COVID-19 Outbreak: An Overview

A mimetic peptide of ACE2 protects against SARS-CoV-2 infection and decreases pulmonary inflammation related to COVID-19

Since human angiotensin-converting enzyme 2 (ACE2) serves as a primary receptor for SARS-CoV-2, characterizing ACE2 regions that allow SARS-CoV-2 to enter human cells is essential for designing peptide-based antiviral blockers and elucidating the pathogenesis of the virus. We identified and synthesized a 25-mer mimetic peptide (encompassing positions 22-46 of the ACE2 alpha-helix α1) implicated in the S1 receptor-binding domain (RBD)-ACE2 interface. The mimetic (wild-type, WT) ACE2 peptide significantly inhibited SARS-CoV-2 infection of human pulmonary Calu-3 cells in vitro. In silico protein modeling predicted that residues F28, K31, F32, F40, and Y41 of the ACE2 alpha-helix α1 are critical for the original, Delta, and Omicron strains of SARS-CoV-2 to establish the Spike RBD-ACE2 interface. Substituting these residues with alanine (A) or aspartic acid (D) abrogated the antiviral protective effect of the peptides, indicating that these positions are critical for viral entry into pulmonary cells. WT ACE2 peptide, but not the A or D mutated peptides, exhibited significant interaction with the SARS-CoV-2 S1 RBD, as shown through molecular dynamics simulations. Through identifying the critical amino acid residues of the ACE2 alpha-helix α1, which is necessary for the Spike RBD-ACE2 interface and mobilized during the in vitro viral infection of cells, we demonstrated that the WT ACE2 peptide protects susceptible K18-hACE2 mice against in vivo SARS-CoV-2 infection and is effective for the treatment of COVID-19.

An emerging network for COVID-19 CT-scan classification using an ensemble deep transfer learning model

Over the past few years, the widespread outbreak of COVID-19 has caused the death of millions of people worldwide. Early diagnosis of the virus is essential to control its spread and provide timely treatment. Artificial intelligence methods are often used as powerful tools to reach a COVID-19 diagnosis via computed tomography (CT) samples. In this paper, artificial intelligence-based methods are introduced to diagnose COVID-19. At first, a network called CT6-CNN is designed, and then two ensemble deep transfer learning models are developed based on Xception, ResNet-101, DenseNet-169, and CT6-CNN to reach a COVID-19 diagnosis by CT samples. The publicly available SARS-CoV-2 CT dataset is utilized for our implementation, including 2481 CT scans. The dataset is separated into 2108, 248, and 125 images for training, validation, and testing, respectively. Based on experimental results, the CT6-CNN model achieved 94.66% accuracy, 94.67% precision, 94.67% sensitivity, and 94.65% F1-score rate. Moreover, the ensemble learning models reached 99.2% accuracy. Experimental results affirm the effectiveness of designed models, especially the ensemble deep learning models, to reach a diagnosis of COVID-19.

Exploring Health Information Seeking Among Participants from a Black Ethnic Group in the UK: a Qualitative Study

Empirical evidence has shown that individuals from minority ethnic communities have been at an increased risk of COVID-19 infections and adverse clinical outcomes including hospitalization, intensive care unit admission, and mortality. The COVID-19 vaccine has been heralded as key in ending the global pandemic. However, evidence suggests that although minority ethnic communities have been disproportionately affected by COVID-19, vaccine delivery to these communities has been poor. A barrier to the vaccine uptake has been health information. Health information is an important variable in the health decision-making process. Lack of or wrong health information has serious implications. Health information leads to better understanding of personal health and appropriate utilization of health services and consequently improves an individual's health outcomes. This study sought to explore the health information seeking practices among participants from a Black ethnic minority community in the UK. This study interviewed six Black Africans from the UK. The study explored and highlighted the thoughts, perceptions, and experiences of the participants while health information seeking. This study found challenges in health information access, assumptions about health information and feelings of being dismissed, and an information void. Participants acknowledge that there is a lot that could be done to improve their health information experiences. Targeted health information and measures such as cultural sensitivity and competency could be important in improving health information seeking, not just for Black Africans but all ethnic minorities in the UK.

Evolution of serious and life-threatening COVID-19 pneumonia as the SARS-CoV-2 pandemic progressed: an observational study of mortality to 60 days after admission to a 15-hospital US health system

OBJECTIVE

In order to predict at hospital admission the prognosis of patients with serious and life-threatening COVID-19 pneumonia, we sought to understand the clinical characteristics of hospitalised patients at admission as the SARS-CoV-2 pandemic progressed, document their changing response to the virus and its variants over time, and identify factors most importantly associated with mortality after hospital admission.

DESIGN

Observational study using a prospective hospital systemwide COVID-19 database.

SETTING

15-hospital US health system.

PARTICIPANTS

26 872 patients admitted with COVID-19 to our Northeast Ohio and Florida hospitals from 1 March 2020 to 1 June 2022.

MAIN OUTCOME MEASURES

60-day mortality (highest risk period) after hospital admission analysed by random survival forests machine learning using demographics, medical history, and COVID-19 vaccination status, and viral variant, symptoms, and routine laboratory test results obtained at hospital admission.

RESULTS

Hospital mortality fell from 11% in March 2020 to 3.7% in March 2022, a 66% decrease (p<0.0001); 60-day mortality fell from 17% in May 2020 to 4.7% in May 2022, a 72% decrease (p<0.0001). Advanced age was the strongest predictor of 60-day mortality, followed by admission laboratory test results. Risk-adjusted 60-day mortality had all patients been admitted in March 2020 was 15% (CI 3.0% to 28%), and had they all been admitted in May 2022, 12% (CI 2.2% to 23%), a 20% decrease (p<0.0001). Dissociation between observed and predicted decrease in mortality was related to temporal change in admission patient profile, particularly in laboratory test results, but not vaccination status or viral variant.

CONCLUSIONS

Hospital mortality from COVID-19 decreased substantially as the pandemic evolved but persisted after hospital discharge, eclipsing hospital mortality by 50% or more. However, after accounting for the many, even subtle, changes across the pandemic in patients' demographics, medical history and particularly admission laboratory results, a patient admitted early in the pandemic and predicted to be at high risk would remain at high risk of mortality if admitted tomorrow.

Three in one: An effective and universal vaccine expressing heterologous tandem RBD trimer by rabies virus vector protects mice against SARS-CoV-2

The rapid emergence of Severe Acute Respiratory Syndrome Coronavirus type 2 (SARS-CoV-2) variants, coupled with severe immune evasion and imprinting, has jeopardized the vaccine efficacy, necessitating urgent development of broad protective vaccines. Here, we propose a strategy employing recombinant rabies viruses (RABV) to create a universal SARS-CoV-2 vaccine expressing heterologous tandem receptor-binding domain (RBD) trimer from the SARS-CoV-2 Prototype, Delta, and Omicron strains (SRV-PDO). The results of mouse immunization indicated that SRV-PDO effectively induced cellular and humoral immune responses, and demonstrated higher immunogenicity and broader SARS-CoV-2 neutralization compared to the recombinant RABVs that only expressed RBD monomers. Moreover, SRV-PDO exhibited full protection against SARS-CoV-2 in the challenge assay. This study demonstrates that recombinant RABV expressing tandem RBD-heterotrimer as a multivalent immunogen could elicit a broad-spectrum immune response and potent protection against SARS-CoV-2, making it a promising candidate for future human or veterinary vaccines and offering a novel perspective in other vaccine design.

Identification of South African Plant-Based Bioactive Compounds as Potential Inhibitors against the SARS-CoV-2 Receptor

The expected progress in SARS-CoV-2 vaccinations, as anticipated in 2020 and 2021, has fallen short, exacerbating global disparities due to a lack of universally recognized "safe and effective" vaccines. This study focuses on extracts of South African medicinal plants, Artemisia annua and Artemisia afra, to identify metabolomic bioactive compounds inhibiting the binding of the SARS-CoV-2 spike protein to ACE2 receptors. The extracts were monitored for cytotoxicity using a resazurin cell viability assay and xCELLigence real-time cell analyzer. Chemical profiling was performed using UPLC-MS/MS, orthogonal projection to latent structures (OPLS), and evaluated using principle component analysis (PCA) models. Identified bioactive compounds were subjected to in vitro SARS-CoV-2 enzyme inhibition assay using standard methods and docked into the spike (S) glycoprotein of SARS-CoV-2 using Schrodinger® suite followed by molecular dynamics simulation studies. Cell viability assays revealed non-toxic effects of extracts on HEK293T cells at lower concentrations. Chemical profiling identified 81 bioactive compounds, with compounds like 6″-O-acetylglycitin, 25-hydroxyvitamin D3-26,23-lactone, and sesaminol glucoside showing promising binding affinity. Molecular dynamics simulations suggested less stable binding, but in vitro studies demonstrated the ability of these compounds to interfere with SARS-CoV-2 spike protein's binding to the human ACE2 receptor. Sesaminol glucoside emerged as the most effective inhibitor against this interaction. This study emphasizes the importance of multiplatform metabolite profiling and chemometrics to understand plant extract composition. This finding is of immense significance in terms of unravelling metabolomics bioactive compounds inhibiting the binding of the SARS-CoV-2 spike protein to ACE2 receptors and holds promise for phytotherapeutics against SARS-CoV-2.

