Stopping the COVID-19 Pandemic: A Review on the Advances of Diagnosis, Treatment, and Control Measures

Personal protective equipment-derived pollution during Covid-19 era: A critical review of ecotoxicology impacts, intervention strategies, and future challenges

During the COVID-19 pandemic, people used personal protective equipment (PPE) to lessen the spread of the virus. The release of microplastics (MPs) from discarded PPE is a new threat to the long-term health of the environment and poses challenges that are not yet clear. PPE-derived MPs have been found in multi-environmental compartments, e.g., water, sediments, air, and soil across the Bay of Bengal (BoB). As COVID-19 spreads, healthcare facilities use more plastic PPE, polluting aquatic ecosystems. Excessive PPE use releases MPs into the ecosystem, which aquatic organisms ingest, distressing the food chain and possibly causing ongoing health problems in humans. Thus, post-COVID-19 sustainability depends on proper intervention strategies for PPE waste, which have received scholarly interest. Although many studies have investigated PPE-induced MPs pollution in the BoB countries (e.g., India, Bangladesh, Sri Lanka, and Myanmar), the ecotoxicity impacts, intervention strategies, and future challenges of PPE-derived waste have largely gone unnoticed. Our study presents a critical literature review covering the ecotoxicity impacts, intervention strategies, and future challenges across the BoB countries (e.g., India (162,034.45 tons), Bangladesh (67,996 tons), Sri Lanka (35,707.95 tons), and Myanmar (22,593.5 tons). The ecotoxicity impacts of PPE-derived MPs on human health and other environmental compartments are critically addressed. The review's findings infer a gap in the 5R (Reduce, Reuse, Recycle, Redesign, and Restructure) Strategy's implementation in the BoB coastal regions, hindering the achievement of UN SDG-12. Despite widespread research advancements in the BoB, many questions about PPE-derived MPs pollution from the perspective of the COVID-19 era still need to be answered. In response to the post-COVID-19 environmental remediation concerns, this study highlights the present research gaps and suggests new research directions considering the current MPs' research advancements on COVID-related PPE waste. Finally, the review suggests a framework for proper intervention strategies for reducing and monitoring PPE-derived MPs pollution in the BoB countries.

Computational studies of potential antiviral compounds from some selected Nigerian medicinal plants against SARS-CoV-2 proteins

The challenges posed by COVID-19's emergence have led to a search for its therapies. There is no cure for COVID-19 infection yet, but there is significant progress in vaccine formulation for prophylaxis and drug development (such as paxlovid) for high-risk patients. As a contribution to the ongoing quest for solutions, this study shows potent phytocompounds identification as inhibitors of SARS-CoV-2 targets using in silico methods. We used virtual screening, molecular docking, and molecular dynamics (MD) simulations to investigate the interaction of some phytochemicals with 3CLpro, ACE2, and PLpro proteins crucial to the SARS-CoV-2 viral cycle. The predicted docking scores range from −5.5 to −9.4 kcal/mol, denoting appreciable binding of these compounds to the SARS-CoV-2 proteins and presenting a multitarget inhibition for COVID-19. Some phytocompounds interact favorably at non-active sites of the enzymes. For instance, MD simulation shows that an identified site on PLpro is stable and likely an allosteric region for inhibitor binding and modulation. These phytocompounds could be developed into effective therapy against COVID-19 and probed as potential multitarget-directed ligands and drug candidates against the SARS-CoV-2 virus. The study unveils drug repurposing, selectivity, allosteric site targeting, and multitarget-directed ligand in one piece. These concepts are three distinct approaches in the drug design and discovery pipeline.

Current trends in COVID-19 diagnosis and its new variants in physiological fluids: Surface antigens, antibodies, nucleic acids, and RNA sequencing

Rapid, highly sensitive, and accurate virus circulation monitoring techniques are critical to limit the spread of the virus and reduce the social and economic burden. Therefore, point-of-use diagnostic devices have played a critical role in addressing the outbreak of COVID-19 (SARS-CoV-2) viruses. This review provides a comprehensive overview of the current techniques developed for the detection of SARS-CoV-2 in various body fluids (e.g., blood, urine, feces, saliva, tears, and semen) and considers the mutations (i.e., Alpha, Beta, Gamma, Delta, Omicron). We classify and comprehensively discuss the detection methods depending on the biomarker measured (i.e., surface antigen, antibody, and nucleic acid) and the measurement techniques such as lateral flow immunoassay (LFIA), enzyme-linked immunosorbent assay (ELISA), reverse transcriptase-polymerase chain reaction (RT-PCR), reverse transcription loop-mediated isothermal amplification (RT-LAMP), microarray analysis, clustered regularly interspaced short palindromic repeats (CRISPR) and biosensors. Finally, we addressed the challenges of rapidly identifying emerging variants, detecting the virus in the early stages of infection, the detection sensitivity, selectivity, and specificity, and commented on how these challenges can be overcome in the future.

