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Baliga-Gil A, Soszynska-Jozwiak M, Ruszkowska A, Szczesniak I, Kierzek R, Ciechanowska M, Trybus M, Jackowiak P, Peterson JM, Moss WN, Kierzek E. Targeting sgRNA N secondary structure as a way of inhibiting SARS-CoV-2 replication. Antiviral Res 2024; 228:105946. [PMID: 38925369 DOI: 10.1016/j.antiviral.2024.105946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 06/07/2024] [Accepted: 06/22/2024] [Indexed: 06/28/2024]
Abstract
SARS-CoV-2 is a betacoronavirus that causes COVID-19, a global pandemic that has resulted in many infections, deaths, and socio-economic challenges. The virus has a large positive-sense, single-stranded RNA genome of ∼30 kb, which produces subgenomic RNAs (sgRNAs) through discontinuous transcription. The most abundant sgRNA is sgRNA N, which encodes the nucleocapsid (N) protein. In this study, we probed the secondary structure of sgRNA N and a shorter model without a 3' UTR in vitro, using the SHAPE (selective 2'-hydroxyl acylation analyzed by a primer extension) method and chemical mapping with dimethyl sulfate and 1-cyclohexyl-(2-morpholinoethyl) carbodiimide metho-p-toluene sulfonate. We revealed the secondary structure of sgRNA N and its shorter variant for the first time and compared them with the genomic RNA N structure. Based on the structural information, we designed gapmers, siRNAs and antisense oligonucleotides (ASOs) to target the N protein coding region of sgRNA N. We also generated eukaryotic expression vectors containing the complete sequence of sgRNA N and used them to screen for new SARS-CoV-2 gene N expression inhibitors. Our study provides novel insights into the structure and function of sgRNA N and potential therapeutic tools against SARS-CoV-2.
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Affiliation(s)
- Agnieszka Baliga-Gil
- Institute of Bioorganic Chemistry, Polish Academy of Sciences, Noskowskiego 12/14, 61-704, Poznan, Poland
| | - Marta Soszynska-Jozwiak
- Institute of Bioorganic Chemistry, Polish Academy of Sciences, Noskowskiego 12/14, 61-704, Poznan, Poland
| | - Agnieszka Ruszkowska
- Institute of Bioorganic Chemistry, Polish Academy of Sciences, Noskowskiego 12/14, 61-704, Poznan, Poland
| | - Izabela Szczesniak
- Institute of Bioorganic Chemistry, Polish Academy of Sciences, Noskowskiego 12/14, 61-704, Poznan, Poland
| | - Ryszard Kierzek
- Institute of Bioorganic Chemistry, Polish Academy of Sciences, Noskowskiego 12/14, 61-704, Poznan, Poland
| | - Maria Ciechanowska
- Institute of Bioorganic Chemistry, Polish Academy of Sciences, Noskowskiego 12/14, 61-704, Poznan, Poland
| | - Magdalena Trybus
- Institute of Bioorganic Chemistry, Polish Academy of Sciences, Noskowskiego 12/14, 61-704, Poznan, Poland
| | - Paulina Jackowiak
- Institute of Bioorganic Chemistry, Polish Academy of Sciences, Noskowskiego 12/14, 61-704, Poznan, Poland
| | - Jake M Peterson
- Roy J. Carver Department of Biochemistry, Biophysics, and Molecular Biology, Iowa State University, Ames, IA, 50011, USA
| | - Walter N Moss
- Roy J. Carver Department of Biochemistry, Biophysics, and Molecular Biology, Iowa State University, Ames, IA, 50011, USA
| | - Elzbieta Kierzek
- Institute of Bioorganic Chemistry, Polish Academy of Sciences, Noskowskiego 12/14, 61-704, Poznan, Poland.
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Simões JLB, Braga GDC, Coiado JV, Scaramussa AB, Rodrigues APB, Bagatini MD. Takotsubo syndrome as an outcome of the use of checkpoint inhibitor therapy in patients with COVID-19. Biochem Pharmacol 2024; 226:116388. [PMID: 38914315 DOI: 10.1016/j.bcp.2024.116388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 06/11/2024] [Accepted: 06/21/2024] [Indexed: 06/26/2024]
Abstract
Takotsubo Syndrome (TS) is a heart disease caused by extreme exposure of the body to physical or psychological stress. In the context of COVID-19, the virus can be a significant source of stress, with particular attention being paid to the cytokine storm as a cause of damage to the body. New research shows that the production of specific cytokines is linked to the activation of immune checkpoint proteins such as PD-1, PD-L1, and CTLA-4 on T cells. Although initially beneficial in combating infections, it can suppress defense and aid in disease progression. Therefore, checkpoint inhibitor therapy has been highlighted beyond oncological therapies, given its effectiveness in strengthening the immune system. However, this treatment can lead to excessive immune responses, inflammation, and stress on the heart, which can cause Takotsubo Syndrome in patients. Several studies investigate the direct link between this therapy and cardiac injuries in these patients, which can trigger TS. From this perspective, we must delve deeper into this treatment and consider its effects on the prognosis against SARS-CoV-2 infection.
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Affiliation(s)
| | | | - João Victor Coiado
- Medical School, Federal University of Fronteira Sul, Chapecó, SC, Brazil
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Talawar P, Tripathy DK, Kaushal A, Dhar M, Vijaybabu A, Tuppad P, Priyanka S, Kumar D, Sharma R, Kumar SS. Efficacy of lignocaine nebulization in patients with COVID-19 respiratory infection: An exploratory randomized double-blinded controlled trial. J Anaesthesiol Clin Pharmacol 2024; 40:271-275. [PMID: 38919418 PMCID: PMC11196040 DOI: 10.4103/joacp.joacp_205_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 10/02/2022] [Accepted: 10/13/2022] [Indexed: 06/27/2024] Open
Abstract
Background and Aims Coronavirus disease (COVID-19)-related pneumonia is proposed to be an inflammatory process. The treatment currently includes supportive therapy and low-dose steroids. Anti-inflammatory drugs have been proposed to prevent cytokine storms and improve oxygenation in such cases. The study aimed to assess the efficacy of nebulized lignocaine in COVID-19 patients with pneumonia. Material and Methods This was an exploratory randomized double-blinded control trial conducted in COVID-19 patients with respiratory failure requiring oxygen therapy either by face mask or non-invasive mechanical ventilation. Patients included were of the age of more than 18 years of either gender. The patients were randomized to receive either lignocaine or distilled water nebulization. The outcomes assessed were PaO2/FiO2 ratio, hemodynamics, respiratory parameters, and sequential organ failure score (SOFA). Results The two groups were comparable concerning demographic variables. The PaO2/FiO2 were significantly higher in the lignocaine group from day 2 onward. The SPO2 was significantly higher on day 3 in the lignocaine group and thereafter there was no significant difference. Other hemodynamic, respiratory parameters, and SOFA scores showed no difference in both the groups. Conclusion Lignocaine nebulization improved oxygenation in COVID-19 patients and can be used as adjunctive therapy along with other supportive medications.
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Affiliation(s)
- Praveen Talawar
- Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Debendra Kumar Tripathy
- Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ashutosh Kaushal
- Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Mridul Dhar
- Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Adabala Vijaybabu
- Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Praik Tuppad
- Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sangadala Priyanka
- Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Deepak Kumar
- Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ruhi Sharma
- Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sumedha Suresh Kumar
- Department of Anaesthesiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Appaneal HJ, LaPlante KL, Lopes VV, Martin C, Puzniak L, Wiemken TL, Zasowski EJ, McLaughlin JM, Caffrey AR. Nirmatrelvir/Ritonavir Utilization for the Treatment of Non-hospitalized Adults with COVID-19 in the National Veterans Affairs (VA) Healthcare System. Infect Dis Ther 2024; 13:155-172. [PMID: 38217842 PMCID: PMC10828173 DOI: 10.1007/s40121-023-00910-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 12/15/2023] [Indexed: 01/15/2024] Open
Abstract
INTRODUCTION Limited data exist regarding real-world utilization of nirmatrelvir/ritonavir. We identified predictors of nirmatrelvir/ritonavir use among Veterans Affairs (VA) outpatients nationally. METHODS We conducted a retrospective cohort study among outpatients with coronavirus disease 2019 (COVID-19) who were eligible to receive nirmatrelvir/ritonavir between January and December of 2022, to identify factors associated with nirmatrelvir/ritonavir use (i.e., demographics, medical history, prior medication and healthcare exposures, frailty, and other clinical characteristics) using multivariable logistic regression. RESULTS We included 309,755 outpatients with COVID-19 who were eligible for nirmatrelvir/ritonavir, of whom 12.2% received nirmatrelvir/ritonavir. Nirmatrelvir/ritonavir uptake increased from 1.1% to 23.2% over the study period. Factors associated with nirmatrelvir/ritonavir receipt included receiving a COVID-19 booster vs. none (adjusted odds ratio [aOR] 2.19 [95% confidence interval [CI] 2.12-2.26]), age ≥ 50 vs. 18-49 years (aORs > 1.5 for all age groups ≥ 50 years), having HIV (aOR 1.36 [1.22-1.51]), being non-frail vs. severely frail (aOR 1.22 [1.13-1.33]), and having rheumatoid arthritis (aOR 1.12 [1.04-1.21). Those with concomitant use of potentially interacting antiarrhythmics (aOR 0.35 [0.28-0.45]), anticoagulants/antiplatelets (aOR 0.42 [0.40-0.45]), and/or psychiatric/sedatives (aOR 0.84 [0.81-0.87]) were less likely to receive nirmatrelvir/ritonavir. CONCLUSIONS Despite increases over time, overall utilization of nirmatrelvir/ritonavir was low. Predictors of nirmatrelvir/ritonavir utilization were consistent with known risk factors for progression to severe COVID-19, including older age and underlying medical conditions. Unvaccinated and undervaccinated patients and those receiving potentially interacting medications for cardiovascular or mental health conditions (antiarrhythmic, alpha-1 antagonist, anticoagulant/antiplatelet, sedative/hypnotic/psychiatric) were less likely to receive nirmatrelvir/ritonavir. Further education of prescribers and patients about nirmatrelvir/ritonavir treatment guidelines is needed to improve overall uptake and utilization in certain high-risk subpopulations.
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Affiliation(s)
- Haley J Appaneal
- Infectious Diseases Research Program, Providence Veterans Affairs Medical Center, Providence, RI, USA
- Center of Innovation in Long-Term Support Services, Providence Veterans Affairs Medical Center, Providence, RI, USA
- College of Pharmacy, University of Rhode Island, 7 Greenhouse Rd, 265B, Kingston, RI, 02881, USA
| | - Kerry L LaPlante
- Infectious Diseases Research Program, Providence Veterans Affairs Medical Center, Providence, RI, USA
- Center of Innovation in Long-Term Support Services, Providence Veterans Affairs Medical Center, Providence, RI, USA
- College of Pharmacy, University of Rhode Island, 7 Greenhouse Rd, 265B, Kingston, RI, 02881, USA
| | - Vrishali V Lopes
- Infectious Diseases Research Program, Providence Veterans Affairs Medical Center, Providence, RI, USA
| | | | | | | | | | | | - Aisling R Caffrey
- Infectious Diseases Research Program, Providence Veterans Affairs Medical Center, Providence, RI, USA.
- Center of Innovation in Long-Term Support Services, Providence Veterans Affairs Medical Center, Providence, RI, USA.
- College of Pharmacy, University of Rhode Island, 7 Greenhouse Rd, 265B, Kingston, RI, 02881, USA.
- School of Public Health, Brown University, Providence, RI, USA.
