortality risk in SARS-CoV-2 infection for patients with pre-existing liver disease. To corroborate this observation, we retrospectively analysed the admission liver function test (LFT) results of 276 consecutive, anonymised COVID-19 hospital patients in our centre, for whom outcome data were available. Of these patients, 236 (85.5%) had significantly reduced albumin levels at the time of admission to hospital, which was likely indicative of pre-existing chronic liver or renal disease. There was a strong correlation between patient outcome (length of hospital admission or death) and abnormal albumin at the time of hospital admission (p = 0.000012). We discuss potential mechanisms by which our observations of hepatic dysfunction are linked to a risk of COVID-19 mortality, speculating on the importance of recently identified anti-interferon antibodies.
Collapse
|
55
|
Yasmin F, Asghar W, Babar MS, Khan H, Ahmad S, Hameed Z, Asghar MS, Nauman H, Khattak AK, Arshad Z, Shah SMI, Siddiqui SA, Osama M, Zarak MS. Acceptance Rates and Beliefs toward COVID-19 Vaccination among the General Population of Pakistan: A Cross-Sectional Survey. Am J Trop Med Hyg 2021; 105:1230-1239. [PMID: 34525449 PMCID: PMC8592216 DOI: 10.4269/ajtmh.21-0297] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 08/01/2021] [Indexed: 01/02/2023] Open
Abstract
Developing countries like Pakistan have previously suffered from barriers to acceptance of vaccination by the public because of financial and belief barriers. This study aims to explore these beliefs and highlight concerns regarding vaccine hesitancy in the general population of Pakistan since they are a hindrance to an effective coronavirus disease-19 (COVID-19) immunization in the country. A cross-sectional study was performed involving 1,778 participants from all four provinces of Pakistan. Results from the study showed more than half of the participants to be unsure of the safety (50%) and efficacy (51%) of the vaccine, whereas 42% were concerned about the side effects of the vaccine. About 72% of the respondents planned to get vaccinated, whereas 28% refused to do so. Internationally made imported vaccines were more trusted by the participants. Forty-four percent of the participants agreed to receive the vaccine upon recommendation from a physician. Lastly, participants who believed in the efficacy of the polio vaccination also considered the COVID-19 vaccine to be safe and effective.
Collapse
Affiliation(s)
- Farah Yasmin
- 1Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Waleed Asghar
- 2City Gynae Hospital Toba Tek Singh, Medicine, Toba Tek Singh, Punjab, Pakistan
| | - Maryam Salma Babar
- 3Dubai Medical College for Girls, Faculty of Medicine, Dubai, United Arab Emirates
| | - Hiba Khan
- 3Dubai Medical College for Girls, Faculty of Medicine, Dubai, United Arab Emirates
| | - Shoaib Ahmad
- 4General Medicine and Surgery, Punjab Medical College, Faisalabad, Pakistan
| | - Zaid Hameed
- 5Department of Internal Medicine, Allied Hospital, Faisalabad, Pakistan
| | | | - Hamza Nauman
- 1Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | | | - Zara Arshad
- 8Department of Internal Medicine, Capital Hospital, Islamabad, Pakistan
| | | | - Sarush Ahmed Siddiqui
- 1Department of Internal Medicine, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Muhammad Osama
- 10Department of General Surgery, Dow University of Health Sciences, Karachi, Pakistan
| | | |
Collapse
|
56
|
Dowarah J, Marak BN, Yadav UCS, Singh VP. Potential drug development and therapeutic approaches for clinical intervention in COVID-19. Bioorg Chem 2021; 114:105016. [PMID: 34144277 PMCID: PMC8143914 DOI: 10.1016/j.bioorg.2021.105016] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 05/20/2021] [Indexed: 01/25/2023]
Abstract
While the vaccination is now available to many countries and will slowly dissipate to others, effective therapeutics for COVID-19 is still illusive. The SARS-CoV-2 pandemic has posed an unprecedented challenge to researchers, scientists, and clinicians and affected the wellbeing of millions of people worldwide. Since the beginning of the pandemic, a multitude of existing anti-viral, antibiotic, antimalarial, and anticancer drugs have been tested, and some have shown potency in the treatment and management of COVID-19, albeit others failed to leave any positive impact and a few also became controversial as they showed mixed clinical outcomes. In the present article, we have brought together some of the candidate therapeutic drugs being repurposed or used in the clinical trials and discussed their clinical efficacy and safety for COVID-19.
Collapse
Affiliation(s)
- Jayanta Dowarah
- Department of Chemistry, School of Physical Sciences, Mizoram University, Aizawl 796004, Mizoram, India
| | - Brilliant N Marak
- Department of Chemistry, School of Physical Sciences, Mizoram University, Aizawl 796004, Mizoram, India
| | | | - Ved Prakash Singh
- Department of Chemistry, School of Physical Sciences, Mizoram University, Aizawl 796004, Mizoram, India; Department of Industrial Chemistry, School of Physical Sciences, Mizoram University, Aizawl 796004, Mizoram, India.
| |
Collapse
|
57
|
Gupta J, Bavinck M, Ros-Tonen M, Asubonteng K, Bosch H, van Ewijk E, Hordijk M, Van Leynseele Y, Lopes Cardozo M, Miedema E, Pouw N, Rammelt C, Scholtens J, Vegelin C, Verrest H. COVID-19, poverty and inclusive development. WORLD DEVELOPMENT 2021; 145:105527. [PMID: 36570384 PMCID: PMC9758535 DOI: 10.1016/j.worlddev.2021.105527] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/22/2021] [Indexed: 05/05/2023]
Abstract
The COVID-19 epidemic provides yet another reason to prioritize inclusive development. Current response strategies of the global community and countries expose a low level of solidarity with poorer nations and poorer people in all nations. Against this background, this paper addresses the question: What are the development challenges that the COVID-19 pandemic lays bare and what lessons can be learnt for the way recovery processes are designed? Using an inclusive development and DPSIR lens to assess the literature, our study finds that, first, the current response prioritises the 'state' and 'impact' concerns of wealthier classes at the expense of the remainder of the world population. Second, responses have ignored underlying 'drivers' and 'pressures', instead aiming at a quick recovery of the economy. Third, a return to business-as-usual using government funding will lead to a vicious cycle of further ecological degradation, socio-economic inequality and domestic abuse that assist in exacerbating the drivers of the pandemic. We argue instead for an inclusive development approach that leads to a virtuous cycle by emphasizing human health, well-being and ecosystem regeneration. We conclude that the lost years for development did not commence in 2020 with the onset of COVID-19; the downward trend has actually been waxing over the past three decades. From this perspective, COVID-19 may be the shock needed to put the last first and transform vicious into virtuous cycles of inclusive development.
Collapse
Affiliation(s)
- Joyeeta Gupta
- Amsterdam Institute for Social Science Research (AISSR), University of Amsterdam, Nieuwe Achtergracht 166, Postbus 15629, 1001 NC Amsterdam, The Netherlands
| | - Maarten Bavinck
- Amsterdam Institute for Social Science Research (AISSR), University of Amsterdam, Nieuwe Achtergracht 166, Postbus 15629, 1001 NC Amsterdam, The Netherlands
| | - Mirjam Ros-Tonen
- Amsterdam Institute for Social Science Research (AISSR), University of Amsterdam, Nieuwe Achtergracht 166, Postbus 15629, 1001 NC Amsterdam, The Netherlands
| | - Kwabena Asubonteng
- Amsterdam Institute for Social Science Research (AISSR), University of Amsterdam, Nieuwe Achtergracht 166, Postbus 15629, 1001 NC Amsterdam, The Netherlands
| | - Hilmer Bosch
- Amsterdam Institute for Social Science Research (AISSR), University of Amsterdam, Nieuwe Achtergracht 166, Postbus 15629, 1001 NC Amsterdam, The Netherlands
| | - Edith van Ewijk
- Amsterdam Institute for Social Science Research (AISSR), University of Amsterdam, Nieuwe Achtergracht 166, Postbus 15629, 1001 NC Amsterdam, The Netherlands
| | - Michaela Hordijk
- Amsterdam Institute for Social Science Research (AISSR), University of Amsterdam, Nieuwe Achtergracht 166, Postbus 15629, 1001 NC Amsterdam, The Netherlands
| | - Yves Van Leynseele
- Amsterdam Institute for Social Science Research (AISSR), University of Amsterdam, Nieuwe Achtergracht 166, Postbus 15629, 1001 NC Amsterdam, The Netherlands
| | - Mieke Lopes Cardozo
- Amsterdam Institute for Social Science Research (AISSR), University of Amsterdam, Nieuwe Achtergracht 166, Postbus 15629, 1001 NC Amsterdam, The Netherlands
| | - Esther Miedema
- Amsterdam Institute for Social Science Research (AISSR), University of Amsterdam, Nieuwe Achtergracht 166, Postbus 15629, 1001 NC Amsterdam, The Netherlands
| | - Nicky Pouw
- Amsterdam Institute for Social Science Research (AISSR), University of Amsterdam, Nieuwe Achtergracht 166, Postbus 15629, 1001 NC Amsterdam, The Netherlands
| | - Crelis Rammelt
- Amsterdam Institute for Social Science Research (AISSR), University of Amsterdam, Nieuwe Achtergracht 166, Postbus 15629, 1001 NC Amsterdam, The Netherlands
| | - Joeri Scholtens
- Amsterdam Institute for Social Science Research (AISSR), University of Amsterdam, Nieuwe Achtergracht 166, Postbus 15629, 1001 NC Amsterdam, The Netherlands
| | - Courtney Vegelin
- Amsterdam Institute for Social Science Research (AISSR), University of Amsterdam, Nieuwe Achtergracht 166, Postbus 15629, 1001 NC Amsterdam, The Netherlands
| | - Hebe Verrest
- Amsterdam Institute for Social Science Research (AISSR), University of Amsterdam, Nieuwe Achtergracht 166, Postbus 15629, 1001 NC Amsterdam, The Netherlands
| |
Collapse
|
58
|
Benito DA, Bestourous DE, Tong JY, Pasick LJ, Sataloff RT. Tracheotomy in COVID-19 Patients: A Systematic Review and Meta-analysis of Weaning, Decannulation, and Survival. Otolaryngol Head Neck Surg 2021; 165:398-405. [PMID: 33399526 DOI: 10.1177/0194599820984780] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Accepted: 12/09/2020] [Indexed: 12/15/2022]
Abstract
OBJECTIVES A systematic review and meta-analysis was conducted to determine the cumulative incidences of decannulation and mechanical ventilation weaning in patients with coronavirus disease 2019 (COVID-19) who have undergone a tracheotomy. Weighted average mean times to tracheotomy, to decannulation, and to death were calculated from reported or approximated means. DATA SOURCES PubMed, SCOPUS, CINAHL, and the Cochrane library. REVIEW METHODS Studies were screened by 3 investigators independently. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed. Studies including patients with COVID-19 who underwent a tracheotomy were identified. Studies without reported mechanical ventilation weaning or decannulation were excluded. Data were pooled using a random-effects model. RESULTS After identifying 232 unique studies, 18 articles encompassing outcomes for 3234 patients were ultimately included for meta-analysis, with a weighted mean follow-up time of 28.6 ± 6.2 days after tracheotomy. Meta-analysis revealed that 55.0% of tracheotomized patients were weaned successfully from mechanical ventilation (95% CI, 47.4%-62.2%). Approximately 34.9% of patients were decannulated successfully, with a mean decannulation time of 18.6 ± 5.7 days after tracheotomy. The pooled mortality in tracheotomized patients with COVID-19 was 13.1%, with a mean time of death of 13.0 ± 4.0 days following tracheotomy. CONCLUSION At the current state of the coronavirus pandemic, over half of patients who have required tracheotomies are being weaned off of mechanical ventilation. While 13.1% patients have died prior to decannulation, over a third of all tracheotomized patients with COVID-19 reported in the literature have undergone successful decannulation.
Collapse
Affiliation(s)
- Daniel A Benito
- Division of Otolaryngology-Head & Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| | - Daniel E Bestourous
- Division of Otolaryngology-Head & Neck Surgery, George Washington University School of Medicine & Health Sciences, Washington, DC, USA
| | - Jane Y Tong
- Department of Otolaryngology-Head & Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Luke J Pasick
- Department of Otolaryngology-Head & Neck Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Robert T Sataloff
- Department of Otolaryngology-Head & Neck Surgery, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| |
Collapse
|
59
|
ONAY A, ERTAŞ A, SÜZERER V, YENER İ, YILMAZ MA, AYAZ-TİLKAT E, EKİNCİ R, BOZHAN N, İRTEGÜN-KANDEMİR S. Cannabinoids for SARS-CoV-2 and is there evidence of their therapeutic efficacy? Turk J Biol 2021; 45:570-587. [PMID: 34803455 PMCID: PMC8573844 DOI: 10.3906/biy-2105-73] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Accepted: 08/02/2021] [Indexed: 01/08/2023] Open
Abstract
To combat the coronaviruses and their novel variants, therapeutic drugs and the development of vaccines that are to be effective throughout human life are urgently needed. The endocannabinoid system (ECS) acts as a modulator in the activation of the microcirculation, immune system, and autonomic nervous system, along with controlling pharmacological functions such as emotional responses, homeostasis, motor functions, cognition, and motivation. The ECS contains endogenous cannabinoids, cannabinoid receptor (CBRs), and enzymes that regulate their biosynthesis, transport, and degradation. Moreover, phytocannabinoids and synthetic cannabinoids that mimic the action of endocannabinoids also play an essential role in the modulation of the ECS. Cannabinoids, the main constituents of cannabis (Cannabis sativa L.), are therapeutic compounds that have received international attention in the health field due to their therapeutic properties. Recently, they have been tested for the treatment of COVID-19 due to their antiviral properties. Indeed, cannabinoid-type compounds, and in particular cannabidiol (CBD), isolated from glandular trichomes found in the calyx of cannabis flowers with reported antiviral properties is hypothesized to be a therapeutic option in the ministration of SARS-CoV-2 consorted with COVID-19 disease. The relevant articles were determined from the database search published mainly in Web of Science, Google scholar, PubMed, Crossref, and ClinicalTrials.gov database during the pandemic period. The articles were evaluated for the therapeutic potentials, mechanisms of action of cannabinoids, the roles of the ECS in the immune system, impact of cannabinoids in SARS-CoV-2 septic, especially if they address the application of cannabinoids as drugs for the curability and management of SARS-CoV-2 and its novel variants. Although the evidence needed to be considered using cannabinoids in the control and treatment of viral diseases is currently in its infancy, they already offer an opportunity for clinicians due to their effects in relieving pain, improving appetite, and improving childhood epilepsy, especially in cancer and human immunodeficiency virus (HIV/AIDS) patients. In addition to these, the most recent scientific evidence emphasizes their use in the treatment of the coronavirus infected patients. In brief, all preclinic and clinic studies that have been reported show that, through the cannabinoid system, cannabinoids, particularly CBD, have many mechanisms that are effective in the treatment of patients infected by SARS-CoV-2. Thus, more extensive studies are necessary in this area to fully identify the effects of cannabinoids on SARS-CoV-2.
