@article {pmid33450689, year = {2020}, author = {Paraskevis, D and Kostaki, EG and Alygizakis, N and Thomaidis, NS and Cartalis, C and Tsiodras, S and Dimopoulos, MA}, title = {A review of the impact of weather and climate variables to COVID-19: In the absence of public health measures high temperatures cannot probably mitigate outbreaks.}, journal = {The Science of the total environment}, volume = {768}, number = {}, pages = {144578}, doi = {10.1016/j.scitotenv.2020.144578}, pmid = {33450689}, issn = {1879-1026}, abstract = {The new severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) pandemic was first recognized at the end of 2019 and has caused one of the most serious global public health crises in the last years. In this paper, we review current literature on the effect of weather (temperature, humidity, precipitation, wind, etc.) and climate (temperature as an essential climate variable, solar radiation in the ultraviolet, sunshine duration) variables on SARS-CoV-2 and discuss their impact to the COVID-19 pandemic; the review also refers to respective effect of urban parameters and air pollution. Most studies suggest that a negative correlation exists between ambient temperature and humidity on the one hand and the number of COVID-19 cases on the other, while there have been studies which support the absence of any correlation or even a positive one. The urban environment and specifically the air ventilation rate, as well as air pollution, can probably affect, also, the transmission dynamics and the case fatality rate of COVID-19. Due to the inherent limitations in previously published studies, it remains unclear if the magnitude of the effect of temperature or humidity on COVID-19 is confounded by the public health measures implemented widely during the first pandemic wave. The effect of weather and climate variables, as suggested previously for other viruses, cannot be excluded, however, under the conditions of the first pandemic wave, it might be difficult to be uncovered. The increase in the number of cases observed during summertime in the Northern hemisphere, and especially in countries with high average ambient temperatures, demonstrates that weather and climate variables, in the absence of public health interventions, cannot mitigate the resurgence of COVID-19 outbreaks.}, } @article {pmid33450678, year = {2020}, author = {Keflie, TS and Biesalski, HK}, title = {Micronutrients and bioactive substances: Their potential roles in combating COVID-19.}, journal = {Nutrition (Burbank, Los Angeles County, Calif.)}, volume = {84}, number = {}, pages = {111103}, doi = {10.1016/j.nut.2020.111103}, pmid = {33450678}, issn = {1873-1244}, abstract = {OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic is seriously threatening public health and setting off huge economic crises across the world. In the absence of specific drugs for COVID-19, there is an urgent need to look for alternative approaches. Therefore, the aim of this paper was to review the roles of micronutrients and bioactive substances as potential alternative approaches in combating COVID-19.

METHODS: This review was based on the literature identified using electronic searches in different databases.

RESULTS: Vitamins (A, B, C, D, and E), minerals (selenium and zinc), and bioactive substances from curcumin, echinacea, propolis, garlic, soybean, green tea, and other polyphenols were identified as having potential roles in interfering with spike glycoproteins, angiotensin converting enzyme 2, and transmembrane protease serine 2 at the entry site, and inhibiting activities of papain-like protease, 3 chymotrypsin-like protease, and RNA-dependent RNA polymerase in the replication cycle of severe acute respiratory syndrome coronavirus 2. Having immunomodulating, antiinflammatory, antioxidant, and antiviral properties, such micronutrients and bioactive substances are consequently promising alterative nutritional approaches to combat COVID-19.

CONCLUSIONS: The roles of micronutrients and bioactive substances in the fight against COVID-19 are exciting areas of research. This review may suggest directions for further study.}, } @article {pmid33450658, year = {2021}, author = {Wardley, A and Canon, JL and Elsten, L and Peña Murillo, C and Badovinac Crnjevic, T and Fredriksson, J and Piccart, M}, title = {Flexible care in breast cancer.}, journal = {ESMO open}, volume = {6}, number = {1}, pages = {100007}, doi = {10.1016/j.esmoop.2020.100007}, pmid = {33450658}, issn = {2059-7029}, abstract = {Treatment of patients with cancer in hospitals or clinics is resource-intensive and imposes a burden on patients. 'Flexible care' is a term that can be used to describe treatment administered outside the oncology ward, oncological outpatient clinic or office-based oncologist setting. Programmes that reduce travel burden by bringing cancer treatment to the patient's home, workplace or closer to the patient's home, in the form of satellite clinics or mobile cancer units, expand treatment capacity and are well received. Clinical trial data show that, compared with intravenous administration, subcutaneous (s.c.) administration of trastuzumab is preferred by patients with breast cancer (BC), saves healthcare professionals' (HCPs) time, reduces drug preparation and administration time and reduces direct and indirect costs. As such, s.c. trastuzumab is well suited to flexible care. The results of a Belgian study (BELIS) show that home administration of s.c. trastuzumab is feasible and preferred by patients with BC. Numerous programmes and pilot studies in Europe show that s.c. trastuzumab can be administered effectively in the patient's home, in primary care settings or local hospitals. Such programmes require planning, training, careful patient selection and technology to link patients, caregivers and specialists in oncology clinics. Once these elements are in place, flexible care offers patients with BC a choice of how treatment may be delivered and lead to improved quality of life, while reducing pressure on HCPs and hospitals. The concept of flexible care is particularly relevant amid the COVID-19 pandemic where guidelines have been developed encouraging remote care.}, } @article {pmid33450531, year = {2021}, author = {Kesavadev, J and Misra, A and Saboo, B and Aravind, SR and Hussain, A and Czupryniak, L and Raz, I}, title = {Blood glucose levels should be considered as a new vital sign indicative of prognosis during hospitalization.}, journal = {Diabetes & metabolic syndrome}, volume = {15}, number = {1}, pages = {221-227}, doi = {10.1016/j.dsx.2020.12.032}, pmid = {33450531}, issn = {1878-0334}, abstract = {BACKGROUND AND AIMS: The measurement of vital signs is an important part of clinical work up. Presently, measurement of blood glucose is a factor for concern mostly when treating individuals with diabetes. Significance of blood glucose measurement in prognosis of non-diabetic and hospitalized patients is not clear.

METHODS: A systematic search of literature published in the Electronic databases, PubMed and Google Scholar was performed using following keywords; blood glucose, hospital admissions, critical illness, hospitalizations, cardiovascular disease (CVD), morbidity, and mortality. This literature search was largely restricted to non-diabetic individuals.

RESULTS: Blood glucose level, even when in high normal range, or in slightly high range, is an important determinant of morbidity and mortality, especially in hospitalized patients. Further, even slight elevation of blood glucose may increase mortality in patients with COVID-19. Finally, blood glucose variability and hypoglycemia in critically ill individuals without diabetes causes excess in-hospital complications and mortality.

CONCLUSION: In view of these data, we emphasize the significance of blood glucose measurement in all patients admitted to the hospital regardless of presence of diabetes. We propose that blood glucose be included as the "fifth vital sign" for any hospitalized patient.}, } @article {pmid33450464, year = {2021}, author = {Pahl, DA and Wieder, MS and Steinberg, DM}, title = {Social isolation and connection in adolescents with cancer and survivors of childhood cancer: A systematic review.}, journal = {Journal of adolescence}, volume = {87}, number = {}, pages = {15-27}, doi = {10.1016/j.adolescence.2020.12.010}, pmid = {33450464}, issn = {1095-9254}, abstract = {INTRODUCTION: Cancer may cause significant disruptions in normal adolescent development particularly in social domains. Both treatment and survivorship pose challenges to fostering social connections. To better understand these challenges, we conducted a systematic literature review of the experience of social isolation and connectedness in adolescents with cancer and adolescent survivors of childhood cancer.

METHODS: A systematic review of the scientific literature was conducted following PRISMA Guidelines. Eligible articles included original peer-reviewed research published in English between January 2000 and April 2020 that reported on social domains of patients and survivors of cancer between the ages of 10-21. Initial database search identified 4606 articles with 43 studies meeting inclusion criteria.

RESULTS: Results were synthesized into four domains: (1) the prevalence of connectedness/isolation; (2) risk factors associated with social isolation; (3) protective factors against social isolation; (4) the impact of social isolation on psychological health. Overall, adolescent patients and survivors of cancer have satisfactory social connectedness. However, certain subgroups including those with central nervous system tumors are at higher risk of social isolation.

CONCLUSIONS: In general, adolescent cancer patients and survivors report levels of social connectedness consistent with healthy adolescent population norms. The risk and protective factors identified in this review may help serve as important indicators for psychosocial screening and interventions. These findings are particularly relevant in the COVID-19 era as all adolescents face challenges to social connections and psychosocial development.}, } @article {pmid33450400, year = {2021}, author = {Barreto, PS and Vellas, B and Rolland, Y}, title = {Physical activity and exercise in the context of SARS-Cov-2: a perspective from geroscience field.}, journal = {Ageing research reviews}, volume = {}, number = {}, pages = {101258}, doi = {10.1016/j.arr.2021.101258}, pmid = {33450400}, issn = {1872-9649}, abstract = {The recent pandemics of the SARS-Cov-2 has pushed physical activity (PA) and exercise at the forefront of the discussion, since PA is associated with a reduced risk of developing all the chronic diseases strongly associated with severe cases of SARS-Cov-2 and exercise is considered a complimentary therapeutics for the treatment of these age-related conditions. The mechanisms through which PA and exercise could contribute to reduce the severity of the SARS-Cov-2 infection would be multiple, including their capacity to boost the immune system, but also their global effect on slowing down the progression of the aging process. The present perspective presents a discussion on how PA and exercise might hypothetically be linked with SARS-Cov-2 infection, current scientific gaps and shortcomings as well as recommendations for advancing research in this area, placing the debate in the context of aging and gerosciences.}, } @article {pmid33450356, year = {2021}, author = {Sehrawat, S and Rouse, BT}, title = {COVID-19: Disease, or no disease? - that is the question. It's the dose stupid!.}, journal = {Microbes and infection}, volume = {}, number = {}, pages = {104779}, doi = {10.1016/j.micinf.2021.104779}, pmid = {33450356}, issn = {1769-714X}, abstract = {The COVID-19 pandemic has raised many issues not the least of which is the reason for its high variability in consequences to the infected person. In this opinion letter, we advocate that the dose and presentation of the infecting virus is a major factor that affects whether the outcome is subclinical, tissue damaging or even lethal following infection. We briefly describe the known effects of virus dose on the course COVID-19 and discuss practical maneuvers as well as largely untested procedures that can raise the threshold dose needed to break through barriers of resistance.}, } @article {pmid33450319, year = {2021}, author = {Delshadi, R and Bahrami, A and Mcclements, DJ and Moore, MD and Williams, L}, title = {Development of nanoparticle-delivery systems for antiviral agents: A review.}, journal = {Journal of controlled release : official journal of the Controlled Release Society}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.jconrel.2021.01.017}, pmid = {33450319}, issn = {1873-4995}, abstract = {The COVID-19 pandemic has resulted in unprecedented increases in sickness, death, economic disruption, and social disturbances globally. However, the virus (SARS-CoV-2) that caused this pandemic is only one of many viruses threatening public health. Consequently, it is important to have effective means of preventing viral transmission and reducing its devastating effects on human and animal health. Although many antivirals are already available, their efficacy is often limited because of factors such as poor solubility, low permeability, poor bioavailability, un-targeted release, adverse side effects, and antiviral resistance. Many of these problems can be overcome using advanced antiviral delivery systems constructed using nanotechnology principles. These delivery systems consist of antivirals loaded into nanoparticles, which may be fabricated from either synthetic or natural materials. Nevertheless, there is increasing empHasis on the development of antiviral delivery systems from natural substances, such as lipids, phospholipids, surfactants, proteins, and polysaccharides, due to health and environmental issues. The composition, morphology, dimensions, and interfacial characteristics of nanoparticles can be manipulated to improve the handling, stability, and potency of antivirals. This article outlines the major classes of antivirals, summarizes the challenges currently limiting their efficacy, and highlights how nanoparticles can be used to overcome these challenges. Recent studies on the application of antiviral nanoparticle-based delivery systems are reviewed and future directions are described.}, } @article {pmid33450202, year = {2021}, author = {Supady, A and Curtis, JR and Abrams, D and Lorusso, R and Bein, T and Boldt, J and Brown, CE and Duerschmied, D and Metaxa, V and Brodie, D}, title = {Allocating scarce intensive care resources during the COVID-19 pandemic: practical challenges to theoretical frameworks.}, journal = {The Lancet. Respiratory medicine}, volume = {}, number = {}, pages = {}, doi = {10.1016/S2213-2600(20)30580-4}, pmid = {33450202}, issn = {2213-2619}, abstract = {The COVID-19 pandemic strained health-care systems throughout the world. For some, available medical resources could not meet the increased demand and rationing was ultimately required. Hospitals and governments often sought to establish triage committees to assist with allocation decisions. However, for institutions operating under crisis standards of care (during times when standards of care must be substantially lowered in the setting of crisis), relying on these committees for rationing decisions was impractical-circumstances were changing too rapidly, occurring in too many diverse locations within hospitals, and the available information for decision making was notably scarce. Furthermore, a utilitarian approach to decision making based on an analysis of outcomes is problematic due to uncertainty regarding outcomes of different therapeutic options. We propose that triage committees could be involved in providing policies and guidance for clinicians to help ensure equity in the application of rationing under crisis standards of care. An approach guided by egalitarian principles, integrated with utilitarian principles, can support physicians at the bedside when they must ration scarce resources.}, } @article {pmid33449336, year = {2021}, author = {Correale, M and Tricarico, L and Fortunato, M and Dattilo, G and Iacoviello, M and Brunetti, ND}, title = {Infection, atherothrombosis and thromboembolism beyond the COVID-19 disease: what similar in physiopathology and researches.}, journal = {Aging clinical and experimental research}, volume = {}, number = {}, pages = {}, pmid = {33449336}, issn = {1720-8319}, abstract = {The recent Sars-Cov-2 pandemic (COVID-19) has led to growing research on the relationship between thromboembolism and Sars-Cov-2 infection. Nowadays, endothelial dysfunction, platelet activation, coagulation, and inflammatory host immune response are the subject of extensive researches in patients with COVID-19 disease. However, studies on the link between microorganisms or infections and thrombotic or thromboembolic events met fluctuating interest in the past. We, therefore, aimed to briefly summarize previous evidence on this topic, highlighting common points between previous data and what experienced today with SARS-COV2 infections.}, } @article {pmid33449290, year = {2021}, author = {Moschonas, IC and Tselepis, AD}, title = {SARS-CoV-2 infection and thrombotic complications: a narrative review.}, journal = {Journal of thrombosis and thrombolysis}, volume = {}, number = {}, pages = {}, pmid = {33449290}, issn = {1573-742X}, abstract = {The current, global situation regarding the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pandemic and its potentially devastating clinical manifestations, i.e. coronavirus disease 2019 (COVID-19), took the world by storm, as millions of people have been infected worldwide and more than 1,600,000 patients have succumbed. Infection induced by various respiratory viruses may lead to thrombotic complications. Infection-elicited thrombosis may involve a repertoire of distinct, yet interconnected pathophysiological mechanisms, implicating a hyperinflammatory response, platelet activation and triggering of the coagulation cascade. In the present review, we present current knowledge on the pathophysiological mechanisms that may underlie thrombotic complications in SARS-CoV-2 infection. Furthermore, we provide clinical data regarding the incidence rate of thrombotic events in several viral respiratory infections that cause acute respiratory distress syndrome, including SARS-CoV-2 infection and finally we summarize current recommendations concerning thromboprophylaxis and antithrombotic therapy in patients with thrombotic complications related to SARS-CoV-2 infection.}, } @article {pmid33449214, year = {2021}, author = {Yeh, T and Yeung, M and Mendelsohn Curanaj, FA}, title = {Managing Patients with Insulin Pumps and Continuous Glucose Monitors in the Hospital: to Wear or Not to Wear.}, journal = {Current diabetes reports}, volume = {21}, number = {2}, pages = {7}, pmid = {33449214}, issn = {1539-0829}, abstract = {PURPOSE OF REVIEW: As the prevalence of diabetes mellitus in the USA continues to rise, so does the popularity of diabetes management devices such as continuous glucose monitors (CGMs) and insulin pumps. The use of this technology has been shown to improve outpatient glycemic outcomes and quality of life and oftentimes may be continued in the hospital setting. Our aim is to review the current guidelines and available evidence on the continuation of insulin pumps and CGMs in the inpatient setting.

RECENT FINDINGS: Patients with diabetes are at higher risk for hospitalizations and complications due to hyper- or hypoglycemia, metabolic co-morbidities, or as seen recently, more severe illness from infections such as SARS-CoV-2. The maintenance of euglycemia is important to decrease both morbidity and mortality in the hospital setting. There is consensus among experts and medical societies that inpatient use of diabetes technology in carefully selected patients with proper institutional protocols is safe and can improve inpatient glycemic outcomes and reduce hypoglycemia. During the COVID-19 pandemic, CGMs played a vital role in managing hyperglycemia in some hospitalized patients. Insulin pumps and CGMs have the potential to transform glycemic management in hospitalized patients. In order for institutions to safely and effectively incorporate these technologies on their inpatient units, hospital-based providers will need to be able to understand how to manage and utilize these devices in their practice in conjunction with diabetes experts.}, } @article {pmid33449202, year = {2021}, author = {Nuara, A and Fabbri-Destro, M and Scalona, E and Lenzi, SE and Rizzolatti, G and Avanzini, P}, title = {Telerehabilitation in response to constrained physical distance: an opportunity to rethink neurorehabilitative routines.}, journal = {Journal of neurology}, volume = {}, number = {}, pages = {}, pmid = {33449202}, issn = {1432-1459}, abstract = {Ensuring proper dosage of treatment and repetition over time is a major challenge in neurorehabilitation. However, a requirement of physical distancing to date compromises their achievement. While mostly associated to COVID-19, physical distancing is not only required in a pandemic scenario, but also advised for several clinical conditions (e.g. immunocompromised individuals) or forced for specific social contexts (e.g. people living in remote areas worldwide). All these contexts advocate for the implementation of alternative healthcare models. The objective of this perspective is to highlight the benefits of remote administration of rehabilitative treatment, namely telerehabilitation, in counteracting physical distancing barriers in neurorehabilitation. Sustaining boosters of treatment outcome, such as compliance, sustainability, as well as motivation, telerehabilitation may adapt to multiple neurological conditions, with the further advantage of a high potential for individualization to patient's or pathology's specificities. The effectiveness of telerehabilitation can be potentiated by several technologies available to date: virtual reality can recreate realistic environments in which patients may bodily operate, wearable sensors allow to quantitatively monitor the patient's performance, and signal processing may contribute to the prediction of long-term dynamics of patient recovery. Telerehabilitation might spark its advantages far beyond the mere limitation of physical distancing effects, mitigating criticalities of daily neurorehabilitative practice, and thus paving the way to the envision of mixed models of care, where hospital-based procedures are complementarily integrated with telerehabilitative ones.}, } @article {pmid33448667, year = {2020}, author = {Elsner, P}, title = {Teledermatology in the times of COVID-19 - a systematic review.}, journal = {Journal der Deutschen Dermatologischen Gesellschaft = Journal of the German Society of Dermatology : JDDG}, volume = {18}, number = {8}, pages = {841-845}, doi = {10.1111/ddg.14180}, pmid = {33448667}, issn = {1610-0387}, abstract = {The COVID-19 pandemic restricts the care of dermatological patients in many ways. Teledermatology such as video consultation or "store-and-forward" teledermatology could at least partly compensate for this. This systematic review summarizes all published studies on teledermatology during the COVID-19 pandemic. It is based on a MEDLINE search for articles from 2020 in English and German. Two surveys among dermatologists from the USA and India showed that more than 80 % offered teledermatology. Among German dermatologists 17.5 % of 480 respondents offered online video consultation, 11.3 % offline consultation (store and forward) and 10.0 % both. Five cohort studies on teledermatology during the pandemic were identified. Three of them investigated teledermatology in chronic dermatoses (acne, inflammatory skin diseases), one dealt with the care of oncological patients with dermatological complications, and one analyzed teleconsultation in suspected COVID-19 cases. In all studies, teledermatology largely reduced the number of personal consultations. The results indicate that the limitations of personal dermatological care of patients with skin diseases during the COVID-19 pandemic can be at least partially compensated by an extension of teledermatology. Findings from the use of teledermatology during the pandemic should be employed to improve the use and acceptance of teledermatology by patients and dermatologists.}, } @article {pmid33447984, year = {2021}, author = {Kumar, R and Sharma, A and Srivastava, JK and Siddiqui, MH and Uddin, MS and Aleya, L}, title = {Hydroxychloroquine in COVID-19: therapeutic promises, current status, and environmental implications.}, journal = {Environmental science and pollution research international}, volume = {}, number = {}, pages = {}, pmid = {33447984}, issn = {1614-7499}, abstract = {The outbreak of novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has affected the entire world with its infectious spread and mortality rate. The severe cases of coronavirus disease 2019 (COVID-19) are characterized by hypoxia and acute respiratory distress syndrome. In the absence of any specific treatment, just the preventive and supportive care options are available. Therefore, much focus is given to assess the available therapeutic options not only to avoid acute respiratory failure and hypoxia but also to reduce the viral load to control the severity of the disease. The antimalarial drug hydroxychloroquine (HCQ) is among the much-discussed drugs for the treatment and management of COVID-19 patients. This article reviews the therapeutic potential of HCQ in the treatment of COVID-19 based on the available in vitro and clinical evidence, current status of registered HCQ-based clinical trials investigating therapeutic options for COVID-19, and environmental implications of HCQ.}, } @article {pmid33447968, year = {2021}, author = {Klausner, M and Handa, Y and Aizawa, S}, title = {In vitro three-dimensional organotypic culture models of the oral mucosa.}, journal = {In vitro cellular & developmental biology. Animal}, volume = {}, number = {}, pages = {}, pmid = {33447968}, issn = {1543-706X}, abstract = {Three-dimensional, organotypic models of the oral mucosa have been developed to study a wide variety of phenomena occurring in the oral cavity. Although a number of models have been developed in academic research labs, only a few models have been commercialized. Models from academic groups offer a broader range of phenotypes while the commercial models are more focused on the oral and gingival mucosa. The commercialized models are manufactured under highly controlled conditions and meet the requirements of quality standards, which leads to high levels of reproducibility. These in vitro models have been used to evaluate the irritancy of oral care products such as toothpastes, mouthwashes, and mucoadhesives. The effects of cigarette smoke on oral cavity tissues have been studied and compared to those of e-cigarettes. Oral tissue models have facilitated investigation of the mechanisms of oral mucositis and oral candidiasis and have been used to examine transbuccal drug delivery rates and the absorption of nanoparticles. Infection studies have investigated the effects of HIV-1 along with the effects of commensal and pathogenic bacteria. More recently, a differentiated oral tissue model has been shown to express the ACE2 receptor, which is known to be important for the receptor-mediated entry of the SARS-CoV-2 coronavirus into human cells and tissues. Hence, oral mucosal models may find application in determining whether viral infection of the oral mucosa is possible and whether such infection has implications vis-a-vis the current COVID-19 pandemic. As is apparent, these models are used in a broad variety of applications and often offer advantages versus animal models in terms of reproducibility, avoiding species extrapolation, and the ethical concerns related to human and animal experimentation. The goals of this paper are to review commercially available models of the human buccal and gingival mucosa and highlight their use to gain a better understanding of a broad range of phenomena affecting tissues in the oral cavity.}, } @article {pmid33447433, year = {2020}, author = {Zhang, Z and Zhang, L and Zhu, A and Wang, Y and Guan, W and Zeng, Z and Sun, J and Li, F and Zhao, J and Yang, Z and Zhao, J and Zhong, N}, title = {Narrative review of the novel coronavirus SARS-CoV-2: update on genomic characteristics, transmissions and animal model.}, journal = {Journal of thoracic disease}, volume = {12}, number = {12}, pages = {7454-7466}, doi = {10.21037/jtd-20-2084}, pmid = {33447433}, issn = {2072-1439}, abstract = {Two outbreaks of severe respiratory infection caused by severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV) caused global pandemics and highlighted the importance of preparedness for respiratory CoVs. Recently, a third highly pathogenic CoV, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first identified in Wuhan, Hubei, China and posed a public health crisis worldwide. Here, we focus on the recent advances of the novel CoV, and discuss its genomic similarity with other CoVs, transmission, animal model and clinical treatment of coronavirus disease 2019 (COVID-19) induced by SARS-CoV-2, which help epidemic prevention and control, and guide treatment strategies.}, } @article {pmid33447431, year = {2020}, author = {Zhang, T and Huang, WS and Guan, W and Hong, Z and Gao, J and Gao, G and Wu, G and Qin, YY}, title = {Risk factors and predictors associated with the severity of COVID-19 in China: a systematic review, meta-analysis, and meta-regression.}, journal = {Journal of thoracic disease}, volume = {12}, number = {12}, pages = {7429-7441}, doi = {10.21037/jtd-20-1743}, pmid = {33447431}, issn = {2072-1439}, abstract = {Since December 2019, the pneumonia cases infected with 2019 novel coronavirus have appeared, posing a critical threat to global health. In this study, we performed a meta-analysis to discover the different clinical characteristics between severe and non-severe patients with COVID-19 to find the potential risk factors and predictors of this disease's severity, as well as to serve as a guidance for subsequent epidemic prevention and control work. PubMed, Cochrane Library, Medline, Embase and other databases were searched to collect studies on the difference of clinical characteristics of severe and non-severe patients. Meta-analysis was performed using RevMan 5.3 software, and the funnel plots could be made to evaluate the publication bias. P>0.05 means no statistical significance. Furthermore, a meta-regression analysis was performed by using Stata 15.0 to find the potential factors of the high degree of heterogeneity (I2>50%). Sixteen studies have been included, with 1,172 severe patients and 2,803 non-severe patients. Compared with non-severe patients, severe patients were more likely to have the symptoms of dyspnea, hemoptysis, and the complications of ARDS, shock, secondary infection, acute kidney injury, and acute cardiac injury. Interestingly, the former smokers were more prevalent in severe cases as compared to non-severe cases, but there was no difference between the two groups of 'current smokers'. Except for chronic liver disease and chronic kidney disease, the underlying comorbidities of hypertension, diabetes, cardiovascular disease, chronic obstructive pulmonary disease (COPD), malignancy, cerebrovascular disease, and HIV can make the disease worse. In terms of laboratory indicators, the decreased lymphocyte and platelet count, and the increased levels of white blood cell (WBC), D-dimer, creatine kinase, lactate dehydrogenase, procalcitonin, alanine aminotransferase, aspartate aminotransferase, and C-reactive protein were more prevalent in severe patients. Meta-regression analysis showed that patient age, gender, and proportion of severe cases did not significantly impact on the outcomes of any clinical indexes that showed high degree of heterogeneity in the meta-analysis. In conclusion, the severity of COVID-19 could be evaluated by, radiologic finding, some symptoms like dyspnea and hemoptysis, some laboratory indicators, and smoking history, especially the ex-smokers. Compared with non-severe patients, severe patients were more likely to have complications and comorbidities including hypertension, cardiovascular disease etc., which were the risk factors for the disease to be severer, but the chronic liver disease and chronic kidney disease were not associated the severity of COVID-19 in China.}, } @article {pmid33447309, year = {2020}, author = {Duner, P and Salehi, A}, title = {COVID-19 and Possible Pharmacological Preventive Options.}, journal = {Journal of clinical medicine research}, volume = {12}, number = {12}, pages = {758-772}, doi = {10.14740/jocmr4383}, pmid = {33447309}, issn = {1918-3003}, abstract = {The dreadful fear of the coronavirus disease 2019 (COVID-19), which is an infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with the deadly consequences, requires rapid development of pharmacological cures. The objective of this review is to speculate about possible pharmacological options, already available today to prevent or treat the COVID-19 in the early stage of its outbreak. A literature search across PubMed and internet was conducted. A number of studies dealing with COVID-19 were identified. The data elucidated that increased pro-inflammatory and decreased anti-inflammatory cytokines in combination with hypoxia, thromboembolism and pneumonia are involved in the pathogenesis of SARS-CoV-2 infection. Although many drugs has been tested in monotherapy regimen with varying outcome or without desirable effect, there is still hope for better results by simultaneously targeting the virus itself and its symptoms. Theoretically, a mixture of at least two available antiviral drugs in combination with other anti-pathogenic and immune system-enhancing drugs or combination of antiviral drugs with convalescent plasma seems likely to have much better effect than the monotherapy regimen of either of these drugs.}, } @article {pmid33447194, year = {2020}, author = {Shah, SB and Chawla, R}, title = {Cancer in corona times.}, journal = {Saudi journal of anaesthesia}, volume = {14}, number = {4}, pages = {504-509}, doi = {10.4103/sja.SJA_317_20}, pmid = {33447194}, issn = {1658-354X}, abstract = {Humanity is witnessing an unprecedented tsunami of corona virus disease 2019 (COVID-19) patients. Till date, India houses 10,453 confirmed COVID-19 patients with a death toll of 358 nationwide and the number is steadily rising with each passing day. The capital city of Delhi, harbouring 1510 patients, has the dubious distinction of being the second largest hotspot for COVID positive patients in India, second only to the state of Maharashtra. Being immuno-compromised, cancer patients are first more susceptible to catch this virus and secondly may witness a more devastating course. Having cancer is a bigger risk factor for contracting COVID-19 than even old age. "Death due to untreated cancer is a much bigger reality than death due to COVID-19," is one perspective that advocates continuation of cancer therapy in corona times albeit by converting cancer hospitals into virtual corona-free fortresses with several tiers of barriers against corona. The immediate, short and long term implications of the corona pandemic and a nationwide lockdown to curtail it, on cancer patients and their caregivers is discussed at length here tempered with experience from the largest tertiary care oncology setup of Northern India. Rigorous literature review based on Medline, Google scholar, Embase, Cochrane and Scopus database search was utilized.}, } @article {pmid33447193, year = {2020}, author = {Sharma, H and Verma, S}, title = {Unusual routes for transmission of coronavirus disease (COVID-19): Recommendations to interrupt the vicious cycle of infection.}, journal = {Saudi journal of anaesthesia}, volume = {14}, number = {4}, pages = {498-503}, doi = {10.4103/sja.SJA_301_20}, pmid = {33447193}, issn = {1658-354X}, abstract = {The outbreak of the novel COVID-19, which began silently in Wuhan City, China, has now taken the form of a pandemic, with its claws spreading rapidly in many countries, with new and new cases emerging rapidly. The COVID-19-associated CoV is a beta coronavirus, which spreads at such a deadly rate that the World Health Organization (WHO) has to declare it a Public Health Emergency of International Concern (PHEIC). The objective of the narrative review is to describe what is COVID-19-related coronavirus (CoV), its structure and particle size, potential transmission routes, the risk of infection in patients undergoing blood transfusion or in patients with diabetes and cancer, and recommendations to prevent its spread in office settings, travel / recreation settings, residential and health facilities. This paper also discusses several groundbreaking approaches that are used to counter COVID-19. With this narrative review, we hope to raise awareness of the usual and unusual pathways of transmission and prevent the spread of this pandemic disease.}, } @article {pmid33447107, year = {2021}, author = {Yisak, H and Ewunetei, A and Kefale, B and Mamuye, M and Teshome, F and Ambaw, B and Yideg Yitbarek, G}, title = {Effects of Vitamin D on COVID-19 Infection and Prognosis: A Systematic Review.}, journal = {Risk management and healthcare policy}, volume = {14}, number = {}, pages = {31-38}, doi = {10.2147/RMHP.S291584}, pmid = {33447107}, issn = {1179-1594}, abstract = {Introduction: Vitamin D status is related to risks of influenza and respiratory tract infections. Vitamin D has direct antiviral effects primarily against enveloped viruses, and coronavirus is an enveloped virus. The 2019 coronavirus disease had a high mortality rate and impacted the whole population of the planet, with severe acute respiratory syndrome the principal cause of death. Vitamin D can adequately modulate and regulate the immune and oxidative response to infection with COVID-19. The goal of this systematic review was thus to summarize and decide if there were a link between vitamin D status and COVID-19 infection and prognosis.

Methods: The protocol of this study is documented in the Prospero database and can be accessed with the protocol number CRD42020201283. PubMed and Google Scholar were used for a literature search from August 2020 to September 2020. We restricted the year of publication of reviewed articles to 2019-2020, and the selected language was English. Studies that used secondary data, feedback, or analysis of reviews were removed. To assess the standard of studies included, the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) method was used.

Results: Of the nine studies reviewed, seven (77.8%) showed that COVID-19 infection, prognosis, and mortality were correlated with vitamin D status.

Conclusion: Most of the articles reviewed showed that blood vitamin D status can determine the risk of being infected with COVID-19, seriousness of COVID-19, and mortality from COVID-19. Therefore, maintaining appropriate levels of Vitamin D through supplementation or natural methods, eg, sunlight on the skin, is recommended for the public to be able to cope with the pandemic.}, } @article {pmid33447071, year = {2021}, author = {Hanna, R and Dalvi, S and Sălăgean, T and Pop, ID and Bordea, IR and Benedicenti, S}, title = {Understanding COVID-19 Pandemic: Molecular Mechanisms and Potential Therapeutic Strategies. An Evidence-Based Review.}, journal = {Journal of inflammation research}, volume = {14}, number = {}, pages = {13-56}, doi = {10.2147/JIR.S282213}, pmid = {33447071}, issn = {1178-7031}, abstract = {Initially, the SARS-CoV-2 virus was considered as a pneumonia virus; however, a series of peer reviewed medical papers published in the last eight months suggest that this virus attacks the brain, heart, intestine, nervous and vascular systems, as well the blood stream. Although many facts remain unknown, an objective appraisal of the current scientific literature addressing the latest progress on COVID-19 is required. The aim of the present study was to conduct a critical review of the literature, focusing on the current molecular structure of SARS-CoV-2 and prospective treatment modalities of COVID-19. The main objectives were to collect, scrutinize and objectively evaluate the current scientific evidence-based information, as well to provide an updated overview of the topic that is ongoing. The authors underlined potential prospective therapies, including vaccine and phototherapy, as a monotherapy or combined with current treatment modalities. The authors concluded that this review has produced high quality evidence, which can be utilized by the clinical scientific community for future reference, as the knowledge and understanding of the SARS-CoV-2 virus are evolving, in terms of its epidemiological, pathogenicity, and clinical manifestations, which ultimately map the strategic path, towards an effective and safe treatment and production of a reliable and potent vaccine.}, } @article {pmid33446979, year = {2020}, author = {Sodhi, K and Chanchalani, G}, title = {Awake Proning: Current Evidence and Practical Considerations.}, journal = {Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine}, volume = {24}, number = {12}, pages = {1236-1241}, doi = {10.5005/jp-journals-10071-23684}, pmid = {33446979}, issn = {0972-5229}, abstract = {Prone positioning has been shown to improve oxygenation for decades. However, proning in awake, non-intubated patients gained acceptance in the last few months since the onset of coronavirus (COVID-19) pandemic. To overcome the shortage of ventilators, to decrease the overwhelming burden on intensive care beds in the pandemic era, and also as invasive ventilation was associated with poor outcomes, proning of awake, spontaneously breathing patients gathered momentum. Being an intervention with minimal risk and requiring minimum assistance, it is now a globally accepted therapy to improve oxygenation in acute hypoxemic respiratory failure in COVID-19 patients. We thus reviewed the literature of awake proning in non-intubated patients and described a safe protocol to practice the same. How to cite this article: Sodhi K, Chanchalani G. Awake Proning: Current Evidence and Practical Considerations. Indian J Crit Care Med 2020;24(12):1236-1241.}, } @article {pmid33446406, year = {2020}, author = {Czajka, TF and Vance, DJ and Mantis, NJ}, title = {Slaying SARS-CoV-2 One (Single-domain) Antibody at a Time.}, journal = {Trends in microbiology}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.tim.2020.12.006}, pmid = {33446406}, issn = {1878-4380}, abstract = {Camelid-derived and synthetic single-domain antibodies (sdAbs) are emerging as potent weapons against the novel coronavirus, SARS-CoV-2. sdAbs are small, compact, thermostable immunoglobulin elements capable of binding targets with subnanomolar affinities. By leveraging the power of phage- and yeast surface-display technologies, rare sdAbs can be isolated from highly diverse and complex antibody libraries. Once in hand, sdAbs can be engineered to improve binding affinity, avidity, target specificities, and biodistribution. In this Opinion piece we highlight a series of sophisticated studies describing the identification of ultrapotent sdAbs directed against the receptor-binding domain (RBD) of the SARS-CoV-2 Spike protein. We discuss the possible applications of these antibodies in the global fight against COVID-19.}, } @article {pmid33446334, year = {2021}, author = {Chan, J and Auffermann, W and Jenkins, P and Streitmatter, S and Duong, PA}, title = {Implementing a Novel Through-Glass Chest Radiography Technique for COVID-19 Patients: Image Quality, Radiation Dose Optimization, and Practical Considerations.}, journal = {Current problems in diagnostic radiology}, volume = {}, number = {}, pages = {}, doi = {10.1067/j.cpradiol.2020.12.003}, pmid = {33446334}, issn = {1535-6302}, abstract = {RATIONALE AND OBJECTIVES: The novel coronavirus (COVID-19) pandemic has presented many logistical challenges, including unprecedented shortages of personal protective equipment (PPE). A technique of obtaining portable chest radiographs (pCXR) through glass doors or windows to minimize technologist-patient contact and conserve PPE has gained popularity, but remains incompletely evaluated in the literature. Our goal was to quickly implement this technique and evaluate image quality and radiation dose.

MATERIALS AND METHODS: An infographic and video were developed to educate nurses and technologists on the through-glass pCXR technique. Imaging parameters were optimized using a phantom and scatter radiation was measured. Three reviewers independently evaluated 100 conventionally obtained and 100 through-glass pCXRs from March 13, 2020 to April 30, 2020 on patients with suspected COVID-19, using criteria for positioning and sharpness/contrast on a 1 (confident criteria not met) to 5 (confident criteria met) scale. Imaging parameters, including deviation index (DI) were recorded for all radiographs.

RESULTS: The through-glass method was rapidly adopted and conserved one isolation gown per interaction. Although there was a statistically significant difference in the positioning (P value 0.018) and sharpness/contrast (P value 0.016), the difference in mean ratings was small: 4.82 vs 4.65 for positioning and 4.67 vs 4.50 (conventional vs modified) for sharpness/contrast. Scatter radiation was measured using a thorax phantom and found to be acceptable for the patient and nearby personnel. Standard deviation was higher for the DI for the through-glass technique (2.8) compared to the conventional technique (1.8), although the means were similar.

CONCLUSION: The through-glass technique was quickly implemented, producing diagnostic quality chest radiographs while conserving PPE and reducing risks to radiology staff. There was more variability with imaging technique and DI using the through-glass technique, likely due to technologist uncertainty regarding technical modifications. Further work to reduce this variation is necessary to optimize quality and dose.}, } @article {pmid33446327, year = {2020}, author = {Maury, A and Lyoubi, A and Peiffer-Smadja, N and de Broucker, T and Meppiel, E}, title = {Neurological manifestations associated with SARS-CoV-2 and other coronaviruses: A narrative review for clinicians.}, journal = {Revue neurologique}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.neurol.2020.10.001}, pmid = {33446327}, issn = {0035-3787}, abstract = {INTRODUCTION: The past two decades have been marked by three epidemics linked to emerging coronaviruses. The COVID-19 pandemic highlighted the existence of neurological manifestations associated with SARS-CoV-2 infection and raised the question of the neuropathogenicity of coronaviruses. The aim of this review was to summarize the current data about neurological manifestations and diseases linked to human coronaviruses.

MATERIAL AND METHODS: Articles have been identified by searches of PubMed and Google scholar up to September 25, 2020, using a combination of coronavirus and neurology search terms and adding relevant references in the articles.

RESULTS: We found five cohorts providing prevalence data of neurological symptoms among a total of 2533 hospitalized COVID-19 patients, and articles focusing on COVID-19 patients with neurological manifestations including a total of 580 patients. Neurological symptoms involved up to 73% of COVID-19 hospitalized patients, and were mostly headache, myalgias and impaired consciousness. Central nervous system (CNS) manifestations reported in COVID-19 were mostly non-specific encephalopathies that represented between 13% and 40% of all neurological manifestations; post-infectious syndromes including acute demyelinating encephalomyelitis (ADEM, n=13), acute necrotizing encephalopathy (ANE, n=4), Bickerstaff's encephalitis (n=5), generalized myoclonus (n=3) and acute transverse myelitis (n=7); other encephalitis including limbic encephalitis (n=9) and miscellaneous encephalitis with variable radiologic findings (n=26); acute cerebrovascular diseases including ischemic strokes (between 1.3% and 4.7% of COVID-19 patients), hemorrhagic strokes (n=17), cerebral venous thrombosis (n=8) and posterior reversible encephalopathy (n=5). Peripheral nervous system (PNS) manifestations reported in COVID-19 were the following: Guillain-Barré syndrome (n=31) and variants including Miller Fisher syndrome (n=3), polyneuritis cranialis (n=2) and facial diplegia (n=2); isolated oculomotor neuropathy (n=6); critical illness myopathy (n=6). Neuropathological studies in COVID-19 patients demonstrated different patterns of CNS damage, mostly ischemic and hemorrhagic changes with few cases of inflammatory injuries. Only one case suggested SARS-CoV-2 infiltration in endothelial and neural cells. We found 10 case reports or case series describing 22 patients with neurological manifestations associated with other human coronaviruses. Among them we found four MERS patients with ADEM or Bickerstaff's encephalitis, two SARS patients with encephalitis who had a positive SARS-CoV PCR in cerebrospinal fluid, five patients with ischemic strokes associated with SARS, eight MERS patients with critical illness neuromyopathy and one MERS patient with Guillain-Barré Syndrome. An autopsy study on SARS-CoV patients demonstrated the presence of the virus in the brain of eight patients.

CONCLUSION: The wide range of neurological manifestations and diseases associated with SARS-CoV-2 is consistent with multiple pathogenic pathways including post-infectious mechanisms, septic-associated encephalopathies, coagulopathy or endothelitis. There was no definite evidence to support direct neuropathogenicity of SARS-CoV-2.}, } @article {pmid33446246, year = {2021}, author = {Corsi, M and Orsini, A and Pedrinelli, V and Santangelo, A and Bertelloni, CA and Carli, N and Buselli, R and Peroni, D and Striano, P and Dell'Osso, L and Carmassi, C}, title = {PTSD in parents of children with severe diseases: a systematic review to face Covid-19 impact.}, journal = {Italian journal of pediatrics}, volume = {47}, number = {1}, pages = {8}, pmid = {33446246}, issn = {1824-7288}, abstract = {CONTEXT: The literature agrees on the impact of post-traumatic stress symptoms in parents of seriously ill children but there is less clarity about the real extent and gender differences of this psychopathological risk. The recent Covid-19 outbreak highlighted new burdens for researchers on Post Traumatic Stress Disorder (PTSD) and clear evidence-based knowledge on this issue is timely needed.

OBJECTIVE: In this review, we present a synthesis of the updated evidence on PTSD rates in parents of children with severe diseases. We also aim to try to understand if research in this field has been refined over time with the long-term intent to better face the new challenges of Covid-19 in the paediatric field.

DATA SOURCES: The PubMed database was searched.

STUDY SELECTION: Studies were included if they assessed PTSD in parents of children diagnosed with physical illnesses.

DATA EXTRACTION: Of 240 studies, 4 were included.

RESULTS: Analysis of the 4 studies revealed 2 studies with PTSD rates around 20% and in line with previous best-evidence. All 4 studies tried to provide more data on fathers, however, all the studies present the lack of a control group.

LIMITATIONS: The limited number of studies, which also differ widely in the methodology used.