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Velev V, Pavlova M, Alexandrova E, Popov М, Lutakov I, Tcherveniakova T, Angelova A, Hristozova E, Kalchev Y, Ivanov I. Study on patients with Clostridioides difficile infection during the COVID-19 pandemic in Bulgaria. BIOTECHNOL BIOTEC EQ 2023. [DOI: 10.1080/13102818.2023.2169194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Affiliation(s)
- Valeri Velev
- University Hospital "Prof. Iv. Kirov”, Medical University of Sofia, Sofia, Bulgaria
| | - Maria Pavlova
- Department of Microbiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Ekaterina Alexandrova
- Department of Microbiology, National Center of Infectious and Parasitic Diseases, Sofia, Bulgaria
| | - Мetodi Popov
- University Hospital "Prof. Iv. Kirov”, Medical University of Sofia, Sofia, Bulgaria
| | - Ivan Lutakov
- University Hospital "Queen Joanna - ISUL", Medical University of Sofia, Sofia, Bulgaria
| | | | - Andreana Angelova
- Department of Microbiology and Immunology “Prof. Dr. Elissay Yanev”, Faculty of Pharmacy, Medical University of Plovdiv, Plovdiv, Bulgaria
- Laboratory of Microbiology, “St. George” University Hospital, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Eli Hristozova
- Department of Microbiology and Immunology “Prof. Dr. Elissay Yanev”, Faculty of Pharmacy, Medical University of Plovdiv, Plovdiv, Bulgaria
- Laboratory of Microbiology, “St. George” University Hospital, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Yordan Kalchev
- Department of Microbiology and Immunology “Prof. Dr. Elissay Yanev”, Faculty of Pharmacy, Medical University of Plovdiv, Plovdiv, Bulgaria
- Laboratory of Microbiology, “St. George” University Hospital, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Ivan Ivanov
- University Hospital "Prof. Iv. Kirov”, Medical University of Sofia, Sofia, Bulgaria
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Dey A, Vaishak K, Deka D, Radhakrishnan AK, Paul S, Shanmugam P, Daniel AP, Pathak S, Duttaroy AK, Banerjee A. Epigenetic perspectives associated with COVID-19 infection and related cytokine storm: an updated review. Infection 2023; 51:1603-1618. [PMID: 36906872 PMCID: PMC10008189 DOI: 10.1007/s15010-023-02017-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2022] [Accepted: 02/27/2023] [Indexed: 03/13/2023]
Abstract
PURPOSE The COVID-19 pandemic caused by the novel Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) has put the world in a medical crisis for the past three years; nearly 6.3 million lives have been diminished due to the virus outbreak. This review aims to update the recent findings on COVID-19 infections from an epigenetic scenario and develop future perspectives of epi-drugs to treat the disease. METHODS Original research articles and review studies related to COVID-19 were searched and analyzed from the Google Scholar/PubMed/Medline databases mainly between 2019 and 2022 to brief the recent work. RESULTS Numerous in-depth studies of the mechanisms used by SARS-CoV-2 have been going on to minimize the consequences of the viral outburst. Angiotensin-Converting Enzyme 2 receptors and Transmembrane serine protease 2 facilitate viral entry to the host cells. Upon internalization, it uses the host machinery to replicate viral copies and alter the downstream regulation of the normal cells, causing infection-related morbidities and mortalities. In addition, several epigenetic regulations such as DNA methylation, acetylation, histone modifications, microRNA, and other factors (age, sex, etc.) are responsible for the regulations of viral entry, its immune evasion, and cytokine responses also play a major modulatory role in COVID-19 severity, which has been discussed in detail in this review. CONCLUSION Findings of epigenetic regulation of viral pathogenicity open a new window for epi-drugs as a possible therapeutical approach against COVID-19.
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Affiliation(s)
- Amit Dey
- Department of Medical Biotechnology, Faculty of Allied Health Sciences, Chettinad Academy of Research and Education (CARE), Chettinad Hospital and Research Institute (CHRI), Kelambakkam, Chennai, TN, 603103, India
| | - K Vaishak
- Department of Medical Biotechnology, Faculty of Allied Health Sciences, Chettinad Academy of Research and Education (CARE), Chettinad Hospital and Research Institute (CHRI), Kelambakkam, Chennai, TN, 603103, India
| | - Dikshita Deka
- Department of Medical Biotechnology, Faculty of Allied Health Sciences, Chettinad Academy of Research and Education (CARE), Chettinad Hospital and Research Institute (CHRI), Kelambakkam, Chennai, TN, 603103, India
| | - Arun Kumar Radhakrishnan
- Department of Pharmacology, Chettinad Hospital and Research Institute (CHRI), Chettinad Academy of Research and Education (CARE), Chennai, TN, India
| | - Sujay Paul
- Tecnologico de Monterrey, School of Engineering and Sciences, Campus Queretaro, Av. Epigmenio Gonzalez, No.500 Fracc., CP 76130, San Pablo, Querétaro, Mexico
| | - Priyadarshini Shanmugam
- Department of Microbiology, Chettinad Hospital and Research Institute (CHRI), Chettinad Academy of Research and Education (CARE), Chennai, TN, 603103, India
| | - Alice Peace Daniel
- Department of Microbiology, Chettinad Hospital and Research Institute (CHRI), Chettinad Academy of Research and Education (CARE), Chennai, TN, 603103, India
| | - Surajit Pathak
- Department of Medical Biotechnology, Faculty of Allied Health Sciences, Chettinad Academy of Research and Education (CARE), Chettinad Hospital and Research Institute (CHRI), Kelambakkam, Chennai, TN, 603103, India
| | - Asim K Duttaroy
- Department of Nutrition, Institute of Basic Medical Sciences, Faculty of Medicine, University of Oslo, Oslo, Norway.
| | - Antara Banerjee
- Department of Medical Biotechnology, Faculty of Allied Health Sciences, Chettinad Academy of Research and Education (CARE), Chettinad Hospital and Research Institute (CHRI), Kelambakkam, Chennai, TN, 603103, India.
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Soetjahjo B, Malueka RG, Nurudhin A, Purwoko, Sumardi, Wisaksana R, Adhiputri A, Sudadi, Soeroto AY, Sidharta BRA, Thobari JA, Murni TW, Soewondo W, Herningtyas EH, Sudjud RW, Trisnawati I, Ananda NR, Faried A. Effectiveness and safety of normoxic allogenic umbilical cord mesenchymal stem cells administered as adjunctive treatment in patients with severe COVID-19. Sci Rep 2023; 13:12520. [PMID: 37532730 PMCID: PMC10397314 DOI: 10.1038/s41598-023-39268-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 07/22/2023] [Indexed: 08/04/2023] Open
Abstract
Inflammatory response in COVID-19 contributes greatly to disease severity. Mesenchymal Stem Cells (MSCs) have the potential to alleviate inflammation and reduce mortality and length of stay in COVID-19 patients. We investigated the safety and effectiveness of normoxic-allogenic umbilical cord (NA-UC)-MSCs as an adjunctive treatment in severe COVID-19 patients. A double-blind, multicentric, randomized, placebo-controlled trial involving severe COVID-19 patients was performed from January to June 2021 in three major hospitals across Java, Indonesia. Eligible participants (n = 42) were randomly assigned to two groups (1:1), namely the intervention (n = 21) and control (n = 21) groups. UC-MSCs dose was 1 × 106 /kg body weight on day D0, D3, and D6. The primary outcome was the duration of hospitalization. Meanwhile, the secondary outcomes were radiographical progression (Brixia score), respiratory and oxygenation parameters, and inflammatory markers, in addition to the safety profile of NA-UC-MSCs. NA-UC-MSCs administration did not affect the length of hospital stay of severe COVID-19 patients, nor did it improve the Brixia score or mMRC dyspnoea scale better than placebo. Nevertheless, NA-UC-MSCs led to a better recuperation in oxygenation index (120.80 ± 72.70 baseline vs. 309.63 ± 319.30 D + 22, p = 0.038) and oxygen saturation (97.24 ± 4.10% vs. 96.19 ± 3.75% in placebo, p = 0.028). Additionally, compared to the placebo group, the treatment group had a significantly smaller increase in PCT level at D + 22 (1.43 vs. 12.76, p = 0.011). No adverse effects, including serious ones, were recorded until D + 91. NA-UC-MSCs therapy is a very safe adjunct for COVID-19 patients. It improves the oxygenation profile and carries potential to suppress inflammation.
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Affiliation(s)
- Bintang Soetjahjo
- Department of Orthopaedics and Traumatology, Universitas Sebelas Maret-Dr. Moewardi Hospital, Solo, Indonesia
| | - Rusdy Ghazali Malueka
- Department of Neurology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada-Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Arief Nurudhin
- Department of Internal Medicine, Universitas Sebelas Maret-Dr. Moewardi Hospital, Solo, Indonesia
| | - Purwoko
- Department of Anesthesiology and Intensive Therapy, Universitas Sebelas Maret-Dr. Moewardi Hospital, Solo, Indonesia
| | - Sumardi
- Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada-Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Rudi Wisaksana
- Department of Internal Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Artrien Adhiputri
- Department of Pulmonology and Respiratory Medicine, Universitas Sebelas Maret-Dr. Moewardi Hospital, Solo, Indonesia
| | - Sudadi
- Department of Anesthesiology and Intensive Therapy, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada-Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Arto Yuwono Soeroto
- Department of Internal Medicine, Universitas Padjadjaran-Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | | | - Jarir At Thobari
- Department of Pharmacology and Therapy, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Tri Wahyu Murni
- Department of Surgery, Universitas Padjadjaran-Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Widiastuti Soewondo
- Department of Radiology, Universitas Sebelas Maret-Dr. Moewardi Hospital, Solo, Indonesia
| | - Elizabeth Henny Herningtyas
- Department of Clinical Pathology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada-Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Reza Widianto Sudjud
- Department of Anesthesiology-Intensive Therapy, Universitas Padjadjaran-Dr. Hasan Sadikin Hospital, Bandung, Indonesia
| | - Ika Trisnawati
- Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada-Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Nur Rahmi Ananda
- Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada-Dr. Sardjito General Hospital, Yogyakarta, Indonesia
| | - Ahmad Faried
- Department of Neurosurgery, Universitas Padjadjaran - Dr. Hasan Sadikin Hospital, Bandung, 40161, Indonesia.
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Khapre M, Pathania M, Saxena V, Omar BJ, Goyal B, Sinha S, Bahurupi Y, Dhamija P. Effectiveness of Kabasura Kudineer tablets in the management of asymptomatic and mild cases of COVID-19: A pilot double-blinded, randomized controlled trial. J Ayurveda Integr Med 2023; 14:100777. [PMID: 37536025 PMCID: PMC10410514 DOI: 10.1016/j.jaim.2023.100777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 05/11/2023] [Accepted: 07/08/2023] [Indexed: 08/05/2023] Open
Abstract
INTRODUCTION COVID-19 was declared a pandemic in 2020. It has had a devastating effect on human life and the global economy. To date, there is no proven therapy for COVID-19, even though rigorous research is ongoing to test multiple compounds across all systems of medicine. A need was felt to systematically explore the Indian system of medicine to assess its efficacy against COVID-19. The objective of the present study was to examine the effect of Kabasura Kudineer as a standalone therapy on the following: time required to achieve symptom relief & resolution, virological clearance, and levels of IL6, CRP and IgG, and compare it to the standard therapy available for treatment of COVID-19. METHODOLOGY A double-blinded randomized controlled trial was conducted in 110 participants. 55 participants were enrolled in the Kabasura Kudineer arm and 55 in the control (standard therapy + Kabasura Kudineer placebo) arm. Study participants were randomly allocated into the two study arms. They were assessed for symptoms at baseline, and on Day 5 and Day 10. RT PCR, CRP, IL6 and IgG levels were measured at baseline, Day 5 and Day 10. On day 28, participants were interviewed telephonically for symptom assessment alone. STATISTICAL ANALYSIS A per-protocol approach was used. Significant difference between two groups was assessed at baseline, day 5 and day 10 using the Chi-square and Mann Whitney test. RESULT A total of 110 patients participated in study. Four patients in the Kabasura Kudineer arm and 9 in the Standard therapy arm were lost to follow-up. Baseline characteristics for both the groups were matched at baseline. 83.9% and 93.9% patients were relieved of all symptoms by the 10th day in Kabasura and standard therapy groups respectively. Decrease in CRP level was more pronounced in the Kabasura group compared to standard therapy viz. 3 mg/l and 1.26 mg/l. No significant difference was found in IgG level and IL6 levels in both the study groups. However, it was noticed that among the unvaccinated group, the surge in IgG levels was much higher in Kabasura Kudineer group than the standard therapy group. CONCLUSION Kabasura Kudineer as a standalone therapy was as effective and safe as the standard therapy among patients with asymptomatic to mild COVID-19.
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Affiliation(s)
| | | | | | | | - Bela Goyal
- Department of Biochemistry, AIIMS Rishikesh India
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Favilli A, Mattei Gentili M, De Paola F, Laganà AS, Vitagliano A, Bosco M, Cicinelli E, Chiantera V, Uccella S, Parazzini F, Gerli S, Garzon S. COVID-19 and Pregnancy: An Updated Review about Evidence-Based Therapeutic Strategies. J Pers Med 2023; 13:1035. [PMID: 37511648 PMCID: PMC10381390 DOI: 10.3390/jpm13071035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 06/16/2023] [Accepted: 06/22/2023] [Indexed: 07/30/2023] Open
Abstract
The COVID-19 pandemic posed a significant challenge for clinicians in managing pregnant women, who were at high risk of virus transmission and severe illness. While the WHO declared in May 2023 that COVID-19 is no longer a public health emergency, it emphasized that it remains a global health threat. Despite the success of vaccines, the possibility of new pandemic waves due to viral mutations should be considered. Ongoing assessment of the safety and effectiveness of pharmacological therapies is crucial in clinical practice. This narrative review summarizes the evidence-based therapeutic strategies for pregnant women with COVID-19, considering over three years of pandemic experience. The review discusses the safety and effectiveness of various drug regimens (antivirals, anticoagulants, corticosteroids, immunoglobulins, monoclonal antibodies, and therapeutic gases) and procedures (prone positioning and extracorporeal membrane oxygenation). Drugs with contraindications, inefficacy during pregnancy, or unknown adverse effects were excluded from our evaluation. The aim is to provide healthcare professionals with a comprehensive guide for managing pregnant women with COVID-19 based on lessons learned from the pandemic outbreak.
