Asthmatics are at an increased risk of developing exacerbations after infection by respiratory viruses such as Influenza virus (IV), Parainfluenza virus, and Human and severe acute respiratory syndrome Coronaviruses. Asthma itself, mainly when poorly controlled, is an independent risk factor for pneumonia. A subset of Asthmatics can have significant defects in their innate, humoral, and cell-mediated immunity arms, and it may explain the increased susceptibility to infections. With the current COVID 19 pandemic affecting millions of people worldwide and with mortality several times that of seasonal Flu, it was necessary to revisit this subject. The pathogenesis of SARS-CoV-2, the virus that causes COVID 19, can potentiate the development of acute asthmatic exacerbation with the potential to worsen the state of chronic airway inflammation. The relationship is evident from several studies that show asthmatics experiencing a more adverse clinical course of SARS-CoV-2 infection than non-asthmatics. Recent studies show that Dexamethasone significantly decreased mortality among admitted COVID 19 patients. However, the benefit of inhaled corticosteroids, especially in asthmatics, is still inconclusive. Hence, while we are waiting for more studies that further narrates the association between COVID 19 and Asthma, individualizing asthmatics management among clinicians is crucial to achieving adequate disease control.

Background Using network pharmacology，systematicly reveals the Mechanisms of Radix Isatidis in the therapy of coronavirus disease 2019 （COVID-2019）. Methods The active components and targets of Radix Isatidis were obtained by searching the Batman, TCMSP, and SwissTargetPrediction databases, and COVID-19 related targets were searched through Genecards, Drugbank, and Malacards database. After that, we used String database to establish protein-protein interaction, using David database to conduct enrichment analysis of gene ontology and pathway enrichment analysis based on the Kyoto encyclopedia of genes and genomes. The molecular docking was performed using ChemOffice, PyMOL, and Auto Dock software. Result A total of 73 active ingredients and 1584 related gene targets of Radix Isatidis were screened from kinds of databases while 559 gene targets of COVID-19 were picked out. Among them, there are 70 of the same targets. According to the GO enrichment analysis(P≤0.01), 35 of them belong to biological process, 13 of them belong to cell component, and 14 of them belong to molecular function. And for KEGG analysis, 22 pathways were obtained(P≤0.01), including PI3K − Akt signaling pathway andHIF − 1 signaling pathway. Conclusions Radix Isatidis may act on the PI3K − Akt signaling pathway and HIF−1 signaling pathway Through direct or indirect regulation of the above goals and ways to play role in the therapy of COVID-19

Objective: While the coronavirus persists marginally for ninety-five percent of the infected case count, the remaining five percent have been placed in a critical or vital condition. This study investigates to design an intelligent model that predicts the disease severity level by modeling the relationships between the severity of COVID-19 infection and the various demographic/clinical characteristics of individuals. Material and Methods: A public dataset of a cross-sectional study included the demographic and symptomatological characteristics of 223 COVID-19 patients. The dataset was randomly divided into training (75%) and testing (25%) datasets. During training, the class imbalance problem was solved, and the related factors with the COVID-19 severity were selected using the evolutionary method supported by a genetic algorithm. Neural Network (NN), Support Vector Machine (SVM), QUEST algorithms together with confidence weighted voting, voting, and highest confidence wins strategies (HCWS) were constructed, and the predictive power of models was evaluated by performance metrics. Results: Of the individual models, the NN model outperformed SVM and QUEST algorithms based on the performance metrics in the training and testing datasets. However, ensemble approaches gave better predictions as compared to the individual models regarding all the evaluation metrics. Conclusions: The proposed voting ensemble model outperforms other ensemble and individual machine learning approaches for the severity prediction of COVID-19 disease. The proposed ensemble learning model can be integrated into web or mobile applications in classifying the severity of COVID-19 for clinical decision support.

Immune thrombocytopenia (ITP) is well described in children and commonly associated to recent viral infections. We present a 15-year-old male and a 3.5-year-old female with ITP secondary to COVID-19. Both patients presented with bruises, epistaxis and low platelet count. Both were successfully treated with a single dose of intravenous immunoglobulin. They had a history of asymptomatic (the first) and mild (the second), molecularly confirmed, COVID-19 infection three and five weeks prior to thrombocytopenia respectively, raising the possibility of a causal association between SAR-COV-2 and ITP. This linkage is rare and remains a field to be further explored.