CONCLUSIONS: Methodological errors evidenced in all the 4 studies limit their reliability, making the understanding of the paediatric caregiver's concern regarding PTSD still difficult. More sound research is needed.}, } @article {pmid33446109, year = {2021}, author = {Klasa, K and Galaitsi, S and Wister, A and Linkov, I}, title = {System models for resilience in gerontology: application to the COVID-19 pandemic.}, journal = {BMC geriatrics}, volume = {21}, number = {1}, pages = {51}, pmid = {33446109}, issn = {1471-2318}, abstract = {The care needs for aging adults are increasing burdens on health systems around the world. Efforts minimizing risk to improve quality of life and aging have proven moderately successful, but acute shocks and chronic stressors to an individual's systemic physical and cognitive functions may accelerate their inevitable degradations. A framework for resilience to the challenges associated with aging is required to complement on-going risk reduction policies, programs and interventions. Studies measuring resilience among the elderly at the individual level have not produced a standard methodology. Moreover, resilience measurements need to incorporate external structural and system-level factors that determine the resources that adults can access while recovering from aging-related adversities. We use the National Academies of Science conceptualization of resilience for natural disasters to frame resilience for aging adults. This enables development of a generalized theory of resilience for different individual and structural contexts and populations, including a specific application to the COVID-19 pandemic.}, } @article {pmid33445810, year = {2021}, author = {Pum, A and Ennemoser, M and Adage, T and Kungl, AJ}, title = {Cytokines and Chemokines in SARS-CoV-2 Infections-Therapeutic Strategies Targeting Cytokine Storm.}, journal = {Biomolecules}, volume = {11}, number = {1}, pages = {}, doi = {10.3390/biom11010091}, pmid = {33445810}, issn = {2218-273X}, abstract = {The recently identified severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus, the cause of coronavirus disease (COVID-19) and the associated ongoing pandemic, frequently leads to severe respiratory distress syndrome and pneumonia with fatal consequences. Although several factors of this infection and its consequences are not completely clear, the presence and involvement of specific chemokines is undoubtedly crucial for the development and progression of COVID-19. Cytokine storm and the often-resulting cytokine release syndrome (CRS) are pathophysiological hallmarks in COVID-19 infections related to its most severe and fatal cases. In this hyperinflammatory event, chemokines and other cytokines are highly upregulated and are therefore not fulfilling their beneficial function in the host response anymore but causing harmful effects. Here, we present the recent views on the involvement of chemokines and selected cytokines in COVID-19 and the therapeutics currently in clinical development targeting or interfering with them, discussing their potentials in the treatment of COVID-19 infections.}, } @article {pmid33445727, year = {2021}, author = {Ghaffari, A and Meurant, R and Ardakani, A}, title = {COVID-19 Point-of-Care Diagnostics That Satisfy Global Target Product Profiles.}, journal = {Diagnostics (Basel, Switzerland)}, volume = {11}, number = {1}, pages = {}, doi = {10.3390/diagnostics11010115}, pmid = {33445727}, issn = {2075-4418}, support = {not applicable.//Novateur Venture Inc./ ; }, abstract = {COVID-19 pandemic will continue to pose a major public health threat until vaccination-mediated herd immunity is achieved. Most projections predict vaccines will reach a large subset of the population late in 2021 or early 2022. In the meantime, countries are exploring options to remove strict lockdown measures and allow society and the economy to return to normal function. One possibility is to expand on existing COVID-19 testing strategies by including large-scale rapid point-of-care diagnostic tests (POCTs). Currently, there is significant variability in performance and features of available POCTs, making selection and procurement of an appropriate test for specific use case difficult. In this review, we have used the World Health Organization's (WHO) recently published target product profiles (TPPs) for specific use cases of COVID-19 diagnostic tests to screen for top-performing POCTs on the market. Several POCTs, based on clinical sensitivity/specificity, the limit of detection, and time to results, which meet WHO TPP criteria for direct detection of SARS-CoV-2 (acute infection) or indirect diagnosis of past infection (host antibodies), are highlighted here.}, } @article {pmid33445712, year = {2021}, author = {d'Ettorre, G and Ceccarelli, G and Santinelli, L and Vassalini, P and Innocenti, GP and Alessandri, F and Koukopoulos, AE and Russo, A and d'Ettorre, G and Tarsitani, L}, title = {Post-Traumatic Stress Symptoms in Healthcare Workers Dealing with the COVID-19 Pandemic: A Systematic Review.}, journal = {International journal of environmental research and public health}, volume = {18}, number = {2}, pages = {}, doi = {10.3390/ijerph18020601}, pmid = {33445712}, issn = {1660-4601}, support = {Sapienza University of Rome//Sapienza Università di Roma/ ; }, abstract = {Prevention of post-traumatic stress symptoms (PTSS) in healthcare workers (HCWs) facing the current COVID-19 pandemic is a challenge worldwide as HCWs are likely to experience acute and chronic, often unpredictable, occupational stressors leading to PTSS. This review aims to analyze the literature to discover which topics have been focused on and what the latest developments are in managing the occupational risk of PTSS in HCWs during the current pandemic. For the purpose of this review, we searched for publications in MEDLINE/Pubmed using selected keywords. The articles were reviewed and categorized into one or more of the following categories based on their subject matter: risk assessment, risk management, occurrence rates. A total of 16 publications matched our inclusion criteria. The topics discussed were: "Risk Assessment", "Occurrence Rates", and "Risk Management". Young age, low work experience, female gender, heavy workload, working in unsafe settings, and lack of training and social support were found to be predictors of PTSS. This review's findings showed the need for urgent interventions aimed at protecting HCWs from the psychological impact of traumatic events related to the pandemic and leading to PTSS; healthcare policies need to consider preventive and management strategies toward PTSS, and the related psychic sequelae, in HCWs.}, } @article {pmid33445657, year = {2021}, author = {Papapanou, M and Papaioannou, M and Petta, A and Routsi, E and Farmaki, M and Vlahos, N and Siristatidis, C}, title = {Maternal and Neonatal Characteristics and Outcomes of COVID-19 in Pregnancy: An Overview of Systematic Reviews.}, journal = {International journal of environmental research and public health}, volume = {18}, number = {2}, pages = {}, doi = {10.3390/ijerph18020596}, pmid = {33445657}, issn = {1660-4601}, abstract = {(1) Background: A considerable number of systematic reviews, with substantial heterogeneity regarding their methods and included populations, on the impact of COVID-19 on infected pregnant women and their neonates, has emerged. The aim was to describe the obstetric-perinatal and neonatal outcome of infected pregnant women and their newborns during the COVID-19 pandemic; (2) Methods: Three bibliographical databases were searched (last search: September 10, 2020). Quality assessment was performed using the AMSTAR-2 tool. Primary outcomes included mode of delivery, preterm delivery/labor, premature rupture of membranes (PROM/pPROM) and abortions/miscarriages. Outcomes were mainly presented as ranges. A separate analysis, including only moderate and high-quality systematic reviews, was also conducted. The protocol was registered with PROSPERO (CRD42020214447); (3) Results: Thirty-nine reviews were analyzed. Reported rates, regarding both preterm and term gestations, varied between 52.3 and 95.8% for cesarean sections; 4.2-44.7% for vaginal deliveries; 14.3-63.8% specifically for preterm deliveries and 22.7-32.2% for preterm labor; 5.3-12.7% for PROM and 6.4-16.1% for pPROM. Maternal anxiety for potential fetal infection contributed to abortion decisions, while SARS-CoV-2-related miscarriages could not be excluded. Maternal ICU admission and mechanical ventilation rates were 3-28.5% and 1.4-12%, respectively. Maternal mortality rate was <2%, while stillbirth, neonatal ICU admission and mortality rates were <2.5%, 3.1-76.9% and <3%, respectively. Neonatal PCR positivity rates ranged between 1.6% and 10%. After accounting for quality of studies, ranges of our primary outcomes remained almost unchanged, while among our secondary outcomes, maternal ICU admission (3-10%) and mechanical ventilation rates (1.4-5.5%) were found to be relatively lower; (4) Conclusions: Increased rates of cesarean sections and preterm birth rates were found, with iatrogenic reasons potentially involved. In cases of symptomatic women with confirmed infection, high maternal and neonatal ICU admission rates should raise some concerns. The probability of vertical transmission cannot be excluded. Further original studies on women from all trimesters are warranted.}, } @article {pmid33445583, year = {2021}, author = {Zafer, MM and El-Mahallawy, HA and Ashour, HM}, title = {Severe COVID-19 and Sepsis: Immune Pathogenesis and Laboratory Markers.}, journal = {Microorganisms}, volume = {9}, number = {1}, pages = {}, doi = {10.3390/microorganisms9010159}, pmid = {33445583}, issn = {2076-2607}, abstract = {The ongoing outbreak of the novel coronavirus disease 2019 (COVID-19), induced by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has taken a significant toll on people and countries all over the world. The pathogenesis of COVID-19 has not been completely elucidated yet. This includes the interplay between inflammation and coagulation which needs further investigation. The massive production of proinflammatory cytokines and chemokines results in the so-called cytokine storm, leading to plasma leakage, vascular hyperpermeability, and disseminated vascular coagulation. This is usually accompanied by multiorgan failure. The extensive changes in the serum levels of cytokines are thought to play a crucial role in the COVID-19 pathogenesis. Additionally, the viral load and host inflammation factors are believed to have a significant role in host damage, particularly lung damage, from SARS-CoV-2. Interestingly, patients exhibit quantitative and qualitative differences in their immune responses to the virus, which can impact the clinical manifestation and outcomes of COVID-19. There needs to be a better understanding of the dynamic events that involve immune responses, inflammatory reactions, and viral replication in the context of the COVID-19 infection. Here, we discuss the main aspects of COVID-19 pathogenesis while supporting the hypothesis that inflammatory immune responses are involved in the progression of the disease to a more critical and fatal phase. We also explore the similarities and differences between severe COVID-19 and sepsis. A deeper understanding of the COVID-19 clinical picture as it relates to better-known conditions such as sepsis can provide useful clues for the management, prevention, and therapy of the disease.}, } @article {pmid33445452, year = {2021}, author = {Rico-González, M and Pino-Ortega, J and Ardigò, LP}, title = {Playing Non-Professional Football in COVID-19 Time: A Narrative Review of Recommendations, Considerations, and Best Practices.}, journal = {International journal of environmental research and public health}, volume = {18}, number = {2}, pages = {}, doi = {10.3390/ijerph18020568}, pmid = {33445452}, issn = {1660-4601}, abstract = {The coronavirus disease (COVID-19) pandemic in 2020 resulted in widespread interruption of team sports training and competitions. Our aim was to review the recommendations and best practices in return to play in non-professional football after activity lockdown. The authors searched two electronic databases (PubMed, Web of Science) to extract studies published before September 15 2020. Twenty studies explained recommendations, considerations, or best practices in return to play in football, and all of them were clustered into three groups: (1) training load management (n = 10), (2) medical recommendations (n = 9), and (3) recovery related issues (n = 5). The way to establish a progression in training process should be based on training load management and managing the number of stimuli per time. Following the studies, this training process should be divided into three phases: phase 1-physical distancing should be maintained; phases 2 and 3-group training should start. Medical considerations were clustered into different groups: general, pre- and post- training, during training, education, planning to return to competition, and suggestions for post confinement weeks. In particular, social issues, strict hygiene questions, and continuous PCR testing should be considered in return to play over football season. Finally, since a correlation has been found between high-intensive training loads and immunoglobulin A, nutritional and lifestyle recovery strategies should be performed. Moreover, since immunosuppression has been related to congested schedules (<72 h between matches), football federations should avoid this situation.}, } @article {pmid33439949, year = {2021}, author = {Araújo, MS and Santos, MMPD and Silva, CJA and Menezes, RMP and Feijão, AR and Medeiros, SM}, title = {Prone positioning as an emerging tool in the care provided to patients infected with COVID-19: a scoping review.}, journal = {Revista latino-americana de enfermagem}, volume = {29}, number = {}, pages = {e3397}, doi = {10.1590/1518-8345.4732.3397}, pmid = {33439949}, issn = {1518-8345}, mesh = {*COVID-19 ; Humans ; Patient Positioning ; Prone Position ; Respiration, Artificial ; *Respiratory Distress Syndrome ; SARS-CoV-2 ; }, abstract = {OBJECTIVE: to describe scientific evidence regarding the use of prone positioning in the care provided to patients with acute respiratory failure caused by COVID-19.

METHOD: this is a scoping review. PRISMA Extension for Scoping Reviews was used to support the writing of this study. The search was conducted in seven databases and resulted in 2,441 studies, 12 of which compose the sample. Descriptive statistics, such as relative and absolute frequencies, was used to analyze data.

RESULTS: prone positioning was mainly adopted in Intensive Care Units, lasted from a minimum of 12 up to 16 hours, and its prescription was based on specific criteria, such as PaO2/FiO2 ratio, oxygen saturation, and respiratory rate. The most prevalent complications were: accidental extubation, pressure ulcer, and facial edema. Decreased hypoxemia and mortality rates were the main outcomes reported.

CONCLUSION: positive outcomes outweighed complications. Various cycles of prone positioning are needed, which may cause potential work overload for the health staff. Therefore, an appropriate number of trained workers is necessary, in addition to specific institutional protocols to ensure patient safety in this context.}, } @article {pmid33431650, year = {2021}, author = {Howard, J and Huang, A and Li, Z and Tufekci, Z and Zdimal, V and van der Westhuizen, HM and von Delft, A and Price, A and Fridman, L and Tang, LH and Tang, V and Watson, GL and Bax, CE and Shaikh, R and Questier, F and Hernandez, D and Chu, LF and Ramirez, CM and Rimoin, AW}, title = {An evidence review of face masks against COVID-19.}, journal = {Proceedings of the National Academy of Sciences of the United States of America}, volume = {118}, number = {4}, pages = {}, pmid = {33431650}, issn = {1091-6490}, mesh = {*COVID-19/epidemiology/prevention & control ; *Contact Tracing ; Humans ; *Masks ; *SARS-CoV-2 ; }, abstract = {The science around the use of masks by the public to impede COVID-19 transmission is advancing rapidly. In this narrative review, we develop an analytical framework to examine mask usage, synthesizing the relevant literature to inform multiple areas: population impact, transmission characteristics, source control, wearer protection, sociological considerations, and implementation considerations. A primary route of transmission of COVID-19 is via respiratory particles, and it is known to be transmissible from presymptomatic, paucisymptomatic, and asymptomatic individuals. Reducing disease spread requires two things: limiting contacts of infected individuals via physical distancing and other measures and reducing the transmission probability per contact. The preponderance of evidence indicates that mask wearing reduces transmissibility per contact by reducing transmission of infected respiratory particles in both laboratory and clinical contexts. Public mask wearing is most effective at reducing spread of the virus when compliance is high. Given the current shortages of medical masks, we recommend the adoption of public cloth mask wearing, as an effective form of source control, in conjunction with existing hygiene, distancing, and contact tracing strategies. Because many respiratory particles become smaller due to evaporation, we recommend increasing focus on a previously overlooked aspect of mask usage: mask wearing by infectious people ("source control") with benefits at the population level, rather than only mask wearing by susceptible people, such as health care workers, with focus on individual outcomes. We recommend that public officials and governments strongly encourage the use of widespread face masks in public, including the use of appropriate regulation.}, } @article {pmid33431393, year = {2021}, author = {Daoud, AK and Hall, JK and Petrick, H and Strong, A and Piggott, C}, title = {The Potential for Cloth Masks to Protect Health Care Clinicians From SARS-CoV-2: A Rapid Review.}, journal = {Annals of family medicine}, volume = {19}, number = {1}, pages = {55-62}, pmid = {33431393}, issn = {1544-1717}, mesh = {COVID-19/*prevention & control ; Equipment Design ; Humans ; Infectious Disease Transmission, Patient-to-Professional/*prevention & control ; Masks/*standards/supply & distribution ; Materials Testing ; Personal Protective Equipment/supply & distribution ; SARS-CoV-2 ; *Textiles ; United States ; }, abstract = {PURPOSE: The coronavirus disease 2019 (COVID-19) pandemic has led at times to a scarcity of personal protective equipment, including medical masks, for health care clinicians, especially in primary care settings. The objective of this review was to summarize current evidence regarding the use of cloth masks to prevent respiratory viral infections, such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), among health care clinicians.

METHODS: We searched 5 databases, the Centers for Disease Control and Prevention website, and the reference lists of identified articles on April 3, 2020. All identified publications were independently screened by 2 reviewers. Two authors independently extracted data and graded the studies. Randomized control trials (RCTs) were graded using the Consolidated Standards of Reporting Trials (CONSORT) checklist, and observational and nonhuman subject studies were graded using 11 domains common across frequently used critical appraisal tools. All discrepancies were resolved by consensus.

RESULTS: Our search identified 136 original publications. Nine studies met inclusion criteria. We performed a qualitative synthesis of the data from these studies. Four nonrandomized trials, 3 laboratory studies, 1 single-case experiment, and 1 RCT were identified. The laboratory studies found that cloth materials provided measurable levels of particle filtration but were less efficacious at blocking biologic material than medical masks. The RCT found that cloth masks were associated with significantly more viral infections than medical masks.

CONCLUSIONS: The current literature suggests that cloth materials are somewhat efficacious in filtering particulate matter and aerosols but provide a worse fit and inferior protection compared to medical masks in clinical environments. The quality and quantity of literature addressing this question are lacking. Cloth masks lack evidence for adequate protection of health care clinicians against respiratory viral infections.}, } @article {pmid33422089, year = {2021}, author = {Esposito, S and Cotugno, N and Principi, N}, title = {Comprehensive and safe school strategy during COVID-19 pandemic.}, journal = {Italian journal of pediatrics}, volume = {47}, number = {1}, pages = {6}, pmid = {33422089}, issn = {1824-7288}, support = {2020-01//Ospedale Bambino Gesù/ ; }, mesh = {Adolescent ; COVID-19/*epidemiology/*prevention & control/transmission ; Child ; Communicable Disease Control/*organization & administration ; Humans ; *Schools ; }, abstract = {BACKGROUND: Although several studies have tried to evaluate the real efficacy of school closure for pandemic control over time, no definitive answer to this question has been given. Moreover, it has not been clarified whether children or teenagers could be considered a problem for SARS-CoV-2 diffusion or, on the contrary, whether parents and school workers play a greater role. The aims of this review are to discuss about children's safety at school and the better strategies currently able to reduce the risk of SARS-CoV-2 infection at school.

MAIN AIM: Compared to adults, very few cases of COVID-19 were diagnosed in children, who generally suffered from an asymptomatic infection or a mild disease. Moreover, school closure is systematically associated with the development of problems involving students, teachers and parents, particularly among populations with poor resources. Although several researches have tried to evaluate the real efficacy of school closure for pandemic control over time, no definitive answer to this question has been given. Available findings seem to confirm that to ensure adequate learning and to avoid social and economic problems, schools must remain open, provided that the adults who follow children at home and at school absolutely comply with recommendations for prevention measures and that school facilities can be optimized in order to significantly reduce the spread of infection. In this regard, the universal use of face masks in addition to hand hygiene and safe distancing in schools, at least starting from the age of 6 years, seems extremely useful. Moreover, since the beginning of the COVID-19 outbreak the use of telemedicine to manage suspected SARS-CoV-2-infected individuals in the community has appeared to be an easy and effective measure to solve many paediatric problems and could represent a further support to schools .

CONCLUSIONS: We think that schools must remain open, despite COVID-19 pandemic. However, several problems strictly related to school frequency and reduction of infectious risk must be solved before school attendance can be considered completely safe. A single more in-depth guideline agreed between countries with the same school problems could be very useful in eliminating doubts and fostering the compliance of students, teachers and non-teaching school staff reducing errors and misinterpretations.}, } @article {pmid33414783, year = {2020}, author = {Karaderi, T and Bareke, H and Kunter, I and Seytanoglu, A and Cagnan, I and Balci, D and Barin, B and Hocaoglu, MB and Rahmioglu, N and Asilmaz, E and Taneri, B}, title = {Host Genetics at the Intersection of Autoimmunity and COVID-19: A Potential Key for Heterogeneous COVID-19 Severity.}, journal = {Frontiers in immunology}, volume = {11}, number = {}, pages = {586111}, pmid = {33414783}, issn = {1664-3224}, mesh = {Autoimmune Diseases/*genetics ; Autoimmunity/genetics ; COVID-19/*genetics ; Genetic Predisposition to Disease ; Humans ; *SARS-CoV-2 ; Severity of Illness Index ; }, abstract = {COVID-19 presentation is very heterogeneous across cases, and host factors are at the forefront for the variables affecting the disease manifestation. The immune system has emerged as a key determinant in shaping the outcome of SARS-CoV-2 infection. It is mainly the deleterious unconstrained immune response, rather than the virus itself, which leads to severe cases of COVID-19 and the associated mortality. Genetic susceptibility to dysregulated immune response is highly likely to be among the host factors for adverse disease outcome. Given that such genetic susceptibility has also been observed in autoimmune diseases (ADs), a number of critical questions remain unanswered; whether individuals with ADs have a significantly different risk for COVID-19-related complications compared to the general population, and whether studies on the genetics of ADs can shed some light on the host factors in COVID-19. In this perspective, we discuss the host genetic factors, which have been under investigation in association with COVID-19 severity. We touch upon the intricate link between autoimmunity and COVID-19 pathophysiology. We put forth a number of autoimmune susceptibility genes, which have the potential to be additional host genetic factors for modifying the severity of COVID-19 presentation. In summary, host genetics at the intersection of ADs and COVID-19 may serve as a source for understanding the heterogeneity of COVID-19 severity, and hence, potentially holds a key in achieving effective strategies in risk group identification, as well as effective treatments.}, } @article {pmid33403987, year = {2020}, author = {Chetty, T and Daniels, BB and Ngandu, NK and Goga, A}, title = {A rapid review of the effectiveness of screening practices at airports, land borders and ports to reduce the transmission of respiratory infectious diseases such as COVID-19.}, journal = {South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde}, volume = {110}, number = {11}, pages = {1105-1109}, pmid = {33403987}, issn = {2078-5135}, mesh = {Airports ; Body Temperature ; COVID-19/*diagnosis/prevention & control/transmission ; Communicable Disease Control ; Communicable Diseases/*diagnosis/transmission ; Humans ; Influenza, Human/diagnosis/prevention & control/transmission ; Mass Screening/*methods ; *Quarantine ; Respiratory Tract Infections/*diagnosis/prevention & control/transmission ; SARS-CoV-2 ; Severe Acute Respiratory Syndrome/diagnosis/prevention & control/transmission ; *Thermography ; Thermometry ; *Travel ; }, abstract = {BACKGROUND: Travel screening for infectious diseases is often implemented to delay or prevent the entry of infected persons to a country/area.

OBJECTIVES: To evaluate the effectiveness of different point-of-entry screening strategies in achieving a reduction in imported COVID-19 transmission.

METHODS: A rapid evidence review was conducted, systematically searching PubMed and Google Scholar and grey literature on 27 March 2020.

RESULTS: We screened 1 194 records. Nine potential full-text articles were assessed for eligibility and included. Three articles investigated the effectiveness of entry-based thermal and body temperature scanning. Entry-based infrared thermal or body temperature scanning for COVID-19 was unlikely to be effective. Two systematic reviews found no additional benefit of travel restrictions/screening. In a COVID-19 modelling study, airport screening was not effective, with exit and entry thermal scanning identifying half and missing almost half of infected travellers. Two other modelling studies found that entry-based travel screening would achieve only modest delays in community transmission, while international travel quarantine could reduce case importations by 80%.

CONCLUSIONS: There is insufficient evidence to support entry and exit screening at points of entry, as these strategies detect just over half of the infected cases, missing almost half at entry points. The benefits of airport screening therefore need to be context specific and weighed against the resources and cost of implementation, the contribution of imported cases to total cases, and the benefits of identifying 50% of cases in the South African context with the country's high HIV and tuberculosis prevalence and limited resources to deal with a pandemic of this nature.}, } @article {pmid33403980, year = {2020}, author = {Brooke, BD and Raman, J and Frean, J and Rundle, J and Maartens, F and Misiani, E and Mabuza, A and Barnes, KI and Moonasar, DP and Dlamini, Q and Charles, S and Blumberg, L}, title = {Implementing malaria control in South Africa, Eswatini and southern Mozambique during the COVID-19 pandemic.}, journal = {South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde}, volume = {110}, number = {11}, pages = {1072-1076}, pmid = {33403980}, issn = {2078-5135}, mesh = {Animals ; Anopheles/*parasitology ; COVID-19/prevention & control ; Community Health Workers ; Delivery of Health Care/*methods ; Disease Eradication ; Eswatini ; Guidelines as Topic ; *Health Education ; Health Personnel ; Humans ; Insecticides ; Malaria/*prevention & control/therapy ; *Mosquito Control ; Mosquito Vectors/*parasitology ; Mozambique ; Personal Protective Equipment ; Plasmodium ; SARS-CoV-2 ; South Africa ; }, abstract = {The COVID-19 pandemic has strained healthcare delivery systems in a number of southern African countries. Despite this, it is imperative that malaria control and elimination activities continue, especially to reduce as far as possible the number and rate of hospitalisations caused by malaria. The implementation of enhanced malaria control/elimination activities in the context of COVID-19 requires measures to protect healthcare workers and the communities they serve. The aim of this review is therefore to present innovative ideas for the timely implementation of malaria control without increasing the risk of COVID-19 to healthcare workers and communities. Specific recommendations for parasite and vector surveillance, diagnosis, case management, mosquito vector control and community outreach and sensitisation are given.}, } @article {pmid33395781, year = {2020}, author = {Jayawardena, R and Jeyakumar, DT and Misra, A and Hills, AP and Ranasinghe, P}, title = {Obesity: A potential risk factor for infection and mortality in the current COVID-19 epidemic.}, journal = {Diabetes & metabolic syndrome}, volume = {14}, number = {6}, pages = {2199-2203}, pmid = {33395781}, issn = {1878-0334}, mesh = {COVID-19/diagnosis/*mortality ; Epidemics/prevention & control ; Global Health/*trends ; Humans ; Mortality/trends ; Obesity/diagnosis/*mortality ; Risk Factors ; }, abstract = {BACKGROUND AND AIMS: COVID-19 is an ongoing global pandemic, affecting nearly 35 million people from 214 countries as at September 30, 2020 and emerging evidence suggests that obesity is a potential risk factor for communicable diseases, including viral infections. Therefore, we investigated the relationship between obesity prevalence of the total adult population and COVID-19 infection and mortality rates, in different countries.

METHODS: A total of 54 countries from six continents were selected. Country-specific obesity prevalence data were retrieved from the latest non-communicable diseases profiles released by the Non-communicable Diseases and Mental Health Cluster of World Health Organization, while the real time statistics from the Worldometer website were used to extract data on COVID-19 infections and mortality per million of the total population as of September 30, 2020.

RESULTS: Obesity prevalence data ranged from 2.0% (Vietnam) to 35.0% (Saudi Arabia). Among the selected countries, the highest number of COVID-19 cases per million was documented in Qatar (n = 44,789) while the lowest was reported from Vietnam (n = 11). Highest mortality per million population due to COVID-19 infections occurred in Peru (n = 981), in contrast with the smallest number reported in Mongolia (n = 0). A significant positive correlation (r = 0.46; p < 0.001) was observed between the total number of COVID-19 infections and the prevalence of obesity. COVID-19 mortality was also significantly correlated (r = 0.34; p < 0.05) with the prevalence of obesity.

CONCLUSIONS: Obesity prevalence in each country was significantly associated with both infection and mortality rate of COVID-19.}, } @article {pmid33393854, year = {2020}, author = {Nainu, F and Abidin, RS and Bahar, MA and Frediansyah, A and Emran, TB and Rabaan, AA and Dhama, K and Harapan, H}, title = {SARS-CoV-2 reinfection and implications for vaccine development.}, journal = {Human vaccines & immunotherapeutics}, volume = {16}, number = {12}, pages = {3061-3073}, doi = {10.1080/21645515.2020.1830683}, pmid = {33393854}, issn = {2164-554X}, mesh = {Animals ; COVID-19/epidemiology/immunology/*prevention & control ; COVID-19 Vaccines/*administration & dosage/immunology ; Drug Development/methods/*trends ; Humans ; Reinfection/epidemiology/immunology/*prevention & control ; SARS-CoV-2/*drug effects/immunology ; }, abstract = {Coronavirus disease 2019 (COVID-19) pandemic continues to constitute a public health emergency of international concern. Multiple vaccine candidates for COVID-19, which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), have entered clinical trials. However, some evidence suggests that patients who have recovered from COVID-19 can be reinfected. For example, in China, two discharged COVID-19 patients who had recovered and fulfilled the discharge criteria for COVID-19 were retested positive to a reverse transcription polymerase chain reaction (RT-PCR) assay for the virus. This finding is critical and could hamper COVID-19 vaccine development. This review offers literature-based evidence of reinfection with SARS-CoV-2, provides explanation for the possibility of SARS-CoV-2 reinfection both from the agent and host points of view, and discusses its implication for COVID-19 vaccine development.}, } @article {pmid33356661, year = {2020}, author = {Gautret, P and Million, M and Jarrot, PA and Camoin-Jau, L and Colson, P and Fenollar, F and Leone, M and La Scola, B and Devaux, C and Gaubert, JY and Mege, JL and Vitte, J and Melenotte, C and Rolain, JM and Parola, P and Lagier, JC and Brouqui, P and Raoult, D}, title = {Natural history of COVID-19 and therapeutic options.}, journal = {Expert review of clinical immunology}, volume = {16}, number = {12}, pages = {1159-1184}, doi = {10.1080/1744666X.2021.1847640}, pmid = {33356661}, issn = {1744-8409}, mesh = {Aged ; Aged, 80 and over ; Antiviral Agents/*therapeutic use ; *COVID-19/blood/epidemiology/therapy ; Female ; Humans ; Male ; Risk Factors ; SARS-CoV-2/*metabolism ; Severity of Illness Index ; }, abstract = {Introduction: COVID-19 presents benign forms in young patients who frequently present with anosmia. Infants are rarely infected, while severe forms occur in patients over 65 years of age with comorbidities, including hypertension and diabetes. Lymphopenia, eosinopenia, thrombopenia, increased lactate dehydrogenase, troponin, C-reactive protein, D-dimers and low zinc levels are associated with severity.Areas covered: The authors review the literature and provide an overview of the current state of knowledge regarding the natural history of and therapeutic options for COVID-19. Expert opinion: Diagnosis should rely on PCR and not on clinical presumption. Because of discrepancies between clinical symptoms, oxygen saturation or radiological signs on CT scans, pulse oximetry, and radiological investigation should be systematic. The disease evolves in successive phases: an acute virological phase, and, in some patients, a cytokine storm phase; an uncontrolled coagulopathy; and an acute respiratory distress syndrome. Therapeutic options include antivirals, oxygen therapy, immunomodulators, anticoagulants and prolonged mechanical treatment. Early diagnosis, care, and implementation of an antiviral treatment; the use of immunomodulators at a later stage; and the quality of intensive care are critical regarding mortality rates. The higher mortality observed in Western countries remains unexplained. Pulmonary fibrosis may occur in some patients. Its future is unpredictable.}, } @article {pmid33295829, year = {2020}, author = {Sharma, R and Palanisamy, A and Dhama, K and Mal, G and Singh, B and Singh, KP}, title = {Exploring the possible use of saponin adjuvants in COVID-19 vaccine.}, journal = {Human vaccines & immunotherapeutics}, volume = {16}, number = {12}, pages = {2944-2953}, pmid = {33295829}, issn = {2164-554X}, mesh = {Adjuvants, Immunologic/*administration & dosage/chemistry ; Animals ; COVID-19/immunology/*prevention & control ; COVID-19 Vaccines/*administration & dosage/chemistry/immunology ; Humans ; Saponins/*administration & dosage/chemistry/immunology ; Structure-Activity Relationship ; Vaccines, Subunit/administration & dosage/chemistry/immunology ; }, abstract = {There is an urgent need for a safe, efficacious, and cost-effective vaccine for the coronavirus disease 2019 (COVID-19) pandemic caused by novel coronavirus strain, severe acute respiratory syndrome-2 (SARS-CoV-2). The protective immunity of certain types of vaccines can be enhanced by the addition of adjuvants. Many diverse classes of compounds have been identified as adjuvants, including mineral salts, microbial products, emulsions, saponins, cytokines, polymers, microparticles, and liposomes. Several saponins have been shown to stimulate both the Th1-type immune response and the production of cytotoxic T lymphocytes against endogenous antigens, making them very useful for subunit vaccines, especially those for intracellular pathogens. In this review, we discuss the structural characteristics, mechanisms of action, structure-activity relationship of saponins, biological activities, and use of saponins in various viral vaccines and their applicability to a SARS-CoV-2 vaccine.}, } @article {pmid33270497, year = {2020}, author = {Dhama, K and Patel, SK and Natesan, S and Vora, KS and Iqbal Yatoo, M and Tiwari, R and Saxena, SK and Singh, KP and Singh, R and Malik, YS}, title = {COVID-19 in the elderly people and advances in vaccination approaches.}, journal = {Human vaccines & immunotherapeutics}, volume = {16}, number = {12}, pages = {2938-2943}, doi = {10.1080/21645515.2020.1842683}, pmid = {33270497}, issn = {2164-554X}, mesh = {Aged ; Aged, 80 and over ; COVID-19/*epidemiology/*prevention & control ; COVID-19 Vaccines/*therapeutic use ; Clinical Trials as Topic/methods ; Humans ; Vaccination/methods/*trends ; }, abstract = {The rapid worldwide spread of the COVID-19 pandemic, caused by the newly emerged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has resulted in tens of millions of infections and over one million deaths. SARS-CoV-2 infection affects all age groups; however, those over 60 years old are affected more severely. Moreover, pre-existing co-morbidities result in higher COVID-19-associated mortality in the geriatric population. This article highlights the associated risk factors of SARS-CoV-2 infection in older people and progress in developing COVID-19 vaccines, especially for efficient vaccination of the older population. There is also a summary of immunomodulatory and immunotherapeutic approaches to ameliorate the outcome of COVID-19 in older individuals.}, } @article {pmid33270484, year = {2020}, author = {Dhama, K and Natesan, S and Iqbal Yatoo, M and Patel, SK and Tiwari, R and Saxena, SK and Harapan, H}, title = {Plant-based vaccines and antibodies to combat COVID-19: current status and prospects.}, journal = {Human vaccines & immunotherapeutics}, volume = {16}, number = {12}, pages = {2913-2920}, pmid = {33270484}, issn = {2164-554X}, mesh = {Antibodies, Monoclonal/immunology/therapeutic use ; Antibodies, Viral/immunology/*therapeutic use ; Antiviral Agents/immunology/therapeutic use ; Biological Products/immunology/*therapeutic use ; COVID-19/immunology/*prevention & control ; COVID-19 Vaccines/immunology/*therapeutic use ; Humans ; Phytochemicals/immunology/*therapeutic use ; Plants ; *SARS-CoV-2/immunology ; Viral Vaccines/immunology/therapeutic use ; }, abstract = {Globally, researchers are undertaking significant efforts to design and develop effective vaccines, therapeutics, and antiviral drugs to curb the spread of coronavirus disease 2019 (COVID-19). Plants have been used for the production of vaccines, monoclonal antibodies, immunomodulatory proteins, drugs, and pharmaceuticals via molecular farming/transient expression system and are considered as bioreactors or factories for their bulk production. These biological products are stable, safe, effective, easily available, and affordable. Plant molecular farming could facilitate rapid production of biologics on an industrial scale, and has the potential to fulfill emergency demands, such as in the present situation of the COVID-19 pandemic. This article aims to describe the methodology and basics of plant biopharming, in addition to its prospective applications for developing effective vaccines and antibodies to counter COVID-19.}, } @article {pmid33232211, year = {2020}, author = {Yadav, T and Srivastava, N and Mishra, G and Dhama, K and Kumar, S and Puri, B and Saxena, SK}, title = {Recombinant vaccines for COVID-19.}, journal = {Human vaccines & immunotherapeutics}, volume = {16}, number = {12}, pages = {2905-2912}, pmid = {33232211}, issn = {2164-554X}, mesh = {COVID-19/genetics/metabolism/*prevention & control ; COVID-19 Vaccines/genetics/metabolism/*therapeutic use ; Genetic Vectors/genetics/metabolism/therapeutic use ; Humans ; Spike Glycoprotein, Coronavirus/genetics/metabolism ; Vaccines, Synthetic/metabolism/*therapeutic use ; }, abstract = {SARS-CoV-2, the causative agent of COVID-19, has imposed a major public health threat, which needs effective therapeutics and vaccination strategies. Several potential candidate vaccines being rapidly developed are in clinical evaluation. Considering the crucial role of SARS-CoV-2 spike (S) glycoprotein in virus attachment, entry, and induction of neutralizing antibodies, S protein is being widely used as a target for vaccine development. Based on advances in techniques for vaccine design, inactivated, live-vectored, nucleic acid, and recombinant COVID-19 vaccines are being developed and tested for their efficacy. Phase3 clinical trials are underway or will soon begin for several of these vaccines. Assuming that clinical efficacy is shown for one or more vaccines, safety is a major aspect to be considered before deploying such vaccines to the public. The current review focuses on the recent advances in recombinant COVID-19 vaccine research and development and associated issues.}, } @article {pmid33229838, year = {2020}, author = {Wada, K and Hashimoto, Y and Nakajima, M and Ueda, M}, title = {[COVID-19 and stroke].}, journal = {Rinsho shinkeigaku = Clinical neurology}, volume = {60}, number = {12}, pages = {822-839}, doi = {10.5692/clinicalneurol.cn-001529}, pmid = {33229838}, issn = {1882-0654}, mesh = {Acute Coronary Syndrome/complications ; COVID-19/*complications ; Diabetes Mellitus ; Fibrin Fibrinogen Degradation Products/analysis ; Humans ; Hypertension ; Pandemics ; Risk Factors ; Stroke/*complications/*therapy ; Thrombectomy/statistics & numerical data ; Thrombolytic Therapy/statistics & numerical data ; Venous Thromboembolism/complications ; }, abstract = {Due to the pandemic of corona virus disease 2019 (COVID-19), the stroke medical care system is unavoidably undergoing major changes such as a decrease in the number of stroke patients receiving consultation, delay in consultation, and a decrease in the number of intravenous thrombolysis and mechanical thrombectomy procedures. Stroke incidence in COVID-19 patients is approximately 1.1%. The features of stroke with COVID-19 have been elucidated: higher incidence in ischemic stroke than hemorrhagic stroke, increasing number of young patients, high D-dimer levels, and higher risk in elderly patients with cardiovascular risk factors such as hypertension and diabetes. In patients with COVID-19, venous thromboembolism is more common than arterial thromboembolism, and stroke is more common than acute coronary syndrome. Protected code stroke (PCS) has been proposed which provides safe, effective and prompt treatment under complete infection control.}, } @article {pmid33175602, year = {2020}, author = {Vora, KS and Sundararajan, A and Saiyed, S and Dhama, K and Natesan, S}, title = {Impact of COVID-19 on women and children and the need for a gendered approach in vaccine development.}, journal = {Human vaccines & immunotherapeutics}, volume = {16}, number = {12}, pages = {2932-2937}, doi = {10.1080/21645515.2020.1826249}, pmid = {33175602}, issn = {2164-554X}, mesh = {COVID-19/epidemiology/*prevention & control ; COVID-19 Vaccines/pharmacology/*therapeutic use ; Child ; Drug Development/*methods/trends ; Female ; Humans ; Lactation/drug effects ; Pregnancy ; Pregnancy Complications, Infectious/epidemiology/*prevention & control ; Sex Factors ; *Vulnerable Populations ; }, abstract = {The COVID-19 pandemic has imposed unprecedented health and socioeconomic challenges on public health, disrupting it on a global scale. Given that women and children are widely considered the most vulnerable in the times of emergency, whether in war or during a pandemic, the current pandemic has also severely disrupted access to reproductive and child health services. Despite this, data on the effect of the pandemic on pregnant women and newborns remain scarce, and gender-disaggregated indicators of mortality and morbidity are not available. In this context, we suggest the implementation of a gendered approach to ensure the specific needs of women and their newborns are considered during the development of COVID-19 vaccines. Taking into account gender-based biological differences, the inclusion of pregnant and lactating mothers in clinical trials for the development of COVID-19 vaccines is of vital importance.}, } @article {pmid33156739, year = {2020}, author = {Rabaan, AA and Al-Ahmed, SH and Sah, R and Al-Tawfiq, JA and Al-Qaaneh, AM and Al-Jamea, LH and Woodman, A and Al-Qahtani, M and Haque, S and Harapan, H and Bonilla-Aldana, DK and Kumar, P and Dhama, K and Rodriguez-Morales, AJ}, title = {Recent advances in vaccine and immunotherapy for COVID-19.}, journal = {Human vaccines & immunotherapeutics}, volume = {16}, number = {12}, pages = {3011-3022}, pmid = {33156739}, issn = {2164-554X}, mesh = {COVID-19/*immunology/*prevention & control ; COVID-19 Vaccines/administration & dosage/*immunology ; Humans ; Immunity, Cellular/drug effects/*immunology ; Immunologic Factors/administration & dosage/*immunology ; Immunotherapy/methods/*trends ; }, abstract = {The COVID-19 pandemic caused by SARS-CoV-2 has resulted in millions of cases and hundreds of thousands of deaths. Beyond there being no available antiviral therapy, stimulating protective immunity by vaccines is the best option for managing future infections. Development of a vaccine for a novel virus is a challenging effort that may take several years to accomplish. This mini-review summarizes the immunopathological responses to SARS-CoV-2 infection and discusses advances in the development of vaccines and immunotherapeutics for COVID-19.}, } @article {pmid33146561, year = {2020}, author = {Amigues, I and Pearlman, AH and Patel, A and Reid, P and Robinson, PC and Sinha, R and Kim, AH and Youngstein, T and Jayatilleke, A and Konig, M}, title = {Coronavirus disease 2019: investigational therapies in the prevention and treatment of hyperinflammation.}, journal = {Expert review of clinical immunology}, volume = {16}, number = {12}, pages = {1185-1204}, doi = {10.1080/1744666X.2021.1847084}, pmid = {33146561}, issn = {1744-8409}, support = {T32 AR048522/AR/NIAMS NIH HHS/United States ; T32 GM007309/GM/NIGMS NIH HHS/United States ; }, mesh = {*COVID-19/blood/mortality/prevention & control/therapy ; *Cytokine Release Syndrome/blood/mortality/prevention & control/therapy ; Cytokines/*blood ; Humans ; SARS-CoV-2/*metabolism ; *Therapies, Investigational ; }, abstract = {Introduction: The mortality of coronavirus disease 2019 (COVID-19) is frequently driven by an injurious immune response characterized by the development of acute respiratory distress syndrome (ARDS), endotheliitis, coagulopathy, and multi-organ failure. This spectrum of hyperinflammation in COVID-19 is commonly referred to as cytokine storm syndrome (CSS). Areas covered: Medline and Google Scholar were searched up until 15th of August 2020 for relevant literature. Evidence supports a role of dysregulated immune responses in the immunopathogenesis of severe COVID-19. CSS associated with SARS-CoV-2 shows similarities to the exuberant cytokine production in some patients with viral infection (e.g.SARS-CoV-1) and may be confused with other syndromes of hyperinflammation like the cytokine release syndrome (CRS) in CAR-T cell therapy. Interleukin (IL)-6, IL-8, and tumor necrosis factor-alpha have emerged as predictors of COVID-19 severity and in-hospital mortality. Expert opinion: Despite similarities, COVID-19-CSS appears to be distinct from HLH, MAS, and CRS, and the application of HLH diagnostic scores and criteria to COVID-19 is not supported by emerging data. While immunosuppressive therapy with glucocorticoids has shown a mortality benefit, cytokine inhibitors may hold promise as 'rescue therapies' in severe COVID-19. Given the arguably limited benefit in advanced disease, strategies to prevent the development of COVID-19-CSS are needed.}, } @article {pmid33121328, year = {2020}, author = {Barbuddhe, SB and Rawool, DB and Gaonkar, PP and Vergis, J and Dhama, K and Malik, SS}, title = {Global scenario, public health concerns and mitigation strategies to counter current ongoing SARS-CoV-2 / COVID-19 pandemic.}, journal = {Human vaccines & immunotherapeutics}, volume = {16}, number = {12}, pages = {3023-3033}, pmid = {33121328}, issn = {2164-554X}, mesh = {Animals ; COVID-19/*epidemiology/*prevention & control ; COVID-19 Vaccines/*administration & dosage ; Cough/epidemiology/therapy ; Disease Outbreaks/prevention & control ; Fever/epidemiology/therapy ; Global Health/*trends ; Humans ; Pandemics/prevention & control ; Public Health/methods/*trends ; *SARS-CoV-2/drug effects ; }, abstract = {Severe acute respiratory syndrome Coronavirus- 2 (SARS-CoV-2), the etiological agent of the novel coronavirus disease (COVID-19), has posed a great public health threat to the global community as a pandemic. The origin of the virus has been linked to animals, through a yet-to-be-identified intermediate host. The disease is transmitted to humans mainly through inhalation or contact with infected droplets. The variable clinical presentation of COVID-19 includes fever, cough, sore throat, breathlessness, fatigue and malaise; however, cutaneous, ocular, neurological, and gastrointestinal manifestations have also been reported. There is an urgent need to strengthen One Health surveillance, intervention, and management strategies to understand the ecology of coronaviruses and to prevent epidemics in the future. Global attention toward the development of treatments, immunotherapies, vaccines, and control options to combat the COVID-19 pandemic has been on an increasing trend. Here, we review the current epidemiological status, public health concerns, and mitigation strategies for COVID-19.}, } @article {pmid33113472, year = {2020}, author = {Rab, S and Afjal, and Javaid, M and Haleem, A and Vaishya, R}, title = {An update on the global vaccine development for coronavirus.}, journal = {Diabetes & metabolic syndrome}, volume = {14}, number = {6}, pages = {2053-2055}, pmid = {33113472}, issn = {1878-0334}, mesh = {Biomedical Research/methods/trends ; COVID-19/epidemiology/*prevention & control ; COVID-19 Vaccines/*therapeutic use ; Drug Development/methods/*trends ; Global Health/*trends ; Humans ; }, } @article {pmid33080582, year = {2020}, author = {Ricciardolo, FLM and Bertolini, F and Carriero, V and Högman, M}, title = {Nitric oxide's physiologic effects and potential as a therapeutic agent against COVID-19.}, journal = {Journal of breath research}, volume = {15}, number = {1}, pages = {014001}, doi = {10.1088/1752-7163/abc302}, pmid = {33080582}, issn = {1752-7163}, mesh = {Adult ; COVID-19/*metabolism/*therapy/virology ; Humans ; Nitric Oxide/*administration & dosage/*metabolism ; SARS-CoV-2/isolation & purification ; }, abstract = {The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for COVID-19 pneumonia, a pandemic that precipitates huge pressures on the world's social and economic systems. Disease severity varies among individuals. SARS-CoV-2 infection can be associated with e.g. flu-like symptoms, dyspnoea, severe interstitial pneumonia, acute respiratory distress syndrome, multiorgan dysfunction, and generalized coagulopathy. Nitric oxide (NO), is a small signal molecule that impacts pleiotropic functions in human physiology, which can be involved in the significant effects of COVID-19 infection. NO is a neurotransmitter involved in the neural olfactory processes in the central nervous system, and some infected patients have reported anosmia as a symptom. Additionally, NO is a well-known vasodilator, important coagulation mediator, anti-microbial effector and inhibitor of SARS-CoV replication. Exhaled NO is strongly related to the type-2 inflammatory response found in asthma, which has been suggested to be protective against SARS-CoV-2 infection. Several reports indicate that the use of inhaled NO has been an effective therapy during this pandemic since the ventilation-perfusion ratio in COVID-19 patients improved afterwards and they did not require mechanical ventilation. The aim of this mini-review is to summarize relevant actions of NO that could be beneficial in the treatment of COVID-19.}, } @article {pmid33032231, year = {2020}, author = {Pandey, S and Pathak, SK and Pandey, A and Salunke, AA and Chawla, J and Sharma, A and Sharma, S and Thivari, P and Ratna, HVK}, title = {Ivermectin in COVID-19: What do we know?.}, journal = {Diabetes & metabolic syndrome}, volume = {14}, number = {6}, pages = {1921-1922}, pmid = {33032231}, issn = {1878-0334}, mesh = {Animals ; Antiparasitic Agents/therapeutic use ; COVID-19/*drug therapy/epidemiology ; Clinical Trials as Topic/methods ; Humans ; Ivermectin/*therapeutic use ; SARS-CoV-2/*drug effects ; }, } @article {pmid32998093, year = {2020}, author = {Quispe Flores, MA and Concepción Zavaleta, MJ and Plasencia Dueñas, EA and Kcomt Lam, M}, title = {The COVID-19 pandemic in developing countries: A new opportunity to improve the monitoring of patients with diabetes mellitus.}, journal = {Diabetes & metabolic syndrome}, volume = {14}, number = {6}, pages = {1871-1872}, pmid = {32998093}, issn = {1878-0334}, mesh = {Blood Glucose Self-Monitoring/economics/*trends ; COVID-19/economics/*epidemiology ; *Developing Countries ; Diabetes Mellitus/blood/economics/*epidemiology ; Humans ; Pandemics ; Patient Education as Topic/economics/*trends ; Telemedicine/economics/*trends ; }, } @article {pmid32991235, year = {2020}, author = {Malik, YS and Ansari, MI and Ganesh, B and Sircar, S and Bhat, S and Pande, T and Vinodhkumar, OR and Kumar, P and Iqbal Yatoo, M and Tiwari, R and Touil, N and Patel, SK and Pathak, M and Sharun, K and Dhama, K}, title = {BCG vaccine: a hope to control COVID-19 pandemic amid crisis.}, journal = {Human vaccines & immunotherapeutics}, volume = {16}, number = {12}, pages = {2954-2962}, pmid = {32991235}, issn = {2164-554X}, mesh = {Adaptive Immunity/drug effects/immunology ; BCG Vaccine/immunology/pharmacology/*therapeutic use ; COVID-19/immunology/*prevention & control ; COVID-19 Vaccines/immunology/pharmacology/*therapeutic use ; Cross Reactions/drug effects/immunology ; Drug Repositioning/*methods ; Humans ; Pandemics ; Tuberculosis/immunology/prevention & control ; }, abstract = {COVID-19 caused by the virus SARS-CoV-2 has gripped essentially all countries in the world, and has infected millions and killed hundreds of thousands of people. Several innovative approaches are in development to restrain the spread of SARS-CoV-2. In particular, BCG, a vaccine against tuberculosis (TB), is being considered as an alternative therapeutic modality. BCG vaccine is known to induce both humoral and adaptive immunities, thereby activating both nonspecific and cross-reactive immune responses in the host, which combined could effectively resist other pathogens including SARS-CoV-2. Notably, some studies have revealed that SARS-CoV-2 infectivity, case positivity, and mortality rate have been higher in countries that have not adopted BCG vaccination than in countries that have done so. This review presents an overview of the concepts underlying BCG vaccination and its nonspecific immuological effects and protection, resulting in 'trained immunity' and potential utility for resisting COVID-19.}, } @article {pmid32962524, year = {2020}, author = {Gupta, A and Karki, R and Dandu, HR and Dhama, K and Bhatt, ML and Saxena, SK}, title = {COVID-19: benefits and risks of passive immunotherapeutics.}, journal = {Human vaccines & immunotherapeutics}, volume = {16}, number = {12}, pages = {2963-2972}, pmid = {32962524}, issn = {2164-554X}, mesh = {COVID-19/epidemiology/immunology/*therapy ; Humans ; Immunization, Passive/*methods/trends ; Risk Assessment/methods ; }, abstract = {Passive immunotherapeutics (PITs), including convalescent plasma, serum, or hyperimmune immunoglobulin, have been of clinical importance during sudden outbreaks since the early twentieth century for the treatment of viral diseases such as severe acute respiratory syndrome (SARS), middle east respiratory syndrome (MERS) and swine flu (H1N1). With the recent SARS-CoV-2 pandemic, wherein effective antivirals and vaccines are still lacking, an interest in convalescent plasma therapy as a lifesaving option has resurfaced due to its capacity for antigenic neutralization and reducing viremia. This review summarizes convalescent blood products (CBPs) in terms of current technologies and the shortcomings related to the collection, manufacture, pathogen inactivation, and banking of CBPs, with a specific focus on their plausible applications, benefits, and risks in the COVID-19 pandemic.}, } @article {pmid32931361, year = {2020}, author = {Mudgal, R and Nehul, S and Tomar, S}, title = {Prospects for mucosal vaccine: shutting the door on SARS-CoV-2.}, journal = {Human vaccines & immunotherapeutics}, volume = {16}, number = {12}, pages = {2921-2931}, pmid = {32931361}, issn = {2164-554X}, mesh = {Administration, Intranasal/methods ; Animals ; COVID-19/epidemiology/*immunology/*prevention & control ; COVID-19 Vaccines/*administration & dosage/*immunology ; Humans ; Nasal Mucosa/drug effects/*immunology ; Protein Structure, Secondary ; Protein Structure, Tertiary ; SARS-CoV-2/chemistry/drug effects/*immunology ; }, abstract = {The sudden emergence of a highly transmissible and pathogenic coronavirus SARS-CoV-2 in December 2019 from China and its rapid global spread has posed an international health emergency. The rapid development of an effective vaccine is imperative to control the spread of SARS-CoV-2. A number of concurrent efforts to find an effective therapeutic agent or vaccine for COVID-19 (coronavirus disease 2019) are being undertaken globally. Oral and nasal mucosal surfaces serve as the primary portal of entry for pathogens like coronaviruses in the human body. As evidenced by studies on similar coronaviruses (SARS-CoV and MERS-CoV), mucosal vaccination can provide a safe and effective means for the induction of long-lasting systemic and mucosal immunity to confer protection against SARS-CoV-2. This article summarizes the approaches to an effective mucosal vaccine formulation which can be a rewarding approach to combat the unprecedented threat posed by this emerging global pandemic.}, } @article {pmid32929506, year = {2021}, author = {Zong, X and Gu, Y and Yu, H and Li, Z and Wang, Y}, title = {Thrombocytopenia Is Associated with COVID-19 Severity and Outcome: An Updated Meta-Analysis of 5637 Patients with Multiple Outcomes.}, journal = {Laboratory medicine}, volume = {52}, number = {1}, pages = {10-15}, pmid = {32929506}, issn = {1943-7730}, mesh = {Blood Platelets/*pathology ; COVID-19/complications/diagnosis/mortality/*pathology ; Disease Progression ; Hospitalization/statistics & numerical data ; Humans ; Intensive Care Units ; Platelet Count ; Prognosis ; Respiratory Distress Syndrome/complications/diagnosis/mortality/*pathology ; SARS-CoV-2/*pathogenicity ; Severity of Illness Index ; Survival Analysis ; Thrombocytopenia/complications/diagnosis/mortality/*pathology ; }, abstract = {The COVID-19 pandemic is persistent worldwide. A prior meta-analysis suggested the association of thrombocytopenia (TCP) with more severe COVID-19 illness and high mortality. Considering newly published studies, we updated the previous meta-analysis to confirm and explain the association of TCP with COVID-19 severity and multiple outcomes. Twenty-four studies with 5637 patients with COVID-19 were included in this study. The weighted incidence of TCP in COVID-19 was 12.4% (95% confidence interval [CI], 7.9%-17.7%). Data synthesis showed that the platelet number was lower in patients with either more severe illness or poor outcomes and even lower in nonsurvivors, with weighted mean differences of -24.56 × 109/L, -22.48 × 109/L, and -49.02 × 109/L, respectively. The meta-analysis of binary outcomes (with and without TCP) indicated the association between TCP and 3-fold enhanced risk of a composite outcome of intensive care unit admission, progression to acute respiratory distress syndrome, and mortality (odds ratio [OR], 3.49; 95% CI, 1.57-7.78). Subgroup analysis by endpoint events suggested TCP to be significantly associated with mortality (OR, 7.37; 95% CI, 2.08-26.14). Overall, the present comprehensive meta-analysis indicated that approximately 12% of hospitalized patients with COVID-19 have TCP, which also represents a sign of more severe illness and poor outcomes.}, } @article {pmid32915656, year = {2021}, author = {Cirri, D and Pratesi, A and Marzo, T and Messori, L}, title = {Metallo therapeutics for COVID-19. Exploiting metal-based compounds for the discovery of new antiviral drugs.}, journal = {Expert opinion on drug discovery}, volume = {16}, number = {1}, pages = {39-46}, doi = {10.1080/17460441.2020.1819236}, pmid = {32915656}, issn = {1746-045X}, mesh = {Antiviral Agents/*chemistry/*therapeutic use ; COVID-19/*drug therapy ; *Drug Discovery ; Humans ; Organometallic Compounds/pharmacology/*therapeutic use ; SARS-CoV-2/*drug effects ; Small Molecule Libraries ; }, abstract = {INTRODUCTION: The COVID-19 pandemic poses an unprecedented challenge for the rapid discovery of drugs against this life-threatening disease. Owing to the peculiar features of the metal centers that are currently used in medicinal chemistry, metallodrugs might offer an excellent opportunity to achieve this goal.