A novel linear B cell epitope of the canine coronavirus nucleocapsid protein identified by a monoclonal antibody

The infection of canine coronavirus (CCoV) causes a highly contagious disease in dogs with acute gastroenteritis. The efficient serological diagnostics is critical for controlling the disease caused by CCoV. Nucleocapsid (N) protein of CCoV is an important target for developing serological approaches. However, little is known about the antigenic sites in the N protein of CCoV. In this study, we generated a monoclonal antibody (mAb) against the N protein of CCoV, designated as 13E8, through the fusion of the sp2/0 cells with the spleen cells from a mouse immunized with the purified recombinant GST-N protein. Epitope mapping revealed that mAb 13E8 recognized a novel linear B cell epitope in N protein at 294-314aa (named as EP-13E8) by using a serial of truncated N protein through Western blot and ELISA. Sequence analysis showed that the sequence of EP-13E8 was highly conserved (100 %) among different CCoV strains analyzed, but exhibited a low similarity (31.8-63.6 %) with the responding sequence in other coronaviruses of the same genus such as FCoV, PEDV and HCoV except for TGEV (95.5 % identity). Structural assay suggested that the epitope of EP-13E8 were located in the close proximity on the surface of the N protein. Overall, the mAb 13E8 against N protein generated and its epitope EP-13E8 identified here paid the way for further developing epitope-based serological diagnostics for CCoV.

Therapeutic implications of quercetin and its derived-products in COVID-19 protection and prophylactic

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel human coronavirus, which has triggered a global pandemic of the coronavirus infectious disease 2019 (COVID-19). Outbreaks of emerging infectious diseases continue to challenge human health worldwide. The virus conquers human cells through the angiotensin-converting enzyme 2 receptor-driven pathway by mostly targeting the human respiratory tract. Quercetin is a natural flavonoid widely represented in the plant kingdom. Cumulative evidence has demonstrated that quercetin and its derivatives have various pharmacological properties including anti-cancer, anti-hypertension, anti-hyperlipidemia, anti-hyperglycemia, anti-microbial, antiviral, neuroprotective, and cardio-protective effects, because it is a potential treatment for severe inflammation and acute respiratory distress syndrome. Furthermore, it is the main life-threatening condition in patients with COVID-19. This article provides a comprehensive review of the primary literature on the predictable effectiveness of quercetin and its derivatives docked to multi-target of SARS-CoV-2 and host cells via in silico and some of validation through in vitro, in vivo, and clinically to fight SARS-CoV-2 infections, contribute to the reduction of inflammation, which suggests the preventive and therapeutic latency of quercetin and its derived-products against COVID-19 pandemic, multisystem inflammatory syndromes (MIS), and long-COVID.

Variations in Food Safety Concerns, Hygiene Practices, and Purchasing Behaviors During Pandemic Era: What We Learnt from Coronavirus Disease 2019

The purpose of the study is to evaluate the food safety concerns, purchasing behaviors, and hygiene practices of individuals who contracted and did not contract the severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection. A total of 2393 individuals 18-65 years years of age, 760 who contracted and 1633 who did not contract SARS-CoV-2 infection, participated in the study. Participants were administered a questionnaire to assess demographic information, food safety concerns, hygiene practices, purchasing behavior, and fear of the coronavirus disease 2019 (COVID-19). Results indicated that 56.3% of participants expressed concern about food safety, and 67% were concerned about infected individuals while shopping. Participants who did not contract COVID-19 had higher levels of food safety concerns and generally adhered to better hygiene practices such as handwashing, hygienic food preparation, sanitizer use, and cleaning and disinfection practices (p < 0.05). Overall, purchasing behaviors did not significantly differ by the infection status, except for a significant difference in reduced purchase frequency (p < 0.001). In addition, purchasing behavior varied in relation to fear levels (p < 0.05). As the pandemic appears to be increasingly controlled, the insights gained from managing outbreaks might contribute to improved understanding and preparedness for global pandemics and food safety education in the future.

NSP6 inhibits the production of ACE2-containing exosomes to promote SARS-CoV-2 infectivity

The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has triggered a global pandemic, which severely endangers public health. Our and others' works have shown that the angiotensin-converting enzyme 2 (ACE2)-containing exosomes (ACE2-exos) have superior antiviral efficacies, especially in response to emerging variants. However, the mechanisms of how the virus counteracts the host and regulates ACE2-exos remain unclear. Here, we identified that SARS-CoV-2 nonstructural protein 6 (NSP6) inhibits the production of ACE2-exos by affecting the protein level of ACE2 as well as tetraspanin-CD63 which is a key factor for exosome biogenesis. We further found that the protein stability of CD63 and ACE2 is maintained by the deubiquitination of proteasome 26S subunit, non-ATPase 12 (PSMD12). NSP6 interacts with PSMD12 and counteracts its function, consequently promoting the degradation of CD63 and ACE2. As a result, NSP6 diminishes the antiviral efficacy of ACE2-exos and facilitates the virus to infect healthy bystander cells. Overall, our study provides a valuable target for the discovery of promising drugs for the treatment of coronavirus disease 2019.

IMPORTANCE

The outbreak of coronavirus disease 2019 (COVID-19) severely endangers global public health. The efficacy of vaccines and antibodies declined with the rapid emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mutants. Angiotensin-converting enzyme 2-containing exosomes (ACE2-exos) therapy exhibits a broad neutralizing activity, which could be used against various viral mutations. Our study here revealed that SARS-CoV-2 nonstructural protein 6 inhibited the production of ACE2-exos, thereby promoting viral infection to the adjacent bystander cells. The identification of a new target for blocking SARS-CoV-2 depends on fully understanding the virus-host interaction networks. Our study sheds light on the mechanism by which the virus resists the host exosome defenses, which would facilitate the study and design of ACE2-exos-based therapeutics for COVID-19.

Human antimicrobial peptide inactivation mechanism of enveloped viruses

HYPOTHESIS

Enveloped viruses are pivotal in causing various illnesses, including influenza and COVID-19. The antimicrobial peptide LL-37, a critical part of the human innate immune system, exhibits potential as an antiviral agent capable of thwarting these viral threats. Its mode of action involves versatile and non-specific interactions that culminate in dismantling the viral envelope, ultimately rendering the viruses inert. However, the exact mechanism of action is not yet understood.

EXPERIMENTS

Here, the mechanism of LL-37 triggered changes in the structure and function of an enveloped virus is investigated. The bacteriophage "Phi6" is used as a surrogate for pathogenic enveloped viruses. Small angle X-ray and neutron scattering combined with light scattering techniques demonstrate that LL-37 actively integrates into the virus's lipid envelope.

FINDINGS

LL-37 addition to Phi6 leads to curvature modification in the lipid bilayer, ultimately separating the envelope from the nucleocapsid. Additional biological assays confirm the loss of virus infectivity in the presence of LL-37, which coincides with the structural transformations. The results provide a fundamental understanding of the structure-activity relationship related to enveloped viruses. The knowledge of peptide-virus interactions can guide the design of future peptide-based antiviral drugs and therapies.

Unraveling the Dynamics of SARS-CoV-2 Mutations: Insights from Surface Plasmon Resonance Biosensor Kinetics

Surface Plasmon Resonance (SPR) technology is known to be a powerful tool for studying biomolecular interactions because it offers real-time and label-free multiparameter analysis with high sensitivity. This article summarizes the results that have been obtained from the use of SPR technology in studying the dynamics of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) mutations. This paper will begin by introducing the working principle of SPR and the kinetic parameters of the sensorgram, which include the association rate constant (ka), dissociation rate constant (kd), equilibrium association constant (KA), and equilibrium dissociation constant (KD). At the end of the paper, we will summarize the kinetic data on the interaction between angiotensin-converting enzyme 2 (ACE2) and SARS-CoV-2 obtained from the results of SPR signal analysis. ACE2 is a material that mediates virus entry. Therefore, understanding the kinetic changes between ACE2 and SARS-CoV-2 caused by the mutation will provide beneficial information for drug discovery, vaccine development, and other therapeutic purposes.

