251
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Hamed MA. An overview on COVID-19: reality and expectation. BULLETIN OF THE NATIONAL RESEARCH CENTRE 2020; 44:86. [PMID: 32514228 PMCID: PMC7266424 DOI: 10.1186/s42269-020-00341-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Accepted: 05/20/2020] [Indexed: 05/08/2023]
Abstract
Recently, severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), commonly known as coronavirus disease-2019 (COVID-19) has rapidly spread across China and around the world. By the declaration of WHO, COVID-19 outbreak considered as a public health problem of international concern. The aim of this study is to provide a comprehensive view on COVID-19 and the future expectations to control virus progression. Patients with liver disease, diabetes, high blood pressure, and obesity are more susceptible to the incidence of COVID-19 infection. So, there is a rapid need for disease diagnosis, vaccine development, and drug discovery to detect, prevent, and treat this sudden and lethal virus. Real-time polymerase chain reaction (RT-PCR) is considered as a rapid, accurate, and specific tool for disease diagnosis. Under this emergency situation that the world facing against COVID-19, there are about 15 potential vaccine candidates tested globally based on messenger RNA, DNA-based, nanoparticle, synthetic, and modified virus-like particle. Certain drugs that are clinically approved for other diseases were tested against COVID-19 as chloroquine, hydroxychloroquine, ivermectin, favipiravir, ribavirin, and remdesivir. Convalescent plasma transfusion and traditional herbal medicine were also taken into consideration. Due to the absence of effective treatment or vaccines against COVID-19 so far, the precautionary measures according to WHO's strategic objectives are the only way to confront this crisis. Governments should adopt national medical care programs to reduce the risk of exposure to any future viral outbreaks especially to patients with pre-existing medical conditions.
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Affiliation(s)
- Manal A. Hamed
- Department of Therapeutic Chemistry, National Research Centre, El-Buhouth St., Dokki, Giza, Egypt
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252
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Yamaya M, Nishimura H, Deng X, Kikuchi A, Nagatomi R. Protease Inhibitors: Candidate Drugs to Inhibit Severe Acute Respiratory Syndrome Coronavirus 2 Replication. TOHOKU J EXP MED 2020; 251:27-30. [PMID: 32448818 DOI: 10.1620/tjem.251.27] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
The number of patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly increased, although the WHO declared a pandemic. However, drugs that function against SARS-CoV-2 have not been established. SARS-CoV-2 has been suggested to bind angiotensin-converting enzyme 2, the receptor of the SARS coronavirus. SARS coronavirus and coronavirus 229E, the cause of the common cold, replicate through cell-surface and endosomal pathways using a protease, the type II transmembrane protease. To examine the effects of protease inhibitors on the replication of coronavirus 229E, we pretreated primary cultures of human nasal epithelial (HNE) cells with camostat or nafamostat, each of which has been used for the treatment of pancreatitis and/or disseminated intravascular coagulation. HNE cells were then infected with coronavirus 229E, and viral titers in the airway surface liquid of the cells were examined. Pretreatment with camostat (0.1-10 μg/mL) or nafamostat (0.01-1 μg/mL) reduced the titers of coronavirus 229E. Furthermore, a significant amount of type II transmembrane protease protein was detected in the airway surface liquid of HNE cells. Additionally, interferons have been reported to have antiviral effects against SARS coronavirus. The additive effects of interferons on the inhibitory effects of other candidate drugs to treat SARS-CoV-2 infection, such as lopinavir, ritonavir and favipiravir, have also been studied. These findings suggest that protease inhibitors of this type may inhibit coronavirus 229E replication in human airway epithelial cells at clinical concentrations. Protease inhibitors, interferons or the combination of these drugs may become candidate drugs to inhibit the replication of SARS-CoV-2.
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Affiliation(s)
- Mutsuo Yamaya
- Department of Advanced Preventive Medicine for Infectious Disease, Tohoku University Graduate School of Medicine.,Department of Respiratory Medicine, Tohoku University Graduate School of Medicine.,Virus Research Center, Clinical Research Division, Sendai Medical Center
| | - Hidekazu Nishimura
- Virus Research Center, Clinical Research Division, Sendai Medical Center
| | - Xue Deng
- Department of Advanced Preventive Medicine for Infectious Disease, Tohoku University Graduate School of Medicine.,Department of Kampo and Integrative Medicine, Tohoku University Graduate School of Medicine
| | - Akiko Kikuchi
- Department of Kampo and Integrative Medicine, Tohoku University Graduate School of Medicine
| | - Ryoichi Nagatomi
- Laboratory of Health and Sports Science, Division of Biomedical Engineering for Health and Welfare, Tohoku University Graduate School of Biomedical Engineering
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253
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A Review of Potential Antiviral Drugs and Vaccines to Treat COVID-19. JOURNAL OF PURE AND APPLIED MICROBIOLOGY 2020. [DOI: 10.22207/jpam.14.spl1.14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Coronavirus disease 19 (COVID-19) is a challenge to the whole humanity. COVID-19 was first reported in China and rigorous researches are going on for developing vaccine for the pandemic. This review was prepared by following PRISMA guidelines and used the resources from the Web of Science and PubMed. This research focuses on the niches of symptoms and vaccines for COVID-19. The research for vaccine involves research for new vaccine and drug repurposing. Out of various drug repurposing options, Remdesivir, and Favipiravir, Chloroquine and Lopinavir/Ritonavir were found to be the popular ones for treating COVID-19 patients across the world. Even though there are concerns regarding asymptotic patients, the most dominant symptoms of COVID-19 are fever and cough, followed by Dyspnoea and muscle ache. This review concludes that the COVID-19 related research should focus on developing immunity vaccines, and repurposing of drugs. Research on the problems of quarantine life, patient monitoring, and usage of information technology in facing COVID-19 will improve the quality of patient handling during the pandemic. The research on the effectiveness of various models of lockdown and regulation of social life during lockdown periods, improving the safety of health care workers in the workplace will definitely help the governments in their fight against COVID-19.
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254
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Abstract
SARS-CoV-2 (COVID-19) has today multiplied globally and various governments are attempting to stop the outbreak of the disease escalation into a worldwide health crisis. At this juncture, readiness, candor, clarity, and partaking of data are of paramount importance to speed up factual evaluation and starting pattern control activities, including serendipitous findings. Owing to the involvement of COVID-19, many facts regarding virulence, pathogenesis, and the real viral infection source and/or transmission mode still need to be addressed. The infected patients often present clinical symptoms with fever, dyspnea, fatigue, diarrhea, vomiting, and dry cough, as well as pulmonary, infiltrates on imaging. Extensive measures to decrease person-to-person transmission of COVID-19 are being implemented to prevent, recognize, and control the current outbreak as it is very similar to SARS-CoV in its clinical spectrum, epidemiology, and pathogenicity. In response to this fatal disease and disruptive outbreak, it is extremely vital to expedite the drug development process to treat the disease and vaccines for the prevention of COVID-19 that would help us defeat this pandemic expeditiously. This paper sums up and unifies the study of virological aspects, disease transmission, clinically administered techniques, therapeutics options, managements, future directions, designing of vaccines, and news dissemination pertaining to COVID-19.
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255
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Abstract
Novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) lies behind the ongoing outbreak of coronavirus disease 2019 (COVID-19). There is a growing understanding of SARS-CoV-2 in virology, epidemiology, and clinical management strategies. However, no anti-SARS-CoV-2 drug or vaccine has been officially approved due to the absence of adequate evidence. Scientists are racing to develop a treatment for COVID-19. Recent studies have revealed many attractive therapeutic options, even if some of them remain to be further confirmed in rigorous preclinical models and clinical trials. In this minireview, we aim to summarize the updated potential approaches against SARS-CoV-2. We emphasize that further efforts are warranted to develop the safest and most effective approach.
