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Merza MY, Hwaiz RA, Hamad BK, Mohammad KA, Hama HA, Karim AY. Analysis of cytokines in SARS-CoV-2 or COVID-19 patients in Erbil city, Kurdistan Region of Iraq. PLoS One 2021; 16:e0250330. [PMID: 33914789 PMCID: PMC8084148 DOI: 10.1371/journal.pone.0250330] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 04/05/2021] [Indexed: 12/23/2022] Open
Abstract
The emergence of the novel coronavirus and then pandemic outbreak was coined 2019- nCoV or COVID-19 (or SARS-CoV-2 disease 2019). This disease has a mortality rate of about 3·7 percent, and successful therapy is desperately needed to combat it. The exact cellular mechanisms of COVID-19 need to be illustrated in detail. This study aimed to evaluate serum cytokines in COVID-19 patients. In this study, serum was collected from volunteer individuals, moderate COVID-19 patients, severe cases of COVID-19 patients, and patients who recovered from COVID-19 (n = 122). The serum concentrations of interleukins such as IL-1, IL-4, IL-6, IL-8, IL-10, and tumor necrosis factor-alpha (TNF-α), were measured by enzyme-linked immunosorbent assays (ELISA). The concentrations of IL-1 and TNF-α were did not differ significantly among groups. However, the concentration of IL-6 was significantly higher in moderate COVID-19 and severe cases of COVID-19 groups compared to control and recovered groups indicating it to be an independent predictor in the coronavirus disease. The levels of IFN-γ and IL-4 were significantly lower in the recovery group than the severe case of the COVID-19 group. In contrast, the level of IL-10 in recovered COVID-19 patients was significantly higher in compare to severe cases, COVID-19 patients. Varying levels of cytokines were detected in COVID-19 group than control group suggesting distinct immunoregulatory mechanisms involved in COVID-19 pathogenesis. However, additional investigations are needed to be to be performed to understand the exact cellular mechanism of this disease.
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Affiliation(s)
- Mohammed Yousif Merza
- Clinical Analysis Department, College of Pharmacy, Hawler Medical University, Erbil, Kurdistan Region, Iraq
- Medical Analysis Department, College of Science, Tishk International University, Erbil, Kurdistan Region, Iraq
- * E-mail:
| | - Rundk Ahmed Hwaiz
- Medical Analysis Department, College of Science, Tishk International University, Erbil, Kurdistan Region, Iraq
- Department of Clinical Biochemistry, College of Health Science, Hawler Medical University, Erbil, Kurdistan Region, Iraq
| | - Badraldin Kareem Hamad
- Clinical Analysis Department, College of Pharmacy, Hawler Medical University, Erbil, Kurdistan Region, Iraq
| | - Karzan Abdulmuhsin Mohammad
- Department of Pharmacy, Knowledge University, Erbil, Kurdistan Region, Iraq
- Research Center, Salahaddin University-Erbil, Erbil, Kurdistan Region, Iraq
| | - Harmand Ali Hama
- Department of Biology, Faculty of Education, Tishk International University, Erbil, Kurdistan Region, Iraq
| | - Abdulkarim Yasin Karim
- Medical Analysis Department, College of Science, Tishk International University, Erbil, Kurdistan Region, Iraq
- Department of Biology, College of Science, Salahaddin University-Erbil, Erbil, Kurdistan Region, Iraq
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52
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Valdez-Cruz NA, García-Hernández E, Espitia C, Cobos-Marín L, Altamirano C, Bando-Campos CG, Cofas-Vargas LF, Coronado-Aceves EW, González-Hernández RA, Hernández-Peralta P, Juárez-López D, Ortega-Portilla PA, Restrepo-Pineda S, Zelada-Cordero P, Trujillo-Roldán MA. Integrative overview of antibodies against SARS-CoV-2 and their possible applications in COVID-19 prophylaxis and treatment. Microb Cell Fact 2021; 20:88. [PMID: 33888152 PMCID: PMC8061467 DOI: 10.1186/s12934-021-01576-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/03/2021] [Indexed: 02/06/2023] Open
Abstract
SARS-CoV-2 is a novel β-coronavirus that caused the COVID-19 pandemic disease, which spread rapidly, infecting more than 134 million people, and killing almost 2.9 million thus far. Based on the urgent need for therapeutic and prophylactic strategies, the identification and characterization of antibodies has been accelerated, since they have been fundamental in treating other viral diseases. Here, we summarized in an integrative manner the present understanding of the immune response and physiopathology caused by SARS-CoV-2, including the activation of the humoral immune response in SARS-CoV-2 infection and therefore, the synthesis of antibodies. Furthermore, we also discussed about the antibodies that can be generated in COVID-19 convalescent sera and their associated clinical studies, including a detailed characterization of a variety of human antibodies and identification of antibodies from other sources, which have powerful neutralizing capacities. Accordingly, the development of effective treatments to mitigate COVID-19 is expected. Finally, we reviewed the challenges faced in producing potential therapeutic antibodies and nanobodies by cell factories at an industrial level while ensuring their quality, efficacy, and safety.
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Affiliation(s)
- Norma A Valdez-Cruz
- Programa de Investigación de Producción de Biomoléculas, Departamento de Biología Molecular y Biotecnología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, Ciudad de México, México.
| | - Enrique García-Hernández
- Instituto de Química, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, Ciudad de México, México
| | - Clara Espitia
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, Ciudad de México, México
| | - Laura Cobos-Marín
- Facultad de Medicina Veterinaria Y Zootecnia, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, Ciudad de México, México
| | - Claudia Altamirano
- Escuela de Ingeniería Bioquímica, Pontificia Universidad Católica de Valparaíso, Av. Brasil N° 2950, Valparaíso, Chile
| | - Carlos G Bando-Campos
- Programa de Investigación de Producción de Biomoléculas, Departamento de Biología Molecular y Biotecnología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, Ciudad de México, México
| | - Luis F Cofas-Vargas
- Instituto de Química, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, Ciudad de México, México
| | - Enrique W Coronado-Aceves
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, Ciudad de México, México
| | - Ricardo A González-Hernández
- Programa de Investigación de Producción de Biomoléculas, Departamento de Biología Molecular y Biotecnología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, Ciudad de México, México
| | - Pablo Hernández-Peralta
- Facultad de Medicina Veterinaria Y Zootecnia, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, Ciudad de México, México
| | - Daniel Juárez-López
- Programa de Investigación de Producción de Biomoléculas, Departamento de Biología Molecular y Biotecnología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, Ciudad de México, México
| | - Paola A Ortega-Portilla
- Departamento de Inmunología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, Ciudad de México, México
| | - Sara Restrepo-Pineda
- Programa de Investigación de Producción de Biomoléculas, Departamento de Biología Molecular y Biotecnología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, Ciudad de México, México
| | - Patricio Zelada-Cordero
- Programa de Investigación de Producción de Biomoléculas, Departamento de Biología Molecular y Biotecnología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, Ciudad de México, México
| | - Mauricio A Trujillo-Roldán
- Programa de Investigación de Producción de Biomoléculas, Departamento de Biología Molecular y Biotecnología, Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Ciudad Universitaria, 04510, Ciudad de México, México.
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Maier JT, Zickler D, Metz M, Jebens A, Jarchau U, Fischer J, Kimmel V, Prueter E, Hellmeyer L. Peripartum Covid-19 Pneumonia with Severe ARDS - A Case Report. Z Geburtshilfe Neonatol 2021; 225:183-187. [PMID: 33873231 DOI: 10.1055/a-1365-9262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
INTRODUCTION SARS-CoV-2 is a novel coronavirus that was first isolated in Wuhan, China, and resulted in a rapidly spreading pandemic worldwide. Currently there is only limited evidence on the effect of COVID-19 on pregnant women. CASE Here we present one of the first serious COVID-19 cases in pregnancy at term with subsequent delivery. Postpartum the mother required antibiotic and symptomatic treatment. She experienced acute worsening of symptoms and developed acute respiratory failure requiring endotracheal intubation and subsequently extracorporeal membrane oxygenation. CONCLUSION COVID-19 affects all medical disciplines, requiring interdisciplinary approaches and development of patient care regimes. Obstetricians should be aware and be prepared for the special needs of pregnant women with potential prenatal and postnatal issues. Ideally pregnant COVID-19 patients should be cared for at a tertiary perinatal center with experienced perinatologists and neonatologists.
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Affiliation(s)
- Josefine Theresia Maier
- Department of Gynecology and Obstetrics, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Daniel Zickler
- Department of Nephrology and Medical Intensive Care, Charité Medical Faculty Berlin, Berlin, Germany
| | - Melanie Metz
- Department of Gynecology and Obstetrics, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Anja Jebens
- Department of Gynecology and Obstetrics, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Ute Jarchau
- Department of Gynecology and Obstetrics, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Julia Fischer
- Department of Gynecology and Obstetrics, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Viktor Kimmel
- Department of Angiology and Pulmonology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Eric Prueter
- Department of Neonatology, Vivantes Klinikum im Friedrichshain, Berlin, Germany
| | - Lars Hellmeyer
- Department of Gynecology and Obstetrics, Vivantes Klinikum im Friedrichshain, Berlin, Germany
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Lauro R, Irrera N, Eid AH, Bitto A. Could Antigen Presenting Cells Represent a Protective Element during SARS-CoV-2 Infection in Children? Pathogens 2021; 10:476. [PMID: 33920011 PMCID: PMC8071032 DOI: 10.3390/pathogens10040476] [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: 03/01/2021] [Revised: 04/06/2021] [Accepted: 04/10/2021] [Indexed: 12/12/2022] Open
Abstract
Antigen Presenting Cells (APC) are immune cells that recognize, process, and present antigens to lymphocytes. APCs are among the earliest immune responders against an antigen. Thus, in patients with COVID-19, a disease caused by the newly reported SARS-CoV-2 virus, the role of APCs becomes increasingly important. In this paper, we dissect the role of these cells in the fight against SARS-CoV-2. Interestingly, this virus appears to cause a higher mortality among adults than children. This may suggest that the immune system, particularly APCs, of children may be different from that of adults, which may then explain differences in immune responses between these two populations, evident as different pathological outcome. However, the underlying molecular mechanisms that differentiate juvenile from other APCs are not well understood. Whether juvenile APCs are one reason why children are less susceptible to SARS-CoV-2 requires much attention. The goal of this review is to examine the role of APCs, both in adults and children. The molecular mechanisms governing APCs, especially against SARS-CoV-2, may explain the differential immune responsiveness in the two populations.
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Affiliation(s)
- Rita Lauro
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (R.L.); (N.I.)
| | - Natasha Irrera
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (R.L.); (N.I.)
| | - Ali H. Eid
- Department of Basic Medical Sciences, College of Medicine, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
- Biomedical and Pharmaceutical Research Unit, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
| | - Alessandra Bitto
- Department of Clinical and Experimental Medicine, University of Messina, 98125 Messina, Italy; (R.L.); (N.I.)
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Tang Q, Liu Y, Fu Y, Di Z, Xu K, Tang B, Wu H, Di M. A comprehensive evaluation of early potential risk factors for disease aggravation in patients with COVID-19. Sci Rep 2021; 11:8062. [PMID: 33850192 PMCID: PMC8044173 DOI: 10.1038/s41598-021-87413-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Accepted: 03/10/2021] [Indexed: 12/15/2022] Open
Abstract
The 2019 Coronavirus Disease (COVID-19) has become an unprecedented public crisis. We retrospectively investigated the clinical data of 197 COVID-19 patients and identified 88 patients as disease aggravation cases. Compared with patients without disease aggravation, the aggravation cases had more comorbidities, including hypertension (25.9%) and diabetes (20.8%), and presented with dyspnoea (23.4%), neutrophilia (31.5%), and lymphocytopenia (46.7%). These patients were more prone to develop organ damage in liver, kidney, and heart (P < 0.05). A multivariable regression analysis showed that advanced age, comorbidities, dyspnea, lymphopenia, and elevated levels of Fbg, CTnI, IL-6, and serum ferritin were significant predictors of disease aggravation. Further, we performed a Kaplan–Meier analysis to evaluate the prognosis of COVID-19 patients, which suggested that 64.9% of the patients had not experienced ICU transfers and survival from the hospital.
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Affiliation(s)
- Qiang Tang
- Department of General Surgery, Shiyan Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Yanwei Liu
- Department of General Surgery, Shiyan Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Yingfeng Fu
- Department of General Surgery, Shiyan Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Ziyang Di
- Department of General Surgery, Shiyan Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China
| | - Kailiang Xu
- Department of Urology, Jingzhou Central Hospital, The Second Clinical Medical College, Yangtze University, Jingzhou, China
| | - Bo Tang
- Department of Urology, Jingzhou Central Hospital, The Second Clinical Medical College, Yangtze University, Jingzhou, China
| | - Hui Wu
- School of Public Health, Xinxiang Medical University, Henan, China.
| | - Maojun Di
- Department of General Surgery, Shiyan Taihe Hospital, Hubei University of Medicine, Shiyan, Hubei, China.
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56
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Peng HT, Rhind SG, Beckett A. Convalescent Plasma for the Prevention and Treatment of COVID-19: A Systematic Review and Quantitative Analysis. JMIR Public Health Surveill 2021; 7:e25500. [PMID: 33825689 PMCID: PMC8245055 DOI: 10.2196/25500] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 02/19/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND The COVID-19 pandemic, caused by a novel coronavirus termed SARS-CoV-2, has spread quickly worldwide. Convalescent plasma (CP) obtained from patients following recovery from COVID-19 infection and development of antibodies against the virus is an attractive option for either prophylactic or therapeutic treatment, since antibodies may have direct or indirect antiviral activities and immunotherapy has proven effective in principle and in many clinical reports. OBJECTIVE We seek to characterize the latest advances and evidence in the use of CP for COVID-19 through a systematic review and quantitative analysis, identify knowledge gaps in this setting, and offer recommendations and directives for future research. METHODS PubMed, Web of Science, and Embase were continuously searched for studies assessing the use of CP for COVID-19, including clinical studies, commentaries, reviews, guidelines or protocols, and in vitro testing of CP antibodies. The screening process and data extraction were performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Quality appraisal of all clinical studies was conducted using a universal tool independent of study designs. A meta-analysis of case-control and randomized controlled trials (RCTs) was conducted using a random-effects model. RESULTS Substantial literature has been published covering various aspects of CP therapy for COVID-19. Of the references included in this review, a total of 243 eligible studies including 64 clinical studies, 79 commentary articles, 46 reviews, 19 guidance and protocols, and 35 in vitro testing of CP antibodies matched the criteria. Positive results have been mostly observed so far when using CP for the treatment of COVID-19. There were remarkable heterogeneities in the CP therapy with respect to patient demographics, donor antibody titers, and time and dose of CP administration. The studies assessing the safety of CP treatment reported low incidence of adverse events. Most clinical studies, in particular case reports and case series, had poor quality. Only 1 RCT was of high quality. Randomized and nonrandomized data were found in 2 and 11 studies, respectively, and were included for meta-analysis, suggesting that CP could reduce mortality and increase viral clearance. Despite promising pilot studies, the benefits of CP treatment can only be clearly established through carefully designed RCTs. CONCLUSIONS There is developing support for CP therapy, particularly for patients who are critically ill or mechanically ventilated and resistant to antivirals and supportive care. These studies provide important lessons that should inform the planning of well-designed RCTs to generate more robust knowledge for the efficacy of CP in patients with COVID-19. Future research is necessary to fill the knowledge gap regarding prevention and treatment for patients with COVID-19 with CP while other therapeutics are being developed.