Collapse
Affiliation(s)
- Ahmet ONAY
- Department of Biology, Faculty of Science, Dicle University, DiyarbakırTurkey
| | - Abdulselam ERTAŞ
- Department of Pharmacognosy, Faculty of Pharmacy, Dicle University, DiyarbakırTurkey
| | - Veysel SÜZERER
- Department of Pharmacy Services, Vocational School of Health, Bingöl University, BingölTurkey
| | - İsmail YENER
- Department of Analytical Chemistry, Faculty of Pharmacy, Dicle University, DiyarbakırTurkey
| | | | - Emine AYAZ-TİLKAT
- Department of Biology, Faculty of Science and Literature, Batman University, BatmanTurkey
| | - Remzi EKİNCİ
- Department of Field Crops, Faculty of Agriculture, Dicle University, DiyarbakırTurkey
| | - Nesrin BOZHAN
- Department of Biology, Faculty of Science, Dicle University, DiyarbakırTurkey
| | | |
Collapse
|
60
|
Buder F, Bauswein M, Magnus CL, Audebert F, Lang H, Kundel C, Distler K, Reuschel E, Lubnow M, Müller T, Lunz D, Graf B, Schmid S, Müller M, Poeck H, Hanses F, Salzberger B, Peterhoff D, Wenzel JJ, Schmidt B, Lampl BMJ. SARS-CoV-2 infectivity correlates with high viral loads and detection of viral antigen and is terminated by seroconversion. J Infect Dis 2021; 225:190-198. [PMID: 34427652 PMCID: PMC8513404 DOI: 10.1093/infdis/jiab415] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/24/2021] [Indexed: 01/08/2023] Open
Abstract
Background From a public health perspective, effective containment strategies for SARS-CoV-2 should be balanced with individual liberties. Methods We collected 79 respiratory samples from 59 patients monitored in an outpatient center or in the intensive care unit of the University Hospital Regensburg. We analyzed viral load by quantitative real-time PCR, viral antigen by point-of-care assay, time since onset of symptoms and presence of SARS-CoV-2 IgG antibodies in the context of virus isolation from respiratory specimen. Results The odds ratio for virus isolation increased 1.9-fold for each log10 level of SARS-CoV-2 RNA and 7.4-fold with detection of viral antigen, while it decreased 6.3-fold beyond 10 days of symptoms and 20.0-fold with presence of SARS-CoV-2 antibodies. The latter was confirmed for B.1.1.7 strains. The positive predictive value for virus isolation was 60.0% for viral loads above 10 7 RNA copies/mL and 50.0% for the presence of viral antigen. Symptom onset before 10 days and seroconversion predicted lack of infectivity with 93.8% and 96.0%. Conclusions Our data support quarantining patients with high viral load and detection of viral antigen, and lifting restrictive measures with increasing time to symptom onset and seroconversion. Delay of antibody formation may prolong infectivity.
Collapse
Affiliation(s)
- Felix Buder
- Institute of Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
| | - Markus Bauswein
- Institute of Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
| | - Clara L Magnus
- Institute of Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
| | | | | | - Christof Kundel
- Medizinische Klinik 1, Hospital Barmherzige Brüder, Regensburg, Germany
| | - Karin Distler
- Medizinische Klinik 1, Hospital Barmherzige Brüder, Regensburg, Germany
| | - Edith Reuschel
- University Department of Obstetrics and Gynecology At The Hospital St. Hedwig of The Order of St. John, University of Regensburg, Regensburg, Germany
| | - Matthias Lubnow
- Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany
| | - Thomas Müller
- Department of Internal Medicine II, University Hospital Regensburg, Regensburg, Germany
| | - Dirk Lunz
- Department of Anesthesiology, University Hospital Regensburg, Regensburg, Germany
| | - Bernhard Graf
- Department of Anesthesiology, University Hospital Regensburg, Regensburg, Germany
| | - Stephan Schmid
- Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany
| | - Martina Müller
- Department of Internal Medicine I, University Hospital Regensburg, Regensburg, Germany
| | - Hendrik Poeck
- Department of Internal Medicine III, Hematology and Oncology, University Hospital Regensburg, Regensburg, Germany
| | - Frank Hanses
- Emergency Department, University Hospital Regensburg, Regensburg, Germany.,Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - Bernd Salzberger
- Department of Infection Prevention and Infectious Diseases, University Hospital Regensburg, Regensburg, Germany
| | - David Peterhoff
- Institute of Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany
| | - Jürgen J Wenzel
- Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | - Barbara Schmidt
- Institute of Medical Microbiology and Hygiene, University of Regensburg, Regensburg, Germany.,Institute of Clinical Microbiology and Hygiene, University Hospital Regensburg, Regensburg, Germany
| | | |
Collapse
|
61
|
Huang J, Qian C, Bian T, Chu M, Yin W, Pang Y, Bai J, Huang Y. A retrospective analysis from a single center for 60 COVID-19 patients with asymptomatic, mild to moderate, and severe conditions in Wuxi, China. Medicine (Baltimore) 2021; 100:e26748. [PMID: 34397716 PMCID: PMC8322555 DOI: 10.1097/md.0000000000026748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 07/08/2021] [Indexed: 01/19/2023] Open
Abstract
The aim of this study was to retrospectively analyze the clinical data of COVID-19 patients with different severity during February 2020 in Wuxi, China.The present retrospective study included a total of 60 cases who were diagnosed as COVID-19 patients and hospitalized in the Wuxi Fifth People's Hospital during February 2020 to March 2020. Among all patients 14 cases were asymptomatic, 25 cases were with mild stage, 13 cases were with moderate stage, and 8 cases were with severe stage. Basic clinical data as well as clinical characteristics, including temperature, respiratory rate, heart rate, blood gas analysis data, whole blood test data, and the prognosis condition, were collected and analyzed. Statistical analysis was conducted in different severity stage patients.Among the patients, the median temperature gradually increased from the asymptomatic to the severe patients and the median age increased from the mild to the severe patients with statistical difference. The hospitalization duration was the highest in severe patients. Higher heart rate, as well as lower oxygen partial pressure and oxygenation index were observed in severe patients than the other groups. Besides, higher CRP and globulin levels after admission were found in severe patients, and were gradually increased from the asymptomatic patients to the severe patients. On the contrary, the lymphocyte ratio and count was significant lower in severe patients. We also observed higher D-Dimer levels in the severe patients and the difference was statistical. Among all patients, 2 cases (3.33%) died and other patients were all cured after treatment.Statistical difference was mainly found mainly in age, hospitalization duration, temperature, CRP levels, O2 partial pressure and oxygenation index, globulin, lymphocyte ratio, and D-Dimer in patients with different severity. The higher CRP levels, lower O2 partial pressure and oxygenation index, higher globulin, lower lymphocyte ratio, and higher D-Dimer might be associated with the patients' severity.
Collapse
|
62
|
Chu L, Huang F, Zhang M, Huang B, Wang Y. Current status of traditional Chinese medicine for the treatment of COVID-19 in China. Chin Med 2021; 16:63. [PMID: 34315521 PMCID: PMC8314260 DOI: 10.1186/s13020-021-00461-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 06/26/2021] [Indexed: 01/08/2023] Open
Abstract
An ongoing outbreak of severe respiratory illness and pneumonia caused by the severe acute respiratory coronavirus 2 (SARS-CoV-2) commenced in December 2019, and the disease was named as coronavirus disease 2019 (COVID-19). Soon after, scientists identified the characteristics of SARS-CoV-2, including its genome sequence and protein structure. The clinical manifestations of COVID-19 have now been established; and nucleic acid amplification is used for the direct determination of the virus, whereas immunoassays can determine the antibodies against SARS-CoV-2. Clinical trials of several antiviral drugs are ongoing. However, there is still no specific drugs to treat COVID-19. Traditional Chinese medicine (TCM) was used in the treatment of COVID-19 during the early stages of the outbreak in China. Some ancient TCM prescriptions, which were efficacious in the treatment of severe acute respiratory syndrome (SARS) in 2002–03 and the influenza pandemic (H1N1) of 2009, have been improved by experienced TCM practitioners for the treatment of COVID-19 based on their clinical symptoms. These developed new prescriptions include Lianhua Qingwen capsules/granules, Jinhua Qinggan granules and XueBiJing injection, among others. In this review, we have summarized the presenting features of SARS-CoV-2, the clinical characteristics of COVID-19, and the progress in the treatment of COVID-19 using TCMs.
Collapse
Affiliation(s)
- Liang Chu
- Hepatic Surgery Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No.1095 Jie Fang Avenue, Wuhan, 430030, Hubei, China.
| | - Fang Huang
- Department of Pathology, Zhejiang Provincial People's Hospital, People's Hospital of Hangzhou Medical College, Hangzhou, 310014, Zhejiang, China
| | - Mengdan Zhang
- College of Life and Medicine Sciences, Zhejiang Sci-Tech University, No. 928, 2nd Street, Xiasha Higher Education Park, Hangzhou, 310018, Zhejiang, China
| | - Biao Huang
- College of Life and Medicine Sciences, Zhejiang Sci-Tech University, No. 928, 2nd Street, Xiasha Higher Education Park, Hangzhou, 310018, Zhejiang, China
| | - Yigang Wang
- College of Life and Medicine Sciences, Zhejiang Sci-Tech University, No. 928, 2nd Street, Xiasha Higher Education Park, Hangzhou, 310018, Zhejiang, China.
| |
Collapse
|
63
|
A Clinical Monitoring Program of COVID-19 Outpatients: A Prospective Cohort Study. ACTA ACUST UNITED AC 2021; 2021:6644570. [PMID: 34336065 PMCID: PMC8292082 DOI: 10.1155/2021/6644570] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 07/05/2021] [Indexed: 01/08/2023]
Abstract
Purpose Coronavirus disease 2019 (COVID-19) has been associated with a high rate of mortality and morbidity. While a high portion of COVID-19 patients have mild symptoms, a limited number of clinical trials have evaluated the clinical course of this large group of patients. This study was designed to investigate the demographics and clinical characteristics and comorbidity of nonhospitalized COVID-19 patients. Methods This prospective, observational cohort study was performed on nonhospitalized adult patients (≥18 years) with COVID-19. Pharmacotherapy service was responsible for patients' assessment for up to 1 month. Demographic characteristics, the onset of symptoms, severity, duration, laboratory data, and hospitalization rate were evaluated by a pharmacist-based monitoring program. Results From 323 patients who had been referred to the emergency department, 105 individuals were recruited between April 26 and August 2, 2020. Most of the patients were female (66.7%) with a mean age of 39.39 years (SD: ± 15.82). The mean time of the symptom onset was 5.6 days (SD: ±1.79). The majority of patients suffered from fatigue (78.1%), sore throat (67.6%), cough (60%), and myalgia (55.2%). C-reactive protein, white blood cell, lymphocyte, neutrophil-to-lymphocyte ratio, platelet-to-lymphocyte ratio, and hemoglobin levels were recovered significantly during the first two weeks (P < 0.001). Hydroxychloroquine, naproxen, diphenhydramine, azithromycin, and vitamin D3 were the most common medications administered (98%, 96%, 94%, 68%, and 57%, respectively). Forty patients were not symptom-free after the one-month follow-up, and 8 patients (7.6%) were required to revisit without the need for hospitalization. Anosmia (18.1%) and fatigue (17.1%) were the most common persisted symptoms. There were no significant differences between symptom-free and symptomatic patients. Conclusion Mild COVID-19 patients had a wide variety of symptoms and could be symptomatic even one month after the onset of symptoms. The pharmacist-based monitoring system can contribute beneficially to patients through the evaluation of symptoms, reduction of unnecessary visits, and provision of updated information to patients concerning the status of their illness.
Collapse
|
64
|
Delgado-Gonzalez P, Gonzalez-Villarreal CA, Roacho-Perez JA, Quiroz-Reyes AG, Islas JF, Delgado-Gallegos JL, Arellanos-Soto D, Galan-Huerta KA, Garza-Treviño EN. Inflammatory effect on the gastrointestinal system associated with COVID-19. World J Gastroenterol 2021; 27:4160-4171. [PMID: 34326616 PMCID: PMC8311540 DOI: 10.3748/wjg.v27.i26.4160] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 05/27/2021] [Accepted: 06/17/2021] [Indexed: 02/06/2023] Open
Abstract
The severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) that causes coronavirus disease-2019 (COVID-19) has provoked a global pandemic, mainly affecting the respiratory tract; however, a percentage of infected individuals can develop gastrointestinal (GI) symptoms. Some studies describe the development of GI symptoms and how they affect the progression of COVID-19. In this review, we summarize the main mechanisms associated with gut damage during infection by SARS-CoV-2 as well as other organs such as the liver and pancreas. Not only are host factors associated with severe COVID-19 but intestinal microbiota dysbiosis is also observed in patients with severe disease.
Collapse
Affiliation(s)
| | | | - Jorge A Roacho-Perez
- Departamento de Bioquimica y Medicina Molecular, UANL, Monterrey 64610, Nuevo León, Mexico
| | - Adriana G Quiroz-Reyes
- Departamento de Bioquimica y Medicina Molecular, UANL, Monterrey 64610, Nuevo León, Mexico
| | - Jose Francisco Islas
- Departamento de Bioquimica y Medicina Molecular, UANL, Monterrey 64610, Nuevo León, Mexico
| | | | - Daniel Arellanos-Soto
- Departamento de Bioquimica y Medicina Molecular, UANL, Monterrey 64610, Nuevo León, Mexico
| | - Kame A Galan-Huerta
- Departamento de Bioquimica y Medicina Molecular, UANL, Monterrey 64610, Nuevo León, Mexico
| | - Elsa N Garza-Treviño
- Departamento de Bioquimica y Medicina Molecular, UANL, Monterrey 64610, Nuevo León, Mexico
| |
Collapse
|
65
|
The Lived Experiences of COVID-19 Patients in South Korea: A Qualitative Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18147419. [PMID: 34299870 PMCID: PMC8307440 DOI: 10.3390/ijerph18147419] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 07/04/2021] [Accepted: 07/06/2021] [Indexed: 01/05/2023]
Abstract
The purpose of this qualitative study is to provide an in-depth understanding and description of the disease experiences of COVID-19 patients. The participants were 16 patients discharged from hospitals after receiving treatment for COVID-19 in isolation. Data collection was conducted through individual in-depth interviews until data saturation, and the interviews were recorded and transcribed verbatim. Data were analyzed using Colaizzi’s phenomenological method. The participants were quarantined after their COVID-19 diagnosis was confirmed, and they experienced desperate and uncertain times during treatment. The participants expressed shock and dissatisfaction due to an excessive invasion of privacy during the quarantine process and in the quarantine system. As confirmed COVID-19 cases, the participants experienced social stigma and feelings of guilt, negative attitudes from others and society, and negative influences from social networking services and the media. The participants also experienced mental and physical difficulties due to COVID-19 symptoms. However, they rediscovered meaningful relationships through the support of their family and friends in the midst of adversity. It is necessary to provide an integrated psychosocial rehabilitation program to reduce social stigma and improve the resilience of COVID-19 patients.
