Background: The COVID-19 pandemic had significant effects on medical students. Objectives: This study aimed to investigate the psychological impact of the COVID-19 pandemic on preclinical medical students and determine their views about distance education and working on the frontline. Methods: A cross-sectional study was conducted on 722 preclinical medical students. Data were collected with an online questionnaire between 20 and 27 December 2020. A data collection form including questions about sociodemographic characteristics, opinions about distance education and frontline working, the Impact of Event Scale-Revised (IES-R), and the Insomnia Severity Index (ISI) scales was used for data retrieval. Results: The students’ mean age was 20.7±1.6 years, and 393 (54.4%) were female. Of the students, 699 (96.8%) were concerned about their education, 181 (25.1%) had post-traumatic stress disorder, and 171 (23.6%) had insomnia. Post-traumatic stress was higher in women compared to men (χ2 =3.916, p=0.048), in those who had acquaintances with COVID-19 compared to those who had not (χ2 =12.798, p<0.001), those who had a fear of COVID-19 contamination to their relatives compared to those who did not have such a fear (χ2 =34.463, p<0.001), those who followed COVID-19-related news on social media compared to those who did not follow such information (χ2 =8.250, p=0.004), and those who had a high level of anxiety about the interruption of their education compared to those who had less anxiety (χ2 =42.147, p<0.001). PTSD was significantly higher in those who had negative opinions towards distance education (χ2 =17.340, p<0.007), and those with internet connection and quota problems (p<0.001 and p=0.007 respectively). Conclusion: While students are experiencing the psychological effects of the pandemic, they also worry about the interruption of their education. Educators who prepare students for the upcoming pandemics should also be aware of the psychological effects and implement remedial interventions for their mental health

Background: We conducted data analysis to determine whether there are distinguishing characteristics depending on the success or failure of control for COVID-19 by country in the trend of the daily number of confirmed cases and the number of tests. Methods: We obtained the number of confirmed cases and tests per day for almost every country in the world from Our World in Data. We applied the Pearson correlation between the two time series was calculated according to the time delay to analyze the relationship between the number of tests and the number of cases with a lag. Results: For each country, we obtained the time lag that makes the maximum correlation between the number of confirmed cases and the number of tests for COVID-19. It can be seen that countries whose time lag lies in a special section between about 15 and 20 days are generally successful in control COVID-19. It looks like a trench on the battlefield. Conclusion: We have seen the possibility that the success in mitigating COVID-19 can be expressed as a simple indicator of the time lag of the correlation between confirmed cases and tests. This indicator can be presumed to be a sign of an effort to actively tracing infected person.

Aims At the beginning of the Sars-CoV2 pandemic, there were no clinically-tested medications for the effective treatment of coronavirus disease. In this context, on 5 March 2020, the French Public Health Council issued several recommendations for the therapeutic management of this new disease, including the use of hydroxychloroquine (HCQ). An unexpected cardiovascular safety signal was quickly identified as being more frequent than expected thanks to the reports of adverse drug reactions (ADRs) submitted to French regional pharmacovigilance centres (RPVC). The objective of this study was to compare all ADRs reported with HCQ used in its usual indication, collected before the pandemic period (1985 to 31 December, 2019) with those reported with the COVID-19 indication (1 January to 21 July, 2020). Methods For this purpose, reports were extracted from the French pharmacovigilance database and analysed for these two periods. Results Our study showed a different safety profile in COVID-19 patients with more cardiac disorders (57% of ADRs versus 5% before the pandemic period), especially QT interval prolongation, resulting from an interaction with azithromycin in more than 20% of cases. Hepatobiliary disorders were also significantly more frequent. Conclusions These observations could be associated with the effect of the virus itself on the various organs, the profile of the patients treated, and concomitant drug treatments.

Background: Based on the investigations, cytokine-release syndrome (CRS) play a key role in the development of acute respiratory distress syndrome (ARDS) following SARS-CoV-2 infection. Anakinra can be effective in the management of CRS by inhibiting IL-1 from binding to the interleukin-1 receptors. We aimed to review the current clinical evidence regarding the therapeutic effects of anakinra in the management of ARDS in the context of the coronavirus disease 2019 (COVID-19). Methods: PubMed and google scholar databases were searched and all of the case reports, case series and RCTs were reviewed. Also, we searched www.clinicaltrial.gov database for ongoing clinical trials of anakinra. Results: Overall, 31 articles were found, and included 9 case report, 6 case-series and 11 RCTs. One of the reports of RCTs was not peer reviewed. Also, ten ongoing studies were found in the clinicaltrial.gov database searching. Conclusion: Four items have been shown to be important to achieve the optimal therapeutic effect of anakinra in patients withCOVID-19. These items include duration of treatment ≥ 10 days, doses of more than 100 mg, intravenous administration and early initiation of therapy. Also, the use of corticosteroids in combination with anakinra appears to improve clinical outcome compared to monotherapy with anakinra.