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Affiliation(s)
- Haiou Li
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, China
- Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China
| | - Yunjiao Zhou
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, China
- Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China
| | - Meng Zhang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, China
- Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China
| | - Haizhou Wang
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, China
- Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China
| | - Qiu Zhao
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, China
- Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China
| | - Jing Liu
- Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Wuhan, China
- Hubei Clinical Center & Key Lab of Intestinal & Colorectal Diseases, Wuhan, China
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256
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Altmann DM, Douek DC, Boyton RJ. What policy makers need to know about COVID-19 protective immunity. Lancet 2020; 395:1527-1529. [PMID: 32353328 PMCID: PMC7185915 DOI: 10.1016/s0140-6736(20)30985-5] [Citation(s) in RCA: 143] [Impact Index Per Article: 35.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 04/23/2020] [Indexed: 01/05/2023]
Affiliation(s)
- Daniel M Altmann
- Department of Immunology and Inflammation, Faculty of Medicine, Hammersmith Hospital, Imperial College London, London W12 0NN, UK.
| | - Daniel C Douek
- Vaccine Research Center, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD, USA
| | - Rosemary J Boyton
- Department of Infectious Diseases, Faculty of Medicine, Hammersmith Hospital, Imperial College London, London W12 0NN, UK; Lung Division, Royal Brompton & Harefield NHS Foundation Trust, London, UK
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257
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Yousefi B, Valizadeh S, Ghaffari H, Vahedi A, Karbalaei M, Eslami M. A global treatments for coronaviruses including COVID-19. J Cell Physiol 2020; 235:9133-9142. [PMID: 32394467 PMCID: PMC7273044 DOI: 10.1002/jcp.29785] [Citation(s) in RCA: 66] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Accepted: 05/03/2020] [Indexed: 02/06/2023]
Abstract
In late December 2019 in Wuhan, China, several patients with viral pneumonia were identified as 2019 novel coronavirus (2019‐nCoV). So far, there are no specific treatments for patients with coronavirus disease‐19 (COVID‐19), and the treatments available today are based on previous experience with similar viruses such as severe acute respiratory syndrome‐related coronavirus (SARS‐CoV), Middle East respiratory syndrome coronavirus (MERS‐CoV), and Influenza virus. In this article, we have tried to reach a therapeutic window of drugs available to patients with COVID‐19. Cathepsin L is required for entry of the 2019‐nCoV virus into the cell as target teicoplanin inhibits virus replication. Angiotensin‐converting‐enzyme 2 (ACE2) in soluble form as a recombinant protein can prevent the spread of coronavirus by restricting binding and entry. In patients with COVID‐19, hydroxychloroquine decreases the inflammatory response and cytokine storm, but overdose causes toxicity and mortality. Neuraminidase inhibitors such as oseltamivir, peramivir, and zanamivir are invalid for 2019‐nCoV and are not recommended for treatment but protease inhibitors such as lopinavir/ritonavir (LPV/r) inhibit the progression of MERS‐CoV disease and can be useful for patients of COVID‐19 and, in combination with Arbidol, has a direct antiviral effect on early replication of SARS‐CoV. Ribavirin reduces hemoglobin concentrations in respiratory patients, and remdesivir improves respiratory symptoms. Use of ribavirin in combination with LPV/r in patients with SARS‐CoV reduces acute respiratory distress syndrome and mortality, which has a significant protective effect with the addition of corticosteroids. Favipiravir increases clinical recovery and reduces respiratory problems and has a stronger antiviral effect than LPV/r. currently, appropriate treatment for patients with COVID‐19 is an ACE2 inhibitor and a clinical problem reducing agent such as favipiravir in addition to hydroxychloroquine and corticosteroids.
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Affiliation(s)
- Bahman Yousefi
- Department of Immunology, Semnan University of Medical Sciences, Semnan, Iran
| | - Saeid Valizadeh
- Department of Bacteriology and Virology, Semnan University of Medical Sciences, Semnan, Iran
| | - Hadi Ghaffari
- Department of Bacteriology and Virology, Semnan University of Medical Sciences, Semnan, Iran
| | - Azadeh Vahedi
- Department of Bacteriology and Virology, Semnan University of Medical Sciences, Semnan, Iran
| | - Mohsen Karbalaei
- Department of Microbiology and Virology, School of Medicine, Jiroft University of Medical Sciences, Jiroft, Iran
| | - Majid Eslami
- Department of Bacteriology and Virology, Semnan University of Medical Sciences, Semnan, Iran.,Cancer Research Center, Semnan University of Medical Sciences, Semnan, Iran
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258
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Encinar JA, Menendez JA. Potential Drugs Targeting Early Innate Immune Evasion of SARS-Coronavirus 2 via 2'-O-Methylation of Viral RNA. Viruses 2020; 12:E525. [PMID: 32397643 PMCID: PMC7291090 DOI: 10.3390/v12050525] [Citation(s) in RCA: 70] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 05/05/2020] [Accepted: 05/08/2020] [Indexed: 02/06/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causing the COVID-19 respiratory disease pandemic utilizes unique 2'-O-methyltransferase (2'-O-MTase) capping machinery to camouflage its RNA from innate immune recognition. The nsp16 catalytic subunit of the 2'-O-MTase is unusual in its requirement for a stimulatory subunit (nsp10) to catalyze the ribose 2'-O-methylation of the viral RNA cap. Here we provide a computational basis for drug repositioning or de novo drug development based on three differential traits of the intermolecular interactions of the SARS-CoV-2-specific nsp16/nsp10 heterodimer, namely: (1) the S-adenosyl-l-methionine-binding pocket of nsp16, (2) the unique "activating surface" between nsp16 and nsp10, and (3) the RNA-binding groove of nsp16. We employed ≈9000 U.S. Food and Drug Administration (FDA)-approved investigational and experimental drugs from the DrugBank repository for docking virtual screening. After molecular dynamics calculations of the stability of the binding modes of high-scoring nsp16/nsp10-drug complexes, we considered their pharmacological overlapping with functional modules of the virus-host interactome that is relevant to the viral lifecycle, and to the clinical features of COVID-19. Some of the predicted drugs (e.g., tegobuvir, sonidegib, siramesine, antrafenine, bemcentinib, itacitinib, or phthalocyanine) might be suitable for repurposing to pharmacologically reactivate innate immune restriction and antagonism of SARS-CoV-2 RNAs lacking 2'-O-methylation.
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Affiliation(s)
- José Antonio Encinar
- Institute of Research, Development and Innovation in Biotechnology of Elche (IDiBE) and Molecular and Cell Biology Institute (IBMC), Miguel Hernández University (UMH), 03202 Alicante, Spain
| | - Javier A. Menendez
- Program Against Cancer Therapeutic Resistance (ProCURE), Metabolism and Cancer Group, Catalan Institute of Oncology, 17005 Girona, Spain
- Girona Biomedical Research Institute, 17007 Girona, Spain
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259
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Roy NBA, Telfer P, Eleftheriou P, de la Fuente J, Drasar E, Shah F, Roberts D, Atoyebi W, Trompeter S, Layton DM, Lugthart S, Stuart-Smith S, Chakravorty S, Wright J, Porter J, Inusa B, Howard J. Protecting vulnerable patients with inherited anaemias from unnecessary death during the COVID-19 pandemic. Br J Haematol 2020; 189:635-639. [PMID: 32330288 PMCID: PMC7264776 DOI: 10.1111/bjh.16687] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 04/03/2020] [Indexed: 01/03/2023]
Abstract
With the developing COVID‐19 pandemic, patients with inherited anaemias require specific advice regarding isolation and changes to usual treatment schedules. The National Haemoglobinopathy Panel (NHP) has issued guidance on the care of patients with sickle cell disease, thalassaemia, Diamond Blackfan anaemia (DBA), congenital dyserythropoietic anaemia (CDA), sideroblastic anaemia, pyruvate kinase deficiency and other red cell enzyme and membrane disorders. Cascading of accurate information for clinicians and patients is paramount to preventing adverse outcomes, such as patients who are at increased risk of fulminant bacterial infection due to their condition or its treatment erroneously self‐isolating if their fever is mistakenly attributed to a viral cause, delaying potentially life‐saving antibiotic therapy. Outpatient visits should be minimised for most patients, however some, such as first transcranial dopplers for children with sickle cell anaemia should not be delayed as known risk of stroke will outweigh the unknown risk from COVID‐19 infection. Blood transfusion programmes should be continued, but specific changes to usual clinical pathways can be instituted to reduce risk of patient exposure to COVID‐19, as well as contingency planning for possible reductions in blood available for transfusions. Bone marrow transplants for these disorders should be postponed until further notice. With the current lack of evidence on the risk and complications of COVID‐19 infection in these patients, national data collection is ongoing to record outcomes and eventually to identify predictors of disease severity, particularly important if further waves of infection travel through the population.