Collapse
|
66
|
Liatsos GD. Controversies’ clarification regarding ribavirin efficacy in measles and coronaviruses: Comprehensive therapeutic approach strictly tailored to COVID-19 disease stages. World J Clin Cases 2021; 9:5135-5178. [PMID: 34307564 PMCID: PMC8283580 DOI: 10.12998/wjcc.v9.i19.5135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Revised: 01/01/2021] [Accepted: 05/20/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Ribavirin is a broad-spectrum nucleoside antiviral drug with multimodal mechanisms of action, which supports its longevity and quality as a clinical resource. It has been widely administered for measles and coronavirus infections. Despite the large amount of data concerning the use of ribavirin alone or in combination for measles, severe acute respiratory syndrome, Middle East respiratory syndrome, and coronavirus disease 2019 (COVID-19) outbreaks, the conclusions of these studies have been contradictory. Underlying reasons for these discrepancies include possible study design inaccuracies and failures and misinterpretations of data, and these potential confounds should be addressed.
AIM To determine the confounding factors of ribavirin treatment studies and propose a therapeutic scheme for COVID-19.
METHODS PubMed database was searched over a period of five decades utilizing the terms “ribavirin” alone or combined with other compounds in measles, severe acute respiratory syndrome, Middle East respiratory syndrome, and COVID-19 infections. The literature search was performed and described according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Articles were considered eligible when they reported on ribavirin dose regimens and/or specified outcomes concerning its efficacy and/or possible adverse-effects. In vitro and animal studies were also retrieved. A chapter on ribavirin’s pharmacology was included as well.
RESULTS In addition to the difficulties and pressures of an emerging pandemic, there is the burden of designing and conducting well-organized, double-blind, randomized controlled trials. Many studies have succumbed to specific pitfalls, one of which was identified in naturally ribavirin-resistant Vero cell lines in in vitro studies. Other pitfalls include study design inconsistent with the well-established clinical course of disease; inappropriate pharmacology of applied treatments; and the misinterpretation of study results with misconceived generalizations. A comprehensive treatment for COVID-19 is proposed, documented by thorough, long-term investigation of ribavirin regimens in coronavirus infections.
CONCLUSION A comprehensive treatment strictly tailored to distinct disease stages was proposed based upon studies on ribavirin and coronavirus infections.
Collapse
Affiliation(s)
- George D Liatsos
- Department of Internal Medicine, "Hippokration" General Hospital, Athens 11527, Attiki, Greece
| |
Collapse
|
67
|
Yuce M, Cicek E, Inan T, Dag AB, Kurkcuoglu O, Sungur FA. Repurposing of FDA-approved drugs against active site and potential allosteric drug-binding sites of COVID-19 main protease. Proteins 2021; 89:1425-1441. [PMID: 34169568 PMCID: PMC8441840 DOI: 10.1002/prot.26164] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 06/02/2021] [Accepted: 06/06/2021] [Indexed: 02/06/2023]
Abstract
The novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) still has serious negative effects on health, social life, and economics. Recently, vaccines from various companies have been urgently approved to control SARS-CoV-2 infections. However, any specific antiviral drug has not been confirmed so far for regular treatment. An important target is the main protease (Mpro ), which plays a major role in replication of the virus. In this study, Gaussian and residue network models are employed to reveal two distinct potential allosteric sites on Mpro that can be evaluated as drug targets besides the active site. Then, Food and Drug Administration (FDA)-approved drugs are docked to three distinct sites with flexible docking using AutoDock Vina to identify potential drug candidates. Fourteen best molecule hits for the active site of Mpro are determined. Six of these also exhibit high docking scores for the potential allosteric regions. Full-atom molecular dynamics simulations with MM-GBSA method indicate that compounds docked to active and potential allosteric sites form stable interactions with high binding free energy (∆Gbind ) values. ∆Gbind values reach -52.06 kcal/mol for the active site, -51.08 kcal/mol for the potential allosteric site 1, and - 42.93 kcal/mol for the potential allosteric site 2. Energy decomposition calculations per residue elucidate key binding residues stabilizing the ligands that can further serve to design pharmacophores. This systematic and efficient computational analysis successfully determines ivermectine, diosmin, and selinexor currently subjected to clinical trials, and further proposes bromocriptine, elbasvir as Mpro inhibitor candidates to be evaluated against SARS-CoV-2 infections.
Collapse
Affiliation(s)
- Merve Yuce
- Department of Chemical Engineering, Istanbul Technical University, Istanbul, Turkey
| | - Erdem Cicek
- Computational Science and Engineering Division, Informatics Institute, Istanbul Technical University, Istanbul, Turkey
| | - Tugce Inan
- Department of Chemical Engineering, Istanbul Technical University, Istanbul, Turkey
| | - Aslihan Basak Dag
- Department of Molecular Biology and Genetics, Istanbul Technical University, Istanbul, Turkey
| | - Ozge Kurkcuoglu
- Department of Chemical Engineering, Istanbul Technical University, Istanbul, Turkey
| | - Fethiye Aylin Sungur
- Computational Science and Engineering Division, Informatics Institute, Istanbul Technical University, Istanbul, Turkey
| |
Collapse
|
68
|
Fernández Ibáñez JM, Morales Ballesteros MDC, Fernández Anguita MJ, Galindo Andúgar MÁ, Arias Arias Á, Barberá-Farré JR. Influence of influenza vaccine and comorbidity on the evolution of hospitalized COVID-19 patients. Med Clin (Barc) 2021; 158:603-607. [PMID: 34304882 PMCID: PMC8206630 DOI: 10.1016/j.medcli.2021.06.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/28/2021] [Accepted: 06/02/2021] [Indexed: 12/29/2022]
Abstract
Antecedentes y objetivo El brote de la enfermedad COVID-19 está evolucionando en todo el mundo. El objetivo del estudio es evaluar la asociación entre la vacunación antigripal y el riesgo de mortalidad en pacientes con COVID-19 hospitalizados, así como otros factores de riesgo. Materiales y métodos Estudio observacional retrospectivo. Se realizó entre pacientes hospitalizados con COVID-19 del Hospital La Mancha Centro entre el 5 y el 25 de marzo de 2020. Utilizamos una regresión logística multivariable para explorar la asociación entre la vacunación antigripal y la mortalidad por COVID y otros factores de riesgo. Resultados Se incluyeron 410 pacientes. La vacunación antigripal no tuvo efecto entre los pacientes hospitalizados por COVID-19 (OR: 1,55 [IC 95%; 0,96-2,48; p = 0,071]). El aumento de la mortalidad intrahospitalaria se asoció con edad avanzada (OR: 1,05 [IC 95%; 1,02-1,07]), por cada aumento de año; p < 0,001, Charlson ≥ 3 (OR: 1,84 [IC 95%; 1,07-3,15, p = 0,027]) e insuficiencia cardíaca al ingreso (OR: 6 [IC 95%; 1,6-21,7; p = 0,007]). Conclusiones La vacuna antigripal no tuvo efecto en la evolución de pacientes hospitalizados por COVID-19. Los factores de riesgo identificados fueron la edad avanzada, mayor comorbilidad e insuficiencia cardíaca al ingreso.
Collapse
Affiliation(s)
| | | | | | | | - Ángel Arias Arias
- Unidad de Investigación Hospital General Mancha Centro, Alcázar de San Juan, España
| | | |
Collapse
|
69
|
Yang G, Li Z, Mohammed I, Zhao L, Wei W, Xiao H, Guo W, Zhao Y, Qu F, Huang Y. Identification of SARS-CoV-2-against aptamer with high neutralization activity by blocking the RBD domain of spike protein 1. Signal Transduct Target Ther 2021; 6:227. [PMID: 34112756 PMCID: PMC8190169 DOI: 10.1038/s41392-021-00649-6] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 04/27/2021] [Accepted: 05/17/2021] [Indexed: 12/20/2022] Open
Affiliation(s)
- Ge Yang
- School of Life Science; Advanced Research Institute of Multidisciplinary Science; Institute of Engineering Medicine; Key Laboratory of Molecular Medicine and Biotherapy, Beijing Institute of Technology, Beijing, China
| | - Ziyue Li
- School of Life Science; Advanced Research Institute of Multidisciplinary Science; Institute of Engineering Medicine; Key Laboratory of Molecular Medicine and Biotherapy, Beijing Institute of Technology, Beijing, China
| | - Irfan Mohammed
- School of Life Science; Advanced Research Institute of Multidisciplinary Science; Institute of Engineering Medicine; Key Laboratory of Molecular Medicine and Biotherapy, Beijing Institute of Technology, Beijing, China
| | - Liping Zhao
- School of Life Science; Advanced Research Institute of Multidisciplinary Science; Institute of Engineering Medicine; Key Laboratory of Molecular Medicine and Biotherapy, Beijing Institute of Technology, Beijing, China
| | - Wei Wei
- State Key Laboratory of Biochemical Engineering, Institute of Process Engineering, Chinese Academy of Sciences, Beijing, China
| | - Haihua Xiao
- Beijing National Laboratory for Molecular Sciences, State Key Laboratory of Polymer Physics and Chemistry, Institute of Chemistry, Chinese Academy of Sciences, Beijing, China
| | - Weisheng Guo
- Translational Medicine Center, Key Laboratory of Molecular Target & Clinical Pharmacology and the State Key Laboratory of Respiratory Disease, School of Pharmaceutical Sciences & the Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China
| | - Yongxiang Zhao
- National Center for International Research of Biological Targeting Diagnosis and Therapy, Guangxi Key Laboratory of Biological Targeting Diagnosis and Therapy Research, Guangxi Medical University, Nanning, Guangxi, China
| | - Feng Qu
- School of Life Science; Advanced Research Institute of Multidisciplinary Science; Institute of Engineering Medicine; Key Laboratory of Molecular Medicine and Biotherapy, Beijing Institute of Technology, Beijing, China
| | - Yuanyu Huang
- School of Life Science; Advanced Research Institute of Multidisciplinary Science; Institute of Engineering Medicine; Key Laboratory of Molecular Medicine and Biotherapy, Beijing Institute of Technology, Beijing, China.
| |
Collapse
|
70
|
Small molecules as tools for functional assessment of deubiquitinating enzyme function. Cell Chem Biol 2021; 28:1090-1100. [PMID: 34089649 DOI: 10.1016/j.chembiol.2021.04.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/05/2021] [Accepted: 04/23/2021] [Indexed: 12/11/2022]
Abstract
Deubiquitinating enzymes (DUBs) are a largely understudied and untapped resource in the toolkit of protein degradation functionalities. They comprise a large repertoire of enzymes that remove ubiquitin from substrates in a variety of cellular and pathophysiological contexts, and have enormous potential for research and clinical use. It is only within the last 5 years that potent, selective, and well-characterized small-molecule inhibitors of DUBs have been described. These compounds are now being used to study the biological roles of DUBs. Here, we describe downstream applications of small-molecule inhibitors for studying DUBs and provide a framework for future studies. We highlight recent examples of using these inhibitors to confirm and explore the role of these enzymes in both normal and pathological contexts. These studies represent the first steps in the burgeoning field of pharmacological and chemoproteomic studies of DUBs, which will be critical for the continued advancement of DUB field.
Collapse
|
71
|
Mazini L, Rochette L, Malka G. Exosomes contribution in COVID-19 patients' treatment. J Transl Med 2021; 19:234. [PMID: 34059065 PMCID: PMC8165679 DOI: 10.1186/s12967-021-02884-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Accepted: 05/12/2021] [Indexed: 02/07/2023] Open
Abstract
Adipose cell-free derivatives have been recently gaining attention as potential therapeutic agents for various human diseases. In this context, mesenchymal stromal/stem cells (MSCs), adipocyte mesenchymal stem cells (Ad-MSCs) and adipose-derived stem cells (ADSC) possessing potent immunomodulatory activities are proposed as a therapeutic option for the treatment of coronavirus disease 2019 (COVID-19). The COVID-19 represents a global concern of public health caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in which there is not actually any specific therapy. MSCs exert an immunomodulation effect due to the secretion of endogenous factors, such as vascular endothelial growth factor (VEGF), insulin growth factor (IGF), and nerve growth factor (NGF), transforming growth factor (TGF)-β and growth differentiation factor (GDF)-11. Recent reports are promising for further studies and clinical applications of ADSCs and Ad-MSCs in COVID-19 patients. Experimental and clinical studies are exploring the therapeutic potential of both MSCs and derived-exosomes in moderating the morbidity and mortality of COVID-19. In this field, more preclinical and clinical studies are warranted to find an effective treatment for the patients suffering from COVID-19 infection.
Collapse
Affiliation(s)
- Loubna Mazini
- Institut Superieur des Sciences Biologiques et Paramedicales, Université Mohammed VI Polytechnique, Lot 660, 43150, Ben-Guerir, Morocco.
| | - Luc Rochette
- Equipe D'Accueil (EA 7460), Physiopathologie Et Epidémiologie Cérébro-Cardiovasculaires (PEC2), Faculté Des Sciences de Santé, Université de Bourgogne-Franche Comté, 7 Bd Jeanne d'Arc, 21000, Dijon, France
| | - Gabriel Malka
- Institut Superieur des Sciences Biologiques et Paramedicales, Université Mohammed VI Polytechnique, Lot 660, 43150, Ben-Guerir, Morocco
| |
Collapse
|
72
|
Zhou C, Lou B, Li H, Wang X, Ao H, Duan F. Incidence, risk factors and prognostic effect of imaging right ventricular involvement in patients with COVID-19: a dose-response analysis protocol for systematic review. BMJ Open 2021; 11:e049866. [PMID: 34031119 PMCID: PMC8149265 DOI: 10.1136/bmjopen-2021-049866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION Emerging evidence has shown that COVID-19 infection may result in right ventricular (RV) disturbance and be associated with adverse clinical outcomes. The aim of this meta-analysis is to summarise the incidence, risk factors and the prognostic effect of imaging RV involvement in adult patients with COVID-19. METHODS A systematical search will be performed in PubMed, EMBase, ISI Knowledge via Web of Science and preprint databases (MedRxiv and BioRxiv) (until October 2021) to identify all cohort studies in adult patients with COVID-19. The primary outcome will be the incidence of RV involvement (dysfunction and/or dilation) assessed by echocardiography, CT or MRI. Secondary outcomes will include the risk factors for RV involvement and their association with all-cause mortality during hospitalisation. Additional outcomes will include the RV global or free wall longitudinal strain (RV-GLS or RV-FWLS), tricuspid annular plane systolic excursion (TAPSE), fractional area change (FAC) and RV diameter. Univariable or multivariable meta-regression and subgroup analyses will be performed for the study design and patient characteristics (especially acute or chronic pulmonary embolism and pulmonary hypertension). Sensitivity analyses will be used to assess the robustness of our results by removing each included study at one time to obtain and evaluate the remaining overall estimates of RV involvement incidence and related risk factors, association with all-cause mortality, and other RV parameters (RV-GLS or RV-FWLS, TAPSE, S', FAC and RV diameter). Both linear and cubic spline regression models will be used to explore the dose-response relationship between different categories (>2) of RV involvement and the risk of mortality (OR or HR). ETHICS AND DISSEMINATION There was no need for ethics approval for the systematic review protocol according to the Institutional Review Board/Independent Ethics Committee of Fuwai Hospital. This meta-analysis will be disseminated through a peer-reviewed journal for publication. PROSPERO REGISTRATION NUMBER CRD42021231689.