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Affiliation(s)
- Alessandro Favilli
- Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy
| | - Marta Mattei Gentili
- Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy
| | - Francesca De Paola
- Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy
| | - Antonio Simone Laganà
- Unit of Gynecologic Oncology, ARNAS "Civico-Di Cristina-Benfratelli", Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
| | - Amerigo Vitagliano
- Department of Biomedical and Human Oncological Science (DIMO), 1st Unit of Obstetrics and Gynecology, University of Bari, 70121 Bari, Italy
| | - Mariachiara Bosco
- Unit of Obstetrics and Gynecology-Department of Surgery, Dentistry, Pediatrics, and Gynecology, AOUI Verona-University of Verona Piazzale A. Stefani 1, 37126 Verona, Italy
| | - Ettore Cicinelli
- Department of Biomedical and Human Oncological Science (DIMO), 1st Unit of Obstetrics and Gynecology, University of Bari, 70121 Bari, Italy
| | - Vito Chiantera
- Unit of Gynecologic Oncology, ARNAS "Civico-Di Cristina-Benfratelli", Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
| | - Stefano Uccella
- Unit of Obstetrics and Gynecology-Department of Surgery, Dentistry, Pediatrics, and Gynecology, AOUI Verona-University of Verona Piazzale A. Stefani 1, 37126 Verona, Italy
| | - Fabio Parazzini
- Department of Clinic and Community Science, Mangiagalli Hospital, University of Milan, 20122 Milan, Italy
| | - Sandro Gerli
- Section of Obstetrics and Gynecology, Department of Medicine and Surgery, University of Perugia, 06123 Perugia, Italy
| | - Simone Garzon
- Unit of Obstetrics and Gynecology-Department of Surgery, Dentistry, Pediatrics, and Gynecology, AOUI Verona-University of Verona Piazzale A. Stefani 1, 37126 Verona, Italy
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10
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Asai Y, Tsuzuki S, Matsunaga N, Ohmagari N. Regional trends in the use of steroids and favipiravir for COVID-19 treatment. J Infect Public Health 2023; 16:206-213. [PMID: 36603374 DOI: 10.1016/j.jiph.2022.12.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/13/2022] [Accepted: 12/21/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Infectious diseases are treated based on clinical guidelines, which usually require a large amount of data and time to formulate. Therefore, various treatments are tried and used in the early stages of epidemics of emerging and reemerging infectious diseases. In this study, we focused on two drugs for coronavirus disease 2019 (COVID-19) treatment, i.e., steroids and favipiravir, and analyzed the changes in treatment trends by region. METHODS This was a retrospective study of cases from the COVID-19 Registry Japan. The proportion of patients who received steroids and favipiravir was calculated on a monthly and pandemic wave basis, and the trend of drug administration by region was estimated using logistic curves. RESULTS The effect of wave on steroid administration was as high as 2.75 [2.60, 2.90], indicating a rapid increase in the proportion of steroid administration. The odds ratios for Hokuriku and Hokkaido were 0.49 [0.35, 0.68] and 0.55 [0.43, 0.71], respectively, indicating that steroids were less likely administered in these regions. For favipiravir, the effect of timing was 0.43 [0.41, 0.46], denoting a decreasing trend. On the other hand, the odds ratio was very high in some regions, such as Hokkaido (6.66 [5.24, 8.48]), indicating that the administration trend varied by region. CONCLUSIONS The increase in the proportion of steroid use showed the same trend nationwide, although the rate of increase differed, confirming that the use of drugs with proven efficacy was spreading rapidly and that effective treatment was available nationwide. However, the results suggest that drugs such as favipiravir, which were initially expected to be effective, may continue to be administered. Registry studies include larger populations than clinical trials and enable real-time monitoring of medication status and trends. Further use of registry studies for treatment standardization is expected in the future.
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Affiliation(s)
- Yusuke Asai
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan; AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan.
| | - Shinya Tsuzuki
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan; AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | - Nobuaki Matsunaga
- AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
| | - Norio Ohmagari
- Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan; AMR Clinical Reference Center, National Center for Global Health and Medicine, Tokyo, Japan
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11
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Wang Y, Zhang Y, Zhang M, Zhang X, Li H, Wang Y, Wang W, Ji J, Wu L, Zheng D. The prevalence of adverse reactions among individuals with three-dose COVID-19 vaccination. J Infect Public Health 2023; 16:125-132. [PMID: 36516647 PMCID: PMC9724502 DOI: 10.1016/j.jiph.2022.12.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 11/17/2022] [Accepted: 12/05/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Considering the adverse reactions to vaccination against coronavirus disease 2019 (COVID-19), some people, particularly the elderly and those with underlying medical conditions, are hesitant to be vaccinated. This study aimed to explore the prevalence of adverse reactions and provide direct evidence of vaccine safety, mainly for the elderly and people with underlying medical conditions, to receive COVID-19 vaccination. METHODS From 1st March to 30th April 2022, we conducted an online survey of people who had completed three doses of COVID-19 vaccination by convenience sampling. Adverse reaction rates and 95% confidence intervals were calculated. In addition, conditional logistic regression was used to compare the differences in adverse reactions among the elderly and those with underlying medical conditions with the general population. RESULTS A total of 3339 individuals were included in this study, of which 2335 (69.9%) were female, with an average age of 32.1 ± 11.4 years. The prevalence of adverse reactions after the first dose of inactivated vaccine was 24.6% (23.1-26.2%), 19.2% (17.8-20.7%) for the second dose, and 19.1% (17.7-20.6%) for the booster dose; among individuals using messenger RNA vaccines, the prevalence was 42.7% (32.3-53.6%) for the first dose, 47.2% (36.5-58.1%) for the second dose, and 46.1% (35.4-57.0%) for the booster dose. Compared with the general population, the prevalence of adverse events did not differ in individuals with underlying medical conditions and those aged 60 and above. CONCLUSIONS For individuals with underlying medical conditions and those aged 60 and above, the prevalence of adverse reactions is similar to that of the general population, which provides a scientific basis regarding vaccination safety for these populations.
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Affiliation(s)
- Yuying Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Yujie Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Meng Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing 100069, China,Department of Epidemiology and Bio-statistics, School of Public Health, Peking University, Beijing 100191, China
| | - Xiaoyu Zhang
- Department of Anesthesiology, Sanbo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Haibin Li
- Heart Center & Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China
| | - Youxin Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing 100069, China
| | - Wei Wang
- Centre for Precision Health, Edith Cowan University, Perth, WA 6027, Australia
| | - Jianguang Ji
- Center for Primary Health Care Research, Lund University/Region Skåne, 20 502 Malmö, Sweden,Corresponding authors
| | - Lijuan Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing 100069, China,Corresponding authors
| | - Deqiang Zheng
- Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing 100069, China,Center for Primary Health Care Research, Lund University/Region Skåne, 20 502 Malmö, Sweden,Corresponding author at: Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing 100069, China
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12
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Hasan MJ, Rabbani R, Anam AM, Huq SMR. Therapeutic safety and efficacy of triple-immunosuppressants versus dual-immunosuppressants in severe-to-critical COVID-19: a prospective cohort study in Bangladesh. Ann Med 2022; 54:723-732. [PMID: 35238257 PMCID: PMC8903771 DOI: 10.1080/07853890.2022.2039958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Hyperinflammation-induced respiratory failure is a leading cause of mortality in COVID-19 infection. Immunosuppressants such as, Baricitinib and interleukin inhibitors are the drug-of-choice to suppress cytokine storm in COVID-19. Here, we compared the therapeutic safety and efficacy of triple-immunosuppressants with dual-immunosuppressants in patients with severe-to-critical COVID-19. METHODS This study was conducted on 103 confirmed COVID-19 patients. Of 103 patients, 49 (N) and 54 (N) patients received dual-immunosuppressants (baricitinib plus two doses of secukinumab) and triple immunosuppressants (baricitinib plus single dose of tocilizumab and secukinumab) in group A and group B, respectively. Groups were compared in terms of clinical outcome, critical support-requirement, survival, re-hospitalisation, and adverse events (AEs). RESULTS Patients in group B achieved normal blood oxygen saturation level (SpO2) earlier than the patients of group A [4 day (IQR: 3-12) vs 5 day (IQR: 5-14), p < .05]. The requirement of intensive care unit (ICU) and mechanical ventilation (MV) support was less in group B than group A [16.7%/28.6%, 11.1%/18.4%, respectively p < .05]]. The incidence of COVID-19 acute respiratory distress syndrome and 60-day all cause mortality was reduced in group B compared to group A [0.43 (0.19-0.98), p < .05; 0.35 (0.08-1.44), p > .05]. The 60-day re-hospitalisation rate was two-fold high in group A than group B (p = .024). Immunosuppressant-associated adverse events and secondary bacterial/fungal infections were relative high in patients of group B. CONCLUSIONS Triple-immunosuppressants in severe-to-critical COVID-19 infection exhibited better clinical outcome; reduced ICU and MV requirement; shorter hospital stay with deceased 60-day all cause mortality and re-hospitalisation compared to dual-immunosuppressants.
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Affiliation(s)
- Md Jahidul Hasan
- Clinical Pharmacist (Critical Care and Infectious Diseases/Stewardship), Coordinator-Clinical Pharmacy, Department of Pharmacy, Square Hospitals Ltd, West Panthapath, Bangladesh
| | - Raihan Rabbani
- Internal Medicine and Intensive Care Unit, Department of Medical Services, Square Hospitals Ltd, West Panthapath, Bangladesh
| | - Ahmad Mursel Anam
- High Dependency Unit (HDU), Department of Medical Services, Square Hospitals Ltd, West Panthapath, Bangladesh
| | - Shihan Mahmud Redwanul Huq
- Internal Medicine and Intensive Care Unit, Department of Medical Services, Square Hospitals Ltd, West Panthapath, Bangladesh
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13
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Bizzoca ME, Leuci S, Mignogna MD, Muzio EL, Caponio VCA, Muzio LL. Natural compounds may contribute in preventing SARS-CoV-2 infection: a narrative review. FOOD SCIENCE AND HUMAN WELLNESS 2022; 11:1134-1142. [PMID: 38621001 PMCID: PMC9160299 DOI: 10.1016/j.fshw.2022.04.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Coronavirus pandemic infection is the most important health issue worldwide. Coronavirus disease 2019 is a contagious disease characterized by severe acute respiratory syndrome coronavirus 2. To date, excluding the possibility of vaccination, against SARS-CoV-2 infection it is possible to act only with supportive care and non-virus-specific treatments in order to improve the patient's symptoms. Pharmaceutical industry is investigating effects of medicinal plants, phytochemical extracts and aromatic herbs to find out natural substances which may act as antiviral drugs. Several studies have revealed how these substances may interfere with the viral life cycle, viral entry, replication, assembly or discharge, as well as virus-specific host targets or stimulating the host immune system, reducing oxidative stress and inflammatory response. A natural compound can be used as a prophylaxis by people professionally exposed to the risk of contagion and/or positive patients not in intensive care. The aim of this paper is to perform a narrative review of current literature in order to summarize the most studied natural compounds and their modes of action.
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Affiliation(s)
- Maria Eleonora Bizzoca
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia 71122, Italy
| | - Stefania Leuci
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples 80131, Italy
| | - Michele Davide Mignogna
- Department of Neurosciences, Reproductive and Odontostomatological Sciences, Federico II University of Naples, Naples 80131, Italy
| | - Eleonora Lo Muzio
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara 44121, Italy
| | | | - Lorenzo Lo Muzio
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia 71122, Italy
- C.I.N.B.O. (Consorzio Interuniversitario Nazionale per la Bio-Oncologia), Chieti 66100, Italy
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14
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A Large-Scale Dataset of Twitter Chatter about Online Learning during the Current COVID-19 Omicron Wave. DATA 2022. [DOI: 10.3390/data7080109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
The COVID-19 Omicron variant, reported to be the most immune-evasive variant of COVID-19, is resulting in a surge of COVID-19 cases globally. This has caused schools, colleges, and universities in different parts of the world to transition to online learning. As a result, social media platforms such as Twitter are seeing an increase in conversations related to online learning in the form of tweets. Mining such tweets to develop a dataset can serve as a data resource for different applications and use-cases related to the analysis of interest, views, opinions, perspectives, attitudes, and feedback towards online learning during the current surge of COVID-19 cases caused by the Omicron variant. Therefore, this work presents a large-scale, open-access Twitter dataset of conversations about online learning from different parts of the world since the first detected case of the COVID-19 Omicron variant in November 2021. The dataset is compliant with the privacy policy, developer agreement, and guidelines for content redistribution of Twitter, as well as with the FAIR principles (Findability, Accessibility, Interoperability, and Reusability) principles for scientific data management. The paper also briefly outlines some potential applications in the fields of Big Data, Data Mining, Natural Language Processing, and their related disciplines, with a specific focus on online learning during this Omicron wave that may be studied, explored, and investigated by using this dataset.