Design, synthesis and biological evaluation of betulinic acid derivatives as potential inhibitors of 3CL-protease of SARS-CoV-2

During the coronavirus reproduction process, 3-chymotrypsin-like protease (3CLpro) and papain-like protease (PLpro) are accountable for the fragmentation of two polyprotein precursors (pp1a/pp1ab) into substructural proteins. These two proteins are vital for the replication and transcription of the viral genome. Therefore, 3CLpro is a key protein and target for the design of coronavirus inhibitors. In previous studies, we found that betulinic acid has an inhibitory effect on 3CLpro, with 51.5 % inhibition of 3CLpro at 20 µM. Then, series of betulinic acid derivatives were designed, synthesized, and evaluated for their inhibition activities. The results showed that BA02 and BA05 showed significant inhibitory activity on 3CLpro with inhibitory rates of 78.1 % and 82.5 % at 20 µM, respectively. Further evaluation of these two compounds shows that their IC50 values are 7.22 ± 0.14 μM and 6.40 ± 0.14 μM, respectively.

Effects of SARS-CoV-2 Vaccination on Menstrual Cycle: An Italian Survey-Based Study

Vaccination against SARS-CoV-2 has played a critical role in controlling the spread of the pandemic. The main side effects of SARS-CoV-2 vaccination include fever and fatigue; however, the potential impacts on menstrual cycles are to be determined. Given the limited number of studies suggesting menstrual changes post vaccination, this study investigates the correlation between COVID-19 vaccines and menstrual cycle changes in fertile-aged Italian women. A questionnaire was distributed from 1 October to 31 November 2022, focusing on menstrual rhythm and flow changes post vaccination. The analysis involved 471 participants. The study observed a shift from a regular to an irregular menstrual rhythm (p < 0.001), and changes in menstrual duration (p = 0.008 and p < 0.001 for first and second doses, respectively) and flow volume (p < 0.001). Most patients with irregular rhythms were vaccinated in the proliferative phase of their cycle. Within six months post vaccination, 74.2% of women with irregular post-vaccination rhythms reported a return to normality. These findings indicate primarily transient menstrual changes following mRNA COVID-19 vaccination, suggesting the vaccines' safety for women of reproductive age.

Emotions, Perceived Stressors, and Coping Strategies Among Nursing Staff in Saudi Arabia During the COVID-19 Pandemic

Objective The COVID-19 pandemic resulted in heightened stress for nurses and other healthcare workers, particularly during the initial phase of the crisis. Despite the adoption of various coping strategies, psychological distress persisted, affecting nurses' well-being and jeopardizing the overall resilience of the healthcare system. This study assessed the emotional response, perceived stressors, and coping strategies among nurses' staff who worked during the first wave of COVID-19 pandemic. Method A cross-sectional study was carried out among nurses who worked during the initial phase of the COVID-19 crisis (June - August 2020), at a tertiary care center in Western Saudi Arabia. The questionnaire explored five main sections. The first section (15 items) assessed emotions experienced during the initial wave of COVID-19, capturing both positive and negative sentiments, such as "joy" or "fear." The second section (20 items) examined the presence of stressors, like "lack of protective equipment" or "fear of infection." The third section (14 items) evaluated the perceived effectiveness of certain stress-reducing factors, including "peer support" or "training." In the fourth section (13 items), participants rated their usage frequency of various coping strategies, such as "meditation" or "seeking advice." Lastly, the fifth section assessed the hypothetical impact of 10 incentives, like "financial bonuses" or "additional training," in motivating nurses' involvement in future epidemic responses. The questionnaire was completed with demographic and professional data. A convenience sampling method was employed, and 315 nurses participated in the study. Descriptive statistics were carried out using SPSS version 24 for Windows (IBM Corp., Armonk, NY). Result The most commonly experienced emotion was a feeling of responsibility and ethical duty, reported by 97.5% of the participants, followed by nervousness and fear (83.8%), anger (73.3%), and stigma (70.2%). On the other hand, 86.7% were expecting a financial compensation. The most common stressors were related to the nurses' own safety, or the safety of their families and colleagues, reported by 92.4-95.2% of the participants. The perceived uncontrollability of COVID-19 was also a significant stressor. The improvement of the health status of infected colleagues (98.1%) or patients (97.5%) were the most common factors associated with the reduction in nurses' stress. Among the coping strategies, five were almost systematically deployed by the nurses (>95%), all consisting of cognitive and behavioral mechanisms to enhance own knowledge and safety and avoid being infected. The most crucial determinants for commitment in future pandemics are the availability of a cure or vaccine (93.3%), family support (91.4%), adequate personal protective equipment from the hospital (90.8%), and exemption from overtime (90.2%). Conclusion The first wave of COVID-19 exerted a tremendous psychological stress on nurses, due to concerns about safety, disease uncertainties, and social isolation. Analyzing these impacts offers insights for enhancing institutional and national crisis strategies, emphasizing staff safety and psychological well-being, especially for first responders like nurses. Policy implications include prioritizing mental health support and preparedness in future crisis plans. Additionally, ensuring continuous training and strategic workload management is crucial for maintaining frontline commitment.

Comprehensive analysis of research related to rehabilitation and COVID-19, hotspots, mapping, thematic evolution, trending topics, and future directions

BACKGROUND

This study conducted a comprehensive analysis of research pertaining to the intersection of rehabilitation and COVID-19 (COV-REH). The main aim of this study is to analyze the thematic progression and hotspots, detect emerging topics, and suggest possible future research directions in the COV-REH.

METHODS

Appropriate keywords were selected based on the Medical Subject Headings (MeSH) PubMed database and the Scopus database were used to retrieve a total of 3746 original studies conducted in the English language. The data extraction was performed on June 30, 2023. VOSviewer and Bibliometrix utilize CVS and BibTex files to facilitate the performance analysis and generate visual maps. The performance indicators reported for the research components of the COV-REH were compiled using the Scopus Analytics tool.

RESULTS

From 2003 to 2023, 3470 authors from 160 organizations in 119 countries generated 3764 original research documents, with an annual growth of 53.73%. 1467 sources identified these scholarly works. Vitacca, M. (Italy), Harvard University (USA), and the USA published the most articles. This study included 54.1% of medical scholars. Telerehabilitation, exercise, quality of life, case reports, anxiety, and pulmonary rehabilitation were the primary themes of the COV-REH. One component of "telerehabilitation" is now the cardiac rehabilitation cluster. The trending topics in COV-REH are "symptoms," "protocol," and "community-based rehabilitation".

CONCLUSIONS

This study proposed several significant research directions based on the current thematic map and its evolution. Given that COV-REH investigations have been determined to be multidisciplinary, this study contributes conceptually to several fields and has wide-ranging implications for practitioners and policymakers.

Two-Dimensional (2D) materials in the detection of SARS-CoV-2

The SARS-CoV-2 pandemic has resulted in a devastating effect on human health in the last three years. While tremendous effort has been devoted to the development of effective treatment and vaccines against SARS-CoV-2 and controlling the spread of it, collective health challenges have been encountered along with the concurrent serious economic impacts. Since the beginning of the pandemic, various detection methods like PCR-based methods, isothermal nucleic acid amplification-based (INAA) methods, serological methods or antibody tests, and evaluation of X-ray chest results have been exploited to diagnose SARS-CoV-2. PCR-based detection methods in these are considered gold standards in the current stage despite their drawbacks, including being high-cost and time-consuming procedures. Furthermore, the results obtained from the PCR tests are susceptible to sample collection methods and time. When the sample is not collected properly, obtaining a false result may be likely. The use of specialized lab equipment and the need for trained people for the experiments pose additional challenges in PCR-based testing methods. Also, similar problems are observed in other molecular and serological methods. Therefore, biosensor technologies are becoming advantageous with their quick response, high specificity and precision, and low-cost characteristics for SARS-CoV-2 detection. In this paper, we critically review the advances in the development of sensors for the detection of SARS-CoV-2 using two-dimensional (2D) materials. Since 2D materials including graphene and graphene-related materials, transition metal carbides, carbonitrides, and nitrides (MXenes), and transition metal dichalcogenides (TMDs) play key roles in the development of novel and high-performance electrochemical (bio)sensors, this review pushes the sensor technologies against SARS-CoV-2 detection forward and highlights the current trends. First, the basics of SARS-CoV-2 detection are described. Then the structure and the physicochemical properties of the 2D materials are explained, which is followed by the development of SARS-CoV-2 sensors by exploiting the exceptional properties of the 2D materials. This critical review covers most of the published papers in detail from the beginning of the outbreak.