AREAS COVERED: Two main strategies for developing metal-based drugs against the SARS-CoV-2 are herein illustrated. Firstly, a few clinically approved metallodrugs could be evaluated in patients according to a 'drug repurposing' approach. To this respect, the gold drug auranofin seems a promising candidate, but some other clinically established metal compounds are worthy of a careful evaluation as well. On the other hand, libraries of inorganic compounds, featuring a large chemical diversity, should be screened to identify the most effective molecules. This second strategy might be assisted by a pathway-driven discovery approach arising from a preliminary knowledge of the mode of action, exploitable to inhibit the functional activities of the key viral proteins. Also, attention must be paid to selectivity and toxicity issues.

EXPERT OPINION: The medicinal inorganic chemistry community may offer a valuable contribution against COVID-19. The screening of metallodrugs' libraries can expand the explored 'chemical space' and increase the chance of finding effective anti-COVID agents.}, } @article {pmid32915100, year = {2020}, author = {Sharun, K and Tiwari, R and Patel, SK and Karthik, K and Iqbal Yatoo, M and Malik, YS and Singh, KP and Panwar, PK and Harapan, H and Singh, RK and Dhama, K}, title = {Coronavirus disease 2019 (COVID-19) in domestic animals and wildlife: advances and prospects in the development of animal models for vaccine and therapeutic research.}, journal = {Human vaccines & immunotherapeutics}, volume = {16}, number = {12}, pages = {3043-3054}, doi = {10.1080/21645515.2020.1807802}, pmid = {32915100}, issn = {2164-554X}, mesh = {Animals ; Animals, Domestic/virology ; Animals, Wild/virology ; Biomedical Research/*trends ; COVID-19/*prevention & control/transmission ; COVID-19 Vaccines/*therapeutic use ; *Disease Models, Animal ; Humans ; Zoonoses/*prevention & control/transmission ; }, abstract = {SARS-CoV-2, which causes coronavirus disease 2019 (COVID-19), is suspected to have been first contracted via animal-human interactions; it has further spread across the world by efficient human-to-human transmission. Recent reports of COVID-19 in companion animals (dogs and cats) and wild carnivores such as tigers have created a dilemma regarding its zoonotic transmission. Although in silico docking studies, sequence-based computational studies, and experimental studies have shown the possibility of SARS-CoV-2 infection and transmission in cats, ferrets, and other domestic/wild animals, the results are not conclusive of infection under natural conditions. Identifying the potential host range of SARS-CoV-2 will not only help prevent the possibility of human-to-animal and animal-to-human transmission but also assist in identifying efficient animal models that can mimic the clinical symptoms, transmission potential, and pathogenesis of the disease. Such an efficient animal model will accelerate the process of development and evaluation of vaccines, immunotherapeutics, and other remedies for SARS-CoV-2.}, } @article {pmid32914668, year = {2021}, author = {Gorenko, JA and Moran, C and Flynn, M and Dobson, K and Konnert, C}, title = {Social Isolation and Psychological Distress Among Older Adults Related to COVID-19: A Narrative Review of Remotely-Delivered Interventions and Recommendations.}, journal = {Journal of applied gerontology : the official journal of the Southern Gerontological Society}, volume = {40}, number = {1}, pages = {3-13}, doi = {10.1177/0733464820958550}, pmid = {32914668}, issn = {1552-4523}, mesh = {Aged ; Anxiety/etiology/therapy ; Assisted Living Facilities ; Attitude to Computers ; COVID-19/*psychology ; Cognitive Behavioral Therapy/methods ; Delivery of Health Care/*methods ; Depression/etiology/therapy ; Humans ; Independent Living ; Loneliness/psychology ; Nursing Homes ; Physical Distancing ; Privacy ; *Psychological Distress ; SARS-CoV-2 ; Social Isolation/*psychology ; Social Media ; *Telecommunications ; }, abstract = {The COVID-19 pandemic is associated with several short- and long-term negative impacts on the well-being of older adults. Physical distancing recommendations to reduce transmission of the SARS-CoV2-19 virus increase the risk of social isolation and loneliness, which are associated with negative outcomes including anxiety, depression, cognitive decline, and mortality. Taken together, social isolation and additional psychological impacts of the pandemic (e.g., worry, grief) underscore the importance of intervention efforts to older adults. This narrative review draws upon a wide range of evidence to provide a comprehensive overview of appropriate remotely-delivered interventions for older adults that target loneliness and psychological symptoms. These include interventions delivered by a range of individuals (i.e., community members to mental health professionals), and interventions that vary by implementation (e.g., self-guided therapy, remotely-delivered interventions via telephone or video call). Recommendations to overcome barriers to implementation and delivery are provided, with consideration given to the different living situations.}, } @article {pmid32910007, year = {2021}, author = {Burk-Rafel, J and Standiford, TC}, title = {A Novel Ticket System for Capping Residency Interview Numbers: Reimagining Interviews in the COVID-19 Era.}, journal = {Academic medicine : journal of the Association of American Medical Colleges}, volume = {96}, number = {1}, pages = {50-55}, pmid = {32910007}, issn = {1938-808X}, mesh = {COVID-19/*epidemiology ; Education, Medical, Graduate/*methods ; Humans ; Internship and Residency/*organization & administration ; *Pandemics ; *Personnel Selection ; Students, Medical/*statistics & numerical data ; }, abstract = {The 2019 novel coronavirus (COVID-19) pandemic has led to dramatic changes in the 2020 residency application cycle, including halting away rotations and delaying the application timeline. These stressors are laid on top of a resident selection process already under duress with exploding application and interview numbers-the latter likely to be exacerbated with the widespread shift to virtual interviewing. Leveraging their trainee perspective, the authors propose enforcing a cap on the number of interviews that applicants may attend through a novel interview ticket system (ITS). Specialties electing to participate in the ITS would select an evidence-based, specialty-specific interview cap. Applicants would then receive unique electronic tickets-equal in number to the cap-that would be given to participating programs at the time of an interview, when the tickets would be marked as used. The system would be self-enforcing and would ensure each interview represents genuine interest between applicant and program, while potentially increasing the number of interviews-and thus match rate-for less competitive applicants. Limitations of the ITS and alternative approaches for interview capping, including an honor code system, are also discussed. Finally, in the context of capped interview numbers, the authors emphasize the need for transparent preinterview data from programs to inform applicants and their advisors on which interviews to attend, learning from prior experiences and studies on virtual interviewing, adherence to best practices for interviewing, and careful consideration of how virtual interviews may shift inequities in the resident selection process.}, } @article {pmid32900341, year = {2021}, author = {Borah, P and Deb, PK and Deka, S and Venugopala, KN and Singh, V and Mailavaram, RP and Kalia, K and Tekade, RK}, title = {Current Scenario and Future Prospect in the Management of COVID-19.}, journal = {Current medicinal chemistry}, volume = {28}, number = {2}, pages = {284-307}, doi = {10.2174/0929867327666200908113642}, pmid = {32900341}, issn = {1875-533X}, mesh = {Antiviral Agents/*therapeutic use ; COVID-19/*drug therapy/therapy ; COVID-19 Vaccines ; Clinical Trials as Topic ; Humans ; Immunization, Passive ; Immunologic Factors/therapeutic use ; Medicine, Traditional ; Pandemics ; }, abstract = {The COVID-19 pandemic continues to wreak havoc worldwide due to the lack of risk assessment, rapid spreading ability, and propensity to precipitate severe disease in comorbid conditions. In an attempt to fulfill the demand for prophylactic and treatment measures to intercept the ongoing outbreak, the drug development process is facing several obstacles and renaissance in clinical trials, including vaccines, antivirals, immunomodulators, plasma therapy, and traditional medicines. This review outlines the overview of SARS-CoV-2 infection, significant recent findings, and ongoing clinical trials concerning current and future therapeutic interventions for the management of advancing pandemic of the century.}, } @article {pmid32896795, year = {2020}, author = {Singh, AK and Singh, R}, title = {At-admission hyperglycemia is consistently associated with poor prognosis and early intervention can improve outcomes in patients with COVID-19.}, journal = {Diabetes & metabolic syndrome}, volume = {14}, number = {6}, pages = {1641-1644}, pmid = {32896795}, issn = {1878-0334}, mesh = {Blood Glucose/*metabolism ; COVID-19/blood/*diagnosis/epidemiology ; Early Medical Intervention/methods/*trends ; Humans ; Hyperglycemia/blood/*diagnosis/epidemiology ; Patient Admission/*trends ; Prognosis ; Risk Factors ; Treatment Outcome ; }, abstract = {BACKGROUND & AIMS: At-admission hyperglycemia have been associated with poorer outcome during critical illnesses. At-admission hyperglycemia in previously unknown diabetes is not uncommonly encountered entity in patients with COVID-19. We sought to find out the outcomes of at-admission hyperglycemia and effect of early intervention to achieve optimal glycemic control in relation to COVID-19 patients.

METHODS: We searched the PubMed and Google Scholar database up till August 20, 2020 using specific keywords related to our aims and objectives.

RESULTS: All currently available evidences clearly hint that at-admission hyperglycemia in patients with COVID-19 is associated with a poorer outcome, compared with normoglycemic individuals. Fortunately, early intervention by achieving an optimal glycemic control has also been associated with a significant improvement in the outcomes in patients with COVID-19.

CONCLUSION: At-admission hyperglycemia should be taken seriously by all clinicians treating patients with COVID-19. All efforts should be made towards an optimal glycemic control in patients with COVID-19, even in absence of pre-existing diabetes.}, } @article {pmid32893468, year = {2020}, author = {Brüssow, H}, title = {Efforts towards a COVID-19 vaccine.}, journal = {Environmental microbiology}, volume = {22}, number = {10}, pages = {4071-4084}, doi = {10.1111/1462-2920.15225}, pmid = {32893468}, issn = {1462-2920}, mesh = {COVID-19/*prevention & control ; COVID-19 Vaccines/*immunology ; Humans ; SARS-CoV-2/*immunology ; Time Factors ; Vaccines, Inactivated/immunology ; Viral Vaccines/immunology ; World Health Organization ; }, abstract = {To many scientists and political authorities, the development of a vaccine against Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) will be the way to restore normality to civil life in this time of a devastating pandemic. Expectations for a vaccine are high while the case numbers continue to rise. As of mid-August 2020, more than 20 million people have been infected and more than 760 000 lives have been lost worldwide. The threat of this virus to health, the economy and to society is so great that the wish for a fast track vaccine is understandable, but how realistic is it? This survey article tries to give an overview of vaccine candidates in development, including preclinical and clinical testing, and it mentions some of the societal problems of vaccine acceptance.}, } @article {pmid32892060, year = {2020}, author = {Mbunge, E}, title = {Integrating emerging technologies into COVID-19 contact tracing: Opportunities, challenges and pitfalls.}, journal = {Diabetes & metabolic syndrome}, volume = {14}, number = {6}, pages = {1631-1636}, doi = {10.1016/j.dsx.2020.08.029}, pmid = {32892060}, issn = {1878-0334}, mesh = {Artificial Intelligence/trends ; Biomedical Technology/methods/*trends ; COVID-19/diagnosis/*epidemiology/*prevention & control ; Contact Tracing/methods/*trends ; Geographic Information Systems/trends ; Humans ; }, abstract = {BACKGROUND AND AIMS: With no approved vaccines for treating COVID-19 as of August 2020, many health systems and governments rely on contact tracing as one of the prevention and containment methods. However, there have been instances when the infected person forgets his/her contact-persons and does not have their contact details. Therefore, this study aimed at analyzing possible opportunities and challenges of integrating emerging technologies into COVID-19 contact tracing.

METHODS: The study applied literature search from Google Scholar, Science Direct, PubMed, Web of Science, IEEE and WHO COVID-19 reports and guidelines analyzed.

RESULTS: While the integration of technology-based contact tracing applications to combat COVID-19 and break transmission chains promise to yield better results, these technologies face challenges such as technical limitations, dealing with asymptomatic individuals, lack of supporting ICT infrastructure and electronic health policy, socio-economic inequalities, deactivation of mobile devices' WIFI, GPS services, interoperability and standardization issues, security risks, privacy issues, political and structural responses, ethical and legal risks, consent and voluntariness, abuse of contact tracing apps, and discrimination.

CONCLUSION: Integrating emerging technologies into COVID-19 contact tracing is seen as a viable option that policymakers, health practitioners and IT technocrats need to seriously consider in mitigating the spread of coronavirus. Further research is also required on how best to improve efficiency and effectiveness in the utilisation of emerging technologies in contact tracing while observing the security and privacy of people in fighting the COVID-19 pandemic.}, } @article {pmid32891525, year = {2021}, author = {Varikasuvu, SR and Dutt, N and Thangappazham, B and Varshney, S}, title = {Diabetes and COVID-19: A pooled analysis related to disease severity and mortality.}, journal = {Primary care diabetes}, volume = {15}, number = {1}, pages = {24-27}, pmid = {32891525}, issn = {1878-0210}, mesh = {COVID-19/*epidemiology ; Comorbidity ; Diabetes Mellitus/diagnosis/*epidemiology ; Global Health ; Humans ; *Pandemics ; SARS-CoV-2 ; Severity of Illness Index ; Survival Rate/trends ; }, abstract = {Globally, COVID-19 has become a major concern for the diabetic community. We conducted a pooled analysis and constructed a forest plot for the association between diabetes and COVID-19 progression in 47 studies. A random effects meta-analysis (Mantel-Haenszel method) was conducted to estimate the outcomes effect size as odds ratios (OR) and 95% confidence intervals (CI) using Review Manager Software version 5.3. COVID-19 patients with diabetes have a significantly higher risk of disease severity (OR=2.20, 95% CI=1.69-2.86, p<0.00001) and associated mortality outcomes (OR=2.52, 95% CI=1.93-3.30, p=<0.00001).}, } @article {pmid32891011, year = {2020}, author = {Singh, AK and Misra, A}, title = {Impact of COVID-19 and comorbidities on health and economics: Focus on developing countries and India.}, journal = {Diabetes & metabolic syndrome}, volume = {14}, number = {6}, pages = {1625-1630}, pmid = {32891011}, issn = {1878-0334}, mesh = {COVID-19/*economics/*epidemiology ; Comorbidity ; *Cost of Illness ; Developing Countries/*economics ; Diabetes Mellitus/economics/epidemiology ; *Health Status ; Humans ; India/epidemiology ; }, abstract = {BACKGROUND AND AIMS: Presence of comorbidities in patients with Coronavirus disease 2019 (COVID-19) have often been associated with increased in-hospital complications and mortality. Intriguingly, several developed countries with a higher quality of life have relatively higher mortality with COVID-19, compared to the middle- or low-income countries. Moreover, certain ethnic groups have shown a higher predilection to contract COVID-19, with heightened mortality. We sought to review the available literature with regards to impact of COVID-19 and comorbidities on the health and economics, especially in context to the developing countries including India.

METHODS: A Boolean search was carried out in PubMed, MedRxiv and Google Scholar databases up till August 23, 2020 using the specific keywords, to find the prevalence of comorbidities and its outcome in patients with COVID-19.

RESULTS: All available evidence consistently suggests that presence of comorbidities is associated with a poor outcome in patients with COVID-19. Diabetes prevalence is highest in Indian COVID-19 patients, compared to other countries. Majority of the patients with COVID-19 are asymptomatic ranging from 26 to 76%.

CONCLUSIONS: Universal masking is the need of hour during unlock period. Low-income countries such as India, Brazil and Africa with less resources and an average socio-economic background, must adopt a strict policy for an affordable testing programs to trace, test, identify and home quarantine of asymptomatic cases. Despite the huge number of COVID-19 patients, India still has low volume research at the moment.}, } @article {pmid32889947, year = {2021}, author = {Thakur, A and Soklaridis, S and Crawford, A and Mulsant, B and Sockalingam, S}, title = {Using Rapid Design Thinking to Overcome COVID-19 Challenges in Medical Education.}, journal = {Academic medicine : journal of the Association of American Medical Colleges}, volume = {96}, number = {1}, pages = {56-61}, pmid = {32889947}, issn = {1938-808X}, mesh = {COVID-19/*epidemiology ; *Curriculum ; Education, Distance/*methods ; Education, Medical/*organization & administration ; Humans ; Learning ; *Pandemics ; SARS-CoV-2 ; }, abstract = {The rapid rise of cases of coronavirus disease 2019 (COVID-19) has led to the implementation of public health measures on an unprecedented scale. These measures have significantly affected the training environment and the mental health of health care providers and learners. Design thinking offers creative and innovative solutions to emergent complex problems, including those related to training and patient care that have arisen as a result of the COVID-19 pandemic. Design thinking can accelerate the development and implementation of solution prototypes through a process of inspiration, ideation, and implementation. Digital technology can be leveraged as part of this process to provide care and education in new or enhanced ways. Online knowledge hubs, videoconference-based interactive sessions, virtual simulations, and technology-enhanced coaching for health care providers are potential solutions to address identified issues. Limitations of this model include inherent bias toward utilitarian instead of egalitarian principles and the subsequent threat to diversity, equity, and inclusion in solutions. Although medical educators have embraced digital transformation during the COVID-19 pandemic, there is a need to ensure that these changes are sustained.}, } @article {pmid32881641, year = {2020}, author = {Al-Tawfiq, JA and Arabi, Y}, title = {Convalescent plasma therapy for coronavirus infection: experience from MERS and application in COVID-19.}, journal = {Human vaccines & immunotherapeutics}, volume = {16}, number = {12}, pages = {2973-2979}, doi = {10.1080/21645515.2020.1793712}, pmid = {32881641}, issn = {2164-554X}, mesh = {Antibodies, Viral/immunology ; COVID-19/epidemiology/immunology/*therapy ; Coronavirus Infections/epidemiology/immunology/*therapy ; Humans ; Immunization, Passive ; Randomized Controlled Trials as Topic/methods ; }, abstract = {The emergence of the COVID-19 pandemic has resulted in a very large number of infections and high number of mortality. There is no specific therapeutic options that are approved for clinical use. Administration of convalescent plasma as a possible therapy was used in the case of viral pneumonia including SARS and influenza. There have been multiple studies of COVID-19 patients utilizing convalescent plasma. These studies employed different dosage levels and different regiments, were observational and lacked control arms, and had variable outcomes. Two of these studies used plasma with anti-SARS-CoV-2 titers of >1:640 to >1:1000. A recent randomized controlled clinical trial showed no benefit of convalescent plasma in patients with severe diseases. However, the study was terminated early and thus further clinical trials are needed to show efficacy in patients with COVID-19 infection.}, } @article {pmid33445176, year = {2021}, author = {Topf, JM and Williams, PN}, title = {COVID-19, Social Media, and the Role of the Public Physician.}, journal = {Blood purification}, volume = {}, number = {}, pages = {1-7}, doi = {10.1159/000512707}, pmid = {33445176}, issn = {1421-9735}, abstract = {The COVID-19 pandemic has resulted in an avalanche of information, much of it false or misleading. Social media posts with misleading or dangerous opinions and analyses are often amplified by celebrities and social media influencers; these posts have contributed substantially to this avalanche of information. An emerging force in this information infodemic is public physicians, doctors who view a public presence as a large segment of their mission. These physicians bring authority and real-world experience to the COVID-19 discussion. To investigate the role of public physicians, we interviewed a convenience cohort of physicians who have played a role in the infodemic. We asked the physicians about how their roles have changed, how their audience has changed, what role politics plays, and how they address misinformation. The physicians noted increased audience size with an increased focus on the pandemic. Most avoided confronting politics, but others found it unavoidable or that even if they tried to avoide it, it would be brought up by their audience. The physicians felt that confronting and correcting misinformation was a core part of their mission. Public physicians on social media are a new occurrence and are an important part of fighting online misinformation.}, } @article {pmid33445036, year = {2021}, author = {Santos, REA and da Silva, MG and do Monte Silva, MCB and Barbosa, DAM and Gomes, ALDV and Galindo, LCM and da Silva Aragão, R and Ferraz-Pereira, KN}, title = {Onset and duration of symptoms of loss of smell/taste in patients with COVID-19: A systematic review.}, journal = {American journal of otolaryngology}, volume = {42}, number = {2}, pages = {102889}, doi = {10.1016/j.amjoto.2020.102889}, pmid = {33445036}, issn = {1532-818X}, abstract = {OBJECTIVE: The aim of the study was to conduct a systematic review of the literature to investigate the time of onset and duration of symptoms of loss of smell and taste in patients diagnosed with COVID-19.

METHODS: Two independent authors performed a systematic review of the Medline/PubMed, SCOPUS, COCHRANE, Lilacs and Web of Science electronic databases. The time of onset and duration of symptoms were considered primary outcomes. The sex and age of individuals, the geographical location of the study, the prevalence of symptoms, other associated symptoms, associated comorbidities, and the impact on quality of life and eating habits were considered secondary outcomes.

RESULTS: Our search generated 17 articles. Many of the studies reported that the onset of anosmia and ageusia occurred 4 to 5 days after the manifestation of other symptoms of the infection and that these symptoms started to disappear after one week, with more significant improvements in the first two weeks.

CONCLUSION: The present study concludes that the onset of symptoms of loss of smell and taste, associated with COVID-19, occurs 4 to 5 days after other symptoms, and that these symptoms last from 7 to 14 days. Findings, however, varied and there is therefore a need for further studies to clarify the occurrence of these symptoms. This would help to provide early diagnosis and reduce contagion by the virus.}, } @article {pmid33444992, year = {2021}, author = {Hashemi-Madani, N and Emami, Z and Janani, L and Khamseh, ME}, title = {Typical chest CT features can determine the severity of COVID-19: A systematic review and meta-analysis of the observational studies.}, journal = {Clinical imaging}, volume = {74}, number = {}, pages = {67-75}, doi = {10.1016/j.clinimag.2020.12.037}, pmid = {33444992}, issn = {1873-4499}, abstract = {BACKGROUND: It remains unclear whether a specific chest CT characteristic is associated with the clinical severity of COVID-19. This meta-analysis was performed to assess the relationship between different chest CT features and severity of clinical presentation in COVID-19.

METHODS: PubMed, Embase, Scopus, web of science databases (WOS), Cochrane library, and Google scholar were searched up to May 19, 2020 for observational studies that assessed the relationship of different chest CT manifestations and the severity of clinical presentation in COVID-19 infection. Risk of bias assessment was evaluated applying the Newcastle-Ottawa Scale. A random-effects model or fixed-effects model, as appropriately, were used to pool results. Heterogeneity was assessed using Forest plot, Cochran's Q test, and I2. Publication bias was assessed applying Egger's test.

RESULTS: A total of 18 studies involving 3323 patients were included. Bronchial wall thickening (OR 11.64, 95% CI 1.81-74.66) was more likely to be associated with severe cases of COVID-19 infection, followed by crazy paving (OR 7.60, 95% CI 3.82-15.14), linear opacity (OR 3.27, 95% CI 1.10-9.70), and GGO (OR 1.37, 95% CI 1.08-1.73). However, there was no significant association between the presence of consolidation and severity of clinical presentation (OR 2.33, 95% CI 0.85-6.36). Considering the lesion distribution bilateral lung involvement was more frequently associated with severe clinical presentation (OR 3.44, 95% CI 1.74-6.79).

CONCLUSIONS: Our meta-analysis of observational studies indicates some specific chest CT features are associated with clinical severity of COVID-19.}, } @article {pmid33444873, year = {2021}, author = {Sohrabi, C and Mathew, G and Franchi, T and Kerwan, A and Griffin, M and Soleil C Del Mundo, J and Ali, SA and Agha, M and Agha, R}, title = {Impact of the coronavirus (COVID-19) pandemic on scientific research and implications for clinical academic training - a review.}, journal = {International journal of surgery (London, England)}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.ijsu.2020.12.008}, pmid = {33444873}, issn = {1743-9159}, abstract = {A pneumonia outbreak of unknown aetiology emerged in Wuhan, China in December 2019. The causative organism was identified on the 7th of January 2020 as a novel coronavirus (nCoV or 2019-nCoV), later renamed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The resulting coronavirus (COVID-19) disease has infected over 37 57.8 million individuals, resulted in over 1 1.3 million deaths, and has led to an unprecedented impact on research activities worldwide. Extraordinary challenges have also been imposed upon medical and surgical trainees following re-deployment to full-time clinical duties. Moreover, the introduction of travel restrictions and strict lockdown measures have forced the closure of many institutions and laboratories working on research unrelated to the pandemic. The lockdown has similarly stifled supply chains and slowed research and development endeavours, whilst research charities have endured significant financial strains that have since reshaped the allocation and availability of funds. Worldwide scientific adaptation to the COVID-19 pandemic has also been observed through unprecedented levels of international collaboration as well as the uprise of remote telecommunication platforms. Although the long-term consequence of the COVID-19 pandemic on research and academic training is difficult to ascertain, the current crises will inevitably shape working and teaching patterns for years to come. To this end, we provide a comprehensive and critical evaluation of the impact of COVID-19 on scientific research and funding, as well as academic medical and surgical training.}, } @article {pmid33444755, year = {2021}, author = {Chen, C and Zhu, C and Yan, D and Liu, H and Li, D and Zhou, Y and Fu, X and Wu, J and Ding, C and Tian, G and Lan, L and Liu, X and Huang, C and Hecht, R and Li, L and Yang, S}, title = {The epidemiological and radiographical characteristics of asymptomatic infections with the novel coronavirus (COVID-19): A systematic review and meta-analysis.}, journal = {International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.ijid.2021.01.017}, pmid = {33444755}, issn = {1878-3511}, abstract = {OBJECTIVES: The role of asymptomatic infections in the transmission of COVID-19 have drawn considerable attention. Here, we performed a meta-analysis to summarize the epidemiological and radiographical characteristics of asymptomatic infections with COVID-19.

METHODS: Data on the epidemiological and radiographical characteristics of asymptomatic infections were extracted. Pooled proportions with 95% confidence intervals were calculated using a random effects model.

RESULTS: A total of 104 studies involving 20,152 cases were included. The proportion of asymptomatic individuals among those with COVID-19 was 13.34% (10.86%-16.29%), among which the presymptomatic and covert infections were 7.64% (4.02%-14.04%) and 8.44% (5.12%-13.62%), respectively. The proportions of asymptomatic infections among infected children and healthcare workers were 32.24% (23.08%-42.13%) and 36.96% (18.51%-60.21%), respectively. The proportion of asymptomatic infections was significantly higher after 2020/02/29 than before (33.53% vs 10.19%) and in non-Asian regions than in Asia (28.76% vs 11.54%). The median viral shedding duration of asymptomatic infections was 14.14 days (11.25-17.04). A total of 47.62% (31.13%-72.87%) of asymptomatic infections showed lung abnormalities, especially ground-glass opacity 41.11% (19.7%-85.79%).

CONCLUSIONS: Asymptomatic infections were more often found in infected children and healthcare workers, and they increased after 2020/02/29 and in non-Asian regions. Chest radiographical imaging could be conducive to early identification of asymptomatic infections.}, } @article {pmid33443816, year = {2021}, author = {Zhu, H and Zhang, L and Ma, Y and Zhai, M and Xia, L and Liu, J and Yu, S and Duan, W}, title = {The role of SARS-CoV-2 target ACE2 in cardiovascular diseases.}, journal = {Journal of cellular and molecular medicine}, volume = {}, number = {}, pages = {}, doi = {10.1111/jcmm.16239}, pmid = {33443816}, issn = {1582-4934}, support = {2016YFC1301900//National Key Research and Development Program of China/ ; 81570230//National Natural Science Foundation of China/ ; 81870218//National Natural Science Foundation of China/ ; }, abstract = {SARS-CoV-2, the virus responsible for the global coronavirus disease (COVID-19) pandemic, attacks multiple organs of the human body by binding to angiotensin-converting enzyme 2 (ACE2) to enter cells. More than 20 million people have already been infected by the virus. ACE2 is not only a functional receptor of COVID-19 but also an important endogenous antagonist of the renin-angiotensin system (RAS). A large number of studies have shown that ACE2 can reverse myocardial injury in various cardiovascular diseases (CVDs) as well as is exert anti-inflammatory, antioxidant, anti-apoptotic and anticardiomyocyte fibrosis effects by regulating transforming growth factor beta, mitogen-activated protein kinases, calcium ions in cells and other major pathways. The ACE2/angiotensin-(1-7)/Mas receptor axis plays a decisive role in the cardiovascular system to combat the negative effects of the ACE/angiotensin II/angiotensin II type 1 receptor axis. However, the underlying mechanism of ACE2 in cardiac protection remains unclear. Some approaches for enhancing ACE2 expression in CVDs have been suggested, which may provide targets for the development of novel clinical therapies. In this review, we aimed to identify and summarize the role of ACE2 in CVDs.}, } @article {pmid33443121, year = {2020}, author = {Chaudhry, F and Lavandero, S and Xie, X and Sabharwal, B and Zheng, YY and Correa, A and Narula, J and Levy, P}, title = {Manipulation of ACE2 expression in COVID-19.}, journal = {Open heart}, volume = {7}, number = {2}, pages = {}, doi = {10.1136/openhrt-2020-001424}, pmid = {33443121}, issn = {2053-3624}, abstract = {SARS-CoV-2 is the virus responsible for the ongoing COVID-19 outbreak. The virus uses ACE2 receptor for viral entry. ACE2 is part of the counter-regulatory renin-angiotensin-aldosterone system and is also expressed in the lower respiratory tract along the alveolar epithelium. There is, however, significant controversy regarding the role of ACE2 expression in COVID-19 pathogenesis. Some have argued that decreasing ACE2 expression would result in decreased susceptibility to the virus by decreasing available binding sites for SARS-CoV-2 and restricting viral entry into the cells. Others have argued that, like the pathogenesis of other viral pneumonias, including those stemming from previous severe acute respiratory syndrome (SARS) viruses, once SARS-CoV-2 binds to ACE2, it downregulates ACE2 expression. Lack of the favourable effects of ACE2 might exaggerate lung injury by a variety of mechanisms. In order to help address this controversy, we conducted a literature search and review of relevant preclinical and clinical publications pertaining to SARS-CoV-2, COVID-19, ACE2, viral pneumonia, SARS, acute respiratory distress syndrome and lung injury. Our review suggests, although controversial, that patients at increased susceptibility to COVID-19 complications may have reduced baseline ACE2, and by modulating ACE2 expression one can possibly improve COVID-19 outcomes. Herein, we elucidate why and how this potential mechanism might work.}, } @article {pmid33443108, year = {2020}, author = {Song, SJ}, title = {Protecting the Global Mental Health of Forcibly Displaced Children From the COVID-19 Pandemic.}, journal = {Pediatrics}, volume = {}, number = {}, pages = {}, doi = {10.1542/peds.2020-025346}, pmid = {33443108}, issn = {1098-4275}, } @article {pmid33442894, year = {2021}, author = {Awad, WI and Bashir, M}, title = {Mechanical circulatory support-Challenges, strategies, and preparations.}, journal = {Journal of cardiac surgery}, volume = {}, number = {}, pages = {}, doi = {10.1111/jocs.15301}, pmid = {33442894}, issn = {1540-8191}, abstract = {BACKGROUND: Coronavirus disease 2019 (COVID-19) is usually mild, but patients can present with pneumonia, acute respiratory distress syndrome (ARDS), and circulatory shock. Although the symptoms of the disease are predominantly respiratory, the involvement of the cardiovascular system is common. Patients with heart failure (HF) are particularly vulnerable when suffering from COVID-19.

AIM OF THE REVIEW: To examine the challenges faced by healthcare organizations, and mechanical circulatory support management strategies available to patients with heart failure, during the COVID-19 pandemic.

RESULTS: Extracorporeal membrane oxygenation (ECMO) can be lifesaving in patients with severe forms of ARDS, or refractory cardio-circulatory compromise. The Impella RP can provide right ventricular circulatory support for patients who develop right side ventricular failure or decompensation caused by COVID-19 complications, including pulmonary embolus. HT are reserved for only those patients with a high short-term mortality. LVAD as a bridge to transplant may be a viable strategy to get at-risk patients home quickly. Elective LVAD implantations have been reduced and only patients classified as INTERMACS profile 1 and 2 are being considered for LVAD implantation. Delayed recognition of LVAD-related complications, misdiagnosis of COVID-19, and impaired social and psychological well-being for patients and families may ensue. Remote patient care with virtual or telephone contacts is becoming the norm.

CONCLUSIONS: HF incidence, prevalence, and undertreatment will grow as a result of new COVID-19-related heart disease. ECMO should be reserved for highly selected cases of COVID-19 with a reasonable probability of recovery. Special considerations are needed for patients with advanced HF, including those supported by durable LVADs.}, } @article {pmid33442579, year = {2020}, author = {Stephenson, D and Alexander, R and Aggarwal, V and Badawy, R and Bain, L and Bhatnagar, R and Bloem, BR and Boroojerdi, B and Burton, J and Cedarbaum, JM and Cosman, J and Dexter, DT and Dockendorf, M and Dorsey, ER and Dowling, AV and Evers, LJW and Fisher, K and Frasier, M and Garcia-Gancedo, L and Goldsack, JC and Hill, D and Hitchcock, J and Hu, MT and Lawton, MP and Lee, SJ and Lindemann, M and Marek, K and Mehrotra, N and Meinders, MJ and Minchik, M and Oliva, L and Romero, K and Roussos, G and Rubens, R and Sadar, S and Scheeren, J and Sengoku, E and Simuni, T and Stebbins, G and Taylor, KI and Yang, B and Zach, N}, title = {Precompetitive Consensus Building to Facilitate the Use of Digital Health Technologies to Support Parkinson Disease Drug Development through Regulatory Science.}, journal = {Digital biomarkers}, volume = {4}, number = {Suppl 1}, pages = {28-49}, doi = {10.1159/000512500}, pmid = {33442579}, issn = {2504-110X}, abstract = {Innovative tools are urgently needed to accelerate the evaluation and subsequent approval of novel treatments that may slow, halt, or reverse the relentless progression of Parkinson disease (PD). Therapies that intervene early in the disease continuum are a priority for the many candidates in the drug development pipeline. There is a paucity of sensitive and objective, yet clinically interpretable, measures that can capture meaningful aspects of the disease. This poses a major challenge for the development of new therapies and is compounded by the considerable heterogeneity in clinical manifestations across patients and the fluctuating nature of many signs and symptoms of PD. Digital health technologies (DHT), such as smartphone applications, wearable sensors, and digital diaries, have the potential to address many of these gaps by enabling the objective, remote, and frequent measurement of PD signs and symptoms in natural living environments. The current climate of the COVID-19 pandemic creates a heightened sense of urgency for effective implementation of such strategies. In order for these technologies to be adopted in drug development studies, a regulatory-aligned consensus on best practices in implementing appropriate technologies, including the collection, processing, and interpretation of digital sensor data, is required. A growing number of collaborative initiatives are being launched to identify effective ways to advance the use of DHT in PD clinical trials. The Critical Path for Parkinson's Consortium of the Critical Path Institute is highlighted as a case example where stakeholders collectively engaged regulatory agencies on the effective use of DHT in PD clinical trials. Global regulatory agencies, including the US Food and Drug Administration and the European Medicines Agency, are encouraging the efficiencies of data-driven engagements through multistakeholder consortia. To this end, we review how the advancement of DHT can be most effectively achieved by aligning knowledge, expertise, and data sharing in ways that maximize efficiencies.}, } @article {pmid33442578, year = {2020}, author = {Rochester, L and Mazzà, C and Mueller, A and Caulfield, B and McCarthy, M and Becker, C and Miller, R and Piraino, P and Viceconti, M and Dartee, WP and Garcia-Aymerich, J and Aydemir, AA and Vereijken, B and Arnera, V and Ammour, N and Jackson, M and Hache, T and Roubenoff, R}, title = {A Roadmap to Inform Development, Validation and Approval of Digital Mobility Outcomes: The Mobilise-D Approach.}, journal = {Digital biomarkers}, volume = {4}, number = {Suppl 1}, pages = {13-27}, doi = {10.1159/000512513}, pmid = {33442578}, issn = {2504-110X}, abstract = {Health care has had to adapt rapidly to COVID-19, and this in turn has highlighted a pressing need for tools to facilitate remote visits and monitoring. Digital health technology, including body-worn devices, offers a solution using digital outcomes to measure and monitor disease status and provide outcomes meaningful to both patients and health care professionals. Remote monitoring of physical mobility is a prime example, because mobility is among the most advanced modalities that can be assessed digitally and remotely. Loss of mobility is also an important feature of many health conditions, providing a read-out of health as well as a target for intervention. Real-world, continuous digital measures of mobility (digital mobility outcomes or DMOs) provide an opportunity for novel insights into health care conditions complementing existing mobility measures. Accepted and approved DMOs are not yet widely available. The need for large collaborative efforts to tackle the critical steps to adoption is widely recognised. Mobilise-D is an example. It is a multidisciplinary consortium of 34 institutions from academia and industry funded through the European Innovative Medicines Initiative 2 Joint Undertaking. Members of Mobilise-D are collaborating to address the critical steps for DMOs to be adopted in clinical trials and ultimately health care. To achieve this, the consortium has developed a roadmap to inform the development, validation and approval of DMOs in Parkinson's disease, multiple sclerosis, chronic obstructive pulmonary disease and recovery from proximal femoral fracture. Here we aim to describe the proposed approach and provide a high-level view of the ongoing and planned work of the Mobilise-D consortium. Ultimately, Mobilise-D aims to stimulate widespread adoption of DMOs through the provision of device agnostic software, standards and robust validation in order to bring digital outcomes from concept to use in clinical trials and health care.}, } @article {pmid33442555, year = {2021}, author = {Gundlapalli, AV and Salerno, RM and Brooks, JT and Averhoff, F and Petersen, LR and McDonald, LC and Iademarco, MF and , }, title = {SARS-CoV-2 Serologic Assay Needs for the Next Phase of the US COVID-19 Pandemic Response.}, journal = {Open forum infectious diseases}, volume = {8}, number = {1}, pages = {ofaa555}, doi = {10.1093/ofid/ofaa555}, pmid = {33442555}, issn = {2328-8957}, abstract = {Background: There is a need for validated and standardized severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) quantitative immunoglobulin G (IgG) and neutralization assays that can be used to understand the immunology and pathogenesis of SARS-CoV-2 infection and support the coronavirus disease 2019 (COVID-19) pandemic response.