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15
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Dueñas-Castell C, Polanco-Guerra CJ, Martinez-Ávila MC, Almanza Hurtado AJ, Rodriguez Yanez T, Gutierrez-Ariza JC, Rico-Fontalvo J. When to Use Antibiotics in COVID-19: A Proposal Based on Questions. Cureus 2022; 14:e27398. [PMID: 36046297 PMCID: PMC9418620 DOI: 10.7759/cureus.27398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/28/2022] [Indexed: 12/15/2022] Open
Abstract
The COVID-19 pandemic has affected millions of people, including hundreds of deaths. The search for adequate treatments and interventions that influence poor prognostic factors and reduce mortality has led to excessive use of antibiotics based on the possible existence of bacterial co-infection. However, there is no evidence to justify the systematic use of antimicrobials in COVID-19. The recommendations seek to provide knowledge regarding treatment; standardizing a management algorithm requires validation in clinical trials and studies of greater methodological rigor.
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16
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Dao HM, Sahakijpijarn S, Chrostowski RR, Moon C, Mangolini F, Cui Z, Williams RO. Aggregation of Lactoferrin Caused by Droplet Atomization Process via a Two-Fluid Nozzle: The Detrimental Effect of Air-Water Interfaces. Mol Pharm 2022; 19:2662-2675. [PMID: 35639017 DOI: 10.1021/acs.molpharmaceut.2c00358] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Biological macromolecules, especially therapeutic proteins, are delicate and highly sensitive to denaturation from stresses encountered during the manufacture of dosage forms. Thin-film freeze-drying (TFFD) and spray freeze-drying (SFD) are two processes used to convert liquid forms of protein into dry powders. In the production of inhalable dry powders that contain proteins, these potential stressors fall into three categories based on their occurrence during the primary steps of the process: (1) droplet formation (e.g., the mechanism of droplet formation, including spray atomization), (2) freezing, and (3) frozen water removal (e.g., sublimation). This study compares the droplet formation mechanism used in TFFD and SFD by investigating the effects of spraying on the stability of proteins, using lactoferrin as a model. This study considers various perspectives on the denaturation (e.g., conformation) of lactoferrin after subjecting the protein solution to the atomization process using a pneumatic two-fluid nozzle (employed in SFD) or a low-shear drop application through the nozzle. The surface activity of lactoferrin was examined to explore the interfacial adsorption tendency, diffusion, and denaturation process. Subsequently, this study also investigates the secondary and tertiary structure of lactoferrin and the quantification of monomers, oligomers, and, ultimately, aggregates. The spraying process affected the tertiary structure more negatively than the tightly woven secondary structure, resulting in the peak position corresponding to the tryptophan (Trp) residues red-shifting by 1.5 nm. This conformational change can either (a) be reversed at low concentrations via relaxation or (b) proceed to form irreversible aggregates at higher concentrations. Interestingly, when the sample was allowed to progress into micrometer-sized aggregates, such a dramatic change was not detected using methods such as size-exclusion chromatography, polyacrylamide gel electrophoresis, and dynamic light scattering at 173°. A more complete understanding of the heterogeneous protein sample was achieved only through a combination of 173 and 13° backward and forward scattering, a combination of derived count rate measurements, and microflow imaging (MFI). After studying the impact of droplet formation mechanisms on aggregation tendency of lactoferrin, we further investigated two additional model proteins with different surface activity: bovine IgG (serving as a non surface-active negative reference), and β-galactosidase (another surface-active protein). The results corroborated the lactoferrin findings that spray-atomization-related stress-induced protein aggregation was much more pronounced for proteins that are surface active (lactoferrin and β-galactosidase), but it was minimal for non-surface-active protein (bovine IgG). Finally, compared to the low-shear dripping used in the TFFD process, lactoferrin underwent a relatively fast conformational change upon exposure to the high air-water interface of the two-fluid atomization nozzle used in the SFD process as compared to the low shear dripping used in the TFFD process. The interfacial-induced denaturation that occurred during spraying was governed primarily by the size of the atomized droplets, regardless of the duration of exposure to air. The percentage of denatured protein population and associated activity loss, in the case of β-galactosidase, was determined to range from 2 to 10% depending on the air-flow rate of the spraying process.
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Affiliation(s)
- Huy M Dao
- Division of Molecular Pharmaceutics and Drug Delivery, College of Pharmacy, The University of Texas at Austin, Austin, Texas78712, United States
| | | | - Robert R Chrostowski
- Texas Materials Institute, The University of Texas at Austin, Austin, Texas78712, United States
- Materials Science and Engineering Program, The University of Texas at Austin, Austin, Texas78712, United States
| | - Chaeho Moon
- Division of Molecular Pharmaceutics and Drug Delivery, College of Pharmacy, The University of Texas at Austin, Austin, Texas78712, United States
| | - Filippo Mangolini
- Texas Materials Institute, The University of Texas at Austin, Austin, Texas78712, United States
- Walker Department of Mechanical Engineering, The University of Texas at Austin, Austin, Texas78712, United States
| | - Zhengrong Cui
- Division of Molecular Pharmaceutics and Drug Delivery, College of Pharmacy, The University of Texas at Austin, Austin, Texas78712, United States
| | - Robert O Williams
- Division of Molecular Pharmaceutics and Drug Delivery, College of Pharmacy, The University of Texas at Austin, Austin, Texas78712, United States
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17
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Tumminia A, Romano R, Brugaletta G, Scicali R, Biondi G, Oliveri R, Romano M, San Lio PM. The impact of obesity and dyslipidemia on Remdesivir effectiveness in hospitalized patients with SARS-CoV-2-related pneumonia: An observational study. Nutr Metab Cardiovasc Dis 2022; 32:1635-1641. [PMID: 35508458 PMCID: PMC8994684 DOI: 10.1016/j.numecd.2022.04.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 03/11/2022] [Accepted: 04/04/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND AND AIMS Remdesivir (GS-5734), an inhibitor of the viral RNA-dependent, RNA polymerase was early identified as a promising therapeutic candidate against COVID-19. Our aim was to evaluate the impact of several metabolic parameters on Remdesivir effectiveness among hospitalized COVID-19 patients. METHODS AND RESULTS We conducted an observational study on patients with SARS-CoV-2-related pneumonia admitted between May 2020 and September 2021 to the COVID-19 Units of Internal Medicine, Pneumology and Intensive Care of Garibaldi Hospital, Catania, Italy, and treated with Remdesivir. The "Ordinal Scale For Clinical Improvement" was used to assess patients' clinical improvement within 28 days of hospitalization. Short-term mortality rate was also evaluated. A total of 142 patients with SARS-CoV-2-related pneumonia were studied. The prevalence of obesity (20.7% vs. 41.9%, p = 0.03), the average BMI (27.1 ± 4.4 vs. 31.1 ± 6.1, p < 0.01) and the mean LDL-C levels (78 ± 19 mg/dl vs. 103 ± 18 mg/dl, p = 0.03) were significantly lower in early-improved (EI) compared to not-improved (NI) individuals. Obesity was negatively associated to clinical improvement after Remdesivir (OR 0.48, 95%CI 0.17-0.97, p = 0.04). Both obesity (OR 2.82, 95% CI 1.05-7.71, p = 0.04) and dyslipidemia (OR 2.78, 95%CI 1.17-7.16, p = 0.03) were significantly related to patients' mortality. Dyslipidemic subjects experienced a slower clinical improvement than non-dyslipidemic ones (Long-Rank p = 0.04). CONCLUSION Our study showed that unfavorable metabolic conditions such as obesity and dyslipidemia could predict a worse clinical response to Remdesivir as well as the mortality in hospitalized COVID-19 patients. Further prospective and larger-scale studies are needed to confirm these preliminary findings.
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Affiliation(s)
- Andrea Tumminia
- Endocrinology, Department of Clinical and Experimental Medicine, Garibaldi-Nesima Hospital, 95122 Catania, Italy.
| | - Raffaella Romano
- Geriatrics Unit, Garibaldi-Nesima Hospital, 95122 Catania, Italy
| | | | - Roberto Scicali
- Geriatrics Unit, Garibaldi-Nesima Hospital, 95122 Catania, Italy; Department of Clinical and Experimental Medicine, University of Catania, 95100 Catania, Italy
| | | | - Rosario Oliveri
- Pneumology Unit, Garibaldi-Nesima Hospital, 95122 Catania, Italy
| | - Marcello Romano
- Geriatrics Unit, Garibaldi-Nesima Hospital, 95122 Catania, Italy
| | - Paola Magnano San Lio
- Department of Clinical and Experimental Medicine, University of Catania, AOU Policlinico "G. Rodolico - San Marco", 95123 Catania, Italy
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18
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Pirsalehi A, Soleimani M, Hajifathali A, Sadeghi B, Farhadihosseinabadi B, Akhlaghi SS, Roshandel E. Decidual stromal cell therapy for generalized lymphadenopathy as a special clinical manifestation of COVID‐19 infection: A case report. Clin Case Rep 2022; 10:e05851. [PMID: 35600010 PMCID: PMC9109646 DOI: 10.1002/ccr3.5851] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Revised: 04/26/2022] [Accepted: 04/26/2022] [Indexed: 12/31/2022] Open
Abstract
We are going through the greatest global health crisis of the last decades, the coronavirus disease 2019 (COVID‐19) pandemic. It may cause morbidity and mortality in some cases, and there is no therapeutic approach with reproducible and favorable outcomes. As clinical manifestations differ from patient to patient, any report regarding clinical symptoms has been beneficial for early detection and treatment. Due to the immunomodulatory effect of mesenchymal stem cells (MSCs), MSCs‐based therapy has been approved to be one of the therapeutic strategies for COVID‐19 management. For the first time in the literature, we reported generalized lymphadenopathy with fever and no sign of respiratory distress in a 16‐year‐old patient with confirmed COVID‐19 infection as the main clinical signs. We also introduce decidual stromal cells as a potential immunomodulatory treatment for COVID‐19–infected patients.
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Affiliation(s)
- Ali Pirsalehi
- Department of Internal Medicine School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Masoud Soleimani
- Hematopoietic Stem Cell Research Center Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Abbas Hajifathali
- Hematopoietic Stem Cell Research Center Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Behnam Sadeghi
- Translational Cell Therapy Research (TCR) Department of Clinical Science, Intervention and Technology CLINTEC Karolinska Instituted Huddinge Sweden
| | | | - Sedigheh Sadat Akhlaghi
- Department of Internal Medicine School of Medicine Shahid Beheshti University of Medical Sciences Tehran Iran
| | - Elham Roshandel
- Hematopoietic Stem Cell Research Center Shahid Beheshti University of Medical Sciences Tehran Iran
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19
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Lagolio E, Demurtas J, Buzzetti R, Cortassa G, Bottone S, Spadafora L, Cocino C, Smith L, Benzing T, Polidori MC. A rapid and feasible tool for clinical decision making in community-dwelling patients with COVID-19 and those admitted to emergency departments: the Braden-LDH-HorowITZ Assessment-BLITZ. Intern Emerg Med 2022; 17:839-844. [PMID: 34322832 PMCID: PMC8318055 DOI: 10.1007/s11739-021-02805-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 07/09/2021] [Indexed: 02/08/2023]
Abstract
There is no univocal standardized strategy to predict outcomes and stratify risk of SARS-CoV-2 infected patients, notably in emergency departments. Our aim is to develop an accurate indicator of adverse outcomes based on a retrospective analysis of a COVID-19 database established at the Emergency Department (ED) of a North-Italian hospital during the first wave of SARS-CoV-2 infection. Laboratory, clinical, psychosocial and functional characteristics including those obtained from the Braden Scale-a standardized scale to quantify the risk of pressure sores which takes into account aspects of sensory perception, activity, mobility and nutrition-from the records of 117 consecutive patients with swab-positive COVID-19 disease admitted to the Emergency Medicine ward between March 1, 2020 and April 15, 2020 were included in the analysis. Adverse outcomes included admission to the Intensive Care Unit (ICU) and in-hospital death. Among the parameters collected, the highest cutoff sensitivity and specificity scores to best predict adverse outcomes were displayed by lactate dehydrogenase (LDH) blood value at admission > 439 U/L, Horowitz Index (P/F Ratio) < 257 and Braden score < 18. The estimation power reached 93.6%. We named the assessment BLITZ (Braden-LDH-HorowITZ). Despite the retrospective and preliminary nature of the data, a multidimensional tool to assess overall functions, not chronological age, produced the highest prediction power for poor outcomes in relation to SARS-CoV-2 infection. Further analyses are now needed to establish meaningful correlations between ventilation therapies and multidimensional frailty as assessed by ad-hoc validated and standardized tools.