Background. Globally, pharmacovigilance activities were affected by COVID-19. Therefore, several competent health authorities around the world, including several countries in the Middle East, have issued guidelines and practices to ensure that pharmacovigilance activities are maintained and continued during the pandemic. Objective. The aim of this study was to assess the impact of COVID-19, preparedness and performance of national pharmacovigilance systems in participating countries during COVID-19 pandemic. Methods. This was a cross- sectional study that was conducted between July and October 2020. National pharmacovigilance centres in 18 Arab countries in the Middle East were invited to participate in this study. Descriptive analysis was used to summarize and present the results of this study. Results. Responses were obtained from 14 (77.8%) Arab countries. Ten of participating countries (71.4%) have either specific national PV guidelines or local PV practices during the COVID-19 pandemic. Adverse events reporting was the main PV activity that was covered by PV guidelines and practices. National guidelines and practices covered other PV activities in 8 (57.14%) of the participating countries. Performance and practices of national PV centres vary considerably among participating countries during the pandemic. Conclusion. The findings highlight the differences in preparedness and performance of different national PV centres in participating Middle Eastern countries. Improving digital infrastructure among participating countries could serve as a useful tool to minimize the impact of the pandemic on PV activities.

Background: Sepsis-related deaths contribute up to 20% of all global deaths, with the highest-burden from sub-Saharan Africa and Southeast Asia. Cytokines are the mediators of organ dysfunction in systemic inflammatory response syndrome (SIRS) across varied aetiologies, including sepsis. The imbalance of pro and anti-inflammatory cytokines continues to be the crux of the pathophysiology of organ dysfunction in septic shock. Therapies to treat cytokines either by antagonizing them or filtering them out of the body are evolving. Hemoadsorption is a process of filtering out cytokines and other metabolites involved in SIRS by surface adsorption.  Methods: We searched for terms – Hemoadsorption; CytoSorb; in PubMed. We enrolled manuscripts with patients at Indian Centres for review. We extend our review of cytokine storm in COVID-19 and the utility of CytoSorb as an adjuvant in the management of septic shock in COVID-19. Results: Severe acute respiratory syndrome coronavirus -2 (SARS-CoV-2) infection causing COVID-19 (Corona Virus disease - 2019) pandemic has affirmed cytokine storm as the principle pathology causing morbidity and mortality. Management strategies are mostly supportive since specific anti-viral therapy is still in the incipient stage. Cytokine adsorption is being used across most western countries in COVID-19 septic shock.  Conclusion: COVID-19 with cytokine storm as its main pathology is a suitable substrate for the use of CytoSorb. COVID-19 patients with elevated cytokine levels can be offered CytoSorb® hemoadsorption along with other supportive therapies.