Collapse
Affiliation(s)
- Chenghui Zhou
- Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Baohui Lou
- Department of Radiology, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, China
| | - Hui Li
- Department of Echocardiography, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Xin Wang
- Department of Cardiac Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hushan Ao
- Department of Anesthesiology, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Fujian Duan
- Department of Cardiac Surgery, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| |
Collapse
|
73
|
Russo V, Bottino R, D'Andrea A, Silverio A, Di Maio M, Golino P, Nigro G, Valsecchi O, Attena E, Canonico ME, Galasso G, Parodi G, Scudiero F. Chronic Oral Anticoagulation and Clinical Outcome in Hospitalized COVID-19 Patients. Cardiovasc Drugs Ther 2021; 36:705-712. [PMID: 33988835 PMCID: PMC8120255 DOI: 10.1007/s10557-021-07194-y] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/14/2021] [Indexed: 01/08/2023]
Abstract
PURPOSE The clinical course of COVID-19 may be complicated by acute respiratory distress syndrome (ARDS) and thromboembolic events, which are associated with high risk of mortality. Although previous studies reported a lower rate of death in patients treated with heparin, the potential benefit of chronic oral anticoagulation therapy (OAT) remains unknown. We aimed to investigate the association between OAT with the risk of ARDS and mortality in hospitalized patients with COVID-19. METHODS This is a multicenter retrospective Italian study including consecutive patients hospitalized for COVID-19 from March 1 to April 22, 2020, at six Italian hospitals. Patients were divided into two groups according to the chronic assumption of oral anticoagulants. RESULTS Overall, 427 patients were included; 87 patients (19%) were in the OAT group. Of them, 54 patients (13%) were on treatment with non-vitamin k oral anticoagulants (NOACs) and 33 (8%) with vitamin-K antagonists (VKAs). OAT patients were older and had a higher rate of hypertension, diabetes, and coronary artery disease compared to No-OAT group. The rate of ARDS at admission (26% vs 28%, P=0.834), or developed during the hospitalization (9% vs 10%, P=0.915), was similar between study groups; in-hospital mortality (22% vs 26%, P=0.395) was also comparable. After balancing for potential confounders by using the propensity score matching technique, no differences were found in term of clinical outcome between OAT and No-OAT patients CONCLUSION: Oral anticoagulation therapy, either NOACs or VKAs, did not influence the risk of ARDS or death in patients hospitalized with COVID-19.
Collapse
Affiliation(s)
- Vincenzo Russo
- Cardiology Unit, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli" - Monaldi Hospital, Via. Bianchi, 80131, Naples, Italy
| | - Roberta Bottino
- Cardiology Unit, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli" - Monaldi Hospital, Via. Bianchi, 80131, Naples, Italy.
| | - Antonello D'Andrea
- Department of Cardiology, Umberto I Hospital, 84014, Nocera Inferiore, Italy
| | - Angelo Silverio
- Cardiovascolar and Thoracic Department, Division of Cardiology, San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy
| | - Marco Di Maio
- Cardiovascolar and Thoracic Department, Division of Cardiology, San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy.,Division of Cardiology, Maria SS. Addolorata Hospital, Eboli, Salerno, Italy
| | - Paolo Golino
- Cardiology Unit, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli" - Monaldi Hospital, Via. Bianchi, 80131, Naples, Italy
| | - Gerardo Nigro
- Cardiology Unit, Department of Translational Medical Sciences, University of Campania "Luigi Vanvitelli" - Monaldi Hospital, Via. Bianchi, 80131, Naples, Italy
| | - Orazio Valsecchi
- Division of Cardiology, "Bolognini" Hospital, ASST Bergamo Est, Seriate, BG, Italy
| | - Emilio Attena
- Department of Cardiology, Monaldi Hospital, Naples, Italy
| | | | - Gennaro Galasso
- Cardiovascolar and Thoracic Department, Division of Cardiology, San Giovanni di Dio e Ruggi d'Aragona University Hospital, Salerno, Italy
| | - Guido Parodi
- Clinical and Interventional Cardiology, Sassari University Hospital, Sassari, Italy
| | - Fernando Scudiero
- Division of Cardiology, "Bolognini" Hospital, ASST Bergamo Est, Seriate, BG, Italy
| |
Collapse
|
74
|
Tonk M, Růžek D, Vilcinskas A. Compelling Evidence for the Activity of Antiviral Peptides against SARS-CoV-2. Viruses 2021; 13:v13050912. [PMID: 34069206 PMCID: PMC8156787 DOI: 10.3390/v13050912] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/09/2021] [Accepted: 05/12/2021] [Indexed: 12/20/2022] Open
Abstract
Multiple outbreaks of epidemic and pandemic viral diseases have occurred in the last 20 years, including those caused by Ebola virus, Zika virus, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The emergence or re-emergence of such diseases has revealed the deficiency in our pipeline for the discovery and development of antiviral drugs. One promising solution is the extensive library of antimicrobial peptides (AMPs) produced by all eukaryotic organisms. AMPs are widely known for their activity against bacteria, but many possess additional antifungal, antiparasitic, insecticidal, anticancer, or antiviral activities. AMPs could therefore be suitable as leads for the development of new peptide-based antiviral drugs. Sixty therapeutic peptides had been approved by the end of 2018, with at least another 150 in preclinical or clinical development. Peptides undergoing clinical trials include analogs, mimetics, and natural AMPs. The advantages of AMPs include novel mechanisms of action that hinder the evolution of resistance, low molecular weight, low toxicity toward human cells but high specificity and efficacy, the latter enhanced by the optimization of AMP sequences. In this opinion article, we summarize the evidence supporting the efficacy of antiviral AMPs and discuss their potential to treat emerging viral diseases including COVID-19.
Collapse
Affiliation(s)
- Miray Tonk
- Institute for Insect Biotechnology, Justus Liebig University of Giessen, Heinrich-Buff-Ring 26-32, 35392 Giessen, Germany;
- LOEWE Centre for Translational Biodiversity Genomics (LOEWE-TBG), Senckenberganlage 25, 60325 Frankfurt, Germany
| | - Daniel Růžek
- Department of Virology, Veterinary Research Institute, Hudcova 70, CZ-62100 Brno, Czech Republic;
- Biology Centre of the Czech Academy of Sciences, Institute of Parasitology, Branisovska 31, 37005 Ceske Budejovice, Czech Republic
| | - Andreas Vilcinskas
- Institute for Insect Biotechnology, Justus Liebig University of Giessen, Heinrich-Buff-Ring 26-32, 35392 Giessen, Germany;
- LOEWE Centre for Translational Biodiversity Genomics (LOEWE-TBG), Senckenberganlage 25, 60325 Frankfurt, Germany
- Department of Bioresources, Fraunhofer Institute for Molecular Biology and Applied Ecology, Ohlebergsweg 12, 35392 Giessen, Germany
- Correspondence:
| |
Collapse
|
75
|
Exploring status of emergency drugs and vaccine development in Covid-19 pandemic: an update. Virusdisease 2021; 32:198-210. [PMID: 33969152 PMCID: PMC8096892 DOI: 10.1007/s13337-021-00684-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Accepted: 03/22/2021] [Indexed: 12/14/2022] Open
Abstract
COVID-19 outburst initiated from the city of Wuhan in China in December 2019 and has been declared as a public health emergency of international concern. This pandemic portrays a spectrum of clinical complications, primarily affecting the respiratory system reported to be caused by a pathogen SARS-CoV-2 belonging to the family of beta coronavirus. Currently, the main objective of the government authorities of all affected countries and research organizations is to find a potential solution in the form of a pharmacological intervention or a vaccination to eradicate the disease and to have a long-term solution to deal with the pandemic. A multitude of anti-viral regimens is proposed based on the repurposing of currently available drugs for other issues or the compassionate use of drugs to immediately control and optimize the healthcare facilities. Meanwhile, a number of agencies are proposing new drug candidates to recreate the possibility of treating the disease. Similarly, a lot of research work is going on worldwide for the development of vaccination. Currently, a good number of candidates has finally reached the borders of Clinical Trials and are expected to be launched as soon as possible. However, the regulatory framework and authorization of these candidates is the most significant aspect of the whole scenario, which needs a specific set of time for validation purposes. The present work is widely focused on the general aspects of COVID-19 and the regulatory landscape for the emergency authorization of repurposed drug candidates, compassionate use of drugs, investigational entities, and vaccine development worldwide. Supplementary Information The online version contains supplementary material available at 10.1007/s13337-021-00684-5.
Collapse
|
76
|
Ağagündüz D, Çelik MN, Çıtar Dazıroğlu ME, Capasso R. Emergent Drug and Nutrition Interactions in COVID-19: A Comprehensive Narrative Review. Nutrients 2021; 13:1550. [PMID: 34064534 PMCID: PMC8147951 DOI: 10.3390/nu13051550] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Revised: 04/26/2021] [Accepted: 04/28/2021] [Indexed: 01/08/2023] Open
Abstract
Coronaviruses are a large family of viruses that are known to cause respiratory tract infections ranging from colds to more severe diseases, such as Middle East Respiratory Syndrome (MERS) and the Severe Acute Respiratory Syndrome (SARS). New Coronavirus Disease 2019 (COVID-19), which led to deaths as well as social and economic disruptions, is an ongoing worldwide pandemic caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Currently, there is no approved treatment for COVID-19. Hence, only supportive care has been approved by the World Health Organization (WHO) for now. Pharmacological agents used for the adjunctive treatment of COVID-19 following the current literature and clinical experiences include antiviral, anti-inflammatory, and anti-malaria drugs, and other traditional or untraditional treatments. However, it has been reported that the use of these drugs may have some negative effects and comorbidities. Moreover, the current data have indicated that the risk of drug-drug interactions may also be high in polypharmacy cases, especially in elderly people, some comorbidity situations, and intensive care unit (ICU) patients. It is highly possible that these situations can not only increase the risk of drug-drug interactions but also increase the risk of food/nutrition-drug interactions and affect the nutritional status. However, this issue has not yet been entirely discussed in the literature. In this review, current information on the possible mechanisms as well as pharmacokinetic and pharmacodynamic effects of some pharmacological agents used in the treatment of COVID-19 and/or their secondary interactions with nutrition were evaluated and some future directions were given.
Collapse
Affiliation(s)
- Duygu Ağagündüz
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Emek, Ankara 06490, Turkey; (M.N.Ç.); (M.E.Ç.D.)
| | - Menşure Nur Çelik
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Emek, Ankara 06490, Turkey; (M.N.Ç.); (M.E.Ç.D.)
| | - Merve Esra Çıtar Dazıroğlu
- Department of Nutrition and Dietetics, Faculty of Health Sciences, Gazi University, Emek, Ankara 06490, Turkey; (M.N.Ç.); (M.E.Ç.D.)
| | - Raffaele Capasso
- Department of Agricultural Sciences, University of Naples Federico II, 80055 Naples, Italy
| |
Collapse
|
77
|
Harrington WN, Kackos CM, Webby RJ. The evolution and future of influenza pandemic preparedness. Exp Mol Med 2021; 53:737-749. [PMID: 33953324 PMCID: PMC8099712 DOI: 10.1038/s12276-021-00603-0] [Citation(s) in RCA: 72] [Impact Index Per Article: 24.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Revised: 12/29/2020] [Accepted: 12/31/2020] [Indexed: 12/17/2022] Open
Abstract
The influenza virus is a global threat to human health causing unpredictable yet recurring pandemics, the last four emerging over the course of a hundred years. As our knowledge of influenza virus evolution, distribution, and transmission has increased, paths to pandemic preparedness have become apparent. In the 1950s, the World Health Organization (WHO) established a global influenza surveillance network that is now composed of institutions in 122 member states. This and other surveillance networks monitor circulating influenza strains in humans and animal reservoirs and are primed to detect influenza strains with pandemic potential. Both the United States Centers for Disease Control and Prevention and the WHO have also developed pandemic risk assessment tools that evaluate specific aspects of emerging influenza strains to develop a systematic process of determining research and funding priorities according to the risk of emergence and potential impact. Here, we review the history of influenza pandemic preparedness and the current state of preparedness, and we propose additional measures for improvement. We also comment on the intersection between the influenza pandemic preparedness network and the current SARS-CoV-2 crisis. We must continually evaluate and revise our risk assessment and pandemic preparedness plans and incorporate new information gathered from research and global crises.
Collapse
Affiliation(s)
- Walter N Harrington
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, USA
| | - Christina M Kackos
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, USA
- St. Jude Children's Research Hospital, Graduate School of Biomedical Sciences, Memphis, TN, USA
| | - Richard J Webby
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, TN, USA.
| |
Collapse
|
78
|
Turan Ç, Metin N, Utlu Z, Yıldız TT, Caferoğlu Sakat S. Evaluation of the frequency and intensity of favipiravir-associated yellow-green fluorescence in lunulae, hair, and face. J Cosmet Dermatol 2021; 21:1199-1207. [PMID: 33915020 DOI: 10.1111/jocd.14189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 04/06/2021] [Accepted: 04/19/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND We detected yellow-green fluorescence in the face, hair and lunulae of patients using favipiravir. AIM We evaluated the frequency and intensity of favipiravir-associated fluorescence. PATIENTS/METHODS The participants comprised patients who had taken at least a single dose of favipiravir and been examined no later than 30 days after the last dose. The gender, age, body mass index (BMI), Fitzpatrick's skin-type, hair color, N-acetylcysteine use, presence and the intensity of fluorescent reflection under Wood's light in the lunulae of the fingernails, hair, and the face were recorded. RESULTS There were 275 patients, 144 (52.4%) of whom were women. 165 (57.9%) had used treatment for a maximum of 5 days, 99 (34.7%) for 6-10 days, and 21 (7.4%) for more than ten days. Using more than 22 tablets of favipiravir increased the probability of detecting fluorescence in the lunulae by 6.72 (2.61-17.23) times. Using more than 28 tablets increased the risk of fluorescence in hair and the T-zone by 5.92 (2.43-14.71) and 2.88 (1.11-7.47) times, respectively. No relationship was found between the fluorescence intensity in any localization and the total dose. However, we determined a negative correlation between the elapsed time after the last dose and the fluorescence intensity in the lunulae and the T-zone (p=0.036; p=0.031; respectively). It was noted that BMI negatively correlated with the fluorescence intensity in the lunulae (p=0.001). Skin type was related to intensity for all localizations (p<0.001). Fluorescence was found in the lunulae with significantly less frequency in patients using N-acetylcysteine (p=0.040). CONCLUSIONS We must be aware of favipiravir-induced phototoxicity.