Current Artificial Intelligence (AI) Techniques, Challenges, and Approaches in Controlling and Fighting COVID-19: A Review

SARS-CoV-2 (COVID-19) has been one of the worst global health crises in the 21st century. The currently available rollout vaccines are not 100% effective for COVID-19 due to the evolving nature of the virus. There is a real need for a concerted effort to fight the virus, and research from diverse fields must contribute. Artificial intelligence-based approaches have proven to be significantly effective in every branch of our daily lives, including healthcare and medical domains. During the early days of this pandemic, artificial intelligence (AI) was utilized in the fight against this virus outbreak and it has played a major role in containing the spread of the virus. It provided innovative opportunities to speed up the development of disease interventions. Several methods, models, AI-based devices, robotics, and technologies have been proposed and utilized for diverse tasks such as surveillance, spread prediction, peak time prediction, classification, hospitalization, healthcare management, heath system capacity, etc. This paper attempts to provide a quick, concise, and precise survey of the state-of-the-art AI-based techniques, technologies, and datasets used in fighting COVID-19. Several domains, including forecasting, surveillance, dynamic times series forecasting, spread prediction, genomics, compute vision, peak time prediction, the classification of medical imaging-including CT and X-ray and how they can be processed-and biological data (genome and protein sequences) have been investigated. An overview of the open-access computational resources and platforms is given and their useful tools are pointed out. The paper presents the potential research areas in AI and will thus encourage researchers to contribute to fighting against the virus and aid global health by slowing down the spread of the virus. This will be a significant contribution to help minimize the high death rate across the globe.

Personal protective equipment (PPE) pollution driven by the COVID-19 pandemic along the shoreline of Lake Tana, Bahir Dar, Ethiopia

Personal protective equipment (PPE) pollution has become one of the most pending environmental challenges resulting from the pandemic. While various studies investigated PPE pollution in the marine environment, freshwater bodies have been largely overlooked. In the present study, PPE monitoring was carried out in the vicinity of Lake Tana, the largest lake in Ethiopia. PPE density, types, and chemical composition (FTIR spectroscopy) were reported. A total of 221 PPEs were identified with a density ranging from 1.22 × 10^-5 PPE m^-2 (control site S1) to 2.88× 10^-4 PPE m^-2 with a mean density of 1.54 × 10^-4 ± 2.58 × 10^-5 PPE m^-2. Mismanaged PPE waste was found in all the sampling sites, mostly consisting of surgical face masks (93.7%). Statistical analyzes revealed significantly higher PPE densities in sites where several recreational, touristic, and commercial activities take place, thus, revealing the main sources of PPE pollution. Furthermore, polypropylene and polyester fabrics were identified as the main components of surgical and reusable cloth masks, respectively. Given the hazard that PPEs represent to aquatic biota (e.g., entanglement, ingestion) and their ability to release microplastics (MPs), it is necessary to implement sufficient solid waste management plans and infrastructure where lake activities take place. Additionally, local authorities must promote and ensure sustainable tourism in order to maintain the ecosystems in Lake Tana. Prospective research priorities regarding the colonization and degradation of PPE, as well as the release of toxic chemicals, were identified and discussed.