Methods: Literature searches were conducted to identify English language publications from peer-reviewed journals and preprints from January 2020 through November 6, 2020. Relevant publications were reviewed for mention of IgG or neutralization assays for SARS-CoV-2, or both, and the methods of reporting assay results.

Results: Quantitative SARS-CoV-2 IgG results have been reported from a limited number of studies; most studies used in-house laboratory-developed tests in limited settings, and only two semiquantitative tests have received US Food and Drug Administration (FDA) Emergency Use Authorization (EUA). As of November 6, 2020, there is only one SARS-CoV-2 neutralization assay with FDA EUA. Relatively few studies have attempted correlation of quantitative IgG titers with neutralization results to estimate surrogates of protection. The number of individuals tested is small compared with the magnitude of the pandemic, and persons tested are not representative of disproportionately affected populations. Methods of reporting quantitative results are not standardized to enable comparisons and meta-analyses.

Conclusions: Lack of standardized SARS-CoV-2 quantitative IgG and neutralization assays precludes comparison of results from published studies. Interassay and interlaboratory validation and standardization of assays will support efforts to better understand antibody kinetics and longevity of humoral immune responses postillness, surrogates of immune protection, and vaccine immunogenicity and efficacy. Public-private partnerships could facilitate realization of these advances in the United States and worldwide.}, } @article {pmid33442536, year = {2020}, author = {Lin, L and Niu, LL and Zheng, E and Yuan, Y and Ning, N and Yang, M}, title = {Management strategies in a thoracic surgery ward during COVID-19 pandemic: Experience from West China Hospital.}, journal = {World journal of virology}, volume = {9}, number = {4}, pages = {47-53}, doi = {10.5501/wjv.v9.i4.47}, pmid = {33442536}, issn = {2220-3249}, abstract = {The coronavirus disease 2019 was first reported in Wuhan in December 2019 and then spread rapidly throughout the world. On March 11, 2020, the World Health Organization declared coronavirus disease 2019 a pandemic. In response to the pandemic, the management division of West China Hospital oversaw the implementation of hospital-wide emergency measures. In accordance with these measures, the hospital's thoracic surgery ward implemented a new management system by reformulating staff training plans, patient admission procedures, and other systems for managing the ward and protecting perioperative patients. Overall, the ward was successful in restoring normal working order, protecting all staff from occupational exposures, and ensuring the safety of inpatients and their families.}, } @article {pmid33442447, year = {2020}, author = {Anirvan, P and Bharali, P and Gogoi, M and Thuluvath, PJ and Singh, SP and Satapathy, SK}, title = {Liver injury in COVID-19: The hepatic aspect of the respiratory syndrome - what we know so far.}, journal = {World journal of hepatology}, volume = {12}, number = {12}, pages = {1182-1197}, doi = {10.4254/wjh.v12.i12.1182}, pmid = {33442447}, issn = {1948-5182}, abstract = {The 2019 novel coronavirus disease (COVID-19) pandemic due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has posed a serious threat to global public health. Although primarily, the infection causes lung injury, liver enzyme abnormalities have also been reported to occur during the course of the disease. We conducted an extensive literature review using the PubMed database on articles covering a broad range of issues related to COVID-19 and hepatic injury. The present review summarizes available information on the spectrum of liver involvement, the possible mechanisms and risk factors of liver injury due to SARS-CoV-2 infection, and the prognostic significance of the presence of liver injury. Hopefully, this review will enable clinicians, especially the hepatologists, to understand and manage the liver derangements they may encounter in these patients better and provide guidance for further studies on the liver injury of COVID-19.}, } @article {pmid33442386, year = {2020}, author = {Cavalli, G and Farina, N and Campochiaro, C and De Luca, G and Della-Torre, E and Tomelleri, A and Dagna, L}, title = {Repurposing of Biologic and Targeted Synthetic Anti-Rheumatic Drugs in COVID-19 and Hyper-Inflammation: A Comprehensive Review of Available and Emerging Evidence at the Peak of the Pandemic.}, journal = {Frontiers in pharmacology}, volume = {11}, number = {}, pages = {598308}, doi = {10.3389/fphar.2020.598308}, pmid = {33442386}, issn = {1663-9812}, abstract = {Coronavirus disease 2019 (COVID-19) is a condition caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Severe cases of COVID-19 result in acute respiratory distress syndrome and death. A detrimental, hyper-inflammatory immune response with excess release of cytokines is the main driver of disease development and of tissue damage in these patients. Thus, repurposing of biologic agents and other pharmacological inhibitors of cytokines used for the treatment of various inflammatory conditions emerged as a logical therapeutic strategy to quench inflammation and improve the clinical outcome of COVID-19 patients. Evaluated agents include the interleukin one receptor blocker anakinra, monoclonal antibodies inhibiting IL-6 tocilizumab and sarilumab, monoclonal antibodies inhibiting granulocyte-monocyte colony stimulating factor and tumor necrosis factor, and Janus kinase inhibitors. In this review, we discuss the efficacy and safety of these therapeutic options based on direct personal experience and on published evidence from observational studies and randomized clinical trials.}, } @article {pmid33442304, year = {2021}, author = {Pagliano, P and Scarpati, G and Sellitto, C and Conti, V and Spera, AM and Ascione, T and Piazza, O and Filippelli, A}, title = {Experimental Pharmacotherapy for COVID-19: The Latest Advances.}, journal = {Journal of experimental pharmacology}, volume = {13}, number = {}, pages = {1-13}, doi = {10.2147/JEP.S255209}, pmid = {33442304}, issn = {1179-1454}, abstract = {The coronavirus infectious disease-2019 (COVID-19) has overwhelmed like a shock wave in a completely unprepared world. Despite coronavirus infections were involved in previous epidemic outbreaks, no antiviral agent was developed for specific treatment. As a consequence, since the beginning of this pandemic, both repositioned and experimental drugs were used to treat the infected patients without evidence of clinical efficacy. Just based on experience coming from the use of antiviral agents to treat other viruses (eg, lopinavir/ritonavir, remdesivir) and supposed antiviral or immunomodulatory activities of drugs with no approved antiviral indications (eg hydroxychloroquine, tocilizumab), clinicians have faced the ongoing pandemic. Currently, after about 9 months from the COVID-19 spread, there is still no antiviral agent capable of ensuring the cure of this syndrome. Clinical trials are beginning to confirm the benefits of some drugs, while for other compounds, efficacy and safety have not yet been confirmed. Randomized clinical trials (RCT) have denied or downsized the beneficial effects attributed to certain molecules, such as aminoquinolines, largely used in clinical practice at the beginning of COVID-19 spread. Conversely, at the same time, they have provided evidence for unexpected effectiveness of other agents that have been underutilized, such as steroids, which were not used in SARS treatment because of the threatened effect on viral replication. Evidence deriving from pathologic studies have demonstrated that the prothrombotic effects of SARS-CoV-2 can be prevented by heparin prophylaxis, underlining the need for personalized treatment for patients with severe disease. The main aim of this review is to synthesize the available information and evidence on both repositioned and experimental drugs for the treatment of COVID-19, focusing on the need to exercise caution on the use of unproven medical therapies.}, } @article {pmid33442244, year = {2021}, author = {Grygiel-Górniak, B and Oduah, MT}, title = {COVID-19: What Should the General Practitioner Know?.}, journal = {Clinical interventions in aging}, volume = {16}, number = {}, pages = {43-56}, doi = {10.2147/CIA.S268607}, pmid = {33442244}, issn = {1178-1998}, abstract = {Background: SARS-CoV-2 infection is currently the most significant public health challenge. Its presentation ranges from mild to severe respiratory failure and septic shock. Rapid transmission of the virus is dangerous with a high possibility of life-threatening complications. Lack of treatment standards for SARS-CoV-2 is responsible for the current dilemma in clinical medicine.

Methods: An electronic literature search was done using PubMed to gather information on the pathogenesis, transmission of infection, clinical symptoms, diagnosis, and therapeutic options for COVID-19. Search items included "SARS-CoV-2", "COVID-19" and "coronavirus infection".

Results: In light of the current global crisis caused by SARS-CoV-2, the exchange of information within the scientific community should be quick and extremely transparent. Thus, this review presents the available information necessary for a general practitioner. Such presentation of data should allow the reader quick access to basic and crucial information related to epidemiology, viral transmission, clinical symptoms, diagnostics, treatment, and complications that may occur in the course of COVID-19.

Conclusion: Rapidly increasing amounts of information about the diagnosis and treatment of patients with SARS-CoV-2 allow a better understanding of the etiology and course of the infection. In the current epidemiological situation, readily accessible information helps minimize the time to acquire knowledge and focus on prevention methods, diagnostic and treatment options. Thus, this review highlights key issues related to SARS-CoV-2 infection and contains the most useful data for daily medical practice.}, } @article {pmid33442185, year = {2020}, author = {Pramono, LA}, title = {COVID-19 and Thyroid Diseases: How the Pandemic Situation Affects Thyroid Disease Patients.}, journal = {Journal of the ASEAN Federation of Endocrine Societies}, volume = {35}, number = {2}, pages = {155-157}, doi = {10.15605/jafes.035.02.01}, pmid = {33442185}, issn = {0857-1074}, abstract = {Patients with thyroid diseases need special attention during this COVID-19 pandemic. There is a paucity of publications that review the effect of coronavirus infection on thyroid disease patients, such as those with hyperthyroidism, hypothyroidism, thyroid nodules and cancer. This article aims to collect reviews and statements about how the COVID-19 pandemic has affected the management of thyroid disease patients.}, } @article {pmid33442168, year = {2020}, author = {Baidya, A and Singh, SK and Bajaj, S and Zargar, AH and Singh, P and Das, S and Shankar, A}, title = {Diabetes and COVID-19: A Review.}, journal = {Journal of the ASEAN Federation of Endocrine Societies}, volume = {35}, number = {1}, pages = {40-48}, doi = {10.15605/jafes.035.01.06}, pmid = {33442168}, issn = {0857-1074}, abstract = {Coronavirus Disease 2019 (COVID-19) is an emerging disease and since its first identification in Wuhan, China, in December 2019, there has been a rapid increase in cases and deaths across the world. COVID-19 has been shown to have an immense impact in infected persons with diabetes, worsening their outcome, especially in elderly, smokers, obese, those having CVD, CKD, poor glycemic control and long duration of diabetes. In this review we summarize the current understanding of `the impact of COVID-19 on diabetes and discusses the pathophysiological mechanisms and management of diabetes and its complication in this scenario.}, } @article {pmid33442016, year = {2021}, author = {Brodin, P}, title = {Immune determinants of COVID-19 disease presentation and severity.}, journal = {Nature medicine}, volume = {27}, number = {1}, pages = {28-33}, pmid = {33442016}, issn = {1546-170X}, abstract = {COVID-19, caused by SARS-CoV-2 infection, is mild to moderate in the majority of previously healthy individuals, but can cause life-threatening disease or persistent debilitating symptoms in some cases. The most important determinant of disease severity is age, with individuals over 65 years having the greatest risk of requiring intensive care, and men are more susceptible than women. In contrast to other respiratory viral infections, young children seem to be less severely affected. It is now clear that mild to severe acute infection is not the only outcome of COVID-19, and long-lasting symptoms are also possible. In contrast to severe acute COVID-19, such 'long COVID' is seemingly more likely in women than in men. Also, postinfectious hyperinflammatory disease has been described as an additional outcome after SARS-CoV-2 infection. Here I discuss our current understanding of the immunological determinants of COVID-19 disease presentation and severity and relate this to known immune-system differences between young and old people and between men and women, and other factors associated with different disease presentations and severity.}, } @article {pmid33441373, year = {2021}, author = {Gyselinck, I and Janssens, W and Verhamme, P and Vos, R}, title = {Rationale for azithromycin in COVID-19: an overview of existing evidence.}, journal = {BMJ open respiratory research}, volume = {8}, number = {1}, pages = {}, doi = {10.1136/bmjresp-2020-000806}, pmid = {33441373}, issn = {2052-4439}, abstract = {Azithromycin has rapidly been adopted as a repurposed drug for the treatment of COVID-19, despite the lack of high-quality evidence. In this review, we critically appraise the current pharmacological, preclinical and clinical data of azithromycin for treating COVID-19. Interest in azithromycin has been fuelled by favourable treatment outcomes in other viral pneumonias, a documented antiviral effect on SARS-CoV-2 in vitro and uncontrolled case series early in the pandemic. Its antiviral effects presumably result from interfering with receptor mediated binding, viral lysosomal escape, intracellular cell-signalling pathways and enhancing type I and III interferon expression. Its immunomodulatory effects may mitigate excessive inflammation and benefit tissue repair. Currently, in vivo reports on azithromycin in COVID-19 are conflicting and do not endorse its widespread use outside of clinical trials. They are, however, mostly retrospective and therefore inherently biased. The effect size of azithromycin may depend on when it is started. Also, extended follow-up is needed to assess benefits in the recovery phase. Safety data warrant monitoring of drug-drug interactions and subsequent cardiac adverse events, especially with hydroxychloroquine. More prospective data of large randomised controlled studies are expected and much-needed. Uniform reporting of results should be strongly encouraged to facilitate data pooling with the many ongoing initiatives.}, } @article {pmid33441314, year = {2021}, author = {Synowiec, A and Szczepański, A and Barreto-Duran, E and Lie, LK and Pyrc, K}, title = {Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2): a Systemic Infection.}, journal = {Clinical microbiology reviews}, volume = {34}, number = {2}, pages = {}, pmid = {33441314}, issn = {1098-6618}, abstract = {SUMMARYTo date, seven identified coronaviruses (CoVs) have been found to infect humans; of these, three highly pathogenic variants have emerged in the 21st century. The newest member of this group, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was first detected at the end of 2019 in Hubei province, China. Since then, this novel coronavirus has spread worldwide, causing a pandemic; the respiratory disease caused by the virus is called coronavirus disease 2019 (COVID-19). The clinical presentation ranges from asymptomatic to mild respiratory tract infections and influenza-like illness to severe disease with accompanying lung injury, multiorgan failure, and death. Although the lungs are believed to be the site at which SARS-CoV-2 replicates, infected patients often report other symptoms, suggesting the involvement of the gastrointestinal tract, heart, cardiovascular system, kidneys, and other organs; therefore, the following question arises: is COVID-19 a respiratory or systemic disease? This review aims to summarize existing data on the replication of SARS-CoV-2 in different tissues in both patients and ex vivo models.}, } @article {pmid33441249, year = {2021}, author = {Rosa, V and Ho, D and Sabino-Silva, R and Siqueira, WL and Silikas, N}, title = {Fighting viruses with materials science: Prospects for antivirus surfaces, drug delivery systems and artificial intelligence.}, journal = {Dental materials : official publication of the Academy of Dental Materials}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.dental.2020.12.004}, pmid = {33441249}, issn = {1879-0097}, abstract = {OBJECTIVE: Viruses on environmental surfaces, in saliva and other body fluids represent risk of contamination for general population and healthcare professionals. The development of vaccines and medicines is costly and time consuming. Thus, the development of novel materials and technologies to decrease viral availability, viability, infectivity, and to improve therapeutic outcomes can positively impact the prevention and treatment of viral diseases.

METHODS: Herein, we discuss (a) interaction mechanisms between viruses and materials, (b) novel strategies to develop materials with antiviral properties and oral antiviral delivery systems, and (c) the potential of artificial intelligence to design and optimize preventive measures and therapeutic regimen.

RESULTS: The mechanisms of viral adsorption on surfaces are well characterized but no major breakthrough has become clinically available. Materials with fine-tuned physical and chemical properties have the potential to compromise viral availability and stability. Emerging strategies using oral antiviral delivery systems and artificial intelligence can decrease infectivity and improve antiviral therapies.

SIGNIFICANCE: Emerging viral infections are concerning due to risk of mortality, as well as psychological and economic impacts. Materials science emerges for the development of novel materials and technologies to diminish viral availability, infectivity, and to enable enhanced preventive and therapeutic strategies, for the safety and well-being of humankind.}, } @article {pmid33440895, year = {2021}, author = {Mellet, J and Pepper, MS}, title = {A COVID-19 Vaccine: Big Strides Come with Big Challenges.}, journal = {Vaccines}, volume = {9}, number = {1}, pages = {}, doi = {10.3390/vaccines9010039}, pmid = {33440895}, issn = {2076-393X}, support = {SAMRC-RFAUFSP-01-2013/STEM CELLS//South African Medical Research Council/ ; Extramural Unit for Stem Cell Research and Therapy//South African Medical Research Council/ ; Institute for Cellular and Molecular Medicine//University of Pretoria/ ; }, abstract = {As of 8 January 2021, there were 86,749,940 confirmed coronavirus disease 2019 (COVID-19) cases and 1,890,342 COVID-19-related deaths worldwide, as reported by the World Health Organization (WHO). In order to address the COVID-19 pandemic by limiting transmission, an intense global effort is underway to develop a vaccine against SARS-CoV-2. The development of a safe and effective vaccine usually requires several years of pre-clinical and clinical stages of evaluation and requires strict regulatory approvals before it can be manufactured in bulk and distributed. Since the global impact of COVID-19 is unprecedented in the modern era, the development and testing of a new vaccine are being expedited. Given the high-level of attrition during vaccine development, simultaneous testing of multiple candidates increases the probability of finding one that is effective. Over 200 vaccines are currently in development, with over 60 candidate vaccines being tested in clinical trials. These make use of various platforms and are at different stages of development. This review discusses the different phases of vaccine development and the various platforms in use for candidate COVID-19 vaccines, including their progress to date. The potential challenges once a vaccine becomes available are also addressed.}, } @article {pmid33440841, year = {2021}, author = {Le, TT and Vodden, K and Wu, J and Atiwesh, G}, title = {Policy Responses to the COVID-19 Pandemic in Vietnam.}, journal = {International journal of environmental research and public health}, volume = {18}, number = {2}, pages = {}, doi = {10.3390/ijerph18020559}, pmid = {33440841}, issn = {1660-4601}, abstract = {The COVID-19 pandemic has become one of the most serious health crises in human history, spreading rapidly across the globe from January 2020 to the present. With prompt and drastic measures, Vietnam is one of the few countries that has largely succeeded in controlling the outbreak. This result is derived from a harmonious combination of many factors, with the policy system playing a key role. This study assessed the policy responses to the COVID-19 pandemic in Vietnam from the early days of the outbreak in January 2020 to 24 July 2020 (with a total of 413 cases confirmed and 99 days of no new cases infected from the local community) by synthesizing and evaluating 959 relevant policy documents in different classifications. The findings show that the Vietnamese policy system responded promptly, proactively, and effectively at multiple authority levels (33 different agencies from the national to provincial governments), using a range of policy tools and measures. Parallel to the daily occurrence of 2.24 new cases, 5.13 new policy documents were issued on average per day over the study period. The pandemic policy response over the first six months in Vietnam were divided into four periods, I (23 January-5 March), II (6-19 March), III (20 March-21 April), and IV (22 April-24 July). This paper synthesizes eight solution groups for these four anti-pandemic phases, including outbreak announcements and steering documents, medical measures, blockade of the schools, emergency responses, border and entry control measures, social isolation and nationwide social isolation measures, financial supports, and other measures. By emphasizing diversification of the policy responses, from the agencies to the tools and measures, the case study reviews and shares lessons from the successful COVID-19 prevention and control in Vietnam that could be useful for other nations.}, } @article {pmid33440724, year = {2021}, author = {Tanner, JE and Alfieri, C}, title = {The Fatty Acid Lipid Metabolism Nexus in COVID-19.}, journal = {Viruses}, volume = {13}, number = {1}, pages = {}, doi = {10.3390/v13010090}, pmid = {33440724}, issn = {1999-4915}, abstract = {Enteric symptomology seen in early-stage severe acute respiratory syndrome (SARS)-2003 and COVID-19 is evidence of virus replication occurring in the intestine, liver and pancreas. Aberrant lipid metabolism in morbidly obese individuals adversely affects the COVID-19 immune response and increases disease severity. Such observations are in line with the importance of lipid metabolism in COVID-19, and point to the gut as a site for intervention as well as a therapeutic target in treating the disease. Formation of complex lipid membranes and palmitoylation of coronavirus proteins are essential during viral replication and assembly. Inhibition of fatty acid synthase (FASN) and restoration of lipid catabolism by activation of AMP-activated protein kinase (AMPK) impede replication of coronaviruses closely related to SARS-coronavirus-2 (CoV-2). In vitro findings and clinical data reveal that the FASN inhibitor, orlistat, and the AMPK activator, metformin, may inhibit coronavirus replication and reduce systemic inflammation to restore immune homeostasis. Such observations, along with the known mechanisms of action for these types of drugs, suggest that targeting fatty acid lipid metabolism could directly inhibit virus replication while positively impacting the patient's response to COVID-19.}, } @article {pmid33440640, year = {2021}, author = {Suzuki, YJ and Gychka, SG}, title = {SARS-CoV-2 Spike Protein Elicits Cell Signaling in Human Host Cells: Implications for Possible Consequences of COVID-19 Vaccines.}, journal = {Vaccines}, volume = {9}, number = {1}, pages = {}, doi = {10.3390/vaccines9010036}, pmid = {33440640}, issn = {2076-393X}, support = {R21AI142649, R03AG059554, R03AA026516/NH/NIH HHS/United States ; }, abstract = {The world is suffering from the coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 uses its spike protein to enter the host cells. Vaccines that introduce the spike protein into our body to elicit virus-neutralizing antibodies are currently being developed. In this article, we note that human host cells sensitively respond to the spike protein to elicit cell signaling. Thus, it is important to be aware that the spike protein produced by the new COVID-19 vaccines may also affect the host cells. We should monitor the long-term consequences of these vaccines carefully, especially when they are administered to otherwise healthy individuals. Further investigations on the effects of the SARS-CoV-2 spike protein on human cells and appropriate experimental animal models are warranted.}, } @article {pmid33429796, year = {2021}, author = {Liang, XY and Shang, YS and Bai, N and Zhong, PY and Zhang, WJ and Wang, ZL}, title = {Management of acute coronary syndrome in the context of coronavirus disease 2019.}, journal = {Medicine}, volume = {100}, number = {1}, pages = {e24151}, doi = {10.1097/MD.0000000000024151}, pmid = {33429796}, issn = {1536-5964}, mesh = {Acute Coronary Syndrome/mortality/*therapy/*virology ; COVID-19/*epidemiology/transmission ; Cross Infection/*prevention & control ; Humans ; Infection Control/*standards ; Pandemics ; Pneumonia, Viral/*epidemiology/virology ; SARS-CoV-2 ; }, abstract = {ABSTRACT: Coronavirus disease 2019 (COVID-19) is still developing worldwide. The prognosis of the disease will become worse and mortality will be even higher when it is combined with cardiovascular disease. Furthermore, COVID-19 is highly infectious and requires strict isolation measures. For acute coronary syndromes (ACS), a common cardiovascular disease, infection may aggravate the occurrence and development of ACS, making the management of more difficult. It will be an enormous challenge for clinical practice to deal with ACS in this setting of COVID-19.Aim to reduce the mortality of ACS patients during the epidemic of COVID-19 by standardizing procedures as much as possible.Pubmed and other relevant databases were searched to retrieve articles on COVID-19 and articles on ACS management strategies during previous influenza epidemics. The data was described and synthesized to summarize the diagnosis and management strategy of ACS, the preparation of catheter laboratory, and the protection of the medical staff in the context of COVID-19. Ethical approval is not required in this study, because it is a review with no recourse to patient identifiable information.Standardized diagnosis and treatment advice can help reduce the mortality of COVID-19 patients with ACS. In the absence of contraindications, the third generation of thrombolytic drugs should be the first choice for thrombolytic treatment in the isolation ward. For patients who have to receive PCI, this article provides detailed protective measures to avoid nosocomial infection.}, } @article {pmid33416801, year = {2020}, author = {Guragai, M and Achanta, A and Gopez, AY and Niyotwambaza, J and Cardoso, LG and Estavillo, NL and Dykstra, M}, title = {Medical Students' Response to the COVID-19 Pandemic: Experience and Recommendations from Five Countries.}, journal = {Perspectives in biology and medicine}, volume = {63}, number = {4}, pages = {623-631}, doi = {10.1353/pbm.2020.0051}, pmid = {33416801}, issn = {1529-8795}, mesh = {Brazil ; *COVID-19 ; COVID-19 Testing ; Contact Tracing ; Delivery of Health Care ; Education, Medical/methods/organization & administration ; Humans ; Information Dissemination ; Nepal ; Philippines ; Remote Consultation ; Rwanda ; *Students, Medical ; United States ; }, abstract = {The COVID-19 pandemic has provided medical students around the globe with unique challenges and opportunities. With formal medical school education and training interrupted, medical students sought innovative ways to contribute to their health-care systems and communities. Their responses could be organized into three categories: clinical (remote clinical care and triage, helping in COVID testing or treatment centers, and contact tracing), nonclinical (PPE acquisition, COVID-related policy and research, and supporting vulnerable groups in the community), and educational (creating materials to educate peers, the community, or community health workers). We present examples of responses developed by students from five countries: Brazil, Nepal, the Philippines, Rwanda, and the United States. We discuss the challenges, outcomes, and recommendations for each case. One critical opportunity for growth is strengthening international collaborations. We hope that these examples provide a framework for medical students to plan coordinated and effective responses to the next pandemic, and further medical student engagement in international collaboration.}, } @article {pmid33410425, year = {2020}, author = {Sreepadmanabh, M and Sahu, AK and Chande, A}, title = {COVID-19: Advances in diagnostic tools, treatment strategies, and vaccine development.}, journal = {Journal of biosciences}, volume = {45}, number = {}, pages = {}, pmid = {33410425}, issn = {0973-7138}, mesh = {Antiviral Agents/chemical synthesis/*therapeutic use ; Artificial Intelligence ; COVID-19/immunology/*prevention & control/therapy/virology ; COVID-19 Nucleic Acid Testing/*methods ; COVID-19 Vaccines/*biosynthesis/genetics ; CRISPR-Cas Systems ; Disease Management ; Drug Discovery/methods ; Drug Repositioning/methods ; Humans ; Immunization, Passive/methods ; Molecular Diagnostic Techniques ; Molecular Docking Simulation ; Nucleic Acid Amplification Techniques ; Pandemics/*prevention & control ; Protein Engineering/methods ; SARS-CoV-2/drug effects/immunology/*pathogenicity ; }, abstract = {An unprecedented worldwide spread of the SARS-CoV-2 has imposed severe challenges on healthcare facilities and medical infrastructure. The global research community faces urgent calls for the development of rapid diagnostic tools, effective treatment protocols, and most importantly, vaccines against the pathogen. Pooling together expertise across broad domains to innovate effective solutions is the need of the hour. With these requirements in mind, in this review, we provide detailed critical accounts on the leading efforts at developing diagnostics tools, therapeutic agents, and vaccine candidates. Importantly, we furnish the reader with a multidisciplinary perspective on how conventional methods like serology and RT-PCR, as well as cutting-edge technologies like CRISPR/Cas and artificial intelligence/machine learning, are being employed to inform and guide such investigations. We expect this narrative to serve a broad audience of both active and aspiring researchers in the field of biomedical sciences and engineering and help inspire radical new approaches towards effective detection, treatment, and prevention of this global pandemic.}, } @article {pmid33402019, year = {2021}, author = {Aydogdu, MO and Altun, E and Chung, E and Ren, G and Homer-Vanniasinkam, S and Chen, B and Edirisinghe, M}, title = {Surface interactions and viability of coronaviruses.}, journal = {Journal of the Royal Society, Interface}, volume = {18}, number = {174}, pages = {20200798}, doi = {10.1098/rsif.2020.0798}, pmid = {33402019}, issn = {1742-5662}, mesh = {COVID-19/prevention & control/*virology ; Disinfectants/*pharmacology ; Disinfection ; Humans ; SARS-CoV-2/*drug effects/*physiology ; Surface Properties ; }, abstract = {The recently emerged coronavirus pandemic (COVID-19) has become a worldwide threat affecting millions of people, causing respiratory system related problems that can end up with extremely serious consequences. As the infection rate rises significantly and this is followed by a dramatic increase in mortality, the whole world is struggling to accommodate change and is trying to adapt to new conditions. While a significant amount of effort is focused on developing a vaccine in order to make a game-changing anti-COVID-19 breakthrough, novel coronavirus (SARS-CoV-2) is also developing mutations rapidly as it transmits just like any other virus and there is always a substantial chance of the invented antibodies becoming ineffective as a function of time, thus failing to inhibit virus-to-cell binding efficiency as the spiked protein keeps evolving. Hence, controlling the transmission of the virus is crucial. Therefore, this review summarizes the viability of coronaviruses on inanimate surfaces under different conditions while addressing the current state of known chemical disinfectants for deactivation of the coronaviruses. The review attempts to bring together a wide spectrum of surface-virus-cleaning agent interactions to help identify material selection for inanimate surfaces that have frequent human contact and cleaning procedures for effective prevention of COVID-19 transmission.}, } @article {pmid33400419, year = {2021}, author = {Cohen, JL and Dayan, SH and Avram, MM and Saltz, R and Kilmer, S and Maas, CS and Schlessinger, J}, title = {Aesthetic Office Disaster Preparedness and Response Plan.}, journal = {Journal of drugs in dermatology : JDD}, volume = {20}, number = {1}, pages = {10-16}, doi = {10.36849/JDD.2021.5803}, pmid = {33400419}, issn = {1545-9616}, mesh = {COVID-19/epidemiology/*prevention & control/therapy ; Civil Defense/*methods/trends ; Disaster Planning/*methods/trends ; Disasters/*prevention & control ; *Disease Management ; Humans ; Personnel Staffing and Scheduling/trends ; *Physician's Role ; }, abstract = {The coronavirus pandemic (COVID-19) has served as a call-to-arms in preparing practices for the next disaster whether it is another infectious disease or a flood, hurricane, earthquake, a sustained power outage, or something else. A group of predominantly core aesthetic physicians discussed the various aspects of their office procedures that warrant consideration in a proactive approach to the next pandemic/disaster-related event. This guide does not set a standard of practice but contains recommendations that may avoid some of the "lessons learned" with the COVID-19 pandemic. In this paper, the board-certified core aesthetic physicians classified these recommendations into four generalized areas: Practice Management; Supplies and Inventory; Office Staffing Considerations and Protocols; and Patient Management Strategies. Proactive strategies are provided in each of these categories that, if implemented, may alleviate the processes involved with an efficient office closure and reopening process including, in the case of COVID-19, methods to reduce the risk of transmission to doctors, staff, and patients. These strategies also include being prepared for emergency-related notifications of employees and patients; the acquisition of necessary equipment and supplies such as personal protective equipment; and the maintenance and accessibility of essential data and contact information for patients, vendors, financial advisors, and other pertinent entities.J Drugs Dermatol. 2021;20(1):10-16. doi:10.36849/JDD.2021.5803.}, } @article {pmid33380588, year = {2020}, author = {Lin, HY and Lai, PC and Chen, WL}, title = {A narrative review of hydrogen-oxygen mixture for medical purpose and the inhaler thereof.}, journal = {Medical gas research}, volume = {10}, number = {4}, pages = {193-200}, doi = {10.4103/2045-9912.295226}, pmid = {33380588}, issn = {2045-9912}, mesh = {COVID-19/*therapy ; Explosions/prevention & control ; Humans ; Hydrogen/*administration & dosage ; *Nebulizers and Vaporizers/standards ; Oxygen/*administration & dosage ; Oxygen Inhalation Therapy/*methods/standards ; Static Electricity/adverse effects ; Volatilization ; }, abstract = {Recent development regarding mixture of H2 (concentration of ~66%) with O2 (concentration of ~34%) for medical purpose, such as treatment of coronavirus disease-19 (COVID-19) patients, is introduced. Furthermore, the design principles of a hydrogen inhaler which generates mixture of hydrogen (~66%) with oxygen (~34%) for medical purpose are proposed. With the installation of the liquid blocking module and flame arresters, the air pathway of the hydrogen inhaler is divided by multiple isolation zones to prevent any unexpected explosion propagating from one zone to the other. An integrated filtering/cycling module is utilized to purify the impurity, and cool down the temperature of the electrolytic module to reduce the risk of the explosion. Moreover, a nebulizer is provided to selectively atomize the water into vapor which is then mixed with the filtered hydrogen-oxygen mix gas, such that the static electricity of a substance hardly occurs to reduce the risk of the explosion. Furthermore, hydrogen concentration detector is installed to reduce the risk of hydrogen leakage. Result shows that the hydrogen inhaler implementing the aforesaid design rules could effectively inhibit the explosion, even ignition at the outset of the hydrogen inhaler which outputs hydrogen-oxygen gas (approximately 66% hydrogen: 34% oxygen).}, } @article {pmid33375935, year = {2020}, author = {Li, WS and Chan, LL and Chao, YX and Tan, EK}, title = {Parkinson's disease following COVID-19: causal link or chance occurrence?.}, journal = {Journal of translational medicine}, volume = {18}, number = {1}, pages = {493}, pmid = {33375935}, issn = {1479-5876}, mesh = {Adult ; COVID-19/*complications ; Causality ; Female ; Humans ; Male ; Middle Aged ; Parkinson Disease/*complications/diagnosis ; Parkinson Disease, Secondary/diagnosis/etiology ; *SARS-CoV-2 ; Time Factors ; Translational Medical Research ; }, } @article {pmid33372171, year = {2020}, author = {Kong, D and Li, M and Gong, W}, title = {SARS-Cov-2 infection in transplant-related biology: Where do we stand?.}, journal = {Annals of transplantation}, volume = {25}, number = {}, pages = {e924768}, pmid = {33372171}, issn = {2329-0358}, mesh = {COVID-19/*virology ; Humans ; Organ Transplantation ; Risk Factors ; *Transplant Recipients ; }, abstract = {Since December 2019, the novel coronavirus (SARS-CoV-2) emerged in Wuhan and rapidly spread throughout the world. There are nearly 3 951 905 confirmed cases of novel coronary pneumonia and more than 275 067 deaths worldwide, [JHU data-09/05/2020, https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6]. A great number of patients contracted SARS-Cov-2 pneumonia (COVID-19). SARS-CoV-2 invades human target cells through receptor angiotensin-converting enzyme II (ACE2), which are expressed in the lung, kidney, and ileum and mediate inflammatory responses and immune activities. High plasma levels of proinflammatory cytokines were detected in the infected patients. These factors may predispose transplant patients to high risk of poor outcomes. Therefore, transplant patients might be affected by this coronavirus infection and protection of allografts should receive special attention during this outbreak. In the present study we attempt to delineate the transplant-related biology of SARS-CoV-2 infection.}, } @article {pmid33314910, year = {2020}, author = {Lukas, H and Xu, C and Yu, Y and Gao, W}, title = {Emerging Telemedicine Tools for Remote COVID-19 Diagnosis, Monitoring, and Management.}, journal = {ACS nano}, volume = {14}, number = {12}, pages = {16180-16193}, pmid = {33314910}, issn = {1936-086X}, mesh = {Antigens, Viral/analysis ; Biosensing Techniques/instrumentation ; COVID-19/*diagnosis/pathology/*therapy/virology ; COVID-19 Testing/instrumentation/*methods ; Contact Tracing/instrumentation ; *Disease Management ; Humans ; Mobile Applications/supply & distribution ; Monitoring, Physiologic/instrumentation/methods ; Nanotechnology/instrumentation/methods ; Physical Distancing ; Point-of-Care Systems/organization & administration ; Point-of-Care Testing/organization & administration ; Quarantine/organization & administration ; SARS-CoV-2/*genetics/immunology ; Telemedicine/instrumentation/*methods ; }, abstract = {The management of the COVID-19 pandemic has relied on cautious contact tracing, quarantine, and sterilization protocols while we await a vaccine to be made widely available. Telemedicine or mobile health (mHealth) is well-positioned during this time to reduce potential disease spread and prevent overloading of the healthcare system through at-home COVID-19 screening, diagnosis, and monitoring. With the rise of mass-fabricated electronics for wearable and portable sensors, emerging telemedicine tools have been developed to address shortcomings in COVID-19 diagnostics, monitoring, and management. In this Perspective, we summarize current implementations of mHealth sensors for COVID-19, highlight recent technological advances, and provide an overview on how these tools may be utilized to better control the COVID-19 pandemic.}, } @article {pmid33294103, year = {2020}, author = {Amaechi, UA and Sodipo, BO and Nnaji, CA and Owoyemi, A and Omitiran, K and Okedo-Alex, IN and Eboreime, E and Ajumobi, O}, title = {Social approaches to COVID-19 pandemic response: effectiveness and practicality in sub-Saharan Africa.}, journal = {The Pan African medical journal}, volume = {37}, number = {Suppl 1}, pages = {2}, pmid = {33294103}, issn = {1937-8688}, mesh = {Africa South of the Sahara/epidemiology ; COVID-19/epidemiology/*prevention & control ; Humans ; *Physical Distancing ; *Quarantine ; }, abstract = {Introduction: the threat of the coronavirus disease 2019 (COVID-19) pandemic to health systems and communities in sub-Saharan Africa (SSA) is enormous. Social approaches such as distancing measures are essential components of the public health response to respiratory-related infectious disease outbreaks. Due to socio-economic and broader peculiarities of SSA countries, social approaches that were effective elsewhere may have limited practicality in these contexts, and if practical; may yield different or even adverse results. We highlighted the effectiveness of these social approaches and their practicality in SSA.

Methods: we conducted a comprehensive literature search through multiple databases, to identify articles relevant to social distancing. Findings were thematically summarized.

Results: our review found emerging and varying empirical evidence on the effectiveness of social approaches in the control and mitigation of the COVID-19 pandemic; thus, limiting its applicability in SSA contexts. Nonetheless, our review demonstrates that the effectiveness and practicality of social approaches in SSA contexts will depend on available resources; timing, duration, and intensity of the intervention; and compliance. Weak political coordination, anti-science sentiments, distrust of political leaders and limited implementation of legal frameworks can also affect practicality.

Conclusion: to overcome these challenges, tailoring and adaptation of these measures to different but unique contexts for maximum effectiveness, and investment in social insurance mechanisms, are vital.}, } @article {pmid33292107, year = {2020}, author = {Rendic, S and Guengerich, FP}, title = {Metabolism and Interactions of Chloroquine and Hydroxychloroquine with Human Cytochrome P450 Enzymes and Drug Transporters.}, journal = {Current drug metabolism}, volume = {21}, number = {14}, pages = {1127-1135}, doi = {10.2174/1389200221999201208211537}, pmid = {33292107}, issn = {1875-5453}, mesh = {Animals ; COVID-19/drug therapy/metabolism ; Chloroquine/*metabolism/therapeutic use ; Cytochrome P-450 Enzyme Inhibitors/*metabolism/therapeutic use ; Cytochrome P-450 Enzyme System/*metabolism ; Drug Interactions/physiology ; Humans ; Hydroxychloroquine/*metabolism/therapeutic use ; Membrane Transport Proteins/*metabolism ; Pharmaceutical Preparations/metabolism ; }, abstract = {BACKGROUND: In clinical practice, chloroquine and hydroxychloroquine are often co-administered with other drugs in the treatment of malaria, chronic inflammatory diseases, and COVID-19. Therefore, their metabolic properties and the effects on the activity of cytochrome P450 (P450, CYP) enzymes and drug transporters should be considered when developing the most efficient treatments for patients.

METHODS: Scientific literature on the interactions of chloroquine and hydroxychloroquine with human P450 enzymes and drug transporters, was searched using PUBMED.Gov (https://pubmed.ncbi.nlm.nih.gov/) and the ADME database (https://life-science.kyushu.fujitsu.com/admedb/).

RESULTS: Chloroquine and hydroxychloroquine are metabolized by P450 1A2, 2C8, 2C19, 2D6, and 3A4/5 in vitro and by P450s 2C8 and 3A4/5 in vivo by N-deethylation. Chloroquine effectively inhibited P450 2D6 in vitro; however, in vivo inhibition was not apparent except in individuals with limited P450 2D6 activity. Chloroquine is both an inhibitor and inducer of the transporter MRP1 and is also a substrate of the Mate and MRP1 transport systems. Hydroxychloroquine also inhibited P450 2D6 and the transporter OATP1A2.