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Affiliation(s)
- Erik Lagolio
- Emergency Medicine (A&E), Asl2 - Hospital Santa Corona, Pietra Ligure, Italy
| | - Jacopo Demurtas
- Clinical and Experimental Medicine PhD Program, University of Modena and Reggio Emilia, Strada Casal Nuovo, 20 58011, Capalbio (GR), Modena, Italy.
| | | | - Giorgio Cortassa
- Emergency Medicine (A&E), Asl2 - Hospital Santa Corona, Pietra Ligure, Italy
| | - Stefania Bottone
- Emergency Medicine (A&E), Asl2 - Hospital Santa Corona, Pietra Ligure, Italy
| | - Laura Spadafora
- Emergency Medicine (A&E), Asl2 - Hospital Santa Corona, Pietra Ligure, Italy
| | - Cristina Cocino
- Emergency Medicine (A&E), Asl2 - Hospital Santa Corona, Pietra Ligure, Italy
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Thomas Benzing
- Ageing Clinical Research, Department of Internal Medicine and Center for Molecular Medicine, Cologne, University of CologneFaculty of Medicine and University Hospital Cologne, Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress-Responses in Aging-Associated Diseases (CECAD), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Maria Cristina Polidori
- Ageing Clinical Research, Department of Internal Medicine and Center for Molecular Medicine, Cologne, University of CologneFaculty of Medicine and University Hospital Cologne, Cologne, Germany
- Cologne Excellence Cluster on Cellular Stress-Responses in Aging-Associated Diseases (CECAD), University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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20
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Sarzani R, Spannella F, Giulietti F, Di Pentima C, Giordano P, Giacometti A. Possible harm from glucocorticoid drugs misuse in the early phase of SARS-CoV-2 infection: a narrative review of the evidence. Intern Emerg Med 2022; 17:329-338. [PMID: 34718937 PMCID: PMC8557262 DOI: 10.1007/s11739-021-02860-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 09/26/2021] [Indexed: 12/15/2022]
Abstract
Since the publication of the RECOVERY trial, the use of glucocorticoid drugs (GC) has spread for the treatment of severe COVID-19 worldwide. However, the benefit of dexamethasone was largest in patients who received mechanical ventilation or supplemental oxygen therapy, while no benefit was found among patients without hypoxemia. In addition, a positive outcome was found in patients who received dexamethasone after several days of symptoms, while possible harm could exist if administered early. The right time interval for GC administration is still a matter of debate. Previous studies showed that an early GC use during the first phase of the disease, when viral replication peaks, may negatively affect the innate immune response through several mechanisms, such as the inhibition of pro-inflammatory and antiviral cytokine production and signaling pathway, including type I interferon, that is fundamental to counteract the virus and that was found to be impaired in several patients with life-threatening COVID-19. The GC misuse can lead to a more severe disease even in patients who do not have the established risk factors, such as obesity and cardiovascular diseases. In our focused review, we describe the role of immune response in viral infections, especially SARS-CoV-2, and discuss the potential harms of GC misuse in COVID-19.
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Affiliation(s)
- Riccardo Sarzani
- Internal Medicine and Geriatrics, Italian National Research Centre on Aging, Hospital "U. Sestilli", IRCCS INRCA, via della Montagnola n. 81, 60127, Ancona, Italy.
- Department of Clinical and Molecular Sciences, University "Politecnica Delle Marche", Via Tronto 10/a, Ancona, Italy.
| | - Francesco Spannella
- Internal Medicine and Geriatrics, Italian National Research Centre on Aging, Hospital "U. Sestilli", IRCCS INRCA, via della Montagnola n. 81, 60127, Ancona, Italy
- Department of Clinical and Molecular Sciences, University "Politecnica Delle Marche", Via Tronto 10/a, Ancona, Italy
| | - Federico Giulietti
- Internal Medicine and Geriatrics, Italian National Research Centre on Aging, Hospital "U. Sestilli", IRCCS INRCA, via della Montagnola n. 81, 60127, Ancona, Italy
- Department of Clinical and Molecular Sciences, University "Politecnica Delle Marche", Via Tronto 10/a, Ancona, Italy
| | - Chiara Di Pentima
- Internal Medicine and Geriatrics, Italian National Research Centre on Aging, Hospital "U. Sestilli", IRCCS INRCA, via della Montagnola n. 81, 60127, Ancona, Italy
- Department of Clinical and Molecular Sciences, University "Politecnica Delle Marche", Via Tronto 10/a, Ancona, Italy
| | - Piero Giordano
- Internal Medicine and Geriatrics, Italian National Research Centre on Aging, Hospital "U. Sestilli", IRCCS INRCA, via della Montagnola n. 81, 60127, Ancona, Italy
| | - Andrea Giacometti
- Department of Biological Sciences and Public Health, Infectious Diseases Clinic, University "Politecnica Delle Marche", Via Tronto 10/a, Ancona, Italy
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21
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Ramírez-Lozada T, Loranca-García MC, Fuentes-Venado CE, Rodríguez-Cerdeira C, Ocharan-Hernández E, Soriano-Ursúa MA, Farfán-García ED, Chávez-Gutiérrez E, Ramírez-Magaña X, Robledo-Cayetano M, Loza-Mejía MA, Santa-Olalla IAG, Torres-Paez OU, Pinto-Almazán R, Martínez-Herrera E. Does the Fetus Limit Antibiotic Treatment in Pregnant Patients with COVID-19? Antibiotics (Basel) 2022; 11:antibiotics11020252. [PMID: 35203854 PMCID: PMC8868538 DOI: 10.3390/antibiotics11020252] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 02/04/2022] [Accepted: 02/08/2022] [Indexed: 02/07/2023] Open
Abstract
During pregnancy, there is a state of immune tolerance that predisposes them to viral infection, causing maternal-fetal vulnerability to the adverse effects of COVID-19. Bacterial coinfections significantly increase the mortality rate for COVID-19. However, it is known that all drugs, including antibiotics, will enter the fetal circulation in a variable degree despite the role of the placenta as a protective barrier and can cause teratogenesis or other malformations depending on the timing of exposure to the drug. Also, it is important to consider the impact of the indiscriminate use of antibiotics during pregnancy can alter both the maternal and fetal-neonatal microbiota, generating future repercussions in both. In the present study, the literature for treating bacterial coinfections in pregnant women with COVID-19 is reviewed. In turn, we present the findings in 50 pregnant women hospitalized diagnosed with SARS-CoV-2 without previous treatment with antibiotics; moreover, a bacteriological culture of sample types was performed. Seven pregnant women had coinfection with Staphylococcus haemolyticus, Staphylococcus epidermidis, Streptococcus agalactiae, Escherichia coli ESBL +, biotype 1 and 2, Acinetobacter jahnsonii, Enterococcus faecium, and Clostridium difficile. When performing the antibiogram, resistance to multiple drugs was found, such as macrolides, aminoglycosides, sulfa, dihydrofolate reductase inhibitors, beta-lactams, etc. The purpose of this study was to generate more scientific evidence on the better use of antibiotics in these patients. Because of this, it is important to perform an antibiogram to prevent abuse of empirical antibiotic treatment with antibiotics in pregnant women diagnosed with SARS-CoV-2.
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Affiliation(s)
- Tito Ramírez-Lozada
- Servicio de Ginecología y Obstetricia, Hospital Regional de Alta Especialidad de Ixtapaluca, Ixtapaluca 56530, Mexico; (T.R.-L.); (X.R.-M.)
| | - María Concepción Loranca-García
- Hospital General de Zona No. 53, Los Reyes, Instituto Mexicano del Seguro Social (IMSS), Carr Federal México-Puebla Km 17.5, Villa de la Paz, Rincón de los Reyes, Los Reyes Acaquilpan 56400, Mexico;
| | | | - Carmen Rodríguez-Cerdeira
- Efficiency, Quality, and Costs in Health Services Research Group (EFISALUD), Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36213 Vigo, Spain;
- Dermatology Department, Hospital Vithas Ntra. Sra. de Fátima, 36206 Vigo, Spain
- Campus Universitario, University of Vigo, 36310 Vigo, Spain
| | - Esther Ocharan-Hernández
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (E.O.-H.); (M.A.S.-U.); (E.D.F.-G.)
| | - Marvin A. Soriano-Ursúa
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (E.O.-H.); (M.A.S.-U.); (E.D.F.-G.)
| | - Eunice D. Farfán-García
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (E.O.-H.); (M.A.S.-U.); (E.D.F.-G.)
| | - Edwin Chávez-Gutiérrez
- Doctorado en Ciencias en Biomedicina y Biotecnología Molecular, Escuela Nacional de Ciencias Biológicas, IPN, Mexico City 07738, Mexico;
- Unidad de Investigación, Hospital Regional de Alta Especialidad de Ixtapaluca, Estado de Mexico 56530, Mexico; (M.R.-C.); (O.U.T.-P.)
| | - Xóchitl Ramírez-Magaña
- Servicio de Ginecología y Obstetricia, Hospital Regional de Alta Especialidad de Ixtapaluca, Ixtapaluca 56530, Mexico; (T.R.-L.); (X.R.-M.)
| | - Maura Robledo-Cayetano
- Unidad de Investigación, Hospital Regional de Alta Especialidad de Ixtapaluca, Estado de Mexico 56530, Mexico; (M.R.-C.); (O.U.T.-P.)
| | - Marco A. Loza-Mejía
- Design, Isolation, and Synthesis of Bioactive Molecules Research Group, Chemical Sciences School, Universidad La Salle-México, Benjamín Franklin 45, Mexico City 06140, Mexico;
| | | | - Oscar Uriel Torres-Paez
- Unidad de Investigación, Hospital Regional de Alta Especialidad de Ixtapaluca, Estado de Mexico 56530, Mexico; (M.R.-C.); (O.U.T.-P.)
| | - Rodolfo Pinto-Almazán
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (E.O.-H.); (M.A.S.-U.); (E.D.F.-G.)
- Non-Communicable Disease Research Group, Facultad Mexicana de Medicina, Universidad La Salle-México, Las Fuentes 17, Tlalpan Centro I, Tlalpan, Mexico City 14000, Mexico
- Correspondence: (R.P.-A.); (E.M.-H.)
| | - Erick Martínez-Herrera
- Efficiency, Quality, and Costs in Health Services Research Group (EFISALUD), Galicia Sur Health Research Institute (IIS Galicia Sur), SERGAS-UVIGO, 36213 Vigo, Spain;
- Sección de Estudios de Posgrado e Investigación, Escuela Superior de Medicina, Instituto Politécnico Nacional, Mexico City 11340, Mexico; (E.O.-H.); (M.A.S.-U.); (E.D.F.-G.)
- Correspondence: (R.P.-A.); (E.M.-H.)
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22
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Eroglu B, Nuwarda RF, Ramzan I, Kayser V. A Narrative Review of COVID-19 Vaccines. Vaccines (Basel) 2021; 10:62. [PMID: 35062723 PMCID: PMC8779282 DOI: 10.3390/vaccines10010062] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 12/26/2021] [Accepted: 12/29/2021] [Indexed: 12/29/2022] Open
Abstract
The COVID-19 pandemic has shaken the world since early 2020 and its health, social, economic, and societal negative impacts at the global scale have been catastrophic. Since the early days of the pandemic, development of safe and effective vaccines was judged to be the best possible tool to minimize the effects of this pandemic. Drastic public health measures were put into place to stop the spread of the virus, with the hope that vaccines would be available soon. Thanks to the extraordinary commitments of many organizations and individuals from around the globe and the collaborative effort of many international scientists, vaccines against COVID-19 received regulatory approval for emergency human use in many jurisdictions in less than a year after the identification of the viral sequence. Several of these vaccines have been in use for some time; however, the pandemic is still ongoing and likely to persist for the foreseeable future. This is due to many reasons including reduced compliance with public health restrictions, limited vaccine manufacturing/distribution capacity, high rates of vaccine hesitancy, and the emergence of new variants with the capacity to spread more easily and to evade current vaccines. Here we discuss the discovery and availability of COVID-19 vaccines and evolving issues around mass vaccination programs.
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Affiliation(s)
| | | | | | - Veysel Kayser
- Sydney Pharmacy School, Faculty of Medicine and Health, The University of Sydney, Sydney 2006, Australia; (B.E.); (R.F.N.); (I.R.)
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23
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Perri F, Crispo A, Ionna F, Muto P, Caponigro F, Longo F, Montagnese C, Franco P, Pavone E, Aversa C, Guida A, Bimonte S, Ottaiano A, Di Marzo M, Porciello G, Amore A, Celentano E, Della Vittoria Scarpati G, Cascella M. Patients affected by squamous cell carcinoma of the head and neck: A population particularly prone to developing severe forms of COVID-19. Exp Ther Med 2021; 22:1298. [PMID: 34630653 PMCID: PMC8461515 DOI: 10.3892/etm.2021.10733] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 02/17/2021] [Indexed: 01/09/2023] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the recent Coronavirus Disease 2019 (COVID-19) pandemic, which has spread all over the world over the past year. Comorbidities appear to affect the prognosis of patients with such diseases, but the impact of cancer on the course of SARS-CoV2 has remained largely elusive. The aim of the present study is to analyze the outcome of patients affected by squamous cell carcinoma of the head and neck (SCCHN) and a number of their comorbidities, if infected with SARS-CoV2. The clinical data of 100 patients affected by SCCHN, who were undergoing treatment or who had finished their oncologic treatment in the past 6 months, were retrospectively collected and analysed. For each patient, the Charlson Comorbidity Index (CCI) was calculated to provide a score assessing the real weight of comorbidities on the patient's outcome at the time of diagnosis. It was discovered that these patients, besides the SCCHN, frequently presented at diagnosis with several other comorbidities, including hypertension, type 2 diabetes, cardiac arrhytmia, chronic obstructive pulmonary disease and various forms of vasculopathy (and thus a poor CCI). This feature suggest that, given the high frequency of various comorbidities in patients with SCCHN, additional SARS-CoV2 infection could have particularly devastating consequences.