Collapse
Affiliation(s)
- Çağrı Turan
- Department of Dermatology and Venereology, The Republic of Turkey, Health Sciences University Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Nurcan Metin
- Department of Dermatology and Venereology, The Republic of Turkey, Health Sciences University Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Zeynep Utlu
- Department of Dermatology and Venereology, The Republic of Turkey, Health Sciences University Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Türkan Tuğba Yıldız
- Department of Dermatology and Venereology, The Republic of Turkey, Health Sciences University Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| | - Selcen Caferoğlu Sakat
- Department of Dermatology and Venereology, The Republic of Turkey, Health Sciences University Erzurum Regional Training and Research Hospital, Erzurum, Turkey
| |
Collapse
|
79
|
García-Montero C, Fraile-Martínez O, Bravo C, Torres-Carranza D, Sanchez-Trujillo L, Gómez-Lahoz AM, Guijarro LG, García-Honduvilla N, Asúnsolo A, Bujan J, Monserrat J, Serrano E, Álvarez-Mon M, De León-Luis JA, Álvarez-Mon MA, Ortega MA. An Updated Review of SARS-CoV-2 Vaccines and the Importance of Effective Vaccination Programs in Pandemic Times. Vaccines (Basel) 2021; 9:vaccines9050433. [PMID: 33925526 PMCID: PMC8146241 DOI: 10.3390/vaccines9050433] [Citation(s) in RCA: 68] [Impact Index Per Article: 22.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 04/21/2021] [Accepted: 04/22/2021] [Indexed: 12/16/2022] Open
Abstract
Since the worldwide COVID-19 pandemic was declared a year ago, the search for vaccines has become the top priority in order to restore normalcy after 2.5 million deaths worldwide, overloaded sanitary systems, and a huge economic burden. Vaccine development has represented a step towards the desired herd immunity in a short period of time, owing to a high level of investment, the focus of researchers, and the urge for the authorization of the faster administration of vaccines. Nevertheless, this objective may only be achieved by pursuing effective strategies and policies in various countries worldwide. In the present review, some aspects involved in accomplishing a successful vaccination program are addressed, in addition to the importance of vaccination in a pandemic in the face of unwillingness, conspiracy theories, or a lack of information among the public. Moreover, we provide some updated points related to the landscape of the clinical development of vaccine candidates, specifically, the top five vaccines that are already being assessed in Phase IV clinical trials (BNT162b2, mRNA-1273, AZD1222, Ad26.COV2.S, and CoronaVac).
Collapse
Affiliation(s)
- Cielo García-Montero
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (C.G.-M.); (O.F.-M.); (L.S.-T.); (A.M.G.-L.); (N.G.-H.); (J.B.); (J.M.); (M.Á.-M.); (M.A.Á.-M.); (M.A.O.)
| | - Oscar Fraile-Martínez
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (C.G.-M.); (O.F.-M.); (L.S.-T.); (A.M.G.-L.); (N.G.-H.); (J.B.); (J.M.); (M.Á.-M.); (M.A.Á.-M.); (M.A.O.)
| | - Coral Bravo
- Department of Public and Maternal and Child Health, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain;
- Department of Obstetrics and Gynecology, University Hospital Gregorio Marañón, 28009 Madrid, Spain
- Health Research Institute Gregorio Marañón, 28009 Madrid, Spain
| | | | - Lara Sanchez-Trujillo
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (C.G.-M.); (O.F.-M.); (L.S.-T.); (A.M.G.-L.); (N.G.-H.); (J.B.); (J.M.); (M.Á.-M.); (M.A.Á.-M.); (M.A.O.)
- Service of Pediatric, Hospital Universitario Principe de Asturias, 28801 Alcalá de Henares, Spain
| | - Ana M. Gómez-Lahoz
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (C.G.-M.); (O.F.-M.); (L.S.-T.); (A.M.G.-L.); (N.G.-H.); (J.B.); (J.M.); (M.Á.-M.); (M.A.Á.-M.); (M.A.O.)
| | - Luis G. Guijarro
- Unit of Biochemistry and Molecular Biology (CIBEREHD), Department of System Biology, University of Alcalá, 28801 Alcalá de Henares, Spain;
| | - Natalio García-Honduvilla
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (C.G.-M.); (O.F.-M.); (L.S.-T.); (A.M.G.-L.); (N.G.-H.); (J.B.); (J.M.); (M.Á.-M.); (M.A.Á.-M.); (M.A.O.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain;
| | - Angel Asúnsolo
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain;
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcala de Henares, Spain
| | - Julia Bujan
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (C.G.-M.); (O.F.-M.); (L.S.-T.); (A.M.G.-L.); (N.G.-H.); (J.B.); (J.M.); (M.Á.-M.); (M.A.Á.-M.); (M.A.O.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain;
| | - Jorge Monserrat
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (C.G.-M.); (O.F.-M.); (L.S.-T.); (A.M.G.-L.); (N.G.-H.); (J.B.); (J.M.); (M.Á.-M.); (M.A.Á.-M.); (M.A.O.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain;
| | - Encarnación Serrano
- Los fresnos of Health Centre, Health Area III, Torrejon de Ardoz, 28850 Madrid, Spain;
| | - Melchor Álvarez-Mon
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (C.G.-M.); (O.F.-M.); (L.S.-T.); (A.M.G.-L.); (N.G.-H.); (J.B.); (J.M.); (M.Á.-M.); (M.A.Á.-M.); (M.A.O.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain;
- Immune System Diseases-Rheumatology, Oncology Service an Internal Medicine, University Hospital Príncipe de Asturias, (CIBEREHD), 28806 Alcalá de Henares, Spain
| | - Juan A De León-Luis
- Department of Obstetrics and Gynecology, University Hospital Gregorio Marañón, 28009 Madrid, Spain
- Health Research Institute Gregorio Marañón, 28009 Madrid, Spain
- First of May Health Centre, Health Area I, Rivas Vaciamadrid, 28521 Madrid, Spain;
- Correspondence:
| | - Miguel A. Álvarez-Mon
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (C.G.-M.); (O.F.-M.); (L.S.-T.); (A.M.G.-L.); (N.G.-H.); (J.B.); (J.M.); (M.Á.-M.); (M.A.Á.-M.); (M.A.O.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain;
- Department of Psychiatry and Medical Psychology, Hospital Universitario Infanta Leonor, 28031 Madrid, Spain
| | - Miguel A. Ortega
- Department of Medicine and Medical Specialities, Faculty of Medicine and Health Sciences, University of Alcalá, 28801 Alcalá de Henares, Spain; (C.G.-M.); (O.F.-M.); (L.S.-T.); (A.M.G.-L.); (N.G.-H.); (J.B.); (J.M.); (M.Á.-M.); (M.A.Á.-M.); (M.A.O.)
- Ramón y Cajal Institute of Sanitary Research (IRYCIS), 28034 Madrid, Spain;
- Cancer Registry and Pathology Department, Hospital Universitario Principe de Asturias, 28806 Alcalá de Henares, Spain
| |
Collapse
|
80
|
Dotolo S, Marabotti A, Facchiano A, Tagliaferri R. A review on drug repurposing applicable to COVID-19. Brief Bioinform 2021; 22:726-741. [PMID: 33147623 PMCID: PMC7665348 DOI: 10.1093/bib/bbaa288] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 09/16/2020] [Accepted: 09/30/2020] [Indexed: 12/11/2022] Open
Abstract
Drug repurposing involves the identification of new applications for existing drugs at a lower cost and in a shorter time. There are different computational drug-repurposing strategies and some of these approaches have been applied to the coronavirus disease 2019 (COVID-19) pandemic. Computational drug-repositioning approaches applied to COVID-19 can be broadly categorized into (i) network-based models, (ii) structure-based approaches and (iii) artificial intelligence (AI) approaches. Network-based approaches are divided into two categories: network-based clustering approaches and network-based propagation approaches. Both of them allowed to annotate some important patterns, to identify proteins that are functionally associated with COVID-19 and to discover novel drug–disease or drug–target relationships useful for new therapies. Structure-based approaches allowed to identify small chemical compounds able to bind macromolecular targets to evaluate how a chemical compound can interact with the biological counterpart, trying to find new applications for existing drugs. AI-based networks appear, at the moment, less relevant since they need more data for their application.
Collapse
Affiliation(s)
| | | | | | - Roberto Tagliaferri
- Artificial Intelligence, Statistical Pattern Recognition, Clustering, Biomedical imaging and Bioinformatics
| |
Collapse
|
81
|
Karatas Durusoy G, Gumus G, Demir G. Evaluation of the effect of n95 face mask used by healthcare professionals on choroidal thickness. Photodiagnosis Photodyn Ther 2021; 34:102279. [PMID: 33813019 DOI: 10.1016/j.pdpdt.2021.102279] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/29/2021] [Accepted: 03/29/2021] [Indexed: 12/15/2022]
Abstract
PURPOSE We aimed to show the changes in choroidal thickness (CT) with spectral domain optical coherence tomography (SD-OCT) after prolonged use of N95 mask. METHOD The healthcare workers who use the N95 face-mask, between 30-50 years of age who have best corrected visual acuity (BCVA) ≥10/10, spherical or cylindrical refraction errors less than 2 diopters, with normal intra ocular pressure (IOP), axial length (AL) between 22-24 mm included in the study. The choroid was imaged with enhanced depth imaging (EDI) techniques using SD-OCT. CT was measured, subfoveal, at 1000 μm nasal and temporal of the center of the fovea. Measurements were first made after wearing the N95 mask for at least 2 h without removing it and repeated 15 min after removing. RESULTS After 2 h of the N95 mask using without removal, the mean subfoveal CT was 293.56 ± 76.12(min:185, max:479), the mean temporal CT was 253.81 ± 63.48(min:172, max:384), the mean nasal CT was 239.18 ± 53.92(min:139, max:356). Fifteen minutes after removal of the N95 mask, the mean subfoveal CT was 250.56 ± 52.48(min:172, max:397), the mean temporal was 218.40 ± 53.58(min:129, max:354), the mean nasal CT was 210.67 ± 53.31(min:132, max:366). The differences in subfoveal, temporal and nasal CT between 2 h of N95 mask use and 15 min after removal of the mask were statistically significant (p < 0.05 for each). CONCLUSION Hypercapnia due to prolonged use of the N95 mask may cause choroidal hemodynamic changes and transient increased choroidal thickness.
Collapse
Affiliation(s)
| | - Gulsah Gumus
- Gaziantep Ersin Aslan Training and Research Hospital, Gaziantep, Turkey.
| | - Gokhan Demir
- University of Health Sciences Fatih Sultan Mehmet Training and Research Hospital, Istanbul, Turkey.
| |
Collapse
|
82
|
Mok PL, Koh AEH, Farhana A, Alsrhani A, Alam MK, Suresh Kumar S. Computational drug screening against the SARS-CoV-2 Saudi Arabia isolates through a multiple-sequence alignment approach. Saudi J Biol Sci 2021; 28:2502-2509. [PMID: 33551661 PMCID: PMC7845492 DOI: 10.1016/j.sjbs.2021.01.051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 01/19/2021] [Accepted: 01/21/2021] [Indexed: 11/18/2022] Open
Abstract
COVID-19 is a rapidly emerging infectious disease caused by the SARS-CoV-2 virus currently spreading throughout the world. To date, there are no specific drugs formulated for it, and researchers around the globe are racing against the clock to investigate potential drug candidates. The repurposing of existing drugs in the market represents an effective and economical strategy commonly utilized in such investigations. In this study, we used a multiple-sequence alignment approach for preliminary screening of commercially-available drugs on SARS-CoV sequences from the Kingdom of Saudi Arabia (KSA) isolates. The viral genomic sequences from KSA isolates were obtained from GISAID, an open access repository housing a wide variety of epidemic and pandemic virus data. A phylogenetic analysis of the present 164 sequences from the KSA provinces was carried out using the MEGA X software, which displayed high similarity (around 98%). The sequence was then analyzed using the VIGOR4 genome annotator to construct its genomic structure. Screening of existing drugs was carried out by mining data based on viral gene expressions from the ZINC database. A total of 73 hits were generated. The viral target orthologs were mapped to the SARS-CoV-2 KSA isolate sequence by multiple sequence alignment using CLUSTAL OMEGA, and a list of 29 orthologs with purchasable drug information was generated. The results showed that the SARS CoV replicase polyprotein 1a had the highest sequence similarity at 79.91%. Through ZINC data mining, tanshinones were found to have high binding affinities to this target. These compounds could be ideal candidates for SARS-CoV-2. Other matches ranged between 27 and 52%. The results of this study would serve as a significant endeavor towards drug discovery that would increase our chances of finding an effective treatment or prevention against COVID19.
Collapse
Affiliation(s)
- Pooi Ling Mok
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, P.O. Box 2014, Sakaka, Al-Jawf Province, Saudi Arabia
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia
- Genetics and Regenerative Medicine Research Centre, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia
| | - Avin Ee-Hwan Koh
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia
| | - Aisha Farhana
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, P.O. Box 2014, Sakaka, Al-Jawf Province, Saudi Arabia
| | - Abdullah Alsrhani
- Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, P.O. Box 2014, Sakaka, Al-Jawf Province, Saudi Arabia
| | - Mohammad Khursheed Alam
- Department of Orthodontics, College of Dentistry, Jouf University, P.O. Box 2014, Sakaka, Al-Jawf Province, Saudi Arabia
| | - Subbiah Suresh Kumar
- Genetics and Regenerative Medicine Research Centre, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia
- Department of Medical Microbiology and Parasitology, Universiti Putra Malaysia, 43400 UPM Serdang, Selangor, Malaysia
- UPM-MAKNA Cancer Research Laboratory, Institute of Bioscience, Universiti Putra Malaysia, Serdang 43400 UPM, Selangor, Malaysia
- Department of Biotechnology, Bharath Institute of Higher Education and Research, Bharath University, Selaiyur, Chennai 600073, Tamil Nadu, India
| |
Collapse
|
83
|
Huang K, Zhang P, Zhang Z, Youn JY, Wang C, Zhang H, Cai H. Traditional Chinese Medicine (TCM) in the treatment of COVID-19 and other viral infections: Efficacies and mechanisms. Pharmacol Ther 2021; 225:107843. [PMID: 33811957 PMCID: PMC8011334 DOI: 10.1016/j.pharmthera.2021.107843] [Citation(s) in RCA: 233] [Impact Index Per Article: 77.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 03/27/2021] [Accepted: 03/29/2021] [Indexed: 02/06/2023]
Abstract
COVID-19 has remained an uncontained, worldwide pandemic. While battling for the disease in China, six Traditional Chinese Medicine (TCM) recipes have been shown to be remarkably effective for treating patients with COVID-19. The present review discusses principles of TCM in curing infectious disease, and clinical evidence and mechanisms of the 6 most effective TCM recipes used in treating COVID-19 in 92% of all of the confirmed cases in China. Applications of TCM and specific recipes in the treatment of other viral infections, such as those caused by SARS-CoV, MERS-CoV, hepatitis B virus, hepatitis C virus, influenza A virus (including H1N1 and H7N9), influenza B, dengue virus as well as Ebola virus, are also discussed. Among the 6 TCM recipes, Jinhua Qinggan (JHQG) granules and Lianhua Qingwen (LHQW) capsules are recommended during medical observation; Lung Cleansing and Detoxifying Decoction (LCDD) is recommended for the treatment of both severe and non-severe patients; Xuanfeibaidu (XFBD) granules are recommended for treating moderate cases; while Huashibaidu (HSBD) and Xuebijing (XBJ) have been used in managing severe cases effectively. The common components and the active ingredients of the six TCM recipes have been summarized to reveal most promising drug candidates. The potential molecular mechanisms of the active ingredients in the six TCM recipes that target ACE2, 3CLpro and IL-6, revealed by molecular biological studies and/or network pharmacology prediction/molecular docking analysis/visualization analysis, are fully discussed. Therefore, further investigation of these TCM recipes may be of high translational value in enabling novel targeted therapies for COVID-19, potentially via purification and characterization of the active ingredients in the effective TCM recipes.