Menstrual disturbances following COVID-19 vaccination: A probable puzzle about the role of endocrine and immune pathways

Menstruation is a monthly shedding of the uterine wall, presented by menstrual bleeding in women of reproductive age. Menstruation is regulated by fluctuation of estrogen and progesterone, as well as other endocrine and immune pathways. Many women experienced menstrual disturbances after vaccination against the novel coronavirus in the last two years. Vaccine-induced menstrual disturbances have led to discomfort and concern among reproductive-age women, such that some decided not to receive the subsequent doses of the vaccine. Although many vaccinated women report these menstrual disturbances, the mechanism is still poorly understood. This review article discusses the endocrine and immune changes following COVID-19 vaccination and the possible mechanisms of vaccine-related menstrual disturbances.

COVID-19 hospitalized patients and oral changes: a case-control study

OBJECTIVES

To investigate the association between hospitalization for COVID-19 and oral changes, and to evaluate whether oral changes can indicate a higher risk of disease progression to death.

MATERIALS AND METHODS

This case-control study analyzed patients hospitalized (university hospital), including those in intensive care unit and clinical wards. The study group comprised 69 COVID-19 positive patients (PCR-test), while the control group included 43 COVID-19 negative patients. A dentist performed oral evaluations, and salivary samples were collected for calcium, phosphatase, and pH analysis. Sociodemographic data, hospitalization information, and hematological test results were collected from electronic-medical records. The presence of oral changes was assessed using chi-square tests, and the predicted risk of death was analyzed using binary logistic regression.

RESULTS

COVID-19 positive patients had a significantly higher prevalence of oral changes compared to COVID-19 negative patients. The presence of any oral changes in COVID-19 positive patients indicated a 13-fold higher risk of mortality. "Bleeding ulcers," "pressure ulcers," and "angular cheilitis" were significantly associated with hospitalization for COVID-19.

CONCLUSION

There may be an association between hospitalization for COVID-19 and the development of oral changes, including bleeding ulcers, pressure ulcers. and angular cheilitis. These oral changes may serve as potential indicator for disease progression an increased risk of death.

CLINICAL RELEVANCE

COVID-19 hospitalized patients have a higher prevalence of oral changes, which indicate an increased risk of mortality. Oral medicine staff should be included in multidisciplinary teams to detect and treat these oral changes promptly.

Prediction of COVID-19 Using a WOA-BILSTM Model

The COVID-19 pandemic has had a significant impact on the world, highlighting the importance of the accurate prediction of infection numbers. Given that the transmission of SARS-CoV-2 is influenced by temporal and spatial factors, numerous researchers have employed neural networks to address this issue. Accordingly, we propose a whale optimization algorithm-bidirectional long short-term memory (WOA-BILSTM) model for predicting cumulative confirmed cases. In the model, we initially input regional epidemic data, including cumulative confirmed, cured, and death cases, as well as existing cases and daily confirmed, cured, and death cases. Subsequently, we utilized the BILSTM as the base model and incorporated WOA to optimize the specific parameters. Our experiments employed epidemic data from Beijing, Guangdong, and Chongqing in China. We then compared our model with LSTM, BILSTM, GRU, CNN, CNN-LSTM, RNN-GRU, DES, ARIMA, linear, Lasso, and SVM models. The outcomes demonstrated that our model outperformed these alternatives and retained the highest accuracy in complex scenarios. In addition, we also used Bayesian and grid search algorithms to optimize the BILSTM model. The results showed that the WOA model converged fast and found the optimal solution more easily. Thus, our model can assist governments in developing more effective control measures.

Identification of Leading Compounds from Euphorbia neriifolia (Dudsor) Extracts as a Potential Inhibitor of SARS-CoV-2 ACE2-RBDS1 Receptor Complex: An Insight from Molecular Docking ADMET Profiling and MD-simulation Studies

Coronavirus disease-19 (COVID-19) are deadly and infectious disease that impacts individuals in a variety of ways. Scientists have stepped up their attempts to find an antiviral drug that targets the spike protein (S) of Angiotensin converting enzyme 2 (ACE2) (receptor protein) as a viable therapeutic target for coronavirus. The most recent study examines the potential antagonistic effects of 17 phytochemicals present in the plant extraction of Euphorbia neriifolia on the anti-SARS-CoV-2 ACE2 protein. Computational techniques like molecular docking, absorption, distribution, metabolism, excretion, and toxicity (ADMET) investigations, and molecular dynamics (MD) simulation analysis were used to investigate the actions of these phytochemicals. The results of molecular docking studies showed that the control ligand (2-acetamido-2-deoxy-β-D-glucopyranose) had a binding potential of -6.2 kcal/mol, but the binding potentials of delphin, β-amyrin, and tulipanin are greater at -10.4, 10.0, and -9.6 kcal/mol. To verify their drug-likeness, the discovered hits were put via Lipinski filters and ADMET analysis. According to MD simulations of the complex run for 100 numbers, delphin binds to the SARS-CoV-2 ACE2 receptor's active region with good stability. In root-mean-square deviation (RMSD) and root mean square fluctuation (RMSF) calculations, delphinan, β-amyrin, and tulipanin showed reduced variance with the receptor binding domain subunit 1(RBD S1) ACE2 protein complex. The solvent accessible surface area (SASA), radius of gyration (Rg), molecular surface area (MolSA), and polar surface area (PSA) validation results for these three compounds were likewise encouraging. The convenient binding energies across the 100 numbers binding period were discovered by using molecular mechanics of generalized born and surface (MM/GBSA) to estimate the ligand-binding free energies to the protein receptor. All things considered, the information points to a greater likelihood of chemicals found in Euphorbia neriifolia binding to the SARS-CoV-2 ACE2 active site. To determine these lead compounds' anti-SARS-CoV-2 potential, in vitro and in vivo studies should be conducted.

How to cite this article

Islam MN, Pramanik MEA, Hossain MA, et al. Identification of Leading Compounds from Euphorbia Neriifolia (Dudsor) Extracts as a Potential Inhibitor of SARS-CoV-2 ACE2-RBDS1 Receptor Complex: An Insight from Molecular Docking ADMET Profiling and MD-simulation Studies. Euroasian J Hepato-Gastroenterol 2023;13(2):89-107.

Harnessing aptamers against COVID-19: a therapeutic strategy

The novel coronavirus crisis caused by severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) was a global pandemic. Although various therapeutic approaches were developed over the past 2 years, novel strategies with more efficient applicability are required to target new variants. Aptamers are single-stranded (ss)RNA or DNA oligonucleotides capable of folding into unique 3D structures with robust binding affinity to a wide variety of targets following structural recognition. Aptamer-based theranostics have proven excellent capability for diagnosing and treating various viral infections. Herein, we review the current status and future perspective of the potential of aptamers as COVID-19 therapies.

Rapid protocols to support COVID-19 clinical diagnosis based on hematological parameters

Purpose

In December 2019, the Covid-19 pandemic began in the world. To reduce mortality, in addiction to mass vaccination, it is necessary to massify and accelerate clinical diagnosis, as well as creating new ways of monitoring patients that can help in the construction of specific treatments for the disease.

Objective

In this work, we propose rapid protocols for clinical diagnosis of COVID-19 through the automatic analysis of hematological parameters using evolutionary computing and machine learning. These hematological parameters are obtained from blood tests common in clinical practice.

Method

We investigated the best classifier architectures. Then, we applied the particle swarm optimization algorithm (PSO) to select the most relevant attributes: serum glucose, troponin, partial thromboplastin time, ferritin, D-dimer, lactic dehydrogenase, and indirect bilirubin. Then, we assessed again the best classifier architectures, but now using the reduced set of features. Finally, we used decision trees to build four rapid protocols for Covid-19 clinical diagnosis by assessing the impact of each selected feature. The proposed system was used to support clinical diagnosis and assessment of disease severity in patients admitted to intensive and semi-intensive care units as a case study in the city of Paudalho, Brazil.

Results

We developed a web system for Covid-19 diagnosis support. Using a 100-tree random forest, we obtained results for accuracy, sensitivity, and specificity superior to 99%. After feature selection, results were similar. The four empirical clinical protocols returned accuracies, sensitivities and specificities superior to 98%.

Conclusion

By using a reduced set of hematological parameters common in clinical practice, it was possible to achieve results of accuracy, sensitivity, and specificity comparable to those obtained with RT-PCR. It was also possible to automatically generate clinical decision protocols, allowing relatively accurate clinical diagnosis even without the aid of the web decision support system.