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Affiliation(s)
- Francesco Perri
- Head and Neck Medical and Experimental Oncology Unit, Istituto Nazionale Tumori, IRCCS ‘Fondazione G. Pascale’, I-80131 Naples, Italy,Correspondence to: Dr Francesco Perri, Head and Neck Medical and Experimental Oncology Unit, Istituto Nazionale Tumori, IRCCS ‘Fondazione G. Pascale’, 8031 Via M. Semmola, I-80131 Naples, Italy
| | - Anna Crispo
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori, IRCCS ‘Fondazione G. Pascale’, I-80131 Naples, Italy
| | - Franco Ionna
- Otolaryngology Unit, Istituto Nazionale Tumori, IRCCS ‘Fondazione G. Pascale’, I-80131 Naples, Italy
| | - Paolo Muto
- Radiation Oncology Unit, Istituto Nazionale Tumori, IRCCS ‘Fondazione G. Pascale’, I-80131 Naples, Italy
| | - Francesco Caponigro
- Head and Neck Medical and Experimental Oncology Unit, Istituto Nazionale Tumori, IRCCS ‘Fondazione G. Pascale’, I-80131 Naples, Italy
| | - Francesco Longo
- Otolaryngology Unit, Casa Sollievo della Sofferenza di San Giovanni Rotondo, I-71013 Foggia, Italy
| | - Concetta Montagnese
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori, IRCCS ‘Fondazione G. Pascale’, I-80131 Naples, Italy
| | - Pierluigi Franco
- Otolaryngology Unit, Istituto Nazionale Tumori, IRCCS ‘Fondazione G. Pascale’, I-80131 Naples, Italy
| | - Ettore Pavone
- Otolaryngology Unit, Istituto Nazionale Tumori, IRCCS ‘Fondazione G. Pascale’, I-80131 Naples, Italy
| | - Corrado Aversa
- Otolaryngology Unit, Istituto Nazionale Tumori, IRCCS ‘Fondazione G. Pascale’, I-80131 Naples, Italy
| | - Agostino Guida
- Otolaryngology Unit, Istituto Nazionale Tumori, IRCCS ‘Fondazione G. Pascale’, I-80131 Naples, Italy
| | - Sabrina Bimonte
- Department of Anesthesia and Pain Medicine, Istituto Nazionale Tumori, IRCCS ‘Fondazione G. Pascale’, I-80131 Naples, Italy
| | - Alessandro Ottaiano
- Innovative Therapies for Abdominal Metastases, Department of Abdominal Oncology, Istituto Nazionale Tumori, IRCCS ‘Fondazione G. Pascale’, I-80131 Naples, Italy
| | - Massimiliano Di Marzo
- Colorectal and Abdominal Surgery Unit, Istituto Nazionale Tumori, IRCCS ‘Fondazione G. Pascale’, I-80131 Naples, Italy
| | - Giuseppe Porciello
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori, IRCCS ‘Fondazione G. Pascale’, I-80131 Naples, Italy
| | - Alfonso Amore
- Department Melanoma, Soft Tissue, Muscle-Skeletal and Head-Neck, Istituto Nazionale Tumori, IRCCS ‘Fondazione G. Pascale’, I-80131 Naples, Italy
| | - Egidio Celentano
- Epidemiology and Biostatistics Unit, Istituto Nazionale Tumori, IRCCS ‘Fondazione G. Pascale’, I-80131 Naples, Italy
| | | | - Marco Cascella
- Department of Anesthesia and Pain Medicine, Istituto Nazionale Tumori, IRCCS ‘Fondazione G. Pascale’, I-80131 Naples, Italy
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24
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Skwarek A, Gąsecka A, Jaguszewski MJ, Szarpak Ł, Dzieciątkowski T, Filipiak KJ. Nanoparticles: a breakthrough in COVID-19 prevention, diagnosis and treatment. Arch Med Sci 2021; 19:1410-1420. [PMID: 37732058 PMCID: PMC10507787 DOI: 10.5114/aoms/142103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 09/09/2021] [Indexed: 09/22/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), declared a global pandemic by the World Health Organization (WHO). The three key principles in management of the COVID-19 pandemic are prevention, early detection and targeted treatment. Vaccine-based prevention together with early detection has already proven its efficacy in controlling the pandemic. Early detection of infected patients could substantially accelerate the implementation of treatment, but also help to identify infection hotspots, whereas targeted treatment might destroy the virus and minimize damage to healthy tissue. Nanoparticles hold great promise with respect to these aspects. They may also be the solution to emerging clinical problems such as reinfection, pregnancy-related COVID-19 and coinfection. Here, we aim to discuss the potential applications of nanoparticles to combat the COVID-19 pandemic.
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Affiliation(s)
- Aleksandra Skwarek
- 1 Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | - Aleksandra Gąsecka
- 1 Chair and Department of Cardiology, Medical University of Warsaw, Warsaw, Poland
| | | | - Łukasz Szarpak
- Maria Skłodowska-Curie Medical Academy, Warsaw, Poland
- Maria Skłodowska-Curie Białystok Oncology Center, Bialystok, Poland
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25
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Sonzogni-Desautels K, Ndao M. Will Auranofin Become a Golden New Treatment Against COVID-19? Front Immunol 2021; 12:683694. [PMID: 34630379 PMCID: PMC8492993 DOI: 10.3389/fimmu.2021.683694] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 09/06/2021] [Indexed: 12/15/2022] Open
Abstract
Auranofin is an FDA-approved disease-modifying anti-rheumatic drug that has been used for decades for treatment of rheumatoid arthritis. This gold(I) compound has anti-inflammatory properties because it reduces IL-6 expression via inhibition of the NF-κB-IL-6-STAT3 signaling pathway. Also, by inhibiting redox enzymes such as thioredoxin reductase, auranofin increases cellular oxidative stress and promotes apoptosis. Auranofin also possesses antiviral properties. Recently, it was reported that auranofin reduced by 95% SARS-CoV-2 RNA in infected human cells in vitro and decreased SARS-CoV-2-induced cytokine expression, including IL-6. During SARS-CoV-2 infection, a cytokine storm involving IL-6 increases severity of illness and worsens prognosis. Therefore, auranofin could, in our point of view, reduce pathology due to SARS-CoV-2-induced IL-6. COVID-19 is a rapidly-evolving respiratory disease now distributed worldwide. Strikingly high numbers of new COVID-19 cases are reported daily. We have begun a race to vaccinate people, but due to the complex logistics of this effort, the virus will continue to spread before all humans can be immunized, and new variants that may be less well contained by current vaccines are of concern. The COVID-19 pandemic has overwhelmed health care systems and new treatments to reduce mortality are urgently needed. We encourage to further evaluate the potential of auranofin in the treatment of COVID-19 in vitro and in animal models of SARS-CoV-2 infection and, if preliminary data are promising, in clinical trials with COVID-19 patients. In our opinion, auranofin has the potential to become a valuable addition to available therapies in this pandemic.
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Affiliation(s)
- Karine Sonzogni-Desautels
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, QC, Canada.,Department of Microbiology and Immunology, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada
| | - Momar Ndao
- Infectious Diseases and Immunity in Global Health Program, Research Institute of the McGill University Health Centre, Montreal, QC, Canada.,Department of Microbiology and Immunology, Faculty of Medicine and Health Sciences, McGill University, Montreal, QC, Canada.,National Reference Centre for Parasitology, Research Institute of the McGill University Health Centre, Montreal, QC, Canada
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26
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Dai T, Zhang L, Dai X, Zhang X, Lu B, Zheng Y, Shen D, Yan Y, Ji C, Yu J, Sun L. Multimode participation of traditional Chinese medicine in the treatment of COVID-19. Integr Med Res 2021; 10:100781. [PMID: 34642626 PMCID: PMC8496941 DOI: 10.1016/j.imr.2021.100781] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Revised: 09/28/2021] [Accepted: 09/29/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND The outbreak of COVID-19 has swiftly spread across China and all over the world, resulting in severe contagious pneumonia. However, no specific anti-COVID-19 drugs or methods are available for the treatment of this acute and fatal disease. In recent years, as the efficacy and safety of traditional Chinese medicine (TCM) have been universally acknowledged, it has been brought to a crucial status domestically and overseas for the treatment of COVID-19. METHODS We searched relevant literature, electronic databases, and official statements, diagnoses and protocols to retrieve studies and applications related to traditional Chinese medicine for COVID-19 in terms of regulations and policies, clinical evidence, preclinical rationale and big data analysis and then summarized the discovery and development of potential drugs and their targets. RESULTS Clinicians, researchers, governments, the public, colleges, institutes and companies collected and classified associated policies, regulations and actual contributions, searched clinical trials and preclinical experimental outcomes from databases, studied potential TCM drugs with possible mechanisms, retrieved numerous big data analysis method and gathered pooled results of compounds along with their effective targets to make traditional Chinese medicine vital to cover all stages of patients in the treatment and control of COVID-19. CONCLUSION Traditional Chinese medicine provides new evidence to support the clinical value of TCM for COVID-19.
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Affiliation(s)
- Tieying Dai
- Department of Hematology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China
| | - Leyin Zhang
- Department of Oncology, Hangzhou TCM Hospital of Zhejiang Chinese Medical University (Hangzhou Hospital of Traditional Chinese Medicine), Hangzhou, China
| | - Xinyang Dai
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Xinran Zhang
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Beibei Lu
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yuxi Zheng
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Deyi Shen
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yici Yan
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Congqi Ji
- The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jieru Yu
- School of Basic Medical Sciences, Zhejiang Chinese Medical University, Hangzhou, China
| | - Leitao Sun
- Department of Medical Oncology, The First Affiliated Hospital of Zhejiang Chinese Medical University (Zhejiang Provincial Hospital of Traditional Chinese Medicine), Hangzhou, China
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27
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Rivas AL, Hoogesteijn AL. Biologically grounded scientific methods: The challenges ahead for combating epidemics. Methods 2021; 195:113-119. [PMID: 34492300 PMCID: PMC8423586 DOI: 10.1016/j.ymeth.2021.09.001] [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: 06/14/2021] [Revised: 08/26/2021] [Accepted: 09/02/2021] [Indexed: 01/12/2023] Open
Abstract
The protracted COVID 19 pandemic may indicate failures of scientific methodologies. Hoping to facilitate the evaluation and/or update of methods relevant in Biomedicine, several aspects of scientific processes are here explored. First, the background is reviewed. In particular, eight topics are analyzed: (i) the history of Higher Education models in reference to the pursuit of science and the type of student cognition pursued, (ii) whether explanatory or actionable knowledge is emphasized depending on the well- or ill-defined nature of problems, (iii) the role of complexity and dynamics, (iv) how differences between Biology and other fields influence methodologies, (v) whether theory, hypotheses or data drive scientific research, (vi) whether Biology is reducible to one or a few factors, (vii) the fact that data, to become actionable knowledge, require structuring, and (viii) the need of inter-/trans-disciplinary knowledge integration. To illustrate how these topics interact, a second section describes four temporal stages of scientific methods: conceptualization, operationalization, validation and evaluation. They refer to the transition from abstract (non-measurable) concepts (such as 'health') to the selection of concrete (measurable) operations (such as 'quantification of ́anti-virus specific antibody titers'). Conceptualization is the process that selects concepts worth investigating, which continues as operationalization when data-producing variables viewed to reflect critical features of the concepts are chosen. Because the operations selected are not necessarily valid, informative, and may fail to solve problems, validations and evaluations are critical stages, which require inter/trans-disciplinary knowledge integration. It is suggested that data structuring can substantially improve scientific methodologies applicable in Biology, provided that other aspects here mentioned are also considered. The creation of independent bodies meant to evaluate biologically oriented scientific methods is recommended.
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Affiliation(s)
| | - Almira L Hoogesteijn
- Human Ecology, Centro de Investigación y de Estudios Avanzados (CINVESTAV), Merida, Mexico.