Synopsis of symptoms of COVID-19 during second wave of the pandemic in India

COVID-19 was caused by the original coronavirus, severe acute respiratory syndrome associated coronavirus-2 (SARS CoV2), which originated in Wuhan, China. COVID-19 had a large breakout of cases in early 2020, resulting in an epidemic that turned into a pandemic. This quickly enveloped the global healthcare system. The principal testing method for COVID-19 detection, according to the WHO, is reverse transcription polymerase chain reaction (RT-PCR). Isolation of patients, quarantine, masking, social distancing, sanitizer use, and complete lockdown were all vital health-care procedures for everyone. With the 'new normal' and vaccination programmes, the number of cases and recovered patients began to rise months later. The easing of restrictions during the plateau phase resulted in a rebound of instances, which hit the people with more ferocity and vengeance towards the start of April 2021. Coronaviruses have evolved to cause respiratory, enteric, hepatic, and neurologic diseases, resulting in a wide range of diseases and symptoms such as fever, cough, myalgia or fatigue, shortness of breath, muscle ache, headache, sore throat, rhinorrhea, hemoptysis, chest pain, nausea, vomiting, diarrhoea, anosmia, and ageusia. Coronavirus infections can be mild, moderate, or severe in intensity. COVID-19 pulmonary dysfunction includes lung edoema, ground-glass opacities, surfactant depletion, and alveolar collapse. Patients who presented with gastrointestinal (GI) symptoms such as anorexia, nausea, vomiting, or diarrhoea had a higher risk of negative outcomes. COVID-19's influence on cognitive function is one of COVID-19's long-term effects. More clinical situations need to be reviewed by healthcare professionals so that an appropriate management protocol may be developed to reduce morbidity and death in future coming third/fourth wave cases.

The unfurl of the coronavirus and its thwack on humans and the environment: a review

The new coronavirus disease 2019 (COVID-19) severe acute respiratory syndrome coronavirus 2 was first discovered in Wuhan (China) in December 2019 and belongs to the same family as that of the severe acute respiratory syndrome coronavirus 1. On January 30, 2020, the World Health Organization announced the outbreak as a Public Health Emergency of International Concern. Diagnosis of this disease is carried out by using special molecular tests. It is mandatory to identify the individual with COVID-19 symptoms, and isolation is necessary to prevent further transmission of this virus. This review highlights the formation, prodrome, transmission and survival mechanism of COVID-19 and shows that the pandemic circumstance fundamentally improves the air quality in various urban areas across the globe, decreases water contamination and commotion and diminishes the tension on the traveller objections, which may facilitate the reclamation of the natural framework. The worldwide effect of this new outbreak is still dubious.

Presenting characteristics, comorbidities, and outcomes among COVID-19 patients hospitalized in twin cities of Pakistan

Background

COVID-19 became a pandemic rapidly after its emergence in December 2019. It belongs to the coronavirus family of viruses, which have struck a few times before in history. Data based on previous research regarding etiology and epidemiology of other viruses from this family helped played a vital role in formulating prevention and precaution strategies during the initial stages of this pandemic. Data related to COVID-19 in Pakistan were not initially documented on a large scale. In addition, due to a weak health care system and low economic conditions, Pakistan’s population, in general, already suffers from many comorbidities, which can severely affect the outcome of patients infected with COVID-19.

Objective

COVID-19 infections are coupled with a manifestation of various notable outcomes that can be documented and characterized clinically. The aim of this study was to examine these clinical manifestations, which can serve as indicators for early detection as well as severity prognosis for COVID-19 infections, especially in high-risk groups.

Methods

A retrospective observational study involving abstraction of demographic features, presenting symptoms, and adverse clinical outcomes for 1812 patients with COVID-19 was conducted. Patients were admitted to the four major hospitals in the Rawalpindi-Islamabad region of Pakistan, and the study was conducted from February to August 2020. Multivariate regression analysis was carried out to identify significant indicators of COVID-19 severity, intensive care unit (ICU) admission, ventilator aid, and mortality. The study not only relates COVID-19 infection with comorbidities, but also examines other related factors, such as age and gender.

Results

This study identified fever (1592/1812, 87.9%), cough (1433/1812, 79.1%), and shortness of breath (998/1812, 55.1%) at the time of hospital admission as the most prevalent symptoms for patients with COVID-19. These symptoms were common but not conclusive of the outcome of infection. Out of 1812 patients, 24.4% (n=443) required ICU admission and 21.5% (n=390) required ventilator aid at some point of disease progression during their stay at the hospital; 25.9% (n=469) of the patients died. Further analysis revealed the relationship of the presented symptoms and comorbidities with the progression of disease severity in these patients. Older adult patients with comorbidities, such as hypertension, diabetes, chronic kidney disease, and asthma, were significantly affected in higher proportions, resulting in requirement of ICU admission and ventilator aid in some cases and, in many cases, even mortality.