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Affiliation(s)
- Henry T Peng
- Defence Research and Development Canada, Toronto Research Centre, Toronto, ON, Canada
| | - Shawn G Rhind
- Defence Research and Development Canada, Toronto Research Centre, Toronto, ON, Canada
| | - Andrew Beckett
- St. Michael's Hospital, Toronto, ON, Canada
- Royal Canadian Medical Services, Ottawa, ON, Canada
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57
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In search of drugs to alleviate suppression of the host's innate immune responses against SARS-CoV-2 using a molecular modeling approach. In Silico Pharmacol 2021; 9:26. [PMID: 33842190 PMCID: PMC8019474 DOI: 10.1007/s40203-021-00085-y] [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: 07/23/2020] [Accepted: 03/15/2021] [Indexed: 02/02/2023] Open
Abstract
Severe Acute Respiratory Syndrome coronavirus (SARS-CoV), Middle East Respiratory Syndrome coronavirus (MERS-CoV) and the novel SARS-CoV-2 evade the host innate immunity, and subsequently the adaptive immune response, employing one protease called Papain-like protease (PLpro). The PLpro and the 3CL main protease are responsible for the cleavage of the polyproteins encoded by the + sense RNA genome of the virus to produce several non-structured proteins (NSPs). However, the PLpro also performs deubiquitination and deISGylation of host proteins and signaling molecules, and thus antagonize the host innate immune response, since ubiquitination and ISGylation are critical processes which invoke host's antiviral immune responses. Thus, to maintain host antiviral defense, inhibition of the PLpro is the primary therapeutic strategy. Furthermore, inhibition of the enzyme prevents replication of the virus. The present study employs molecular modeling approaches to determine potential of different approved and repurposed drugs and other compounds as inhibitors of the SARS-CoV-2 PLpro. The results of the study demonstrated that drugs like Stallimycin, and known protease inhibitors including Telaprevir, Grazoprevir and Boceprevir, were highly potent in inhibiting the enzyme. In addition, several plant-derived polyphenols, including Corylifol A and Kazinol J, were found to be potent inhibitors. Based on the findings, we suggest that clinical trials be initiated with these inhibitors. So far, PLpro inhibition has been given less attention as a strategy to contain COVID-19 pandemic, and thus the present study is of high significance and has therapeutic implications in containing the pandemic. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40203-021-00085-y.
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Ali S, Uddin SM, Ali A, Anjum F, Ali R, Shalim E, Khan M, Ahmed I, M Muhaymin S, Bukhari U, Luxmi S, Khan AS, Quraishy S. Production of hyperimmune anti-SARS-CoV-2 intravenous immunoglobulin from pooled COVID-19 convalescent plasma. Immunotherapy 2021; 13:397-407. [PMID: 33557591 PMCID: PMC7871744 DOI: 10.2217/imt-2020-0263] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2020] [Accepted: 01/28/2021] [Indexed: 12/23/2022] Open
Abstract
Background: This study assesses the feasibility of producing hyperimmune anti-COVID-19 intravenously administrable immunoglobulin (C-IVIG) from pooled convalescent plasma (PCP) to provide a safe and effective passive immunization treatment option for COVID-19. Materials & methods: PCP was fractionated by modified caprylic acid precipitation followed by ultrafiltration/diafiltration to produce hyperimmune C-IVIG. Results: In C-IVIG, the mean SARS-CoV-2 antibody level was found to be threefold (104 ± 30 cut-off index) that of the PCP (36 ± 8.5 cut-off index) and mean protein concentration was found to be 46 ± 3.7 g/l, comprised of 89.5% immunoglobulins. Conclusion: The current method of producing C-IVIG is feasible as it uses locally available PCP and simpler technology and yields a high titer of SARS-CoV-2 antibody. The safety and efficacy of C-IVIG will be evaluated in a registered clinical trial (NCT04521309).
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Affiliation(s)
- Shaukat Ali
- Dow College of Biotechnology, Dow University of Health Sciences, Karachi, Pakistan
- Dow Research Institute of Biotechnology & Biomedical Sciences, Dow University of Health Sciences, Karachi, Pakistan
| | - Syed M Uddin
- Dow College of Biotechnology, Dow University of Health Sciences, Karachi, Pakistan
| | - Ayesha Ali
- Dow College of Biotechnology, Dow University of Health Sciences, Karachi, Pakistan
| | - Fatima Anjum
- Dow Research Institute of Biotechnology & Biomedical Sciences, Dow University of Health Sciences, Karachi, Pakistan
| | - Rashid Ali
- Dow College of Biotechnology, Dow University of Health Sciences, Karachi, Pakistan
| | - Elisha Shalim
- Dow College of Biotechnology, Dow University of Health Sciences, Karachi, Pakistan
| | - Mujtaba Khan
- Dow College of Biotechnology, Dow University of Health Sciences, Karachi, Pakistan
| | - Iqra Ahmed
- Dow College of Biotechnology, Dow University of Health Sciences, Karachi, Pakistan
| | - Sheikh M Muhaymin
- Dow College of Biotechnology, Dow University of Health Sciences, Karachi, Pakistan
| | - Uzma Bukhari
- Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Shobha Luxmi
- Dow University Hospital, Dow University of Health Sciences, Karachi, Pakistan
| | - Abdul S Khan
- National Control Laboratory for Biologicals, Islamabad, Pakistan
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Sheervalilou R, Shirvaliloo M, Sargazi S, Bahari S, Saravani R, Shahraki J, Shirvalilou S, Shahraki O, Nazarlou Z, Shams Z, Ghaznavi H. Convalescent Blood: Current Perspective on the Efficacy of a Legacy Approach in COVID-19 Treatment. Blood Purif 2021; 51:1-14. [PMID: 33789273 PMCID: PMC8089443 DOI: 10.1159/000513164] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 11/17/2020] [Indexed: 12/15/2022]
Abstract
Since early 2020, COVID-19 has wreaked havoc in many societies around the world. As of the present, the SARS-CoV-2-borne disease is propagating in almost all countries, affecting hundreds of thousands of people in an unprecedented way. As the name suggests, the novel coronavirus, widely known as SARS-CoV-2, is a new emerging human pathogen. A novel disease of relatively unknown origin, COVID-19 does not seem to be amenable to the currently available medicines since there is no specific cure for the disease. In the absence of any vaccine or effective antiviral medication, we have no tools at our disposal, but the method of quarantine, be it domestic or institutional, to hinder any further progression of this outbreak. However, there is a record of physicians in the past who practiced convalescent blood transfusion. To their awe, the method seemed to be useful. It is anticipated that these contemporary methods will outdo any other vaccination process in the time being, as blood transfusion is instead a cost-effective and time-friendly technique. Following a successful trial, this new approach of contemporary nature to a viral disease may serve as an emergency intervention to intercept infectious outbreaks and prevent an impending epidemic/pandemic. In this review, we document the most recent evidence regarding the efficiency of convalescent plasma and serum therapy on SARS, MERS, and particularly COVID-19, while discussing potential advantages and possible risks of such practice.
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Affiliation(s)
- Roghayeh Sheervalilou
- Pharmacology Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
- Cellular and Molecular Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Milad Shirvaliloo
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saman Sargazi
- Cellular and Molecular Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Soraiya Bahari
- Genomic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ramin Saravani
- Cellular and Molecular Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Jafar Shahraki
- Department of Toxicology and Pharmacology, School of Pharmacy, Zabol University of Medical Sciences, Zabol, Iran
| | - Sakine Shirvalilou
- Finetech in Medicine Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Omolbanin Shahraki
- Pharmacology Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
- Cellular and Molecular Research Center, Resistant Tuberculosis Institute, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Ziba Nazarlou
- Material Engineering Department, College of Science Koç University, Istanbul, Turkey
| | - Zinat Shams
- Department of Biological Science, Kharazmi University, Tehran, Iran
| | - Habib Ghaznavi
- Pharmacology Research Center, Zahedan University of Medical Sciences, Zahedan, Iran
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Golamari R, Kapoor N, Devaraj T, Sahu N, Kramer C, Jain R. Experimental therapies under investigation for COVID-19. J Community Hosp Intern Med Perspect 2021; 11:187-193. [PMID: 33889318 PMCID: PMC8043541 DOI: 10.1080/20009666.2021.1874093] [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: 10/12/2020] [Accepted: 01/06/2021] [Indexed: 12/18/2022] Open
Abstract
Coronavirus Disease 2019, caused by the virus, Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), is a pandemic first discovered in Wuhan, China which has claimed over 1.7 million lives to date across the globe as of 24 December 2020. As the virus spreads across the world affecting millions of patients, there has been a massive movement to discover readily available and effective treatment options including vaccines. One of the limiting factors in treating the disease is its varied presentation and effect in patients, ranging from asymptomatic patients to those left in intensive care units, intubated and fighting for their lives. There are numerous clinical trials and small-scale studies underway to investigate potential treatment options. However, very few studies and drugs demonstrated efficacy while many more are under investigation, leaving care teams dependent on supportive care coupled with experimental treatment options. In this review, we summarize the various treatment options explored to treat COVID-19, discussing possible the mechanisms of fighting the virus.
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Affiliation(s)
- Reshma Golamari
- Assistant Professor of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Neeru Kapoor
- Microbiologist, Maulana Azad Medical College, New Delhi, India
| | - Tanuja Devaraj
- Assistant Professor of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA
| | - Nitasa Sahu
- Assistant Professor of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA
| | | | - Rohit Jain
- Assistant Professor of Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, PA, USA
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Moazzami B, Chaichian S, Samie S, Zolbin MM, Jesmi F, Akhlaghdoust M, Pishkuhi MA, Mirshafiei ZS, Khalilzadeh F, Safari D. Does endometriosis increase susceptibility to COVID-19 infections? A case-control study in women of reproductive age. BMC Womens Health 2021; 21:119. [PMID: 33752656 PMCID: PMC7983080 DOI: 10.1186/s12905-021-01270-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 03/16/2021] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND In today's world, coronavirus disease 2019 (COVID-19) is the most critical health problem and research is continued on studying the associated factors. But it is not clear whether endometriosis increases the risk of COVID-19. METHODS Women who referred to the gynecology clinic were evaluated and 507 women with endometriosis (case group) were compared with 520 women without endometriosis (control group). COVID-19 infection, symptoms, exposure, hospitalization, isolation, H1N1 infection and vaccination, and past medical history of the participants were recorded and compared between the groups using IBM SPSS Statistics for Windows version 21. RESULTS Comparison between the groups represent COVID-19 infection in 3.2% of the case group and 3% of the control group (P = 0.942). The control group had a higher frequency of asymptomatic infection (95.7% vs. 94.5%; P < 0.001) and fever (1.6% vs. 0%; P = 0.004), while the frequency of rare symptoms was more common in the case group (P < 0.001). The average disease period was 14 days in both groups (P = 0.694). COVID-19 infection was correlated with close contact (r = 0.331; P < 0.001 in the case group and r = 0.244; P < 0.001 in the control group), but not with the history of thyroid disorders, H1N1 vaccination, traveling to high-risk areas, and social isolation (P > 0.05). CONCLUSION Endometriosis does not increase the susceptibility to COVID-19 infections, but alters the manifestation of the disease. The prevalence of the disease may depend on the interaction between the virus and the individual's immune system but further studies are required in this regard.
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Affiliation(s)
- Bahram Moazzami
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Tehran, Iran
| | - Shahla Chaichian
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Tehran, Iran.
| | - Saeed Samie
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Tehran, Iran
| | - Masoumeh Majidi Zolbin
- Pediatric Urology and Regenerative Medicine Research Center, Section of Tissue Engineering and Stem Cells Therapy, Children's Hospital Medical Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Jesmi
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Tehran, Iran
| | - Meisam Akhlaghdoust
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Tehran, Iran
| | - Mahin Ahmadi Pishkuhi
- PhD Student in Epidemiology, Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Sadat Mirshafiei
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Tehran, Iran
| | - Fereshteh Khalilzadeh
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Tehran, Iran
| | - Dorsa Safari
- Pars Advanced and Minimally Invasive Medical Manners Research Center, Pars Hospital, Tehran, Iran
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Vieira C, Nery L, Martins L, Jabour L, Dias R, Simões E Silva AC. Downregulation of Membrane-bound Angiotensin Converting Enzyme 2 (ACE2) Receptor has a Pivotal Role in COVID-19 Immunopathology. Curr Drug Targets 2021; 22:254-281. [PMID: 33081670 DOI: 10.2174/1389450121666201020154033] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 09/06/2020] [Accepted: 09/22/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND The Coronavirus Disease 2019 (COVID-19) is becoming the major health issue in recent human history with thousands of deaths and millions of cases worldwide. Newer research and old experience with other coronaviruses highlighted a probable underlying mechanism of disturbance of the renin-angiotensin system (RAS) that is associated with the intrinsic effects of SARS-CoV-2 infection. OBJECTIVE In this review, we aimed to describe the intimate connections between the RAS components, the immune system and COVID-19 pathophysiology. METHODS This non-systematic review article summarizes recent evidence on the relationship between COVID-19 and the RAS. RESULTS Several studies have indicated that the downregulation of membrane-bound ACE2 may exert a key role for the impairment of immune functions and for COVID-19 patients' outcomes. The downregulation may occur by distinct mechanisms, particularly: (1) the shedding process induced by the SARS-CoV-2 fusion pathway, which reduces the amount of membrane-bound ACE2, stimulating more shedding by the high levels of Angiotensin II; (2) the endocytosis of ACE2 receptor with the virus itself and (3) by the interferon inhibition caused by SARS-CoV-2 effects on the immune system, which leads to a reduction of ACE2 receptor expression. CONCLUSION Recent research provides evidence of a reduction of the components of the alternative RAS axis, including ACE2 and Angiotensin-(1-7). In contrast, increased levels of Angiotensin II can activate the AT1 receptor in several organs. Consequently, increased inflammation, thrombosis and angiogenesis occur in patients infected with SARS-COV-2. Attention should be paid to the interactions of the RAS and COVID-19, mainly in the context of novel vaccines and proposed medications.