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28
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Albrecht L, Bishop E, Jay B, Lafoux B, Minoves M, Passaes C. COVID-19 Research: Lessons from Non-Human Primate Models. Vaccines (Basel) 2021; 9:886. [PMID: 34452011 PMCID: PMC8402317 DOI: 10.3390/vaccines9080886] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/28/2021] [Accepted: 07/30/2021] [Indexed: 12/14/2022] Open
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the coronavirus disease 2019 (COVID-19). It emerged from China in December 2019 and rapidly spread across the globe, causing a pandemic with unprecedented impacts on public health and economy. Therefore, there is an urgent need for the development of curative treatments and vaccines. In humans, COVID-19 pathogenesis shows a wide range of symptoms, from asymptomatic to severe pneumonia. Identifying animal models of SARS-CoV-2 infection that reflect the clinical symptoms of COVID-19 is of critical importance. Nonhuman primates (NHPss) correspond to relevant models to assess vaccine and antiviral effectiveness. This review discusses the use of NHPs as models for COVID-19 research, with focus on the pathogenesis of SARS-CoV-2 infection, drug discovery and pre-clinical evaluation of vaccine candidates.
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Affiliation(s)
- Laure Albrecht
- Institut Pasteur, Centre d’Enseignement, Cours Virologie Fondamentale, 75015 Paris, France; (L.A.); (E.B.); (B.J.); (B.L.); (M.M.)
- Département de Sciences de la vie, Sorbonne Université, 75006 Paris, France
- École normale supérieure Paris-Saclay, 91190 Gif-sur-Yvette, France
| | - Elodie Bishop
- Institut Pasteur, Centre d’Enseignement, Cours Virologie Fondamentale, 75015 Paris, France; (L.A.); (E.B.); (B.J.); (B.L.); (M.M.)
- Département de Sciences de la vie, Sorbonne Université, 75006 Paris, France
- École normale supérieure Paris-Saclay, 91190 Gif-sur-Yvette, France
| | - Basile Jay
- Institut Pasteur, Centre d’Enseignement, Cours Virologie Fondamentale, 75015 Paris, France; (L.A.); (E.B.); (B.J.); (B.L.); (M.M.)
- École normale supérieure Paris-Saclay, 91190 Gif-sur-Yvette, France
- Département de Biologie, École Normale Supérieure, 75005 Paris, France
| | - Blaise Lafoux
- Institut Pasteur, Centre d’Enseignement, Cours Virologie Fondamentale, 75015 Paris, France; (L.A.); (E.B.); (B.J.); (B.L.); (M.M.)
- Département de Biologie, École Normale Supérieure, 75005 Paris, France
| | - Marie Minoves
- Institut Pasteur, Centre d’Enseignement, Cours Virologie Fondamentale, 75015 Paris, France; (L.A.); (E.B.); (B.J.); (B.L.); (M.M.)
- Département de Sciences de la vie, Sorbonne Université, 75006 Paris, France
| | - Caroline Passaes
- Département de Sciences du vivant, Université de Paris, 75006 Paris, France
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Vallejos J, Zoni R, Bangher M, Villamandos S, Bobadilla A, Plano F, Campias C, Chaparro Campias E, Medina MF, Achinelli F, Guglielmone HA, Ojeda J, Farizano Salazar D, Andino G, Kawerin P, Dellamea S, Aquino AC, Flores V, Martemucci CN, Martinez SM, Segovia JE, Reynoso PI, Sosa NC, Robledo ME, Guarrochena JM, Vernengo MM, Ruiz Diaz N, Meza E, Aguirre MG. Ivermectin to prevent hospitalizations in patients with COVID-19 (IVERCOR-COVID19) a randomized, double-blind, placebo-controlled trial. BMC Infect Dis 2021; 21:635. [PMID: 34215210 PMCID: PMC8250562 DOI: 10.1186/s12879-021-06348-5] [Citation(s) in RCA: 54] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/17/2021] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) has changed our lives. The scientific community has been investigating re-purposed treatments to prevent disease progression in coronavirus disease (COVID-19) patients. OBJECTIVE To determine whether ivermectin treatment can prevent hospitalization in individuals with early COVID-19. DESIGN, SETTING AND PARTICIPANTS A randomized, double-blind, placebo-controlled study was conducted in non-hospitalized individuals with COVID-19 in Corrientes, Argentina. Patients with SARS-CoV-2 positive nasal swabs were contacted within 48 h by telephone to invite them to participate. The trial randomized 501 patients between August 19th 2020 and February 22nd 2021. INTERVENTION Patients were randomized to ivermectin (N = 250) or placebo (N = 251) arms in a staggered dose, according to the patient's weight, for 2 days. MAIN OUTCOMES AND MEASURES The efficacy of ivermectin to prevent hospitalizations was evaluated as primary outcome. We evaluated secondary outcomes in relationship to safety and other efficacy end points. RESULTS The mean age was 42 years (SD ± 15.5) and the median time since symptom onset to the inclusion was 4 days [interquartile range 3-6]. The primary outcome of hospitalization was met in 14/250 (5.6%) individuals in ivermectin group and 21/251 (8.4%) in placebo group (odds ratio 0.65; 95% confidence interval, 0.32-1.31; p = 0.227). Time to hospitalization was not statistically different between groups. The mean time from study enrollment to invasive mechanical ventilatory support (MVS) was 5.25 days (SD ± 1.71) in ivermectin group and 10 days (SD ± 2) in placebo group, (p = 0.019). There were no statistically significant differences in the other secondary outcomes including polymerase chain reaction test negativity and safety outcomes. LIMITATIONS Low percentage of hospitalization events, dose of ivermectin and not including only high-risk population. CONCLUSION Ivermectin had no significant effect on preventing hospitalization of patients with COVID-19. Patients who received ivermectin required invasive MVS earlier in their treatment. No significant differences were observed in any of the other secondary outcomes. TRIAL REGISTRATION ClinicalTrials.gov NCT04529525 .
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Affiliation(s)
- Julio Vallejos
- Instituto de Cardiología de Corrientes, Bolivar 1334, Zip code, 3400, Corrientes, Argentina
| | - Rodrigo Zoni
- Instituto de Cardiología de Corrientes, Bolivar 1334, Zip code, 3400, Corrientes, Argentina.
| | - María Bangher
- Instituto de Cardiología de Corrientes, Bolivar 1334, Zip code, 3400, Corrientes, Argentina
| | - Silvina Villamandos
- Instituto de Cardiología de Corrientes, Bolivar 1334, Zip code, 3400, Corrientes, Argentina
| | - Angelina Bobadilla
- Epidemiology. Ministerio de Salud Pública de la Provincia de Corrientes, Corrientes, Argentina
| | - Fabian Plano
- Hospital de Campaña, Ministerio de Salud Pública de la Provincia de Corrientes, Ministerio de Salud Pública de Corrientes, Corrientes, Argentina
| | - Claudia Campias
- Epidemiology. Ministerio de Salud Pública de la Provincia de Corrientes, Corrientes, Argentina
| | | | - Maria Fernanda Medina
- Instituto de Cardiología de Corrientes, Bolivar 1334, Zip code, 3400, Corrientes, Argentina
| | - Fernando Achinelli
- Hospital de Campaña, Ministerio de Salud Pública de la Provincia de Corrientes, Ministerio de Salud Pública de Corrientes, Corrientes, Argentina
| | | | - Jorge Ojeda
- Hospital de Campaña, Ministerio de Salud Pública de la Provincia de Corrientes, Ministerio de Salud Pública de Corrientes, Corrientes, Argentina
| | - Diego Farizano Salazar
- Hospital de Campaña, Ministerio de Salud Pública de la Provincia de Corrientes, Ministerio de Salud Pública de Corrientes, Corrientes, Argentina
| | - Gerardo Andino
- Ministerio de Salud Pública de la Provincia de Corrientes, Corrientes, Argentina
| | - Pablo Kawerin
- Ministerio de Salud Pública de la Provincia de Corrientes, Corrientes, Argentina
| | - Silvana Dellamea
- Hospital de Campaña, Ministerio de Salud Pública de la Provincia de Corrientes, Ministerio de Salud Pública de Corrientes, Corrientes, Argentina
| | - Antonia Cristina Aquino
- Hospital de Campaña, Ministerio de Salud Pública de la Provincia de Corrientes, Ministerio de Salud Pública de Corrientes, Corrientes, Argentina
| | - Victor Flores
- Hospital de Campaña, Ministerio de Salud Pública de la Provincia de Corrientes, Ministerio de Salud Pública de Corrientes, Corrientes, Argentina
| | | | | | - Juan Emanuel Segovia
- Epidemiology. Ministerio de Salud Pública de la Provincia de Corrientes, Corrientes, Argentina
| | - Paola Itati Reynoso
- Instituto de Cardiología de Corrientes, Bolivar 1334, Zip code, 3400, Corrientes, Argentina
| | - Noelia Carolina Sosa
- Instituto de Cardiología de Corrientes, Bolivar 1334, Zip code, 3400, Corrientes, Argentina
| | | | | | - Maria Mercedes Vernengo
- Epidemiology. Ministerio de Salud Pública de la Provincia de Corrientes, Corrientes, Argentina
| | - Natalia Ruiz Diaz
- Ministerio de Salud Pública de la Provincia de Corrientes, Corrientes, Argentina
| | - Elba Meza
- Epidemiology. Ministerio de Salud Pública de la Provincia de Corrientes, Corrientes, Argentina
| | - María Gabriela Aguirre
- Instituto de Cardiología de Corrientes, Bolivar 1334, Zip code, 3400, Corrientes, Argentina
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Olszewska-Parasiewicz J, Szarpak Ł, Rogula S, Gąsecka A, Szymańska U, Kwiatkowska M, Jaguszewski MJ, Sierpiński R, Zaczyński A, Wierzba W, Kosior DA. Statins in COVID-19 Therapy. Life (Basel) 2021; 11:life11060565. [PMID: 34208435 PMCID: PMC8234902 DOI: 10.3390/life11060565] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 06/03/2021] [Accepted: 06/11/2021] [Indexed: 01/08/2023] Open
Abstract
Inhibitors of 3-hydroxy-3methylgultaryl-coenzyme A reductase (statins) are one of the main groups of drugs used in preventing and treating cardiovascular diseases worldwide. They are widely available, cheap, and well-tolerated. Based on statins’ pleiotropic properties, including improvement of endothelial dysfunction, antioxidant properties, atherosclerotic plaque stabilization, and inhibition of inflammatory responses, it can be hypothesized that the use of statins, at least as an adjuvant in antiviral therapy, may be justified. All these effects might be especially beneficial in patients with COVID-19, suffering from endothelial dysfunction, microvascular and macrovascular thrombosis, and cytokine storm. Here, we review the recent data regarding the pathophysiology of SARS-CoV-2 activity in host cells, proposed COVID-19 therapy, the pleiotropic activity of statins, and statins in clinical trials in respiratory infections. According to the guidelines of the European and American Cardiac Societies, in patients with cardiovascular disease or high cardiovascular risk with concomitant COVID-19 it is recommended to continue statin treatment. However, the initiation of statin therapy de novo in COVID-19 treatment should only be done as part of a clinical trial.
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Affiliation(s)
- Justyna Olszewska-Parasiewicz
- Central Clinical Hospital the Ministry of the Interior and Administration, Wołoska 137, 02-507 Warsaw, Poland; (J.O.-P.); (U.S.); (M.K.); (A.Z.); (W.W.); (D.A.K.)
| | - Łukasz Szarpak
- Maria Sklodowska-Curie Białystok Oncology Centre, Ogrodowa 12, 15-027 Białystok, Poland
- Maria Sklodowska-Curie Medical Academy in Warsaw, Solidarnosci 12, 03-411 Warsaw, Poland
- Correspondence:
| | - Sylwester Rogula
- Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland; (S.R.); (A.G.)
| | - Aleksandra Gąsecka
- Department of Cardiology, Medical University of Warsaw, Banacha 1a, 02-097 Warsaw, Poland; (S.R.); (A.G.)
| | - Urszula Szymańska
- Central Clinical Hospital the Ministry of the Interior and Administration, Wołoska 137, 02-507 Warsaw, Poland; (J.O.-P.); (U.S.); (M.K.); (A.Z.); (W.W.); (D.A.K.)
| | - Maria Kwiatkowska
- Central Clinical Hospital the Ministry of the Interior and Administration, Wołoska 137, 02-507 Warsaw, Poland; (J.O.-P.); (U.S.); (M.K.); (A.Z.); (W.W.); (D.A.K.)
| | - Milosz J. Jaguszewski
- Department of Cardiology, Medical University of Gdańsk, Dębinki 7, 80-952 Gdańsk, Poland;
| | - Radosław Sierpiński
- Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszyński University, 01-815 Warsaw, Poland;
| | - Artur Zaczyński
- Central Clinical Hospital the Ministry of the Interior and Administration, Wołoska 137, 02-507 Warsaw, Poland; (J.O.-P.); (U.S.); (M.K.); (A.Z.); (W.W.); (D.A.K.)
| | - Waldemar Wierzba
- Central Clinical Hospital the Ministry of the Interior and Administration, Wołoska 137, 02-507 Warsaw, Poland; (J.O.-P.); (U.S.); (M.K.); (A.Z.); (W.W.); (D.A.K.)