The widespread use of images of the SARS-CoV-2 establishes a visual brand for the virus and helps raise public awareness; yet some of these images can evoke disgust among viewers and polarize their fear along lines of existing feelings toward the disease. This study selected 21 images of SARS-Cov-2 produced by the CDC, NIAID, and third-party illustrators with varying visual appearance. Using an experiment with a nationally representative sample of U.S. adults (N=500), we found that the images evoking the highest level of disgust backfire among who are least concerned about COVID and cause less fear than visually pleasing images.

Introduction On the verge of vaccination, the most pressing issue seems to be vaccine hesitancy. In this era of communication, Bangladeshi people may have pre-determined concerns about receiving the vaccines. Accordingly, our study attempted to understand belief, attitude, and intention to take the COVID-19 vaccine among the country’s adult population. Methods This cross-sectional study was conducted in all eight divisions of Bangladesh. Seven thousand three hundred fifty-seven data were collected from the adult population between January 17 and February 2, 2021, by structured questionnaires. Statistical software STATA (Version 16.1) and R (Version 4.0) programming language were used for all analyses. Results Although most of the study participants were from Dhaka division (n=2,519, 34.24%), a minimum involvement of 500 participants was ensured from each division during this study. The most common age group was ≤30 years (n=3,394, 46.18%). Almost two thirds of respondents were male (n=4,819, 65.50%) and married (n= 4,985, 67.76%). A large portion (79.85%) of people who had positive vaccine intentions believed that vaccination should be made mandatory for everyone. The majority of the respondents believed that the vaccine would work against COVID-19 infection (n=4,954, 67%). PCA and FA analyzed the association of vaccine acceptance and various socio-demographic factors. Conclusion Our study evaluated the belief, attitude, and intention to receive the COVID-19 vaccine in Bangladesh and found some strong discussion points. The results of this study can boost vaccination programs by providing essential insights.

Background: The ongoing outbreak of Coronavirus Disease 2019 (COVID-19) represents a major threat to human health, which impairs the functionality of several organs. One of the hardest challenges in the fight against COVID-19 is the development of wide-scale, effective, and rapid laboratory tests to control disease severity, progression, and possible sudden worsening. Monitoring patients in real-time is indeed highly demanded in this pandemic era when physicians need reliable and quantitative tools to prioritize patients’ access to intensive care departments. In this regard, salivary biomarkers are extremely promising, as they allow for a fast and non-invasive specimens’ collection, which can be repeated multiple times. Methods: We compare salivary levels of immunoglobulin A subclasses (IgA1 and IgA2) and free-light chains (FLC k and λ) in a cohort of 29 SARS-CoV-2 patients and 21 healthy subjects. Results: We found that each biomarkers differs significantly between the two groups, with p-values ranging from 10-8 to 10-4. The performance ranking of these markers, shows that λFLC level (p=1.4e-8) is the best-suited candidate to discriminate the two groups, with an accuracy of 0.94 (0.87-1.00 95% CI), a precision of 0.91 (0.81-1.00 95% CI), a sensitivity of 1.00 (0.96-1.00 95% CI) and a specificity of 0.86 (0.70-1.00 95% CI). Conclusion: These results suggest λFLC as an ideal indicator of patient conditions. This is more strengthened in consideration that λFLC half-life (approximately 6 hours) is significantly shorter than the IgA one (21 days): thus λFLC appears displaying the potential to effectively monitor patients fluctuation in real-time

In the first year of its appearance, the 2019 coronavirus disease (COVID-19) has affected more than 120 million individuals and killed 2 million people worldwide. The pandemic has also triggered numerous global initiatives to tackle the newly emerging disease, including the development of SARS-CoV-2 vaccines and the attempt to discover potential pharmacological therapies. Nonetheless, despite the success of SARS-CoV-2 vaccines development, the COVID-19 therapy remains challenging. Several repurposed drugs that were documented to be useful in small clinical trials have been shown to be ineffective in larger studies. Additionally, the pathophysiology of SARS-CoV-2 infection displayed the predominance of cytokine storm in inducing multiorgan damage. Therefore, the potential benefits of both immune modulation and suppression in COVID-19 have been extensively discussed. Here, we reviewed the roles of immunomodulation as potential COVID-19 pharmacological modalities based on the existing data and proposed several new immunologic targets to be tested in the foreseeable future.