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Affiliation(s)
- Cristina Vieira
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Lucas Nery
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Ludimila Martins
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Luiz Jabour
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Raphael Dias
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
| | - Ana Cristina Simões E Silva
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, MG, Brazil
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Akyala AI, Awayimbo JR, Elayo MI, Olugbade OT, Akabe EA, Akinyoade A. Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection among health care workers in Nasarawa State, Nigeria: implications for infection prevention and control measures. Pan Afr Med J 2021; 37:21. [PMID: 33456645 DOI: 10.11604/pamj.supp.2020.37.21.25767] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2020] [Accepted: 10/07/2020] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION health care workers (HCWs) are on the frontline, waging war against SARS-CoV-2 and have a higher risk of infection with exposure to an infected person with SARS-CoV-2. There is a paucity of information on clinical characteristics and infection risk gradient of HCWs with SARS-CoV-2 with the view to marshal preventive measures. METHODS we conducted a multi-center case series analysis of 648 HCWs who were randomly selected in private and public hospitals across Nasarawa State, managing cases of SARS-CoV-2. Demographic and epidemiological information, were abstracted from electronic medical records of cases from February to July 2020. Throat and Nasopharyngeal swabs and real-time reverse transcriptase-polymerase chain reaction (RT-PCR) tests for SARS-CoV-2 nucleic acid were performed. RESULTS overall, 134 of 648 HCWs across health centers in Nasarawa State tested positive for SARS-CoV-2. Eighty male HCWs constituted 30.9% of respondents with a median (interquartile range) age of 36.7 (30.0-47.0) years. Overall, 50 of 134 HCWs (67.5%) with SAR-COV-2 had mild disease. The five most common symptoms amongst cases were fever (67 [90.5%]), myalgia or fatigue (60 [81.1%]), cough (50[67.6%]), sore throat (50 [67.6%]), and muscle ache (50 [67.6%]). Contact with index patients (65 [59.1%]) and colleagues with infection (10 [13.9%]) as well as community-acquired infection (14 [18.9%]) were the main routes of exposure for HCWs. CONCLUSION HCWs in Nasarawa State face an unprecedented occupational risk of morbidity and mortality as a result of SARS-CoV-2. There is need for rapid development of sustainable infection prevention control measures that protect HCWs from the SARS-CoV-2 ongoing pandemic.
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Affiliation(s)
- Adamu Ishaku Akyala
- Department of Microbiology, Faculty of Natural and Applied Sciences, Nasarawa State University, Keffi, Nasarawa State, Nigeria.,Nigeria Field Epidemiology and Laboratory Training Programme (N-FELTP), African Field Epidemiology Network, 50 Haile Selassie Street, Asokoro Abuja, Nigeria
| | - Jaggu Ruth Awayimbo
- Department of Microbiology, Faculty of Natural and Applied Sciences, Nasarawa State University, Keffi, Nasarawa State, Nigeria
| | - Margaret Itake Elayo
- Department of Epidemiology, State Ministry of Health, Lafia, Nasarawa State, Nigeria
| | - Olukemi Titilope Olugbade
- Nigeria Field Epidemiology and Laboratory Training Programme (N-FELTP), African Field Epidemiology Network, 50 Haile Selassie Street, Asokoro Abuja, Nigeria.,Department of Medical and Health Services, Lagos, Nigeria.,Ministry of Defense, 2, Division Nigeria Army, Ibadan, Nigeria
| | - Emmanuel Agbadu Akabe
- Department of Epidemiology, State Ministry of Health, Lafia, Nasarawa State, Nigeria
| | - Akinyinka Akinyoade
- Department of Community Health, Obafemi Awolowo University Teaching Hospital (OAUTHC), Ile-Ife, Nigeria
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Capodice JL, Chubak BM. Traditional Chinese herbal medicine-potential therapeutic application for the treatment of COVID-19. Chin Med 2021; 16:24. [PMID: 33618736 PMCID: PMC7897885 DOI: 10.1186/s13020-020-00419-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Accepted: 12/22/2020] [Indexed: 02/08/2023] Open
Abstract
Traditional Chinese Medicine (TCM) is a complete medical system that has evolved over millennia to include practices and procedures such as acupuncture, herbal medicine, manual therapies, nutrition, and mind–body therapies such as qi gong. In modern-day China and other Asian countries, TCM is a medical subspecialty utilized alongside western biomedicine. During the current Coronavirus Disease 19 (COVID-19) pandemic, TCM and TCM herbal medicine is being used and a number of single herbs and combination formulas have significant bioactivity and therapeutic potential. The purpose of this paper is to highlight the use of TCM in the treatment of COVID-19. This commentary provides the reader with a concise background on COVID-19 and summarizes TCM concepts including identification, pattern diagnosis, and treatment principles commonly used for the treatment of viral influenza-like diseases. It also highlights some of the challenges and potential for using TCM in an integrated medical setting.
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Affiliation(s)
- Jillian L Capodice
- Department of Urology, Icahn School of Medicine, Mount Sinai Health System, New York, NY, USA.
| | - Barbara M Chubak
- Department of Urology, Icahn School of Medicine, Mount Sinai Health System, New York, NY, USA
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Iqbal Yatoo M, Hamid Z, Rather I, Nazir QUA, Bhat RA, Ul Haq A, Magray SN, Haq Z, Sah R, Tiwari R, Natesan S, Bilal M, Harapan H, Dhama K. Immunotherapies and immunomodulatory approaches in clinical trials - a mini review. Hum Vaccin Immunother 2021; 17:1897-1909. [PMID: 33577374 PMCID: PMC7885722 DOI: 10.1080/21645515.2020.1871295] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The coronavirus disease (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has created havoc worldwide. Due to the non-availability of any vaccine or drugs against COVID-19, immunotherapies involving convalescent plasma, immunoglobulins, antibodies (monoclonal or polyclonal), and the use of immunomodulatory agents to enhance immunity are valuable alternative options. Cell-based therapies including natural killer cells, T cells, stem cells along with cytokines and toll-like receptors (TLRs) based therapies are also being exploited potentially against COVID-19. Future research need to strengthen the field of developing effective immunotherapeutics and immunomodulators with a thrust of providing appropriate, affordable, convenient, and cost-effective prophylactic and treatment regimens to combat global COVID-19 crisis that has led to a state of medical emergency enforcing entire countries of the world to devote their research infrastructure and manpower in tackling this pandemic.
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Affiliation(s)
- Mohd Iqbal Yatoo
- Division of Veterinary Clinical Complex, Faculty of Veterinary Sciences and Animal Husbandry, Shuhama, Alusteng Srinagar, Sher-E-Kashmir University of Agricultural Sciences and Technology of Kashmir, Shalimar, Jammu and Kashmir, India
| | - Zeenat Hamid
- Department of Biotechnology, University of Kashmir, Jammu and Kashmir, India
| | - Izhar Rather
- Division of Veterinary Clinical Complex, Faculty of Veterinary Sciences and Animal Husbandry, Shuhama, Alusteng Srinagar, Sher-E-Kashmir University of Agricultural Sciences and Technology of Kashmir, Shalimar, Jammu and Kashmir, India
| | - Qurat Ul Ain Nazir
- Division of Veterinary Clinical Complex, Faculty of Veterinary Sciences and Animal Husbandry, Shuhama, Alusteng Srinagar, Sher-E-Kashmir University of Agricultural Sciences and Technology of Kashmir, Shalimar, Jammu and Kashmir, India
| | - Riyaz Ahmed Bhat
- Division of Veterinary Clinical Complex, Faculty of Veterinary Sciences and Animal Husbandry, Shuhama, Alusteng Srinagar, Sher-E-Kashmir University of Agricultural Sciences and Technology of Kashmir, Shalimar, Jammu and Kashmir, India
| | - Abrar Ul Haq
- Division of Veterinary Clinical Complex, Faculty of Veterinary Sciences and Animal Husbandry, Shuhama, Alusteng Srinagar, Sher-E-Kashmir University of Agricultural Sciences and Technology of Kashmir, Shalimar, Jammu and Kashmir, India
| | - Suhail Nabi Magray
- Division of Animal Biotechnology, Faculty of Veterinary Sciences and Animal Husbandry, Shuhama, Alusteng Srinagar, Sher-E-Kashmir University of Agricultural Sciences and Technology of Kashmir, Shalimar, Jammu and Kashmir, India
| | - Zulfqar Haq
- ICAR-Centre for Research on Poultry, Division of Livestock Production and Management, Faculty of Veterinary Sciences and Animal Husbandry, Shuhama, Alusteng Srinagar, Sher-E-Kashmir University of Agricultural Sciences and Technology of Kashmir, Shalimar, Jammu and Kashmir, India
| | - Ranjit Sah
- Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu, Nepal
| | - Ruchi Tiwari
- Department of Veterinary Microbiology and Immunology, College of Veterinary Sciences, UP Pandit Deen Dayal Upadhayay Pashu Chikitsa Vigyan Vishwavidyalay Evum Go-Anusandhan Sansthan (DUVASU), Mathura, Uttar Pradesh, India
| | - SenthilKumar Natesan
- Department of Infectious Diseases, Indian Institute of Public Health Gandhinagar, Gandhinagar, Gujarat, India
| | - Muhammad Bilal
- School of Life Science and Food Engineering, Huaiyin Institute of Technology, Huaian, China
| | - Harapan Harapan
- Medical Research Unit, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia.,Tropical Disease Centre, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia.,Department of Microbiology, School of Medicine, Universitas Syiah Kuala, Banda Aceh, Indonesia
| | - Kuldeep Dhama
- Division of Pathology, ICAR-Indian Veterinary Research Institute, Izatnagar, Uttar Pradesh, India
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Kumar P, Sah AK, Tripathi G, Kashyap A, Tripathi A, Rao R, Mishra PC, Mallick K, Husain A, Kashyap MK. Role of ACE2 receptor and the landscape of treatment options from convalescent plasma therapy to the drug repurposing in COVID-19. Mol Cell Biochem 2021; 476:553-574. [PMID: 33029696 PMCID: PMC7539757 DOI: 10.1007/s11010-020-03924-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Accepted: 09/19/2020] [Indexed: 02/06/2023]
Abstract
Since the first case reports in Wuhan, China, the SARS-CoV-2 has caused a pandemic and took lives of > 8,35,000 people globally. This single-stranded RNA virus uses Angiotensin-converting enzyme 2 (ACE2) as a receptor for entry into the host cell. Overexpression of ACE2 is mainly observed in hypertensive, diabetic and heart patients that make them prone to SARS-CoV-2 infection. Mitigations strategies were opted globally by the governments to minimize transmission of SARS-CoV-2 via the implementation of social distancing norms, wearing the facemasks, and spreading awareness using digital platforms. The lack of an approved drug treatment regimen, and non-availability of a vaccine, collectively posed a challenge for mankind to fight against the SARS-CoV-2 pandemic. In this scenario, repurposing of existing drugs and old treatment options like convalescent plasma therapy can be one of the potential alternatives to treat the disease. The drug repurposing provides a selection of drugs based on the scientific rationale and with a shorter cycle of clinical trials, while plasma isolated from COVID-19 recovered patients can be a good source of neutralizing antibody to provide passive immunity. In this review, we provide in-depth analysis on these two approaches currently opted all around the world to treat COVID-19 patients. For this, we used "Boolean Operators" such as AND, OR & NOT to search relevant research articles/reviews from the PUBMED for the repurposed drugs and the convalescent plasma in the COVID-19 treatment. The repurposed drugs like Chloroquine and Hydroxychloroquine, Tenofovir, Remdesivir, Ribavirin, Darunavir, Oseltamivir, Arbidol (Umifenovir), Favipiravir, Anakinra, and Baricitinib are already being used in clinical trials to treat the COVID-19 patients. These drugs have been approved for a different indication and belong to a diverse category such as anti-malarial/anti-parasitic, anti-retroviral/anti-viral, anti-cancer, or against rheumatoid arthritis. Although, the vaccine would be an ideal option for providing active immunity against the SARS-CoV-2, but considering the current situation, drug repurposing and convalescent plasma therapy and repurposed drugs are the most viable option against SARS-CoV-2.
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Affiliation(s)
- Pravindra Kumar
- School of Life & Allied Health Sciences, The Glocal University, Saharanpur, UP, India
| | - Ashok Kumar Sah
- Department of Medical Laboratory Technology, Amity Medical School, Amity University Haryana, Panchgaon, Manesar, Gurugram, Haryana, India
| | - Greesham Tripathi
- Amity Stem Cell Institute, Amity Medical School, Amity University Haryana, Panchgaon, Manesar, Gurugram, Haryana, 122413, India
| | - Anjali Kashyap
- Department of Biotechnology, Thapar Institute of Engineering & Technology, Patiala, Punjab, India
| | - Avantika Tripathi
- Amity Stem Cell Institute, Amity Medical School, Amity University Haryana, Panchgaon, Manesar, Gurugram, Haryana, 122413, India
| | - Rashmi Rao
- School of Life & Allied Health Sciences, The Glocal University, Saharanpur, UP, India
| | - Prabhu C Mishra
- Amity Stem Cell Institute, Amity Medical School, Amity University Haryana, Panchgaon, Manesar, Gurugram, Haryana, 122413, India
| | - Koustav Mallick
- National Liver Disease Biobank, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Amjad Husain
- Centre for Science & Society, Indian Institute of Science Education and Research, Bhopal, India
- Innovation and Incubation Centre for Entrepreneurship (IICE), Indian Institute of Science Education and Research, Bhopal, India
| | - Manoj Kumar Kashyap
- Amity Stem Cell Institute, Amity Medical School, Amity University Haryana, Panchgaon, Manesar, Gurugram, Haryana, 122413, India.