Assessment and strategy development for SARS-CoV-2 screening in wildlife: A review

Coronaviruses (members of the Coronaviridae family) are prominent in veterinary medicine, with several known infectious agents commonly reported. In contrast, human medicine has disregarded coronaviruses for an extended period. Within the past two decades, coronaviruses have caused three major outbreaks. One such outbreak was the coronavirus disease 2019 (COVID-19) caused by the coronavirus severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Over the 3-year COVID-19 outbreak, several instances of zooanthroponosis have been documented, which pose risks for virus modifications and possible re-emergence of the virus into the human population, causing a new epidemic and possible threats for vaccination or treatment failure. Therefore, widespread screening of animals is an essential technique for mitigating future risks and repercussions. However, mass detection of SARS-CoV-2 in wild animals might be challenging. In silico prediction modeling, experimental studies conducted on various animal species, and natural infection episodes recorded in various species might provide information on the potential threats to wildlife. They may be useful for diagnostic and mass screening purposes. In this review, the possible methods of wildlife screening, based on experimental data and environmental elements that might play a crucial role in its effective implementation, are reviewed.

A Recombinant RBD-Based Phage Vaccine Report: A Solution to the Prevention of New Diseases?

The safety, inherent immunogenicity, stability, and low-cost production of bacteriophages make them an ideal platform for vaccine development. Most vaccination strategies against COVID-19 have targeted the spike protein of SARS-CoV-2 to generate neutralizing antibodies. P1, a truncated RBD-derived spike protein, has been shown to induce virus-neutralizing antibodies in preclinical studies. In this study, we first investigated whether recombinant phages displaying P1 on the M13 major protein could immunize mice against COVID-19, and second, whether inoculation with 50 µg of purified P1 in addition to the recombinant phages would stimulate the immune systems of the animals. The results showed that the mice that received recombinant phages were immunized against the phage particles, but did not have anti-P1 IgG. In contrast, compared with the negative control, the group that received a combination of P1 protein and recombinant phage was immunized against the P1 protein. In both groups, CD4⁺ and CD8⁺ T cells appeared in the lung tissue. These results suggest that the number of antigens on the phage body plays a crucial role in stimulating the immune system against the bacteriophage, although it is immunogenic enough to function as a phage vaccine.

An integrated in-silico Pharmaco-BioInformatics approaches to identify synergistic effects of COVID-19 to HIV patients

BACKGROUND

With high inflammatory states from both COVID-19 and HIV conditions further result in complications. The ongoing confrontation between these two viral infections can be avoided by adopting suitable management measures.

PURPOSE

The aim of this study was to figure out the pharmacological mechanism behind apigenin's role in the synergetic effects of COVID-19 to the progression of HIV patients.

METHOD

We employed computer-aided methods to uncover similar biological targets and signaling pathways associated with COVID-19 and HIV, along with bioinformatics and network pharmacology techniques to assess the synergetic effects of apigenin on COVID-19 to the progression of HIV, as well as pharmacokinetics analysis to examine apigenin's safety in the human body.

RESULT

Stress-responsive, membrane receptor, and induction pathways were mostly involved in gene ontology (GO) pathways, whereas apoptosis and inflammatory pathways were significantly associated in the Kyoto encyclopedia of genes and genomes (KEGG). The top 20 hub genes were detected utilizing the shortest path ranked by degree method and protein-protein interaction (PPI), as well as molecular docking and molecular dynamics simulation were performed, revealing apigenin's strong interaction with hub proteins (MAPK3, RELA, MAPK1, EP300, and AKT1). Moreover, the pharmacokinetic features of apigenin revealed that it is an effective therapeutic agent with minimal adverse effects, for instance, hepatoxicity.

CONCLUSION

Synergetic effects of COVID-19 on the progression of HIV may still be a danger to global public health. Consequently, advanced solutions are required to give valid information regarding apigenin as a suitable therapeutic agent for the management of COVID-19 and HIV synergetic effects. However, the findings have yet to be confirmed in patients, suggesting more in vitro and in vivo studies.

Lung fibrosis: Post-COVID-19 complications and evidences

BACKGROUND

COVID 19, a lethal viral outbreak that devastated lives and the economy across the globe witnessed non-compensable respiratory illnesses in patients. As been evaluated in reports, patients receiving long-term treatment are more prone to acquire Pulmonary Fibrosis (PF). Repetitive damage and repair of alveolar tissues increase oxidative stress, inflammation and elevated production of fibrotic proteins ultimately disrupting normal lung physiology skewing the balance towards the fibrotic milieu.

AIM

In the present work, we have discussed several important pathways which are involved in post-COVID PF. Further, we have also highlighted the rationale for the use of antifibrotic agents for post-COVID PF to decrease the burden and improve pulmonary functions in COVID-19 patients.

CONCLUSION

Based on the available literature and recent incidences, it is crucial to monitor COVID-19 patients over a period of time to rule out the possibility of residual effects. There is a need for concrete evidence to deeply understand the mechanisms responsible for PF in COVID-19 patients.

Clinical, demographic and oxidative profile of patients with COVID-19 and disease severity

This study aimed to profile the clinical progression, demographics, and oxidative status of COVID-19 patients, correlating with disease severity. The study included 143 participants: 93 patients with COVID-19 (28 outpatients, 65 inpatients), and 50 control participants. Thiobarbituric acid reactive substance (TBARS) was used as an oxidative damage marker. Antioxidant activity was assessed via quantification of Vitamin C, sulfhydryl groups, ferric reduction ability of plasma (FRAP), Uric acid (UA), and evaluation of delta-aminolevulinate dehydratase (δ-ALA-D) enzymatic activity. Geriatric patients, especially men, with comorbidities such as obesity and/or chronic diseases were more likely to develop the most severe form of COVID-19. The activity of the δ-ALA-D was lower in inpatients, and there was no significant difference with the outpatient. Antioxidants decreased in COVID-19 groups, while lipid peroxidation increased. FRAP and Vitamin C decreased with evolution of the disease. Oxidative stress could be used as a predictor of worsening clinical condition.

The Circulation of Common Respiratory Viruses and Their Co-infection with Severe Acute Respiratory Syndrome Coronavirus 2 Before and After Coronavirus Disease of 2019 Vaccination

Background: Respiratory viruses play important roles in respiratory tract infections; they are the major cause of diseases such as the common cold, bronchiolitis, pneumonia, etc., in humans that circulate more often in the cold seasons. During the COVID-19 pandemic, many strict public health measures, such as hand hygiene, the use of face masks, social distancing, and quarantines, were implemented worldwide to control the pandemic. Besides controlling the COVID-19 pandemic, these introduced measures might change the spread of other common respiratory viruses. Moreover, with COVID-19 vaccination and reducing public health protocols, the circulation of other respiratory viruses probably increases in the community. Objectives: This study aims to explore changes in the circulation pattern of common respiratory viruses during the COVID-19 pandemic. Methods: In the present study, we evaluated the circulation of seven common respiratory viruses (influenza viruses A and B, rhinovirus, and seasonal human Coronaviruses (229E, NL63, OC43, and HKU1) and their co-infection with SARS-CoV-2 in suspected cases of COVID-19 in two time periods before and after COVID-19 vaccination. Clinical nasopharyngeal swabs of 400 suspected cases of COVID-19 were tested for SARS-CoV-2 and seven common respiratory viruses by reverse transcription real-time polymerase chain reaction. Results: Our results showed common respiratory viruses were detected only in 10% and 8% of SARS-CoV-2-positive samples before and after vaccination, respectively, in which there were not any significant differences between them (P-value = 0.14). Moreover, common viral respiratory infections were found only in 12% and 32% of SARS-CoV-2-negative specimens before and after vaccination, respectively, in which there was a significant difference between them (P-value = 0.041). Conclusions: Our data showed a low rate of co-infection of other respiratory viruses with SARS-CoV-2 at both durations, before and after COVID-19 vaccination. Moreover, the circulation of common respiratory viruses before the COVID-19 vaccination was lower, probably due to non-pharmaceutical interventions (NPI), while virus activity (especially influenza virus A) was significantly increased after COVID-19 vaccination with reducing strict public health measures.

PEGylation Prolongs the Half-Life of Equine Anti-SARS-CoV-2 Specific F(ab')2

Therapeutic antibodies-F(ab')₂ obtained from hyperimmune equine plasma could treat emerging infectious diseases rapidly because of their high neutralization activity and high output. However, the small-sized F(ab')₂ is rapidly eliminated by blood circulation. This study explored PEGylation strategies to maximize the half-life of equine anti-SARS-CoV-2 specific F(ab')₂. Equine anti-SARS-CoV-2 specific F(ab')₂ were combined with 10 KDa MAL-PEG-MAL in optimum conditions. Specifically, there were two strategies: Fab-PEG and Fab-PEG-Fab, F(ab')₂ bind to a PEG or two PEG, respectively. A single ion exchange chromatography step accomplished the purification of the products. Finally, the affinity and neutralizing activity was evaluated by ELISA and pseudovirus neutralization assay, and ELISA detected the pharmacokinetic parameters. The results displayed that equine anti-SARS-CoV-2 specific F(ab')₂ has high specificity. Furthermore, PEGylation F(ab')₂-Fab-PEG-Fab had a longer half-life than specific F(ab')₂. The serum half-life of Fab-PEG-Fab, Fab-PEG, and specific F(ab')₂ were 71.41 h, 26.73 h, and 38.32 h, respectively. The half-life of Fab-PEG-Fab was approximately two times as long as the specific F(ab')₂. Thus far, PEGylated F(ab')₂ has been prepared with high safety, high specificity, and a longer half-life, which could be used as a potential treatment for COVID-19.