Anaphylactic Reaction Following Receipt of COVID-19 Vaccines: Report of Two CasesTo the Editor,Though rare, anaphylactic reactions may occur after vaccine injection. Therefore, it is necessary to equip every vaccination location with trained healthcare personnel and resuscitative equipment to manage probable anaphylaxis. Since there is limited knowledge on adverse reactions of novel COVID-19 vaccine, here we report two cases of anaphylactic reaction after injection of Sputnik-V and Oxford-AstraZeneca COVID-19 vaccines (Detailed presentation onSupplementary File ). InA 54-year-old woman was referred to receive the second dose of Sputnik-V vaccine. She denied a history of allergy, angioedema, and anaphylactic reactions, and no severe reactions to childhood vaccines occurred. Immediately after vaccination, a significant injection site bleeding was started. One minute after injection, the patient suddenly developed dizziness, facial angioedema, flushing, severe compressive chest pain, dyspnea, and fear of death. Due to the patient’s signs and symptoms, and intravenous (IV) fluid therapy and 100 mg hydrocortisone were initiated. The patient’s condition improved in hours, and the symptoms were relieved within two days. However, after 3 weeks, she is suffering from the new onset nasal rhinorrhea and itching.A 25-year-old man was referred to receive the first dose of AstraZeneca vaccine. He had no history of underlying medical disorders and hypersensitivity reactions. Childhood vaccination was done without any adverse reaction. He underwent the intramuscular (IM) injection of AstraZeneca vaccine. Almost seven hours after vaccination, the patient gradually developed progressive cyanosis and swelling of all fingers of both hands, fever, chills, fatigue, headache, and shortness of breath. Gradually, the patient’s clinical condition deteriorated. His elbows and legs became cyanotic, and he developed coldness and numbness of the upper limbs (Figure 1) . Due to the patient’s symptoms and signs, anaphylactic shock was considered, and treatment with normal saline and 100 mg hydrocortisone was started. Gradually, the patient’s cyanosis resolved, and he was discharged.Anaphylactic shocks are rare, but life-threatening events may occur after receiving vaccines. Individuals may develop anaphylactic reactions within a few seconds or several hours after vaccine injection1. Our first case developed anaphylactic symptoms within one minute after receiving the COVID-19 vaccine, while the second one’s symptoms were revealed after seven hours. Moreover, both cases had no history of previous allergic or anaphylactic reactions. Therefore, it is necessary to follow-up individuals who undergo vaccine injection during at least the first hours of vaccination.Injection of the vaccine was performed with 2cc syringe without aspiration, and unusual bleeding was observed without any bleeding disorder. Therefore, IV administration of the vaccine may cause an early anaphylactic reaction in the first case. Recommendations vary on aspiration before vaccine injection 2. However, this procedure is not currently recommended for COVID-19 vaccines3.Diagnosis of anaphylactic shock is based on the patient’s clinical signs and symptoms. Prompt treatment should be initiated as soon as the anaphylactic shock is considered. Injection of IM epinephrine and IV fluids is recommended as the first-line treatment for patients with anaphylactic shock 1. After epinephrine administration, IV hydrocortisone should be injected. However, our patients were treated with hydrocortisone as the first-line drug for the emergency treatment of anaphylaxis. An anaphylactic reaction could be life-threatening, and any delay in treatment may increase the risk of patient mortality 1. Therefore, healthcare providers should be trained to treat anaphylactic events accurately, and required equipment should be available.Newly-made COVID-19 vaccines are currently authorized for emergency use in many countries. Because of being novel, vaccine adverse events are not fully known 4. Surveillance programs are necessary to monitor for complications. This challenge is notable in developing countries where infrastructure has some shortcomings. Hence, evidence for adverse events may have some drawbacks for vaccines administrated in developing countries.References1. Bousquet J, Agache I, Blain H, et al. Management of anaphylaxis due to COVID-19 vaccines in the elderly. Allergy . 2021;n/a(n/a). doi:https://doi.org/10.1111/all.148382. Petousis-Harris H. Vaccine injection technique and reactogenicity—Evidence for practice. Vaccine . 2008;26(50):6299-6304. doi:https://doi.org/10.1016/j.vaccine.2008.08.0523. center for disease control. Vaccine Administration. Epidemiology and Prevention of Vaccine-Preventable Diseases. Published 2020. https://www.cdc.gov/vaccines/pubs/pinkbook/vac-admin.html4. Sampath V, Rabinowitz G, Shah M, et al. Vaccines and Allergic reactions: the past, the current COVID-19 pandemic, and future perspectives. Allergy . 2021;n/a(n/a). doi:https://doi.org/10.1111/all.14840Figure 1. Cyanosis and swelling of hands 8 hours after receiving AstraZeneca Vaccine. Cyanosis may be a cardiac-related symptom of anaphylaxis.

Since the beginning of the SARS-CoV-2 pandemic healthcare professionals have found it necessary to generate diagnostic methods for the disease that are easy to use, reliable, and accessible. The Berlin-Charité protocol has been one of the most recommended methods for detecting SARS-CoV-2 from the onset of the pandemic. However, new diagnostic techniques such as GeneXpert have been developed and proven to be efficient, fast, and easy to use to detect infected patients. The purpose of this study, conducted at the National Institute for Respiratory Diseases in Mexico, was to compare the diagnostic performance of the Berlin-Charité protocol and GeneXpert for the detection of SARS-CoV-2, evaluating a cohort of 135 Mexican patients. For statistical analysis, sensitivity, specificity, positive predictive value, negative predictive value, and likelihood ratios for each assay were calculated. The diagnostic parameters for GeneXpert were found to be 100% in both sensitivity and specificity. The Berlin-Charité protocol performance had a sensitivity of 72% and specificity of 100%. With this study, it can be concluded that the diagnosis of SARS-Cov_2 infection through GeneXpert was 29% more specific than the Berlin protocol.