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Hartog N, Faber W, Frisch A, Bauss J, Bupp CP, Rajasekaran S, Prokop JW. SARS-CoV-2 infection: molecular mechanisms of severe outcomes to suggest therapeutics. Expert Rev Proteomics 2021; 18:105-118. [PMID: 33779460 PMCID: PMC8022340 DOI: 10.1080/14789450.2021.1908894] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 03/22/2021] [Indexed: 02/06/2023]
Abstract
Introduction:The year 2020 was defined by the 29,903 base pairs of RNA that codes for the SARS-CoV-2 genome. SARS-CoV-2 infects humans to cause COVID-19, spreading from patient-to-patient yet impacts patients very divergently.Areas covered: Within this review, we address the known molecular mechanisms and supporting data for COVID-19 clinical course and pathology, clinical risk factors and molecular signatures, therapeutics of severe COVID-19, and reinfection/vaccination. Literature and published datasets were reviewed using PubMed, Google Scholar, and NCBI SRA tools. The combination of exaggerated cytokine signaling, pneumonia, NETosis, pyroptosis, thrombocytopathy, endotheliopathy, multiple organ dysfunction syndrome (MODS), and acute respiratory distress syndrome (ARDS) create a positive feedback loop of severe damage in patients with COVID-19 that impacts the entire body and may persist for months following infection. Understanding the molecular pathways of severe COVID-19 opens the door for novel therapeutic design. We summarize the current insights into pathology, risk factors, secondary infections, genetics, omics, and drugs being tested to treat severe COVID-19.Expert opinion: A growing level of support suggests the need for stronger integration of biomarkers and precision medicine to guide treatment strategies of severe COVID-19, where each patient has unique outcomes and thus require guided treatment.
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Affiliation(s)
- Nicholas Hartog
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
- Allergy & Immunology, Spectrum Health, Grand Rapids, MI, USA
| | - William Faber
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
- Department of Chemistry, Grand Rapids Community College, Grand Rapids, MI, USA
| | - Austin Frisch
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
| | - Jacob Bauss
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
| | - Caleb P Bupp
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
- Spectrum Health Medical Genetics, Grand Rapids, MI, USA
| | - Surender Rajasekaran
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
- Pediatric Intensive Care Unit, Helen DeVos Children’s Hospital, Grand Rapids, MI, USA
- Office of Research, Office of Research, Spectrum Health, Grand Rapids, MI, USA
| | - Jeremy W Prokop
- Department of Pediatrics and Human Development, College of Human Medicine, Michigan State University, Grand Rapids, MI, USA
- Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI, USA
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68
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Sun H, Su X, Huang L, Mu D, Qu Y. Research Progress on the Cardiac Injury from ACE2 Targeting in SARS-CoV-2 Infection. Biomolecules 2021; 11:196. [PMID: 33573324 PMCID: PMC7911115 DOI: 10.3390/biom11020196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Revised: 01/23/2021] [Accepted: 01/27/2021] [Indexed: 01/08/2023] Open
Abstract
The epidemic due to the novel coronavirus (SARS-CoV-2) is now a global concern, posing a severe threat to the health of populations. At present, all countries in the world are stepping up the development of vaccines and antiviral agents to prevent the infection and further transmission of SARS-CoV-2. An in-depth investigation of the target organs and pathogenesis regarding SARS-CoV-2 infection will be beneficial for virus therapy. Besides pulmonary injury, SARS-CoV-2 also causes cardiac injury, but the exact mechanisms are unclear. This review summarizes the essential structural characteristics of SARS-CoV-2 and angiotensin-converting enzyme 2 (ACE2), describes the cardiac manifestations following SARS-CoV-2 infection, and explores the mechanisms of cardiac injury targeting ACE2 after the viral invasion. We aim to help the timely detection of related symptoms and implementation of therapeutic measures by clinicians for SARS-CoV-2 infection.
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Affiliation(s)
- Hao Sun
- Department of Pediatrics/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Ministry of Education), West China Second University Hospital, Sichuan University, Chengdu 610041, China; (H.S.); (X.S.); (D.M.)
| | - Xiaojuan Su
- Department of Pediatrics/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Ministry of Education), West China Second University Hospital, Sichuan University, Chengdu 610041, China; (H.S.); (X.S.); (D.M.)
| | - Lingyi Huang
- West China College of Stomatology, Sichuan University, Chengdu 610041, China;
| | - Dezhi Mu
- Department of Pediatrics/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Ministry of Education), West China Second University Hospital, Sichuan University, Chengdu 610041, China; (H.S.); (X.S.); (D.M.)
| | - Yi Qu
- Department of Pediatrics/Key Laboratory of Birth Defects and Related Diseases of Women and Children (Ministry of Education), West China Second University Hospital, Sichuan University, Chengdu 610041, China; (H.S.); (X.S.); (D.M.)
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Abstract
COVID-19 global pandemic has not ceased to spread worldwide since December 2019. Today, scientists and healthcare workers are urgently working to stop this viral invasion and protect the world community. Deciphering the specific cellular and molecular immune response to the new coronavirus 2019 is an essential step in order to develop effective treatment and vaccine. Recovery from COVID-19 infection was linked to appropriate immune responses. However, disease severity was correlated to impaired immune reactions. This review summarized the latest research findings on the role of immune system in fighting and also in the pathogenesis of COVID-19. In addition, it highlighted the immunological basis for the new coronavirus 2019 prevention, therapy and diagnosis.
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Affiliation(s)
- Norma Saad
- Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
| | - Salim Moussa
- Faculty of Health Sciences, Beirut Arab University, Beirut, Lebanon
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Checchi V, Bellini P, Bencivenni D, Consolo U. COVID-19 Dentistry-Related Aspects: A Literature Overview. Int Dent J 2021; 71:21-26. [PMID: 33616049 PMCID: PMC7361251 DOI: 10.1111/idj.12601] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
A new coronavirus (Sars-CoV-2) was detected in China at the end of 2019 and has since caused a worldwide pandemic. This virus is responsible for an acute respiratory syndrome (COVID-19), distinguished by a potentially lethal interstitial bilateral pneumonia. Because Sars-CoV-2 is highly infective through airborne contamination, the high infection risk in the dental environment is a serious problem for both professional practitioners and patients. This literature overview provides a description of the clinical aspects of COVID-19 and its transmission, while supplying valuable information regarding protection and prevention measures.
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Affiliation(s)
- Vittorio Checchi
- Unit of Dentistry and Oral-Maxillo-Facial Surgery, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Italy
| | - Pierantonio Bellini
- Unit of Dentistry and Oral-Maxillo-Facial Surgery, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Italy.
| | - Davide Bencivenni
- Unit of Dentistry and Oral-Maxillo-Facial Surgery, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Italy
| | - Ugo Consolo
- Unit of Dentistry and Oral-Maxillo-Facial Surgery, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Transplant Surgery, Oncology and Regenerative Medicine Relevance, University of Modena and Reggio Emilia, Modena, Italy
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71
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Setiawati Y, Wahyuhadi J, Joestandari F, Maramis MM, Atika A. Anxiety and Resilience of Healthcare Workers During COVID-19 Pandemic in Indonesia. J Multidiscip Healthc 2021; 14:1-8. [PMID: 33442258 PMCID: PMC7797347 DOI: 10.2147/jmdh.s276655] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 12/09/2020] [Indexed: 12/12/2022] Open
Abstract
Introduction The COVID-19 pandemic has an impact on the physical health and mental health of the community, including healthcare workers. Several studies have shown symptoms of depression, anxiety, and sleep disorders in healthcare workers during this pandemic. However, not many studies have examined the resilience of healthcare workers during this pandemic. Resilience is a person's ability to rise and adapt when times are difficult and is considered to have a protective effect on mental problems. Purpose This study aims to determine the correlation between resilience and anxiety in healthcare workers during COVID-19 pandemic. Materials and Methods This research was a cross-sectional study with observational analytic methods. The respondents were healthcare workers at Dr. Soetomo Hospital as the COVID-19 referral hospital in Surabaya, East Java, Indonesia. Data were collected from 10 to 16 June 2020 by distributing online questionnaires through the Google form application. There were three questionnaires used: demographic data, the State-Trait Anxiety Inventory (STAI) questionnaire, and the Connor-Davidson Resilience Scale (CR-RISC) questionnaire. Results The 227 respondents had filled out the questionnaire online with 33% had high state anxiety and 26.9% had high trait anxiety. The mean score of the respondents' resilience was 69 ± 15.823. The Spearman correlation test showed a significant relationship between anxiety and resilience (p <0.05), both S-Anxiety and T-Anxiety. Conclusion A significant correlation was found between the level of resilience and anxiety experienced by healthcare workers during the COVID-19 pandemic. The lower the resilience, the higher the anxiety experienced.
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Affiliation(s)
- Yunias Setiawati
- Department of Psychiatry, Faculty of Medicine, Universitas Airlangga, Surabaya, Jawa Timur, Indonesia.,Department of Psychiatry, Dr. Soetomo General Hospital, Surabaya, Jawa Timur, Indonesia
| | - Joni Wahyuhadi
- Faculty of Medicine, Universitas Airlangga, Surabaya, Jawa Timur, Indonesia.,Department of Neuro Surgery, Dr. Soetomo General Hospital, Surabaya, Jawa Timur, Indonesia
| | | | - Margarita M Maramis
- Department of Psychiatry, Faculty of Medicine, Universitas Airlangga, Surabaya, Jawa Timur, Indonesia.,Department of Psychiatry, Dr. Soetomo General Hospital, Surabaya, Jawa Timur, Indonesia
| | - Atika Atika
- Department of Public Health, Universitas Airlangga, Surabaya, Jawa Timur, Indonesia
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72
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Shukla A, Parmar P, Kapoor G, Goswami D, Jha CK, Patel B, Saraf M. Curse of La Corona: unravelling the scientific and psychological conundrums of the 21st century pandemic. Mol Divers 2021; 26:555-568. [PMID: 33392967 PMCID: PMC7779162 DOI: 10.1007/s11030-020-10167-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2020] [Accepted: 11/28/2020] [Indexed: 01/12/2023]
Abstract
Microbes possess a tremendous potential to interact with their surroundings and have continued to shape the future of all life forms existing on earth. Of all the groups of microbes, viruses are the most nefarious creatures which cannot be solely classified as living or non-living but still pose the greatest threats to the biosphere. Viruses are minuscule, diverse and are probably the only entities that exhibit non-mutualistic association with other lifeforms while retaining their ability to infect and hijack any of the existing living being on the planet. The latest global devastation, caused by novel SARS-CoV-2, is unparalleled in the last century. This review encompasses the mysterious origin of this virus by tracking its lineage, which may help to decode the conundrum of SARS-CoV-2 and shed more light on its epidemiology. The implications and the challenge posed by this virus to the scientific community to the medical community and the economy at large are reflected. Also discussed is the paradigm shift brought upon by the COVID-19 pandemic on the human psyche and their behaviour.
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Affiliation(s)
- Arpit Shukla
- Department of Biological Sciences and Biotechnology, Institute of Advanced Research, University of Innovation, Koba Institutional Area, Gandhinagar, Gujarat 382426 India
- Department of Microbiology and Biotechnology, University School of Sciences, Gujarat University, Ahmedabad, Gujarat 380009 India
| | - Paritosh Parmar
- Department of Microbiology and Biotechnology, University School of Sciences, Gujarat University, Ahmedabad, Gujarat 380009 India
| | - Gitanjali Kapoor
- Department of Psychology, University School of Psychology, Philosophy and Education, Gujarat University, Ahmedabad, Gujarat 380009 India
| | - Dweipayan Goswami
- Department of Microbiology and Biotechnology, University School of Sciences, Gujarat University, Ahmedabad, Gujarat 380009 India
| | - Chaitanya Kumar Jha
- Microbiology Department, Gujarat Arts and Science College, Ahmedabad, Gujarat 380006 India
| | - Baldev Patel
- Department of Microbiology and Biotechnology, University School of Sciences, Gujarat University, Ahmedabad, Gujarat 380009 India
| | - Meenu Saraf
- Department of Microbiology and Biotechnology, University School of Sciences, Gujarat University, Ahmedabad, Gujarat 380009 India
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73
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Ravula U, Chunchu SR, Gente VK. Whole blood derived covid convalescent plasma: An economical option among developing countries. Transfus Apher Sci 2021; 60:103045. [PMID: 33419658 PMCID: PMC7776123 DOI: 10.1016/j.transci.2020.103045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2020] [Accepted: 12/29/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Ushasree Ravula
- Department of Transfusion Medicine, ESIC Medical College Hospital, Hyderabad, Telangana, India.
| | - Srinivasa Rao Chunchu
- Department of Transfusion Medicine, ESIC Medical College Hospital, Hyderabad, Telangana, India
| | - Vikram Kumar Gente
- Department of Hematology, ESIC Medical College Hospital, Hyderabad, Telangana, India
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74
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Charan J, Kaur RJ, Bhardwaj P, Haque M, Sharma P, Misra S, Godman B. Rapid review of suspected adverse drug events due to remdesivir in the WHO database; findings and implications. Expert Rev Clin Pharmacol 2021; 14:95-103. [PMID: 33252992 PMCID: PMC7784780 DOI: 10.1080/17512433.2021.1856655] [Citation(s) in RCA: 43] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 11/24/2020] [Indexed: 12/19/2022]
Abstract
Objectives: Remdesivir has shown promise in the management of patients with COVID-19 although recent studies have shown concerns with its effectiveness in practice. Despite this there is a need to document potential adverse drug events (ADEs) to guide future decisions as limited ADE data available before the COVID-19 pandemic. Methods: Interrogation of WHO VigiBase® from 2015 to 2020 coupled with published studies of ADEs in COVID-19 patients. The main outcome measures are the extent of ADEs broken down by factors including age, seriousness, region and organ. Results: A total 1086 ADEs were reported from the 439 individual case reports up to July 19, 2020, in the VigiBase®, reduced to 1004 once duplicates were excluded. Almost all ADEs concerned COVID-19 patients (92.5%), with an appreciable number from the Americas (67.7%). The majority of ADEs were from males > 45 years and were serious (82.5%). An increase in hepatic enzymes (32.1%), renal injury (14.4%), rise in creatinine levels (11.2%), and respiratory failure (6.4%) were the most frequently reported ADEs. Conclusions: Deterioration of liver and kidney function are frequently observed ADEs with remdesivir; consequently, patients should be monitored for these ADEs. The findings are in line with ADEs included in regulatory authority documents.
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Affiliation(s)
- Jaykaran Charan
- Department of Pharmacology, All India Institute of Medical Sciences, Jodhpur, India
| | - Rimple Jeet Kaur
- Department of Pharmacology, S.N. Medical College, Jodhpur, India
| | - Pankaj Bhardwaj
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Jodhpur, India
| | - Mainul Haque
- Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kuala Lumpur, Malaysia
| | - Praveen Sharma
- Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, India
| | - Sanjeev Misra
- Department of Surgical Oncology, All India Institute of Medical Sciences, Jodhpur, India
| | - Brian Godman
- Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
- School of Pharmacy, Sefako Makgatho Health Sciences University, Pretoria, South Africa
- School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia
- Division of Clinical Pharmacology, Karolinska Institute, Karolinska University Hospital Huddinge, Stockholm, Sweden
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75
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Al Mahmasani L, Hodroj MH, Finianos A, Taher A. COVID-19 pandemic and transfusion medicine: the worldwide challenge and its implications. Ann Hematol 2021; 100:1115-1122. [PMID: 33527161 PMCID: PMC7850517 DOI: 10.1007/s00277-021-04441-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 01/26/2021] [Indexed: 02/07/2023]
Abstract
COVID-19 pandemic has imposed worldwide challenge and has significantly affected transfusion medicine. Shortage in blood products along with concerns regarding the safety of blood products have emerged. Measures to overcome these challenges have been implemented in order to decrease the demand on blood products and to encourage blood donations while taking full precautions to minimize risk of COVID-19 transmission mainly at blood banks and medical centers. Several countries have been successful in facing these new challenges. In addition, the role of plasma therapy in the treatment of COVID-19 patients, especially in severe cases, has been proposed and current studies are being conducted to determine its efficacy. Other therapeutic options are currently being explored. So far, the use of convalescent plasma is considered a promising rescue treatment to be looked at.