- UHE Satellite Campus in Warsaw, University of Humanities and Economics in Łódź, Felińskego 15, 01-513 Warsaw, Poland
| | - Dariusz A. Kosior
- Central Clinical Hospital the Ministry of the Interior and Administration, Wołoska 137, 02-507 Warsaw, Poland; (J.O.-P.); (U.S.); (M.K.); (A.Z.); (W.W.); (D.A.K.)
- Mossakowski Medical Research Institute, Polish Academy of Sciences, 02-106 Warsaw, Poland
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31
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Niktab I, Haghparast M, Beigi MH, Megraw TL, Kiani A, Ghaedi K. Design of advanced siRNA therapeutics for the treatment of COVID-19. Meta Gene 2021; 29:100910. [PMID: 33996501 PMCID: PMC8106235 DOI: 10.1016/j.mgene.2021.100910] [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: 10/10/2020] [Revised: 04/10/2021] [Accepted: 04/30/2021] [Indexed: 12/13/2022] Open
Abstract
COVID-19 is a newly emerged viral disease that is currently affecting the whole globe. A variety of therapeutic approaches are underway to block the SARS-CoV-2 virus. Among these methods, siRNAs could be a safe and specific option, as they have been tested against other viruses. siRNAs are a class of inhibitor RNAs that act promisingly as mRNA expression blockers and they can be designed to interfere with viral mRNA to block virus replication. In order to do this, we designed and evaluated the efficacy of six highly specific siRNAs, which target essential viral mRNAs with no predicted human genome off-targets. We observed a significant reduction in the copy number viral mRNAs after treatment with the siRNAs, and are expected to inhibit virus replication. We propose siRNAs as a potential co-therapy for acute SARS-CoV-2 infection.
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Affiliation(s)
- Iman Niktab
- Department of Cell and Molecular Biology and Microbiology, Faculty of Biological Science & Technology, University of Isfahan, Isfahan, Iran.,Department of Biology, Faculty of Sciences, Shahid Bahonar University of Kerman, Kerman, Iran
| | - Maryam Haghparast
- Department of Cell and Molecular Biology and Microbiology, Faculty of Biological Science & Technology, University of Isfahan, Isfahan, Iran
| | - Mohammad-Hossein Beigi
- Department of Cell and Molecular Biology and Microbiology, Faculty of Biological Science & Technology, University of Isfahan, Isfahan, Iran.,Silicon Hall: Micro/Nano Manufacturing Facility, Faculty of Engineering and Applied Science, Ontario Tech University, Ontario, Canada
| | - Timothy L Megraw
- Department of Biomedical Sciences, Florida State University College of Medicine, USA
| | - Amirkianoosh Kiani
- Silicon Hall: Micro/Nano Manufacturing Facility, Faculty of Engineering and Applied Science, Ontario Tech University, Ontario, Canada
| | - Kamran Ghaedi
- Department of Cell and Molecular Biology and Microbiology, Faculty of Biological Science & Technology, University of Isfahan, Isfahan, Iran
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32
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Polidori MC, Sies H, Ferrucci L, Benzing T. COVID-19 mortality as a fingerprint of biological age. Ageing Res Rev 2021; 67:101308. [PMID: 33621704 PMCID: PMC7896489 DOI: 10.1016/j.arr.2021.101308] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 02/09/2021] [Accepted: 02/18/2021] [Indexed: 12/19/2022]
Abstract
Corona virus disease 2019 (COVID-19) is a global emergency able to overwhelm the healthcare capacities worldwide and to affect the older generation especially. When addressing the pathophysiological mechanisms and clinical manifestations of COVID-19, it becomes evident that the disease targets pathways and domains affected by the main aging- and frailty-related pathophysiological changes. A closer analysis of the existing data supports a possible role of biological age rather than chronological age in the prognosis of COVID-19. There is a need for systematic, consequent action of identifying frail (not only older, not only multimorbid, not only symptomatic) persons at risk of poor outcomes.
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Affiliation(s)
- M Cristina Polidori
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.
| | - Helmut Sies
- Institute of Biochemistry and Molecular Biology I, Faculty of Medicine, Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany; Leibniz Research Institute for Environmental Medicine, Düsseldorf, Germany
| | | | - Thomas Benzing
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
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33
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Rybicka M, Miłosz E, Bielawski KP. Superiority of MALDI-TOF Mass Spectrometry over Real-Time PCR for SARS-CoV-2 RNA Detection. Viruses 2021; 13:v13050730. [PMID: 33922195 PMCID: PMC8145549 DOI: 10.3390/v13050730] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 04/16/2021] [Accepted: 04/19/2021] [Indexed: 12/11/2022] Open
Abstract
At present, the RT-PCR test remains the gold standard for early diagnosis of SARS-CoV-2. Nevertheless, there is growing evidence demonstrating that this technique may generate false-negative results. Here, we aimed to compare the new mass spectrometry-based assay MassARRAY® SARS-CoV-2 Panel with the RT-PCR diagnostic test approved for clinical use. The study group consisted of 168 suspected patients with symptoms of a respiratory infection. After simultaneous analysis by RT-PCR and mass spectrometry methods, we obtained discordant results for 17 samples (10.12%). Within fifteen samples officially reported as presumptive positive, 13 were positive according to the MS-based assay. Moreover, four samples reported by the officially approved RT-PCR as negative were positive in at least one MS assay. We have successfully demonstrated superior sensitivity of the MS-based assay in SARS-CoV-2 detection, showing that MALDI-TOF MS seems to be ideal for the detection as well as discrimination of mutations within the viral genome.
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Affiliation(s)
- Magda Rybicka
- Department of Molecular Diagnostics, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, Abrahama 58, 80-307 Gdansk, Poland;
- Correspondence: ; Tel.: +48-058-523-6435
| | - Ewa Miłosz
- Laboratory of Molecular Biology, Medical University of Gdansk, Marii Skłodowskiej-Curie 3A, 80-210 Gdansk, Poland;
| | - Krzysztof Piotr Bielawski
- Department of Molecular Diagnostics, Intercollegiate Faculty of Biotechnology, University of Gdansk and Medical University of Gdansk, Abrahama 58, 80-307 Gdansk, Poland;
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Kanimozhi G, Pradhapsingh B, Singh Pawar C, Khan HA, Alrokayan SH, Prasad NR. SARS-CoV-2: Pathogenesis, Molecular Targets and Experimental Models. Front Pharmacol 2021; 12:638334. [PMID: 33967772 PMCID: PMC8100521 DOI: 10.3389/fphar.2021.638334] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 03/26/2021] [Indexed: 02/05/2023] Open
Abstract
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a recent pandemic outbreak threatening human beings worldwide. This novel coronavirus disease-19 (COVID-19) infection causes severe morbidity and mortality and rapidly spreading across the countries. Therefore, there is an urgent need for basic fundamental research to understand the pathogenesis and druggable molecular targets of SARS-CoV-2. Recent sequencing data of the viral genome and X-ray crystallographic data of the viral proteins illustrate potential molecular targets that need to be investigated for structure-based drug design. Further, the SARS-CoV-2 viral pathogen isolated from clinical samples needs to be cultivated and titrated. All of these scenarios demand suitable laboratory experimental models. The experimental models should mimic the viral life cycle as it happens in the human lung epithelial cells. Recently, researchers employing primary human lung epithelial cells, intestinal epithelial cells, experimental cell lines like Vero cells, CaCo-2 cells, HEK-293, H1299, Calu-3 for understanding viral titer values. The human iPSC-derived lung organoids, small intestinal organoids, and blood vessel organoids increase interest among researchers to understand SARS-CoV-2 biology and treatment outcome. The SARS-CoV-2 enters the human lung epithelial cells using viral Spike (S1) protein and human angiotensin-converting enzyme 2 (ACE-2) receptor. The laboratory mouse show poor ACE-2 expression and thereby inefficient SARS-CoV-2 infection. Therefore, there was an urgent need to develop transgenic hACE-2 mouse models to understand antiviral agents' therapeutic outcomes. This review highlighted the viral pathogenesis, potential druggable molecular targets, and suitable experimental models for basic fundamental research.
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Affiliation(s)
- G. Kanimozhi
- Department of Biochemistry, Dharmapuram Gnanambigai Government Arts College for Women, Mayiladuthurai, India
| | - B. Pradhapsingh
- Department of Biochemistry and Biotechnology, Annamalai University, Annamalainagar, India
| | - Charan Singh Pawar
- Department of Biochemistry and Biotechnology, Annamalai University, Annamalainagar, India
| | - Haseeb A. Khan
- Department of Biochemistry, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - Salman H. Alrokayan
- Department of Biochemistry, College of Science, King Saud University, Riyadh, Saudi Arabia
| | - N. Rajendra Prasad
- Department of Biochemistry and Biotechnology, Annamalai University, Annamalainagar, India
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Hendricks CL, Herd C, Nel M, Tintinger G, Pepper MS. The COVID-19 Treatment Landscape: A South African Perspective on a Race Against Time. Front Med (Lausanne) 2021; 8:604087. [PMID: 33681243 PMCID: PMC7933453 DOI: 10.3389/fmed.2021.604087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 01/21/2021] [Indexed: 12/15/2022] Open
Abstract
The pandemic caused by SARS-CoV-2 has infected more than 94 million people worldwide (as of 17 January 2020). Severe disease is believed to be secondary to the cytokine release syndrome (CRS or "cytokine storm") which causes local tissue damage as well as multi-organ dysfunction and thrombotic complications. Due to the high mortality rates in patients receiving invasive ventilation, practice has changed from "early-intubation" for acute respiratory distress syndrome (ARDS) to a trial of non-invasive ventilation (NIV) or high flow nasal cannula (HFNC) oxygen. Reports indicating the benefit of NIV and HFNC have been encouraging and have led to more than 20,000 such devices being manufactured and ready for roll-out in South Africa (SA) as of July 2020. The need to identify drugs with clear clinical benefits has led to an array of clinical trials, most of which are repurposing drugs for COVID-19. The treatment landscape reflects the need to target both the virus and its effects such as the CRS and thrombotic complications. Conflicting results have the potential to confuse the implementation of coordinated treatment strategies and guidelines. The purpose of this review is to address pertinent areas in the current literature on the available medical treatment options for COVID-19. Remdesivir, tocilizumab, and dexamethasone are some of the treatment options that have shown the most promise, but further randomized trials are required to particularly address timing and dosages to confidently create standardized protocols. For the SA population, two healthcare sectors exist. In the private sector, patients with medical insurance may have greater access to a wider range of treatment options than those in the public sector. The latter serves >80% of the population, and resource constraints require the identification of drugs with the most cost-effective use for the greatest number of affected patients.
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Affiliation(s)
- Candice Laverne Hendricks
- Department of Medical Immunology, Institute for Cellular and Molecular Medicine, University of Pretoria, Pretoria, South Africa
| | - Candice Herd
- Department of Medical Immunology, Institute for Cellular and Molecular Medicine, University of Pretoria, Pretoria, South Africa
| | - Marcel Nel
- Department of Medical Immunology, Institute for Cellular and Molecular Medicine, University of Pretoria, Pretoria, South Africa
| | - Gregory Tintinger
- Department of Internal Medicine, University of Pretoria, Pretoria, South Africa
| | - Michael Sean Pepper
- Department of Medical Immunology, Institute for Cellular and Molecular Medicine, University of Pretoria, Pretoria, South Africa
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Mediterranean Diet for the Prevention of Gestational Diabetes in the Covid-19 Era: Implications of Il-6 In Diabesity. Int J Mol Sci 2021; 22:ijms22031213. [PMID: 33530554 PMCID: PMC7866163 DOI: 10.3390/ijms22031213] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Revised: 01/21/2021] [Accepted: 01/22/2021] [Indexed: 02/07/2023] Open
Abstract
The aim of this review is to highlight the influence of the Mediterranean Diet (MedDiet) on Gestational Diabetes Mellitus (GDM) and Gestational Weight Gain (GWG) during the COVID-19 pandemic era and the specific role of interleukin (IL)-6 in diabesity. It is known that diabetes, high body mass index, high glycated hemoglobin and raised serum IL-6 levels are predictive of poor outcomes in coronavirus disease 2019 (COVID-19). The immunopathological mechanisms of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection include rising levels of several cytokines and in particular IL-6. The latter is associated with hyperglycemia and insulin resistance and could be useful for predicting the development of GDM. Rich in omega-3 polyunsaturated fatty acids, vitamins, and minerals, MedDiet improves the immune system and could modulate IL-6, C reactive protein and Nuclear Factor (NF)-κB. Moreover, polyphenols could modulate microbiota composition, inhibit the NF-κB pathway, lower IL-6, and upregulate antioxidant enzymes. Finally, adhering to the MedDiet prior to and during pregnancy could have a protective effect, reducing GWG and the risk of GDM, as well as improving the immune response to viral infections such as COVID-19.
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