China declared officially outbreak as an epidemic on January 20 after findings of human-to-human transmission. On March 11, 2020, World Health Organization (WHO) declared COVID-19 a global Pandemic after the spread and severity of the outbreak. The virus is transmitted from the infected person through respiratory droplets and by touching the surfaces, contaminated with viruses. At present, India is in the middle of the second wave due to a variant virus. Covid-19 cases have risen faster in the second wave than the first wave in India. Union Health Ministry of India issued the latest guidelines for the treatment of Covid-19 depends upon the severity of the disease i.e. mild, moderate and severe. Ministry of Ayush, Government of India has given guidelines for the treatment of Covid-19. Vaccines are a critical tool in the battle against the COVID-19 war. Covishield and Covaxin vaccines are being administered in India. Even if we are vaccinated, we have to take certain preventive measures until the COVID-19 cases dropdown.

Background and purpose Coronavirus Disease 2019 (COVID-19), caused by SARS-CoV-2 infection, is a severe acute respiratory syndrome with an underlying inflammatory state. We have previously demonstrated that acute inflammation modulates cytochromes P450 (CYP) activities in an isoform-specific manner. We therefore hypothesized that COVID-19 might also impact CYP activities, and thus aimed to evaluate the impact of acute inflammation in the context of SARS-CoV-2 infection on the six main human CYPs activity. Experimental Approach This prospective observational study was conducted in 28 patients hospitalized at the Geneva University Hospitals (Switzerland) with a diagnosis of moderate to severe COVID-19. They received the Geneva phenotyping cocktail orally during the first 72h of hospitalization and after three months. Capillary blood samples were collected 2h after cocktail administration to assess the metabolic ratios (MRs) of CYP1A2, 2B6, 2C9, 2C19, 2D6 and 3A. CRP, IL-6 and TNF-α levels were also measured in blood. Key Results CYP1A2, CYP2C19, and CYP3A MRs decreased by 52.6% (p=0.0001), 74.7% (p=0.0006) and 22.8% (p=0.045), respectively, in COVID-19 patients. CYP2B6 and CYP2C9 MRs increased by 101.1% (p=0.009) and 55.8% (p=0.0006) respectively. CYP2D6 MRs variation did not reach statistical significance (p=0.072). As expected, COVID-19 was a good acute inflammation model as mean serum levels of CRP, IL-6 and TNF-α were significantly (p<0.001) higher during SARS-CoV-2 infection. Conclusion and implications CYP activities are modulated in an isoform-specific manner by SARS-CoV-2 infection. The pharmacokinetics of CYP substrates, whether used to treat the disease or as the usual treatment of patients, could be therefore clinically impacted.