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Affiliation(s)
- Layal Al Mahmasani
- grid.411654.30000 0004 0581 3406Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Mohammad Hassan Hodroj
- grid.411654.30000 0004 0581 3406Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon
| | - Antoine Finianos
- grid.411654.30000 0004 0581 3406Department of Internal Medicine, Division of Haematology-Oncology, American University of Beirut Medical Centre, Cairo Street, PO Box 11-0236, Riad El Solh, Beirut, 1107 2020 Lebanon
| | - Ali Taher
- grid.411654.30000 0004 0581 3406Department of Internal Medicine, Division of Haematology-Oncology, American University of Beirut Medical Centre, Cairo Street, PO Box 11-0236, Riad El Solh, Beirut, 1107 2020 Lebanon
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76
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Rathi H, Burman V, Datta SK, Rana SV, Mirza AA, Saha S, Kumar R, Naithani M. Review on COVID-19 Etiopathogenesis, Clinical Presentation and Treatment Available with Emphasis on ACE2. Indian J Clin Biochem 2021; 36:3-22. [PMID: 33424145 PMCID: PMC7778574 DOI: 10.1007/s12291-020-00953-y] [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: 07/06/2020] [Accepted: 12/19/2020] [Indexed: 02/07/2023]
Abstract
In December 2019, Wuhan city in the Hubei province of China reported for the first time a cluster of patients infected with a novel coronavirus, since then there has been an outburst of this disease across the globe affecting millions of human inhabitants. Severe acute respiratory syndrome coronavirus type-2 (SARS-CoV-2), is a member of beta coronavirus family which upon exposure caused a highly infectious disease called novel coronavirus disease-2019 (COVID-19). COVID-19, a probably bat originated disease was declared by World Health Organization (WHO) as a global pandemic in March 2020. Since then, despite rigorous global containment and quarantine efforts, the disease has affected nearly 56,261,952 laboratory confirmed human population and caused deaths of over 1,349,506 lives worldwide. Virus passes in majority through respiratory droplets and then enters lung epithelial cells by binding to angiotensin converting enzyme 2 (ACE2) receptor and there it undergoes replication and targeting host cells causing severe pathogenesis. Majority of human population exposed to SARS-CoV-2 having fully functional immune system undergo asymptomatic infection while 5-10% are symptomatic and only 1-2% are critically affected and requires ventilation support. Older people or people with co-morbidities are severely affected by COVID-19. These categories of patients also display cytokine storm due to dysfunctional immune response which brutally destroys the affected organs and may lead to death in some. Real time PCR is still considered as standard method of diagnosis along with other serology, radiological and biochemical investigations. Till date, no specific validated medication is available for the treatment of COVID-19 patients. Thus, this review provides detailed knowledge about the different landscapes of disease incidence, etiopathogenesis, involvement of various organs, diagnostic criteria's and treatment guidelines followed for management of COVID-19 infection since its inception. In conclusion, extensive research to recognize novel pathways and their cross talk to combat this virus in precarious settings is our future positive hope.
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Affiliation(s)
- Himani Rathi
- Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand India
| | - Vishakha Burman
- Department of Biotechnology, SVBP University of Agriculture and Technology, Meerut, Uttar Pradesh India
| | - Sudip Kumar Datta
- Department of Laboratory Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Satya Vati Rana
- Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand India
| | - Anissa Atif Mirza
- Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand India
| | - Sarama Saha
- Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand India
| | - Raman Kumar
- Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand India
| | - Manisha Naithani
- Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand India
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77
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Hussain I, Hussain A, Alajmi MF, Rehman MT, Amir S. Impact of repurposed drugs on the symptomatic COVID-19 patients. J Infect Public Health 2021; 14:24-38. [PMID: 33341481 PMCID: PMC7720699 DOI: 10.1016/j.jiph.2020.11.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 10/28/2020] [Accepted: 11/05/2020] [Indexed: 01/08/2023] Open
Abstract
An outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel coronavirus capable of causing coronavirus disease 2019 (COVID-19), was declared as a global public health emergency on January 30, 2020, by the World Health Organization. In this devastating situation, precautionary measures, early diagnosis, and repurposed drugs appear to be timely and decisive factors by which to handle this problem until the discovery of an effective, dedicated vaccine or medicine is made. Currently, some researchers and clinicians have claimed evidence exists in favor of the use of some antimalarial drugs (chloroquine, hydroxychloroquine) antiviral drugs (remdesivir, favipiravir, lopinavir, ritonavir, umifenovir) vitamins, traditional Chinese medicines, and herbal medicines against SARS-CoV-2 infection. Based on the available literature, this review article sought to highlight the current understanding of the origin, transmission, diagnosis, precautionary measures, infection and drug action mechanisms, therapeutic role, and toxicities of targeted drugs for the prevention and cure of COVID-19. This review may be useful for developing further strategies as a blueprint and understanding the mentioned drugs' mechanisms to elucidate the possible target of action by which to successfully freeze the replication of the SARS-CoV-2 virus.
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Affiliation(s)
- Iqbal Hussain
- Department of General Studies, Jubail Industrial College, Jubail Industrial City, Jubail, 31961, Saudi Arabia
| | - Afzal Hussain
- Department of Pharmacognosy, College of Pharmacy, King Saud University, PO Box 2457, Riyadh, 11451, Saudi Arabia.
| | - Mohamed F Alajmi
- Department of Pharmacognosy, College of Pharmacy, King Saud University, PO Box 2457, Riyadh, 11451, Saudi Arabia.
| | - Md Tabish Rehman
- Department of Pharmacognosy, College of Pharmacy, King Saud University, PO Box 2457, Riyadh, 11451, Saudi Arabia
| | - Samira Amir
- Department of Chemistry, College of Science and General Studies, Alfaisal University, PO Box 50927, Riyadh 11533, Saudi Arabia
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Khadka S, Nisar S, Syed NIH, Shrestha DB, Budhathoki P. Different aspects of convalescent plasma therapy for COVID-19 treatment; a critical review. Immunopharmacol Immunotoxicol 2020; 43:30-36. [PMID: 33356684 DOI: 10.1080/08923973.2020.1863983] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The novel coronavirus disease (COVID-19) has been declared a pandemic by the World Health Organization (WHO) and is ominously threatening the survival of humankind on the whole planet. With a quick spread of the outbreak from its origin, Wuhan, China, to almost all over the world, it has affected more than seven million people to date, hence it has devastated every part of the infrastructural skeleton of governance. Continuously escalating disease burden and lack of proven therapeutic approaches are mounting challenges to health scientists and ultimately to healthcare providers. Although recent studies have shown benefits in decreasing the severity and duration of the illness and there are more benefits compared to risks, plasma therapy cannot be considered as a standard of care until the ongoing trials are completed and they establish definite evidence on its therapeutic efficacy and safety. Though a beneficial aspect may be there, acquiring donors and adequate availability of plasma is equally challenging, and its associated untoward effects related to biological therapeutic agents. The rational practice of CP therapy guided by risk-benefit judgment from aspects of donor and recipient can be a therapeutic option in such a global health crisis.
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Affiliation(s)
- Sitaram Khadka
- Department of Pharmacy Practice, Shree Birendra Hospital; Nepalese Army Institute of Health Sciences, Kathmandu, Nepal.,Department of Physiology and Pharmacology, Punjab University College of Pharmacy, University of the Punjab, Lahore, Pakistan
| | - Shameem Nisar
- Department of Physiology and Pharmacology, Punjab University College of Pharmacy, University of the Punjab, Lahore, Pakistan
| | - Nawazish-I-Husain Syed
- Department of Physiology and Pharmacology, Punjab University College of Pharmacy, University of the Punjab, Lahore, Pakistan
| | - Dhan Bahadur Shrestha
- Department of Emergency Medicine and General Practice, Mangalbare Hospital, Morang, Nepal
| | - Pravash Budhathoki
- Department of Emergency Medicine and General Practice, Dr Iwamura Memorial Hospital, Bhaktapur, Nepal
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79
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Otuonye NM, Olumade TJ, Ojetunde MM, Holdbrooke SA, Ayoola JB, Nyam IY, Iwalokun B, Onwuamah C, Uwandu M, Abayomi A, Osibogun A, Bowale A, Osikomaiya B, Thomas B, Mutiu B, Odunukwe NN. Clinical and Demographic Characteristics of COVID-19 patients in Lagos, Nigeria: A Descriptive Study. J Natl Med Assoc 2020; 113:301-306. [PMID: 33358220 PMCID: PMC7759120 DOI: 10.1016/j.jnma.2020.11.011] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2020] [Revised: 10/06/2020] [Accepted: 11/27/2020] [Indexed: 12/18/2022]
Abstract
Introduction COVID-19 is an emerging, rapidly evolving global situation, infecting over 25 million people and causing more than 850,000 deaths. Several signs and symptoms have been described to be characteristic of the disease. However, there is a dearth of report on the description of the clinical characteristics of the disease in patients from Nigeria. This study was designed to provide a description of the clinical and demographic characteristics of COVID-19 patients in Nigeria. Methods This study is a case series that includes patients that are evaluated between May and August 2020, and diagnosed with COVID-19. Patient health records were reviewed and evaluated to describe the clinical characteristics on presentation. Results A total of 154 COVID-19 patients were included in this study, with a mean age (S.D.) of 46.16 (13.701). Most of the patients survived (mortality rate of 2.6%), and were symptomatic (89.6%). There were more males (74.7%) than females, and the most common symptoms were fever, breathing difficulty, dry cough and malaise. Co-morbidities were also present in almost half of the study participants (49.4%). Conclusion This study presents the most extensive description, to date, on the clinical and demographic characteristics of COVID-19 patients in Nigeria. Males are more likely than females to be infected with COVID-19 and the most occurring symptoms are fever, breathing difficulty, malaise, dry cough and chest pain. Old age and the presence of co-morbidities may also be associated with developing the severe disease.
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Affiliation(s)
| | - Testimony Jesupamilerin Olumade
- Department of Biological Sciences, Redeemer's University, Ede, Osun state; African Centre of Excellence for Genomics of Infectious Diseases, Redeemer's University, Ede, Osun state
| | | | | | | | - Itse Yusuf Nyam
- Central Research Laboratory, Nigerian Institute of Medical Research, Yaba, Lagos
| | - Bamidele Iwalokun
- Molecular Biological and Biotechnology Department, Nigerian Institute of Medical Research, Yaba, Lagos
| | - Chika Onwuamah
- Centre for Human Virology and Genomics, Nigerian Institute of Medical Research, Yaba, Lagos
| | - Mabel Uwandu
- Centre for Human Virology and Genomics, Nigerian Institute of Medical Research, Yaba, Lagos
| | - Akinola Abayomi
- Lagos State Ministry of Health, Alausa, Ikeja, Lagos, Nigeria
| | - Akin Osibogun
- College of Medicine University of Lagos, Nigeria; Lagos State Primary Health Care Board, Lagos, Nigeria
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Ferorelli D, Mandarelli G, Solarino B. Ethical Challenges in Health Care Policy during COVID-19 Pandemic in Italy. MEDICINA (KAUNAS, LITHUANIA) 2020; 56:E691. [PMID: 33322462 PMCID: PMC7764230 DOI: 10.3390/medicina56120691] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 11/28/2020] [Accepted: 12/11/2020] [Indexed: 02/07/2023]
Abstract
Since the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, Italy has proven to be one of the countries with the highest coronavirus-linked death rate. To reduce the impact of SARS-CoV-2 coronavirus, the Italian Government decision-makers issued a series of law decrees that imposed measures limiting social contacts, stopped non-essential production activities, and restructured public health care in order to privilege assistance to patients infected with SARS-CoV-2. Health care services were substantially limited including planned hospitalization and elective surgeries. These substantial measures were criticized due to their impact on individual rights including freedom and autonomy, but were justified by the awareness that hospitals would have been unable to cope with the surge of infected people who needed treatment for COVID-19. The imbalance between the need to guarantee ordinary care and to deal with the pandemic, in a context of limited health resources, raises ethical concerns as well as clinical management issues. The emergency scenario caused by the COVID-19 pandemic, especially in the lockdown phase, led the Government and health care decision-makers to prioritize community safety above the individuals' rights. This new community-centered approach to clinical care has created tension among the practitioners and exposed health workers to malpractice claims. Reducing the morbidity and mortality rates of the COVID-19 pandemic is the priority of every government, but the legitimate question remains whether the policy that supports this measure could be less harmful for the health care system.
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Affiliation(s)
- Davide Ferorelli
- Interdisciplinary Department of Medicine, Section of Legal Medicine, University of Bari, Piazza Giulio, Cesare 11, 70100 Bari, Italy; (G.M.); (B.S.)
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81
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Haji-Maghsoudi S, Sadeghifar M, Roshanaei G, Mahjub H. The Impact of Control Measures and Holiday Seasons on Incidence and Mortality Rate of COVID-19 in Iran. J Res Health Sci 2020; 20:e00500. [PMID: 33424009 PMCID: PMC8695787 DOI: 10.34172/jrhs.2020.35] [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] [Subscribe] [Scholar Register] [Received: 10/13/2020] [Revised: 11/15/2020] [Accepted: 11/30/2020] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Preventive measures on the COVID-19 pandemic is an effective way to control its spread. We aimed to investigate the effect of control measures and holiday seasons on the incidence and mortality rate of COVID-19 in Iran. STUDY DESIGN An observational study. METHODS The daily data of confirmed new cases and deaths in Iran were taken from the Johns Hopkins University COVID-19 database. We calculated weekly data from 19 Feb to 6 Oct 2020. To estimate the impact of control measures and holiday seasons on the incidence rate of new cases and deaths, an autoregressive hidden Markov model (ARHMM) with two hidden states fitted the data. The hidden states of the fitted model can distinguish the peak period from the non-peak period. RESULTS The control measures with a delay of one-week and two-week had a decreasing effect on the new cases in the peak and non-peak periods, respectively (P=0.005). The holiday season with a two-week delay increased the total number of new cases in the peak periods (P=0.031). The peak period for the occurrence of COVID-19 was estimated at 3 weeks. In the peak period of mortality, the control measures with a three-week delay decreased the COVID-19 mortality (P=0.010). The expected duration of staying in the peak period of mortality was around 6 weeks. CONCLUSION When an increasing trend was seen in the country, the control measures could decline the incidence and mortality related to COVID-19. Implementation of official restrictions on holiday seasons could prevent an upward trend of incidence for COVID-19 during the peak period.