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Affiliation(s)
- Noémi B A Roy
- John Radcliffe Hospital, Oxford, UK.,NIHR Biomedical Research Centre, Oxford, UK
| | | | | | - Josu de la Fuente
- Imperial College London, London, UK.,Imperial College Healthcare NHS Trust, London, UK
| | - Emma Drasar
- University College London Hospital, London, UK.,Whittigton Health NHS Trust, London, UK
| | - Farrukh Shah
- University College London Hospital, London, UK.,Whittigton Health NHS Trust, London, UK
| | | | | | - Sara Trompeter
- NHS Blood and Transplant, London, UK.,University College London Hospitals NHS Foundation Trust, London, UK
| | | | | | | | | | | | - John Porter
- University College London Hospital, London, UK
| | - Baba Inusa
- Guys and St Thomas's NHS Trust, London, UK
| | - Jo Howard
- Guys and St Thomas's NHS Trust, London, UK
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260
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Provenzani A, Polidori P. Covid-19 and drug therapy, what we learned. Int J Clin Pharm 2020; 42:833-836. [PMID: 32382873 PMCID: PMC7203261 DOI: 10.1007/s11096-020-01049-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 04/27/2020] [Indexed: 01/10/2023]
Abstract
COVID-19, the disease associated in December 2019 with the novel coronavirus SARS-CoV-2, was observed for the first time in China and then spread worldwide becoming pandemic. Currently, there is still no licensed specific antiviral treatment for the human coronavirus disease and a vaccine will not be ready soon. However, based on experience from the use of other antiviral agents to treat similar virusses, some treatment options have been tried with some efficacy. Clinical trials for future therapies are still ongoing. In the meantime, prevention, control, active communication and investment in research are the only ways to overcome this challenge.
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Affiliation(s)
- Alessio Provenzani
- Department of Clinical Pharmacy, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Via E. Tricomi n. 5, 90127, Palermo, Italy.
| | - Piera Polidori
- Department of Clinical Pharmacy, Mediterranean Institute for Transplantation and Advanced Specialized Therapies (ISMETT), Via E. Tricomi n. 5, 90127, Palermo, Italy
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261
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Kalita P, Padhi AK, Zhang KYJ, Tripathi T. Design of a peptide-based subunit vaccine against novel coronavirus SARS-CoV-2. Microb Pathog 2020; 145:104236. [PMID: 32376359 PMCID: PMC7196559 DOI: 10.1016/j.micpath.2020.104236] [Citation(s) in RCA: 139] [Impact Index Per Article: 34.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Revised: 04/21/2020] [Accepted: 04/27/2020] [Indexed: 12/15/2022]
Abstract
Coronavirus disease 2019 (COVID-19) is an emerging infectious disease that was first reported in Wuhan, China, and has subsequently spread worldwide. In the absence of any antiviral or immunomodulatory therapies, the disease is spreading at an alarming rate. A possibility of a resurgence of COVID-19 in places where lockdowns have already worked is also developing. Thus, for controlling COVID-19, vaccines may be a better option than drugs. An mRNA-based anti-COVID-19 candidate vaccine has entered a phase 1 clinical trial. However, its efficacy and potency have to be evaluated and validated. Since vaccines have high failure rates, as an alternative, we are presenting a new, designed multi-peptide subunit-based epitope vaccine against COVID-19. The recombinant vaccine construct comprises an adjuvant, cytotoxic T-lymphocyte (CTL), helper T-lymphocyte (HTL), and B-cell epitopes joined by linkers. The computational data suggest that the vaccine is non-toxic, non-allergenic, thermostable, with the capability to elicit a humoral and cell-mediated immune response. The stabilization of the vaccine construct is validated with molecular dynamics simulation studies. This unique vaccine is made up of 33 highly antigenic epitopes from three proteins that have a prominent role in host-receptor recognition, viral entry, and pathogenicity. We advocate this vaccine must be synthesized and tested urgently as a public health priority. The rapid increase of SARS-CoV-2 infections across the globe has triggered R&D on an effective vaccine. We present a multi-epitope subunit-based vaccine designed using an integrated immunoinformatics approach. Our vaccine is made up of 33 highly antigenic epitopes from three vital pathogen proteins. Computational data predict that the vaccine is non-toxic, non-allergenic, and immunogenic. An experimental evaluation of this vaccine is required to determine its practical immunogenic potency.
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Affiliation(s)
- Parismita Kalita
- Molecular and Structural Biophysics Laboratory, Department of Biochemistry, North-Eastern Hill University, Shillong, 793022, India; Molecular Biophysics Unit, Indian Institute of Science, Bangalore, 560012, India
| | - Aditya K Padhi
- Laboratory for Structural Bioinformatics, Center for Biosystems Dynamics Research, RIKEN, Yokohama, Kanagawa, 230-0045, Japan
| | - Kam Y J Zhang
- Laboratory for Structural Bioinformatics, Center for Biosystems Dynamics Research, RIKEN, Yokohama, Kanagawa, 230-0045, Japan
| | - Timir Tripathi
- Molecular and Structural Biophysics Laboratory, Department of Biochemistry, North-Eastern Hill University, Shillong, 793022, India.
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262
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Bein B, Bachmann M, Huggett S, Wegermann P. SARS-CoV-2/COVID-19: Evidence-Based Recommendations on Diagnosis and Therapy. Geburtshilfe Frauenheilkd 2020; 80:491-498. [PMID: 32435065 PMCID: PMC7234827 DOI: 10.1055/a-1156-3991] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
COVID-19, a new viral disease affecting primarily the respiratory system and the lung, has caused a pandemic posing serious challenges to healthcare systems around the world. In about 20% of patients, severe symptoms occur after a mean incubation period of 5 - 6 days; 5% of patients need intensive care therapy. Mortality is about 1 - 2%. Protecting healthcare workers is of paramount importance in order to prevent hospital-acquired infections. Therefore, during all procedures associated with aerosol production, personal protective equipment consisting of a FFP2/FFP3 (N95) respiratory mask, gloves, safety glasses and a waterproof overall should be used. Therapy is based on established recommendations issued for patients with acute lung injury (ARDS). Lung protective ventilation, prone position, restrictive fluid management and adequate management of organ failure are the mainstays of therapy. In case of fulminant lung failure, veno-venous extracorporeal membrane oxygenation may be used as a rescue in experienced centres. New, experimental therapies are evolving with ever increasing frequency; currently, however, no evidence-based recommendation is possible. If off-label and compassionate use of these drugs is considered, an individual benefit-risk assessment is necessary, since serious side effects have been reported.