Impaired humoral immunity of COVID-19 patients with re-detectable positive RNA test after recoveryQing Lei1,2, Caizheng Yu3, Yang Li4, Hongyan Hou5, Banga Ndzouboukou Jo-Lewis1, Zhuqing Ouyang1, Yandi Zhang1, Xiaosong Lin1, Zongjie Yao1, Fu hui1, Ziyong Sun5, Feng Wang5,*, Shengce Tao4,*, Xionglin Fan1,*1Department of Pathogen Biology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.2Department of Medical Laboratory, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.3Department of Public Health, Tongji Hospital, Tongji Medical College, Huazhong University ofScience and Technology, Wuhan, China.4Shanghai Center for Systems Biomedicine, Key Laboratory of Systems Biomedicine (Ministry of Education), Shanghai Jiao Tong University, Shanghai 200240, China5Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.*Correspondence’ e-mail: Xiong-lin Fan(xlfan@hust.edu.cn), Sheng-ce Tao(taosc@sjtu.edu.cn), Feng Wang(fengwang@tjh.tjmu.edu.cn)To the Editor,The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly spread worldwide.1,2As of May 28, 2020, WHO estimated that there had been 169 million confirmed cases and 3.5 million patients died from SARS-CoV-2 infection.3 Due to lack of etiological treatments, about 3.5%-18% of discharged COVID-19 patients after recovery had a re-tested positive result for SARS-CoV-2 RNA, who was also named after re-detectable positive patients (RP).4-8 Moreover, RP patients may have the potential for virus transmission.9,10However, the mechanism of the occurrence of RP patients remains little known.Humoral immunity, especially neutralizing antibody plays an important role in preventing against SARS-CoV-2 infection, and even disease progression. To elucidate the role of humoral immunity in RP patients, we compared anti-SARS-CoV-2 IgM and IgG antibody responses between RP and non-RP patients in this study. 21 RP patients from Wuhan Pulmonary Hospital (Wuhan, China) between Jan 11, 2020, and April 1, 20204 and 113 non-RP patients discharged from Tongji Hospital, between February 17, 2020, and April 28, 2020 were recruited. Non-RP had negative NAT results while RP patients had at least once positive result during weekly follow-up after discharge. The median time from discharge to a positive retest of 21 RP patients was 14 (range: 4-24) days, and their serum samples were collected at the time of the positive retest. Besides, the serum samples of 113 non-RP patients were collected on the 14th day after discharge. At the same time, we collected serum samples of 601 non-COVID-19 controls including healthy donors, lung cancer patients, patients with autoimmune diseases from Ruijin Hospital (Shanghai, China), Tongren Hospital (Shanghai, China), or National Institutes for Food and Drug Control.11 All serum samples were stored under -80oC until use.First, we used a homemade proteome microarray to detect serum IgM (red) or IgG (green) antibody responses against 20 out of 28 predicted proteins of SARS-CoV-2 with Alexa Fluor 647-conjugated donkey anti-human IgM and Cy3-conjugated goat anti-human IgG (Figure S1) , as previously described. Based on the fluorescent intensity extracted from the microarray, anti-SARS-CoV-2 IgM and IgG profiles for each serum sample were established (Figure 1 ). Interestingly, there were differential IgM and IgG profiles observed between RP patients and non-RP patients. RP patients elicited lower levels of IgM and IgG responses against NSP7, ORF3a, and ORF7b, as well as anti-S1 and N specific IgM and IgG than non-RP patients (Figure 2 ). More importantly, RP patients induced higher levels of specific IgG antibodies against most non-structural and accessory proteins, such as NSP1, NSP2, NSP4, NSP5, NSP7, NSP8, NSP9, NSP10, RdRp, NSP14, NSP15, NSP16, ORF-3b, ORF6, and ORF9b, and E structural protein (Figure 2 ). Previously, the levels of IgG responses to NSP4, NSP7, NSP9, NSP10, RdRp, NSP14 and ORF3 might be related with the poor prognosis and severity of COVID-19.Further, a pseudotyped virus-based neutralization assay platform was used to detect the levels of serum nAb. Unexpectedly, RP patients elicited lower levels of nAb than non-RP. In particular, 90.5% (19/21) RP patients could not detect the nAb response (NT50<10) (Figure S2 ).In conclusion, RP patients impaired humoral immunity, which might benefit the replication of residual SARS-CoV-2 virus in vivo. Our findings have an important impact on improving clinical management. The criterion for patients’ recovery and discharge should be improved to prevent recurrence , such as serological detection and even nAb response, besides persisting and repeated NAT screening.

Background: The COVID-19 pandemic led to an increase in research activity worldwide. The Vall d’Hebron University Hospital Research Ethics Committee (VH-REC) adapted its procedures to give out the opinion rapidly. We aimed to describe the characteristics of the VH-REC activity and studies evaluated during the first outbreak. Methods: Clinical trials (CT), post-authorization studies (PAS) and research projects (RP) on COVID-19 were included and followed up. Variables were described through usual descriptive methods. Results: 157 studies were evaluated: 10 CT, 16 PAS and 131 RP, in 25 bi-weekly online meetings. Non-commercial, unicentric and national studies predominated (95%, 54% and 88%, respectively). The main objective of CT and PAS studies was to test efficacy and safety, and for RP to describe patients’ outcomes. Some studies focused on specific interest groups, such as healthcare professionals or immunosuppressed patients (10% both). The median time of protocols’ evaluation was 3 days. 58.6% (92) required further clarifications, mainly due to aspects of data protection, informed consent, and biological samples. The final opinion was favourable in 93% (146). Regarding follow-up, 123 studies had been initiated and 64 also finalized. Results have been published in 59% (51) of studies. Conclusions and implications: COVID-19 pandemic has led to greater academic and local research, especially through research projects. Electronic sources were implemented for evaluation shortening and ease follow-up. These measures should remain to streamline VH-REC processes, and trends to publish results favoured. This study could allow comparisons with other activity periods (e.g. pre or post-pandemic), or with other REC’