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Affiliation(s)
- Saiedeh Haji-Maghsoudi
- Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Majid Sadeghifar
- Department of Statistics, Faculty of Basic Sciences, Bu-Ali Sina University, Hamadan, Iran
| | - Ghodratollah Roshanaei
- Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
- Modeling of Noncommunicable Diseases Research Center, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Hossein Mahjub
- Department of Biostatistics, School of Public Health, Hamadan University of Medical Sciences, Hamadan, Iran
- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
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Dassarma B, Tripathy S, Matsabisa M. Emergence of ancient convalescent plasma (CP) therapy: To manage COVID-19 pandemic. Transfus Clin Biol 2020; 28:123-127. [PMID: 33285298 PMCID: PMC7718590 DOI: 10.1016/j.tracli.2020.11.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 11/13/2020] [Accepted: 11/26/2020] [Indexed: 12/23/2022]
Abstract
Since December 2019, the human populations of the 195 global countries continue experiencing grave health and life threats due to the current COVID-19 pandemic. As a result of the novelty of the pathogen, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), at present there is lack of preventive as well as therapeutic options for treating and managing the infection. The use of ancient immunotherapeutic technique – the convalescent plasma (CP) therapy, may act as an immediate and available option to control the COVID-19 pandemic. This review provides a concept and understanding on the CP therapy, its potential to control SARS-CoV-2 pandemic. The CP therapy might act as an immediate saviour for society from the virus. Although the CP therapy has exert affirmative result against COVID-19 it has not been recommended for long time use in COVID-19 and this review gives support for its possible application.
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Affiliation(s)
- Barsha Dassarma
- Department of Pharmacology, School of Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein 9300, South Africa
| | - Satyajit Tripathy
- Department of Pharmacology, School of Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein 9300, South Africa
| | - Motlalepula Matsabisa
- Department of Pharmacology, School of Medicine, Faculty of Health Sciences, University of the Free State, Bloemfontein 9300, South Africa.
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Richard SA, Kampo S, Esquijarosa Hechavarria M. Elucidating the pivotal role of convalescent plasma therapy in critically ill COVID-19 patients: A review. Hematol Rep 2020; 12:8630. [PMID: 33324480 PMCID: PMC7731664 DOI: 10.4081/hr.2020.8630] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 10/30/2020] [Indexed: 12/12/2022] Open
Abstract
World Health Organization (WHO) declared coronavirus disease (COVID-19) a pandemic in March 2020. Currently almost every country in the world has reported cases with moderate to high mortality rates. The European Union (EU), the United States of America (USA) and the United Kingdom (UK) are the severely affected countries. Nevertheless, the WHO is very much concern about countries with weak health systems. The clinical characteristics of COVID-19 varies extensively, ranging from asymptomatic infections to severe as well as critical pneumonia with high mortality rates in the elderly and patients with co-morbid medical illness. Convalescent Plasma Therapy (CPT) has been successfully used in treating various viral disease outbreaks such as 1918 influenza pneumonia pandemic, poliomyelitis, measles, mumps, Machupo virus, Junin virus, Lassa virus, Ebola etc. High-titer specific antibodies maybe capable of binding to Coronavirus- 19 (CoV-19) and neutralize the viral particles, inhibit entry to uninfected cells, and trigger potent effector mechanisms such as complement activation as well as phagocytosis. Therefore, in most countries with very weak health systems with no Intensive Care Units (ICUs) or trained ICU physicians, early initiation of CPT for severely COVID- 19 patients may be rewarding. Therefore, solidarity control trials on CPT for COVID- 19 patients involving large number of patients are urgently needed.
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Affiliation(s)
| | - Sylvanus Kampo
- Department of Anesthesia and Critical care, School of Medicine, University of Health and Allied Sciences, Ho, Ghana
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84
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Muralidar S, Ambi SV, Sekaran S, Krishnan UM. The emergence of COVID-19 as a global pandemic: Understanding the epidemiology, immune response and potential therapeutic targets of SARS-CoV-2. Biochimie 2020; 179:85-100. [PMID: 32971147 PMCID: PMC7505773 DOI: 10.1016/j.biochi.2020.09.018] [Citation(s) in RCA: 131] [Impact Index Per Article: 32.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 09/14/2020] [Accepted: 09/15/2020] [Indexed: 02/07/2023]
Abstract
An acute respiratory disease caused by a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that surfaced in China in late 2019, continues to spread rapidly across the globe causing serious concerns. The coronavirus disease 2019 (COVID-19) is declared as a public health emergency worldwide by the World Health Organization (WHO). Increasing evidences have demonstrated human-to-human transmission that primarily affects the upper respiratory tract followed by lower respiratory tract damage leading to severe pneumonia. Based on the current status, the elderly population and people with prior co-morbidities are highly susceptible to serious health effects including cytokine up-regulation and acute respiratory distress syndrome (ARDS). Currently, COVID-19 research is still in the preliminary stage necessitating rigorous studies. There is no specific drug or vaccine targeting SARS-CoV-2 currently and only symptomatic treatment is being administered, but several antivirals are under active investigation. In this review, we have summarized the epidemiology, entry mechanism, immune response, and therapeutic implications, possible drug targets, their ongoing clinical trials, and put forward vital questions to offer new directions to the COVID-19 research.
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Affiliation(s)
- Shibi Muralidar
- School of Chemical and Biotechnology, SASTRA Deemed-to-be-University, Thanjavur, 613401, Tamil Nadu, India
| | - Senthil Visaga Ambi
- School of Chemical and Biotechnology, SASTRA Deemed-to-be-University, Thanjavur, 613401, Tamil Nadu, India.
| | - Saravanan Sekaran
- School of Chemical and Biotechnology, SASTRA Deemed-to-be-University, Thanjavur, 613401, Tamil Nadu, India; Centre for Nanotechnology & Advanced Biomaterials (CeNTAB), School of Chemical and Biotechnology, SASTRA Deemed-to-be-University, Thanjavur, 613401, Tamil Nadu, India
| | - Uma Maheswari Krishnan
- School of Chemical and Biotechnology, SASTRA Deemed-to-be-University, Thanjavur, 613401, Tamil Nadu, India; Centre for Nanotechnology & Advanced Biomaterials (CeNTAB), School of Chemical and Biotechnology, SASTRA Deemed-to-be-University, Thanjavur, 613401, Tamil Nadu, India; School of Arts, Science & Technology (SASH), SASTRA Deemed-to-be-University, Thanjavur, 613401, Tamil Nadu, India
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85
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Tsatsakis A, Calina D, Falzone L, Petrakis D, Mitrut R, Siokas V, Pennisi M, Lanza G, Libra M, Doukas SG, Doukas PG, Kavali L, Bukhari A, Gadiparthi C, Vageli DP, Kofteridis DP, Spandidos DA, Paoliello MMB, Aschner M, Docea AO. SARS-CoV-2 pathophysiology and its clinical implications: An integrative overview of the pharmacotherapeutic management of COVID-19. Food Chem Toxicol 2020; 146:111769. [PMID: 32979398 PMCID: PMC7833750 DOI: 10.1016/j.fct.2020.111769] [Citation(s) in RCA: 100] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/16/2020] [Accepted: 09/18/2020] [Indexed: 02/06/2023]
Abstract
Common manifestations of COVID-19 are respiratory and can extend from mild symptoms to severe acute respiratory distress. The severity of the illness can also extend from mild disease to life-threatening acute respiratory distress syndrome (ARDS). SARS-CoV-2 infection can also affect the gastrointestinal tract, liver and pancreatic functions, leading to gastrointestinal symptoms. Moreover, SARS-CoV-2 can cause central and peripheral neurological manifestations, affect the cardiovascular system and promote renal dysfunction. Epidemiological data have indicated that cancer patients are at a higher risk of contracting the SARS-CoV-2 virus. Considering the multitude of clinical symptoms of COVID-19, the objective of the present review was to summarize their pathophysiology in previously healthy patients, as well as in those with comorbidities. The present review summarizes the current, though admittedly fluid knowledge on the pathophysiology and symptoms of COVID-19 infection. Although unclear issues still remain, the present study contributes to a more complete understanding of the disease, and may drive the direction of new research. The recognition of the severity of the clinical symptoms of COVID-19 is crucial for the specific therapeutic management of affected patients.
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Affiliation(s)
- Aristides Tsatsakis
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, 71003, Heraklion, Greece; I.M. Sechenov First Moscow State Medical University (Sechenov University), 119146, Moscow, Russia.
| | - Daniela Calina
- Department of Clinical Pharmacy, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania.
| | - Luca Falzone
- Epidemiology Unit, IRCCS Istituto Nazionale Tumori "Fondazione G. Pascale", 80131, Naples, Italy.
| | - Dimitrios Petrakis
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, 71003, Heraklion, Greece.
| | - Radu Mitrut
- Department of Cardiology, University and Emergency Hospital, 050098, Bucharest, Romania.
| | - Vasileios Siokas
- Department of Neurology, University of Thessaly, University Hospital of Larissa, 41221, Larissa, Greece.
| | - Manuela Pennisi
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123, Catania, Italy.
| | - Giuseppe Lanza
- Department of Surgery and Medical-Surgical Specialties, University of Catania, 95123, Catania, Italy; Department of Neurology IC, Oasi Research Institute-IRCCS, 94018, Troina, Italy.
| | - Massimo Libra
- Department of Biomedical and Biotechnological Sciences, University of Catania, 95123, Catania, Italy; Research Center for Prevention, Diagnosis and Treatment of Cancer, University of Catania, 95123, Catania, Italy.
| | - Sotirios G Doukas
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, 71003, Heraklion, Greece; Department of Internal Medicine, Saint Peter's University Hospital, 254 Easton Ave, New Brunswick, NJ, 08901, USA.
| | - Panagiotis G Doukas
- University of Pavol Josef Safarik University, Faculty of Medicine, Kosice, Slovakia.
| | - Leena Kavali
- Department of Internal Medicine, Saint Peter's University Hospital, 254 Easton Ave, New Brunswick, NJ, 08901, USA.
| | - Amar Bukhari
- Department of Medicine, Division of Pulmonary and Critical Care 240 Easton Ave, Adult Ambulatory at Cares Building 4th Floor, New Brunswick, NJ, 08901, USA.
| | - Chiranjeevi Gadiparthi
- Division of Gastroenterology, Hepatology and Clinical Nutrition, Saint Peter's University Hospital, New Brunswick, NJ, USA.
| | - Dimitra P Vageli
- Department of Surgery, The Yale Larynx Laboratory, New Haven, CT, 06510, USA.
| | - Diamantis P Kofteridis
- Department of Internal Medicine, University Hospital of Heraklion, 71110, Heraklion, Crete, Greece.
| | - Demetrios A Spandidos
- Laboratory of Clinical Virology, Medical School, University of Crete, Heraklion, 71003, Greece.
| | - Monica M B Paoliello
- Department of Molecular Pharmacology, Albert Eisntein College of Medicine, 1300 Morris Park Avenue Bronx, NY, 10461, USA.
| | - Michael Aschner
- I.M. Sechenov First Moscow State Medical University (Sechenov University), 119146, Moscow, Russia; Department of Molecular Pharmacology, Albert Eisntein College of Medicine, 1300 Morris Park Avenue Bronx, NY, 10461, USA.
| | - Anca Oana Docea
- Department of Toxicology, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania.
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86
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Sheervalilou R, Shirvaliloo M, Dadashzadeh N, Shirvalilou S, Shahraki O, Pilehvar‐Soltanahmadi Y, Ghaznavi H, Khoei S, Nazarlou Z. COVID-19 under spotlight: A close look at the origin, transmission, diagnosis, and treatment of the 2019-nCoV disease. J Cell Physiol 2020; 235:8873-8924. [PMID: 32452539 PMCID: PMC7283670 DOI: 10.1002/jcp.29735] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Accepted: 04/17/2020] [Indexed: 01/07/2023]
Abstract
Months after the outbreak of a new flu-like disease in China, the entire world is now in a state of caution. The subsequent less-anticipated propagation of the novel coronavirus disease, formally known as COVID-19, not only made it to headlines by an overwhelmingly high transmission rate and fatality reports, but also raised an alarm for the medical community all around the globe. Since the causative agent, SARS-CoV-2, is a recently discovered species, there is no specific medicine for downright treatment of the infection. This has led to an unprecedented societal fear of the newly born disease, adding a psychological aspect to the physical manifestation of the virus. Herein, the COVID-19 structure, epidemiology, pathogenesis, etiology, diagnosis, and therapy have been reviewed.
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Affiliation(s)
- Roghayeh Sheervalilou
- Cellular and Molecular Research Center, Resistant Tuberculosis InstituteZahedan University of Medical SciencesZahedanIran
| | | | - Nahid Dadashzadeh
- Legal Medicine Research Center, Legal Medicine OrganizationTehranIran
| | - Sakine Shirvalilou
- Finetech in Medicine Research CenterIran University of Medical SciencesTehranIran
| | - Omolbanin Shahraki
- Cellular and Molecular Research Center, Resistant Tuberculosis InstituteZahedan University of Medical SciencesZahedanIran
| | - Younes Pilehvar‐Soltanahmadi
- Cellular and Molecular Research Center, Research Institute for Cellular and Molecular MedicineUrmia University of Medical SciencesUrmiaIran
| | | | - Samideh Khoei
- Department of Medical PhysicsSchool of Medicine, Iran University of Medical SciencesTehranIran
| | - Ziba Nazarlou
- Material Engineering DepartmentCollege of Science Koç UniversityIstanbulTurkey
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87
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Hosseini A, Hashemi V, Shomali N, Asghari F, Gharibi T, Akbari M, Gholizadeh S, Jafari A. Innate and adaptive immune responses against coronavirus. Biomed Pharmacother 2020; 132:110859. [PMID: 33120236 PMCID: PMC7580677 DOI: 10.1016/j.biopha.2020.110859] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/21/2020] [Accepted: 09/25/2020] [Indexed: 01/08/2023] Open
Abstract
Coronaviruses (CoVs) are a member of the Coronaviridae family with positive-sense single- stranded RNA. In recent years, the CoVs have become a global problem to public health. The immune responses (innate and adaptive immunity) are essential for elimination and clearance of CoVs infections, however, uncontrolled immune responses can result in aggravating acute lung injury and significant immunopathology. Gaining profound understanding about the interaction between CoVs and the innate and adaptive immune systems could be a critical step in the field of treatment. In this review, we present an update on the host innate and adaptive immune responses against SARS-CoV, MERS-CoV and newly appeared SARS-CoV-2.