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Affiliation(s)
- Berthold Bein
- Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und Schmerztherapie der Asklepios Klinik St. Georg, Hamburg, Germany
| | - Martin Bachmann
- Klinik für Intensivmedizin und Beatmungsmedizin, Asklepios Klinikum Harburg, Harburg, Germany
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263
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Theoharides TC. COVID-19, pulmonary mast cells, cytokine storms, and beneficial actions of luteolin. Biofactors 2020; 46:306-308. [PMID: 32339387 PMCID: PMC7267424 DOI: 10.1002/biof.1633] [Citation(s) in RCA: 91] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 04/07/2020] [Indexed: 01/08/2023]
Affiliation(s)
- Theoharis C. Theoharides
- Laboratory of Molecular Immunopharmacology and Drug Discovery, Department of ImmunologyTufts University School of MedicineBostonMA
- School of Graduate Biomedical SciencesTufts University School of MedicineBostonMassachusetts
- Department of Internal MedicineTufts University School of Medicine and Tufts Medical CenterBostonMassachusetts
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264
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Zhai P, Ding Y, Wu X, Long J, Zhong Y, Li Y. The epidemiology, diagnosis and treatment of COVID-19. Int J Antimicrob Agents 2020; 55:105955. [PMID: 32234468 PMCID: PMC7138178 DOI: 10.1016/j.ijantimicag.2020.105955] [Citation(s) in RCA: 492] [Impact Index Per Article: 123.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 03/16/2020] [Accepted: 03/19/2020] [Indexed: 02/08/2023]
Abstract
In December 2019, the outbreak of the novel coronavirus disease (COVID-19) in China spread worldwide, becoming an emergency of major international concern. SARS-CoV-2 infection causes clusters of severe respiratory illness similar to severe acute respiratory syndrome coronavirus. Human-to-human transmission via droplets, contaminated hands or surfaces has been described, with incubation times of 2-14 days. Early diagnosis, quarantine, and supportive treatments are essential to cure patients. This paper reviews the literature on all available information about the epidemiology, diagnosis, isolation and treatments of COVID-19. Treatments, including antiviral agents, chloroquine and hydroxychloroquine, corticosteroids, antibodies, convalescent plasma transfusion and vaccines, are discussed in this article. In addition, registered trials investigating treatment options for COVID-19 infection are listed.
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Affiliation(s)
- Pan Zhai
- Department of Neurology, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, 430073, Hubei, China
| | - Yanbing Ding
- Department of Neurology, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, 430073, Hubei, China
| | - Xia Wu
- Department of Respiratory Medicine, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, 430073, Hubei, China
| | - Junke Long
- Department of Cardiovascular Medicine, The Second Xiangya Hospital, Central South University, Changsha, Hunan, 410011, China
| | - Yanjun Zhong
- ICU Center, The Second Xiangya Hospital, Central South University, Furong, Changsha, Hunan, 41001, China
| | - Yiming Li
- Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, China.
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265
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van Rensburg R, Pillay-Fuentes Lorente V, Decloedt EH. Current evidence for directed and supportive investigational therapies against COVID-19. Afr J Thorac Crit Care Med 2020; 26:10.7196/AJTCCM.2020.v26i2.072. [PMID: 34235422 PMCID: PMC7221540 DOI: 10.7196/ajtccm.2020.v26i2.072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2020] [Indexed: 12/04/2022] Open
Abstract
Coronavirus disease 2019 (COVID-19) is a global health crisis. There is currently a great need for effective and safe therapies directed at the disease, but no drugs are presently registered for use in COVID-19. Several directed therapies have been proposed, and most are still in clinical trials. Currently available published, peer-reviewed results mostly involve small sample sizes with study limitations restricting the interpretation of the findings. Many trials currently published also do not have a control group, limiting the interpretation of the effect of the intervention. Investigational directed therapies as well as investigational supportive therapies against COVID-19 are reviewed here. Chloroquine and hydroxychloroquine show promise as directed therapies, but current trial results are conflicting. Lopinavir/ritonavir also shows potential, but was started late in the disease course in most trials. No randomised controlled evidence is currently available for remdesivir and favipiravir. Corticosteroid use is not recommended for directed therapy against COVID-19, and the role of tocilizumab is currently unclear, based on limited evidence. Early initiation of investigational directed therapies may provide benefit in selected patients. The results from larger randomised controlled trials will clarify the place of these therapies in COVID-19 treatment.
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Affiliation(s)
- R van Rensburg
- Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - V Pillay-Fuentes Lorente
- Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - E H Decloedt
- Division of Clinical Pharmacology, Department of Medicine, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
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266
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Alanagreh L, Alzoughool F, Atoum M. The Human Coronavirus Disease COVID-19: Its Origin, Characteristics, and Insights into Potential Drugs and Its Mechanisms. Pathogens 2020; 9:E331. [PMID: 32365466 PMCID: PMC7280997 DOI: 10.3390/pathogens9050331] [Citation(s) in RCA: 149] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 04/25/2020] [Accepted: 04/27/2020] [Indexed: 12/15/2022] Open
Abstract
The emerging coronavirus disease (COVID-19) swept across the world, affecting more than 200 countries and territories. Genomic analysis suggests that the COVID-19 virus originated in bats and transmitted to humans through unknown intermediate hosts in the Wuhan seafood market, China, in December of 2019. This virus belongs to the Betacoronavirus group, the same group of the 2003 severe acute respiratory syndrome coronavirus (SARS-CoV), and for the similarity, it was named SARS-CoV-2. Given the lack of registered clinical therapies or vaccines, many physicians and scientists are investigating previously used clinical drugs for COVID-19 treatment. In this review, we aim to provide an overview of the CoVs origin, pathogenicity, and genomic structure, with a focus on SARS-CoV-2. Besides, we summarize the recently investigated drugs that constitute an option for COVID-19 treatment.
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Affiliation(s)
- Lo’ai Alanagreh
- Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, The Hashemite University, Zarqa 13133, Jordan
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267
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Kumar S, Zhi K, Mukherji A, Gerth K. Repurposing Antiviral Protease Inhibitors Using Extracellular Vesicles for Potential Therapy of COVID-19. Viruses 2020; 12:E486. [PMID: 32357553 PMCID: PMC7290948 DOI: 10.3390/v12050486] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/16/2020] [Accepted: 04/24/2020] [Indexed: 12/17/2022] Open
Abstract
In January 2020, Chinese health agencies reported an outbreak of a novel coronavirus-2 (CoV-2) which can lead to severe acute respiratory syndrome (SARS). The virus, which belongs to the coronavirus family (SARS-CoV-2), was named coronavirus disease 2019 (COVID-19) and declared a pandemic by the World Health Organization (WHO). Full-length genome sequences of SARS-CoV-2 showed 79.6% sequence identity to SARS-CoV, with 96% identity to a bat coronavirus at the whole-genome level. COVID-19 has caused over 133,000 deaths and there are over 2 million total confirmed cases as of April 15th, 2020. Current treatment plans are still under investigation due to a lack of understanding of COVID-19. One potential mechanism to slow disease progression is the use of antiviral drugs to either block the entry of the virus or interfere with viral replication and maturation. Currently, antiviral drugs, including chloroquine/hydroxychloroquine, remdesivir, and lopinavir/ritonavir, have shown effective inhibition of SARS-CoV-2 in vitro. Due to the high dose needed and narrow therapeutic window, many patients are experiencing severe side effects with the above drugs. Hence, repurposing these drugs with a proper formulation is needed to improve the safety and efficacy for COVID-19 treatment. Extracellular vesicles (EVs) are a family of natural carriers in the human body. They play a critical role in cell-to-cell communications. EVs can be used as unique drug carriers to deliver protease inhibitors to treat COVID-19. EVs may provide targeted delivery of protease inhibitors, with fewer systemic side effects. More importantly, EVs are eligible for major aseptic processing and can be upscaled for mass production. Currently, the FDA is facilitating applications to treat COVID-19, which provides a very good chance to use EVs to contribute in this combat.
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Affiliation(s)
- Santosh Kumar
- Department of Pharmaceutical Sciences, University of Tennessee Health Science Center, 881 Madison Ave, Memphis, TN 38163, USA; (A.M.); (K.G.)
| | - Kaining Zhi
- Plough Center for Sterile Drug Delivery Solutions, University of Tennessee Health Science Center, 208 South Dudley Street, Memphis, TN 38163, USA;
| | - Ahona Mukherji
- Department of Pharmaceutical Sciences, University of Tennessee Health Science Center, 881 Madison Ave, Memphis, TN 38163, USA; (A.M.); (K.G.)
| | - Kelli Gerth
- Department of Pharmaceutical Sciences, University of Tennessee Health Science Center, 881 Madison Ave, Memphis, TN 38163, USA; (A.M.); (K.G.)