CONCLUSIONS: Chloroquine caused a statistically significant decrease in P450 2D6 activity in vitro and in vivo, also inhibiting its own metabolism by the enzyme. The inhibition indicates a potential for clinical drug-drug interactions when taken with other drugs that are predominant substrates of the P450 2D6. When chloroquine and hydroxychloroquine are used clinically with other drugs, substrates of P450 2D6 enzyme, attention should be given to substrate-specific metabolism by P450 2D6 alleles present in individuals taking the drugs.}, } @article {pmid33289066, year = {2021}, author = {Griffiths, R and Babu, S and Dixon, P and Freeman, N and Hurford, D and Kelleher, E and Moppett, I and Ray, D and Sahota, O and Shields, M and White, S}, title = {Guideline for the management of hip fractures 2020: Guideline by the Association of Anaesthetists.}, journal = {Anaesthesia}, volume = {76}, number = {2}, pages = {225-237}, doi = {10.1111/anae.15291}, pmid = {33289066}, issn = {1365-2044}, mesh = {Anesthesia/standards ; COVID-19 ; Case Management/*standards ; Guidelines as Topic ; Hip Fractures/surgery/*therapy ; Humans ; Pandemics ; Quality Improvement ; }, abstract = {We convened a multidisciplinary Working Party on behalf of the Association of Anaesthetists to update the 2011 guidance on the peri-operative management of people with hip fracture. Importantly, these guidelines describe the core aims and principles of peri-operative management, recommending greater standardisation of anaesthetic practice as a component of multidisciplinary care. Although much of the 2011 guidance remains applicable to contemporary practice, new evidence and consensus inform the additional recommendations made in this document. Specific changes to the 2011 guidance relate to analgesia, medicolegal practice, risk assessment, bone cement implantation syndrome and regional review networks. Areas of controversy remain, and we discuss these in further detail, relating to the mode of anaesthesia, surgical delay, blood management and transfusion thresholds, echocardiography, anticoagulant and antiplatelet management and postoperative discharge destination. Finally, these guidelines provide links to supplemental online material that can be used at readers' institutions, key references and UK national guidance about the peri-operative care of people with hip and periprosthetic fractures during the COVID-19 pandemic.}, } @article {pmid33248163, year = {2021}, author = {Nath, A and Smith, B}, title = {Neurological issues during COVID-19: An overview.}, journal = {Neuroscience letters}, volume = {742}, number = {}, pages = {135533}, pmid = {33248163}, issn = {1872-7972}, support = {/NS/NINDS NIH HHS/United States ; }, mesh = {Brain/*pathology ; COVID-19/*complications/metabolism/*pathology ; Humans ; Nervous System Diseases/*etiology/metabolism/*pathology ; }, abstract = {COVID-19 has shaken the core of the medical health system. The wide spread death and destruction of patients and health care workers in unprecedented in the modern era. While the pulmonary complications have received the most attention, it is the neurological manifestations that are disabling, persistent and common in patients infected with SARS-CoV-2. The entire neuro-axis can be involved resulting in a wide variety of manifestations. While the pathophysiology is not well understood, many of the clinical manifestations seem to be immune mediated. The socio-economic consequences of these complications are dire. These unprecedented times also calls for unprecedented action. Novel clinical trial designs need to be considered so that multiple agents can be studied. In the context of these clinical trials, disease pathophysiology and standardized batteries and biological markers for patient assessment need to be developed.}, } @article {pmid33248161, year = {2021}, author = {Katal, S and Gholamrezanezhad, A}, title = {Neuroimaging findings in COVID-19: A narrative review.}, journal = {Neuroscience letters}, volume = {742}, number = {}, pages = {135529}, pmid = {33248161}, issn = {1872-7972}, mesh = {COVID-19/*diagnostic imaging/epidemiology/*metabolism ; Encephalitis/diagnostic imaging/epidemiology/metabolism ; Humans ; Neuroimaging/*methods ; Positron-Emission Tomography/methods ; Stroke/diagnostic imaging/epidemiology/metabolism ; }, abstract = {In this mini-review, we aim to summarize some of the most common neuroimaging findings seen in patients with COVID-19.}, } @article {pmid33248159, year = {2021}, author = {Mukerji, SS and Solomon, IH}, title = {What can we learn from brain autopsies in COVID-19?.}, journal = {Neuroscience letters}, volume = {742}, number = {}, pages = {135528}, pmid = {33248159}, issn = {1872-7972}, support = {R21 NS119660/NS/NINDS NIH HHS/United States ; K23 MH115812/MH/NIMH NIH HHS/United States ; }, mesh = {Autopsy ; Brain/*pathology/*virology ; COVID-19/*pathology ; Humans ; Reverse Transcriptase Polymerase Chain Reaction/methods ; SARS-CoV-2/*isolation & purification ; }, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of coronavirus disease 2019 (COVID-19) for which there have been over 50 million confirmed cases and 1.2 million deaths globally. While many SARS-CoV-2 infected individuals are asymptomatic or experience respiratory symptoms, extrapulmonary manifestations, including neurological symptoms and conditions, are increasingly recognized. There remains no clear understanding of the mechanisms that underlie neurological symptoms in COVID-19 and whether SARS-CoV-2 has the potential for neuroinvasion in humans. In this minireview, we discuss what is known from human autopsies in fatal COVID-19, including highlighting studies that investigate for the presence of SARS-CoV-2 in brain and olfactory tissue, and summarize the neuropathological consequences of infection. Incorporating microscopic and molecular findings from brain tissue into what we know about clinical disease will inform best practice management guidance and direct research priorities as it relates to neurological morbidity from COVID-19.}, } @article {pmid33248158, year = {2021}, author = {Gold, DM and Galetta, SL}, title = {Neuro-ophthalmologic complications of coronavirus disease 2019 (COVID-19).}, journal = {Neuroscience letters}, volume = {742}, number = {}, pages = {135531}, pmid = {33248158}, issn = {1872-7972}, mesh = {COVID-19/*complications/diagnosis/metabolism ; Cytokine Release Syndrome/diagnosis/*etiology/metabolism ; Humans ; Nervous System Diseases/diagnosis/*etiology/metabolism ; Vision Disorders/diagnosis/*etiology/metabolism ; }, abstract = {Multiple neuro-ophthalmological manifestations have been described in association with COVID-19. These symptoms and signs may be the result of a range of pathophysiological mechanisms throughout the course from acute illness to recovery phase. Optic nerve dysfunction, eye movement abnormalities and visual field defects have been described.}, } @article {pmid33243000, year = {2021}, author = {Siegel, RM and Mallow, PJ}, title = {The Impact of COVID-19 on Vulnerable Populations and Implications for Children and Health Care Policy.}, journal = {Clinical pediatrics}, volume = {60}, number = {2}, pages = {93-98}, doi = {10.1177/0009922820973018}, pmid = {33243000}, issn = {1938-2707}, mesh = {Adult ; COVID-19/*epidemiology ; Child ; *Cost of Illness ; Female ; *Health Policy ; Healthcare Disparities ; Humans ; Male ; Pandemics ; Pneumonia, Viral/*epidemiology/virology ; SARS-CoV-2 ; *Vulnerable Populations ; }, } @article {pmid33174406, year = {2020}, author = {Tavazzi, G and Corradi, F and Mojoli, F and Forfori, F and Via, G}, title = {Contextualizing cardiac dysfunction in critically ill patients with COVID-19.}, journal = {Minerva anestesiologica}, volume = {86}, number = {12}, pages = {1340-1345}, doi = {10.23736/S0375-9393.20.14859-4}, pmid = {33174406}, issn = {1827-1596}, mesh = {Angiotensin-Converting Enzyme 2/genetics ; COVID-19/*complications ; Critical Illness/*therapy ; Heart Diseases/*etiology/*therapy ; Humans ; Ventricular Dysfunction, Right/etiology/therapy ; }, abstract = {Acute cardiac injury incidence in COVID-19 is about 13 times higher in the Intensive Care Unit (ICU)/severely ill than in less critical patients. Patients with cardiovascular comorbidities seem to be more prone to develop higher acuity of the infection, and myocardial injury has been reported amongst them in up to 15% of those hospitalized and up to 30% of ICU-admitted ones. The symptoms of over ischemia/heart failure may be challenging to distinguish as dyspnea and chest discomfort overlap with those due to COVID-19. Therefore, beside close monitoring with electrocardiography, biomarkers and, in case of demonstrated cardiac involvement, echocardiography, strategies to improve myocardial oxygen delivery should be promptly applied. The cytokine release with complement and iNO dysregulation are established mechanisms potentially leading to sepsis-related cardiomyopathy, making sepsis per se one of the potential mechanism leading to acute cardiac injury in COVID-19 patients. Moreover, the hyper-inflammation with endothelial dysfunction is likely be responsible of both pulmonary in-situ platelet aggregation and deep thrombosis potentially leading to severe pulmonary embolism and right ventricular failure. Besides the customary antithrombotic prophylaxis for critical patients, D-dimer levels and tighter coagulation monitoring are recommended and should guide the choice for anticoagulation treatment. We summarize the current knowledge regarding cardiovascular involvement in patient with COVID-19.}, } @article {pmid33125297, year = {2021}, author = {Tabari, P and Amini, M and Khoshnood, K and Arya, N}, title = {Multi-dimensional effects of the COVID-19 pandemic considering the WHO's ecological approach.}, journal = {Global public health}, volume = {16}, number = {1}, pages = {136-148}, doi = {10.1080/17441692.2020.1839934}, pmid = {33125297}, issn = {1744-1706}, mesh = {Animals ; COVID-19/*epidemiology ; Communicable Disease Control/*organization & administration ; Communicable Diseases, Emerging/epidemiology/prevention & control ; *Global Health ; Humans ; Pandemics/*prevention & control ; Politics ; *Public Health Practice ; SARS-CoV-2 ; *World Health Organization ; Zoonoses/epidemiology/prevention & control ; }, abstract = {At the end of 2019, a new virus named SARS-CoV-2 emerged in China, provoking coronavirus disease 2019 or COVID-19. Self-isolation and quarantine as key strategies to overcoming the spread of the disease have had major, micro, and macroscopic consequences. This commentary, therefore, seeks to review critical factors impacting the COVID-19 pandemic through the spectrum of levels, categorising effects in the WHO's ecological framework (individual, relational, community, and societal aspects). We further describe the management of the crisis at each level to help guide health personnel, communities, governments, and international policymakers in understanding how their actions fit into a larger picture as they seek to manage the crisis.}, } @article {pmid33116284, year = {2020}, author = {Green, ED and Gunter, C and Biesecker, LG and Di Francesco, V and Easter, CL and Feingold, EA and Felsenfeld, AL and Kaufman, DJ and Ostrander, EA and Pavan, WJ and Phillippy, AM and Wise, AL and Dayal, JG and Kish, BJ and Mandich, A and Wellington, CR and Wetterstrand, KA and Bates, SA and Leja, D and Vasquez, S and Gahl, WA and Graham, BJ and Kastner, DL and Liu, P and Rodriguez, LL and Solomon, BD and Bonham, VL and Brody, LC and Hutter, CM and Manolio, TA}, title = {Strategic vision for improving human health at The Forefront of Genomics.}, journal = {Nature}, volume = {586}, number = {7831}, pages = {683-692}, pmid = {33116284}, issn = {1476-4687}, mesh = {Biomedical Research/economics/*trends ; COVID-19/genetics ; Genome, Human/*genetics ; Genomics/economics/*trends ; Humans ; National Human Genome Research Institute (U.S.)/economics ; Public Health/*standards ; Social Change ; Translational Medical Research/economics/*trends ; United States ; }, abstract = {Starting with the launch of the Human Genome Project three decades ago, and continuing after its completion in 2003, genomics has progressively come to have a central and catalytic role in basic and translational research. In addition, studies increasingly demonstrate how genomic information can be effectively used in clinical care. In the future, the anticipated advances in technology development, biological insights, and clinical applications (among others) will lead to more widespread integration of genomics into almost all areas of biomedical research, the adoption of genomics into mainstream medical and public-health practices, and an increasing relevance of genomics for everyday life. On behalf of the research community, the National Human Genome Research Institute recently completed a multi-year process of strategic engagement to identify future research priorities and opportunities in human genomics, with an emphasis on health applications. Here we describe the highest-priority elements envisioned for the cutting-edge of human genomics going forward-that is, at 'The Forefront of Genomics'.}, } @article {pmid33019889, year = {2021}, author = {Friedler, A}, title = {Sociocultural, behavioural and political factors shaping the COVID-19 pandemic: the need for a biocultural approach to understanding pandemics and (re)emerging pathogens.}, journal = {Global public health}, volume = {16}, number = {1}, pages = {17-35}, doi = {10.1080/17441692.2020.1828982}, pmid = {33019889}, issn = {1744-1706}, mesh = {Animals ; *Behavior ; COVID-19/*epidemiology ; Communicable Diseases, Emerging/*epidemiology ; *Cultural Characteristics ; Humans ; Pandemics ; *Politics ; SARS-CoV-2 ; Zoonoses/epidemiology ; }, abstract = {Although there has been increasing focus in recent years on interdisciplinary approaches to health and disease, and in particular the dimension of social inequalities in epidemics, infectious diseases have been much less focused on. This is especially true in the area of cultural dynamics and their effects on pathogen behaviours, although there is evidence to suggest that this relationship is central to shaping our interactions with infectious disease agents on a variety of levels. This paper makes a case for a biocultural approach to pandemics such as COVID-19. It then uses this biocultural framework to examine the anthropogenic dynamics that influenced and continue to shape the COVID-19 pandemic, both during its initial phase and during critical intersections of the pandemic. Through this understanding of biocultural interactions between people, animals and pathogens, a broader societal and political dimension is drawn as a function of population level and international cultures, to reflect on the culturally mediated differential burden of the pandemic. Ultimately, it is argued that a biocultural perspective on infectious disease pandemics will allow for critical reflection on how culture shapes our behaviours at all levels, and how the effects of these behaviours are ultimately foundational to pathogen ecology and evolution.}, } @article {pmid32990980, year = {2021}, author = {Shojaeefar, E and Malih, N and Rezaei, N}, title = {The possible double-edged sword effects of vitamin D on COVID-19: A hypothesis.}, journal = {Cell biology international}, volume = {45}, number = {1}, pages = {54-57}, doi = {10.1002/cbin.11469}, pmid = {32990980}, issn = {1095-8355}, mesh = {Angiotensin-Converting Enzyme 2/*metabolism ; Animals ; COVID-19/drug therapy/*metabolism ; Humans ; Treatment Outcome ; Vitamin D/*administration & dosage/*metabolism ; Vitamin D Deficiency/drug therapy/*metabolism ; }, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) gains access to host cells by attaching to angiotensin-converting enzyme 2 (ACE2). Vitamin D (VitD) can upregulate ACE2 and has an antagonistic effect on Renin, which exerts a vasodilatation and anti-inflammatory effect against coronavirus disease (COVID-19). However, it may also facilitate viral entry by increasing ACE2 as the main SARS-CoV-2 receptor and mediates ROS production through NADPH oxidase, as a double-edged sword effect. Lung function and the immune system are also influenced by VitD through several mechanisms, including increased natural antibiotics (Defensin and Cathelicidin) and upregulated transforming growth factor-β. A higher IgA, Th2/Th1 ratio, and T-regulatory cells are attributable to VitD effects on the immune cells, while these changes may also be a double-edged sword in COVID-19. Although VitD supplementation might be highly recommended in COVID-19, the administration's dosage and route could be challenging. Furthermore, this issue has not been mentioned in various studies so far. So, the report aimed to explain the current challenges with the application of VitD in COVID-19.}, } @article {pmid32972300, year = {2021}, author = {Hanna, KS and Segal, EM and Barlow, A and Barlow, B}, title = {Clinical strategies for optimizing infusion center care through a pandemic.}, journal = {Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners}, volume = {27}, number = {1}, pages = {165-179}, doi = {10.1177/1078155220960211}, pmid = {32972300}, issn = {1477-092X}, mesh = {Ambulatory Care ; Antineoplastic Agents/administration & dosage/*therapeutic use ; *COVID-19 ; Delivery of Health Care ; Humans ; Neoplasms/*drug therapy ; *Pandemics ; }, abstract = {The national pandemic resulting from the novel coronavirus, COVID-19, has made the delivery of care for patients with cancer a challenge. There are competing risks of mortality from cancer versus serious complications and higher risk of death from COVID-19 in immunocompromised hosts. Furthermore, compounding these concerns is the inadequate supply of personal protective equipment, decreased hospital capacity, and paucity of effective treatments or vaccines to date for COVID-19. Guidance measures and recommendations have been published by national organizations aiming to facilitate the delivery of care in a safe and effective manner, many of which, are permanently adoptable interventions. Given the critical importance to continue chemotherapy, there remains additional interventions to further enhance patient safety while conserving healthcare resources such as adjustments in medication administration, reduction in laboratory or drug monitoring, and home delivery of specialty infusions. In this manuscript, we outline how to implement these actionable interventions of chemotherapy and supportive care delivery to further enhance the current precautionary measures while maintaining safe and effective patient care. Coupled with current published standards, these strategies can help alleviate the numerous challenges associated with this pandemic.}, } @article {pmid32962623, year = {2020}, author = {Ali, A and Kamjani, MH and Kesselman, MM}, title = {The Role of Tocilizumab in Cytokine Storm and Improving Outcomes in COVID-19.}, journal = {Recent patents on anti-infective drug discovery}, volume = {15}, number = {2}, pages = {104-112}, doi = {10.2174/1574891X15666200922155712}, pmid = {32962623}, issn = {2212-4071}, mesh = {Animals ; Antibodies, Monoclonal, Humanized/pharmacology/*therapeutic use ; COVID-19/diagnosis/*drug therapy/metabolism ; Cytokine Release Syndrome/diagnosis/*drug therapy/metabolism ; Humans ; Interleukin-6/antagonists & inhibitors/metabolism ; Receptors, Interleukin-6/*antagonists & inhibitors/metabolism ; Treatment Outcome ; }, abstract = {To date, severe acute respiratory syndrome coronavirus 2 (SARSCoV- 2) has infected millions of individuals worldwide. This virus causes coronavirus disease 2019 (COVID-19) and has led to numerous deaths worldwide. A large percentage of infected patients present asymptomatically, augmenting the spread of the virus. Symptomatic COVID-19 commonly causes mild to severe respiratory disease and fever, but some individuals experience serious complications resulting in death. Immune compromised, high risk, and elderly individuals are at an increased risk of more severe consequences of the illness such as respiratory failure, organ dysfunction, and shock. Cytokine storm (also known as cytokine release syndrome (CRS)), a systemic inflammatory response that can be triggered by an infection, has been associated with the symptom progression of COVID-19. This review evaluates several published studies that have implemented tocilizumab (TCZ), an IL-6 receptor antibody (US20120253016A1), in COVID-19 treatment. Outcomes and biomarkers of patients treated with TCZ are compared to patients treated with standard of care regimens. Interleukin-6 (IL-6), a prominent inflammatory cytokine involved in CRS in various inflammatory conditions, may have a vital role in the underlying mechanism involved in debilitating SARS-CoV-2 infections and could serve as a viable treatment target. Studies suggest that TCZ may aid in the recovery of patients with COVID-19 and reduce mortality.}, } @article {pmid32957894, year = {2020}, author = {Ray, SK and Mukherjee, S}, title = {Understanding the Role of Corona Virus based on Current Scientific Evidence - A Review with Emerging Importance in Pandemic.}, journal = {Recent patents on anti-infective drug discovery}, volume = {15}, number = {2}, pages = {89-103}, doi = {10.2174/1574891X15999200918144833}, pmid = {32957894}, issn = {2212-4071}, mesh = {Angiotensin-Converting Enzyme 2/antagonists & inhibitors/metabolism ; Angiotensin-Converting Enzyme Inhibitors/pharmacology/therapeutic use ; Animals ; Antiviral Agents/pharmacology/therapeutic use ; COVID-19/*drug therapy/*epidemiology/metabolism ; COVID-19 Vaccines/therapeutic use ; Evidence-Based Medicine/*methods ; Humans ; SARS-CoV-2/*drug effects/isolation & purification/metabolism ; }, abstract = {Coronavirus disease is a potentially deadly disease and of significant apprehension for global communal health because of its lethality. Vaccines and antiviral medications are still under trial to prevent or treat human coronavirus (HCoV) till date. The virus HCoV originated in 2003, SARS-CoV, which causes respiratory syndrome having distinctive pathogenesis and infections of the respiratory tract. A mechanism was projected for the evolution of SARS virus, and a handy association with bats was found. When this virus reaches the respective host system, the infection starts with spike protein binding to its complementary receptor of the host cell. The coronavirus spike protein's association with its host cell receptor complement is crucial in deciding the virus infectivity, tissue tropism and species variety. Recent studies show that SARS Coronavirus 2 or COVID-19 requires protease to get into cells, offering a new therapeutic target. Distinctive attention and exertions should be given to defending or reducing transmission in vulnerable populaces, including those directly associated with caregiving and treatment and also aged one. Researchers are planning to develop a vaccine for COVID-19, and in this approach are also considered developing a vaccine that sensitizes our immune system preventing from this pandemic. The present review focuses on the role of S-spike protein in COVID-19, which helps the virus intruding the enzyme ACE2 (Angiotensin-Converting Enzyme 2). Passive antibody therapy is an additional alternative to use blood donors from hale and hearty people who have already recovered from COVID-19 and therapeutic advancement in handling the COVID-19 pandemic.}, } @article {pmid32956925, year = {2020}, author = {Mbunge, E}, title = {Effects of COVID-19 in South African health system and society: An explanatory study.}, journal = {Diabetes & metabolic syndrome}, volume = {14}, number = {6}, pages = {1809-1814}, pmid = {32956925}, issn = {1878-0334}, mesh = {COVID-19/*epidemiology/mortality ; Contact Tracing ; Delivery of Health Care ; Economic Factors ; Food Assistance/statistics & numerical data ; Gender-Based Violence/statistics & numerical data ; Health Policy ; Humans ; Life Style ; Mental Disorders/*epidemiology ; Personal Protective Equipment/*supply & distribution ; Physical Distancing ; *Poverty ; Psychosocial Support Systems ; *Public Policy ; SARS-CoV-2 ; Sedentary Behavior ; Socioeconomic Factors ; South Africa/epidemiology ; Substance-Related Disorders/epidemiology ; *Unemployment ; }, abstract = {BACKGROUND AND AIMS: The underestimation of the severity of COVID-19 by the South African government resulted in delayed action against the pandemic. Ever since WHO declared COVID-19 a pandemic preventive action was comprehensively upgraded worldwide. This prompted South African authorities to implement physical distancing, self-isolation, closure of non-essential services, schools, travelling restrictions and recursive national lockdowns to mitigate the impact of COVID-19. This explanatory study sought to review the effects of COVID-19 in the South African health system and society.

METHODS: The study applied literature research of COVID-19 reports, policies from the National Department of Health, WHO, Africa CDC, and articles from Google Scholar, Science Direct, Web of Science, Scopus and PubMed.

RESULTS: The South African health system is affected by the lack of PPEs, increased mortality rates, mental health problems, substance abuse, resurgent of NCDs. The closure of international borders, global demand meltdown, supply disruptions, dramatic scaling down of human and industrial activities during lockdown cause socio-economic problems. The prolonged effects of lockdown on psychosocial support services resulted in the outbursts of uncertainties, acute panic, fear, depression, obsessive behaviours, social unrests, stigmatization, anxiety, increased gender-based violence cases and discrimination in the distribution of relief food aid.

CONCLUSION: To slow down the spread of COVID-19, massive testing must be adopted, contact tracing, isolation, and home quarantine guidelines for asymptomatic cases which promote behavioural change and reviewing of policy on food relief.}, } @article {pmid32955087, year = {2021}, author = {Snow, EK and Miller, JL and Kester, L and Mendham, NA and Heydorn, JD and Huang, SC and Leu, LL and Kohoutek, LM and Rosanelli, NC and Harves, KM}, title = {Creation and maintenance of a table for assessment of evolving evidence for COVID-19-related treatments.}, journal = {American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists}, volume = {78}, number = {2}, pages = {154-157}, doi = {10.1093/ajhp/zxaa334}, pmid = {32955087}, issn = {1535-2900}, mesh = {Antiviral Agents/administration & dosage/classification ; COVID-19/epidemiology/*therapy ; Clinical Trials as Topic/methods/standards ; Evidence-Based Pharmacy Practice/*methods/standards ; Humans ; *Pharmacists/standards ; *Societies, Pharmaceutical/standards ; Statistics as Topic/*methods/standards ; United States/epidemiology ; }, abstract = {PURPOSE: This report describes the development and maintenance of a table to present an assessment of evidence for treatments used in patients with coronavirus disease 2019 (COVID-19).

SUMMARY: AHFS Drug Information (AHFS DI) (American Society of Health-System Pharmacists, Bethesda, MD) is ASHP's evidence-based drug compendium that contains drug monographs written for pharmacists and other healthcare professionals. The professional editorial and analytical staff of pharmacists critically evaluate published evidence to develop drug monographs for AHFS DI. In response to the global COVID-19 pandemic, these skills were applied to assess emerging evidence for COVID-19-related treatments, and the information was compiled into a new resource for pharmacists and other healthcare professionals to use at the point of care. A list of therapies was developed and prioritized based on review of scientific and public discussions on the use of these therapies in patients with COVID-19; certain therapies used for supportive care and therapies that might theoretically be harmful to patients with COVID-19 also were considered for inclusion. Potential treatments were identified, and the evidence for use in patients with COVID-19 was assessed and summarized in a table format. Information presented for each therapy included the rationale for use, summaries of clinical trials or experience, trial registry numbers, and dosage regimens. Comments on safety and efficacy, including limitations of available data, were presented along with recommendations from recognized authorities. The editorial team continued to add new therapies to the table and update existing entries as new evidence emerged.

CONCLUSION: A comprehensive table that summarized available evidence for potential treatments for patients with COVID-19 was developed. The table format enabled the drug information editorial staff to provide ongoing updates as new information emerged during the pandemic.}, } @article {pmid32954746, year = {2020}, author = {Guo, W and Zhou, Q and Xu, J}, title = {Negative results in nucleic acid test of COVID-19 patients: assessment from the perspective of clinical laboratories.}, journal = {Annals of palliative medicine}, volume = {9}, number = {6}, pages = {4246-4251}, doi = {10.21037/apm-20-568}, pmid = {32954746}, issn = {2224-5839}, mesh = {COVID-19/*diagnosis/virology ; COVID-19 Nucleic Acid Testing/*standards ; Humans ; Laboratories/*organization & administration ; *Negative Results ; SARS-CoV-2/isolation & purification ; }, abstract = {Since December 2019, there had been an outbreak of coronavirus disease 2019 (COVID-19). Pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is prevalent around the world, and the number of infected cases has increased rapidly. Viral nucleic acid test of SARS-CoV-2 can provide direct evidence for rapid diagnosis, disease course monitoring, and therapeutic efficacy. However, in practice, false-negative results in nucleic acid test are common, causing missed diagnoses, which are not conducive to the prevention and control of this outbreak. This article analyzes the possible causes and proposed measures to reduce the false-negative rate of nucleic acid test results and more effectively curb the outbreak.}, } @article {pmid32951577, year = {2020}, author = {Gupta, RK and Apte, GR and Lokhande, KB and Mishra, S and Pal, JK}, title = {Carbohydrate-Binding Agents: Potential of Repurposing for COVID-19 Therapy.}, journal = {Current protein & peptide science}, volume = {21}, number = {11}, pages = {1085-1096}, doi = {10.2174/1389203721666200918153717}, pmid = {32951577}, issn = {1875-5550}, mesh = {Antiviral Agents/chemistry/*metabolism/*pharmacology/therapeutic use ; COVID-19/*drug therapy/metabolism ; *Carbohydrate Metabolism ; *Drug Repositioning ; Humans ; }, abstract = {With the emergence of the novel severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), the whole world is suffering from atypical pneumonia, which resulted in more than 559,047 deaths worldwide. In this time of crisis and urgency, the only hope comes from new candidate vaccines and potential antivirals. However, formulating new vaccines and synthesizing new antivirals are a laborious task. Therefore, considering the high infection rate and mortality due to COVID-19, utilization of previous information, and repurposing of existing drugs against valid viral targets have emerged as a novel drug discovery approach in this challenging time. The transmembrane spike (S) glycoprotein of coronaviruses (CoVs), which facilitates the virus's entry into the host cells, exists in a homotrimeric form and is covered with N-linked glycans. S glycoprotein is known as the main target of antibodies having neutralizing potency and is also considered as an attractive target for therapeutic or vaccine development. Similarly, targeting of N-linked glycans of S glycoprotein envelope of CoV via carbohydrate-binding agents (CBAs) could serve as an attractive therapeutic approach for developing novel antivirals. CBAs from natural sources like lectins from plants, marine algae and prokaryotes and lectin mimics like Pradimicin-A (PRM-A) have shown antiviral activities against CoV and other enveloped viruses. However, the potential use of CBAs specifically lectins was limited due to unfavorable responses like immunogenicity, mitogenicity, hemagglutination, inflammatory activity, cellular toxicity, etc. Here, we reviewed the current scenario of CBAs as antivirals against CoVs, presented strategies to improve the efficacy of CBAs against CoVs; and studied the molecular interactions between CBAs (lectins and PRM-A) with Man9 by molecular docking for potential repurposing against CoVs in general, and SARSCoV- 2, in particular.}, } @article {pmid32949157, year = {2021}, author = {Akiyama, S and Yamada, A and Sakuraba, A}, title = {Safety of nontumor necrosis factor-targeted biologics in the COVID-19 pandemic.}, journal = {Journal of medical virology}, volume = {93}, number = {2}, pages = {714-716}, pmid = {32949157}, issn = {1096-9071}, mesh = {Antibodies, Monoclonal/therapeutic use ; Azetidines/therapeutic use ; Biological Products/adverse effects/*therapeutic use ; COVID-19/immunology/*therapy ; Humans ; Interleukins/*antagonists & inhibitors ; Janus Kinase Inhibitors/therapeutic use ; Purines/therapeutic use ; Pyrazoles/therapeutic use ; Randomized Controlled Trials as Topic ; Sulfonamides/therapeutic use ; Tumor Necrosis Factor-alpha ; }, } @article {pmid32942253, year = {2020}, author = {Gupta, R and Misra, A}, title = {Clinical considerations in patients with diabetes during times of COVID19: An update on lifestyle factors and antihyperglycemic drugs with focus on India.}, journal = {Diabetes & metabolic syndrome}, volume = {14}, number = {6}, pages = {1777-1781}, pmid = {32942253}, issn = {1878-0334}, mesh = {Blood Glucose/metabolism ; COVID-19/complications/epidemiology/*therapy ; Diabetes Mellitus, Type 1/complications/*drug therapy/metabolism ; Diabetes Mellitus, Type 2/complications/*drug therapy/metabolism ; Glycated Hemoglobin A/metabolism ; Humans ; Hypoglycemic Agents/*therapeutic use ; India/epidemiology ; SARS-CoV-2 ; Telemedicine ; }, abstract = {BACKGROUND: Diabetes is recognized as an important comorbidity in patients with COVID-19 and a large amount of literature has become available regarding this. The aim of this article is to review the literature regarding various aspects of association between diabetes and COVID-19 and to highlight clinically relevant points with focus on India.

METHODS: We searched Pubmed and Google Scholar databases for articles regarding diabetes and COVID-19 published between March 19, 2020 and August 30, 2020.

RESULTS: Diabetes and poor glycemic control are associated with increased severity and mortality in patients with COVID-19. Several clinical scenarios about hyperglycemia and COVID-19 are identified and each of these needs specific management strategies.

CONCLUSION: It is prudent to maintain good glycemic control in patients with diabetes in order to minimize the complications of COVID-19. There is a need for well conducted studies to asses the role of individual antihyperglycemic therapies in COVID-19 and also the behavior of new onset diabetes diagnosed either after COVID-19 infection or during this time.}, } @article {pmid32938531, year = {2020}, author = {Fouché, A and Fouché, DF and Theron, LC}, title = {Child protection and resilience in the face of COVID-19 in South Africa: A rapid review of C-19 legislation.}, journal = {Child abuse & neglect}, volume = {110}, number = {Pt 2}, pages = {104710}, pmid = {32938531}, issn = {1873-7757}, mesh = {COVID-19/*prevention & control ; Child ; Child Abuse/*legislation & jurisprudence/statistics & numerical data ; Communicable Disease Control/*legislation & jurisprudence ; Family Characteristics ; *Government Regulation ; Humans ; Pandemics/prevention & control ; Resilience, Psychological ; South Africa ; Vulnerable Populations ; }, abstract = {BACKGROUND & PURPOSE: In response to the COVID-19 (C-19) pandemic, the South African government instituted strict lockdown and related legislation. Although this response was well intended, many believed it advanced children's vulnerability to abuse and neglect. This article interrogates these concerns. It investigates how C-19 legislation enabled, or constrained, South African children's protection from abuse and neglect and appraises the findings from a social-ecological resilience perspective with the aim of advancing child protection in times of emergency.

METHOD: The authors conducted a rapid review of the legislation, directives and regulations pertaining to South Africa's strict lockdown (15 March to 31 May 2020). They searched two databases (SA Government platform and LexisNexus) and identified 140 documents for potential inclusion. Following full-text screening, 17 documents were reviewed. Document analysis was used to extract relevant themes.

FINDINGS: The regulations and directives that informed South Africa's strict lockdown offered three protective pathways. They (i) limited C-19 contagion and championed physical health; (ii) ensured uninterrupted protection (legal and statutory) for children at risk of abuse; and (iii) advanced social protection measures available to disadvantaged households.

CONCLUSION: C-19 legislation has potential to advance children's protection from abuse and neglect during emergency times. However, this potential will be curtailed if C-19 legislation is inadequately operationalised and/or prioritises physical health to the detriment of children's intellectual, emotional, social and security needs. To overcome such risks, social ecologies must work with legislators to co-design and co-operationalise C-19 legislation that will not only protect children, but advance their resilience.}, } @article {pmid32936465, year = {2021}, author = {Zhou, P and Li, Z and Xie, L and An, D and Fan, Y and Wang, X and Li, Y and Liu, X and Wu, J and Li, G and Li, Q}, title = {Research progress and challenges to coronavirus vaccine development.}, journal = {Journal of medical virology}, volume = {93}, number = {2}, pages = {741-754}, doi = {10.1002/jmv.26517}, pmid = {32936465}, issn = {1096-9071}, support = {81803813//National Natural Science Foundation of China/International ; 81973549//National Natural Science Foundation of China/International ; 81973814//National Natural Science Foundation of China/International ; 2018KCXTD007//Science & Technology Planning Project of Guangdong Province Office of Education/International ; 2019KYTD102//Science & Technology Planning Project of Guangdong Province Office of Education/International ; SKLNMKF201906//The Open Project of State Key Laboratory of Natural Medicines/International ; }, mesh = {Animals ; COVID-19/immunology/*prevention & control/virology ; COVID-19 Vaccines/*biosynthesis ; Camelus ; Coronavirus Infections/immunology/*prevention & control/virology ; Cricetulus ; Disease Models, Animal ; Humans ; Macaca mulatta ; Mice ; Middle East Respiratory Syndrome Coronavirus/drug effects/immunology ; SARS Virus/drug effects/immunology ; SARS-CoV-2/drug effects/immunology ; Severe Acute Respiratory Syndrome/immunology/*prevention & control/virology ; Spike Glycoprotein, Coronavirus/chemistry/genetics/*immunology ; Vaccines, Subunit ; Vaccines, Synthetic/biosynthesis ; Vaccines, Virus-Like Particle/biosynthesis ; }, abstract = {Coronaviruses (CoVs) are nonsegmented, single-stranded, positive-sense RNA viruses highly pathogenic to humans. Some CoVs are known to cause respiratory and intestinal diseases, posing a threat to the global public health. Against this backdrop, it is of critical importance to develop safe and effective vaccines against these CoVs. This review discusses human vaccine candidates in any stage of development and explores the viral characteristics, molecular epidemiology, and immunology associated with CoV vaccine development. At present, there are many obstacles and challenges to vaccine research and development, including the lack of knowledge about virus transmission, pathogenesis, and immune response, absence of the most appropriate animal models.}, } @article {pmid32921419, year = {2021}, author = {Sánchez Santos, R and Garcia Ruiz de Gordejuela, A and Breton Lesmes, I and Lecube Torelló, A and Moizé Arcone, V and Arroyo Martin, JJ and Fernandez Alsina, E and Martín Antona, E and Rubio Herrera, MÁ and Sabench Pereferrer, F and Sánchez Pernaute, A and Vilallonga Puy, R}, title = {Obesity and SARS-CoV-2: Considerations on bariatric surgery and recommendations for the start of surgical activity.}, journal = {Cirugia espanola}, volume = {99}, number = {1}, pages = {4-10}, pmid = {32921419}, issn = {1578-147X}, mesh = {Bariatric Surgery/*standards ; COVID-19/*epidemiology ; Comorbidity ; Humans ; Obesity/epidemiology/*surgery ; *Pandemics ; *Practice Guidelines as Topic ; SARS-CoV-2 ; }, abstract = {The SARS-CoV-2 pandemic has a great impact worldwide, being Spain one of the most affected countries. The delay in bariatric surgery can have fatal consequences since up to 50% of the patients who are on the waiting list develop a new comorbidity during the time they remain on it and 1.5% of patients die while waiting for the intervention. That is why bariatric surgery should not be delayed, if the occupation of the hospital by COVID-19+ patients decreases significantly, and sufficient resources and safety are available to restart surgery in patients with benign pathology. This document contains the main recommendations for the bariatric surgery programs in our country from the point of view of safety, bariatric patient preparation and follow up during the SARS-CoV-2 pandemia.}, } @article {pmid32917554, year = {2021}, author = {Farooqi, AT and Snoek, FJ and Khunti, K}, title = {Management of chronic cardiometabolic conditions and mental health during COVID-19.}, journal = {Primary care diabetes}, volume = {15}, number = {1}, pages = {21-23}, doi = {10.1016/j.pcd.2020.08.016}, pmid = {32917554}, issn = {1878-0210}, mesh = {COVID-19/*epidemiology ; Chronic Disease ; *Disease Management ; Humans ; Mental Disorders/*epidemiology/therapy ; *Mental Health ; Metabolic Syndrome/*epidemiology/therapy ; *Pandemics ; SARS-CoV-2 ; }, } @article {pmid33440306, year = {2021}, author = {Rahimi, G and Rahimi, B and Panahi, M and Abkhiz, S and Saraygord-Afshari, N and Milani, M and Alizadeh, E}, title = {An overview of Betacoronaviruses-associated severe respiratory syndromes, focusing on sex-type-specific immune responses.}, journal = {International immunopharmacology}, volume = {92}, number = {}, pages = {107365}, doi = {10.1016/j.intimp.2021.107365}, pmid = {33440306}, issn = {1878-1705}, abstract = {Emerging beta-coronaviruses (β-CoVs), including Severe Acute Respiratory Syndrome CoV-1 (SARS-CoV-1), Middle East Respiratory Syndrome-CoV (MERS-CoV), and Severe Acute Respiratory Syndrome CoV-2 (SARS-CoV-2, the cause of COVID19) are responsible for acute respiratory illnesses in human. The epidemiological features of the SARS, MERS, and new COVID-19 have revealed sex-dependent variations in the infection, frequency, treatment, and fatality rates of these syndromes. Females are likely less susceptible to viral infections, perhaps due to their steroid hormone levels, the impact of X-linked genes, and the sex-based immune responses. Although mostly inactive, the X chromosome makes the female's immune system more robust. The extra immune-regulatory genes of the X chromosome are associated with lower levels of viral load and decreased infection rate. Moreover, a higher titer of the antibodies and their longer blood circulation half-life are involved in a more durable immune protection in females. The activation rate of the immune cells and the production of TLR7 and IFN are more prominent in females. Although the bi-allelic expression of the immune regulatory genes can sometimes lead to autoimmune reactions, the higher titer of TLR7 in females is further associated with a stronger anti-viral immune response. Considering these sex-related differences and the similarities between the SARS, MERS, and COVID-19, we will discuss them in immune responses against the β-CoVs-associated syndromes. We aim to provide information on sex-based disease susceptibility and response. A better understanding of the evasion strategies of pathogens and the host immune responses can provide worthful insights into immunotherapy, and vaccine development approaches.}, } @article {pmid33440299, year = {2020}, author = {Milanese, M and Corsico, AG and Bellofiore, S and Carrozzi, L and Di Marco, F and Iovene, B and Richeldi, L and Sanna, A and Santus, P and Schisano, M and Scichilone, N and Vancheri, C and Cerveri, I and , }, title = {Suggestions for lung function testing in the context of COVID-19.}, journal = {Respiratory medicine}, volume = {177}, number = {}, pages = {106292}, doi = {10.1016/j.rmed.2020.106292}, pmid = {33440299}, issn = {1532-3064}, abstract = {The 2019 coronavirus disease (COVID-19) pandemic is currently a challenge worldwide. Due to the characteristics of lung function tests, the risk of cross infection may be high between health care workers and patients. The role of lung function testing is well defined for the diagnosis of various diseases and conditions. Lung function tests are also indispensable in evaluating the response to medical treatment, in monitoring patient respiratory and systemic pathologies, and in evaluating preoperative risk in cardiothoracic and major abdominal surgeries. However, lung function testing represents a potential route for COVID-19 transmission, due to the aerosol generated during the procedures and the concentration of patients with pulmonary diseases in lung function laboratories. Currently, the opportunities for COVID-19 transmission remain partially unknown, and data are continuously evolving. This review provides useful information on the risks and recommendations for lung function testing, which have varied according to the phase of the pandemic. This information may support national and regional boards and the health authorities to which they belong. There is a need for rapid re-opening of lung function laboratories, but maximum safety is required in the COVID-19 era.}, } @article {pmid33439544, year = {2020}, author = {Stamu-O'Brien, C and Carniciu, S and Halvorsen, E and Jafferany, M}, title = {Psychological aspects of COVID-19.}, journal = {Journal of cosmetic dermatology}, volume = {19}, number = {9}, pages = {2169-2173}, doi = {10.1111/jocd.13601}, pmid = {33439544}, issn = {1473-2165}, abstract = {BACKGROUND: COVID-19 pandemic has affected the world from every aspect. Individuals are drained from social, financial, and emotional percussion of this pandemic. Psychosocial consequences are far greater than are being perceived. It is anticipated that once the pandemic is over the psycho-emotional turbulence would shake the whole populations of affected countries.

AIMS AND OBJECTIVES: To review the psychological consequences of COVID-19 pandemic.

METHODS: A literature search was conducted on major databases from January 2020 to April 2020 with the search terms of Covid-19, Corona virus, psychological, depression, anxiety, phobias, obsessive behaviors, paranoia, parental relationship, marital life and maternal and fetal bond.

CONCLUSION: Patients with COVID-19 infection are more likely to suffer from a myriad of psychological consequences, and this infection may have profound effect on parenting, relationships, marital life, elderly, and maternal-fetal bond.}, } @article {pmid33439437, year = {2021}, author = {Karuppan, MKM and Devadoss, D and Nair, M and Chand, HS and Lakshmana, MK}, title = {SARS-CoV-2 Infection in the Central and Peripheral Nervous System-Associated Morbidities and Their Potential Mechanism.}, journal = {Molecular neurobiology}, volume = {}, number = {}, pages = {}, pmid = {33439437}, issn = {1559-1182}, support = {1R01DA052271/DA/NIDA NIH HHS/United States ; 3R21AI144374-02S1//National Institute of Allergy and Infectious Diseases, NIH/ ; }, abstract = {The recent outbreak of SARS-CoV-2 infections that causes coronavirus-induced disease of 2019 (COVID-19) is the defining and unprecedented global health crisis of our time in both the scale and magnitude. Although the respiratory tract is the primary target of SARS-CoV-2, accumulating evidence suggests that the virus may also invade both the central nervous system (CNS) and the peripheral nervous system (PNS) leading to numerous neurological issues including some serious complications such as seizures, encephalitis, and loss of consciousness. Here, we present a comprehensive review of the currently known role of SARS-CoV-2 and identify all the neurological problems reported among the COVID-19 case reports throughout the world. The virus might gain entry into the CNS either through the trans-synaptic route via the olfactory neurons or through the damaged endothelium in the brain microvasculature using the ACE2 receptor potentiated by neuropilin-1 (NRP-1). The most critical of all symptoms appear to be the spontaneous loss of breathing in some COVID-19 patients. This might be indicative of a dysfunction within the cardiopulmonary regulatory centers in the brainstem. These pioneering studies, thus, lay a strong foundation for more in-depth basic and clinical research required to confirm the role of SARS-CoV-2 infection in neurodegeneration of critical brain regulatory centers.}, } @article {pmid33438250, year = {2021}, author = {Shivangi, S and Meena, LS}, title = {A comprehensive review of COVID-19 in India: A frequent catch of the information.}, journal = {Biotechnology and applied biochemistry}, volume = {}, number = {}, pages = {}, doi = {10.1002/bab.2101}, pmid = {33438250}, issn = {1470-8744}, abstract = {The arrival of novel health crisis by a novel member of coronavirus group named as SARS-CoV-2 by WHO took the whole world in global emergency by affecting 206 countries. The virus infects 205 countries with 86,839,226 confirmed cases, 61,565,949 recoveries and 1,876,243 deaths as on 6th January 2021. Evidences pointed out the fact that virus might first originated in bats in China and it takes only two months to cover almost every country of the world. SARS-CoV-2 belongs to Beta coronavirus and is enveloped, positive sense and single stranded RNA virus. The treatment would be difficult as SARS-CoV-2 is an RNA virus and thus the mutation rate is higher in comparison to DNA viruses. The virus infection also leads to generation of effective protective immune response of TNF, IL-1β, IL-6, IL-8, G-CSF and GM-CSF etc. that may help in virus elimination. The speed of the global spread of the current pandemic is of major concern and it creates a significant threat to economic and human health. In India, the infection spreads with an infection and fatality rate of the disease are 1.7 and 2.8% respectively. By this review we want to emphasize the actual situation and major factors associated with COVID-19 pandemic, its significance, destructions, important findings, treatments and preventive measures taken by all nations to provide better cure without having much loss. This article is protected by copyright. All rights reserved.}, } @article {pmid33438132, year = {2021}, author = {Kameda, T and Mizuma, Y and Taniguchi, H and Fujita, M and Taniguchi, N}, title = {Point-of-care lung ultrasound for the assessment of pneumonia: a narrative review in the COVID-19 era.}, journal = {Journal of medical ultrasonics (2001)}, volume = {}, number = {}, pages = {}, pmid = {33438132}, issn = {1613-2254}, abstract = {In the coronavirus disease-2019 (COVID-19) era, point-of-care lung ultrasound (LUS) has attracted increased attention. Prospective studies on LUS for the assessment of pneumonia in adult patients were extensively carried out for more than 10 years before this era. None of these prospective studies attempted to differentiate bacterial and viral pneumonia in adult patients using LUS. The majority of studies considered the LUS examination to be positive if sonographic consolidations or multiple B-lines were observed. Significant differences existed in the accuracy of these studies. Some studies revealed that LUS showed superior sensitivity to chest X-ray. These results indicate that point-of-care LUS has the potential to be an initial imaging modality for the diagnosis of pneumonia. The LUS diagnosis of ventilator-associated pneumonia in intensive care units is more challenging in comparison with the diagnosis of community-acquired pneumonia in emergency departments due to the limited access to the mechanically ventilated patients and the high prevalence of atelectasis. However, several studies have demonstrated that the combination of LUS findings with other clinical markers improved the diagnostic accuracy. In the COVID-19 era, many case reports and small observational studies on COVID-19 pneumonia have been published in a short period. Multiple B-lines were the most common and consistent finding in COVID-19 pneumonia. Serial LUS showed the deterioration of the disease. The knowledge and ideas on the application of LUS in the management of pneumonia that are expected to accumulate in the COVID-19 era may provide us with clues regarding more appropriate management.}, } @article {pmid33438054, year = {2021}, author = {Strobl, S and Roth, W}, title = {[International publication activity during the COVID-19 pandemic].}, journal = {Der Pathologe}, volume = {}, number = {}, pages = {}, pmid = {33438054}, issn = {1432-1963}, abstract = {BACKGROUND: Pandemics lead to new challenges for healthcare systems and a subsequent shift of the scientific focus, which can partially be seen in alterations in scientific publication activity.

OBJECTIVES: Follow-up on the global publication activity within the course of the COVID-19 pandemic in a comparison of national contexts with regards to local infection rates and the involvement of the discipline of pathology.

MATERIALS AND METHODS: Comparative analysis of the number of publications in the PubMed® database concerning COVID-19 with respect to publication type, date and place of publication, affiliation to an institute of pathology, and correlation with the number of SARS-CoV‑2 infections over the same timeframe.

RESULTS: After an initial peak with regards to the number of publications in the months of May and June 2020, a slight decrease was observed, followed by another increase starting in August/September 2020. Further, the time between data collection and publication contracted to approximately 3-4 months. Countries faced with early SARS-CoV‑2 infections published promptly, even though there was no overall association between the number of publications and COVID-19 case numbers. On average, 4% of authors were affiliated to an institute of pathology, with a steady increase of this percentage within the course of the pandemic.

CONCLUSIONS: COVID-19 altered global publication activity by providing for an unprecedented number of publications combined with an acceleration of publication times irrespective of the geographical location and overall case numbers.}, } @article {pmid33437971, year = {2021}, author = {Peravali, M and Joshi, I and Ahn, J and Kim, C}, title = {A Systematic Review and Meta-analysis of Clinical Characteristics and Outcomes in Lung Cancer Patients with COVID-19.}, journal = {JTO clinical and research reports}, volume = {}, number = {}, pages = {100141}, doi = {10.1016/j.jtocrr.2020.100141}, pmid = {33437971}, issn = {2666-3643}, abstract = {Background: Cancer is considered to be an independent risk factor for severe illness and higher mortality in patients with Coronavirus disease 2019 (COVID-19). These adverse outcomes have been suspected to be more severe in lung cancer patients. The objective of this systematic review and meta-analysis is to outline patient characteristics, challenges in diagnosis and treatment, and outcomes of lung cancer patients with COVID-19.