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Affiliation(s)
- Arezoo Hosseini
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Vida Hashemi
- Department of Basic Science, Faculty of Medicine, Maragheh University of Medical Sciences, Maragheh, Iran
| | - Navid Shomali
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Faezeh Asghari
- Department of Immunology, School of Medicine, Tarbiat Modares University of Medical Sciences, Tehran, Iran
| | - Tohid Gharibi
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran; Department of Immunology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Morteza Akbari
- Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Saber Gholizadeh
- Department of Medical Entomology and Vector Control, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran
| | - Abbas Jafari
- Department of Toxicology and Cellular and Molecular Research Center, School of Public Health, Urmia University of Medical Sciences, Urmia, Iran.
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Wheeler SE, Shurin GV, Keetch C, Mitchell G, Kattel G, McBreen J, Shurin MR. Evaluation of SARS-CoV-2 prototype serologic test in hospitalized patients. Clin Biochem 2020; 86:8-14. [PMID: 32858060 PMCID: PMC7448777 DOI: 10.1016/j.clinbiochem.2020.08.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Revised: 08/12/2020] [Accepted: 08/19/2020] [Indexed: 12/28/2022]
Abstract
OBJECTIVES Humoral immune response to SARS-CoV-2 infection has been reported in several patient cohorts with results that vary by method and population studied due to the lack of reliable commercial assays available as the pandemic initially spread. We sought to clinically assess commercial prototype SARS-CoV-2 IgG and IgA assays for use in screening for prior infection and convalescent plasma donation. DESIGN AND METHODS Prototype SARS-CoV-2 IgG and IgA assays from Euroimmun were assessed utilizing remnant specimens. Specificity testing used specimens in their convalescent window for the common coronaviruses and other infectious diseases known to be associated with increased non-specificity in serologic assays. Sensitivity testing utilized serial specimens from molecularly confirmed SARS-CoV-2 critically ill patients to assess seroconversion. Utilizing recombinant spike protein we also developed a competitive confirmation procedure to increase assay specificity. RESULTS We determined specificity to be 97% and 81%, respectively, when indeterminate samples were considered positive and 99% and 86% when indeterminate samples were considered negative. We developed a new confirmation methodology to enhance the specificity of the assays with an anticipated specificity of 98% for IgA. Valuation of hospitalized COVID-19 patients determined median IgA seroconversion to be 8 days and IgG 10 days. Neither level nor timing of antibody response correlated with days on ventilation. End titer measurements indicate that validated improved assays may be capable of semi-quantitative measurement. CONCLUSIONS We found these assays to be clinically acceptable for the high prevalence population tested, for instance, for convalescent plasma donation.
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Affiliation(s)
- Sarah E Wheeler
- Department of Pathology, University of Pittsburgh, 200 Lothrop St, Pittsburgh, PA 15213, USA; Department of Pathology, University of Pittsburgh Medical Center, 3477 Euler Way, Pittsburgh, 15213 PA, USA.
| | - Galina V Shurin
- Department of Pathology, University of Pittsburgh, 200 Lothrop St, Pittsburgh, PA 15213, USA
| | - Christian Keetch
- Department of Pathology, University of Pittsburgh Medical Center, 3477 Euler Way, Pittsburgh, 15213 PA, USA
| | - Gretchen Mitchell
- Department of Pathology, University of Pittsburgh Medical Center, 3477 Euler Way, Pittsburgh, 15213 PA, USA
| | - Gaurav Kattel
- Department of Pathology, University of Pittsburgh Medical Center, 3477 Euler Way, Pittsburgh, 15213 PA, USA
| | - Jeffrey McBreen
- Department of Pathology, University of Pittsburgh Medical Center, 3477 Euler Way, Pittsburgh, 15213 PA, USA
| | - Michael R Shurin
- Department of Pathology, University of Pittsburgh, 200 Lothrop St, Pittsburgh, PA 15213, USA; Department of Pathology, University of Pittsburgh Medical Center, 3477 Euler Way, Pittsburgh, 15213 PA, USA; Department of Immunology, University of Pittsburgh, 200 Lothrop St, Pittsburgh, PA 15213, USA
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89
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90
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Farooq S, Ngaini Z. Natural and Synthetic Drugs as Potential Treatment for Coronavirus Disease 2019 (COVID-2019). CHEMISTRY AFRICA 2020. [PMCID: PMC7682129 DOI: 10.1007/s42250-020-00203-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Coronavirus disease 2019 (COVID-19) has become a global pandemic in a short period, where a tragically large number of human lives being lost. It is an infectious pandemic that recently infected more than two hundred countries in the world. Many potential treatments have been introduced, which are considered potent antiviral drugs and commonly reported as herbal or traditional and medicinal treatments. A variety of bioactive metabolites extracts from natural herbal have been reported for coronaviruses with some effective results. Food and Drug Administration (FDA) has approved numerous drugs to be introduced against COVID-19, which commercially available as antiviral drugs and vaccines. In this study, a comprehensive review is discussed on the potential antiviral remedies based on natural and synthetic drugs. This review highlighted the potential remedies of COVID-19 which successfully applied to patients with high cytopathic inhibition potency for cell-to-cell spread and replication of coronavirus.
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91
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Faizan A, Abhichandan D, Sharique S, Upasana P, Sabiha N. Therapeutic Approach For COVID-19 – Clinical Challenges And Implementation. BIONATURA 2020. [DOI: 10.21931/rb/2020.05.04.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
SAR-CoV-2 originated from China with first case reporting from Wuhan, has been declared as pandemic by WHO on March 11 2020, which has affected millions of people around the globe with 213 countries and territories infected worldwide. It has caused the death of around 0.6 million individuals with no specific or promising vaccines or treatment available until now to prevent COVID 19, which has been approved; this has led the world to a global crisis not only on the health front but also affected the economic sectors. Researchers across the globe are working around the clock with their level best to discover promising therapeutic approaches for COVID 19, but till now for the treatment, only 3 therapeutics have been approved, including dexamethasone in U.K. and Japan, Avigan in Russia, Italy, and China and remdesivir in Japan and Australia; also convalescent plasma therapy is seen to be effective in critical cases of COVID-19, however, there are limitations with the use of this plasma therapy like the time point of treatment, optimal dose as the dose may vary with number of patients the particular therapeutic effects of convalescent plasma therapy will be further explored in randomized clinical trials. Several complete multinational studies are investigating alternative therapies. More than 100 countries entered a cooperation to evaluate applicants for high-profile COVID-19 diagnosis with this most massive WHO's cooperation. According to WHO's information, there are 28 vaccine candidates under clinical evaluation, with 6 of them entering phase 3. This review emphasizes the allopathic approaches along with the Chinese herbal medicine for the prevention of COVID-19. This paper also includes a brief discussion on the vaccine and nutritional supplements.
Keywords: SAR-CoV-2, COVID-19, therapeutics, drugs, vaccines
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Affiliation(s)
- Ahmad Faizan
- Department of Medical Elementology and Toxicology, Jamia Hamdard, Delhi, India
| | - Das Abhichandan
- Centre for Biotechnology and Bioinformatics, Dibrugarh University, Assam, India
| | | | - Pathak Upasana
- Centre for Biotechnology and Bioinformatics, Dibrugarh University, Assam, India
| | - Naaz Sabiha
- Department of Biotechnology, Jamia Hamdard, Delhi, India
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92
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Albahri OS, Al-Obaidi JR, Zaidan AA, Albahri AS, Zaidan BB, Salih MM, Qays A, Dawood KA, Mohammed RT, Abdulkareem KH, Aleesa AM, Alamoodi AH, Chyad MA, Zulkifli CZ. Helping doctors hasten COVID-19 treatment: Towards a rescue framework for the transfusion of best convalescent plasma to the most critical patients based on biological requirements via ml and novel MCDM methods. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2020; 196:105617. [PMID: 32593060 PMCID: PMC7305916 DOI: 10.1016/j.cmpb.2020.105617] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 06/16/2020] [Indexed: 05/04/2023]
Abstract
CONTEXT People who have recently recovered from the threat of deteriorating coronavirus disease-2019 (COVID-19) have antibodies to the coronavirus circulating in their blood. Thus, the transfusion of these antibodies to deteriorating patients could theoretically help boost their immune system. Biologically, two challenges need to be surmounted to allow convalescent plasma (CP) transfusion to rescue the most severe COVID-19 patients. First, convalescent subjects must meet donor selection plasma criteria and comply with national health requirements and known standard routine procedures. Second, multi-criteria decision-making (MCDM) problems should be considered in the selection of the most suitable CP and the prioritisation of patients with COVID-19. OBJECTIVE This paper presents a rescue framework for the transfusion of the best CP to the most critical patients with COVID-19 on the basis of biological requirements by using machine learning and novel MCDM methods. METHOD The proposed framework is illustrated on the basis of two distinct and consecutive phases (i.e. testing and development). In testing, ABO compatibility is assessed after classifying donors into the four blood types, namely, A, B, AB and O, to indicate the suitability and safety of plasma for administration in order to refine the CP tested list repository. The development phase includes patient and donor sides. In the patient side, prioritisation is performed using a contracted patient decision matrix constructed between 'serological/protein biomarkers and the ratio of the partial pressure of oxygen in arterial blood to fractional inspired oxygen criteria' and 'patient list based on novel MCDM method known as subjective and objective decision by opinion score method'. Then, the patients with the most urgent need are classified into the four blood types and matched with a tested CP list from the test phase in the donor side. Thereafter, the prioritisation of CP tested list is performed using the contracted CP decision matrix. RESULT An intelligence-integrated concept is proposed to identify the most appropriate CP for corresponding prioritised patients with COVID-19 to help doctors hasten treatments. DISCUSSION The proposed framework implies the benefits of providing effective care and prevention of the extremely rapidly spreading COVID-19 from affecting patients and the medical sector.
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Affiliation(s)
- O S Albahri
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan, Tanjung Malim 35900, Malaysia
| | - Jameel R Al-Obaidi
- Department of Biology, Faculty of Science and Mathematics, Universiti Pendidikan Sultan Idris, Tanjong Malim, Perak 35900, Malaysia
| | - A A Zaidan
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan, Tanjung Malim 35900, Malaysia.
| | - A S Albahri
- Informatics Institute for Postgraduate Studies (IIPS), Iraqi Commission for Computers and Informatics (ICCI), Baghdad, Iraq
| | - B B Zaidan
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan, Tanjung Malim 35900, Malaysia
| | - Mahmood M Salih
- Department of Computer Science, Computer Science and Mathematics College, Tikrit University, Tikrit 34001, Iraq
| | - Abdulhadi Qays
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan, Tanjung Malim 35900, Malaysia
| | - K A Dawood
- Faculty of Computer Science and Information Technology, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - R T Mohammed
- Faculty of Computer Science and Information Technology, Universiti Putra Malaysia, Seri Kembangan, Malaysia
| | - Karrar Hameed Abdulkareem
- Faculty of Computer Science and Information Technology, Universiti Tun Hussein Onn Malaysia, Parit Raja, Malaysia
| | - A M Aleesa
- Faculty of Electronic and Electrical Engineering, Universiti Tun Hussein Onn, Batu Pahat, Johor 86400, Malaysia
| | - A H Alamoodi
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan, Tanjung Malim 35900, Malaysia
| | - M A Chyad
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan, Tanjung Malim 35900, Malaysia
| | - Che Zalina Zulkifli
- Department of Computing, Faculty of Arts, Computing and Creative Industry, Universiti Pendidikan, Tanjung Malim 35900, Malaysia
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Storch-de-Gracia P, Leoz-Gordillo I, Andina D, Flores P, Villalobos E, Escalada-Pellitero S, Jiménez R. [Clinical spectrum and risk factors for complicated disease course in children admitted with SARS-CoV-2 infection]. An Pediatr (Barc) 2020; 93:323-333. [PMID: 32950434 PMCID: PMC7457908 DOI: 10.1016/j.anpedi.2020.07.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 07/27/2020] [Accepted: 07/29/2020] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION At this time there are still major questions about the characteristics of disease caused by the new coronavirus (COVID-19) in children as well as factors associated with the development of severe forms of the disease. STUDY DESIGN Retrospective study including patients under 18 years of age admitted with SARS-CoV-2 infection from March 1 to April 30, 2020. Infection was confirmed by realtime reverse transcriptase-polymerase chain reaction (RT-PCR) or antibody testing. We describe the epidemiological and clinical data, laboratory and imaging findings, as well as treatment and outcome in these patients. In light of these findings, patients were classified into two severity groups and then compared. RESULTS Thirty-nine children were included, with a median age of 9 years (range 12 days-16 years); 23 were boys. Cases with uncomplicated disease course (24) mostly presented to the emergency department (ED) with fever and/or respiratory symptoms without significant alterations in laboratory findings. Of the 15 children with a complicated course, 12 developed shock. In addition to fever, they frequently presented altered appearance, extreme tachycardia, abdominal pain, vomiting, diarrhea, rash, and/or conjunctival hyperemia. They also showed greater lymphopenia (p = 0.001), elevated neutrophil/lymphocyte ratio (p = 0.001), C-reactive protein (p < 0.001), procalcitonin (p = 0.001), D-dimer (p < 0.001), and ferritin (p < 0.001). CONCLUSIONS SARS-CoV-2 infection in admitted children presents with great clinical variability. When provided supportive care, patients with predominant respiratory symptoms without altered laboratory-test results generally have an uncomplicated course. Patients with complicated disease present mainly with fever and abdominal and/or mucocutaneous symptoms. Most develop shock. Elevation of inflammatory markers may allow for early detection and the final outcome is good.