Collapse
Affiliation(s)
- Kai Huang
- Department of Anesthesiology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, United States of America
| | - Pan Zhang
- Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Zhenghao Zhang
- Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China
| | - Ji Youn Youn
- Department of Anesthesiology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, United States of America
| | - Chen Wang
- Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China; Chinese Academy of Medical Sciences/Peking Union Medical College, Beijing, China.
| | - Hongchun Zhang
- Center of Respiratory Medicine, China-Japan Friendship Hospital, Beijing, China.
| | - Hua Cai
- Department of Anesthesiology, Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, United States of America.
| |
Collapse
|
84
|
Fink K, Nitsche A, Neumann M, Grossegesse M, Eisele KH, Danysz W. Amantadine Inhibits SARS-CoV-2 In Vitro. Viruses 2021; 13:539. [PMID: 33804989 PMCID: PMC8063946 DOI: 10.3390/v13040539] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 03/17/2021] [Accepted: 03/19/2021] [Indexed: 02/06/2023] Open
Abstract
Since the SARS-CoV-2 pandemic started in late 2019, the search for protective vaccines and for drug treatments has become mandatory to fight the global health emergency. Travel restrictions, social distancing, and face masks are suitable counter measures, but may not bring the pandemic under control because people will inadvertently or at a certain degree of restriction severity or duration become incompliant with the regulations. Even if vaccines are approved, the need for antiviral agents against SARS-CoV-2 will persist. However, unequivocal evidence for efficacy against SARS-CoV-2 has not been demonstrated for any of the repurposed antiviral drugs so far. Amantadine was approved as an antiviral drug against influenza A, and antiviral activity against SARS-CoV-2 has been reasoned by analogy but without data. We tested the efficacy of amantadine in vitro in Vero E6 cells infected with SARS-CoV-2. Indeed, amantadine inhibited SARS-CoV-2 replication in two separate experiments with IC50 concentrations between 83 and 119 µM. Although these IC50 concentrations are above therapeutic amantadine levels after systemic administration, topical administration by inhalation or intranasal instillation may result in sufficient amantadine concentration in the airway epithelium without high systemic exposure. However, further studies in other models are needed to prove this hypothesis.
Collapse
Affiliation(s)
- Klaus Fink
- Merz Pharmaceuticals GmbH, 60318 Frankfurt, Germany; (K.-H.E.); (W.D.)
| | - Andreas Nitsche
- Robert-Koch-Institut, Zentrum für Biologische Gefahren und Spezielle Pathogene: Hochpathogene Viren (ZBS 1), 13353 Berlin, Germany; (A.N.); (M.N.); (M.G.)
| | - Markus Neumann
- Robert-Koch-Institut, Zentrum für Biologische Gefahren und Spezielle Pathogene: Hochpathogene Viren (ZBS 1), 13353 Berlin, Germany; (A.N.); (M.N.); (M.G.)
| | - Marica Grossegesse
- Robert-Koch-Institut, Zentrum für Biologische Gefahren und Spezielle Pathogene: Hochpathogene Viren (ZBS 1), 13353 Berlin, Germany; (A.N.); (M.N.); (M.G.)
| | - Karl-Heinz Eisele
- Merz Pharmaceuticals GmbH, 60318 Frankfurt, Germany; (K.-H.E.); (W.D.)
| | - Wojciech Danysz
- Merz Pharmaceuticals GmbH, 60318 Frankfurt, Germany; (K.-H.E.); (W.D.)
| |
Collapse
|
85
|
Akhter J, Quéromès G, Pillai K, Kepenekian V, Badar S, Mekkawy AH, Frobert E, Valle SJ, Morris DL. The Combination of Bromelain and Acetylcysteine (BromAc) Synergistically Inactivates SARS-CoV-2. Viruses 2021; 13:v13030425. [PMID: 33800932 PMCID: PMC7999995 DOI: 10.3390/v13030425] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 02/25/2021] [Accepted: 03/01/2021] [Indexed: 02/06/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection is the cause of a worldwide pandemic, currently with limited therapeutic options. The spike glycoprotein and envelope protein of SARS-CoV-2, containing disulfide bridges for stabilization, represent an attractive target as they are essential for binding to the ACE2 receptor in host cells present in the nasal mucosa. Bromelain and Acetylcysteine (BromAc) has synergistic action against glycoproteins by breakage of glycosidic linkages and disulfide bonds. We sought to determine the effect of BromAc on the spike and envelope proteins and its potential to reduce infectivity in host cells. Recombinant spike and envelope SARS-CoV-2 proteins were disrupted by BromAc. Spike and envelope protein disulfide bonds were reduced by Acetylcysteine. In in vitro whole virus culture of both wild-type and spike mutants, SARS-CoV-2 demonstrated a concentration-dependent inactivation from BromAc treatment but not from single agents. Clinical testing through nasal administration in patients with early SARS-CoV-2 infection is imminent.
Collapse
Affiliation(s)
- Javed Akhter
- Department of Surgery, St. George Hospital, Sydney, NSW 2217, Australia; (J.A.); (V.K.); (S.B.); (A.H.M.); (S.J.V.)
- Mucpharm Pty Ltd., Sydney, NSW 2217, Australia;
| | - Grégory Quéromès
- CIRI, Centre International de Recherche en Infectiologie, Team VirPatH, Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007 Lyon, France; (G.Q.); (E.F.)
| | | | - Vahan Kepenekian
- Department of Surgery, St. George Hospital, Sydney, NSW 2217, Australia; (J.A.); (V.K.); (S.B.); (A.H.M.); (S.J.V.)
- Hospices Civils de Lyon, EMR 3738 (CICLY), Lyon 1 Université, F-69921 Lyon, France
| | - Samina Badar
- Department of Surgery, St. George Hospital, Sydney, NSW 2217, Australia; (J.A.); (V.K.); (S.B.); (A.H.M.); (S.J.V.)
- St. George & Sutherland Clinical School, University of New South Wales, Sydney, NSW 2217, Australia
| | - Ahmed H. Mekkawy
- Department of Surgery, St. George Hospital, Sydney, NSW 2217, Australia; (J.A.); (V.K.); (S.B.); (A.H.M.); (S.J.V.)
- Mucpharm Pty Ltd., Sydney, NSW 2217, Australia;
- St. George & Sutherland Clinical School, University of New South Wales, Sydney, NSW 2217, Australia
| | - Emilie Frobert
- CIRI, Centre International de Recherche en Infectiologie, Team VirPatH, Univ Lyon, Inserm, U1111, Université Claude Bernard Lyon 1, CNRS, UMR5308, ENS de Lyon, F-69007 Lyon, France; (G.Q.); (E.F.)
- Laboratoire de Virologie, Institut des Agents Infectieux (IAI), Hospices Civils de Lyon, Groupement Hospitalier Nord, F-69004 Lyon, France
| | - Sarah J. Valle
- Department of Surgery, St. George Hospital, Sydney, NSW 2217, Australia; (J.A.); (V.K.); (S.B.); (A.H.M.); (S.J.V.)
- Mucpharm Pty Ltd., Sydney, NSW 2217, Australia;
- St. George & Sutherland Clinical School, University of New South Wales, Sydney, NSW 2217, Australia
| | - David L. Morris
- Department of Surgery, St. George Hospital, Sydney, NSW 2217, Australia; (J.A.); (V.K.); (S.B.); (A.H.M.); (S.J.V.)
- Mucpharm Pty Ltd., Sydney, NSW 2217, Australia;
- St. George & Sutherland Clinical School, University of New South Wales, Sydney, NSW 2217, Australia
- Correspondence: ; Tel.: +61-(02)-91132590
| |
Collapse
|
86
|
Alam T, Lipovich L. miRCOVID-19: Potential Targets of Human miRNAs in SARS-CoV-2 for RNA-Based Drug Discovery. Noncoding RNA 2021; 7:18. [PMID: 33801496 PMCID: PMC8005926 DOI: 10.3390/ncrna7010018] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 02/08/2021] [Accepted: 02/25/2021] [Indexed: 12/24/2022] Open
Abstract
Sense-antisense interactions of long and short RNAs in human cells are integral to post-transcriptional gene regulation, in particular that of mRNAs by microRNAs. Many viruses, including severe acute respiratory syndrome coronavirus 2 SARS-CoV-2 (the causative agent of coronavirus disease 2019, COVID-19), have RNA genomes, and interactions between host and viral RNAs, while known to be functional in other viral diseases, have not yet been investigated in COVID-19. To remedy this gap in knowledge, we present miRCOVID-19, a computational meta-analysis framework identifying the predicted binding sites of human microRNAs along the SARS-CoV-2 RNA genome. To highlight the potential relevance of SARS-CoV-2-genome-complementary miRNAs to COVID-19 pathogenesis, we assessed their expression in COVID-19-relevant tissues using public transcriptome data. miRCOVID-19 identified 14 high-confidence mature miRNAs that are highly likely to interact with the SARS-CoV-2 genome and are expressed in diverse respiratory epithelial and immune cell types that are relevant to COVID-19 pathogenesis. As a proof of principle, we have shown that human miR-122, a previously known co-factor of another RNA virus, the hepatitis C virus (HCV) whose genome it binds as a prerequisite for pathogenesis, was predicted to also bind the SARS-CoV-2 RNA genome with high affinity, suggesting the perspective of repurposing anti-HCV RNA-based drugs, such as Miravirsen, to treat COVID-19. Our study is the first to identify all high-confidence binding sites of human miRNAs in the SARS-CoV-2 genome using multiple tools. Our work directly facilitates experimental validation of the reported targets, which would accelerate RNA-based drug discovery for COVID-19 and has the potential to provide new avenues for treating symptomatic COVID-19, and block SARS-CoV-2 replication, in humans.
Collapse
Affiliation(s)
- Tanvir Alam
- College of Science and Engineering, Hamad Bin Khalifa University, Doha 34110, Qatar
| | - Leonard Lipovich
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, 505055 Dubai, United Arab Emirates
| |
Collapse
|
87
|
Dash P, Mohapatra S, Ghosh S, Nayak B. A Scoping Insight on Potential Prophylactics, Vaccines and Therapeutic Weaponry for the Ongoing Novel Coronavirus (COVID-19) Pandemic- A Comprehensive Review. Front Pharmacol 2021; 11:590154. [PMID: 33815095 PMCID: PMC8015872 DOI: 10.3389/fphar.2020.590154] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 12/29/2020] [Indexed: 12/18/2022] Open
Abstract
The emergence of highly virulent CoVs (SARS-CoV-2), the etiologic agent of novel ongoing "COVID-19" pandemics has been marked as an alarming case of pneumonia posing a large global healthcare crisis of unprecedented magnitude. Currently, the COVID-19 outbreak has fueled an international demand in the biomedical field for the mitigation of the fast-spreading illness, all through the urgent deployment of safe, effective, and rational therapeutic strategies along with epidemiological control. Confronted with such contagious respiratory distress, the global population has taken significant steps towards a more robust strategy of containment and quarantine to halt the total number of positive cases but such a strategy can only delay the spread. A substantial number of potential vaccine candidates are undergoing multiple clinical trials to combat COVID-19 disease, includes live-attenuated, inactivated, viral-vectored based, sub-unit vaccines, DNA, mRNA, peptide, adjuvant, plant, and nanoparticle-based vaccines. However, there are no licensed anti-COVID-19 drugs/therapies or vaccines that have proven to work as more effective therapeutic candidates in open-label clinical trial studies. To counteract the infection (SARS-CoV-2), many people are under prolonged treatment of many chemical drugs that inhibit the PLpro activity (Ribavirin), viral proteases (Lopinavir/Ritonavir), RdRp activity (Favipiravir, Remdesivir), viral membrane fusion (Umifenovir, Chloroquine phosphate (CQ), Hydroxychloroquine phosphate (HCQ), IL-6 overexpression (Tocilizumab, Siltuximab, Sarilumab). Mesenchymal Stem Cell therapy and Convalescent Plasma Therapy have emerged as a promising therapeutic strategy against SARS-CoV-2 virion. On the other hand, repurposing previously designed antiviral agents with tolerable safety profile and efficacy could be the only promising approach and fast response to the novel virion. In addition, research institutions and corporations have commenced the redesign of the available therapeutic strategy to manage the global crisis. Herein, we present succinct information on selected anti-COVID-19 therapeutic medications repurposed to combat SARS-CoV-2 infection. Finally, this review will provide exhaustive detail on recent prophylactic strategies and ongoing clinical trials to curb this deadly pandemic, outlining the major therapeutic areas for researchers to step in.
Collapse
Affiliation(s)
| | | | | | - Bismita Nayak
- Immunology and Molecular Medicine Laboratory, Department of Life Science, National Institute of Technology Rourkela, Odisha, India
| |
Collapse
|
88
|
Desai A, Caltagirone G, Sari S, Pocaterra D, Kogan M, Azzolini E, Savevski V, Martinelli-Boneschi F, Voza A. The Use of Antiviral Agents against SARS-CoV-2: Ineffective or Time and Age Dependent Result? A Retrospective, Observational Study among COVID-19 Older Adults. J Clin Med 2021; 10:686. [PMID: 33578922 PMCID: PMC7916694 DOI: 10.3390/jcm10040686] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 02/06/2021] [Accepted: 02/08/2021] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Our aim was to investigate the impact of therapeutics with antiviral activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on mortality of older adults affected by coronavirus disease 2019 (COVID-19), taking into consideration the time interval from symptoms onset to drugs administration. METHODS Data from 143 COVID-19 patients over 65 years of age admitted to the Humanitas Clinical and Research Center Emergency Department (Milan, Italy) and treated with Lopinavir/ritonavir (LPV/r) or Darunavir/cobicistat (DVR/c) associated to Hydroxychloroquine (HCQ) were retrospectively analyzed. Statistical analysis was performed by using a logistic regression model and survival analysis to assess the role of different predictors of in-hospital mortality, including an early (<6 days from symptoms onset) vs. late treatment onset, signs and symptoms at COVID-19 presentation, type of antiviral treatment (LPV/r or DVR/c) and patients' age (65-80 vs. >80 years old). RESULTS Multivariate analysis showed that an older age (OR: 2.54) and dyspnea as presenting symptom (OR: 2.01) were associated with higher mortality rate, whereas cough as presenting symptom (OR: 0.53) and a timely drug administration (OR: 0.44) were associated with lower mortality. Survival analysis demonstrated that the timing of drug administration had an impact on mortality in 65-80 years-old patients (p = 0.02), whereas no difference was seen in those >80 years-old. This impact was more evident in patients with dyspnea as primary symptom of COVID-19, in whom mortality decreased from 57.1% to 38.3% due to timely drug administration (OR: 0.5; p = 0.04). CONCLUSIONS There was a significant association between the use of a combined antiviral regimen and HCQ and lower mortality, when timely-administered, in COVID-19 patients aged 65-80 years. Our findings support timely treatment onset as a key component in the treatment of COVID-19.