Outcomes of Thoracoscopic Lobectomy after Recent COVID-19 Infection

BACKGROUND

The COVID-19 outbreak had a massive impact on lung cancer patients with the rise in the incidence and mortality of lung cancer.

METHODS

We evaluated whether a recent COVID-19 infection affected the outcome of patients undergoing thoracoscopic lobectomy for lung cancer using a retrospective observational mono-centric study conducted between January 2020 and August 2022. Postoperative complications and 90-day mortality were reported. We compared lung cancer patients with a recent history of COVID-19 infection prior to thoracoscopic lobectomy to those without recent COVID-19 infection. Univariable and multivariable analyses were performed.

RESULTS

One hundred and fifty-three consecutive lung cancer patients were enrolled. Of these 30 (19%), had a history of recent COVID-19 infection prior to surgery. COVID-19 was not associated with a higher complication rate or 90-day mortality. Patients with recent COVID-19 infection had more frequent pleural adhesions (p = 0.006). There were no differences between groups regarding postoperative complications, conversion, drain removal time, total drainage output, and length of hospital stay.

CONCLUSIONS

COVID-19 infection did not affect the outcomes of thoracoscopic lobectomy for lung cancer. The treatment of these patients should not be delayed in case of recent COVID-19 infection and should not differ from that of the general population.

Shark nanobodies with potent SARS-CoV-2 neutralizing activity and broad sarbecovirus reactivity

Despite rapid and ongoing vaccine and therapeutic development, SARS-CoV-2 continues to evolve and evade, presenting a need for next-generation diverse therapeutic modalities. Here we show that nurse sharks immunized with SARS-CoV-2 recombinant receptor binding domain (RBD), RBD-ferritin (RFN), or spike protein ferritin nanoparticle (SpFN) immunogens elicit a set of new antigen receptor antibody (IgNAR) molecules that target two non-overlapping conserved epitopes on the spike RBD. Representative shark antibody variable NAR-Fc chimeras (ShAbs) targeting either of the two epitopes mediate cell-effector functions, with high affinity to all SARS-CoV-2 viral variants of concern, including the divergent Omicron strains. The ShAbs potently cross-neutralize SARS-CoV-2 WA-1, Alpha, Beta, Delta, Omicron BA.1 and BA.5, and SARS-CoV-1 pseudoviruses, and confer protection against SARS-CoV-2 challenge in the K18-hACE2 transgenic mouse model. Structural definition of the RBD-ShAb01-ShAb02 complex enabled design and production of multi-specific nanobodies with enhanced neutralization capacity, and picomolar affinity to divergent sarbecovirus clade 1a, 1b and 2 RBD molecules. These shark nanobodies represent potent immunotherapeutics both for current use, and future sarbecovirus pandemic preparation.

Occurrence and transport of SARS-CoV-2 in wastewater streams and its detection and remediation by chemical-biological methods

This paper explains the transmission of SARS-CoV and influences of several environmental factors in the transmission process. The article highlighted several methods of collection, sampling and monitoring/estimation as well as surveillance tool for detecting SARS-CoV in wastewater streams. In this context, WBE (Wastewater based epidemiology) is found to be the most effective surveillance tool. Several methods of genomic sequencing are discussed in the paper, which are applied in WBE, like qPCR-based wastewater testing, metagenomics-based analysis, next generation sequencing etc. Additionally, several types of biosensors (colorimetric biosensor, mobile phone-based biosensors, and nanomaterials-based biosensors) showed promising results in sensing SARS-CoV in wastewater. Further, this review paper outlined the gaps in assessing the factors responsible for transmission and challenges in detection and monitoring along with the remediation and disinfection methods of this virus in wastewater. Various methods of disinfection of SARS-CoV-2 in wastewater are discussed (primary, secondary, and tertiary phases) and it is found that a suite of disinfection methods can be used for complete disinfection/removal of the virus. Application of ultraviolet light, ozone and chlorine-based disinfectants are also discussed in the context of treatment methods. This study calls for continuous efforts to gather more information about the virus through continuous monitoring and analyses and to address the existing gaps and identification of the most effective tool/ strategy to prevent SARS-CoV-2 transmission. Wastewater surveillance can be very useful in effective surveillance of future pandemics and epidemics caused by viruses, especially after development of new technologies in detecting and disinfecting viral pathogens more effectively.

Natural Flavonoid Derivatives Have Pan-Coronavirus Antiviral Activity

The SARS-CoV-2 protease (3CLpro) is one of the key targets for the development of efficacious drugs for COVID-19 treatment due to its essential role in the life cycle of the virus and exhibits high conservation among coronaviruses. Recent studies have shown that flavonoids, which are small natural molecules, have antiviral activity against coronaviruses (CoVs), including SARS-CoV-2. In this study, we identified the docking sites and binding affinity of several natural compounds, similar to flavonoids, and investigated their inhibitory activity towards 3CLpro enzymatic activity. The selected compounds were then tested in vitro for their cytotoxicity, for antiviral activity against SARS-CoV-2, and the replication of other coronaviruses in different cell lines. Our results showed that Baicalein (100 μg/mL) exerted strong 3CLpro activity inhibition (>90%), whereas Hispidulin and Morin displayed partial inhibition. Moreover, Baicalein, up to 25 μg/mL, hindered >50% of SARS-CoV-2 replication in Vero E6 cultures. Lastly, Baicalein displayed antiviral activity against alphacoronavirus (Feline-CoV) and betacoronavirus (Bovine-CoV and HCoV-OC43) in the cell lines. Our study confirmed the antiviral activity of Baicalein against SARS-CoV-2 and demonstrated clear evidence of its pan-coronaviral activity.

COVID-19's influence on cardiac function: a machine learning perspective on ECG analysis

In December 2019, the spread of the SARS-CoV-2 virus to the world gave rise to probably the biggest public health problem in the world: the COVID-19 pandemic. Initially seen only as a disease of the respiratory system, COVID-19 is actually a blood disease with effects on the respiratory tract. Considering its influence on hematological parameters, how does COVID-19 affect cardiac function? Is it possible to support the clinical diagnosis of COVID-19 from the automatic analysis of electrocardiography? In this work, we sought to investigate how COVID-19 affects cardiac function using a machine learning approach to analyze electrocardiography (ECG) signals. We used a public database of ECG signals expressed as photographs of printed signals, obtained in the context of emergency care. This database has signals associated with abnormal heartbeat, myocardial infarction, history of myocardial infarction, COVID-19, and healthy heartbeat. We propose a system to support the diagnosis of COVID-19 based on hybrid deep architectures composed of pre-trained convolutional neural networks for feature extraction and Random Forests for classification. We investigated the LeNet, ResNet, and VGG16 networks. The best results were obtained with the VGG16 and Random Forest network with 100 trees, with attribute selection using particle swarm optimization. The instance size has been reduced from 4096 to 773 attributes. In the validation step, we obtained an accuracy of 94%, kappa index of 0.91, and sensitivity, specificity, and area under the ROC curve of 100%. This work showed that the influence of COVID-19 on cardiac function is quite considerable: COVID-19 did not present confusion with any heart disease, nor with signs of healthy individuals. It is also possible to build a solution to support the clinical diagnosis of COVID-19 in the context of emergency care from a non-invasive and technologically scalable solution, based on hybrid deep learning architectures.

Integrated Data Analysis Uncovers New COVID-19 Related Genes and Potential Drug Re-Purposing Candidates

The COVID-19 pandemic is an acute and rapidly evolving global health crisis. To better understand this disease's molecular basis and design therapeutic strategies, we built upon the recently proposed concept of an integrated cell, iCell, fusing three omics, tissue-specific human molecular interaction networks. We applied this methodology to construct infected and control iCells using gene expression data from patient samples and three cell lines. We found large differences between patient-based and cell line-based iCells (both infected and control), suggesting that cell lines are ill-suited to studying this disease. We compared patient-based infected and control iCells and uncovered genes whose functioning (wiring patterns in iCells) is altered by the disease. We validated in the literature that 18 out of the top 20 of the most rewired genes are indeed COVID-19-related. Since only three of these genes are targets of approved drugs, we applied another data fusion step to predict drugs for re-purposing. We confirmed with molecular docking that the predicted drugs can bind to their predicted targets. Our most interesting prediction is artenimol, an antimalarial agent targeting ZFP62, one of our newly identified COVID-19-related genes. This drug is a derivative of artemisinin drugs that are already under clinical investigation for their potential role in the treatment of COVID-19. Our results demonstrate further applicability of the iCell framework for integrative comparative studies of human diseases.