Conclusions

Older adult patients with comorbidities, such as hypertension, diabetes, asthma, chronic obstructive pulmonary disorder, and chronic kidney disease, are at increased risk of developing severe COVID-19 infections, with an increased likelihood of adverse clinical outcomes.

Psychiatric emergency admissions during and after COVID-19 lockdown: short-term impact and long-term implications on mental health

BACKGROUND

The 'lockdown' measures, adopted to restrict population movements in order to help curb the novel coronavirus disease 2019 (COVID-19) pandemic, contributed to a global mental health crisis. Although several studies have extensively examined the impact of lockdown measures on the psychological well-being of the general population, little is known about long-term implications. This study aimed to identify changes in psychiatric emergency department (ED) admissions between two 8-week periods: during and immediately after lifting the lockdown.

METHODS

Socio-demographic and clinical information on 1477 psychiatric ED consultations at the University Hospital of Geneva (HUG) were retrospectively analyzed.

RESULTS

When grouped according to admission dates, contrary to what we expected, the post-lockdown group presented with more severe clinical conditions (as measured using an urgency degree index) compared to their lockdown counterparts. Notably, after the lockdown had been lifted we observed a statistically significant increase in suicidal behavior and psychomotor agitation and a decrease in behavior disorder diagnoses. Furthermore, more migrants arrived at the HUG ED after the lockdown measures had been lifted. Logistic regression analysis identified diagnoses of suicidal behavior, behavioral disorders, psychomotor agitation, migrant status, involuntary admission, and private resident discharge as predictors of post-lockdown admissions.

CONCLUSIONS

Collectively, these findings can have implications concerning the prioritization of mental health care facilities and access for patients at risk of psychopathological decompensation in time of confinement policies, but above all, provide a foundation for future studies focusing on the long-term impact of the pandemic and its associated sanitary measures on mental health.

TRIAL REGISTRATION

Research Ethics Committee of Geneva, Registration number 2020-01510, approval date: 29 June 2020.

Personal protective equipment (PPE) pollution driven by the COVID-19 pandemic in Cox's Bazar, the longest natural beach in the world

The extensive use of personal protective equipment (PPE) driven by the COVID-19 pandemic has become an important contributor to marine plastic pollution. However, there are very few studies quantifying and characterizing this type of pollution in coastal areas. In the present study, we monitored the occurrence of PPE (face masks, bouffant caps, and gloves) discarded in 13 sites along Cox's Bazar beach, the longest naturally occurring beach in the world. The vast majority of the items were face masks (97.9%), and the mean PPE density across sites was 6.29 × 10^-3 PPE m^-2. The presence of illegal dumping sites was the main source of PPE, which was mainly located on touristic/recreational beaches. Fishing activity contributed to PPE pollution at a lower level. Poor solid waste management practices in Cox's Bazar demonstrated to be a major driver of PPE pollution. The potential solutions and sustainable alternatives were discussed.

Thymoquinone against infectious diseases: Perspectives in recent pandemics and future therapeutics

The recent pandemics caused by coronavirus infections have become major challenges in 21st century human health. Scientists are struggling hard to develop a complete cure for infectious diseases, for example, drugs or vaccines against these deadly infectious diseases. We have searched papers on thymoquinone (TQ) and its effects on different infectious diseases in databases like Pubmed, Web of Science, Scopus, and Google Scholar, and reviewed them in this study. To date research suggests that natural products may become a potential therapeutic option for their prodigious anti-viral or anti-microbial effects on infectious diseases. TQ, a natural phytochemical from black seeds, is known for its health-beneficial activities against several diseases, including infections. It is evident from different in vitro and in vivo studies that TQ is effective against tuberculosis, influenza, dengue, Ebola, Zika, hepatitis, malaria, HIV, and even recent pandemics caused by severe acute respiratory syndrome of coronaviruses (SARS-CoV and SARS-CoV-2). In these cases, the molecular mechanism of TQ is partly clear but mostly obscure. In this review article, we have discussed the role of TQ against different infectious diseases, including COVID-19, and also critically reviewed the future use of TQ use to fight against infectious diseases.

An Overview of the Treatment Options Used for the Management of COVID-19 in Pakistan: Retrospective Observational Study

BACKGROUND

Since the first reports of COVID-19 infection, the foremost requirement has been to identify a treatment regimen that not only fights the causative agent but also controls the associated complications of the infection. Due to the time-consuming process of drug discovery, physicians have used readily available drugs and therapies for treatment of infections to minimize the death toll.