A document by Céline Delestrain. Click on the document to view its contents.

Many SARS-CoV-2 variants of concern has been reported recently which were linked to increased transmission. In our earlier study on virus shedding using VOC 202012/01(UK variant) and D614G variant in hamster model, we observed significantly higher viral RNA shedding through nasal wash in case of UK variant. Here, we have compared the transmission of both the UK and D614G variant by various routes in Syrian hamsters to understand the transmission efficiency of the variant. The study demonstrated comparable transmission efficiency of both UK and D614G variants of SARS-CoV-2 in Syrian hamsters.

INTRODUCTION: The COVID-19 infection, along with various drugs administered for its treatment may prolong ventricular repolarization and QT interval, increasing the risk of potentially fatal arrhythmias. Electrocardiogram (ECG) tracing with conventional devices increases health worker exposure to COVID-19. METHODS: In sequential tests, corrected QT interval (QTc) of electrocardiographic tracing obtained with AliveCor® single-lead (DI) Kardia Mobile (KM) was compared to QTc obtained with a 12-lead ECG. Authors evaluated numeric precision (proportion of measurements with a difference <10 msec), and consistency between the two devices in determining QTc prolongation (QTc ≥470 ms in male, or ≥480 ms in female), with kappa statistics. RESULTS: Records of 128 hospitalized patients with a suspected or confirmed COVID-19 diagnosis in the Hospital Universitario San Ignacio, Bogotá D.C. (Colombia) were included. The QTc interval measured with KM was similar to the interval measured with conventional ECG (442.5 ± 40.5 vs. 442.4 ± 40.2 ms, p: 0.986). Numeric precision was 93%. Concordance between the two devices for determining QTc prolongation was excellent, both in females (kappa: 0.901) and males (kappa: 0.896). CONCLUSION: Single-lead electrocardiographic tracing obtained with the AliveCor® Kardia Mobile allows accurate QTc interval assessment. Since KM use is fast and practical, it is ideal for reducing the exposure time of healthcare workers in the COVID-19 pandemic. The KM is capable of detecting prolonged QTc during treatment in COVID-19 patients. KEY WORDS: Kardia Mobile; AliveCor; corrected QT; QT interval; smart phone, ventricular arrhythmias, COVID-19.

Objective: To assess the nutritional status of pregnant and postpartum women with COVID-19 and to verify the association with clinical outcomes of mortality and prematurity of childbirth. Design: Retrospective observational longitudinal study. Setting: University hospital in Goiânia-Goiás-Brazil. Population or sample: 34 patients with confirmed diagnosis of COVID-19, between June and September 2020. Methods: Medical records was analysided. All eligble cases was included. The collected data refer to demographic, clinical, obstetric and neonatal and anthropometric variables. Main outcome measures: Maternal deaths and prematury of childbirth. Results: 34 patients were evaluated (n=29 pregnants and n=5 postpartum women), with a mean age of 28.71±4.79 years. Of the total, 91.20% were overweight or obese with a current average BMI of 32.10±7.67 kg/m2. Of these cases, 14 had previous diseases, as well as the majority of these are in the overweight group (n=11) and had clinical complications, with ICU stay and use of ventilatory support. The clinical outcomes of mortality and premature birth accounted for 14.70% vs 68.70% of the sample, respectively, with one death in the eutrophic group and four in those with overweight/obesity (p=0.38), as well as the 11 premature births, 90.0% occurred in this group (p=0.47), with an average gestational age of delivery of 33.56±3.98 weeks. Conclusion: There was no association between nutritional status and maternal and perinatal outcomes, although most patients are overweight or obese, with severe clinical complications.

A document by Yeshey Dorjey. Click on the document to view its contents.