Environmental challenges of COVID-19 pandemic: resilience and sustainability - A review

The emergence of novel respiratory disease (COVID-19) caused by SARS-CoV-2 has become a public health emergency worldwide and perturbed the global economy and ecosystem services. Many studies have reported the presence of SARS-CoV-2 in different environmental compartments, its transmission via environmental routes, and potential environmental challenges posed by the COVID-19 pandemic. None of these studies have comprehensively reviewed the bidirectional relationship between the COVID-19 pandemic and the environment. For the first time, we explored the relationship between the environment and the SARS-CoV-2 virus/COVID-19 and how they affect each other. Supporting evidence presented here clearly demonstrates the presence of SARS-CoV-2 in soil and water, denoting the role of the environment in the COVID-19 transmission process. However, most studies fail to determine if the viral genomes they have discovered are infectious, which could be affected by the environmental factors in which they are found.The potential environmental impact of the pandemic, including water pollution, chemical contamination, increased generation of non-biodegradable waste, and single-use plastics have received the most attention. For the most part, efficient measures have been used to address the current environmental challenges from COVID-19, including using environmentally friendly disinfection technologies and employing measures to reduce the production of plastic wastes, such as the reuse and recycling of plastics. Developing sustainable solutions to counter the environmental challenges posed by the COVID-19 pandemic should be included in national preparedness strategies. In conclusion, combating the pandemic and accomplishing public health goals should be balanced with environmentally sustainable measures, as the two are closely intertwined.

Simple hemogram to support the decision-making of COVID-19 diagnosis using clusters analysis with self-organizing maps neural network

The pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which is related to new coronavirus disease (COVID-19) has mobilized several scientifics to explore clinical data using soft-computing approaches. In the context of machine learning, previous studies have explored supervised algorithms to predict and support diagnosis based on several clinical parameters from patients diagnosed with and without COVID-19. However, in most of them the decision is based on a "black-box" method, making it impossible to discover the variable relevance in decision making. Hence, in this study, we introduce a non-supervised clustering analysis with neural network self-organizing maps (SOM) as a strategy of decision-making. We propose to identify potential variables in routine blood tests that can support clinician decision-making during COVID-19 diagnosis at hospital admission, facilitating rapid medical intervention. Based on SOM features (visual relationships between clusters and identification of patterns and behaviors), and using linear discriminant analysis , it was possible to detect a group of units of the map with a discrimination power around 83% to SARS-CoV-2-positive patients. In addition, we identified some variables in admission blood tests (Leukocytes, Basophils, Eosinophils, and Red cell Distribution Width) that, in combination had strong influence in the clustering performance, which could assist a possible clinical decision. Thus, although with limitations, we believe that SOM can be used as a soft-computing approach to support clinician decision-making in the context of COVID-19.

The Effect of COVID-19 on Long-Term Cardiac Function in Patients With Chronic Heart Failure

Aim      To evaluate functional changes in the heart in the long-term following COVID-19 in patients with chronic heart failure (CHF).Material and methods  Case reports of 54 patients aged 69.1±9.7 years who had COVID-19 from January 2021 through January 2022 and had been previously diagnosed with NYHA functional class II-III CHF were studied. Two comparison groups were isolated: HF with LV EF &gt;50 % (n=39) and &lt;50 % (n=15). Echocardiography was used to evaluate changes in LV EF and pulmonary artery systolic pressure (PASP) 5-6 months following COVID-19.Results In all CHF patients after COVID-19 at 5.8 months on average, LV EF decreased (median difference, 2.5 %; 95 % confidence interval (CI): 6.99×10-5- 4.99) and PASP increased (median difference, 8 mm Hg; 95 % CI: 4.5-12.9). In the HF group with LV EF &lt;50 %, the decrease in EF was greater than in the group with LV EF &gt;50 % (6.9 and 0.7 %, respectively; p=0.037); furthermore, the CHF phenotype did not influence the change in PASP (p=0.4). The one-factor regression analysis showed that the dynamics of LV EF decrease was significantly influenced by the baseline decrease in LV EF, whereas the change in PASP was influenced by the dynamics of LV EF decrease, presence of dyslipidemia, and statin treatment. Furthermore, the multifactorial analysis showed that prognostically significant factors for long-term changes in LV EF following COVID-19 were male gender (odds ratio (OR), 5.92; 95 % CI: 1.31-26.75; p=0.014), LV EF at baseline &lt;50 % (OR, 0.88; 95 % CI: 0.8-0.96; p&lt;0.001); changes in PASP depended on the presence of dyslipidemia (OR, 0.08; 95 % CI: 0.01-0.84; p=0.018).Conclusion      This study showed that COVID-19 in the long term can influence the course of CHF; in this process, HF patients with EF &lt;50 % have progression of systolic dysfunction and PASP, whereas patients with EF &gt;50 % have an isolated increase in PASP.

Toward an efficient approximate analytical solution for 4-compartment COVID-19 fractional mathematical model

With the recent trend in the spread of coronavirus disease 2019 (Covid-19), there is a need for an accurate approximate analytical solution from which several intrinsic features of COVID-19 dynamics can be extracted. This study proposes a time-fractional model for the SEIR COVID-19 mathematical model to predict the trend of COVID-19 epidemic in China. The efficient approximate analytical solution of multistage optimal homotopy asymptotic method (MOHAM) is used to solve the model for a closed-form series solution and mathematical representation of COVID-19 model which is indeed a field where MOHAM has not been applied. The equilibrium points and basic reproduction number ( R 0 ) are obtained and the local stability analysis is carried out on the model. The behaviour of the pandemic is studied based on the data obtained from the World Health Organization. We show on tables and graphs the performance, behaviour, and mathematical representation of the various fractional-order of the model. The study aimed to expand the application areas of fractional-order analysis. The results indicate that the infected class decreases gradually until 14 October 2021, and it will still decrease slightly if people are being vaccinated. Lastly, we carried out the implementation using Maple software 2021a.

An Industrial Approach to Production of Tofacitinib Citrate (TFC) as an Anti-COVID-19 Agent: A Joint Experimental and Theoretical Study

In this report, we have presented our experience about a facile method for synthesis of tofacitinib citrate (TFC). The developed analytical methods for identification and qualifications are also included. As TFC seems to be effective in treatment of the symptoms of COVID-19 (SARS family), manufacturing of this active pharmaceutical ingredient (API) could be helpful. The API of TFC was prepared from the diamine intermediate in an ambient and solvent-free condition. Elimination of the reaction solvent resulted in decreasing the cost and preventing the rejection of the organic volatile impurity (OVI) test. The final citrate addition step was carried out using water as a solvent (the citrate content was 37.5% by potentiometry). Moreover, the results of the Karl-Fischer (KF) titration analysis was about 0.24%, which showed that the use of water does not increase the water content of the crystal structure.

pH profiles of 3-chymotrypsin-like protease (3CLpro) from SARS-CoV-2 elucidate its catalytic mechanism and a histidine residue critical for activity

3-Chymotrypsin-like protease (3CLpro) is a promising drug target for coronavirus disease 2019 and related coronavirus diseases because of the essential role of this protease in processing viral polyproteins after infection. Understanding the detailed catalytic mechanism of 3CLpro is essential for designing effective inhibitors of infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Molecular dynamics studies have suggested pH-dependent conformational changes of 3CLpro, but experimental pH profiles of SARS-CoV-2 3CLpro and analyses of the conserved active-site histidine residues have not been reported. In this work, pH-dependence studies of the kinetic parameters of SARS-CoV-2 3CLpro revealed a bell-shaped pH profile with 2 pK_a values (6.9 ± 0.1 and 9.4 ± 0.1) attributable to ionization of the catalytic dyad His41 and Cys145, respectively. Our investigation of the roles of conserved active-site histidines showed that different amino acid substitutions of His163 produced inactive enzymes, indicating a key role of His163 in maintaining catalytically active SARS-CoV-2 3CLpro. By contrast, the H164A and H172A mutants retained 75% and 26% of the activity of WT, respectively. The alternative amino acid substitutions H172K and H172R did not recover the enzymatic activity, whereas H172Y restored activity to a level similar to that of the WT enzyme. The pH profiles of H164A, H172A, and H172Y were similar to those of the WT enzyme, with comparable pK_a values for the catalytic dyad. Taken together, the experimental data support a general base mechanism of SARS-CoV-2 3CLpro and indicate that the neutral states of the catalytic dyad and active-site histidine residues are required for maximum enzyme activity.