Methods: A comprehensive search was conducted using EMBASE and PUBMED databases using the terms "COVID" and "cancer." Studies that reported clinical characteristics and/or outcomes of lung cancer patients with COVID-19 were then systematically identified. Meta-analysis for COVID-19 related mortality associated with lung cancer compared to other cancer types was conducted. The results were reported as odds ratio (OR) and confidence intervals (CI) using mixed-effects logistic regression model.

Results: The most commonly reported clinical findings in lung cancer patients with COVID-19 were fever and cough, with 68% and 61%, respectively. Laboratory and radiographic findings were consistent with broadly reported data. The meta-analysis noted a statistically significant increase in mortality rate in lung cancer patients compared to other cancer patients, OR 1.62 (95% CI: 1.06-2.48). Lung cancer patients with COVID-19 also reflected greater severity of illness and higher rates of ICU admissions and mechanical ventilation.

Conclusions: COVID-19 in lung cancer patients is associated with severe disease and increased mortality relative to patients with other malignancies and the general population. There is conflicting evidence on the effect of specific lung cancer treatments on outcomes. Until more definitive data is available, lung cancer directed treatment should be continued or restarted as early as possible in mild to moderate cases to prevent worsening cancer-related mortality.}, } @article {pmid33437938, year = {2021}, author = {Patro, R and Salmela, L}, title = {Algorithms meet sequencing technologies - 10th edition of the RECOMB-Seq workshop.}, journal = {iScience}, volume = {24}, number = {1}, pages = {101956}, doi = {10.1016/j.isci.2020.101956}, pmid = {33437938}, issn = {2589-0042}, abstract = {DNA and RNA sequencing is a core technology in biological and medical research. The high throughput of these technologies and the consistent development of new experimental assays and biotechnologies demand the continuous development of methods to analyze the resulting data. The RECOMB Satellite Workshop on Massively Parallel Sequencing brings together leading researchers in computational genomics to discuss emerging frontiers in algorithm development for massively parallel sequencing data. The 10th meeting in this series, RECOMB-Seq 2020, was scheduled to be held in Padua, Italy, but due to the ongoing COVID-19 pandemic, the meeting was carried out virtually instead. The online workshop featured keynote talks by Paola Bonizzoni and Zamin Iqbal, two highlight talks, ten regular talks, and three short talks. Seven of the works presented in the workshop are featured in this edition of iScience, and many of the talks are available online in the RECOMB-Seq 2020 YouTube channel.}, } @article {pmid33437929, year = {2021}, author = {Malviya, A and Mishra, A}, title = {Childhood Multisystem Inflammatory Syndrome: An Emerging Disease with Prominent Cardiovascular Involvement-A Scoping Review.}, journal = {SN comprehensive clinical medicine}, volume = {}, number = {}, pages = {1-12}, doi = {10.1007/s42399-020-00650-0}, pmid = {33437929}, issn = {2523-8973}, abstract = {Multisystem inflammatory syndrome in children (MIS-C) or paediatric inflammatory multisystem syndrome temporally associated with SARS-CoV-2 (PIMS-TS) is an emerging disease in children affected with severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection and thought to be an immune-mediated post-infectious complication of SARS-CoV-2. The disease presentation is similar to Kawasaki disease but has certain distinguishing features. The exact pathogenesis is still not clear but an aberrant immune response, antibody-mediated vascular damage and virus-mediated abnormal type I and III interferon-gamma response are thought to be responsible. Most children who are previously healthy present after 2-4 weeks of SARS-CoV-2 infections with febrile illness of short duration with prominent gastrointestinal, cardiac and hematologic manifestations, progressing to vasoplegic shock, requiring vasopressor therapy. Cardiovascular involvement is prominently marked by acute myocardial injury/myocarditis and the development of coronary artery aneurysms. Laboratory markers of inflammation are elevated uniformly. Most children require intensive care, and few need invasive ventilation. The treatment mainly consists of anti-inflammatory and immunomodulatory therapy like intravenous immunoglobulins and steroids. The overall prognosis is good and reported mortality rates are 0-4%.}, } @article {pmid33437928, year = {2021}, author = {Hoeferlin, C and Hosseini, H}, title = {Review of Clinical and Operative Recommendations for Ophthalmology Practices During the COVID-19 Pandemic.}, journal = {SN comprehensive clinical medicine}, volume = {}, number = {}, pages = {1-6}, doi = {10.1007/s42399-020-00633-1}, pmid = {33437928}, issn = {2523-8973}, abstract = {In response to climbing global case and fatality rates of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its associated disease, COVID-19, ophthalmology practices have modified their clinical and operative approach to patient care in an attempt to reduce spread of the virus. The presence of SARS-CoV-2 viral RNA in the preocular tear film raises speculation that the ocular surface can act as an initial site of infection as well as a potential source of person-to-person viral transmission. More recently, conjunctival specimens and immunohistochemical analyses have identified the presence of cellular surface factors necessary for SARS-CoV-2 infection on the ocular surface. Together, these results highlight the importance of safety measures in ophthalmology practices to prevent transmission of SARS-CoV-2. As ophthalmic exams typically require close proximity between a patient's respiratory tract and the provider, clinical and surgical recommendations are aimed at reducing unnecessary patient-provider interactions. Subspecialty professional guidelines can be used to instruct ophthalmologists on the necessity of various procedures and best practice measures. Ophthalmology practice during the COVID-19 pandemic has been dramatically curtailed in an effort to reduce the risk of transmission and converse valuable personal protective equipment (PPE), and the impacts of the ongoing pandemic on ophthalmology practices will be felt for the foreseeable future.}, } @article {pmid33437798, year = {2020}, author = {Vashisht, R and Krishnan, S and Duggal, A}, title = {A narrative review of non-pharmacological management of SARS-CoV-2 respiratory failure: a call for an evidence based approach.}, journal = {Annals of translational medicine}, volume = {8}, number = {23}, pages = {1599}, doi = {10.21037/atm-20-4633}, pmid = {33437798}, issn = {2305-5839}, abstract = {A novel severe acute respiratory syndrome coronavirus (SARS-CoV-2) belonging to genus beta-coronavirus has been associated with an acute respiratory disease termed coronavirus disease 2019 (COVID-19). As of September 3, 2020, SARS-CoV-2 had caused 867,219 fatalities in 188 nations across the globe. Rapid progression to bronchopneumonia manifesting with severe hypoxemia and eventual evolution into acute respiratory distress syndrome (ARDS) necessitating mechanical ventilation is the hallmark of this disease. The novel nature of COVID-19 pneumonia and the high morbidity and mortality associated with the same has vexed the critical care community. A cultural shift away from evidence-based medicine, and the impetus to attempt newer unproven therapies like awake proning, interleukin receptor 6 antagonists, inhaled nitric oxide, empiric anticoagulation etc. over modalities that have been tested over the decades is slowly gaining ground. The suggestions to delay intubations and liberalize tidal volumes have polarized the medical field like never before. The lack of consistency in management practices and establishing practices based on anecdotes and experiences can lead to devastating outcomes in the patients affected by this deadly virus. In this narrative review, we attempt to re-emphasize the need for an evidence-based approach to the management of COVID-19 related ARDS and review treatment strategies that have been established after rigorous trials and have stood the test of time.}, } @article {pmid33437743, year = {2020}, author = {Aghili, R and Honardoost, M and Khamseh, ME}, title = {COVID-19: Case fatality and ACE2 inhibitors treatment concerns in patients with comorbidities.}, journal = {Medical journal of the Islamic Republic of Iran}, volume = {34}, number = {}, pages = {147}, doi = {10.34171/mjiri.34.147}, pmid = {33437743}, issn = {1016-1430}, abstract = {The Corona Virus Disease 2019 (COVID-19) outbreak is becoming pandemic with the highest mortality in patients with associated comorbidities. These RNA viruses containing 4 structural proteins usually use spike protein to enter the host cell. Angiotensin-converting enzyme 2 (ACE2) acts as a host receptor for the virus. Therefore, medications acting on renin-angiotensin-aldosterone system can lead to serious complications, especially in patients with diabetes and hypertension. To avoid this, other potential treatment modalities should be used in COVID-19 patients with associated comorbidities.}, } @article {pmid33437719, year = {2020}, author = {Mohamadi, M and Goodarzi, A and Aryannejad, A and Fattahi, N and Alizadeh-Khoei, M and Miri, S and Hekmat, H and Payab, M and Bodaghabadi, M}, title = {Geriatric challenges in the new coronavirus disease-19 (COVID-19) pandemic: A systematic review.}, journal = {Medical journal of the Islamic Republic of Iran}, volume = {34}, number = {}, pages = {123}, doi = {10.34171/mjiri.34.123}, pmid = {33437719}, issn = {1016-1430}, abstract = {Background: During the COVID-19 pandemic, elderly individuals (with the chronological age of 65 years and above) are more susceptible to the SARS-CoV-2 infection complications due to altered immune system response and the higher rate of underlying comorbidities. A vast majority of mortalities are reported in elderly patients; thus, this study aimed to evaluate complications of COVID-19 in elderly patients. Methods: A systematic review was conducted according to MOOSE guidelines. Science Direct, Google Scholar, Scopus, PubMed databases were searched for published articles related to COVID-19 in the elderly up to March 26, 2020. Search MeSh terms included "Severe acute respiratory syndrome coronavirus 2", "2019-nCoV", "SARS-CoV-2", "comorbidity", "elderly", and "geriatrics". Results: In total 1360 potentially relevant articles were screened, of which 35 were relevant and their full texts were considered for the review. Organ damages to the pulmonary system, cardiovascular, liver, and renal system are more prevalent in the elderly with SARS-CoV-2 infection. As the chance of multiorgan involvement is more common among elderly patients, preventive, multidisciplinary, and holistic evaluations are essential to reduce disease consequences. Conclusion: More attention needs to be paid to elderly individuals in the quarantine. Social contact should be made and maintained through online facilities, media, and phone calls to ensure patients' mental health during this stressful situation. Also, they should be provided with enough food and medications by their families or friends. Also, providing social and volunteer services might play an important role in the mental health of those patients who have no social network.}, } @article {pmid33437703, year = {2020}, author = {Varma, SR and Jaber, M and Abu Fanas, S and Desai, V and Thomas, S and Khair, M}, title = {Pathogen Reduction Technology: A Novel Possibility for Inactivation of Blood Products Used in Oral and Periodontal Surgeries.}, journal = {Journal of International Society of Preventive & Community Dentistry}, volume = {10}, number = {6}, pages = {713-718}, doi = {10.4103/jispcd.JISPCD_327_20}, pmid = {33437703}, issn = {2231-0762}, abstract = {Emergency surgical treatment has been challenging and the risk of blood contamination has been high, which is a concern among the medical and dental fraternity. The risk outweighs the benefits in these unprecedented times if proper screening and inactivation of blood products are not performed. Pathogen reduction technologies incorporate various modalities for the inactivation of blood products mainly related to blood transfusion. Oral surgical procedures and periodontal surgeries use platelet-rich fibrin for various regenerative procedures that amplify the prognosis positively. The use of blood products for various treatments could result in contamination, a factor which should be significant attention. The objective of this study was to review the role of pathogen reduction technology in inactivating pathogens in blood products and its use in oral and periodontal surgical procedures. The literature presented in the study is from original studies from a period of 2000 to 2020 which was sourced from Medline, PubMed, and Cochrane central databases. Relevant published papers and in-press papers that provided information were identified and selected. The studies presented have shown data related to implementation of pathogen reduction technologies in relation to the severe acute respiratory syndrome, Middle East respiratory syndrome, and its possible implementation in coronavirus disease-2019 (COVID-19). The paper reviews the various technologies offered and the possibility to eradicate pathogens found in routine blood products, used in oral and periodontal surgical procedures. In all probability, the use of pathogen reduction technology might offer a ray of light to contain the spread among dental treatment procedures.}, } @article {pmid33437699, year = {2020}, author = {Castro-Ruiz, C and Vergara-Buenaventura, A}, title = {Povidone-Iodine Solution: A Potential Antiseptic to Minimize the Risk of COVID-19? A Narrative Review.}, journal = {Journal of International Society of Preventive & Community Dentistry}, volume = {10}, number = {6}, pages = {681-685}, doi = {10.4103/jispcd.JISPCD_304_20}, pmid = {33437699}, issn = {2231-0762}, abstract = {Objectives: Patients are mask-free during dental attention. In addition, dentists and dental staff after working for hours need to hydrate or eat. Removing the mask makes them vulnerable to the risk of contamination. For those cases, a prophylactic decontamination protocol could be useful as an adjunct to the most recommended biosecurity protocols. This article aims to provide a comprehensive review of the published evidence about the use of povidone-iodine (PVP-I) against SARS-CoV-2 and to propose a prophylactic protocol for dental attention using PVP-I during the COVID-19 pandemic.

Materials and Methods: An electronic search in Medline via PubMed, Scopus, Cochrane Library and Scielo databases was performed up to July 24, 2020, to identify relevant literature focusing on Povidone Iodine, SARS-CoV-2, COVID-19, SARS-COV, MERS, antiviral mouthwashes, and oral cavity.

Results: Clinical studies on the virucidal effectiveness of PVP-I against SARS-CoV-2 have not yet been reported. We identify a recent in vitro study showing PVP-I effectiveness at 0.5, 1, and 1.5% within 15s of contact. Moreover, another in vitro study has shown ≥99.99% virucidal activity as 1% mouthwash and 0.45% throat spray. The only study in SARS-CoV-2 confirmed patients reported a significant 3h drop in viral load after rinsing with 15 mL of 1% PVP-I for 1min.

Conclusions: Although no clinical trials have reported the efficacy of PVP-I on SARS-CoV-2, recent studies in patients with positive PCR to SARS-CoV-2 found a significant 3-h drop in viral load. We believe that an oral prophylactic protocol with PVP-I for dental healthcare workers and patients as an adjunct to the current biosecurity protocol could minimize the transmission risk during COVID-19 pandemic.}, } @article {pmid33437688, year = {2020}, author = {Soltany, A and Hasan, AR and Mohanna, F}, title = {Burn management during the COVID-19 pandemic: recommendations and considerations.}, journal = {Avicenna journal of medicine}, volume = {10}, number = {4}, pages = {163-173}, doi = {10.4103/ajm.ajm_153_20}, pmid = {33437688}, issn = {2231-0770}, abstract = {Coronavirus disease-2019 (COVID-19) is a respiratory disease, caused by a novel coronavirus (SARS-COV-2). This disease has been raising international public health concerns since its recent outbreak in December 2019. As the virus is easily transmitted by respiratory droplets, all hospital departments needed to change their practices in an attempt to control the spread of this virus. Burn units and clinics are particularly affected by this pandemic because of the larger risk of contamination for both patients and caregivers. Furthermore, cross-clinical aspects especially pain management and complications such as coagulopathy might be caused by both extensive burns and COVID-19 infections, which makes the management of these patients particularly challenging. That's why we covered both main aspects in this review. In addition, we present briefly a synthesis of guidelines from several entities to help manage the health crisis and provide optimal care for all burn patients during this pandemic.}, } @article {pmid33437687, year = {2020}, author = {Hejaz, HA}, title = {Palestinian strategies, guidelines, and challenges in the treatment and management of coronavirus disease-2019 (COVID-19).}, journal = {Avicenna journal of medicine}, volume = {10}, number = {4}, pages = {135-162}, doi = {10.4103/ajm.ajm_171_20}, pmid = {33437687}, issn = {2231-0770}, abstract = {Background: Coronavirus disease-2019 (COVID-19) outbreak is a global concern and the World Health Organization (WHO) has declared it as a Public Health Emergency of International Concern. The Palestinian Authority (PA) has quickly and effectively responded to the outbreak of COVID-19, using an internationally and nationally coordinated, to contain the spread of the virus within the borders. The PA approaches are containment and suppression, which is designed to protect the citizens from infection while also mitigating the stress on the health care system. The PA immediately declared a State of Emergency when the first cases in Palestine were diagnosed on 5 March 2020 and launched robust national containment measures to encourage the citizens to protect themselves and follow the guidance.

Objectives: There is currently no vaccine or effective treatment for COVID-19, the treatment is either supportive and/ or the treatment of symptoms. Several strategies in the treatment of the disease were applied including medications. This review aims to summarize the different strategies, guidelines, challenges, and treatments used against COVID-19 worldwide and in Palestine.

Materials and Methods: Different literature and guidelines among different databases were searched. Literature reviewing was conducted using the following search engines, Google Scholar, Medline, Pub Med, EMBASE, Web of Science, and Science Direct. Data also obtained from WHO and PA reports, and the published peer-reviewed articles of 2019-nCoV. The review focuses on the strategies, guidelines, therapeutics, challenges, and different approaches used in the treatment and management of the disease in Palestine and globally.

Conclusion: The Palestinian Ministry of Health (MoH) strategies to end the COVID-19 pandemic were; slow and stop transmission; provide optimized care for patients; and minimize the impact of the epidemic on health systems, social services, and economic activity. Thus, proper management, right actions, and effective treatment of the disease should be considered to achieve these strategies. The biggest problem for PA to control and stop the outbreak of the disease is the different challenges which include; the Israeli military and economic control, uncontrol the borders, shortage of medical and financial resources, crowded cities and refugee camps, poverty, food insecurity, and the financial crisis. To date, there are no specific vaccines or medicines for COVID-19; and treatments are under investigation through clinical trials. However, an array of drugs approved for other indications, as well as multiple investigational agents, are being studied for the treatment of COVID-19; in several hundred clinical trials around the World. Treatment is essentially supportive and symptomatic.}, } @article {pmid33437350, year = {2020}, author = {Chen, X and Yu, C and Jing, H and Wang, C and Zhao, X and Zhang, J and Zhang, S and Liu, H and Xie, R and Shi, J}, title = {COVID-19 associated thromboinflammation of renal capillary: potential mechanisms and treatment.}, journal = {American journal of translational research}, volume = {12}, number = {12}, pages = {7640-7656}, pmid = {33437350}, issn = {1943-8141}, abstract = {Coronavirus disease 2019 (COVID-19) infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global pandemic disease with high morbidity and mortality. Inflammatory and thrombosis are its main manifestations. As an important organ of hemofiltration metabolism, the kidney is prone to blockage and destruction when filter high inflammatory and high viscous blood of COVID-19, resulting in the loss of a large amount of protein, aggravating blood concentration, and then worsening COVID-19 hypercoagulability, which may explain the phenomenon of erythrocytes aggregation blocking the capillary lumen and the main reason why the kidney has become the second largest involvement organs. Therefore, this review discusses the effects of pathophysiological mechanisms such as inflammatory storm, endothelial injury, phosphatidylserine expression, extracellular traps release on renal capillary thrombosis caused by COVID-19 infection. Meanwhile, in view of the above mechanisms, we put forward the potential targets of antithrombotic therapy, and graded management of patients, reasonable use of drugs according to the severity of the disease and the choice of time. And we support the view of prevention of thrombus before admission, continuous anticoagulation and drug choice after discharge. It is suggested that the symptomatic and supportive treatment of renal disease in critically ill patients should be combined with the concept of antithrombotic therapy. The ultimate goal is to reduce the occurrence and development of kidney disease, provide direction for the current management of COVID-19 with kidney disease, and reduce the mortality of COVID-19.}, } @article {pmid33437291, year = {2021}, author = {Mumtaz, N and Saqulain, G and Mumtaz, N}, title = {COVID-19 Rehab Fright Management.}, journal = {Pakistan journal of medical sciences}, volume = {37}, number = {1}, pages = {277-282}, doi = {10.12669/pjms.37.1.3187}, pmid = {33437291}, issn = {1682-024X}, abstract = {Being diagnosed as positive for SARS-2 CoV RNA on PCR generates anxiety and stress as well as depression due to the prospects of being isolated. With genetically varied forms of virus on the rise the widely adopted manner to protect oneself is social distancing. This is frightening for rehabilitation professionals who at times are exposed at close quarters to the patients as rehabilitation is essential. Data in this backdrop is lacking, as this is a recent and ongoing pandemic. As such the current study was conducted with an attempt to review and highlight the causes of fright among rehabilitation professionals and possible management options in the wake of current pandemic of COVID-19 in the perspective of Pakistan. For this purpose literature was searched from major electronic databases including PubMed, Google, Google Scholar and Web-of-science, with keywords "Covid-19, mental health, telehealth, telemedicine, tele-rehabilitation and combination of words". Eighty English, full text articles were studied out of which 36 were used for the literature review. With this literature review we conclude that COVID-19 has resulted in fear of contracting and transmitting this disease among health professionals and can be reduced and managed by provision of tele-rehabilitation and telehealth facilities. Patients emerging from prolonged mechanical ventilations require extensive rehabilitation to restore routine body functions. The role of the otolaryngologist and speech language pathologist (SLP) is formal and direct to ensure appropriate and timely long term intervention and rehabilitation to ensure that these individuals re-enter mainstream activities.}, } @article {pmid33437211, year = {2021}, author = {Wang, CL and Liu, YY and Wu, CH and Wang, CY and Wang, CH and Long, CY}, title = {Impact of COVID-19 on Pregnancy.}, journal = {International journal of medical sciences}, volume = {18}, number = {3}, pages = {763-767}, doi = {10.7150/ijms.49923}, pmid = {33437211}, issn = {1449-1907}, abstract = {Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and is an emerging disease. There has been a rapid increase in cases and deaths since it was identified in Wuhan, China, in early December 2019, with over 4,000,000 cases of COVID-19 including at least 250,000 deaths worldwide as of May 2020. However, limited data about the clinical characteristics of pregnant women with COVID-19 have been reported. Given the maternal physiologic and immune function changes during pregnancy, pregnant women may be at a higher risk of being infected with SARS-CoV-2 and developing more complicated clinical events. Information on severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS) may provide insights into the effects of COVID-19's during pregnancy. Even though SARS and MERS have been associated with miscarriage, intrauterine death, fetal growth restriction and high case fatality rates, the clinical course of COVID-19 pneumonia in pregnant women has been reported to be similar to that in non-pregnant women. In addition, pregnant women do not appear to be at a higher risk of catching COVID-19 or suffering from more severe disease than other adults of similar age. Moreover, there is currently no evidence that the virus can be transmitted to the fetus during pregnancy or during childbirth. Babies and young children are also known to only experience mild forms of COVID-19. The aims of this systematic review were to summarize the possible symptoms, treatments, and pregnancy outcomes of women infected with COVID-19 during pregnancy.}, } @article {pmid33437145, year = {2021}, author = {Sharma, I and Kumari, P and Sharma, A and Saha, SC}, title = {SARS-CoV-2 and the reproductive system: known and the unknown..!!.}, journal = {Middle East Fertility Society journal}, volume = {26}, number = {1}, pages = {1}, doi = {10.1186/s43043-020-00046-z}, pmid = {33437145}, issn = {1110-5690}, abstract = {Background: COVID-19 is the most recent zoonotic outbreak of coronaviruses. Mostly, it invades the cells of the respiratory system by binding to the receptor angiotensin-converting enzyme 2 (ACE2) which is also present in other organs like the kidney, testis, ovaries, breast, heart, and intestine, rendering them prone to be infected. The reproductive potential is a must for the sustenance of any species and it is our prime duty to safeguard the reproductive system of the present generation from such a deadly virus. The previously reported coronaviruses like severe acute respiratory syndrome coronavirus (SARS-CoV) had a detrimental impact on reproductive organs. There is a dearth of sufficient research to provide substantial evidence for the harmful effects of this novel virus on the reproductive system. Hence, our review compiles the knowledge available until now to boost research in this regard and to take the necessary steps in time.

Main body of abstract: Here we tried to compile all the data available on the effect of SARS-CoV-2 on the reproductive system as well as vertical transmission of the virus. All related articles published from February to August 2020 were reviewed and thoroughly analyzed. SARS-CoV-2 has been found to affect the sperm concentration and motility, thus degrading the fertility of males. In females, it is suspected that this virus affects the oocyte quality and ovarian function, resulting in infertility or miscarriage. Traces of SARS-CoV-2 virus have also been found in the breast milk of the infected mothers and the semen of infected males. Vertical transmission of SARS-CoV-2 has also been reported in some cases.

Conclusion: Based on the literature review, SARS-CoV-2 seems to have the potential of affecting both male and female reproductive tracts. This review brings together the findings and observations made in the area of reproductive health during the current pandemic. The reproductive system of the young population is preordained for subsequent disorders, infertility, reduced sperm count, and motility. Therefore, the research and medical practices should focus on possible vulnerability being posed by SARS-CoV-2 to the gametes and future generations. We, hereby, recommend close monitoring of young and pregnant COVID-19 patients concerning reproductive health with utmost priority.}, } @article {pmid33437144, year = {2021}, author = {da Silva Júnior, PR and Gomes, ALOR and Coelho, LEA and Morais, MA and de Almeida, PVFC and Neri, WJR and Mascena, GV and de Farias Leal, AA}, title = {Anosmia and COVID-19: perspectives on its association and the pathophysiological mechanisms involved.}, journal = {The Egyptian journal of neurology, psychiatry and neurosurgery}, volume = {57}, number = {1}, pages = {8}, doi = {10.1186/s41983-020-00266-0}, pmid = {33437144}, issn = {1110-1083}, abstract = {With the spread of SARS-CoV-2, contingency measures and plans to facilitate the screening of infected patients are needed. Changes in olfaction have been cited as symptoms of the disease, and it is important to prove or exclude its association with this condition to refine the symptomatic criteria for early isolation. This article aims to analyze the association between olfactory disorders and SARS-CoV-2 infection as well as investigate the possible underlying pathophysiological mechanisms. The research was carried out using the PubMed, Science Direct, and LILACS databases on May 9, 2020, and updated on May 21. Combinations of MeSH descriptors and the Boolean operator, "AND," were used: coronavirus infections AND olfactory disorders, coronavirus infections, and neurological manifestations. A total of 1187 articles were found in the databases, of which 17 were included in the study. The data suggest that changes in smell are strongly associated with Covid-19, especially in women and patients with fever; these changes increase the degree of suspicion of Covid-19, and they warrant early implementation of isolation and surveillance measures. There are still gaps in the elucidation of the pathways involved in the loss of smell caused by SARS-CoV-2; however, the great affinity of the virus for ACE-2 receptors, which are present in large quantities in the nasal cavity and olfactory bulb, has been considered.}, } @article {pmid33437134, year = {2021}, author = {Pieter, J and Körner, W and Harth, V and Preisser, AM}, title = {[Adaptation of infection protection measures in public services due to the COVID-19 pandemic].}, journal = {Zentralblatt fur Arbeitsmedizin, Arbeitsschutz und Ergonomie}, volume = {}, number = {}, pages = {1-7}, doi = {10.1007/s40664-020-00418-2}, pmid = {33437134}, issn = {0944-2502}, abstract = {The COVID-19 pandemic is changing the requirements for occupational health and safety in the workplace. The aim of the measures implemented nationwide is to reduce the spread of the virus. This applies to all areas of life, including the workplace. The "public service" includes many system-relevant occupational groups: police, fire brigade, judiciary, municipal cleaning, waterworks and administrative bodies at local and state levels. There is a broad diversity of activities in communal and federal state enterprises, especially with regard to internal organisation as well as personnel and spatial conditions. Direct interactions with people are often necessary. Maintaining the functionality of these structures is essential for public life. Education institutions and care facilities for children, people with handicaps and vulnerable groups, institutions for nursing and geriatric care as well as public transport are not covered in this statement due to their special work structures. These recommendations address the professionally accountable in the respective public service institutions. It deals with infection control measures at work in the public service, derived from the risk assessments of various settings. The measures presented can be implemented as part of an operational concept for temporary infection control measures. The aim is to provide general guidance on infection protection with respect to work situations in order to slow down the dissemination of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), to protect at-risk groups, and ensure the functioning of the aforementioned structures.}, } @article {pmid33437133, year = {2021}, author = {Mojtahedzadeh, N and Rohwer, E and Lengen, J and Harth, V and Mache, S}, title = {[Health-promoting work design for telework in the context of the COVID-19 pandemic].}, journal = {Zentralblatt fur Arbeitsmedizin, Arbeitsschutz und Ergonomie}, volume = {}, number = {}, pages = {1-6}, doi = {10.1007/s40664-020-00419-1}, pmid = {33437133}, issn = {0944-2502}, abstract = {Background: The contact restrictions associated with the COVID-19 pandemic have led many companies to allow their employees to work from home for infection control reasons.

Objective: This literature review explores the question in what way health-promoting work from home can be excercised.

Results: Working from home requires consideration of the same guidelines just like those for office and computer workstations. To prevent negative mental and physical stress reactions, an ergonomic workstation design is recommended. Furthermore, the organization of working time (structuring the working day, adhering to breaks and regeneration units, and avoiding disturbances and interruptions) is of great importance for a health-promoting work design at home.

Conclusion: Important components of a health-promoting work design are temporal, spatial and mental separation of work and private life. Employees and their individual needs must be taken into account when designing a health-promoting workplace at home; however, the responsibility for implementing health-promoting work design mostly lies solely with the employees due to the ad hoc change of workplace.}, } @article {pmid33437070, year = {2020}, author = {Senniappan, K and Jeyabalan, S and Rangappa, P and Kanchi, M}, title = {Hyperbaric oxygen therapy: Can it be a novel supportive therapy in COVID-19?.}, journal = {Indian journal of anaesthesia}, volume = {64}, number = {10}, pages = {835-841}, doi = {10.4103/ija.IJA_613_20}, pmid = {33437070}, issn = {0019-5049}, abstract = {The coronavirus disease 2019 (COVID-19) is a pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). Although 85% of infected patients remain asymptomatic, 5% show severe symptoms such as hypoxaemic respiratory failure and multiple end organ dysfunction (MODS) requiring intensive care unit (ICU) admission with a mortality rate of about 2.8%. Since a definitive treatment is yet to be identified, preventive and supportive strategies remain the mainstay of management. Supportive measures such as oxygen therapy with nasal cannula, face mask, noninvasive ventilation, mechanical ventilation and even extreme measures such as extracorporeal membrane oxygenation (ECMO) fail to improve oxygenation in some patients. Hence, hyperbaric oxygen therapy (HBOT) has been proposed as a supportive strategy to improve oxygenation in COVID-19 patients. HBOT is known to increase tissue oxygenation by increasing the amount of dissolved oxygen in plasma. HBOT also mitigates tissue inflammation thus reducing the ill effects of cytokine storm in COVID-19 patients. Though there is limited literature available on HBOT in COVID-19 patients, considering the present need for additional supportive therapy to improve oxygenation, HBOT has been proposed as a novel supportive treatment in COVID-19 patients.}, } @article {pmid33436435, year = {2021}, author = {Thompson, CW and Phelps, KL and Allard, MW and Cook, JA and Dunnum, JL and Ferguson, AW and Gelang, M and Khan, FAA and Paul, DL and Reeder, DM and Simmons, NB and Vanhove, MPM and Webala, PW and Weksler, M and Kilpatrick, CW}, title = {Preserve a Voucher Specimen! The Critical Need for Integrating Natural History Collections in Infectious Disease Studies.}, journal = {mBio}, volume = {12}, number = {1}, pages = {}, pmid = {33436435}, issn = {2150-7511}, abstract = {Despite being nearly 10 months into the COVID-19 (coronavirus disease 2019) pandemic, the definitive animal host for SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), the causal agent of COVID-19, remains unknown. Unfortunately, similar problems exist for other betacoronaviruses, and no vouchered specimens exist to corroborate host species identification for most of these pathogens. This most basic information is critical to the full understanding and mitigation of emerging zoonotic diseases. To overcome this hurdle, we recommend that host-pathogen researchers adopt vouchering practices and collaborate with natural history collections to permanently archive microbiological samples and host specimens. Vouchered specimens and associated samples provide both repeatability and extension to host-pathogen studies, and using them mobilizes a large workforce (i.e., biodiversity scientists) to assist in pandemic preparedness. We review several well-known examples that successfully integrate host-pathogen research with natural history collections (e.g., yellow fever, hantaviruses, helminths). However, vouchering remains an underutilized practice in such studies. Using an online survey, we assessed vouchering practices used by microbiologists (e.g., bacteriologists, parasitologists, virologists) in host-pathogen research. A much greater number of respondents permanently archive microbiological samples than archive host specimens, and less than half of respondents voucher host specimens from which microbiological samples were lethally collected. To foster collaborations between microbiologists and natural history collections, we provide recommendations for integrating vouchering techniques and archiving of microbiological samples into host-pathogen studies. This integrative approach exemplifies the premise underlying One Health initiatives, providing critical infrastructure for addressing related issues ranging from public health to global climate change and the biodiversity crisis.}, } @article {pmid33436320, year = {2021}, author = {Mirzaei, F and Khodadadi, I and Vafaei, SA and Abbasi-Oshaghi, E and Tayebinia, H and Farahani, F}, title = {Importance of hyperglycemia in COVID-19 intensive-care patients: Mechanism and treatment strategy.}, journal = {Primary care diabetes}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.pcd.2021.01.002}, pmid = {33436320}, issn = {1878-0210}, abstract = {This review reported that coronavirus disease 2019 (COVID-19) infected patients with short time bed rest or quarantine and airway inflammation are at more risk of developing hyperglycemia and insulin resistance. This condition can induce oxidative stress, decrease immune system function, impair endothelial function, induce apoptosis, and reduce antioxidant in the lungs. We provide a possible mechanism in severe COVID-19 patients and recommend treatment strategy to reduce mortality rate and prevent adverse outcomes after intensive care unit (ICU).}, } @article {pmid33436263, year = {2020}, author = {Liu, D and Baumeister, RF and Zhou, Y}, title = {Mental health outcomes of coronavirus infection survivors: A rapid meta-analysis.}, journal = {Journal of psychiatric research}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.jpsychires.2020.10.015}, pmid = {33436263}, issn = {1879-1379}, abstract = {BACKGROUND: The current COVID pandemic is happening while the long-term effects of coronavirus infection remain poorly understood. The present article meta-analyzed mental health outcomes (anxiety, depression, etc.) from a previous coronavirus outbreak in China (2002).

METHOD: CNKI, Wanfang, PubMed/Medline, Scopus, Web of Science, Baidu Scholar, and Google Scholar were searched up to early June 2020 for articles in English or Chinese reporting mental illness symptoms of SARS patients. Main outcome measures include SCL-90, SAS, SDS, and IES-R scales. 29 papers met the inclusion criteria. The longest follow-up time included in the analysis was 46 months.

FINDINGS: The systematic meta-analysis indicated that mental health problems were most serious before or at hospital discharge and declined significantly during the first 12 months after hospital discharge. Nevertheless, average symptom levels remained above healthy norms even at 12 months and continued to improve, albeit slowly, thereafter.

INTERPRETATION: The adverse mental health impact of being hospitalized with coronavirus infection long outlasts the physical illness. Mental health issues were the most serious for coronavirus infected patients before (including) hospital discharge and improved continuously during the first 12 months after hospital discharge. If COVID-19 infected patients follow a similar course of mental health development, most patients should recover to normal after 12 months of hospital discharge.}, } @article {pmid33435929, year = {2021}, author = {Trougakos, IP and Stamatelopoulos, K and Terpos, E and Tsitsilonis, OE and Aivalioti, E and Paraskevis, D and Kastritis, E and Pavlakis, GN and Dimopoulos, MA}, title = {Insights to SARS-CoV-2 life cycle, pathophysiology, and rationalized treatments that target COVID-19 clinical complications.}, journal = {Journal of biomedical science}, volume = {28}, number = {1}, pages = {9}, pmid = {33435929}, issn = {1423-0127}, abstract = {BACKGROUND: Gaining further insights into SARS-CoV-2 routes of infection and the underlying pathobiology of COVID-19 will support the design of rational treatments targeting the life cycle of the virus and/or the adverse effects (e.g., multi-organ collapse) that are triggered by COVID-19-mediated adult respiratory distress syndrome (ARDS) and/or other pathologies.

MAIN BODY: COVID-19 is a two-phase disease being marked by (phase 1) increased virus transmission and infection rates due to the wide expression of the main infection-related ACE2, TMPRSS2 and CTSB/L human genes in tissues of the respiratory and gastrointestinal tract, as well as by (phase 2) host- and probably sex- and/or age-specific uncontrolled inflammatory immune responses which drive hyper-cytokinemia, aggressive inflammation and (due to broad organotropism of SARS-CoV-2) collateral tissue damage and systemic failure likely because of imbalanced ACE/ANGII/AT1R and ACE2/ANG(1-7)/MASR axes signaling.

CONCLUSION: Here we discuss SARS-CoV-2 life cycle and a number of approaches aiming to suppress viral infection rates or propagation; increase virus antigen presentation in order to activate a robust and durable adaptive immune response from the host, and/or mitigate the ARDS-related "cytokine storm" and collateral tissue damage that triggers the severe life-threatening complications of COVID-19.}, } @article {pmid33435548, year = {2021}, author = {Yan, P and Daliri, EB and Oh, DH}, title = {New Clinical Applications of Electrolyzed Water: A Review.}, journal = {Microorganisms}, volume = {9}, number = {1}, pages = {}, doi = {10.3390/microorganisms9010136}, pmid = {33435548}, issn = {2076-2607}, abstract = {As the situation of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is still deteriorating, there has been a huge increase in the demand and use of disinfectants. Electrolyzed water (EW), as a novel broad-spectrum disinfectant and cleaner, has been widely used for several years. EW can be produced in an electrolysis chamber which contains dilute salt and tap water. It is an effective antimicrobial and antibiofilm agent, with several advantages such as on-the-spot, cheap, environmentally friendly and safe for human beings. Therefore, EW holds potential significance for high-risk settings in hospitals and other clinical facilities. EW can also be applied for wound healing, advanced tissue care, and dental clinics. The present review article highlights the latest developments and new perspectives of EW, especially in clinical fields. Furthermore, the main action modes of antibiofilm and antimicrobial will be summarized.}, } @article {pmid33435547, year = {2021}, author = {Wong, YP and Khong, TY and Tan, GC}, title = {The Effects of COVID-19 on Placenta and Pregnancy: What Do We Know So Far?.}, journal = {Diagnostics (Basel, Switzerland)}, volume = {11}, number = {1}, pages = {}, doi = {10.3390/diagnostics11010094}, pmid = {33435547}, issn = {2075-4418}, support = {FRGS/1/2019/SKK13/UKM/02/1//Ministry of Higher Education, Malaysia/ ; }, abstract = {The current coronavirus disease 2019 (COVID-19) pandemic, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has inflicted a serious health crisis globally. This virus is associated with a spectrum of respiratory illness ranging from asymptomatic, mild to severe pneumonia, and acute respiratory distress syndrome. Accumulating evidence supports that COVID-19 is not merely a respiratory illness per se, but potentially affects other organ systems including the placenta. SARS-CoV-2 gains access to human cells via angiotensin-converting enzyme 2 (ACE-2). The abundance of ACE-2 on the placental cell surface, especially the syncytiotrophoblasts, could potentially contribute to vertical transplacental transmission to the fetus following maternal COVID-19 infection. Intriguingly, despite the placentas being tested positive for SARS-CoV-2, there are very few newborns that manifest virus-induced diseases. The protective effects of the placental barrier to viral infection, limiting the spread of the virus to newborn infants, remain a mystery. The detrimental role of COVID-19 in pregnancies is largely debatable, although COVID-19 maternal infection has been implicated in unfavorable pregnancy outcomes. In this review, we summarize the pathological features manifested in placenta due to COVID-19 maternal infection that have been previously reported, and relate them to the possible disease manifestation. The potential mechanistic pathways associated with transplacental viral transmission and adverse pregnancy outcomes are also discussed.}, } @article {pmid33435521, year = {2021}, author = {Dominguez, LJ and Veronese, N and Guerrero-Romero, F and Barbagallo, M}, title = {Magnesium in Infectious Diseases in Older People.}, journal = {Nutrients}, volume = {13}, number = {1}, pages = {}, doi = {10.3390/nu13010180}, pmid = {33435521}, issn = {2072-6643}, abstract = {Reduced magnesium (Mg) intake is a frequent cause of deficiency with age together with reduced absorption, renal wasting, and polypharmacotherapy. Chronic Mg deficiency may result in increased oxidative stress and low-grade inflammation, which may be linked to several age-related diseases, including higher predisposition to infectious diseases. Mg might play a role in the immune response being a cofactor for immunoglobulin synthesis and other processes strictly associated with the function of T and B cells. Mg is necessary for the biosynthesis, transport, and activation of vitamin D, another key factor in the pathogenesis of infectious diseases. The regulation of cytosolic free Mg in immune cells involves Mg transport systems, such as the melastatin-like transient receptor potential 7 channel, the solute carrier family, and the magnesium transporter 1 (MAGT1). The functional importance of Mg transport in immunity was unknown until the description of the primary immunodeficiency XMEN (X-linked immunodeficiency with Mg defect, Epstein-Barr virus infection, and neoplasia) due to a genetic deficiency of MAGT1 characterized by chronic Epstein-Barr virus infection. This and other research reporting associations of Mg deficit with viral and bacterial infections indicate a possible role of Mg deficit in the recent coronavirus disease 2019 (COVID-19) and its complications. In this review, we will discuss the importance of Mg for the immune system and for infectious diseases, including the recent pandemic of COVID-19.}, } @article {pmid33435454, year = {2021}, author = {Zmievskaya, E and Valiullina, A and Ganeeva, I and Petukhov, A and Rizvanov, A and Bulatov, E}, title = {Application of CAR-T Cell Therapy beyond Oncology: Autoimmune Diseases and Viral Infections.}, journal = {Biomedicines}, volume = {9}, number = {1}, pages = {}, doi = {10.3390/biomedicines9010059}, pmid = {33435454}, issn = {2227-9059}, support = {19-74-20026//Russian Science Foundation/ ; CΠ-227.2019.4//Stipend of the President of Russian Federation/ ; }, abstract = {Adoptive cell transfer (ACT) has long been at the forefront of the battle with cancer that began last century with the therapeutic application of tumor-infiltrating lymphocytes (TILs) against melanoma. The development of novel ACT approaches led researchers and clinicians to highly efficient technologies based on genetically engineered T lymphocytes, with chimeric antigen receptor (CAR)-T cells as the most prominent example. CARs consist of an extracellular domain that represents the single-chain variable fragment (scFv) of a monoclonal antibody (mAb) responsible for target recognition and the intracellular domain, which was built from up to several signaling motifs that mediated T cell activation. The number of potential targets amenable for CAR-T cell therapy is expanding rapidly, which means that the tremendous success of this approach in oncology could be further translated to treating other diseases. In this review, we outlined modern trends and recent developments in CAR-T cell therapy from an unusual point of view by focusing on diseases beyond cancer, such as autoimmune disorders and viral infections, including SARS-CoV-2.}, } @article {pmid33435405, year = {2021}, author = {Gheorghe, G and Ilie, M and Bungau, S and Stoian, AMP and Bacalbasa, N and Diaconu, CC}, title = {Is There a Relationship between COVID-19 and Hyponatremia?.}, journal = {Medicina (Kaunas, Lithuania)}, volume = {57}, number = {1}, pages = {}, doi = {10.3390/medicina57010055}, pmid = {33435405}, issn = {1648-9144}, abstract = {Nowadays, humanity faces one of the most serious health crises, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. The severity of coronavirus disease 2019 (COVID-19) pandemic is related to the high rate of interhuman transmission of the virus, variability of clinical presentation, and the absence of specific therapeutic methods. COVID-19 can manifest with non-specific symptoms and signs, especially among the elderly. In some cases, the clinical manifestations of hyponatremia may be the first to appear. The pathophysiological mechanisms of hyponatremia among patients with COVID-19 are diverse, including syndrome of inappropriate antidiuretic hormone secretion (SIADH), digestive loss of sodium ions, reduced sodium ion intake or use of diuretic therapy. Hyponatremia may also be considered a negative prognostic factor in patients diagnosed with COVID-19. We need further studies to evaluate the etiology and therapeutic management of hyponatremia in patients with COVID-19.}, } @article {pmid33435337, year = {2021}, author = {Yu, YJ and Park, YS and Keller, A and Noh, JW and Cha, J}, title = {A Mixed-Methods Systematic Review of the Impacts of Coronavirus on Society and Culture.}, journal = {International journal of environmental research and public health}, volume = {18}, number = {2}, pages = {}, doi = {10.3390/ijerph18020491}, pmid = {33435337}, issn = {1660-4601}, support = {202013C11//Korea Medical Device Development Fund/ ; }, abstract = {Little is understood of the social and cultural effects of coronaviruses such as coronavirus disease 2019 (COVID-19), severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS-CoV). This systematic review aims to synthesize existing findings (both qualitative and quantitative) that focus on the social and cultural impacts of coronaviruses in order to gain a better understanding of the COVID-19 pandemic. Utilizing a predetermined search strategy, we searched CINAHL, PsycINFO, PubMed, and Web of Science to identify existing (qualitative, quantitative, and mixed-methods) studies pertaining to the coronavirus infections and their intersection with societies and cultures. A narrative synthesis approach was applied to summarize and interpret findings of the study. Stemming from SARS outbreak in 2003, qualitative and quantitative findings (twelve adopted quantitative methods and eight exclusively used qualitative methods) were organized under five topical domains: governance, crisis communication and public knowledge, stigma and discrimination, social compliance of preventive measures, and the social experience of health workers. The selected studies suggest that current societies are not equipped for effective coronavirus response and control. This mixed-methods systematic review demonstrates that the effects of coronaviruses on a society can be debilitating.}, } @article {pmid33422039, year = {2021}, author = {De Kock, JH and Latham, HA and Leslie, SJ and Grindle, M and Munoz, SA and Ellis, L and Polson, R and O'Malley, CM}, title = {A rapid review of the impact of COVID-19 on the mental health of healthcare workers: implications for supporting psychological well-being.}, journal = {BMC public health}, volume = {21}, number = {1}, pages = {104}, pmid = {33422039}, issn = {1471-2458}, support = {Rapid COVID-19 response: UHI/Portfolio//Chief Scientist Office, Scottish Government Health and Social Care Directorate/International ; }, mesh = {COVID-19/epidemiology/*psychology/*therapy ; Health Personnel/*psychology ; Humans ; Mental Disorders/*epidemiology ; Risk Factors ; }, abstract = {BACKGROUND: Health and social care workers (HSCWs) have carried a heavy burden during the COVID-19 crisis and, in the challenge to control the virus, have directly faced its consequences. Supporting their psychological wellbeing continues, therefore, to be a priority. This rapid review was carried out to establish whether there are any identifiable risk factors for adverse mental health outcomes amongst HSCWs during the COVID-19 crisis.