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268
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5-Fluorouracil in combination with deoxyribonucleosides and deoxyribose as possible therapeutic options for the Coronavirus, COVID-19 infection. Med Hypotheses 2020; 142:109754. [PMID: 32438240 PMCID: PMC7194918 DOI: 10.1016/j.mehy.2020.109754] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 04/21/2020] [Indexed: 12/11/2022]
Abstract
The recent global pandemic created by the Coronavirus SARS-CoV-2, started in Wuhan, China in December 2019, has generated panic, both in term of human death (4–5% of infected patients identified through testing) and the global economy. Human sufferings seem to be continuing, and it is not clear how long this will continue and how much more destruction it is going to cause until complete control is achieved. One of the most disturbing issues is Covid-19 treatment; although a large number of medications, previously used successfully with other viruses (including Chinese herbal medicines and anti-malaria drugs), are under consideration, there remain questions as to whether they can play a satisfactory role for this disease. Global attempts are ongoing to find the drugs for the treatment of this virus but none of the antiviral drugs used for treatment of other human viral infection is working and hence attempts to find new drugs are continuing. Here the author is proposing that 5-Fluorouracil (5-FU) which when used on its own is failing as an antiviral agent due to the removal of this compound by proof reading ability exceptionally found in Coronaviruses. The author here is proposing to test 5-FU in combination with a number of deoxynucleosides on animal models infected with this Covid-19. Should encouraging results ensue, therapies could then be tried on patients.
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269
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Asai A, Konno M, Ozaki M, Otsuka C, Vecchione A, Arai T, Kitagawa T, Ofusa K, Yabumoto M, Hirotsu T, Taniguchi M, Eguchi H, Doki Y, Ishii H. COVID-19 Drug Discovery Using Intensive Approaches. Int J Mol Sci 2020; 21:E2839. [PMID: 32325767 PMCID: PMC7215413 DOI: 10.3390/ijms21082839] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/09/2020] [Accepted: 04/14/2020] [Indexed: 12/20/2022] Open
Abstract
Since the infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was reported in China during December 2019, the coronavirus disease 2019 (COVID-19) has spread on a global scale, causing the World Health Organization (WHO) to issue a warning. While novel vaccines and drugs that target SARS-CoV-2 are under development, this review provides information on therapeutics which are under clinical trials or are proposed to antagonize SARS-CoV-2. Based on the information gained from the responses to other RNA coronaviruses, including the strains that cause severe acute respiratory syndrome (SARS)-coronaviruses and Middle East respiratory syndrome (MERS), drug repurposing might be a viable strategy. Since several antiviral therapies can inhibit viral replication cycles or relieve symptoms, mechanisms unique to RNA viruses will be important for the clinical development of antivirals against SARS-CoV-2. Given that several currently marketed drugs may be efficient therapeutic agents for severe COVID-19 cases, they may be beneficial for future viral pandemics and other infections caused by RNA viruses when standard treatments are unavailable.
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Affiliation(s)
- Ayumu Asai
- Center of Medical Innovation and Translational Research, Osaka University Graduate School of Medicine, Suita, Yamadaoka 2-2, Osaka 565-0871, Japan; (A.A.); (M.K.); (M.O.); (C.O.); (T.A.); (T.K.); (K.O.); (M.Y.); (T.H.); (H.E.); (Y.D.)
- Institute of Scientific and Industrial Research, Osaka University, 8-1 Mihogaoka, Ibaraki, Osaka 567-0047, Japan;
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan
- Artificial Intelligence Research Center, Institute of Scientific and Industrial Research, Osaka University, 8-1 Mihogaoka, Ibaraki, Osaka 567-0047, Japan
| | - Masamitsu Konno
- Center of Medical Innovation and Translational Research, Osaka University Graduate School of Medicine, Suita, Yamadaoka 2-2, Osaka 565-0871, Japan; (A.A.); (M.K.); (M.O.); (C.O.); (T.A.); (T.K.); (K.O.); (M.Y.); (T.H.); (H.E.); (Y.D.)
| | - Miyuki Ozaki
- Center of Medical Innovation and Translational Research, Osaka University Graduate School of Medicine, Suita, Yamadaoka 2-2, Osaka 565-0871, Japan; (A.A.); (M.K.); (M.O.); (C.O.); (T.A.); (T.K.); (K.O.); (M.Y.); (T.H.); (H.E.); (Y.D.)
| | - Chihiro Otsuka
- Center of Medical Innovation and Translational Research, Osaka University Graduate School of Medicine, Suita, Yamadaoka 2-2, Osaka 565-0871, Japan; (A.A.); (M.K.); (M.O.); (C.O.); (T.A.); (T.K.); (K.O.); (M.Y.); (T.H.); (H.E.); (Y.D.)
| | - Andrea Vecchione
- Department of Clinical and Molecular Medicine, University of Rome “Sapienza”, Santo Andrea Hospital, via di Grottarossa, 1035-00189 Rome, Italy;
| | - Takahiro Arai
- Center of Medical Innovation and Translational Research, Osaka University Graduate School of Medicine, Suita, Yamadaoka 2-2, Osaka 565-0871, Japan; (A.A.); (M.K.); (M.O.); (C.O.); (T.A.); (T.K.); (K.O.); (M.Y.); (T.H.); (H.E.); (Y.D.)
- Unitech Co., Ltd., Kashiwa 277-0005, Japan
| | - Toru Kitagawa
- Center of Medical Innovation and Translational Research, Osaka University Graduate School of Medicine, Suita, Yamadaoka 2-2, Osaka 565-0871, Japan; (A.A.); (M.K.); (M.O.); (C.O.); (T.A.); (T.K.); (K.O.); (M.Y.); (T.H.); (H.E.); (Y.D.)
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan
- Kyowa-kai Medical Corporation, Osaka 540-0008, Japan
| | - Ken Ofusa
- Center of Medical Innovation and Translational Research, Osaka University Graduate School of Medicine, Suita, Yamadaoka 2-2, Osaka 565-0871, Japan; (A.A.); (M.K.); (M.O.); (C.O.); (T.A.); (T.K.); (K.O.); (M.Y.); (T.H.); (H.E.); (Y.D.)
- Prophoenix Division, Food and Life-Science Laboratory, Idea Consultants, Inc., Osaka-City, Osaka 559-8519, Japan
| | - Masami Yabumoto
- Center of Medical Innovation and Translational Research, Osaka University Graduate School of Medicine, Suita, Yamadaoka 2-2, Osaka 565-0871, Japan; (A.A.); (M.K.); (M.O.); (C.O.); (T.A.); (T.K.); (K.O.); (M.Y.); (T.H.); (H.E.); (Y.D.)
- Kinshu-Kai Medical Corporation, Osaka 558-0041, Japan
| | - Takaaki Hirotsu
- Center of Medical Innovation and Translational Research, Osaka University Graduate School of Medicine, Suita, Yamadaoka 2-2, Osaka 565-0871, Japan; (A.A.); (M.K.); (M.O.); (C.O.); (T.A.); (T.K.); (K.O.); (M.Y.); (T.H.); (H.E.); (Y.D.)
- Hirotsu Bio Science Inc., Tokyo 107-0062, Japan
| | - Masateru Taniguchi
- Institute of Scientific and Industrial Research, Osaka University, 8-1 Mihogaoka, Ibaraki, Osaka 567-0047, Japan;
| | - Hidetoshi Eguchi
- Center of Medical Innovation and Translational Research, Osaka University Graduate School of Medicine, Suita, Yamadaoka 2-2, Osaka 565-0871, Japan; (A.A.); (M.K.); (M.O.); (C.O.); (T.A.); (T.K.); (K.O.); (M.Y.); (T.H.); (H.E.); (Y.D.)