I am a professor and attending pharmacist in the field of pharmaceutical sciences and writer or co-author of at least 5 manuscripts about different aspects of COVID-19. More than 15 months from the first report of COVID-19, over 120 million people all over the world infected by this virus, and more than 2.5 million of them have died. Although different treatment approaches have been proposed, management of the COVID-19 patients is steal remained controversial. In this regard, I want to share my personal experience from the exposure to the coronavirus and the consequence of this infection on my health status. I am a 51 years old male, known case of hypertension, dyslipidemia, and chronic kidney disease. During working hours of colleagues in the Faculty of Pharmacy, I visited one of my colleagues in his office. After leaving the Faculty, my colleague declares that his RT-PCR test of COVID-19 is positive and it took 3 days for me to experience the first sign of the COVID-19 as fever. Many complications have occurred for me during the different stages of COVID-19 infection that I shared and explained in detail with the suggested pharmacotherapies. According to the pathophysiology of COVID-19 infection and my personal experience during COVID-19 infection, I want to emphasize the necessity of early initiation of anti-inflammatory agents including corticosteroids and colchicine in high-risk patients with mild-to-moderate COVID-19 pneumonia who shows respiratory system involvement, in order to prevent progression to the severe and critical stages of this disease.

Although severe acute respiratory syndrome coronavirus 2 is primarily known for its significant and potentially fatal pulmonary manifestations, case reports and literature review have linked the infection to multiple organ systems, including hematological manifestations. Scattered among these reports are cases of lymphopenia and neutropenia as well as evidence of children presenting in hypercoagulable states related to COVID-19. We present a case describing a pediatric patient who presented with leukopenia, thrombocytopenia, and severe neutropenia: a unique combination based on the current literature.

More than one year has been passed since the first report of COVID-19 from Wuhan city of China. Soon this virus was spread around the world and became a pandemic and till now, over 122 million people have been infected and over 2.69 million of them have been dead due to COVID-19 infection. Many efforts have been done regarding different aspects of COVID-19 pharmacotherapy and its challenges. Coronavirus can negatively affect the immune system. This complication can be exaggerated in pregnant women with micronutrient and elemental deficiencies. Also, coronavirus itself can induce micronutrients malabsorption and result in their severe deficiencies that can lead to increased risk of infection in these group of patients. The most important micronutrients that can support the immune system are zinc, selenium, iron, vitamin A, C, D, and E. So, it has been suggested that administration of supplemental micronutrients would be helpful to prevent the severe complications of COVID-19 infection in pregnant women [4]. Vitamin A deficiency during pregnancy can result in congenital defects, anorectal malformation, schizophrenia, gestational diabetes, and diabetes mellitus. Also, excessive administration of supplemental vitamin A should be avoided during pregnancy. Vitamin C deficiency during pregnancy could be accompanied by several pregnancy complications including gestational diabetes, gestational hypertension, and preeclampsia. So, administration of supplemental vitamin C would be promising in pregnant women who are infected with new coronavirus to prevent these complications during pregnancy and boosting of the immunity system. VitaminD can play an important role in protection against viral respiratory tract infection.

Since December 2019 from Wuhan, China coronavirus affected worldwide and spread pneumonia-like illness, currently named as coronavirus disease (COVID-19). It is spread through infected droplets; the major symptoms are dry cough with fever and general weakness. Elders and peoples with multiple diseases are more like to infected with COVID-19. Using disinfectant and face mask in public is the main preventive measure. Here in this review, we revised current knowledge about the disease, complications, diagnosis methods, and preventive measures.

A 27-year-old underwent a diseased kidney transplant. Three days after transplantation COVID-19 was diagnosed for our patient. Immunosuppressants were reduced and a renal biopsy was done which showed acute T cell-mediated rejection. We aimed to report a case to help clinicians better understand the risks to kidney transplant recipients.

The statistical analysis of the different versions of the Atom-Bond Connectivity (ABC) Descriptors (indices) are used to infer the drug molecular structures that are helpful for chemical and medical scientists to nd out the chemical and biological characteristics of drugs. In this article, we compute and analyze the linear and non-linear regression models of the different versions of ABC indices and their polynomials of some Molecular structures of COVID-19 drugs.