ABSTRACT Purpose Kidney involvement is frequent among patients with coronavirus disease 2019 (Covid-19). However, kidney involvement is varied and mild kidney injury can easily go unnoticed. We aimed to investigate the urinalysis data of Covid-19 patients on admission and to explore the value of urinalysis in the prediction of AKI and in-hospital mortality in patients with Covid-19. Methods The demographic, clinical and laboratory data of patients with confirmed Covid-19 were collected from the electronic health records of the hospital. The outcomes were development of AKI and in-hospital mortality. Results 244 patients were included in the analysis. Mean age was 59.6 ± 13.7 and 65.2% of patients were male. Median SCr on admission was 0.86 (0.72-1.05) mg/dL. Glucosuria, proteinuria and hematuria were found in 36.1%, 22.9% and 22.1% of patients, respectively. AKI was detected in 63 patients (25.8%) on any time of hospitalization. According to multivariate binary logistic regression analayses; AKI development was associated with higher WBC and decreased eGFR as well as with proteinuria on admission. During median 8 (IQR, 5-12) days of follow-up, 33 patients (13.5%) died. Older age, higher CRP levels and proteinuria on admission were also independent predictors of in-hospital mortaliy. Conclusion Proteinuria on admission is associated with development of AKI and in-hospital mortality in patients with Covid-19. Urinalysis can be useful for the evaluation of COVID-19 progression and early diagnosis of kidney damage before SCr rise.

Objective: This study aimed to identify and characterize the 100 most cited dental articles on COVID-19. Materials and Methods: We searched the Web of Science core collection database to identify the 100 most-cited dental articles on COVID-19 in the category of ”Dentistry, Oral Surgery and Medicine” on May 09, 2021. Among the included top most cited articles, the following parameters were recorded and analyzed: article title, publication date, authorship, institution and country of origin, journals, with its impact factor and quartile, number of citations, study design, study topic, and level of evidence (LOE). Results: The mean citation count of the 100 most-cited dental articles on COVID-19 was 32.77 (range 4-750). Four papers were cited more than 100 times. The most productive countries were the USA and China. The Sichuan University from China was the most cited institution. Although 521 authors from 32 different countries contributed to the articles, only 28% had international collaborations. The Journal of Dental Research has the most publications (n=10). The most common study type was narrative reviews (n=38) followed by cross-sectional studies (n=26). Of the 100 most-cited articles, 50 were of LOE VII and 32 LOE V. The recent focuses of the articles were saliva, mouth-washes, oral health, and dental education. Conclusion: According to our analysis, the co-authorship network of the studies is not sufficiently strong. Establishing international cooperation between researchers may increase the quality of future research on COVID-19.

The traditional career path from MD Pharmacology to the medical affairs(MA) within pharmaceutical industry is becoming increasingly challenging and competitive. The MA role has evolved from a ‘medical- knowledge-and-support-only’ role to a ‘strategic decision-making, scientific partner’. Traditional MD Pharmacology background and related knowledge are essential but may no longer be sufficient to ensure ‘Day-1-preparedness’ for an MA role. Transitioning from a medical college environment to the corporate environment would become easier if one develops certain additional soft and hard skills as elaborated in this article. The objective of this manuscript is to recommend how to better-equip the MD Pharmacology residents to be a confident, resourceful and successful MA professionalS. We also elucidate on key skill gaps and the suggested approaches to invest the residency time more judiciously to bridge those gaps for developing more industry-ready pharmacologists. A special segment on changes pertaining to COVID-19 pandemic is also included.

Outbreaks of emerging infectious diseases continue to challenge human health. Novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has triggered a global coronavirus pandemic, namely COVID-19. Multiple variants of SARS-CoV-2 virus are circulating and raises question with respect to effectiveness of different lines of treatment such as vaccines and antiviral drugs. To find appropriate prevention/treatment, 21 plant-based ingredients were identified with antiviral properties. We pseudo typed SARS-CoV-2 on a lentiviral vector plasmid and tested the impact of five different herbal formulations in mammalian HEK293T cells. Viral inactivation assay showed that the natural extracts in herb-derived phytoconstituents based formulation, BITS-003 comprising of Bacopa monnieri, Glycyerrhiza glabra, Asparagus racemosus-wild, and Nigella sativa bear strong virucidal properties, inactivating enveloped viruses from 2log10 (or 99%) to >4log10 (or 99.99%). Moreover, bacterial and yeast cells treated with BITS-003 displayed reduced growth. Topical use of formulation as mouthwash/gargle will be effective in reducing symptoms of respiratory viral infections with a potential to decrease viral load in buccal/oral cavity. This may inhibit the coronavirus spreading to the lungs of infected person and at the same time will reduce the risk of viral transmission to other susceptible persons through micro-droplets originating from the oral cavity of the infected person.