Collapse
Affiliation(s)
- Antonio Desai
- Emergency Department, Humanitas Clinical and Research Center, IRCCS, 20089 Milan, Italy; (G.C.); (M.K.); (A.V.)
- Department of Biomedical Sciences, Humanitas University, 20090 Pieve Emanuele, Italy;
| | - Giuseppe Caltagirone
- Emergency Department, Humanitas Clinical and Research Center, IRCCS, 20089 Milan, Italy; (G.C.); (M.K.); (A.V.)
- Department of Biomedical Sciences, Humanitas University, 20090 Pieve Emanuele, Italy;
| | - Sharon Sari
- Internal Medicine Department, Geriatrics, Santa Margherita Rehabilitation and Cure Institute, ASP, 27100 Pavia, Italy;
| | - Daria Pocaterra
- Department of Infectious Diseases, Humanitas Clinical and Research Center, IRCCS, 20089 Milan, Italy;
| | - Maria Kogan
- Emergency Department, Humanitas Clinical and Research Center, IRCCS, 20089 Milan, Italy; (G.C.); (M.K.); (A.V.)
| | - Elena Azzolini
- Department of Biomedical Sciences, Humanitas University, 20090 Pieve Emanuele, Italy;
- Health Directorate, Humanitas Clinical and Research Center, IRCCS, 20089 Milan, Italy
| | - Victor Savevski
- Artificial Intelligence Center, Humanitas Clinical and Research Center, IRCCS, 20089 Milan, Italy;
| | - Filippo Martinelli-Boneschi
- Dino Ferrari Centre, Neuroscience Section, Department of Pathophysiology and Transplantation (DEPT), University of Milan, 20122 Milan, Italy;
- Neurology Unit and MS Centre, Fondazione IRCCS Ca’ Granda Ospedale Maggiore, Policlinico, 20122 Milan, Italy
| | - Antonio Voza
- Emergency Department, Humanitas Clinical and Research Center, IRCCS, 20089 Milan, Italy; (G.C.); (M.K.); (A.V.)
| |
Collapse
|
89
|
Braune K, Rojas PD, Hofferbert J, Valera Sosa A, Lebedev A, Balzer F, Thun S, Lieber S, Kirchberger V, Poncette AS. Interdisciplinary Online Hackathons as an Approach to Combat the COVID-19 Pandemic: Case Study. J Med Internet Res 2021; 23:e25283. [PMID: 33497350 PMCID: PMC7872325 DOI: 10.2196/25283] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 01/02/2021] [Accepted: 01/16/2021] [Indexed: 12/24/2022] Open
Abstract
Background The COVID-19 outbreak has affected the lives of millions of people by causing a dramatic impact on many health care systems and the global economy. This devastating pandemic has brought together communities across the globe to work on this issue in an unprecedented manner. Objective This case study describes the steps and methods employed in the conduction of a remote online health hackathon centered on challenges posed by the COVID-19 pandemic. It aims to deliver a clear implementation road map for other organizations to follow. Methods This 4-day hackathon was conducted in April 2020, based on six COVID-19–related challenges defined by frontline clinicians and researchers from various disciplines. An online survey was structured to assess: (1) individual experience satisfaction, (2) level of interprofessional skills exchange, (3) maturity of the projects realized, and (4) overall quality of the event. At the end of the event, participants were invited to take part in an online survey with 17 (+5 optional) items, including multiple-choice and open-ended questions that assessed their experience regarding the remote nature of the event and their individual project, interprofessional skills exchange, and their confidence in working on a digital health project before and after the hackathon. Mentors, who guided the participants through the event, also provided feedback to the organizers through an online survey. Results A total of 48 participants and 52 mentors based in 8 different countries participated and developed 14 projects. A total of 75 mentorship video sessions were held. Participants reported increased confidence in starting a digital health venture or a research project after successfully participating in the hackathon, and stated that they were likely to continue working on their projects. Of the participants who provided feedback, 60% (n=18) would not have started their project without this particular hackathon and indicated that the hackathon encouraged and enabled them to progress faster, for example, by building interdisciplinary teams, gaining new insights and feedback provided by their mentors, and creating a functional prototype. Conclusions This study provides insights into how online hackathons can contribute to solving the challenges and effects of a pandemic in several regions of the world. The online format fosters team diversity, increases cross-regional collaboration, and can be executed much faster and at lower costs compared to in-person events. Results on preparation, organization, and evaluation of this online hackathon are useful for other institutions and initiatives that are willing to introduce similar event formats in the fight against COVID-19.
Collapse
Affiliation(s)
- Katarina Braune
- Department of Paediatric Endocrinology and Diabetes, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany.,Hacking Health Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany
| | | | | | - Alvaro Valera Sosa
- Hacking Health Berlin, Berlin, Germany.,CityLAB Berlin, Building Health Lab, Berlin, Germany.,Department of Design and Typologies, Technische Universität Berlin, Berlin, Germany
| | | | - Felix Balzer
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Anesthesiology and Intensive Care Medicine, Berlin, Germany.,Einstein Center Digital Future, Berlin, Germany
| | | | - Sascha Lieber
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Anesthesiology and Intensive Care Medicine, Berlin, Germany.,Executive Board, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Valerie Kirchberger
- Executive Board, Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Akira-Sebastian Poncette
- Hacking Health Berlin, Berlin, Germany.,Berlin Institute of Health, Berlin, Germany.,Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Department of Anesthesiology and Intensive Care Medicine, Berlin, Germany.,Einstein Center Digital Future, Berlin, Germany
| |
Collapse
|
90
|
Santana MVS, Silva-Jr FP. De novo design and bioactivity prediction of SARS-CoV-2 main protease inhibitors using recurrent neural network-based transfer learning. BMC Chem 2021; 15:8. [PMID: 33531083 PMCID: PMC7852053 DOI: 10.1186/s13065-021-00737-2] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 01/16/2021] [Indexed: 12/13/2022] Open
Abstract
The global pandemic of coronavirus disease (COVID-19) caused by SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) created a rush to discover drug candidates. Despite the efforts, so far no vaccine or drug has been approved for treatment. Artificial intelligence offers solutions that could accelerate the discovery and optimization of new antivirals, especially in the current scenario dominated by the scarcity of compounds active against SARS-CoV-2. The main protease (Mpro) of SARS-CoV-2 is an attractive target for drug discovery due to the absence in humans and the essential role in viral replication. In this work, we developed a deep learning platform for de novo design of putative inhibitors of SARS-CoV-2 main protease (Mpro). Our methodology consists of 3 main steps: (1) training and validation of general chemistry-based generative model; (2) fine-tuning of the generative model for the chemical space of SARS-CoV- Mpro inhibitors and (3) training of a classifier for bioactivity prediction using transfer learning. The fine-tuned chemical model generated > 90% valid, diverse and novel (not present on the training set) structures. The generated molecules showed a good overlap with Mpro chemical space, displaying similar physicochemical properties and chemical structures. In addition, novel scaffolds were also generated, showing the potential to explore new chemical series. The classification model outperformed the baseline area under the precision-recall curve, showing it can be used for prediction. In addition, the model also outperformed the freely available model Chemprop on an external test set of fragments screened against SARS-CoV-2 Mpro, showing its potential to identify putative antivirals to tackle the COVID-19 pandemic. Finally, among the top-20 predicted hits, we identified nine hits via molecular docking displaying binding poses and interactions similar to experimentally validated inhibitors.
Collapse
Affiliation(s)
- Marcos V S Santana
- LaBECFar-Laboratório de Bioquímica Experimental e Computacional de Fármacos, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, 21040-900, Brazil
| | - Floriano P Silva-Jr
- LaBECFar-Laboratório de Bioquímica Experimental e Computacional de Fármacos, Instituto Oswaldo Cruz, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, 21040-900, Brazil.
| |
Collapse
|
91
|
Moradimajd P, Samaee H, Sedigh-Maroufi S, Kourosh-Aami M, Mohsenzadagan M. Administration of intravenous immunoglobulin in the treatment of COVID-19: A review of available evidence. J Med Virol 2021; 93:2675-2682. [PMID: 33314173 DOI: 10.1002/jmv.26727] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 11/24/2020] [Accepted: 12/09/2020] [Indexed: 01/02/2023]
Abstract
Since December 31, 2019, unknown causes of pneumonia have been reported in Wuhan, China. This special pneumonia associated with a novel coronavirus was named 2019-nCoV by the World Health Organization (WHO) in January 2020. From the beginning of this infectious disease, clinicians and researchers have been endeavoring to discover an effective and suitable treatment for affected patients. To date, there is no definitive and specific treatments for coronavirus disease-19 (COVID-19) infection while drugs introduced are still in the clinical trial phase. Intravenous immune globulin (IVIG) is a biological product prepared from the serum and an optional treatment for patients with antibody deficiencies. In many countries, much attention has been paid to the use of IVIG in the treatment of patients with COVID-19. Due to the therapeutic importance of IVIG in virus infections, in the current study, we reviewed the possible effect of IVIG in viral infections and potential evidence of IVIG therapy in patients with COVID-19 virus.
Collapse
Affiliation(s)
- Parisa Moradimajd
- Department of Anesthesia, Faculty of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Samaee
- Departement of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Shahnam Sedigh-Maroufi
- Department of Anesthesia, Faculty of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Masoumeh Kourosh-Aami
- Department of Neuroscience, School of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Monireh Mohsenzadagan
- Department of Medical Laboratory Science, Faculty of Allied Medical Sciences, Iran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
92
|
Strizova Z, Smetanova J, Bartunkova J, Milota T. Principles and Challenges in anti-COVID-19 Vaccine Development. Int Arch Allergy Immunol 2021; 182:339-349. [PMID: 33524979 PMCID: PMC7900461 DOI: 10.1159/000514225] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 12/30/2020] [Indexed: 12/05/2022] Open
Abstract
The number of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected patients keeps rising in most of the European countries despite the pandemic precaution measures. The current antiviral and anti-inflammatory therapeutic approaches are only supportive, have limited efficacy, and the prevention in reducing the transmission of SARS-CoV-2 virus is the best hope for public health. It is presumed that an effective vaccination against SARS-CoV-2 infection could mobilize the innate and adaptive immune responses and provide a protection against severe forms of coronavirus disease 2019 (COVID-19) disease. As the race for the effective and safe vaccine has begun, different strategies were introduced. To date, viral vector-based vaccines, genetic vaccines, attenuated vaccines, and protein-based vaccines are the major vaccine types tested in the clinical trials. Over 80 clinical trials have been initiated; however, only 18 vaccines have reached the clinical phase II/III or III, and 4 vaccine candidates are under consideration or have been approved for the use so far. In addition, the protective effect of the off-target vaccines, such as Bacillus Calmette-Guérin and measles vaccine, is being explored in randomized prospective clinical trials with SARS-CoV-2-infected patients. In this review, we discuss the most promising anti-COVID-19 vaccine clinical trials and different vaccination strategies in order to provide more clarity into the ongoing clinical trials.
Collapse
Affiliation(s)
- Zuzana Strizova
- Department of Immunology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czechia
| | - Jitka Smetanova
- Department of Immunology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czechia
| | - Jirina Bartunkova
- Department of Immunology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czechia
| | - Tomas Milota
- Department of Immunology, Second Faculty of Medicine, Charles University and University Hospital Motol, Prague, Czechia,
- Department of Paediatric and Adult Rheumatology, University Hospital Motol, Prague, Czechia,
| |
Collapse
|
93
|
Rodriguez-Guerra M, Jadhav P, Vittorio TJ. Current treatment in COVID-19 disease: a rapid review. Drugs Context 2021; 10:2020-10-3. [PMID: 33569082 PMCID: PMC7850293 DOI: 10.7573/dic.2020-10-3] [Citation(s) in RCA: 38] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 12/11/2020] [Indexed: 12/15/2022] Open
Abstract
The world has faced the most challenging pandemic of the modern era, that of severe acute respiratory syndrome coronavirus 2 infection, causing coronavirus disease and affecting over 35 million people globally. The wide range of clinical manifestations associated with this viral disease is thought to be related to the overexpression of inflammatory markers. Due to a dysregulated host response, the most severe form involves multi-organ failure and thromboembolic complications. Immunomodulatory therapies may help prevent its progression and anticoagulation has been shown to reduce the risk of thrombotic complications. As this is a new entity for the medical world, there are no known therapeutic options nor has the prevention of complications been established. Anti-inflammatory agents, antimicrobial therapy, and vitamin supplements are short of clear benefits, but there is limited data to review. Other agents, such as convalescent plasma, eculizumab, immunoglobulins, neutralizing IgG1 monoclonal antibodies, remdesivir, steroids, and tocilizumab, have shown a possible impact on inpatient length of stay and mortality rate. This review aims to assess the efficacy and safety of these available therapies in light of current evidence. We compare these treatment options based on their impact on symptom management, inpatient length of stay, and overall morbidity and mortality.
Collapse
Affiliation(s)
| | - Preeti Jadhav
- Division of Cardiology, BronxCare Hospital Center, Bronx, NY, USA
| | | |
Collapse
|
94
|
Effective drugs used to combat SARS-CoV-2 infection and the current status of vaccines. Biomed Pharmacother 2021; 137:111330. [PMID: 33550043 PMCID: PMC7843108 DOI: 10.1016/j.biopha.2021.111330] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 01/24/2021] [Accepted: 01/25/2021] [Indexed: 02/06/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a causal factor of the coronavirus disease 2019 (COVID-19). Drug repurposing, portraying patented drugs as a successful drug development technique, could shorten the period and minimize costs relative to de novo drug exploration. Recently several drugs have been used as anti-SARS-CoV-2 such as Remdesivir, Favipiravir, Hydroxychloroquine, Azithromycin, Lopinavir/Ritonavir, Nafamostat mesylate and so on. Despite such efforts, there is currently no successful broad-spectrum antiviral countermeasures to combat SARS-CoV-2 or possibly potential CoVs pandemic. Therefore it is desperately important to recognize and test widely efficient, reliable anti-CoV therapies now and in the future. Remdesivir and Favipiravir were more promising despite having side effects; it had prominent efficacy and efficiency while still not yet approved as the official anti-viral drug for SARS CoV-2. In this review, we summarizes the current drug and vaccine discovery status against SARS-CoV-2, predicting that these efforts will help create effective drugs and vaccines for SARS-CoV-2.