METHODS: We undertook a rapid review of the literature following guidelines by the WHO and the Cochrane Collaboration's recommendations. We searched across 14 databases, executing the search at two different time points. We included published, observational and experimental studies that reported the psychological effects on HSCWs during the COVID-19 pandemic.

RESULTS: The 24 studies included in this review reported data predominantly from China (18 out of 24 included studies) and most sampled urban hospital staff. Our study indicates that COVID-19 has a considerable impact on the psychological wellbeing of front-line hospital staff. Results suggest that nurses may be at higher risk of adverse mental health outcomes during this pandemic, but no studies compare this group with the primary care workforce. Furthermore, no studies investigated the psychological impact of the COVID-19 pandemic on social care staff. Other risk factors identified were underlying organic illness, gender (female), concern about family, fear of infection, lack of personal protective equipment (PPE) and close contact with COVID-19. Systemic support, adequate knowledge and resilience were identified as factors protecting against adverse mental health outcomes.

CONCLUSIONS: The evidence to date suggests that female nurses with close contact with COVID-19 patients may have the most to gain from efforts aimed at supporting psychological well-being. However, inconsistencies in findings and a lack of data collected outside of hospital settings, suggest that we should not exclude any groups when addressing psychological well-being in health and social care workers. Whilst psychological interventions aimed at enhancing resilience in the individual may be of benefit, it is evident that to build a resilient workforce, occupational and environmental factors must be addressed. Further research including social care workers and analysis of wider societal structural factors is recommended.}, } @article {pmid33411674, year = {2021}, author = {Graf, J and Mares, J and Barnett, M and Aktas, O and Albrecht, P and Zamvil, SS and Hartung, HP}, title = {Targeting B cells to modify MS, NMOSD, and MOGAD: Part 2.}, journal = {Neurology(R) neuroimmunology & neuroinflammation}, volume = {8}, number = {1}, pages = {}, doi = {10.1212/NXI.0000000000000919}, pmid = {33411674}, issn = {2332-7812}, mesh = {Aquaporin 4 ; B-Lymphocytes ; *COVID-19 ; Humans ; *Neuromyelitis Optica/drug therapy ; SARS-CoV-2 ; }, abstract = {Ocrelizumab, rituximab, ofatumumab, ublituximab, inebilizumab, and evobrutinib are immunotherapies that target various B cell-related proteins. Most of these treatments have proven efficacy in relapsing and progressive forms of MS and neuromyelitis optica spectrum disease (NMOSD) or are in advanced stages of clinical development. Currently, ocrelizumab and inebilizumab are licensed for treatment of MS and NMOSD, respectively. This part of the review focuses on monoclonal antibody B cell-depleting strategies in NMOSD and the emerging related myelin oligodendrocyte glycoprotein (MOG) immunoglobulin G-associated disease (MOGAD). Case series and phase 2/3 studies in these inflammatory disorders are assessed. The safety profile of long-term B-cell depletion in MS, NMOSD, and MOGAD will be highlighted. Finally implications of the current coronavirus disease 2019 pandemic on the management of patients with these disorders and the use of B cell-depleting agents will be discussed.}, } @article {pmid33408212, year = {2021}, author = {Rieckert, A and Schuit, E and Bleijenberg, N and Ten Cate, D and de Lange, W and de Man-van Ginkel, JM and Mathijssen, E and Smit, LC and Stalpers, D and Schoonhoven, L and Veldhuizen, JD and Trappenburg, JC}, title = {How can we build and maintain the resilience of our health care professionals during COVID-19? Recommendations based on a scoping review.}, journal = {BMJ open}, volume = {11}, number = {1}, pages = {e043718}, pmid = {33408212}, issn = {2044-6055}, mesh = {COVID-19/*epidemiology/psychology ; Employment/*psychology ; Health Personnel/*psychology ; Humans ; *Mental Health ; *Pandemics ; SARS-CoV-2 ; }, abstract = {OBJECTIVE: To explore how to build and maintain the resilience of frontline healthcare professionals exposed to COVID-19 outbreak working conditions.

DESIGN: Scoping review supplemented with expert interviews to validate the findings.

SETTING: Hospitals.

METHODS: We searched PubMed, Embase, PsycINFO, CINAHL, bioRxiv and medRxiv systematically and grey literature for articles focusing on the impact of COVID-19-like working conditions on the physical and/or mental health of healthcare professionals in a hospital setting. Articles using an empirical design about determinants or causes of physical and/or mental health and about interventions, measures and policies to preserve physical and/or mental health were included. Four experts were interviewed to reflect on the results from the scoping review.

RESULTS: In total, 4471 records were screened leading to an inclusion of 73 articles. Recommendations prior to the outbreak fostering resilience included optimal provision of education and training, resilience training and interventions to create a feeling of being prepared. Recommendations during the outbreak consisted of (1) enhancing resilience by proper provision of information, psychosocial support and treatment (eg, create enabling conditions such as forming a psychosocial support team), monitoring the health status of professionals and using various forms and content of psychosocial support (eg, encouraging peer support, sharing and celebrating successes), (2) tasks and responsibilities, in which attention should be paid to kind of tasks, task mix and responsibilities as well as the intensity and weight of these tasks and (3) work patterns and working conditions. Findings of the review were validated by experts.

CONCLUSIONS: Recommendations were developed on how to build and maintain resilience of frontline healthcare professionals exposed to COVID-19 outbreak working conditions. These practical and easy to implement recommendations can be used by hospitals and other healthcare organisations to foster and preserve short-term and long-term physical and mental health and employability of their professionals.}, } @article {pmid33408209, year = {2021}, author = {Arevalo-Rodriguez, I and Seron, P and Buitrago-García, D and Ciapponi, A and Muriel, A and Zambrano-Achig, P and Del Campo, R and Galán-Montemayor, JC and Simancas-Racines, D and Perez-Molina, JA and Khan, KS and Zamora, J}, title = {Recommendations for SARS-CoV-2/COVID-19 testing: a scoping review of current guidance.}, journal = {BMJ open}, volume = {11}, number = {1}, pages = {e043004}, pmid = {33408209}, issn = {2044-6055}, mesh = {COVID-19/*diagnosis/epidemiology ; COVID-19 Testing/*standards ; Humans ; Pandemics ; *Practice Guidelines as Topic ; *SARS-CoV-2 ; Tomography, X-Ray Computed/*methods ; }, abstract = {BACKGROUND: Testing used in screening, diagnosis and follow-up of COVID-19 has been a subject of debate. Several organisations have developed formal advice about testing for COVID-19 to assist in the control of the disease. We collated, delineated and appraised current worldwide recommendations about the role and applications of tests to control SARS-CoV-2/COVID-19.

METHODS: We searched for documents providing recommendations for COVID-19 testing in PubMed, EMBASE, LILACS, the Coronavirus Open Access Project living evidence database and relevant websites such as TRIP database, ECRI Guidelines Trust, the GIN database, from inception to 21 September 2020. Two reviewers applied the eligibility criteria to potentially relevant citations without language or geographical restrictions. We extracted data in duplicate, including assessment of methodological quality using the Appraisal of Guidelines for Research and Evaluation-II tool.

RESULTS: We included 47 relevant documents and 327 recommendations about testing. Regarding the quality of the documents, we found that the domains with the lowest scores were 'Editorial independence' (Median=4%) and 'Applicability' (Median=6%). Only six documents obtained at least 50% score for the 'Rigour of development' domain. An important number of recommendations focused on the diagnosis of suspected cases (48%) and deisolation measures (11%). The most frequently recommended test was the reverse transcription-PCR (RT-PCR) assay (87 recommendations) and the chest CT (38 recommendations). There were 22 areas of agreement among guidance developers, including the use of RT-PCR for SARS-Cov-2 confirmation, the limited role of bronchoscopy, the use chest CT and chest X-rays for grading severity and the co-assessment for other respiratory pathogens.

CONCLUSION: This first scoping review of recommendations for COVID-19 testing showed many limitations in the methodological quality of included guidance documents that could affect the confidence of clinicians in their implementation. Future guidance documents should incorporate a minimum set of key methodological characteristics to enhance their applicability for decision making.}, } @article {pmid33407281, year = {2021}, author = {Alfraji, N and Mazahir, U and Chaudhri, M and Miskoff, J}, title = {Anti-synthetase syndrome: a rare and challenging diagnosis for bilateral ground-glass opacities-a case report with literature review.}, journal = {BMC pulmonary medicine}, volume = {21}, number = {1}, pages = {11}, pmid = {33407281}, issn = {1471-2466}, mesh = {Autoantibodies/*immunology ; COVID-19/*epidemiology ; Comorbidity ; Diagnosis, Differential ; Female ; Humans ; Lung/*diagnostic imaging ; Middle Aged ; Myositis/*diagnosis/epidemiology/immunology ; *Pandemics ; Prognosis ; *Rare Diseases ; *SARS-CoV-2 ; }, abstract = {BACKGROUND: Anti-synthetase syndrome (ASS) is an uncommon immune-mediated entity characterized by myositis, interstitial lung disease (ILD), non-erosive arthritis, and less common features such as fever, Raynaud's phenomenon, and skin changes in association with anti-aminoacyl-transfer-RNA antibodies, most commonly anti-Jo-1 antibodies.

CASE PRESENTATION: We present a challenging and rare case of ASS-associated ILD presenting with unexplained respiratory symptoms and bilateral infiltrates on chest imaging during the COVID-19 pandemic. High clinical suspicion for ASS with early appropriate therapy with corticosteroids and immunosuppressive agents led to marked clinical improvement.

CONCLUSION: High index of suspicion for ASS is mandated in patients with unexplained ILD. A comprehensive autoimmune work-up is important as an early treatment with corticosteroids with or without immunomodulators improves patient outcomes and survival in an otherwise poor prognostic disease.}, } @article {pmid33407008, year = {2021}, author = {Bredan, A and Bakoush, O}, title = {COVID-19 epidemic in Libya.}, journal = {The Libyan journal of medicine}, volume = {16}, number = {1}, pages = {1871798}, doi = {10.1080/19932820.2021.1871798}, pmid = {33407008}, issn = {1819-6357}, mesh = {COVID-19/*epidemiology ; Humans ; Libya/epidemiology ; *Pandemics ; Risk Factors ; *SARS-CoV-2 ; }, abstract = {The first case of COVID-19 was identified in Libya on 24/3/2020, and about 2 months later, the number of reported COVID-19 cases started to increase notably. The outbreak was first prominent in the southern region (Sabha) and then spread to the western and eastern parts of Libya. By 24/12/2020, the reported total number of deaths from COVID-19 reached 1415. There seems to be no published data on the size of the epidemic in Libya. Here, we estimated the number of Libyans exposed to COVID-19 by using a COVID-19 mortality adjusted mathematical model for the spread of infectious diseases. We estimated that 14-20% of the Libyan population have been exposed to the COVID-19 pandemic. Thus, the risk of spread of COVID-19 infections during the coming months is high, and a considerable number of Libyans, particularly the elderly and people with chronic diseases, should be protected against COVID-19 infection. This is particularly urgent in the light of unofficial reports that the relevant healthcare facilities are under extreme stress.}, } @article {pmid33399851, year = {2021}, author = {Sharma, RK and Li, J and Krishnan, S and Richards, EM and Raizada, MK and Mohandas, R}, title = {Angiotensin-converting enzyme 2 and COVID-19 in cardiorenal diseases.}, journal = {Clinical science (London, England : 1979)}, volume = {135}, number = {1}, pages = {1-17}, doi = {10.1042/CS20200482}, pmid = {33399851}, issn = {1470-8736}, support = {R01 HL102033/HL/NHLBI NIH HHS/United States ; K08 HL130945/HL/NHLBI NIH HHS/United States ; }, mesh = {Angiotensin II/metabolism ; Angiotensin-Converting Enzyme 2/genetics/*metabolism ; Animals ; COVID-19/*enzymology/genetics/metabolism/virology ; Heart Diseases/*enzymology/genetics/metabolism/virology ; Humans ; Kidney Diseases/*enzymology/genetics/metabolism/virology ; Receptors, Virus/genetics/metabolism ; Renin-Angiotensin System ; SARS-CoV-2/physiology ; }, abstract = {The rapid spread of the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has brought into focus the key role of angiotensin-converting enzyme 2 (ACE2), which serves as a cell surface receptor required for the virus to enter cells. SARS-CoV-2 can decrease cell surface ACE2 directly by internalization of ACE2 bound to the virus and indirectly by increased ADAM17 (a disintegrin and metalloproteinase 17)-mediated shedding of ACE2. ACE2 is widely expressed in the heart, lungs, vasculature, kidney and the gastrointestinal (GI) tract, where it counteracts the deleterious effects of angiotensin II (AngII) by catalyzing the conversion of AngII into the vasodilator peptide angiotensin-(1-7) (Ang-(1-7)). The down-regulation of ACE2 by SARS-CoV-2 can be detrimental to the cardiovascular system and kidneys. Further, decreased ACE2 can cause gut dysbiosis, inflammation and potentially worsen the systemic inflammatory response and coagulopathy associated with SARS-CoV-2. This review aims to elucidate the crucial role of ACE2 both as a regulator of the renin-angiotensin system and a receptor for SARS-CoV-2 as well as the implications for Coronavirus disease 19 and its associated cardiovascular and renal complications.}, } @article {pmid33387996, year = {2020}, author = {Burlacu, A and Crisan-Dabija, R and Covic, A and Raiu, C and Mavrichi, I and Popa, IV and Lillo-Crespo, M}, title = {Pandemic lockdown, healthcare policies and human rights: integrating opposed views on COVID-19 public health mitigation measures.}, journal = {Reviews in cardiovascular medicine}, volume = {21}, number = {4}, pages = {509-516}, doi = {10.31083/j.rcm.2020.04.274}, pmid = {33387996}, issn = {1530-6550}, mesh = {COVID-19/*epidemiology/transmission ; Communicable Disease Control/*methods ; *Health Policy ; *Human Rights ; Humans ; Pandemics/legislation & jurisprudence/*prevention & control ; *Public Health ; *SARS-CoV-2 ; }, abstract = {The issue of the COVID-19 pandemic occupies the agenda of the whole world. The pivot of this pandemic is a crucial element that has become almost as important as the virus itself, namely the lockdown. Although, the rationale for lockdown is well-sustained by strong epidemiological arguments, exploring the 'other' unwanted consequences of the contemporary COVID-19 pandemic is mandatory for coagulating a robust agreed position against the numerous problems generated by the SARS-CoV-2 virus. Starting from the rationale of the lockdown, in this paper we explored and exposed the other consequences of the COVID-19 pandemic measures such as the use or abuse of human rights and freedom restrictions, economic issues, marginalized groups and eclipse of all other diseases. Our scientific attempt is to coagulate a stable position and integrate current opposing views by advancing the idea that rather than applying the uniform lockdown policy, one could recommend instead an improved model targeting more strict and more prolonged lockdowns to vulnerable risk/age groups while enabling less stringent measures for the lower-risk groups, minimizing both economic losses and deaths. Rigorous (and also governed by freedom) debating may be able to synchronize the opposed perspectives between those advocating an extreme lockdown (e.g., most of the epidemiologists and health experts), and those criticizing all restrictive measures (e.g., economists and human rights experts). Confronting the multiple facets of the public health mitigation measures is the only way to avoid contributing to history with yet another failure, as seen in other past epidemics.}, } @article {pmid33387993, year = {2020}, author = {Thamman, R and Janardhanan, R}, title = {Cardiac rehabilitation using telemedicine: the need for tele cardiac rehabilitation.}, journal = {Reviews in cardiovascular medicine}, volume = {21}, number = {4}, pages = {497-500}, doi = {10.31083/j.rcm.2020.04.201}, pmid = {33387993}, issn = {1530-6550}, mesh = {COVID-19/*epidemiology ; Cardiac Rehabilitation/*methods ; Comorbidity ; Heart Diseases/epidemiology/*rehabilitation ; Humans ; *Pandemics ; SARS-CoV-2 ; Telemedicine/*methods ; }, abstract = {Cardiac Rehabilitation programs have shown to improve outcomes. The COVID-19 pandemic has posed barriers to these programs. A virtual platform might be a good solution to these challenges. Tele Cardiac Rehabilitation and remote patient monitoring provide an excellent alternative practical solution.}, } @article {pmid33377885, year = {2020}, author = {Ophinni, Y and Hasibuan, AS and Widhani, A and Maria, S and Koesnoe, S and Yunihastuti, E and Karjadi, TH and Rengganis, I and Djauzi, S}, title = {COVID-19 Vaccines: Current Status and Implication for Use in Indonesia.}, journal = {Acta medica Indonesiana}, volume = {52}, number = {4}, pages = {388-412}, pmid = {33377885}, issn = {0125-9326}, mesh = {COVID-19/immunology/prevention & control ; COVID-19 Vaccines/*pharmacology/supply & distribution ; Clinical Trials, Phase III as Topic ; Genetic Vectors ; Humans ; Immunity, Herd ; Indonesia ; Patient Selection ; RNA, Messenger/immunology ; SARS-CoV-2/genetics/immunology ; Vaccines, DNA ; Vaccines, Inactivated ; Vaccines, Synthetic ; }, abstract = {The coronavirus disease 2019 (COVID-19) has inflicted catastrophic damages in public health, economic and social stability-putting life globally on hold in 2020 and presumably a year more. Indonesia bears a heavy burden of the pandemic, counting the highest case prevalence and fatality rate in all of Southeast Asia. One hope remains in the groundbreaking universal effort in search of a vaccine against the causative virus SARS-CoV-2, which has shown success unparalleled in human vaccine development thus far. An array of modalities including novel techniques are being utilized as vaccine platforms, with the closest to phase III clinical trial completion being mRNA (manufactured by Moderna and BioNTech/Pfizer), inactivated virus (Sinovac, Sinopharm), viral vector (Oxford/AstraZeneca, Gamaleya, Janssen/Johnson&Johnson, CanSino), and protein subunit (Novavax). The vaccine produced by BioNTech/Pfizer has been deployed to the public as the first ever licensed COVID-19 vaccine. In this review, we will review all of these modalities on their safety and immunogenicity, phase II/III trial results of the nine vaccine candidates and current situation as of 29 December 2020, as well as the implication for use and distribution in Indonesia. COVID-19 vaccine progress, however, is moving exceedingly fast and new advances are unfolding on a daily basis, to which we hope an update to this review can be published in early 2021.}, } @article {pmid33353524, year = {2021}, author = {Al-Benna, S}, title = {Negative pressure rooms and COVID-19.}, journal = {Journal of perioperative practice}, volume = {31}, number = {1-2}, pages = {18-23}, doi = {10.1177/1750458920949453}, pmid = {33353524}, issn = {2515-7949}, mesh = {COVID-19 ; Coronavirus Infections/*prevention & control ; Humans ; Infection Control/*methods/*standards ; Operating Rooms/*standards ; Patient Isolators/*standards ; Perioperative Care/*standards ; Practice Guidelines as Topic ; Ventilation/*standards ; }, abstract = {The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes 2019 novel coronavirus disease (COVID-19), has rapidly developed into a global pandemic and public health emergency. The transmission and virulence of this new pathogen have raised concern for how best to protect healthcare professionals while effectively providing care to the infected patient requiring surgery. Although negative pressure rooms are ideal for aerosol-generating procedures, such as intubation and extubation, most operating theatres are generally maintained at a positive pressure when compared with the surrounding areas. This article compares negative and positive pressure rooms and the advantages of a negative pressure environment in optimising clinical care and minimising the exposure of patients and health care professionals to SARS-CoV-2.}, } @article {pmid33002972, year = {2020}, author = {Ortiz, D}, title = {Assessment and management of agitation, sleep, and mental illness in the surgical ICU.}, journal = {Current opinion in critical care}, volume = {26}, number = {6}, pages = {634-639}, doi = {10.1097/MCC.0000000000000762}, pmid = {33002972}, issn = {1531-7072}, mesh = {*COVID-19 ; Critical Illness ; *Delirium/diagnosis/therapy ; Humans ; Intensive Care Units ; Pain Management ; Psychomotor Agitation/therapy ; SARS-CoV-2 ; Sleep ; }, abstract = {PURPOSE OF REVIEW: Increased focus on patient-centered outcomes, mental health, and delirium prevention makes this review timely and relevant for critical care.

RECENT FINDINGS: This review focuses on patient-centered outcomes in the ICU, highlighting the latest research to promote brain health and psychological recovery during and after perioperative critical illness. Topics include sedation in the obese patient, delirium severity assessments, the role of the Psychiatry Consultation-Liaison in the ICU, Post-intensive care syndrome, and the importance of family engagement in the COVID era.

SUMMARY: Highlighting new research, such as novel implementation strategies in addition to a lack of research in certain areas like sleep in the ICU may lead to innovation and establishment of evidence-based practices in critical care. Perioperative brain health is multifaceted, and an increase in multidisciplinary interventions may help improve outcomes and decrease morbidity in ICU survivors.}, } @article {pmid32981089, year = {2021}, author = {Shah, RR}, title = {Chloroquine and hydroxychloroquine for COVID-19: Perspectives on their failure in repurposing.}, journal = {Journal of clinical pharmacy and therapeutics}, volume = {46}, number = {1}, pages = {17-27}, pmid = {32981089}, issn = {1365-2710}, mesh = {Antiviral Agents/administration & dosage/adverse effects ; Azithromycin/administration & dosage/adverse effects ; COVID-19/*drug therapy/virology ; Chloroquine/*administration & dosage/adverse effects ; Dose-Response Relationship, Drug ; Drug Repositioning ; Humans ; Hydroxychloroquine/*administration & dosage/adverse effects ; Long QT Syndrome/chemically induced ; Treatment Outcome ; Viral Load ; }, abstract = {WHAT IS KNOWN AND OBJECTIVE: Non-clinical studies suggest that chloroquine (CQ) and hydroxychloroquine (HCQ) have antiviral activities. Early clinical reports of successful HCQ-associated reduction in viral load from small studies in COVID-19 patients spurred a large number of national and international clinical trials to test their therapeutic potential. The objective of this review is to summarize the current evidence on the safety and efficacy of these two agents and to provide a perspective on why their repurposing has hitherto failed.

METHODS: Published studies and rapidly emerging data were reviewed to gather evidence on safety and efficacy of CQ and HCQ in patients with COVID-19 infection or as prophylaxis. The focus is on clinically relevant efficacy endpoints and their adverse effects on QT interval.

RESULTS AND DISCUSSION: At the doses used, the two agents, given alone or with azithromycin (AZM), are not effective in COVID-19 infection. The choice of (typically subtherapeutic) dosing regimens, influenced partly by "QT-phobia," varied widely and seems anecdotal without any pharmacologically reliable supporting clinical evidence. A substantial proportion of patients receiving CQ/HCQ/AZM regimen developed QTc interval prolongation, many with absolute QTc interval exceeding the potential proarrhythmic threshold, but very few developed proarrhythmia.

WHAT IS NEW AND CONCLUSION: The strategy to repurpose CQ/HCQ to combat COVID-19 infection is overshadowed by concerns about their QT liability, resulting in choice of potentially subtherapeutic doses. Although the risk of QT-related proarrhythmia is real, it is low and manageable by careful monitoring. Recent discontinuation of HCQ from at least four large studies effectively marks the end of efforts at repurposing of CQ or HCQ for COVID-19 infection. This episode leaves behind important questions on dose selection and risk/benefit balance in repurposing drugs generally.}, } @article {pmid32972205, year = {2021}, author = {Tukpah, AM and Moll, M and Gay, E}, title = {COVID-19 Racial and Ethnic Inequities in Acute Care and Critical Illness Survivorship.}, journal = {Annals of the American Thoracic Society}, volume = {18}, number = {1}, pages = {23-25}, pmid = {32972205}, issn = {2325-6621}, mesh = {COVID-19/*ethnology ; Critical Care/*methods ; Critical Illness/*epidemiology ; *Ethnic Groups ; Humans ; *Pandemics ; *SARS-CoV-2 ; *Survivorship ; }, } @article {pmid32970479, year = {2020}, author = {Berger, MM and Hackett, PH and Bärtsch, P}, title = {No Relevant Analogy Between COVID-19 and Acute Mountain Sickness.}, journal = {High altitude medicine & biology}, volume = {21}, number = {4}, pages = {315-318}, doi = {10.1089/ham.2020.0147}, pmid = {32970479}, issn = {1557-8682}, mesh = {Acute Disease ; *Altitude Sickness/complications/drug therapy ; Angiotensin-Converting Enzyme 2/metabolism ; *COVID-19/complications/drug therapy ; *Erythropoietin/therapeutic use ; Humans ; Hypoxia/complications ; Inflammation/complications ; SARS-CoV-2 ; Symptom Assessment ; }, abstract = {Berger, Marc Moritz, Peter H. Hackett, and Peter Bärtsch. No relevant analogy between COVID-19 and acute mountain sickness. High Alt Med Biol. 21:315-318, 2020.-Clinicians and scientists have suggested therapies for coronavirus disease-19 (COVID-19) that are known to be effective for other medical conditions. A recent publication suggests that pathophysiological mechanisms underlying acute mountain sickness (a syndrome of nonspecific neurological symptoms typically experienced by nonacclimatized individuals at altitudes >2500 m) may overlap with the mechanisms causing COVID-19. In this short review, we briefly evaluate this mistaken analogy and demonstrate that this concept is not supported by scientific evidence.}, } @article {pmid32961274, year = {2020}, author = {de Queiroz, NMGP and Marinho, FV and Chagas, MA and Leite, LCC and Homan, EJ and de Magalhães, MTQ and Oliveira, SC}, title = {Vaccines for COVID-19: perspectives from nucleic acid vaccines to BCG as delivery vector system.}, journal = {Microbes and infection}, volume = {22}, number = {10}, pages = {515-524}, pmid = {32961274}, issn = {1769-714X}, support = {R01 AI116453/AI/NIAID NIH HHS/United States ; }, mesh = {Angiotensin-Converting Enzyme 2/chemistry ; Antibodies, Viral/immunology ; BCG Vaccine/*administration & dosage ; COVID-19/*immunology/prevention & control ; COVID-19 Vaccines/*immunology ; Epitope Mapping ; Humans ; Middle East Respiratory Syndrome Coronavirus/chemistry ; Protein Binding ; SARS-CoV-2/*immunology ; Spike Glycoprotein, Coronavirus/chemistry/*immunology ; Vaccines, DNA/*immunology ; Viral Vaccines/*immunology ; }, abstract = {This article discusses standard and new disruptive strategies in the race to develop an anti-COVID-19 vaccine. We also included new bioinformatic data from our group mapping immunodominant epitopes and structural analysis of the spike protein. Another innovative approach reviewed here is the use of BCG vaccine as priming strategy and/or delivery system expressing SARS-CoV-2 antigens.}, } @article {pmid33434886, year = {2021}, author = {Tian, Y and Zhou, LQ}, title = {Evaluating the impact of COVID-19 on male reproduction.}, journal = {Reproduction (Cambridge, England)}, volume = {161}, number = {2}, pages = {R37-R44}, doi = {10.1530/REP-20-0523}, pmid = {33434886}, issn = {1741-7899}, abstract = {Invasion or damage of the male reproductive system is one of the reported outcomes of viral infection. Current studies have documented that SARS-CoV-2, which causes COVID-19, can damage the male reproductive system in large part by inflammatory damage caused by a cytokine storm. However, whether SARS-CoV-2 can infect the human testis directly and enter semen is controversial. Other adverse effects of SARS-CoV-2 on male reproduction are also of concern and require comprehensive evaluation. Here, we analyze the invasiveness of SARS-CoV-2 in the testis and examine reported mechanisms by which SARS-CoV-2 interferes with male reproduction. Long-term implications of SARS-CoV-2 infection on male reproduction are also discussed. It should be emphasized that although COVID-19 may induce testicular damage, a substantial decrease in male reproductive capacity awaits clinical evidence. We propose that there is an urgent need to track male COVID-19 patients during their recovery. The development of suitable experimental models, including human reproductive organoids, will be valuable to further investigate the viral impact on reproduction for current and future pandemics.}, } @article {pmid33434780, year = {2021}, author = {Ghodake, GS and Shinde, SK and Kadam, AA and Saratale, RG and Saratale, GD and Syed, A and Elgorban, AM and Marraiki, N and Kim, DY}, title = {Biological characteristics and biomarkers of novel SARS-CoV-2 facilitated rapid development and implementation of diagnostic tools and surveillance measures.}, journal = {Biosensors & bioelectronics}, volume = {177}, number = {}, pages = {112969}, doi = {10.1016/j.bios.2021.112969}, pmid = {33434780}, issn = {1873-4235}, abstract = {Existing coronavirus named as a severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has speeded its spread across the globe immediately after emergence in China, Wuhan region, at the end of the year 2019. Different techniques, including genome sequencing, structural feature classification by electron microscopy, and chest imaging using computed tomography, are primarily used to diagnose and screen SARS-CoV-2 suspected individuals. Determination of the viral structure, surface proteins, and genome sequence has provided a design blueprint for the diagnostic investigations of novel SARS-CoV-2 virus and rapidly emerging diagnostic technologies, vaccine trials, and cell-entry-inhibiting drugs. Here, we describe recent understandings on the spike glycoprotein (S protein), receptor-binding domain (RBD), and angiotensin-converting enzyme 2 (ACE2) and their receptor complex. This report also aims to review recently established diagnostic technologies and developments in surveillance measures for SARS-CoV-2 as well as the characteristics and performance of emerging techniques. Smartphone apps for contact tracing can help nations to conduct surveillance measures before a vaccine and effective medicines become available. We also describe promising point-of-care (POC) diagnostic technologies that are under consideration by researchers for advancement beyond the proof-of-concept stage. Developing novel diagnostic techniques needs to be facilitated to establish automatic systems, without any personal involvement or arrangement to curb an existing SARS-CoV-2 epidemic crisis, and could also be appropriate for avoiding the emergence of a future epidemic crisis.}, } @article {pmid33434768, year = {2021}, author = {Sterley, TL and Bains, JS}, title = {Social communication of affective states.}, journal = {Current opinion in neurobiology}, volume = {68}, number = {}, pages = {44-51}, doi = {10.1016/j.conb.2020.12.007}, pmid = {33434768}, issn = {1873-6882}, abstract = {Social interactions promote the communication of explicit and implicit information between individuals. Implicit or subconscious sharing of cues can be useful in conveying affective states. Knowing the affective state of others can guide future interactions, while an inability to decipher another's affective state is a core feature of autism spectrum disorder. The precise neural circuitry and mechanisms involved in communicating affective states are not well understood. Over the past few years, a number of important observations in rodent models have increased our knowledge of the neural processes for social communication of affective state. Here we highlight these contributions by first describing the rodent models used to investigate social communication of affect and then summarising the neural circuitry and processes implicated by these rodent models. We relate these findings to humans as well as to the current global context where social interactions have been modified by the Covid-19 pandemic.}, } @article {pmid33434662, year = {2021}, author = {Tandon, M and Kataria, S and Patel, J and Mehta, TR and Daimee, M and Patel, V and Prasad, A and Chowdhary, AA and Jaiswal, S and Sriwastava, S}, title = {A Comprehensive Systematic Review of CSF analysis that defines Neurological Manifestations of COVID-19.}, journal = {International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.ijid.2021.01.002}, pmid = {33434662}, issn = {1878-3511}, abstract = {BACKGROUND: Limited literature exists on CSF findings in COVID-19 patients with neurological symptoms. In this review, we conducted a descriptive analysis of CSF findings in patients with COVID-19 to understand prognosis and explore therapeutic options.

METHODS: We searched PubMed, Google Scholar and Scopus databases using the keywords "SARS-CoV-2 in cerebrospinal fluid", "SARS-CoV-2 and CNS Complications" for reports of CSF findings in COVID-19 related neurological manifestations. Descriptive analysis were conducted to observe the CSF protein and cell counts based on age, gender, severity and fatality of COVID-19, and whether central (CNS) or peripheral nervous system (PNS).

RESULTS: A total of 113 patients were identified from 67 studies. Of these, 7 patients (6.2 %) were fatal COVID-19 cases and 35 patients (31%) were considered severe COVID-19 cases. CSF protein was elevated in 100% (7/7) of the fatal cases with an average of 61.28 mg/dl, and in 65.0 % (52/80) in non-fatal cases with an average 56.73 mg/dl. CSF protein levels were elevated in 74.5% (38/51) patients with non-severe COVID-19 and 68.6% (24/35) in those with a severe COVID-19 infection. CSF cell count was increased in 43% of fatal cases, 25.7% severe cases and 29.4% of non-severe cases.

CONCLUSION: Our analysis showed that the most common CSF picture in COVID-19 infection is elevated protein with very occasionally mild lymphocyte predominant pleiocytosis. Further studies to elucidate pathophysiology of neurological complications in COVID-19 are recommended.}, } @article {pmid33434163, year = {2020}, author = {Tian, Y and Zhou, LQ}, title = {Evaluating the Impact of COVID-19 on Male Reproduction.}, journal = {Reproduction (Cambridge, England)}, volume = {}, number = {}, pages = {}, doi = {10.1530/REP-20-0523}, pmid = {33434163}, issn = {1741-7899}, abstract = {Invasion or damage of the male reproductive system is one of the reported outcomes of viral infection. Current studies have documented that SARS-CoV-2, which causes COVID-19, can damage the male reproductive system in large part by inflammatory damage caused by cytokine storm. However, whether SARS-CoV-2 can infect the human testis directly and enter semen is controversial. Other adverse effects of SARS-CoV-2 on male reproduction are also of concern and require comprehensive evaluation. Here, we analyze the invasiveness of SARS-CoV-2 in the testis and examine reported mechanisms by which SARS-CoV-2 interferes with male reproduction. Long-term implications of SARS-CoV-2 infection on male reproduction are also discussed. It should be emphasized that although COVID-19 may induce testicular damage, substantial decrease in male reproductive capacity awaits clinical evidence. We propose that there is an urgent need to track male COVID-19 patients during their recovery. Development of suitable experimental models, including human reproductive organoids, will be valuable to further investigate viral impact on reproduction for current and future pandemics.}, } @article {pmid33433756, year = {2021}, author = {Iodice, F and Romoli, M and Giometto, B and Clerico, M and Tedeschi, G and Bonavita, S and Leocani, L and Lavorgna, L and , }, title = {Stroke and digital technology: a wake-up call from COVID-19 pandemic.}, journal = {Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology}, volume = {}, number = {}, pages = {}, pmid = {33433756}, issn = {1590-3478}, abstract = {INTRODUCTION: The pandemic has implemented the need for new digital technologies as useful tools during the emergency and the long recovery phase that will follow. SARS-CoV-2 has strongly impacted stroke care with significant contraction in a number of patients treated.

METHODS: This mini-review is an initiative of the "Digital Technologies, Web and Social Media Study Group" of the Italian Society of Neurology and briefly discusses digital tools for managing the acute phase and the rehabilitation after stroke, even considering the new apps that will improve the process of remote monitoring of patients after discharge at home.

RESULTS: Telemedicine and digital technologies could play a role in each of the three stroke-belt stages: hyperacute treatment and reperfusion, acute care, etiological classification and secondary prevention and rehabilitation.

CONCLUSION: The global emergency represented by the COVID-19 pandemic can be the stimulus to accelerate the digitalization process in the field of stroke for the use of new methods on a large scale.}, } @article {pmid33433382, year = {2021}, author = {Salehi, M and Amanat, M and Mohammadi, M and Salmanian, M and Rezaei, N and Saghazadeh, A and Garakani, A}, title = {The prevalence of post-traumatic stress disorder related symptoms in Coronavirus outbreaks: A systematic-review and meta-analysis.}, journal = {Journal of affective disorders}, volume = {282}, number = {}, pages = {527-538}, doi = {10.1016/j.jad.2020.12.188}, pmid = {33433382}, issn = {1573-2517}, abstract = {BACKGROUND: Infectious disease outbreaks affect physical and mental health of humans worldwide. Studies showed that the prevalence of post-traumatic stress disorder (PTSD) symptoms increased in these conditions. This systematic-review and meta-analysis aimed to assess the prevalence of PTSD related symptoms in coronavirus outbreaks.

METHODS: Systematic search of literature was conducted in Scopus, Embase, PubMed, and Web of Science. Google Scholar and Grey literature including conference proceedings were also checked. Published articles from November 1, 2012 until May 18, 2020 were searched. Subgroup analysis, meta-regression and sensitivity analysis were also conducted to assess heterogeneity.

RESULTS: We found 38 articles with 19,428 individuals met the eligibility criteria. Of these papers, 35 studies were included in meta-analysis. The prevalence of PTSD symptoms was estimated to be about 18% (95%CI: 15% to 20%). These symptoms were more frequent in cohort studies (29%) compared to cross-sectional (15%) and case-control (11%) studies. Prevalence rates of PTSD symptoms in MERS (36%) outbreaks were higher than SARS (18%) and COVID-19 (9%) outbreaks. Meta-regression showed that the geographical location of study was the source of heterogeneity (R2: 19.8%, P-value: 0.003). Meta-analysis reported that about three in every ten survivors of coronavirus infection, about two in every ten healthcare workers, and about one in every ten individuals of general population experienced PTSD symptoms in outbreaks.

LIMITATIONS: PTSD cannot be objectively assessed and this can lead to information bias of included studies.

CONCLUSION: PTSD symptoms are shown to be common in coronavirus outbreaks. Mental care should be, therefore, considered in the present COVID-19 pandemic.}, } @article {pmid33433350, year = {2021}, author = {Yang, C and Xiao, SY}, title = {COVID-19 and inflammatory bowel disease: A pathophysiological assessment.}, journal = {Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie}, volume = {135}, number = {}, pages = {111233}, doi = {10.1016/j.biopha.2021.111233}, pmid = {33433350}, issn = {1950-6007}, abstract = {Coronavirus disease-2019 (COVID-19), caused by SARS-CoV-2, has led to the ongoing global pandemic. Although most patients experience no or only mild symptoms, some patients can develop severe illness, such as progressive pneumonia, acute respiratory distress syndrome, secondary hemophagocytic lymphohistiocytosis and multiple organ failure caused by cytokine release syndrome. A majority of COVID-19 patients also develop gastrointestinal symptoms. These can present special challenges to the management of patients with inflammatory bowel disease (IBD) due to potential interactions between the immune response related to SARS-CoV-2 infection and dysregulated immunity associated with IBD. In this context, the pathogenesis of COVID-19 is reviewed in order to address these questions regarding immune interactions between COVID-19 and IBD.}, } @article {pmid33433050, year = {2021}, author = {Gegúndez-Fernández, JA and Llovet-Osuna, F and Fernández-Vigo, JI and Mendicute Del Barrio, J and Pablo-Júlvez, L and Muñoz-Negrete, FJ and Zarranz-Ventura, J and Durán de la Colina, J and de Rojas Silva, V and Jiménez-Alfaro, I and Calonge-Cano, M and Galindo-Ferreiro, A and Castillo-Gómez, A and Mantolán-Sarmiento, C and Duch-Samper, A and Álvarez de Toledo-Elizalde, J and Duch-Mestres, F and Elies-Amat, D and Ortega-Usobiaga, J and Saornil-Alvarez, MA and Villarrubia Cuadrado, A and Garay Aramburu, G and Fonollosa Carduch, A and Cordero Coma, JM and García Delpech, S and Cárceles Cárceles, JA and Benítez Del Castillo Sánchez, JM and Gómez de Liaño Sánchez, P and Harto Castaño, M and Arias Puente, A and García-Layana, A and , }, title = {Recommendations for ophthalmologic practice during the easing of COVID-19 control measures.}, journal = {Acta ophthalmologica}, volume = {}, number = {}, pages = {}, doi = {10.1111/aos.14752}, pmid = {33433050}, issn = {1755-3768}, abstract = {In the context of the COVID-19 pandemic, this paper provides recommendations for medical eye care during the easing of control measures after lockdown. The guidelines presented are based on a literature review and consensus among all Spanish Ophthalmology Societies regarding protection measures recommended for the ophthalmologic care of patients with or without confirmed COVID-19 in outpatient, inpatient, emergency and surgery settings. We recommend that all measures be adapted to the circumstances and availability of personal protective equipment at each centre and also highlight the need to periodically update recommendations as we may need to readopt more restrictive measures depending on the local epidemiology of the virus. These guidelines are designed to avoid the transmission of SARS-CoV-2 among both patients and healthcare staff as we gradually return to normal medical practice, to prevent postoperative complications and try to reduce possible deficiencies in the diagnosis, treatment and follow-up of the ophthalmic diseases. With this update (5th) the Spanish Society of Ophthalmology is placed as one of the major ophthalmology societies providing periodic and systematized recommendations for ophthalmic care during the COVID-19 pandemic.}, } @article {pmid33432484, year = {2021}, author = {Jamshidi, E and Babajani, A and Soltani, P and Niknejad, H}, title = {Proposed Mechanisms of Targeting COVID-19 by Delivering Mesenchymal Stem Cells and Their Exosomes to Damaged Organs.}, journal = {Stem cell reviews and reports}, volume = {}, number = {}, pages = {}, pmid = {33432484}, issn = {2629-3277}, abstract = {With the outbreak of coronavirus disease (COVID-19) caused by novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the world has been facing an unprecedented challenge. Considering the lack of appropriate therapy for COVID-19, it is crucial to develop effective treatments instead of supportive approaches. Mesenchymal stem cells (MSCs) as multipotent stromal cells have been shown to possess treating potency through inhibiting or modulating the pathological events in COVID-19. MSCs and their exosomes participate in immunomodulation by controlling cell-mediated immunity and cytokine release. Furthermore, they repair the renin-angiotensin-aldosterone system (RAAS) malfunction, increase alveolar fluid clearance, and reduce the chance of hypercoagulation. Besides the lung, which is the primary target of SARS-CoV-2, the heart, kidney, nervous system, and gastrointestinal tract are also affected by COVID-19. Thus, the efficacy of targeting these organs via different delivery routes of MSCs and their exosomes should be evaluated to ensure safe and effective MSCs administration in COVID-19. This review focuses on the proposed therapeutic mechanisms and delivery routes of MSCs and their exosomes to the damaged organs. It also discusses the possible application of primed and genetically modified MSCs as a promising drug delivery system in COVID-19. Moreover, the recent advances in the clinical trials of MSCs and MSCs-derived exosomes as one of the promising therapeutic approaches in COVID-19 have been reviewed.}, } @article {pmid33432419, year = {2021}, author = {Yehya, A and Shah, KS and Mitter, SS and Ibrahim, NE and Sperry, B and Shah, M and Chaudhry, SP and Rajagopalan, N and Hernandez-Montfort, J and Mohan, R and Alexander, KM and Sinha, S and Butler, J and Kittleson, MM}, title = {Challenges and the innovations in the care of advanced heart failure patients during COVID-19.}, journal = {Heart failure reviews}, volume = {}, number = {}, pages = {}, pmid = {33432419}, issn = {1573-7322}, abstract = {The COVID-19 pandemic underscored our healthcare system's unpreparedness to manage an unprecedented pandemic. Heart failure (HF) physicians from 14 different academic and private practice centers share their systems' challenges and innovations to care for patients with HF, heart transplantation, and patients on LVAD support during the COVID-19 pandemic. We discuss measures implemented to alleviate the fear in seeking care, ensure continued optimization of guideline directed medical therapy (GDMT), manage the heart transplant waiting list, continue essential outpatient monitoring of anticoagulation in LVAD patients and surveillance testing post-heart transplant, and prevent physician burnout. This collaborative work can build a foundation for better preparation in the face of future challenges.}, } @article {pmid33432288, year = {2021}, author = {Jegan, R and Rajalakshmy, P and Subha Hency Jose, P and Nimi, WS}, title = {2019-nCoV effects, transmission and preventive measures: an overview.}, journal = {Zeitschrift fur Gesundheitswissenschaften = Journal of public health}, volume = {}, number = {}, pages = {1-9}, doi = {10.1007/s10389-020-01435-4}, pmid = {33432288}, issn = {2198-1833}, abstract = {Aim: COVID-19 has led to a global crisis not only in the health sector but also in the economic, social and education sectors, as well as the lives of common man. This paper reviews the origin, characteristics and transmission of the SARS-CoV-2 Virus and the preventive measures adopted by the world's nations to curb the effects of the pandemic.

Subjects and methods: The temporal and spatial profile of the COVID-19 spread is highly dynamic and is progressively changing at a rapid pace. This article is an attempt to mitigate the pandemic threat by sharing the review outcome from an extensive literature survey on recent articles on COVID-19 and its impact.

Results: Statistical analysis presented by the World Health Organization and other health organizations explicitly indicates that optimized support and care extended to infected persons is the key to therapy, and the clinical effectiveness of alternative techniques is still under study. Though there have been announcements on the discovery of drugs for the virus, the authenticity of these reports are yet to be verified.