Anxiety of pregnant women in time of catastrophic events, including COVID-19 pandemic: a systematic review and meta-analysis

PURPOSE

In March 2020, daily life was disrupted by the new virus SARS-CoV-2, which causes COVID-19. Pandemic-related prenatal anxiety could lead to depression, a risk factor for adverse pregnancy outcomes and abnormal neonatal development. This study aimed to investigate the impact of anxiety on the mental health of pregnant women exposed to catastrophic events as compared to those without such exposure.

MATERIALS AND METHODS

PubMed/MEDLINE, Web of Science, Cochrane Library, Scopus, and EMBASE were searched for relevant studies. This study compared the prevalence of anxiety among pregnant women during a catastrophic event.

RESULTS

Fifteen full texts were assessed for inclusion, with 3 included, 10 excluded for not meeting criteria, and 2 excluded for other reasons. The included studies were published before the current COVID-19 pandemic but included the SARS 2003 outbreak. During the current COVID-19 pandemic, 10 further studies were conducted, but they failed to meet the inclusion criteria. A meta-analysis of two studies using STAI revealed that women exposed to a catastrophic event had a higher mean STAI score of 1.82 points (95% CI: 0.47-3.18 points).

CONCLUSION

Women with complications during pregnancy should be assessed for anxiety independently from catastrophic events. During financial crises, environmental or other disasters, special attention should be given to women with low risk, normal pregnancies.

Novel coronavirus mutations: Vaccine development and challenges

The ongoing global pandemic of novel coronavirus pneumonia (COVID-19) caused by the SARS-CoV-2 has a significant impact on global health and economy system. In this context, there have been some landmark advances in vaccine development. Over 100 new coronavirus vaccine candidates have been approved for clinical trials, with ten WHO-approved vaccines including four inactivated virus vaccines, two mRNA vaccines, three recombinant viral vectored vaccines and one protein subunit vaccine on the "Emergency Use Listing". Although the SARS-CoV-2 has an internal proofreading mechanism, there have been a number of mutations emerged in the pandemic affecting its transmissibility, pathogenicity and immunogenicity. Of these, mutations in the spike (S) protein and the resultant mutant variants have posed new challenges for vaccine development and application. In this review article, we present an overview of vaccine development, the prevalence of new coronavirus variants and their impact on protective efficacy of existing vaccines and possible immunization strategies coping with the viral mutation and diversity.

Ultrasound assessment of SARS-CoV-2 pneumonia: a literature review for the primary care physician

The SARS-CoV-2 pandemic is considered one of the most critical global health emergencies in the last century. The diagnostic approach to the novel coronavirus disease (COVID-19) and its possible complications through a point-of-care-ultrasound (POCUS) evaluation could represent a good solution in the primary care setting. POCUS is a non-invasive technique that can be used outside hospitals to screen COVID-19 patients and their complications safely. Moreover, it offers several applications of diagnostic evaluation not only on lung parenchyma but also to search disease complications, such as the cardiovascular system, even at the patients' home. This narrative review aims to analyse the literature and provide data to primary care physicians engaged in monitoring and treating patients with SARS-CoV-2 infection. Key MessagesPOCUS is an important tool for the diagnostic approach in the primary care setting already before the start of the SARS-CoV-2 pandemic.Portable devices are useful in monitoring the clinical evolution of patients with infection from SARS-CoV-2 at home.The ultrasonographic features can help the general practice physicians to evaluate the presence of lung involvement and to diagnose complications from the SARS-CoV-2 infection involving districts such as the cardiovascular system.

Computational Study of Helicase from SARS-CoV-2 in RNA-Free and Engaged Form

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the pandemic that broke out in 2020 and continues to be the cause of massive global upheaval. Coronaviruses are positive-strand RNA viruses with a genome of ~30 kb. The genome is replicated and transcribed by RNA-dependent RNA polymerase together with accessory factors. One of the latter is the protein helicase (NSP13), which is essential for viral replication. The recently solved helicase structure revealed a tertiary structure composed of five domains. Here, we investigated NSP13 from a structural point of view, comparing its RNA-free form with the RNA-engaged form by using atomistic molecular dynamics (MD) simulations at the microsecond timescale. Structural analyses revealed conformational changes that provide insights into the contribution of the different domains, identifying the residues responsible for domain-domain interactions in both observed forms. The RNA-free system appears to be more flexible than the RNA-engaged form. This result underlies the stabilizing role of the nucleic acid and the functional core role of these domains.

Impact of the COVID-19 Pandemic on the Female Sexual Function Index and Female Behavioral Changes: A Cross-Sectional Survey Study in Thailand

Sexual health alterations are associated with disasters. Consequently, the COVID-19 pandemic may affect female sexual function. This study aimed to determine the COVID-19 pandemic effect on female sexual function and to know the risk of female sexual dysfunction. This online, cross-sectional, observational research was conducted during the pandemic period. A logistic regression model was used to investigate the associations between outcomes and potential risk factors. In total, 432 sexually active women participating in the region affected by the COVID-19 pandemic were analyzed. The overall findings of our study are that 60 percent of females were at risk for female sexual dysfunction. The average FSFI score was 21.27 ± 7.17. Comparing female sexual behavior before and during the COVID-19 pandemic reveals a significant decrease in the frequency of having sex per week, foreplay duration, and coital duration. In the multivariate analysis, the factors associated with the development of RFSD are age greater than 45 years (adjusted odds ratios (AOR) 15.09, 95% confidence interval (CI) 3.67-62.07), body mass index (BMI) greater than 25 (AOR 3.26, 95%CI 1.23-8.67), jobs as a healthcare provider (AOR 8.45, 95%CI 3.66-19.53), previous COVID-19 infection within the previous three months (AOR 36.81, 95%CI 10.93-123.98), and screened-positive anxiety (AOR 13.07, 95%CI 4.75-35.94). COVID-19 influences female sexual behavior and may increase the risk of sexual dysfunction in women. Concern for the effects of female sexual quality of life in high-risk individuals is essential.

Molecular Function of cGAS-STING in SARS-CoV-2: A Novel Approach to COVID-19 Treatment

Coronavirus illness 2019 is a significant worldwide health danger that began with severe acute respiratory syndrome coronavirus two infections. It is the largest pandemic of our lifetime to date, affecting millions of people and crippling economies globally. There is currently no viable therapy for this devastating condition. The fast spread of SARS-CoV-2 underlines the critical need for favorable treatments to prevent SARS-CoV-2 infection and dissemination. Regulating the upstream cytokine release might be a possible method for COVID-19 therapy. We propose that more consideration be paid to the dysregulated IFN-I release in COVID-19 and that cGAS and STING be considered therapeutic targets for avoiding cytokine storms and as critical components in host antiviral defense mechanisms.

Anticipating the Next Chess Move: Blocking SARS-CoV-2 Replication and Simultaneously Disarming Viral Escape Mechanisms

The COVID-19 pandemic initiated a race to determine the best measures to control the disease and to save as many people as possible. Efforts to implement social distancing, the use of masks, and massive vaccination programs turned out to be essential in reducing the devastating effects of the pandemic. Nevertheless, the high mutation rates of SARS-CoV-2 challenge the vaccination strategy and maintain the threat of new outbreaks due to the risk of infection surges and even lethal variations able to resist the effects of vaccines and upset the balance. Most of the new therapies tested against SARS-CoV-2 came from already available formulations developed to treat other diseases, so they were not specifically developed for SARS-CoV-2. In parallel, the knowledge produced regarding the molecular mechanisms involved in this disease was vast due to massive efforts worldwide. Taking advantage of such a vast molecular understanding of virus genomes and disease mechanisms, a targeted molecular therapy based on siRNA specifically developed to reach exclusive SARS-CoV-2 genomic sequences was tested in a non-transformed human cell model. Since coronavirus can escape from siRNA by producing siRNA inhibitors, a complex strategy to simultaneously strike both the viral infectious mechanism and the capability of evading siRNA therapy was developed. The combined administration of the chosen produced siRNA proved to be highly effective in successfully reducing viral load and keeping virus replication under control, even after many days of treatment, unlike the combinations of siRNAs lacking this anti-anti-siRNA capability. Additionally, the developed therapy did not harm the normal cells, which was demonstrated because, instead of testing the siRNA in nonhuman cells or in transformed human cells, a non-transformed human thyroid cell was specifically chosen for the experiment. The proposed siRNA combination could reduce the viral load and allow the cellular recovery, presenting a potential innovation for consideration as an additional strategy to counter or cope COVID-19.