Collapse
|
95
|
Janik E, Bartos M, Niemcewicz M, Gorniak L, Bijak M. SARS-CoV-2: Outline, Prevention, and Decontamination. Pathogens 2021; 10:114. [PMID: 33498679 PMCID: PMC7911301 DOI: 10.3390/pathogens10020114] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Revised: 01/20/2021] [Accepted: 01/21/2021] [Indexed: 02/06/2023] Open
Abstract
The new coronavirus began to spread around the world in late 2019. Initially, it was found only in China, but in the following days there were reported cases of infections in other countries. Subsequently, based on taxonomy, phylogeny, and accepted practice, the virus was officially designated as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As a result of the rapid spread of SARS-CoV-2 in different countries around the world, on March 11, 2020, the World Health Organization (WHO) announced a status change in the disease caused by this coronavirus-from an epidemic to a pandemic disease. Although the world is taking unprecedented efforts to control the spread of SARS-CoV-2, the number of confirmed cases is rising. Therefore, effective preventive measures are needed in order to limit the spread of illness. The prevention measures are mainly based on information on the virus transmission routes, its environmental stability, and persistence on commonly touched surfaces. Social distancing, mask usage, and good hygiene practice are the most important recommendations for general public. Healthcare professionals who are directly involved in SARS-CoV-2 patients care are more exposed to virus infection and additional protection measures are necessary, including protective suits, aprons, face shields, goggles, and gloves. Due to the stability of SARS-CoV-2 on different surfaces, such as glass, paper, or wood, proper disinfection is crucial. Several studies have shown that despite the virus's stability, it is sensitive to various disinfectants, such as ethanol, isopropanol, sodium hypochlorite, or hydrogen peroxide. These findings underline the importance of having comprehensive knowledge about SARS-CoV-2 and multidirectional strategies in order to limit the spread of the virus. This review is a summary of the most important information about SARS-CoV-2, such as its stability on different surfaces, protection strategies, and decontamination options.
Collapse
Affiliation(s)
- Edyta Janik
- Biohazard Prevention Centre, Faculty of Biology and Environmental Protection, University of Lodz, Pomorska 141/143, 90-236 Lodz, Poland. (E.J.); (M.N.); (L.G.)
| | - Maciej Bartos
- Department of Biodiversity Studies and Bioeducation, Faculty of Biology and Environmental Protection, University of Lodz, Banacha 1/3, 90-237 Lodz, Poland.
| | - Marcin Niemcewicz
- Biohazard Prevention Centre, Faculty of Biology and Environmental Protection, University of Lodz, Pomorska 141/143, 90-236 Lodz, Poland. (E.J.); (M.N.); (L.G.)
| | - Leslaw Gorniak
- Biohazard Prevention Centre, Faculty of Biology and Environmental Protection, University of Lodz, Pomorska 141/143, 90-236 Lodz, Poland. (E.J.); (M.N.); (L.G.)
| | - Michal Bijak
- Biohazard Prevention Centre, Faculty of Biology and Environmental Protection, University of Lodz, Pomorska 141/143, 90-236 Lodz, Poland. (E.J.); (M.N.); (L.G.)
| |
Collapse
|
96
|
A review of potential suggested drugs for coronavirus disease (COVID-19) treatment. Eur J Pharmacol 2021; 895:173890. [PMID: 33482181 PMCID: PMC7816644 DOI: 10.1016/j.ejphar.2021.173890] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Revised: 12/11/2020] [Accepted: 01/14/2021] [Indexed: 12/15/2022]
Abstract
The latest pandemic, coronavirus disease-2019 (COVID-19), is associated with high prevalence and easy transmission, which is expanding globally with no conventional treatment or vaccine. The new virus revealed 79% and 50% genomic similarities with severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), respectively. Accordingly, since the disease resists testing and adopting new therapeutics, repositioning pre-existing drugs may present a fast and attractive strategy with known safety, characteristics, and dosage used. However, they are not specific and targeted. Therefore, several drugs have been investigated for their efficacy and safety in the treatment of COVID-19; most of them are undergoing clinical trials. This article summarizes clinical investigations of potential therapeutic drugs used as COVID-19 therapy. Subsequently, it prepares a pattern of results and therapeutic targets to help further experiment designs. We have investigated drugs as classified in the following three groups; 1) The drugs which computationally showed effectiveness (in silico) but needed further lab confirmations; 2) Emetine, Teicoplanin, and Nelfinavir have shown effectiveness in vitro; 3) The drugs currently under clinical trial.
Collapse
|
97
|
Fouladirad S, Bach H. Development of Coronavirus Treatments Using Neutralizing Antibodies. Microorganisms 2021; 9:microorganisms9010165. [PMID: 33451069 PMCID: PMC7828509 DOI: 10.3390/microorganisms9010165] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 01/09/2021] [Accepted: 01/11/2021] [Indexed: 12/19/2022] Open
Abstract
The Coronavirus disease 2019 (COVID-19), caused by the novel coronavirus SARS-CoV-2, was first reported in December 2019 in Wuhan, Hubei province, China. This virus has led to 61.8 million cases worldwide being reported as of December 1st, 2020. Currently, there are no definite approved therapies endorsed by the World Health Organization for COVID-19, focusing only on supportive care. Treatment centers around symptom management, including oxygen therapy or invasive mechanical ventilation. Immunotherapy has the potential to play a role in the treatment of SARS-CoV-2. Monoclonal antibodies (mAbs), in particular, is a relatively new approach in the world of infectious diseases and has the benefit of overcoming challenges with serum therapy and intravenous immunoglobulins preparations. Here, we reviewed the articles published in PubMed with the purpose of summarizing the currently available evidence for the use of neutralizing antibodies as a potential treatment for coronaviruses. Studies reporting in vivo results were summarized and analyzed. Despite promising data from some studies, none of them progressed to clinical trials. It is expected that neutralizing antibodies might offer an alternative for COVID-19 treatment. Thus, there is a need for randomized trials to understand the potential use of this treatment.
Collapse
Affiliation(s)
- Saman Fouladirad
- Department of Medicine, University of British Columbia, Vancouver, BC V6T 1Z, Canada;
| | - Horacio Bach
- Department of Medicine, University of British Columbia, Vancouver, BC V6T 1Z, Canada;
- Division of Infectious Diseases, University of British Columbia, Vancouver, BC V6T 1Z, Canada
- Correspondence: ; Tel.: +1-604-727-9719; Fax: +1-604-875-4013
| |
Collapse
|
98
|
Syeda HB, Syed M, Sexton KW, Syed S, Begum S, Syed F, Prior F, Yu F. Role of Machine Learning Techniques to Tackle the COVID-19 Crisis: Systematic Review. JMIR Med Inform 2021; 9:e23811. [PMID: 33326405 PMCID: PMC7806275 DOI: 10.2196/23811] [Citation(s) in RCA: 71] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 10/27/2020] [Accepted: 11/15/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND SARS-CoV-2, the novel coronavirus responsible for COVID-19, has caused havoc worldwide, with patients presenting a spectrum of complications that have pushed health care experts to explore new technological solutions and treatment plans. Artificial Intelligence (AI)-based technologies have played a substantial role in solving complex problems, and several organizations have been swift to adopt and customize these technologies in response to the challenges posed by the COVID-19 pandemic. OBJECTIVE The objective of this study was to conduct a systematic review of the literature on the role of AI as a comprehensive and decisive technology to fight the COVID-19 crisis in the fields of epidemiology, diagnosis, and disease progression. METHODS A systematic search of PubMed, Web of Science, and CINAHL databases was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines to identify all potentially relevant studies published and made available online between December 1, 2019, and June 27, 2020. The search syntax was built using keywords specific to COVID-19 and AI. RESULTS The search strategy resulted in 419 articles published and made available online during the aforementioned period. Of these, 130 publications were selected for further analyses. These publications were classified into 3 themes based on AI applications employed to combat the COVID-19 crisis: Computational Epidemiology, Early Detection and Diagnosis, and Disease Progression. Of the 130 studies, 71 (54.6%) focused on predicting the COVID-19 outbreak, the impact of containment policies, and potential drug discoveries, which were classified under the Computational Epidemiology theme. Next, 40 of 130 (30.8%) studies that applied AI techniques to detect COVID-19 by using patients' radiological images or laboratory test results were classified under the Early Detection and Diagnosis theme. Finally, 19 of the 130 studies (14.6%) that focused on predicting disease progression, outcomes (ie, recovery and mortality), length of hospital stay, and number of days spent in the intensive care unit for patients with COVID-19 were classified under the Disease Progression theme. CONCLUSIONS In this systematic review, we assembled studies in the current COVID-19 literature that utilized AI-based methods to provide insights into different COVID-19 themes. Our findings highlight important variables, data types, and available COVID-19 resources that can assist in facilitating clinical and translational research.
Collapse
Affiliation(s)
- Hafsa Bareen Syeda
- Department of Neurology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Mahanazuddin Syed
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Kevin Wayne Sexton
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Health Policy and Management, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Shorabuddin Syed
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Salma Begum
- Department of Information Technology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Farhanuddin Syed
- College of Medicine, Shadan Institute of Medical Sciences, Hyderabad, India
| | - Fred Prior
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
- Department of Radiology, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Feliciano Yu
- Department of Biomedical Informatics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| |
Collapse
|
99
|
Bezerra Espinola MS, Bertelli M, Bizzarri M, Unfer V, Laganà AS, Visconti B, Aragona C. Inositol and vitamin D may naturally protect human reproduction and women undergoing assisted reproduction from Covid-19 risk. J Reprod Immunol 2021; 144:103271. [PMID: 33493945 PMCID: PMC7833496 DOI: 10.1016/j.jri.2021.103271] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Revised: 12/22/2020] [Accepted: 12/29/2020] [Indexed: 12/16/2022]
Abstract
In late 2019, the new Coronavirus has been identified in the city of Wuhan then COVID-19 spreads like wildfire in the rest of the world. Pregnant women represent a risk category for increased abortion rates and vertical transmission with adverse events on the newborns has been recently confirmed. The scientific world is struggling for finding an effective cure for counteracting symptomatology. Today, there are many therapeutic proposes but none of them can effectively counteract the infection. Moreover, many of these compounds show important side effects not justifying their use. Scientific literature reports an immune system over-reaction through interleukins-6 activation. In this regard, the possibility to control the immune system represents a possible strategy for counteracting the onset of COVID-19 symptomatology. Vitamin D deficiency shows increased susceptibility to acute viral respiratory infections. Moreover, Vitamin D seems involved in host protection from different virus species by modulating activation and release of cytokines. Myo-inositol down-regulates the expression of IL-6 by phosphatidyl-inositol-3-kinase (PI3K) pathway. Furthermore, myo-inositol is the precursor of phospholipids in the surfactant and it is applied for inducing surfactant synthesis in infants for treating respiratory distress syndrome (RDS). This review aims to summarize the evidence about COVID-19 infection in pregnant women and to encourage the scientific community to investigate the use of Vitamin D and Myo-inositol which could represent a possible preventive treatment for pregnant women or women undergoing assisted reproductive technologies (ART).
Collapse
Affiliation(s)
| | - Matteo Bertelli
- MAGI'S LAB, Rovereto (Trento), Italy; MAGI EUREGIO, Bolzano, Italy; EBTNA-LAB, Rovereto (Trento), Italy
| | - Mariano Bizzarri
- Department of Experimental Medicine, Sapienza University of Rome, Systems Biology Group Lab, Rome, Italy
| | - Vittorio Unfer
- Department of Experimental Medicine, Sapienza University of Rome, Systems Biology Group Lab, Rome, Italy
| | - Antonio Simone Laganà
- Department of Obstetrics and Gynecology, "Filippo Del Ponte" Hospital, University of Insubria, Varese, Italy
| | | | - Cesare Aragona
- Department of Experimental Medicine, Sapienza University of Rome, Systems Biology Group Lab, Rome, Italy.
| |
Collapse
|
100
|
Gutiérrez-Abejón E, Tamayo E, Martín-García D, Álvarez FJ, Herrera-Gómez F. Clinical Profile, Treatment and Predictors during the First COVID-19 Wave: A Population-Based Registry Analysis from Castile and Leon Hospitals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E9360. [PMID: 33327546 PMCID: PMC7765016 DOI: 10.3390/ijerph17249360] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Revised: 12/04/2020] [Accepted: 12/07/2020] [Indexed: 01/08/2023]
Abstract
The first wave of the COVID-19 pandemic collapsed the hospitals in Castile and Leon (Spain). An analysis of the clinical characteristics, drug therapies and principal outcome predictors in the COVID-19 hospitalized patients from 1 March to 31 May 2020 is presented through a population-based registry study. Hospital stay variables, ventilation mode data and clinical outcomes were observed. In Castile and Leon hospitals, 7307 COVID-19 patients were admitted, with 57.05% being male and a median of 76 years. The mortality rate was 24.43%, with a high incidence of severe acute respiratory syndrome (SARS) (14.03%) and acute kidney injury (AKI) (10.87%). The most used medicines were antibiotics (90.83%), antimalarials (42.63%), steroids (44.37%) and antivirals, such as lopinavir/ritonavir (42.63%). The use of tocilizumab (9.37%) and anti-SIRS (systemic inflammatory response syndrome) medicines (7.34%) were remarkable. Fundamentally, death occurred more likely over 65 years of age (OR: 9.05). In addition, the need for ventilation was associated with a higher probability of death (OR: 3.59), SARS (OR: 5.14) and AKI (OR: 2.31). The drug-use pattern had been modified throughout the COVID-19 first wave. Multiple factors, such as age, gender and the need for mechanical ventilation, were related to the worst evolution prognosis of the disease.
Collapse
Affiliation(s)
- Eduardo Gutiérrez-Abejón
- Pharmacological Big Data Laboratory, Faculty of Medicine, University of Valladolid, 47005 Valladolid, Spain; (F.J.Á.); (F.H.-G.)
- Technical Direction of Pharmaceutical Assistance, Gerencia Regional de Salud de Castilla y León, 47007 Valladolid, Spain
| | - Eduardo Tamayo
- BioCritic. Group for Biomedical Research in Critical Care Medicine, 47005 Valladolid, Spain;
- Department of Anaesthesiology, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
- Department of Surgery, Faculty of Medicine, University of Valladolid, 47005 Valladolid, Spain
| | - Débora Martín-García
- Department of Nephrology, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain;
| | - F. Javier Álvarez
- Pharmacological Big Data Laboratory, Faculty of Medicine, University of Valladolid, 47005 Valladolid, Spain; (F.J.Á.); (F.H.-G.)
- BioCritic. Group for Biomedical Research in Critical Care Medicine, 47005 Valladolid, Spain;
- CEIm, Hospital Clínico Universitario de Valladolid, 47003 Valladolid, Spain
| | - Francisco Herrera-Gómez
- Pharmacological Big Data Laboratory, Faculty of Medicine, University of Valladolid, 47005 Valladolid, Spain; (F.J.Á.); (F.H.-G.)
- BioCritic. Group for Biomedical Research in Critical Care Medicine, 47005 Valladolid, Spain;
- Department of Nephrology, Hospital Virgen de la Concha, 49022 Zamora, Spain
| |
Collapse
|