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Affiliation(s)
| | - Inés Leoz-Gordillo
- Unidad de Cuidados Intensivos. Hospital Infantil Universitario Niño Jesús, Madrid, España
| | - David Andina
- Servicio de Urgencias. Hospital Infantil Universitario Niño Jesús, Madrid, España
| | - Patricia Flores
- Servicio de Pediatría. Hospital Infantil Universitario Niño Jesús, Madrid, España
| | - Enrique Villalobos
- Servicio de Pediatría. Hospital Infantil Universitario Niño Jesús, Madrid, España
| | | | - Raquel Jiménez
- Servicio de Pediatría. Hospital Infantil Universitario Niño Jesús, Madrid, España
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Storch-de-Gracia P, Leoz-Gordillo I, Andina D, Flores P, Villalobos E, Escalada-Pellitero S, Jiménez R. Clinical spectrum and risk factors for complicated disease course in children admitted with SARS-CoV-2 infection. An Pediatr (Barc) 2020; 93:323-333. [PMID: 33083499 PMCID: PMC7561329 DOI: 10.1016/j.anpede.2020.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Accepted: 07/29/2020] [Indexed: 01/08/2023] Open
Abstract
INTRODUCTION At this time there are still major questions about the characteristics of disease caused by the new coronavirus (COVID-19) in children as well as factors associated with the development of severe forms of the disease. STUDY DESIGN Retrospective study including patients under 18 years of age admitted with SARS-CoV-2 infection from March 1 to April 30, 2020. Infection was confirmed by real-time reverse transcriptase polymerase chain reaction (RT-PCR) or antibody testing. We describe the epidemiological and clinical data, laboratory and imaging findings, as well as treatment and outcome in these patients. In light of these findings, patients were classified into two severity groups and then compared. RESULTS Thirty-nine children were included, with a median age of 9 years (range 12 days-16 years); 23 were boys. Cases with uncomplicated disease course (24) mostly presented to the emergency department (ED) with fever and/or respiratory symptoms without significant alterations in laboratory findings. Of the 15 children with a complicated course, 12 developed shock. In addition to fever, they frequently presented altered appearance, extreme tachycardia, abdominal pain, vomiting, diarrhea, rash, and/or conjunctival hyperemia. They also showed greater lymphopenia (p = 0.001), elevated neutrophil/lymphocyte ratio (p = 0.001), C-reactive protein (p < 0.001), procalcitonin (p = 0.001), D-dimer (p < 0.001), and ferritin (p < 0.001). CONCLUSIONS SARS-CoV-2 infection in admitted children presents with great clinical variability. When provided supportive care, patients with predominant respiratory symptoms without altered laboratory-test results generally have an uncomplicated course. Patients with complicated disease present mainly with fever and abdominal and/or mucocutaneous symptoms. Most develop shock. Elevation of inflammatory markers may allow for early detection and the final outcome is good.
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Affiliation(s)
| | - Inés Leoz-Gordillo
- Unidad de Cuidados Intensivos, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - David Andina
- Servicio de Urgencias, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Patricia Flores
- Servicio de Pediatría, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | - Enrique Villalobos
- Servicio de Pediatría, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
| | | | - Raquel Jiménez
- Servicio de Pediatría, Hospital Infantil Universitario Niño Jesús, Madrid, Spain
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95
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Avcilar H, Eken A. Could imiquimod (Aldara 5% cream) or other TLR7 agonists be used in the treatment of COVID-19? Med Hypotheses 2020; 144:110202. [PMID: 33254510 PMCID: PMC7434307 DOI: 10.1016/j.mehy.2020.110202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 08/17/2020] [Indexed: 01/05/2023]
Abstract
Toll-like receptor 7 is critical in recognition of single strand RNA viruses, including SARS CoV-2, and generation of anti-viral immunity. Coronaviruses evolved strategies to dampen the host immunity. Herein, we discuss the potential use of TLR7 agonists in the early stages of COVID-19 treatment.
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Affiliation(s)
- Huseyin Avcilar
- Erciyes University, Immunology Department, Faculty of Medicine, Kayseri, Turkey.
| | - Ahmet Eken
- Betul-Ziya Eren Genome and Stem Cell Center, Kayseri, Turkey; Erciyes University, Medical Biology Department, Faculty of Medicine, Kayseri, Turkey.
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96
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Al Helali AA, Saeed GA, Elholiby TI, Kukkady MA, Mazrouei SSA. Radiological and clinical improvement in a patient with COVID-19 pneumonia postconvalescent plasma transfusion: A case report. Radiol Case Rep 2020; 15:2171-2174. [PMID: 32901209 PMCID: PMC7471760 DOI: 10.1016/j.radcr.2020.07.031] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 07/11/2020] [Accepted: 07/12/2020] [Indexed: 12/15/2022] Open
Abstract
Currently, there are no approved specific antiviral agents for novel coronavirus disease 2019 (COVID-19). Convalescent plasma has not yet been approved for use in patients with COVID-19 infection; however, it is regulated as an investigational product. This is a case report of a 55-year-old male, with COVID-19 pneumonia who has received convalescent plasma as part of a treatment plan which showed significant radiological and clinical improvement post-treatment.
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Key Words
- ACR, American College of Radiology
- AJR, American Journal of Roentgenology
- CECT, COVID-19, coronavirus disease 2019
- COVID-19
- CRP, C-reactive protein
- CT, computed tomography
- CXR, chest x-ray
- Convalescent plasma transfusion
- Crazy paving appearance
- ED, emergency department
- Groung-glass opacities
- HRCT, high-resolution computed tomography
- ICU, intensive care unit
- NC, nasal cannula
- RT-PCR
- RT-PCR, Reverse transcription polymerase chain reaction
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97
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Czech M, Balcerzak M, Antczak A, Byliniak M, Piotrowska-Rutkowska E, Drozd M, Juszczyk G, Religioni U, Vaillancourt R, Merks P. Flu Vaccinations in Pharmacies-A Review of Pharmacists Fighting Pandemics and Infectious Diseases. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E7945. [PMID: 33138198 PMCID: PMC7662566 DOI: 10.3390/ijerph17217945] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 10/22/2020] [Accepted: 10/27/2020] [Indexed: 12/23/2022]
Abstract
The phenomenon of population ageing observed over recent years involves growing healthcare needs and the limited staffing and financing of healthcare systems, and as such demands some functional changes in the healthcare model in many countries. This situation is particularly significant in the face of a pandemic, e.g., flu, and currently COVID-19.As well as social education, preventive vaccinations are the most effective method of fighting the infectious diseases posing a special threat to seniors. Despite this, the vaccination coverage level in most European countries is relatively low. This is largely due to patients having limited access to vaccinations. In some countries, implementing vaccinations in pharmacies and by authorized pharmacists has significantly improved vaccination coverage rates and herd immunity, while lowering the cost of treating infections and the resulting complications, as well as minimizing the phenomenon of inappropriate antibiotic therapies. This article presents the role of pharmacists in the prevention of infectious diseases, pointing out the measurable effects of engaging pharmacists in conducting preventive vaccinations, as well as analyzing the models of implementing and conducting vaccinations in pharmacies in selected countries, and depicting recommendations regarding vaccinations developed by international organizations. The presented data is used to suggest requirements for the implementation of preventive vaccinations in community pharmacies.
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Affiliation(s)
- Marcin Czech
- Department of Pharmacoeconomics, Institute of Mother and Child, 01-211 Warsaw, Poland;
| | | | - Adam Antczak
- Polish Flu Vaccination Coalition, 00-061 Warsaw, Poland;
| | - Michał Byliniak
- Polish Pharmaceutical Chamber, 00-238 Warsaw, Polska; (M.B.); (E.P.-R.)
| | | | - Mariola Drozd
- Didactic Center, Department of Ethics and Medical Law, Department of Social Medicine, Inter-Faculty, Medical University of Lublin, 20-081 Lublin, Poland;
| | - Grzegorz Juszczyk
- Department of Public Health, Medical University of Warsaw, 02-097 Warsaw, Poland;
- National Institute of Public Health—National Institute of Hygiene, 00-791 Warsaw, Poland
| | - Urszula Religioni
- Collegium of Business Administration, Warsaw School of Economics, 02-513 Warsaw, Poland;
| | - Regis Vaillancourt
- Pharmacie Children’s Hospital of Eastern Ontario, Centre Hospitalier Pour Enfants de l’est de l’Ontario, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada;
| | - Piotr Merks
- Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszyński University, 01-815 Warsaw, Poland
- Department of Pharmaceutical Technology, Faculty of Pharmacy, Collegium Medicum in Bydgoszcz, 85-067 Bydgoszcz, Poland
- Trade Union of Pharmacy Workers, 01-315 Warsaw, Poland
- Employed Pharmacist in Europe (EPhEU) Verband Angestellter Apotheker Österreichs (VAAÖ) Berufliche Interessenvertretung Spitalgasse 31/4, 1090 Vienna, Austria
- Polish Pharmaceutical Group, 91-342 Łódź, Poland
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98
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Therapeutic modalities and novel approaches in regenerative medicine for COVID-19. Int J Antimicrob Agents 2020; 56:106208. [PMID: 33213829 PMCID: PMC7582055 DOI: 10.1016/j.ijantimicag.2020.106208] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 09/25/2020] [Accepted: 10/17/2020] [Indexed: 02/08/2023]
Abstract
The recent coronavirus disease 2019 outbreak around the world has had an enormous impact on the global health burden, threatening the lives of many individuals, and has had severe socio-economic consequences. Many pharmaceutical and biotechnology companies have commenced intensive research on different therapeutic strategies, from repurposed antiviral drugs to vaccines and monoclonal antibodies to prevent the spread of the disease and treat infected patients. Among the various strategies, advanced therapeutic approaches including cell- and gene-editing-based therapeutics are also being investigated, and initial results in in-vitro and early phase I studies have been promising. However, further assessments are required. This article reviews the underlying mechanisms for the pathogenesis of severe acute respiratory syndrome coronavirus-2, and discusses available therapeutic candidates and advanced modalities that are being evaluated in in-vitro/in-vivo models and are of note in clinical trials.
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99
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De Angelis G, Posteraro B, Biscetti F, Ianiro G, Zileri Dal Verme L, Cattani P, Franceschi F, Sanguinetti M, Gasbarrini A. Confirmed or unconfirmed cases of 2019 novel coronavirus pneumonia in Italian patients: a retrospective analysis of clinical features. BMC Infect Dis 2020; 20:775. [PMID: 33076874 PMCID: PMC7570420 DOI: 10.1186/s12879-020-05504-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Accepted: 10/12/2020] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Since December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged as a novel etiologic agent of viral pneumonia. We aimed to compare clinical features of 165 Italian patients with laboratory confirmed or unconfirmed 2019-nCoV pneumonia. METHODS On March 31, 2020, hospitalized patients who presented with fever and/or respiratory symptoms, exposures, and presence of lung imaging features consistent with 2019-nCoV pneumonia were included. Before admission to a hospital ward, patients underwent RT-PCR based SARS-CoV-2 RNA detection in their nasopharyngeal swab samples. RESULTS Of 165 patients studied, 119 had positive RT-PCR results and 46 were RT-PCR negative for 2 days or longer (i.e., when the last swab sample was obtained). The median age was 70 years (IQR, 58-78), and 123 (74.6%) of 165 patients had at least one comorbidity. The majority of patients (101/165, 61.2%) had a mild pneumonia, and the remaining patients (64/165, 38.8%) a severe/critical pneumonia. We did not find any substantial difference in symptoms, incubation periods, and radiographic/CT abnormalities as well as in many of the biological abnormalities recorded. However, at multivariable analysis, higher concentrations of hemoglobin (OR, 1.34; 95% CI, 1.11-1.65; P = 0.003) and lower counts of leukocytes (OR, 0.81; 95% CI, 0.72-0.90; P < 0.001) were statistically associated with confirmed COVID-19 diagnosis. While mortality rates were similar, patients with confirmed diagnosis were more likely to receive antivirals (95% vs 19.6%, P < 0.001) and to develop ARDS (63% vs 37%, P = 0.003) than those with unconfirmed COVID-19 diagnosis. CONCLUSIONS Our findings suggest that unconfirmed 2019-nCoV pneumonia cases may be actually COVID-19 cases and that clinicians should be cautious when managing patients with presentations compatible with COVID-19.
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Affiliation(s)
- Giulia De Angelis
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy.,Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Brunella Posteraro
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy.,Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Federico Biscetti
- Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Gianluca Ianiro
- Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Lorenzo Zileri Dal Verme
- Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Paola Cattani
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy.,Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy
| | - Francesco Franceschi
- Dipartimento di Scienze dell'Emergenza, Anestesiologiche e della Rianimazione, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
| | - Maurizio Sanguinetti
- Dipartimento di Scienze Biotecnologiche di Base, Cliniche Intensivologiche e Perioperatorie, Università Cattolica del Sacro Cuore, Rome, Italy. .,Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo A. Gemelli 8, 00168, Rome, Italy.
| | - Antonio Gasbarrini
- Dipartimento di Scienze Mediche e Chirurgiche, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy
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100
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Flesia L, Monaro M, Mazza C, Fietta V, Colicino E, Segatto B, Roma P. Predicting Perceived Stress Related to the Covid-19 Outbreak through Stable Psychological Traits and Machine Learning Models. J Clin Med 2020; 9:E3350. [PMID: 33086558 PMCID: PMC7603217 DOI: 10.3390/jcm9103350] [Citation(s) in RCA: 125] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Revised: 10/11/2020] [Accepted: 10/14/2020] [Indexed: 12/23/2022] Open
Abstract
The global SARS-CoV-2 outbreak and subsequent lockdown had a significant impact on people's daily lives, with strong implications for stress levels due to the threat of contagion and restrictions to freedom. Given the link between high stress levels and adverse physical and mental consequences, the COVID-19 pandemic is certainly a global public health issue. In the present study, we assessed the effect of the pandemic on stress levels in N = 2053 Italian adults, and characterized more vulnerable individuals on the basis of sociodemographic features and stable psychological traits. A set of 18 psycho-social variables, generalized regressions, and predictive machine learning approaches were leveraged. We identified higher levels of perceived stress in the study sample relative to Italian normative values. Higher levels of distress were found in women, participants with lower income, and participants living with others. Higher rates of emotional stability and self-control, as well as a positive coping style and internal locus of control, emerged as protective factors. Predictive learning models identified participants with high perceived stress, with a sensitivity greater than 76%. The results suggest a characterization of people who are more vulnerable to experiencing high levels of stress during the COVID-19 pandemic. This characterization may contribute to early and targeted intervention strategies.
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Affiliation(s)
- Luca Flesia
- Associazione Novilunio Onlus, 35020 Ponte San Nicolò (PD), Italy;
| | - Merylin Monaro
- Department of General Psychology, University of Padua, 35131 Padua, Italy;
| | - Cristina Mazza
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (C.M.); (P.R.)
| | - Valentina Fietta
- Department of General Psychology, University of Padua, 35131 Padua, Italy;
| | - Elena Colicino
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Barbara Segatto
- Department of Political Science, Law, and International Studies, University of Padua, 35123 Padua, Italy;
| | - Paolo Roma
- Department of Human Neuroscience, Sapienza University of Rome, 00185 Rome, Italy; (C.M.); (P.R.)
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