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan
| | - Yuichiro Doki
- Center of Medical Innovation and Translational Research, Osaka University Graduate School of Medicine, Suita, Yamadaoka 2-2, Osaka 565-0871, Japan; (A.A.); (M.K.); (M.O.); (C.O.); (T.A.); (T.K.); (K.O.); (M.Y.); (T.H.); (H.E.); (Y.D.)
- Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita 565-0871, Japan
| | - Hideshi Ishii
- Center of Medical Innovation and Translational Research, Osaka University Graduate School of Medicine, Suita, Yamadaoka 2-2, Osaka 565-0871, Japan; (A.A.); (M.K.); (M.O.); (C.O.); (T.A.); (T.K.); (K.O.); (M.Y.); (T.H.); (H.E.); (Y.D.)
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270
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Calligari P, Bobone S, Ricci G, Bocedi A. Molecular Investigation of SARS-CoV-2 Proteins and Their Interactions with Antiviral Drugs. Viruses 2020; 12:v12040445. [PMID: 32295237 PMCID: PMC7232184 DOI: 10.3390/v12040445] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 03/27/2020] [Accepted: 04/13/2020] [Indexed: 12/12/2022] Open
Abstract
A new Coronavirus strain, named SARS-CoV-2, suddenly emerged in early December 2019. SARS-CoV-2 resulted in being dramatically infectious, with thousands of people infected. In this scenario, and without effective vaccines available, the importance of an immediate tool to support patients and against viral diffusion becomes evident. In this study, we exploit the molecular docking approach to analyze the affinity between different viral proteins and several inhibitors, originally developed for other viral infections. Our data show that, in some cases, a relevant binding can be detected. These findings support the hypothesis to develop new antiviral agents against COVID-19, on the basis of already established therapies.
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Affiliation(s)
| | | | | | - Alessio Bocedi
- Correspondence: ; Tel.: +39-067-259-4353; Fax: +39-067-259-4328
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271
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Guidon AC, Amato AA. COVID-19 and neuromuscular disorders. Neurology 2020; 94:959-969. [PMID: 32284362 DOI: 10.1212/wnl.0000000000009566] [Citation(s) in RCA: 201] [Impact Index Per Article: 50.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2020] [Accepted: 04/09/2020] [Indexed: 01/13/2023] Open
Abstract
The coronavirus 2019 (COVID-19) pandemic has potential to disproportionately and severely affect patients with neuromuscular disorders. In a short period of time, it has already caused reorganization of neuromuscular clinical care delivery and education, which will likely have lasting effects on the field. This article reviews (1) potential neuromuscular complications of COVID-19, (2) assessment and mitigation of COVID-19-related risk for patients with preexisting neuromuscular disease, (3) guidance for management of immunosuppressive and immunomodulatory therapies, (4) practical guidance regarding neuromuscular care delivery, telemedicine, and education, and (5) effect on neuromuscular research. We outline key unanswered clinical questions and highlight the need for team-based and interspecialty collaboration. Primary goals of clinical research during this time are to develop evidence-based best practices and to minimize morbidity and mortality related to COVID-19 for patients with neuromuscular disorders.
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Affiliation(s)
- Amanda C Guidon
- From the Division of Neuromuscular Medicine, Department of Neurology, Massachusetts General Hospital (A.C.G.), and Division of Neuromuscular Medicine, Department of Neurology, Brigham and Woman's Hospital (A.A.A.), Harvard Medical School, Boston, MA.
| | - Anthony A Amato
- From the Division of Neuromuscular Medicine, Department of Neurology, Massachusetts General Hospital (A.C.G.), and Division of Neuromuscular Medicine, Department of Neurology, Brigham and Woman's Hospital (A.A.A.), Harvard Medical School, Boston, MA.
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272
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Yip CCY, Ho CC, Chan JFW, To KKW, Chan HSY, Wong SCY, Leung KH, Fung AYF, Ng ACK, Zou Z, Tam AR, Chung TWH, Chan KH, Hung IFN, Cheng VCC, Tsang OTY, Tsui SKW, Yuen KY. Development of a Novel, Genome Subtraction-Derived, SARS-CoV-2-Specific COVID-19-nsp2 Real-Time RT-PCR Assay and Its Evaluation Using Clinical Specimens. Int J Mol Sci 2020; 21:E2574. [PMID: 32276333 PMCID: PMC7177594 DOI: 10.3390/ijms21072574] [Citation(s) in RCA: 60] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 04/04/2020] [Accepted: 04/06/2020] [Indexed: 01/02/2023] Open
Abstract
The pandemic novel coronavirus infection, Coronavirus Disease 2019 (COVID-19), has affected at least 190 countries or territories, with 465,915 confirmed cases and 21,031 deaths. In a containment-based strategy, rapid, sensitive and specific testing is important in epidemiological control and clinical management. Using 96 SARS-CoV-2 and 104 non-SARS-CoV-2 coronavirus genomes and our in-house program, GolayMetaMiner, four specific regions longer than 50 nucleotides in the SARS-CoV-2 genome were identified. Primers were designed to target the longest and previously untargeted nsp2 region and optimized as a probe-free real-time reverse transcription-polymerase chain reaction (RT-PCR) assay. The new COVID-19-nsp2 assay had a limit of detection (LOD) of 1.8 TCID50/mL and did not amplify other human-pathogenic coronaviruses and respiratory viruses. Assay reproducibility in terms of cycle threshold (Cp) values was satisfactory, with the total imprecision (% CV) values well below 5%. Evaluation of the new assay using 59 clinical specimens from 14 confirmed cases showed 100% concordance with our previously developed COVID-19-RdRp/Hel reference assay. A rapid, sensitive, SARS-CoV-2-specific real-time RT-PCR assay, COVID-19-nsp2, was developed.
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Affiliation(s)
- Cyril Chik-Yan Yip
- Department of Microbiology, Queen Mary Hospital, HKSAR, Hong Kong, China; (C.C.-Y.Y.); (T.W.-H.C.); (V.C.-C.C.)
| | - Chi-Chun Ho
- Genomics and Bioinformatics Programme, The Chinese University of Hong Kong, HKSAR, Hong Kong, China;
| | - Jasper Fuk-Woo Chan
- State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, HKSAR, Hong Kong, China; (J.F.-W.C.); (K.K.-W.T.); (K.-H.C.)
- Department of Microbiology, The University of Hong Kong, HKSAR, Hong Kong, China; (K.-H.L.); (A.Y.-F.F.); (A.C.-K.N.); (Z.Z.)
- Department of Clinical Microbiology and Infection, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, China
- Carol Yu Centre for Infection, Li Ka Shing Faculty of Medicine, The University of Hong Kong, HKSAR, Hong Kong, China
| | - Kelvin Kai-Wang To
- State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, HKSAR, Hong Kong, China; (J.F.-W.C.); (K.K.-W.T.); (K.-H.C.)
- Department of Microbiology, The University of Hong Kong, HKSAR, Hong Kong, China; (K.-H.L.); (A.Y.-F.F.); (A.C.-K.N.); (Z.Z.)
- Department of Clinical Microbiology and Infection, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, China
- Carol Yu Centre for Infection, Li Ka Shing Faculty of Medicine, The University of Hong Kong, HKSAR, Hong Kong, China
| | | | | | - Kit-Hang Leung
- Department of Microbiology, The University of Hong Kong, HKSAR, Hong Kong, China; (K.-H.L.); (A.Y.-F.F.); (A.C.-K.N.); (Z.Z.)
| | - Agnes Yim-Fong Fung
- Department of Microbiology, The University of Hong Kong, HKSAR, Hong Kong, China; (K.-H.L.); (A.Y.-F.F.); (A.C.-K.N.); (Z.Z.)
| | - Anthony Chin-Ki Ng
- Department of Microbiology, The University of Hong Kong, HKSAR, Hong Kong, China; (K.-H.L.); (A.Y.-F.F.); (A.C.-K.N.); (Z.Z.)
| | - Zijiao Zou
- Department of Microbiology, The University of Hong Kong, HKSAR, Hong Kong, China; (K.-H.L.); (A.Y.-F.F.); (A.C.-K.N.); (Z.Z.)
| | | | - Tom Wai-Hin Chung
- Department of Microbiology, Queen Mary Hospital, HKSAR, Hong Kong, China; (C.C.-Y.Y.); (T.W.-H.C.); (V.C.-C.C.)
| | - Kwok-Hung Chan
- State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, HKSAR, Hong Kong, China; (J.F.-W.C.); (K.K.-W.T.); (K.-H.C.)