OBJECTIVE

The aim of this study is to provide a snapshot analysis of the major drugs used in a cohort of 1562 Pakistani patients during the period from May to July 2020, when the first wave of COVID-19 peaked in Pakistan.

METHODS

A retrospective observational study was performed to provide an overview of the major drugs used in a cohort of 1562 patients with COVID-19 admitted to the four major tertiary-care hospitals in the Rawalpindi-Islamabad region of Pakistan during the peak of the first wave of COVID-19 in the country (May-July 2020).

RESULTS

Antibiotics were the most common choice out of all the therapies employed, and they were used as first line of treatment for COVID-19. Azithromycin was the most prescribed drug for treatment. No monthly trend was observed in the choice of antibiotics, and these drugs appeared to be a random but favored choice throughout the months of the study. It was also noted that even antibiotics used for multidrug resistant infections were prescribed irrespective of the severity or progression of the infection. The results of the analysis are alarming, as this approach may lead to antibiotic resistance and complications in immunocompromised patients with COVID-19. A total of 1562 patients (1064 male, 68.1%, and 498 female, 31.9%) with a mean age of 47.35 years (SD 17.03) were included in the study. The highest frequency of patient hospitalizations occurred in June (846/1562, 54.2%).

CONCLUSIONS

Guidelines for a targeted treatment regime are needed to control related complications and to limit the misuse of antibiotics in the management of COVID-19.

A simplified alternative diagnostic algorithm for SARS-CoV-2 suspected symptomatic patients and confirmed close contacts (asymptomatic): A consensus of Latin American experts

INTRODUCTION

Latin America accounts for one-quarter of global COVID-19 cases and one-third of deaths. Inequalities in the region lead to barriers regarding the best use of diagnostic tests during the pandemic. There is a need for a simplified guideline, considering the region's health resources' low availability, international guidelines, medical literature, and local expertise.

METHODS

Nine experts from Latin American countries developed a simplified algorithm for COVID-19 diagnosis, using a modified Delphi method. Twenty-four questions related to diagnostic settings were proposed, followed by discussion of the literature and experts' experience.

RESULTS

The algorithm considers three timeframes (≤7 days, 8-13 days, and ≥ 14 days) and discusses diagnostic options for each one. SARS-CoV-2 rRT-PCR is the test of choice from day 1 to day 14 after symptom onset or close contact, although antigen testing may be used in particular situations, from days 5 to 7. Antibody assays may be used for confirmation, mainly after day 14. If the clinical suspicion is very high, but other tests are negative, these assays may be used as an adjunct to decision-making from day 8 to day 13.

CONCLUSION

The proposed algorithm aims to support COVID-19 diagnosis decision-making in Latin America.

SARS-CoV-2: Outline, Prevention, and Decontamination

The new coronavirus began to spread around the world in late 2019. Initially, it was found only in China, but in the following days there were reported cases of infections in other countries. Subsequently, based on taxonomy, phylogeny, and accepted practice, the virus was officially designated as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As a result of the rapid spread of SARS-CoV-2 in different countries around the world, on March 11, 2020, the World Health Organization (WHO) announced a status change in the disease caused by this coronavirus-from an epidemic to a pandemic disease. Although the world is taking unprecedented efforts to control the spread of SARS-CoV-2, the number of confirmed cases is rising. Therefore, effective preventive measures are needed in order to limit the spread of illness. The prevention measures are mainly based on information on the virus transmission routes, its environmental stability, and persistence on commonly touched surfaces. Social distancing, mask usage, and good hygiene practice are the most important recommendations for general public. Healthcare professionals who are directly involved in SARS-CoV-2 patients care are more exposed to virus infection and additional protection measures are necessary, including protective suits, aprons, face shields, goggles, and gloves. Due to the stability of SARS-CoV-2 on different surfaces, such as glass, paper, or wood, proper disinfection is crucial. Several studies have shown that despite the virus's stability, it is sensitive to various disinfectants, such as ethanol, isopropanol, sodium hypochlorite, or hydrogen peroxide. These findings underline the importance of having comprehensive knowledge about SARS-CoV-2 and multidirectional strategies in order to limit the spread of the virus. This review is a summary of the most important information about SARS-CoV-2, such as its stability on different surfaces, protection strategies, and decontamination options.