Background & Aim The COVID-19 pandemic led to interesting challenges, when delivering outpatient care during the national lockdown. This was especially pertinent in Otolaryngology, which is not only very heavily outpatient based but also very highly procedural focused. It also presented difficulties for patients shielding due to being deemed high risk. Following advice given by both the NHS and ENT UK, all routine clinics were cancelled and telephone consultations introduced to maintain an ENT service for patients. This study looks at the impact of telephone clinics in a district general hospital on patient outcomes and what benefits can be gained from this method of service delivery. Study Design A retrospective study was undertaken examining telephone clinic consultations of newly referred patients over seven days during a nationwide lockdown. This included all adult and paediatric patients referred routinely. Follow-up patients and 2 week wait referrals were excluded. Higher risk patients were identified using guidelines listed by the NHS and the hospital electronic patient database was used to collect patient information. Clinic outcomes were collected and collated on Microsoft Excel. Patients were followed up to 8 months. Results Data was collected from 104 patients. The age ranged from 1 to 91; with 74 patients being seen by consultants, 18 by registrars and 12 by associate specialists. Outcomes of these consultations showed that 17 patients were discharged, 15 had outpatient imaging requested, 11 referred to another specialty, 11 had further telephone clinic follow up, 31 were given patient initiated follow up and 19 were brought back for face-to-face appointments. Overall, 57% of patients avoided a hospital visit and only 17% needed a face-to-face appointment. Of the patients who were higher risk, 49% were managed remotely. After 8 months there was no significant morbidity or mortality. Conclusions Almost half of all higher risk patients avoided coming in to hospital. The majority of patients were managed remotely and thus reduced the risk and spread of infection to patients and staff. This shows that telemedicine has been a significantly useful mode of service delivery during the pandemic and has further scope in routine ENT outpatient care.

Background: The COVID 19 infection, which is caused by the novel coronavirus SARS-CoV-2, has rapidly emerged as a global public health issue. This study aimed to evaluate whether subclinical myocardial dysfunction using left ventricular global longitudinal strain (LVGLS) in non-hospitalized mildly symptomatic COVID-19 patients. Methods: Fifty (26 male, 24 female) non-hospitalized COVID-19 patients and 50 age- and sex-matched healthy volunteers have included in the study. Apical four-, three-, and two-chamber images were analyzed longitudinally by conventional methods and speckle tracking echocardiography (STE) for left ventricle functions. Results: The mean age of the COVID-19 patients was 39.55±8.96, 52% of them were male. The most prevalent presenting symptoms were fever (in 34 (68%)), asthenia (in 30 (60%)), loss of appetite (in 21 (42%)), myalgia (in 20 (40%)), and cough (in 13 (26%)). Plasma levels of C-reactive protein (CRP) were significantly higher in the COVID-19 patients than in the controls (10.84±12.44 vs. 4.50±2.81, p < 0.001). There was no significant difference between the groups in terms of standard echocardiography and Doppler parameters (p>0.05). Left ventricular longitudinal strain and strain velocity parameters were significantly decreased in COVID-19 patients compared to healthy individuals. LV-GLS values (-21,72 ± 3,85% vs. -23,11 ± 4,16%; P =0,003) were significantly lower in COVID-19 patients when compared with the healthy controls. Conclusion: Mildly symptomatic COVID-19 patients also have subclinical myocardial dysfunction similar to hospitalized patients. STE has the potential for detecting subclinical LV systolic dysfunction and can provide useful information on the risk stratification in the mildly symptomatic COVID-19 population.

Rationale, aims and objectives: A review of studies published over the last six years gives update about this hot topic. In the middle of COVID-19 pandemic, this study findings can help understand how population may perceive vaccinations. The objectives of this study were to review the literature covering the perceptions about influenza vaccines and to determine factors influencing the acceptance of vaccination using Health Belief Model (HBM). Methods: A comprehensive literature search was performed utilizing PubMed and Google Scholar databases. Three keywords were used: Influenza vaccine, perceptions, and Middle East. Empirical studies that dealt with people/ HCW perceptions of influenza vaccine in the Middle East and written in English were included. The search covered articles published between January 2015 and November 2020. Results: A total of 34 cross-sectional studies from of 22 countries were included in this review. The vaccination rates in Middle East varied widely. However, the overall influenza vaccination rates were generally low (<50%) among general population, particularly among pregnant women and children. HCWs had relatively higher vaccination rates compared to general population. Old age, health comorbidities or working in high-risk environments were noted as major motivators to receive the vaccine. Concerns about adverse reactions and the lack of vaccine efficacy were the most predominant reported barriers to receiving the vaccines. Lastly, cues to actions included receiving advice from HCWs, influence of institutional requirement, awareness/ educational pamphlets and influence from the media. Conclusions: The HBM can be helpful in identifying and analyzing motivators and barriers to vaccination. Additionally, by looking at the root causation, this model can help plan campaigns to increase vaccination rates in the region. Finally, we recommend empowering HCWs to proactively advocate for vaccination as part of preventive care.