- Department of Microbiology, The University of Hong Kong, HKSAR, Hong Kong, China; (K.-H.L.); (A.Y.-F.F.); (A.C.-K.N.); (Z.Z.)
- Carol Yu Centre for Infection, Li Ka Shing Faculty of Medicine, The University of Hong Kong, HKSAR, Hong Kong, China
| | - Ivan Fan-Ngai Hung
- Department of Medicine, The University of Hong Kong, HKSAR, Hong Kong, China;
| | - Vincent Chi-Chung Cheng
- Department of Microbiology, Queen Mary Hospital, HKSAR, Hong Kong, China; (C.C.-Y.Y.); (T.W.-H.C.); (V.C.-C.C.)
| | - Owen Tak-Yin Tsang
- Department of Medicine and Geriatrics, Princess Margaret Hospital, HKSAR, Hong Kong, China;
| | - Stephen Kwok Wing Tsui
- School of Biomedical Sciences, The Chinese University of Hong Kong, HKSAR, Hong Kong, China;
| | - Kwok-Yung Yuen
- State Key Laboratory of Emerging Infectious Diseases, The University of Hong Kong, HKSAR, Hong Kong, China; (J.F.-W.C.); (K.K.-W.T.); (K.-H.C.)
- Department of Microbiology, The University of Hong Kong, HKSAR, Hong Kong, China; (K.-H.L.); (A.Y.-F.F.); (A.C.-K.N.); (Z.Z.)
- Department of Clinical Microbiology and Infection, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518053, China
- Carol Yu Centre for Infection, Li Ka Shing Faculty of Medicine, The University of Hong Kong, HKSAR, Hong Kong, China
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273
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Type 1 interferons as a potential treatment against COVID-19. Antiviral Res 2020; 178:104791. [PMID: 32275914 PMCID: PMC7138382 DOI: 10.1016/j.antiviral.2020.104791] [Citation(s) in RCA: 332] [Impact Index Per Article: 83.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 04/03/2020] [Indexed: 02/08/2023]
Abstract
Type 1 interferons have a broad antiviral activity in vitro and are currently evaluated in a clinical trial to treat MERS-CoV. In this review, we discuss preliminary data concerning the potential activity of type 1 interferons on SARS-CoV-2, and the relevance of evaluating these molecules in clinical trials for the treatment of COVID-19. Interferon treatment has shown mixed efficiency against SARS-CoV and MERS-CoV. SARS-CoV-2 is probably more sensitive to interferon than the other coronaviruses. The IFNβ subtype appears to be the most suited for COVID-19 treatment. Interferon treatment should be performed in the early stages of the infection. Investigation on interferon-based COVID-19 treatment is warranted.
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274
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Caputo L, Lentini G, Habtemariam S. Repurposing therapeutic agents and herbal medicines to defeat viral nemesis. Drug Dev Res 2020; 81:641-642. [PMID: 32227604 PMCID: PMC7228223 DOI: 10.1002/ddr.21668] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 03/20/2020] [Accepted: 03/20/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Leonardo Caputo
- Institute of Sciences of Food Production (CNR-ISPA), National Council of Research, Bari, Italy
| | - Giovanni Lentini
- Department of Pharmacy-Pharmaceutical Sciences, University of Bari Aldo Moro, Bari, Italy
| | - Solomon Habtemariam
- Pharmacognosy Research Laboratories and Herbal Analysis Services UK, University of Greenwich, Kent, UK
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275
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de Juan Bagudá J, Farrero Torres M, García-Cosío MD, Recio Mayoral A, Sabé Fernández N, García Pinilla JM, González Costello J. Implicaciones de la pandemia por COVID-19 para el paciente con insuficiencia cardiaca, trasplante cardiaco y asistencia ventricular. Recomendaciones de la Asociación de Insuficiencia Cardiaca de la Sociedad Española de Cardiología. ACTA ACUST UNITED AC 2020. [PMCID: PMC7194925 DOI: 10.1016/j.rccl.2020.03.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
La irrupción de la pandemia por COVID-19 está suponiendo un verdadero reto social y sanitario. Su rápida expansión hace que sean muchos los pacientes afectos que desarrollan clínica asociada, incluyendo síntomas cardiológicos. Los pacientes con afectación cardiaca son un grupo especialmente vulnerable, por su mayor riesgo de contagio y gravedad de la enfermedad. La insuficiencia cardiaca, incluyendo al trasplante cardiaco y las asistencias ventriculares, supone un grupo relevante dentro de los pacientes cardiológicos. Por ello, la Asociación de Insuficiencia Cardiaca de la Sociedad Española de Cardiología ha elaborado una serie de recomendaciones para el abordaje de estos pacientes, en los diferentes escenarios en los que se pueden encontrar: ambulatorio y hospitalizado, con y sin COVID-19.
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276
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Bein B, Bachmann M, Huggett S, Wegermann P. [SARS CoV-2/COVID-19: Evidence-Based Recommendation on Diagnosis and Therapy]. Anasthesiol Intensivmed Notfallmed Schmerzther 2020; 55:257-265. [PMID: 32274773 PMCID: PMC7295266 DOI: 10.1055/a-1146-8674] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
COVID-19, a new viral disease affecting primarily the respiratory system and the lung, has caused a pandemic with serious challenges to health systems around the world. In about 20% of patients, severe symptoms occur after a mean incubation period of 5 - 6 days; 5% of patients need intensive care therapy. Morbidity is about 1 - 2%. Protecting health care workers is of paramount importance in order to prevent hospital acquired infections. Therefore, during all procedures associated with aerosol production, a personal safety equipment consisting of a FFP2/FFP3 (N95) respiratory mask, gloves, safety glasses and a waterproof overall should be used. Therapy is based on established recommendations issued for patients with acute lung injury (ARDS). Lung protective ventilation, prone position, restrictive fluid management and an adequate management of organ failures are the mainstays of therapy. In case of fulminant lung failure, veno-venous extracorporeal membrane oxygenation may be used as a rescue in experienced centres. New, experimental therapies evolve with ever increasing frequency; currently, however, there is no evidence based recommendation possible. If off-label and compassionate use of these drugs is considered, an individual benefit-risk assessment is necessary, since serious side effects have been reported.
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Affiliation(s)
- Berthold Bein
- Korrespondenzadresse Prof. Dr. med. Berthold Bein Klinik für Anästhesiologie, Intensivmedizin, Notfallmedizin und SchmerztherapieAsklepios Klinik St. GeorgLohmühlenstraße 520099 Hamburg
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277
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Gross AE, MacDougall C. Roles of the clinical pharmacist during the COVID-19 pandemic. JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 2020. [DOI: 10.1002/jac5.1231] [Citation(s) in RCA: 47] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Alan E. Gross
- Hospital Pharmacy Services; University of Illinois Hospital and Health Sciences System; Chicago Illinois USA
- Department of Pharmacy Practice; University of Illinois at Chicago College of Pharmacy; Chicago Illinois USA
| | - Conan MacDougall
- Department of Clinical Pharmacy; University of California San Francisco School of Pharmacy; San Francisco California USA
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278
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Affiliation(s)
- Beuy Joob
- Department of Medical Center, Sanitation 1 Medical Academic Center, Bangkok, Thailand
| | - Viroj Wiwanitkit
- Department of Community Medicine, Dr DY Patil University, Pune, India.,Department of Tropical Medicine, Hainan Medical University, Haikou, China.,Department of Laboratory Medicine, Chulalongkorn University, Bangkok, Thailand
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279
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Valencia DN. Brief Review on COVID-19: The 2020 Pandemic Caused by SARS-CoV-2. Cureus 2020; 12:e7386. [PMID: 32337113 PMCID: PMC7179986 DOI: 10.7759/cureus.7386] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 03/24/2020] [Indexed: 12/17/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus responsible for the coronavirus disease of 2019 (COVID-19). First identified in Wuhan (Hubei, China) in December of 2019, it has since been declared a pandemic by the World Health Organization in March of 2020. In this study, we will provide a brief review of viral origin, identification, symptoms, transmission, diagnosis, and potential treatment strategies for the newly identified SARS-CoV-2 strain.