Molecular assays on nasopharyngeal swabs act as the confirmatory test in CoronaVIrus Disease (COVID-19) diagnosis. Despite massive efforts had been made, the high technicalities of nasopharyngeal sampling and molecular assays limit the testing capabilities. Currently, the use of saliva for diagnosis has been recently suggested for COVID-19 diagnostic testing. In a recent research, salivary IgA was associated with the presence of pneumonia, which might illuminate that salivary IgA was independent from serum immunoglobulins. In this study, a total of 44 patients diagnosed with COVID-19 in the Third People’s Hospital of Shenzhen were enrolled. Saliva specimens and serum specimens were obtained at different time points and the immunoglobulins against the SARS-CoV-2 was measured. The results showed that saliva IgA presented higher COI value than IgG and IgM. In matched saliva and serum samples, all saliva presented lower IgG level than serum, and only one saliva sample presented higher IgM level. The conversion rates of saliva IgA and the detection of viral nucleic acid were analyzed in the first and second week after hospitalization. The positive rates were obviously increased when combining the saliva IgA and viral nucleic acid detection. Saliva IgA could serve as useful index for early diagnosis of COVID-19.

The current COVID-19 pandemic is affecting public health and economy worldwide. This pandemic has also affected the working and management strategies of clinical practices, healthcare centres, academics, and research centres. The academic and research institutions, students, and research scholars are diverging towards the online platform such as zoom and google meet for teaching, discussing, and sharing knowledge and ideas. Hospitals have also started following the concept of telemedicine for prescribing medicines to patients. In the current situation, on one side the research related to COVID-19 is conducted at an unprecedented rate whereas on the other side the research concerned with other fields including the CNS research is affected adversely. Initially, during the lockdown, the research activities were resumed, and even after the lockdown is withdrawn the situations are no longer better. It is very challenging to carry out the research activities at an adequate pace keeping in view the present pandemic situation.

The coronavirus disease 2019 (COVID-19) mortality rate has been widely discussed and is considered the primary variable of interest for existing country-level studies, using data from secondary sources (Di Gennaro et al., 2020; Hopman, Allegranzi, & Mehtar, 2020).

Objective: Clinical symptoms of COVID-19 patients differ in regions. Our objective is to explore the characteristics of TCM symptoms and prescriptions of COVID-19 patients in Wanzhou area of Chongqing. Methods: We investigated hospitalized cases of COVID-19 in Wanzhou, Chongqing. The primary outcomes of interest were TCM symptoms and prescriptions, while the secondary outcomes included chest computed tomography (CT), white blood cell counts, lymphocyte levels, and C-reactive protein (CRP) levels.Results: Among the 196 included patients with COVID-19, the top five TCM symptoms were: poor appetite (82.14%), cough (65.31%), fatigue (17.86%), aversion to cold (16.84%), and fever (17.35%). Their five most common TCM prescriptions were: Sashen Radix Ophipodonis Decoction (38.22%), Sijunzi Decoction (37.7%), Maxing Shigan Decoction (31.94%), Sanren Decoction (15.71%), and Xiaochaihu Decoction (12.04%). Participants’ TCM symptom scores before hospital discharge were lower than on admission (P < 0.05). There were also statistically significant differences in white blood cell counts, lymphocyte levels, and CRP levels before or after discharge from hospital as compared with before admission (P < 0.05).Conclusion: The dominant clinical symptoms of patients with COVID-19 in Chongqing were poor appetite, cough, and fatigue, which may be related to the geography and climate of Wanzhou. The TCM prescriptions given to the patients were consistent with their most common symptoms and the fact that the lung and spleen are the main viscera invaded by COVID-19. Traditional Chinese Medicine had a positive effect on patients with COVID-19.

Background: Sufficient data pertaining to the impact of the COVID-19 pandemic on pediatric cancer patients is still currently lacking. The main aim of this prospective study was to describe clinical management and outcomes of COVID-19 in this vulnerable group. Methods: Conducted between May 1st and November 30, 2020, this study included 76 pediatric oncology patients with confirmed COVID-19. Remdesivir (RDV) was the antiviral therapy used. Results: The median age of patients was 9 years. Sixty patients were on first line treatment. Haematological malignancies constituted 86.8% of patients. 35.4% of cases had severe to critical infections. The commonest presentation was fever (93.4%). Chemotherapy was delayed in 59.2% of cases and doses were modified in 30.2%. The sixty-day overall survival (OS) stood at 86.6%, with mortalities occurring only among critically ill patients. Of sixteen acute leukaemia patients in the first induction phase of treatment, 13 survived and 10 achieved induction remission. A negative PCR within 2 weeks and improvement of radiological findings were statistically related to disease severity (p=0.008 and, 0.002 respectively). Better OS was associated with regression of radiological findings after 30 days from infection (p=0.002). Of the forty-five cases who received RDV, 70% were severe to critically ill cases with comparable outcome to patients who did not receive the drug. Conclusions: Most pediatric cancer patients with COVID-19 should have good clinical outcomes, except for those with critical form of infections. Newly diagnosed cases seem to tolerate induction therapy alongside COVID-19 treatment. RDV was well tolerated with no serious adverse events observed.