SARS coronavirus 2 (SARS-CoV-2) in the viral spike (S) encoding a SARS-COV-2 SPIKE D614G mutation protein predominate over time in locales revealing the dynamic aspects of its key viral processes where it is found, implying that this change enhances viral transmission. It has also been observed that retroviruses infected ACE2-expressing cells pseudotyped with SG614 that is presently affecting a growing number of countries markedly more efficiently than those with SD614. In this paper, we strongly combine topology geometric methods targeting at the atomistic level the protein apparatus of the SARS-COV-2 virus that are simple in machine learning anti-viral characteristics, to propose computer-aided rational drug design strategies efficient in computing docking usage, and powerful enough to achieve very high accuracy levels for this in-silico effort for the generation of the AI-Quantum designed molecule of Combination of GisitorviffirnaTM, Roccustyrna_gs1_TM, and Roccustyrna_fr1_TM ligands with Preferred IUPAC Names of (7aR)‐5‐amino‐N‐[(S)‐{2‐[(S)‐[(E)‐(amino methyl idene)amino](cyano)methyl]hydrazin‐1‐yl}(aziridin‐1‐yl)phosphoryl]‐1‐[(2E)‐2‐[(fluoromethanimidoyl)imino]acetyl]‐7‐oxo‐1H,7H,7aH‐pyrazolo[4,3‐d]pyrimidine‐3‐carboxamide; N‐{[(2‐amino‐ 6‐oxo‐6,9‐dihydro‐1H‐purin‐9‐yl)amino]({1‐[5‐ ({[cyano({1‐[(diaminomethylidene)amino]ethenyl})amino]oxy}methyl)‐3,4‐dihydroxyoxolan‐2‐yl]‐1H‐1,2,4‐triazol‐3‐yl}formamido)phosphoryl}‐6‐fluoro‐3,4‐dihydropyrazine‐2‐carboxamide;[3‐(2‐amino‐5‐sulfanylidene‐1,2,4‐triazolidin‐3‐yl)oxaziridin‐2‐yl]({3‐sulfanylidene‐1,2,4,6‐tetraazabicyclo[3.1.0]hexan‐6‐yl})phosphoroso1‐(3,4,5‐trifluorooxolan‐2‐yl)‐1H‐1,2,4‐triazole‐3‐carboxylate targeting the COVID-19-SARS-COV-2 SPIKE D614G mutation using Chern-Simons Topology Euclidean Geometric in a Lindenbaum-Tarski generated QSAR automating modeling and Artificial Intelligence-Driven Predictive Neural Networks.

Background-The COVID-19 pandemic called for significant restructuring of healthcare system in the United Kingdom to overcome the burden on emergency services and restore elective activities.This study aims to discuss the development of a new triage system of reviewing gynaecology e-referrals to secondary care and analyse the sustainability of this service beyond the pandemic.The streamlining of primary care referrals was conceptualised on the framework of Clinical Assessment Service (CAS) as recommended by NHS Long-Term Plan. Method-CAS was implemented in our gynaecology department as a response to COVID-19 pandemic.E-referrals triaged using CAS in phase 1 were reviewed and areas of improvement identified. A second review was carried out in phase 2 after implementing changes to ensure improved services.The outcomes of interest were appropriateness of referrals,destination appointments and percentage of virtual appointments. Results-185 e-referrals in phase 1 and 85 e-referrals in phase 2 were analysed.Training and education of relevant stakeholders and a more efficient CAS in phase 2 resulted in significant reduction in inappropriate referrals from 14% to 3% [RR-0.17 (95% CI - 0.04-0.72); p=0.02].For every 9 e-referral reviewed in CAS,1 inappropriate referral was avoided.The number of virtual appointments increased by 16% (45% in Group 1, 61% in Group 2). Conclusion-CAS framework provides a sustainable strategy to overcome disruptions in the provision of elective outpatient services caused by COVID-19 pandemic.It reduces inappropriate secondary care e-referrals,allows management of eligible patients digitally,shortens patient care pathway and creates a dynamic link between the primary care providers and specialist care.