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280
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Chavez S, Long B, Koyfman A, Liang SY. Coronavirus Disease (COVID-19): A primer for emergency physicians. Am J Emerg Med 2020; 44:220-229. [PMID: 32265065 PMCID: PMC7102516 DOI: 10.1016/j.ajem.2020.03.036] [Citation(s) in RCA: 142] [Impact Index Per Article: 35.5] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 03/22/2020] [Accepted: 03/22/2020] [Indexed: 12/28/2022] Open
Abstract
Introduction Rapid worldwide spread of Coronavirus Disease 2019 (COVID-19) has resulted in a global pandemic. Objective This review article provides emergency physicians with an overview of the most current understanding of COVID-19 and recommendations on the evaluation and management of patients with suspected COVID-19. Discussion Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for causing COVID-19, is primarily transmitted from person-to-person through close contact (approximately 6 ft) by respiratory droplets. Symptoms of COVID-19 are similar to other viral upper respiratory illnesses. Three major trajectories include mild disease with upper respiratory symptoms, non-severe pneumonia, and severe pneumonia complicated by acute respiratory distress syndrome (ARDS). Emergency physicians should focus on identifying patients at risk, isolating suspected patients, and informing hospital infection prevention and public health authorities. Patients with suspected COVID-19 should be asked to wear a facemask. Respiratory etiquette, hand washing, and personal protective equipment are recommended for all healthcare personnel caring for suspected cases. Disposition depends on patient symptoms, hemodynamic status, and patient ability to self-quarantine. Conclusion This narrative review provides clinicians with an updated approach to the evaluation and management of patients presenting to the emergency department with suspected COVID-19.
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Affiliation(s)
- Summer Chavez
- Department of Emergency Medicine, MedStar Georgetown University Hospital, 3800 Reservoir Road, NW, Washington, DC 20007, United States
| | - Brit Long
- Brooke Army Medical Center, Department of Emergency Medicine, 3841 Roger Brooke Dr, Fort Sam Houston, TX 78234, United States.
| | - Alex Koyfman
- The University of Texas Southwestern Medical Center, Department of Emergency Medicine, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States
| | - Stephen Y Liang
- Divisions of Emergency Medicine and Infectious Diseases, Washington University School of Medicine, 660 S. Euclid Ave, St. Louis, MO 63110, United States.
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281
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Gul MH, Htun ZM, Shaukat N, Imran M, Khan A. Potential specific therapies in COVID-19. Ther Adv Respir Dis 2020; 14:1753466620926853. [PMID: 32436445 PMCID: PMC7243039 DOI: 10.1177/1753466620926853] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 04/20/2020] [Indexed: 12/19/2022] Open
Abstract
COVID-19 has grown into a global pandemic that has strained healthcare throughout the world. There is a sense of urgency in finding a cure for this deadly virus. In this study, we reviewed the empiric options used in common practice for COVID-19, based on the literature available online, with an emphasis on human experiences with these treatments on severe acute respiratory syndrome-associated coronavirus (SARS-COV-1) and other viruses. Convalescent blood products are the most promising potential treatment for use in COVID-19. The use of chloroquine or hydroxychloroquine (HCQ), remdesivir, and tocilizumab are some of the other promising potential therapies; however, they are yet to be tested in randomized clinical trials (RCTs). The use of lopinavir-ritonavir did not prove beneficial in a large RCT. The use of corticosteroids should be avoided in COVID-19 pneumonia unless used for other indications, based on the suggestion of harm in patients with SARS-COV-1 and Middle Eastern Respiratory Syndrome (MERS) infection. The reviews of this paper are available via the supplemental material section.
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Affiliation(s)
- Muhammad Hamdan Gul
- Internal Medicine Department, Amita-Presence Saint Joseph Hospital, Chicago, 2900 N Lakeshore Drive, Chicago, IL 60657, USA
| | - Zin Mar Htun
- Internal Medicine Department, Louis A Weiss Memorial Hospital, Chicago, IL, USA
| | - Nauman Shaukat
- Cardiothoracic Surgery, Saint George’s University Hospital, Tooting, London, UK
| | - Muhammad Imran
- Cardiothoracic Surgery, Armed Forces Institute, Rawalpindi, Pakistan
| | - Ahmad Khan
- Internal Medicine Department, West Virginia University- Charleston Division, WV, USA
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282
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Zhang X, Li X, Liao Z, Zhao M, Zhuang Q. Evaluation of psychological stress in scientific researchers during the 2019-2020 COVID-19 outbreak in China. PeerJ 2020; 8:e9497. [PMID: 32704451 PMCID: PMC7346863 DOI: 10.7717/peerj.9497] [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: 03/12/2020] [Accepted: 06/17/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND Beginning in December 2019, coronavirus disease 2019 (COVID-19) caused an outbreak of infectious pneumonia. The Chinese government introduced a series of grounding measures to prevent the spread of COVID-19. The living and working patterns of many scientific researchers also underwent significant changes during this period. METHODS An opportunity sample (n = 251) was obtained in China using a questionnaire with 42 questions on scientific research progress and psychological stress during the COVID-19 epidemic. RESULTS Of the 251 participants, 76.9% indicated that their research was affected by the COVID-19 outbreak, and participants who were affected by the outbreak had higher stress levels than those who were not affected. Participants who conducted COVID-19 research and indicated concern that they would fail to finish the research on time were more likely to indicate high levels of stress. Respondents indicated that extending deadlines (64.1%), receiving support from superiors for research (51.8%), and increasing benefits for researchers (51.0%) would likely relieve outbreak-related stress. CONCLUSION The COVID-19 outbreak had a major impact on the experiments of researchers in the life sciences, especially in basic and clinical medicine. It has also caused high levels of psychological stress in these populations. Measures should be taken to relieve psychological pressure on basic medical researchers and students who will soon complete their degrees (e.g., Master's and PhD candidates in graduation years).
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Affiliation(s)
- Xueyan Zhang
- Transplantation Center, The 3rd Xiangya Hospital of Central South University, Changsha, Hunan, China
- Xiangya School of Medicine of Central South University, Changsha, Hunan, China
| | - Xinyu Li
- Transplantation Center, The 3rd Xiangya Hospital of Central South University, Changsha, Hunan, China
- Xiangya School of Medicine of Central South University, Changsha, Hunan, China
| | - Zhenxin Liao
- Xiangya School of Public Health of Central South University, Changsha, Hunan, China
| | - Mingyi Zhao
- Department of Pediatrics, The 3rd Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Quan Zhuang
- Transplantation Center, The 3rd Xiangya Hospital of Central South University, Changsha, Hunan, China
- Research Center of National Health Ministry on Transplantation Medicine, Changsha, Hunan, China
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283
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Morley JE, Vellas B. Editorial: COVID-19 and Older Adults. J Nutr Health Aging 2020; 24:364-365. [PMID: 32242202 PMCID: PMC7113379 DOI: 10.1007/s12603-020-1349-9] [Citation(s) in RCA: 106] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Accepted: 03/19/2020] [Indexed: 12/14/2022]
Affiliation(s)
- J E Morley
- John E. Morley, MB, BCh, Division of Geriatric Medicine, Saint Louis University School of Medicine, 1402 S. Grand Blvd., M238, St. Louis, MO 63104,
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