Background: Favipiravir, first used for novel influenza strains, is being used today in coronavirus disease 2019 (COVID-19). While many studies have been reported in the literature on hydroxychloroquine’s (HQ) arrhythmogenic adverse effects, data on favipiravir are limited. The authors purposed to demonstrate that the arrhythmic effects of favipiravir are not negligible. Methods: The researchers conducted a retrospective observational study on 194 COVID-19 patients. The study population was classified into two groups based on the treatment regimen: favipiravir (n=101) and HQ (n=93). Pre/post-medication electrocardiograms were evaluated for arrhythmic events. Results: Twenty of 101 (19.8%) subjects in the favipiravir group and 13 of 93 (13.9%) subjects in the HQ group had arrhythmogenic events (p=0.42). The most frequent arrhythmic events in the favipiravir group were sinus bradycardia (13 of 20, 65%) and third-degree atrioventricular block (4 of 20, 20%). Corrected QT (QTc) prolongation was the most seen arrhythmogenic adverse effect (9 of 13, 69%) in the HQ group. The proportion of patients with prolonged QTc were higher in the HQ group than the favipiravir group (9 vs. 3, p=0.04). However, the difference between final and baseline QTc did not differ between the HQ and the favipiravir group (11 [IQR:-9—57] vs. 12 [IQR:-7—103], p=0.59, respectively). The change between pre and post-treatment heart rate was more remarkable in the favipiravir group than the HQ group (12 [IQR:-6—70] vs. 5 [IQR:-8—41], p<0.001, respectively). Conclusions: Favipiravir was significantly associated with sinus bradycardia requiring drug withdrawal. Clinicians should more routinely implement arrhythmia monitoring for patients receiving favipiravir.

Objectives Long-term outcomes of COVID-19 patients who discharge ICU are unclear. We investigated the effect of COVID-19 on lung structure, pulmonary functional, exercise capacity and quality of life in patients discharge from ICU and medical ward. Methods A prospective single-centre study conducted in PCR confirmed COVID-19 patients who has been discharged from University of Health Sciences, Dr. Suat Seren Chest Disease and Thoracic Surgery Teaching and Research Hospital between 15 January and 5 March 2021. Patients who followed up for more than 48 hours in ICU and more than 72 hours in medical ward were included the study. Computed tomography scores, pulmonary functional tests (PFT), 6-min walking distance and health related quality of life by SF-36 were compared between ICU and medical ward patients at 6 months after discharge. Results Seventy patients were included final analyses and 31 of them discharged from ICU. ICU patients had higher CT scores than non-ICU patients at admission (17 vs 11) and follow up visit (6 vs 0). Two-three of ICU patients had at least one abnormal finding at control CT. Advanced age (OR 1.08, 95% CI 1.02-1.15) and higher CT score at admission (OR 1.13, 95% CI 1.01-1.27) were risk factors for having radiological abnormalities at control CT. 90% of the patients discharged from the ICU had at least one persistent symptom. Conclusion A number of COVID-19 survivors could not fully recover after 6 months of hospital discharge. COVID-19 survivor needs to support therapies at recovery phase of the disease.

The Rohingya refugee population in Bangladesh has become more vulnerable to COVID-19 because of their living and environmental conditions. The current study represents an assessment of the Rohingya people’s COVID-19-related knowledge, attitude, and practices (KAP) at eight refugee camps in Cox’s Bazar. This cross-sectional study was completed with a total of 400 responses between July and September of 2020. A questionnaire was created to assess demographic characteristics (5 items), knowledge (10 items), attitude (5 items), practices (5 items), and information sources (1 item). Aside from the total KAP scores, the scores are also presented based on demographic variables. The KAP of the respondents were not satisfactory, with scores of 5.8 ±1.8, 2.2 ± 1.0, and 0.9 ± 0.7, respectively. We found significant differences only in the knowledge scores based on education and gender. In conclusion, this study emphasizes the importance of COVID-19 training that focuses on behavioral changes for the Rohingya people in Bangladesh.