Conclusion: Based on the review, it can be inferred that it is important to boost one's immune system and to stay healthy by developing healthy habits of food intake, sleep, exercise, personal hygiene and so on. Practicing social distancing with a self-motivated attitude will help to control the virus to a large extent. The current situation also demands a great sense of responsibility of people towards society by protecting oneself from the virus in order to protect the society one lives in.}, } @article {pmid33432272, year = {2020}, author = {Ehsanian, R and Workman, J and Jones, D and Selvage, D and Rivers, WE and Manole, AK and Sloan, JH}, title = {Free-standing acute inpatient rehabilitation hospital enhanced practices and policies in response to the COVID-19 outbreak.}, journal = {Future science OA}, volume = {7}, number = {2}, pages = {FSO667}, doi = {10.2144/fsoa-2020-0181}, pmid = {33432272}, issn = {2056-5623}, abstract = {This special report was developed to communicate policy and procedures for free-standing acute inpatient rehabilitation hospitals (AIRHs) to protect patients and healthcare personnel and to prevent further spread of severe acute respiratory syndrome coronavirus 2. The recommended policies were developed in conjunction with the New Mexico Department of Health and hospital leadership. As we attain additional knowledge and experience during this pandemic, suggestions of best practice will continue to evolve for AIRHs. The authors encourage readers to work with local regulatory officials to ensure regulatory compliance as well as respect of the availability of local resources.}, } @article {pmid33431425, year = {2021}, author = {Mohebali, D and Kittleson, MM}, title = {Remote monitoring in heart failure: current and emerging technologies in the context of the pandemic.}, journal = {Heart (British Cardiac Society)}, volume = {}, number = {}, pages = {}, doi = {10.1136/heartjnl-2020-318062}, pmid = {33431425}, issn = {1468-201X}, abstract = {The incidence of heart failure (HF) remains high and patients with HF are at risk for frequent hospitalisations. Remote monitoring technologies may provide early indications of HF decompensation and potentially allow for optimisation of therapy to prevent HF hospitalisations. The need for reliable remote monitoring technology has never been greater as the COVID-19 pandemic has led to the rapid expansion of a new mode of healthcare delivery: the virtual visit. With the convergence of remote monitoring technologies and reliable method of remote healthcare delivery, an understanding of the role of both in the management of patients with HF is critical. In this review, we outline the evidence on current remote monitoring technologies in patients with HF and highlight how these advances may benefit patients in the context of the current pandemic.}, } @article {pmid33430467, year = {2021}, author = {Dąbrowska, J and Sobota, M and Świąder, M and Borowski, P and Moryl, A and Stodolak, R and Kucharczak, E and Zięba, Z and Kazak, JK}, title = {Marine Waste-Sources, Fate, Risks, Challenges and Research Needs.}, journal = {International journal of environmental research and public health}, volume = {18}, number = {2}, pages = {}, doi = {10.3390/ijerph18020433}, pmid = {33430467}, issn = {1660-4601}, abstract = {The article presents a comprehensive and cross-cutting review of key marine waste issues, taking into account: sources, fate, risks, transport pathways, threats, legislation, current challenges, and knowledge gaps. The growing amount of both human-created waste in seas and oceans and waste reaching marine ecosystems from land is one of today's challenges for the global economy and the European Union. It is predicted that if no decisive steps are taken to limit the amount of this type of waste, there may be more plastic waste than fish in the oceans after 2050. The influence of microplastics and nanoplastics on living organisms remains undiagnosed. Within the international and EU law, solutions are being developed to properly manage waste on board ships and to reduce the impact of processes related to the recycling of the vessels on the environment. Currently, over 80% of ships are dismantled in the countries of South Asia, in conditions that threaten the environment and the safety of workers. After World War 2, large quantities of chemical weapons were deposited in the seas. Steel containers with dangerous substances residing in the sea for over 70 years have begun leaking, thus polluting water. For many years, radioactive waste had also been dumped into marine ecosystems, although since 1993 there has been a total ban on such disposal of radionuclides. The impact of the COVID-19 pandemic on marine waste generation has also been presented as a significant factor influencing marine waste generation and management.}, } @article {pmid33430431, year = {2021}, author = {Iba, T and Warkentin, TE and Thachil, J and Levi, M and Levy, JH}, title = {Proposal of the Definition for COVID-19-Associated Coagulopathy.}, journal = {Journal of clinical medicine}, volume = {10}, number = {2}, pages = {}, doi = {10.3390/jcm10020191}, pmid = {33430431}, issn = {2077-0383}, support = {11596632//Promotion and Mutual Aid Corporation for Private Schools of Japan/ ; }, abstract = {Thrombotic events are common complications in COVID-19 patients that include both thrombus formation in large vessels and the microvasculature of the lung and other organs. COVID-19-associated coagulopathy (CAC) and disseminated intravascular coagulation (DIC) have similarities and differences, and whether CAC is a form of DIC is the subject of debate. Reported mechanisms of CAC include activated coagulation, endotheliopathy, up-regulated innate and adaptive immunity, and activated complement system. Although the clinical features and laboratory findings of CAC and DIC seem different, there are fundamental similarities that should be considered. Basically, the pathological findings of COVID-19 fall within the scope of the definition of DIC, i.e., systemic activation of coagulation caused by or resulting from the microvascular damage. Therefore, we suggest that although CAC differs from usual infection-associated DIC, its various features indicate that it can be considered a thrombotic phenotype DIC. This review summarizes the current knowledge about CAC including differences and similarities with sepsis-associated DIC.}, } @article {pmid33430424, year = {2021}, author = {Chugh, RM and Bhanja, P and Norris, A and Saha, S}, title = {Experimental Models to Study COVID-19 Effect in Stem Cells.}, journal = {Cells}, volume = {10}, number = {1}, pages = {}, doi = {10.3390/cells10010091}, pmid = {33430424}, issn = {2073-4409}, support = {P20//The University of Kansas Cancer Center/ ; }, abstract = {The new strain of coronavirus (severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2)) emerged in 2019 and hence is often referred to as coronavirus disease 2019 (COVID-19). This disease causes hypoxic respiratory failure and acute respiratory distress syndrome (ARDS), and is considered as the cause of a global pandemic. Very limited reports in addition to ex vivo model systems are available to understand the mechanism of action of this virus, which can be used for testing of any drug efficacy against virus infectivity. COVID-19 induces tissue stem cell loss, resulting inhibition of epithelial repair followed by inflammatory fibrotic consequences. Development of clinically relevant models is important to examine the impact of the COVID-19 virus in tissue stem cells among different organs. In this review, we discuss ex vivo experimental models available to study the effect of COVID-19 on tissue stem cells.}, } @article {pmid33430309, year = {2021}, author = {Terracciano, R and Preianò, M and Fregola, A and Pelaia, C and Montalcini, T and Savino, R}, title = {Mapping the SARS-CoV-2-Host Protein-Protein Interactome by Affinity Purification Mass Spectrometry and Proximity-Dependent Biotin Labeling: A Rational and Straightforward Route to Discover Host-Directed Anti-SARS-CoV-2 Therapeutics.}, journal = {International journal of molecular sciences}, volume = {22}, number = {2}, pages = {}, doi = {10.3390/ijms22020532}, pmid = {33430309}, issn = {1422-0067}, abstract = {Protein-protein interactions (PPIs) are the vital engine of cellular machinery. After virus entry in host cells the global organization of the viral life cycle is strongly regulated by the formation of virus-host protein interactions. With the advent of high-throughput -omics platforms, the mirage to obtain a "high resolution" view of virus-host interactions has come true. In fact, the rapidly expanding approaches of mass spectrometry (MS)-based proteomics in the study of PPIs provide efficient tools to identify a significant number of potential drug targets. Generation of PPIs maps by affinity purification-MS and by the more recent proximity labeling-MS may help to uncover cellular processes hijacked and/or altered by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), providing promising therapeutic targets. The possibility to further validate putative key targets from high-confidence interactions between viral bait and host protein through follow-up MS-based multi-omics experiments offers an unprecedented opportunity in the drug discovery pipeline. In particular, drug repurposing, making use of already existing approved drugs directly targeting these identified and validated host interactors, might shorten the time and reduce the costs in comparison to the traditional drug discovery process. This route might be promising for finding effective antiviral therapeutic options providing a turning point in the fight against the coronavirus disease-2019 (COVID-19) outbreak.}, } @article {pmid33430234, year = {2021}, author = {Kervevan, J and Chakrabarti, LA}, title = {Role of CD4+ T Cells in the Control of Viral Infections: Recent Advances and Open Questions.}, journal = {International journal of molecular sciences}, volume = {22}, number = {2}, pages = {}, doi = {10.3390/ijms22020523}, pmid = {33430234}, issn = {1422-0067}, support = {18096 and ECTZ88800//Agence Nationale de Recherches sur le Sida et les Hépatites Virales/ ; AI25-1-02343/2344/2345//Sidaction/ ; SARS-CoV-2 CP 2017-266//DIM ELICIT Région Ile-de-France/ ; Task Force SARS-CoV-2 TROPICORO//Institut Pasteur/ ; }, abstract = {CD4+ T cells orchestrate adaptive immune responses through their capacity to recruit and provide help to multiple immune effectors, in addition to exerting direct effector functions. CD4+ T cells are increasingly recognized as playing an essential role in the control of chronic viral infections. In this review, we present recent advances in understanding the nature of CD4+ T cell help provided to antiviral effectors. Drawing from our studies of natural human immunodeficiency virus (HIV) control, we then focus on the role of high-affinity T cell receptor (TCR) clonotypes in mediating antiviral CD4+ T cell responses. Last, we discuss the role of TCR affinity in determining CD4+ T cell differentiation, reviewing the at times divergent studies associating TCR signal strength to the choice of a T helper 1 (Th1) or a T follicular helper (Tfh) cell fate.}, } @article {pmid33430200, year = {2021}, author = {Perricone, C and Triggianese, P and Bursi, R and Cafaro, G and Bartoloni, E and Chimenti, MS and Gerli, R and Perricone, R}, title = {Intravenous Immunoglobulins at the Crossroad of Autoimmunity and Viral Infections.}, journal = {Microorganisms}, volume = {9}, number = {1}, pages = {}, doi = {10.3390/microorganisms9010121}, pmid = {33430200}, issn = {2076-2607}, abstract = {Intravenous immunoglobulins (IVIG) are blood preparations pooled from the plasma of donors that have been first employed as replacement therapy in immunodeficiency. IVIG interact at multiple levels with the different components of the immune system and exert their activity against infections. Passive immunotherapy includes convalescent plasma from subjects who have recovered from infection, hyperimmune globulin formulations with a high titer of neutralizing antibodies, and monoclonal antibodies (mAbs). IVIG are used for the prevention and treatment of several infections, especially in immunocompromised patients, or in case of a poorly responsive immune system. The evolution of IVIG from a source of passive immunity to a powerful immunomodulatory/anti-inflammatory agent results in extensive applications in autoimmune diseases. IVIG composition depends on the antibodies of the donor population and the alterations of protein structure due to the processing of plasma. The anti-viral and anti-inflammatory activity of IVIG has led us to think that they may represent a useful therapeutic tool even in COVID-19. The human origin of IVIG carries specific criticalities including risks of blood products, supply, and elevated costs. IVIG can be useful in critically ill patients, as well as early empirical treatment. To date, the need for further well-designed studies stating protocols and the efficacy/tolerability profile of IVIG and convalescent plasma in selected situations are awaited.}, } @article {pmid33429973, year = {2021}, author = {Schipilliti, FM and Garajová, I and Rovesti, G and Balsano, R and Piacentini, F and Dominici, M and Gelsomino, F}, title = {The Growing Skyline of Advanced Hepatocellular Carcinoma Treatment: A Review.}, journal = {Pharmaceuticals (Basel, Switzerland)}, volume = {14}, number = {1}, pages = {}, doi = {10.3390/ph14010043}, pmid = {33429973}, issn = {1424-8247}, abstract = {Hepatocellular carcinoma (HCC) is the main type of liver cancer. In the majority of cases, HCC is diagnosed at the advanced stage, leading to poor prognosis. In recent years, many efforts have been devoted to investigating potential new and more effective drugs and, indeed, the treatment armamentarium for advanced HCC has broadened tremendously, with targeted- and immune-therapies, and probably the combination of both, playing pivotal roles. Together with new established knowledge, many issues are emerging, with the role of neoadjuvant/adjuvant settings, the definition of the best transitioning time from loco-regional treatments to systemic therapy, the identification of potential predictive biomarkers, and radiomics being just some of the topics that will have to be further explored in the next future. Clearly, the current COVID-19 pandemic has influenced the management of HCC patients and some considerations about this topic will be elucidated.}, } @article {pmid33429925, year = {2021}, author = {Klopf, J and Brostjan, C and Eilenberg, W and Neumayer, C}, title = {Neutrophil Extracellular Traps and Their Implications in Cardiovascular and Inflammatory Disease.}, journal = {International journal of molecular sciences}, volume = {22}, number = {2}, pages = {}, doi = {10.3390/ijms22020559}, pmid = {33429925}, issn = {1422-0067}, abstract = {Neutrophils are primary effector cells of innate immunity and fight infection by phagocytosis and degranulation. Activated neutrophils also release neutrophil extracellular traps (NETs) in response to a variety of stimuli. These NETs are net-like complexes composed of cell-free DNA, histones and neutrophil granule proteins. Besides the evolutionarily conserved mechanism to capture and eliminate pathogens, NETs are also associated with pathophysiological processes of various diseases. Here, we elucidate the mechanisms of NET formation and their different implications in disease. We focused on autoinflammatory and cardiovascular disorders as the leading cause of death. Neutrophil extracellular traps are not only present in various cardiovascular diseases but play an essential role in atherosclerotic plaque formation, arterial and venous thrombosis, as well as in the development and progression of abdominal aortic aneurysms. Furthermore, NETosis can be considered as a source of autoantigens and maintains an inflammatory milieu promoting autoimmune diseases. Indeed, there is further need for research into the balance between NET induction, inhibition, and degradation in order to pharmacologically target NETs and their compounds without impairing the patient's immune defense. This review may be of interest to both basic scientists and clinicians to stimulate translational research and innovative clinical approaches.}, } @article {pmid33429880, year = {2021}, author = {Prüβ, BM}, title = {Current State of the First COVID-19 Vaccines.}, journal = {Vaccines}, volume = {9}, number = {1}, pages = {}, doi = {10.3390/vaccines9010030}, pmid = {33429880}, issn = {2076-393X}, support = {ND02438//U.S. Department of Agriculture/ ; }, abstract = {SARS CoV-2 and its associated disease COVID-19 has devastated the world during 2020. Masks and social distancing could be efficient if done by large proportions of the population, but pandemic fatigue has decreased their efficacy. Economic shut downs come with large price tags and cannot be a long term solution either. The announcements by three vaccine manufacturers in November that their vaccines are 90% or more effective has given hope to at least those in the population who plan to get vaccinated as soon as a scientifically and medically sound vaccine becomes available. This review summarizes the underlying design strategies and current status of development of the nine vaccines that were in phase III trial on 8 November 2020. Contracts between vaccine manufacturing companies and governments aim at distributing the vaccine to a large part of the world population. Questions remain how the temperature sensitive mRNA vaccines will be transported and/or stored and how vaccination will be prioritized within each country. Additionally, current contracts do not cover all countries, with a serious gap in Africa and South America. The second part of this review will detail current distribution plans and remaining challenges with vaccine accessibility and acceptance.}, } @article {pmid33417755, year = {2020}, author = {Sommer-Larraza, G and Mallen-Trejo, A and Tomás-Reyna, C and Rodríguez-Reséndiz, F}, title = {[Guidelines for restarting elective orthopaedic surgery post Covid-19 in Mexico].}, journal = {Acta ortopedica mexicana}, volume = {34}, number = {3}, pages = {176-182}, pmid = {33417755}, issn = {2306-4102}, mesh = {*COVID-19 ; Elective Surgical Procedures ; Humans ; Mexico ; *Orthopedic Procedures ; Pandemics ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Elaborate an updated guideline of recommendations for the safe return to elective orthopedic surgery post COVID-19 pandemic.

METHODS: Bibliographic review of relevant global literature.

RESULTS: Recommendation guidelines with appropriate definitions of orthopedic elective surgery, correct contagion risk stratification for COVID-19, considerations for specific risk groups, hospital adaptations and anesthetic, intraoperative and postoperative special care for a safe restart of orthopedic elective surgery post COVID-19 pandemic.

CONCLUSIONS: The safe restart of orthopedic elective surgery is possible as long as we take into consideration the appropriate recommendations, which we have summarized in this review.}, } @article {pmid33408715, year = {2020}, author = {Leonardi, AJ and Proenca, RB}, title = {Akt-Fas to Quell Aberrant T Cell Differentiation and Apoptosis in Covid-19.}, journal = {Frontiers in immunology}, volume = {11}, number = {}, pages = {600405}, pmid = {33408715}, issn = {1664-3224}, mesh = {Apoptosis/*immunology ; CD4-Positive T-Lymphocytes/*immunology/pathology ; CD8-Positive T-Lymphocytes/*immunology/pathology ; COVID-19/*immunology/pathology ; Cell Differentiation/*immunology ; Humans ; Proto-Oncogene Proteins c-akt/*immunology ; SARS-CoV-2/*immunology ; fas Receptor/*immunology ; }, abstract = {Aberrant T cell differentiation and lymphopenia are hallmarks of severe COVID-19 disease. Since T cells must race to cull infected cells, they are quick to differentiate and achieve cytotoxic function. With this responsiveness, comes hastened apoptosis, due to a coupled mechanism of death and differentiation in both CD4+ and CD8+ lymphocytes via CD95 (Fas) and serine-threonine kinase (Akt). T cell lymphopenia in severe cases may represent cell death or peripheral migration. These facets depict SARS-Cov-2 as a lympho-manipulative pathogen; it distorts T cell function, numbers, and death, and creates a dysfunctional immune response. Whether preservation of T cells, prevention of their aberrant differentiation, and expansion of their population may alter disease course is unknown. Its investigation requires experimental interrogation of the linked differentiation and death pathway by agents known to uncouple T cell proliferation and differentiation in both CD4+ and CD8+ T cells.}, } @article {pmid33398362, year = {2021}, author = {Albashir, AAD}, title = {Renin-Angiotensin-Aldosterone System (RAAS) Inhibitors and Coronavirus Disease 2019 (COVID-19).}, journal = {Southern medical journal}, volume = {114}, number = {1}, pages = {51-56}, pmid = {33398362}, issn = {1541-8243}, mesh = {Angiotensin Receptor Antagonists/*therapeutic use ; Angiotensin-Converting Enzyme Inhibitors/*therapeutic use ; Animals ; COVID-19/*drug therapy/epidemiology/metabolism ; Humans ; *Pandemics ; Renin-Angiotensin System/drug effects/*physiology ; SARS-CoV-2 ; }, abstract = {Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the virus responsible for the coronavirus disease 2019 (COVID-19) pandemic. The angiotensin-converting enzyme 2 (ACE2) has been proven to be used by SARS-CoV-2 for host cell entry. Considering that angiotensin receptor blockers and ACE inhibitors (ACEIs) upregulate the expression of ACE2 in animal studies, there may be a concern about whether these drugs may increase COVID-19 susceptibility and severity. Recently, there has been a debate among clinicians about whether to continue or to stop ACEIs and angiotensin receptor blockers in the context of COVID-19. Also, some media outlets and health systems have called for the discontinuation of these drugs in the context of suspected COVID-19. This has necessitated an urgent release of guidance on the use of such medications in COVID-19 patients. To date, multiple theories relating to the pure effects of renin-angiotensin-aldosterone system (RAAS) inhibitors on COVID-19 infections have been postulated. Favorable effects include blocking the ACE2 receptors, preventing viral entry into the heart and lungs, and protecting against lung injury in COVID-19. Adverse effects include a possible retrograde feedback mechanism that upregulates ACE2 receptors. This review provides greater insight into the role of the RAAS axis in acute lung injury and the effects of RAAS inhibitors on SARS-CoVs. The hypothesis that RAAS inhibitors facilitate viral insertion and the alternative hypothesis of the beneficial role of these drugs are discussed. Up-to-date published data concerning the RAAS inhibitors and COVID-19 are summarized.}, } @article {pmid33394906, year = {2020}, author = {Khan, AR and Farooqui, MO and Jatoi, NN and Jawaid, S and Mahdi, D and Khosa, F}, title = {Neurological Manifestations of SARS-CoV-2: A Narrative Review.}, journal = {The neurologist}, volume = {26}, number = {1}, pages = {15-19}, pmid = {33394906}, issn = {2331-2637}, mesh = {COVID-19/*complications ; Central Nervous System Diseases/diagnostic imaging/*etiology/physiopathology ; Humans ; Musculoskeletal Diseases/diagnostic imaging/*etiology/physiopathology ; Peripheral Nervous System Diseases/diagnostic imaging/*etiology/physiopathology ; }, abstract = {BACKGROUND: Coronavirus disease 2019 (COVID-19) pandemic started as an outbreak in China and soon crossed borders to affect the populations in all countries of the world. During the initial course of the disease, COVID-19 was perceived as a pneumonia-like illness. However, recent findings of COVID-19 patients suggest that the virus has the potential to disseminate to different tissues and organs, and cause significant complications.

SUMMARY: Neurological symptoms are of great significance as these usually present in and complicate critical cases. Many case reports and case series have documented the findings of neurological complications in COVID-19 patients. From the existing data, the most frequent symptoms in these patients were broadly classified into the central nervous system (CNS), peripheral nervous system, and skeletal muscular symptoms. CNS symptoms include meningitis, encephalitis, cerebrovascular complications, peripheral nervous system symptoms include anosmia, ageusia, and skeletal muscular symptoms include myalgias. It is postulated that the cause may be direct CNS injury through blood and neuronal pathways or indirectly because of an immune-mediated response, hypoxia caused by decreased oxygen saturation, or by the binding of subacute respiratory syndrome-coronavirus-2 to the host angiotensin-converting enzyme-2 receptors. Striking radiologic findings in COVID-19 patients with neurological symptoms have also emerged.

CONCLUSIONS: As subacute respiratory syndrome-coronavirus-2 may potentially have lethal implications on the nervous system, it is important that neurologists are better informed about the spectrum of clinical manifestations, radiologic findings, and likely mechanisms of injury. Understanding the symptoms and radiologic imaging allows clinicians to consider brain imaging in any patient with suspected COVID-19 and neurological symptoms.}, } @article {pmid33382966, year = {2020}, author = {Huang, C and Li, Q and Xu, W and Chen, L}, title = {Molecular and cellular mechanisms of liver dysfunction in COVID-19.}, journal = {Discovery medicine}, volume = {30}, number = {160}, pages = {107-112}, pmid = {33382966}, issn = {1944-7930}, mesh = {Antiviral Agents/therapeutic use ; COVID-19/complications/drug therapy/*metabolism/pathology ; Humans ; Hypoxia/drug therapy/*metabolism/pathology ; Inflammation/drug therapy/metabolism/pathology ; Liver/*blood supply/*metabolism/pathology ; Liver Diseases/drug therapy/etiology/*metabolism/pathology ; SARS-CoV-2/*metabolism ; }, abstract = {Liver injury has been reported as a common complication in Coronavirus disease 2019 (COVID-19). Recently, more and more studies reported that the degree of liver damages was associated with the severity of COVID-19. Although the exact mechanism of liver injury in COVID-19 patients is unknown, recent studies have made some explorations and investigations. In this review, we summarized the potential mechanisms of liver dysfunction in COVID-19 patients gleaned from recently published research reports, which suggested that the progression of pre-existing liver diseases, direct damage of liver by SARS-CoV-2, systemic inflammation caused by SARS-CoV-2 infection, anti-viral drug toxicity, and hypoxia-reperfusion may be associated with liver injury in patients with COVID-19. Hypoxic liver injury due to ischemia and shock, cholestasis-related liver injury due to altered bile metabolism, and hepatocellular injury due to drug toxicity or overwhelming inflammation might occur in severe COVID-19 patients with sepsis. To understand the pathogenesis of liver dysfunction in COVID-19 patients, further research is needed to focus on liver-related comorbidities, the evidence of viral replication in hepatocytes and bile duct cells, histological features of liver injury, and the influence of hepatotoxic antiviral drugs. We also suggested that special attention should be paid to monitoring inflammatory cytokines and hypoxia for the prevention and treatment of liver injury in severe COVID-19 patients. A deep understanding of the mechanism of liver injury is helpful for the management and treatment of COVID-19 patients.}, } @article {pmid33381955, year = {2020}, author = {Abdel-Rahman, N and Izbicki, G}, title = {To Fly Or Not To Fly? Aviation and Respiratory Diseases.}, journal = {The Israel Medical Association journal : IMAJ}, volume = {22}, number = {12}, pages = {794-799}, pmid = {33381955}, issn = {1565-1088}, mesh = {*Aircraft ; Asthenia/etiology ; Bronchiectasis/etiology ; COVID-19/etiology ; Humans ; Pulmonary Disease, Chronic Obstructive/etiology ; Respiratory Tract Diseases/*etiology ; Travel ; }, abstract = {BACKGROUND: For most passengers, even those with respiratory disease, air travel is safe and comfortable. Some travelers may experience hypoxia at sea level but may not need supplemental oxygen during air travel in a hypobaric hypoxic environment. For some individuals compensatory pulmonary mechanisms may be inadequate, causing profound hypoxia. In addition, venous thromboembolism/pulmonary emboli may occur, especially during long haul flights. With adequate screening, patients at risk can be identified, therapeutic solutions can be proposed for the flight, and most can travel can continue safely with supplemental oxygen and other preventive measures.}, } @article {pmid33361386, year = {2021}, author = {Manouchehri, N and Steinman, L and Stuve, O}, title = {Biological Significance of Anti-SARS-CoV-2 Antibodies: Lessons Learned From Progressive Multifocal Leukoencephalopathy.}, journal = {Neurology(R) neuroimmunology & neuroinflammation}, volume = {8}, number = {2}, pages = {}, pmid = {33361386}, issn = {2332-7812}, mesh = {Adaptive Immunity/*immunology ; Antibodies, Viral/*immunology ; Antibody Formation/*immunology ; Humans ; Immunity, Humoral/*immunology ; Leukoencephalopathy, Progressive Multifocal/drug therapy/*immunology ; SARS-CoV-2/*immunology ; T-Lymphocytes/*immunology ; }, abstract = {OBJECTIVE: To discuss the pathogenic and diagnostic relevance of cellular and humoral immune responses against severe acute respiratory syndrome novel coronavirus (SARS-COV-2) and pertinent observations made in progressive multifocal leukoencephalopathy (PML).

METHODS: Review of pertinent literature. RESULTS: There is at least 1 precedent for an antibody response against a viral pathogen that fails to provide host protection in the absence of immune-competent CD4+ T cells. PML is an infection of the CNS caused by JC virus (JCV), which commonly occurs during treatment with the therapeutic monoclonal antibody natalizumab. In this context, the humoral immune response fails to prevent JCV reactivation, and elevated anti-JCV serum indices are associated with a higher PML incidence. The more relevant immune-competent cells in host defense against JCV appear to be T cells. T cell-mediated responses are also detectable in convalescing patients with SARS-COV-2 irrespective of the humoral immune response.

CONCLUSION: Based on pathogenic lessons learned from PML under natalizumab therapy, we suggest the incorporation of functional assays that determine neutralizing properties of SARS-CoV-2-specific antibodies. In addition, we outline the potential role of T-cell detection assays in determining herd immunity in a given population or in studying therapeutic responses to vaccines.}, } @article {pmid33315752, year = {2021}, author = {Ogunbodede, OT and Zablotska-Manos, I and Lewis, DA}, title = {Potential and demonstrated impacts of the COVID-19 pandemic on sexually transmissible infections.}, journal = {Current opinion in infectious diseases}, volume = {34}, number = {1}, pages = {56-61}, pmid = {33315752}, issn = {1473-6527}, mesh = {COVID-19/*epidemiology ; HIV Infections/*epidemiology/transmission ; Humans ; Incidence ; *SARS-CoV-2 ; Sexual Behavior ; Sexual Health ; Sexual Partners ; Sexually Transmitted Diseases/*epidemiology/transmission ; }, abstract = {PURPOSE OF REVIEW: This review considers the potential and demonstrated impacts of SARS-CoV-2 on the sexually transmissible infection (STI)/HIV transmission.

RECENT FINDINGS: COVID-19 increases the vulnerability of those at highest risk of acquiring STI/HIV. Altered health-seeking behaviour, reductions in STI/HIV clinic capacity, service disruptions and redeployment of human resources to assist COVID-19 control efforts have impacted on STI/HIV control programmes. Reports of reduced STI incidence are emerging, but it is hard to determine whether this is real or due to decreased testing during COVID-19 lockdown periods. Fear of COVID-19 and implemented control measures have altered STI/HIV transmission dynamics. Sexual health services adapted to the pandemic by reducing face-to-face patient encounters in favour of telehealth and mail-based initiatives as well as more stringent triage practice. Many sexual health and HIV treatment services now operate at reduced capacity and experience ongoing service disruptions, which necessarily translates into poorer outcomes for patients and their communities.

SUMMARY: In the short-term, COVID-19 related sexual behaviour change is driving STI/HIV transmission downwards. However, the impacts of the global COVID-19 response on sexual health-seeking behaviour and STI/HIV services threaten to drive STI/HIV transmission upwards. Ultimately, the expected rebound in STI/HIV incidence will require an appropriate and timely public health response.

VIDEO ABSTRACT: http://links.lww.com/COID/A31.}, } @article {pmid33310371, year = {2021}, author = {Murillo, J and Villegas, LM and Ulloa-Murillo, LM and Rodríguez, AR}, title = {Recent trends on omics and bioinformatics approaches to study SARS-CoV-2: A bibliometric analysis and mini-review.}, journal = {Computers in biology and medicine}, volume = {128}, number = {}, pages = {104162}, pmid = {33310371}, issn = {1879-0534}, mesh = {*Bibliometrics ; *COVID-19/epidemiology/genetics/metabolism ; *Computational Biology ; Humans ; Molecular Docking Simulation ; *Pandemics ; *Phylogeny ; *SARS-CoV-2/genetics/metabolism ; }, abstract = {BACKGROUND: The successful sequencing of SARS-CoV-2 cleared the way for the use of omics technologies and integrative biology research for combating the COVID-19 pandemic. Currently, many research groups have slowed down their respective projects to concentrate efforts in the study of the biology of SARS-CoV-2. In this bibliometric analysis and mini-review, we aimed to describe how computational methods or omics approaches were used during the first months of the COVID-19 pandemic.

METHODS: We analyzed bibliometric data from Scopus, BioRxiv, and MedRxiv (dated June 19th, 2020) using quantitative and knowledge mapping approaches. We complemented our analysis with a manual process of carefully reading the selected articles to identify either the omics or bioinformatic tools used and their purpose.

RESULTS: From a total of 184 articles, we found that metagenomics and transcriptomics were the main sources of data to perform phylogenetic analysis aimed at corroborating zoonotic transmission, identifying the animal origin and taxonomic allocation of SARS-CoV-2. Protein sequence analysis, immunoinformatics and molecular docking were used to give insights about SARS-CoV-2 targets for drug and vaccine development. Most of the publications were from China and USA. However, China, Italy and India covered the top 10 most cited papers on this topic.

CONCLUSION: We found an abundance of publications using omics and bioinformatics approaches to establish the taxonomy and animal origin of SARS-CoV-2. We encourage the growing community of researchers to explore other lesser-known aspects of COVID-19 such as virus-host interactions and host response.}, } @article {pmid33305994, year = {2021}, author = {Özdemir, V and Endrenyi, L}, title = {Rethinking Clinical Trials and Personalized Medicine with Placebogenomics and Placebo Dose.}, journal = {Omics : a journal of integrative biology}, volume = {25}, number = {1}, pages = {1-12}, doi = {10.1089/omi.2020.0208}, pmid = {33305994}, issn = {1557-8100}, mesh = {*Clinical Trials as Topic/methods/standards ; Dose-Response Relationship, Drug ; Genomics/methods ; Humans ; Nocebo Effect ; Outcome Assessment, Health Care ; *Placebo Effect ; *Precision Medicine/methods/standards ; *Research Design ; }, abstract = {Pharmacogenomics, nutrigenomics, vaccinomics, and the nascent field of plant omics are examples of variability science. They are embedded within an overarching framework of personalized medicine. Across these public health specialties, the significance and biology of the placebo response have been historically neglected. A placebo is any substance such as a sugar pill administered in the guise of medication, but one that does not have pharmacological activity. Placebos do have clinical effects, however, that can be substantive in magnitude and vary markedly from person-to-person depending, for example, on the type of disease, symptoms, or clinical trial design. Research over the past several decades attests to a genuine neurobiological basis for placebo effects. All drugs have placebo components that contribute to their overall treatment effect. Placebos are used in clinical trials as control groups to ascertain the net pharmacological effect of a drug candidate. Not only less well known but also relevant to rational therapeutics and personalized medicine is the nocebo. A nocebo effect occurs when an inert substance is administered in a context that induces negative expectations, worsening patients' symptoms. With the COVID-19 pandemic, there are high public expectations for new vaccines and medicines to end the contagion, while at the same time antiscience, post-truth, and antivaccine movements are worrisomely on the rise. These social movements, changes in public health cultures, and conditioned behavioral responses can trigger both placebo and nocebo effects. Hence, in clinical trials, forecasting and explaining placebo and nocebo variability are more important than ever for robust science and personalized health care. Against this overarching context, this article provides (1) a brief history of placebo and (2) a discussion on biology, mechanisms, and variability of placebo effects, and (3) discusses three emerging new concepts: placebogenomics, nocebogenomics, and augmented placebo, that is, the notion of a "placebo dose." We conclude with a roadmap for placebogenomics, its synergies with the nascent field of social pharmacology, and the ways in which a new taxonomy of drug and placebo variability can be anticipated in the next decade.}, } @article {pmid33236131, year = {2021}, author = {Tsai, SC and Lu, CC and Bau, DT and Chiu, YJ and Yen, YT and Hsu, YM and Fu, CW and Kuo, SC and Lo, YS and Chiu, HY and Juan, YN and Tsai, FJ and Yang, JS}, title = {Approaches towards fighting the COVID‑19 pandemic (Review).}, journal = {International journal of molecular medicine}, volume = {47}, number = {1}, pages = {3-22}, pmid = {33236131}, issn = {1791-244X}, mesh = {Antiviral Agents/*therapeutic use ; *COVID-19/drug therapy/epidemiology/genetics/pathology ; Humans ; *Medicine, Chinese Traditional ; *Pandemics ; *SARS-CoV-2/genetics/metabolism ; }, abstract = {The coronavirus disease 2019 (COVID‑19) outbreak, which has caused >46 millions confirmed infections and >1.2 million coronavirus related deaths, is one of the most devastating worldwide crises in recent years. Infection with COVID‑19 results in a fever, dry cough, general fatigue, respiratory symptoms, diarrhoea and a sore throat, similar to those of acute respiratory distress syndrome. The causative agent of COVID‑19, SARS‑CoV‑2, is a novel coronavirus strain. To date, remdesivir has been granted emergency use authorization for use in the management of infection. Additionally, several efficient diagnostic tools are being actively developed, and novel drugs and vaccines are being evaluated for their efficacy as therapeutic agents against COVID‑19, or in the prevention of infection. The present review highlights the prevalent clinical manifestations of COVID‑19, characterizes the SARS‑CoV‑2 viral genome sequence and life cycle, highlights the optimal methods for preventing viral transmission, and discusses possible molecular pharmacological mechanisms and approaches in the development of anti‑SARS‑CoV‑2 therapeutic agents. In addition, the use of traditional Chinese medicines for management of COVID‑19 is discussed. It is expected that novel anti‑viral agents, vaccines or an effective combination therapy for treatment/management of SARS‑CoV‑2 infection and spread therapy will be developed and implemented in 2021, and we would like to extend our best regards to the frontline health workers across the world in their fight against COVID‑19.}, } @article {pmid33226269, year = {2020}, author = {Morin, CM}, title = {Profile of Somryst Prescription Digital Therapeutic for Chronic Insomnia: Overview of Safety and Efficacy.}, journal = {Expert review of medical devices}, volume = {17}, number = {12}, pages = {1239-1248}, doi = {10.1080/17434440.2020.1852929}, pmid = {33226269}, issn = {1745-2422}, mesh = {COVID-19 ; Chronic Disease ; Cognitive Behavioral Therapy/instrumentation ; Humans ; Prescriptions ; SARS-CoV-2 ; Sleep Initiation and Maintenance Disorders/*drug therapy ; }, abstract = {Introduction: Prescription digital therapeutics (PDTs) represent a new class of software-based medical devices authorized by the Food and Drug Administration (FDA) to treat disease. Somryst™, the first PDT for treating chronic insomnia, delivers cognitive behavioral therapy for insomnia (CBT-I) via a mobile application. CBT-I is the guideline-recommended, first-line treatment for chronic insomnia, but availability of CBT-I therapists is limited. Somryst addresses this need by providing asynchronous access to CBT-I treatment. As a contactless therapeutic medium, Somryst is also an ideal option when face-to-face therapy is not available or recommended for safety reasons (e.g. because of possible exposure to the SARS-CoV-2 virus). Areas covered: This review summarizes the mechanisms of action and technical features of Somryst, and describes safety and effectiveness data from the randomized trials on which FDA clearance was based. Expert opinion: Somryst demonstrates robust clinical efficacy with a favorable benefit-to-risk profile for treating adults with chronic insomnia. FDA clearance was based on data from 2 clinical trials of the first-generation web-based CBT-I platform Sleep Healthy Using the Internet (SHUTi). Somryst, and PDTs in general, are promising devices to address the need for greater accessibility to effective therapies.}, } @article {pmid33207372, year = {2021}, author = {Alexaki, VI and Henneicke, H}, title = {The Role of Glucocorticoids in the Management of COVID-19.}, journal = {Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme}, volume = {53}, number = {1}, pages = {9-15}, pmid = {33207372}, issn = {1439-4286}, support = {The Deutsche Forschungsgemeinschaft//SFB-TRR 205 to V.I.A. & HE 8391/1-1 to H.H./ ; }, mesh = {Anti-Inflammatory Agents/*therapeutic use ; COVID-19/*drug therapy ; Glucocorticoids/*therapeutic use ; Humans ; Immunosuppressive Agents/*therapeutic use ; Respiratory Distress Syndrome/*drug therapy/virology ; *SARS-CoV-2 ; }, abstract = {Coronavirus disease 2019 (COVID-19), caused by an infection with the novel coronavirus SARS-CoV-2, has resulted in a global pandemic and poses an emergency to public health systems worldwide. COVID-19 is highly infectious and is characterized by an acute respiratory illness that varies from mild flu-like symptoms to the life-threatening acute respiratory distress syndrome (ARDS). As such, there is an urgent need for the development of new therapeutic strategies, which combat the high mortality in severely ill COVID-19 patients. Glucocorticoids are a frontline treatment for a diverse range of inflammatory diseases. Due to their immunosuppressive functions, the use of glucocorticoids in the treatment of COVID-19 patients was initially regarded with caution. However, recent studies concluded that the initiation of systemic glucocorticoids in patients suffering from severe and critical COVID-19 is associated with lower mortality. Herein we review the anti-inflammatory effects of glucocorticoids and discuss emerging issues in their clinical use in the context of COVID-19.}, } @article {pmid33203968, year = {2021}, author = {de-Madaria, E and Capurso, G}, title = {COVID-19 and acute pancreatitis: examining the causality.}, journal = {Nature reviews. Gastroenterology & hepatology}, volume = {18}, number = {1}, pages = {3-4}, pmid = {33203968}, issn = {1759-5053}, mesh = {COVID-19/*epidemiology ; Comorbidity ; Global Health ; Humans ; Incidence ; Pancreatitis/*epidemiology ; *Pandemics ; *SARS-CoV-2 ; }, } @article {pmid33203245, year = {2020}, author = {Saran, S and Gurjar, M and Baronia, AK and Lohiya, A and Azim, A and Poddar, B and Rao, NS}, title = {Personal protective equipment during COVID-19 pandemic: a narrative review on technical aspects.}, journal = {Expert review of medical devices}, volume = {17}, number = {12}, pages = {1265-1276}, doi = {10.1080/17434440.2020.1852079}, pmid = {33203245}, issn = {1745-2422}, mesh = {*COVID-19 ; Humans ; Infectious Disease Transmission, Patient-to-Professional/prevention & control ; Pandemics/prevention & control ; *Personal Protective Equipment/standards/supply & distribution ; SARS-CoV-2 ; }, abstract = {Introduction: The current pandemic of novel Corona Virus Disease 2019 (COVID-19) has created a significant shortage of personal protective equipment (PPE) in many countries of the world, stressing medical services during this crisis. Along with addressing problems of demand and supply mismatch, there also a need to ensure the procurement of high-quality PPEs that provides both safety and comfort to users. The purpose of this article is to review existing standards and recommendations on the technical aspects of PPE. Areas covered: For this review, MEDLINE, Google Scholar, and Research Gate were searched. Studies reporting technical aspects of the components of PPE including mask and respirator, gown, and coverall, gloves, goggles, face shields, or visors, and boots, are included in this review. Expert opinion: The design and materials of PPE needs further research, which might have minimal carriage of infective biological load like the use of antimicrobial repellent finishes along with adequate tensile strength and breathability through the fabric. Respirators should have the least resistance while providing maximum protection; goggles should not have fogging. Also, there is a need of formulating universal technical specifications for medically used PPE and ensuring easy availability of the testing facilities.}, } @article {pmid33146552, year = {2021}, author = {Halpin, DMG and Criner, GJ and Papi, A and Singh, D and Anzueto, A and Martinez, FJ and Agusti, AA and Vogelmeier, CF}, title = {Global Initiative for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease. The 2020 GOLD Science Committee Report on COVID-19 and Chronic Obstructive Pulmonary Disease.}, journal = {American journal of respiratory and critical care medicine}, volume = {203}, number = {1}, pages = {24-36}, doi = {10.1164/rccm.202009-3533SO}, pmid = {33146552}, issn = {1535-4970}, mesh = {Adrenal Cortex Hormones/*therapeutic use ; COVID-19/*complications/epidemiology ; *Disease Management ; Humans ; Lung/*physiopathology ; Oxygen Inhalation Therapy/*methods ; Pulmonary Disease, Chronic Obstructive/diagnosis/physiopathology/*prevention & control ; SARS-CoV-2 ; *Societies, Medical ; Tomography, X-Ray Computed/methods ; }, abstract = {The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has raised many questions about the management of patients with chronic obstructive pulmonary disease (COPD) and whether modifications of their therapy are required. It has raised questions about recognizing and differentiating coronavirus disease (COVID-19) from COPD given the similarity of the symptoms. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) Science Committee used established methods for literature review to present an overview of the management of patients with COPD during the COVID-19 pandemic. It is unclear whether patients with COPD are at increased risk of becoming infected with SARS-CoV-2. During periods of high community prevalence of COVID-19, spirometry should only be used when it is essential for COPD diagnosis and/or to assess lung function status for interventional procedures or surgery. Patients with COPD should follow basic infection control measures, including social distancing, hand washing, and wearing a mask or face covering. Patients should remain up to date with appropriate vaccinations, particularly annual influenza vaccination. Although data are limited, inhaled corticosteroids, long-acting bronchodilators, roflumilast, or chronic macrolides should continue to be used as indicated for stable COPD management. Systemic steroids and antibiotics should be used in COPD exacerbations according to the usual indications. Differentiating symptoms of COVID-19 infection from chronic underlying symptoms or those of an acute COPD exacerbation may be challenging. If there is suspicion for COVID-19, testing for SARS-CoV-2 should be considered. Patients who developed moderate-to-severe COVID-19, including hospitalization and pneumonia, should be treated with evolving pharmacotherapeutic approaches as appropriate, including remdesivir, dexamethasone, and anticoagulation. Managing acute respiratory failure should include appropriate oxygen supplementation, prone positioning, noninvasive ventilation, and protective lung strategy in patients with COPD and severe acute respiratory distress syndrome. Patients who developed asymptomatic or mild COVID-19 should be followed with the usual COPD protocols. Patients who developed moderate or worse COVID-19 should be monitored more frequently and accurately than the usual patients with COPD, with particular attention to the need for oxygen therapy.}, } @article {pmid33129692, year = {2021}, author = {Skaria, T and Wälchli, T and Vogel, J}, title = {CGRP Receptor Antagonism in COVID-19: Potential Cardiopulmonary Adverse Effects.}, journal = {Trends in molecular medicine}, volume = {27}, number = {1}, pages = {7-10}, pmid = {33129692}, issn = {1471-499X}, mesh = {Animals ; *COVID-19/drug therapy/metabolism/pathology ; *Calcitonin Gene-Related Peptide Receptor Antagonists/adverse effects/therapeutic use ; *Heart Diseases/chemically induced/metabolism/pathology ; Humans ; Receptors, Calcitonin Gene-Related Peptide/*metabolism ; SARS-CoV-2/*metabolism ; }, abstract = {Recently, the US FDA has authorized a drug repurposing trial with calcitonin gene-related peptide (CGRP) receptor antagonists to reduce lung inflammation in coronavirus 2019 (COVID-19). However, the well-established cardiopulmonary protective effects of CGRP raise concerns about the safety of antagonizing CGRP in COVID-19. Awareness regarding potential cardiopulmonary adverse effects may enable their early detection and prevent illness from worsening.}, } @article {pmid33119402, year = {2021}, author = {Lim, ZJ and Subramaniam, A and Ponnapa Reddy, M and Blecher, G and Kadam, U and Afroz, A and Billah, B and Ashwin, S and Kubicki, M and Bilotta, F and Curtis, JR and Rubulotta, F}, title = {Case Fatality Rates for Patients with COVID-19 Requiring Invasive Mechanical Ventilation. A Meta-analysis.}, journal = {American journal of respiratory and critical care medicine}, volume = {203}, number = {1}, pages = {54-66}, doi = {10.1164/rccm.202006-2405OC}, pmid = {33119402}, issn = {1535-4970}, mesh = {COVID-19/mortality/therapy ; Global Health ; Humans ; *Pandemics ; Respiration, Artificial/*methods ; SARS-CoV-2 ; Survival Rate/trends ; }, abstract = {Rationale: Initial reports of case fatality rates (CFRs) among adults with coronavirus disease (COVID-19) receiving invasive mechanical ventilation (IMV) are highly variable.Objectives: To examine the CFR of patients with COVID-19 receiving IMV.Methods: Two authors independently searched PubMed, Embase, medRxiv, bioRxiv, the COVID-19 living systematic review, and national registry databases. The primary outcome was the "reported CFR" for patients with confirmed COVID-19 requiring IMV. "Definitive hospital CFR" for patients with outcomes at hospital discharge was also investigated. Finally, CFR was analyzed by patient age, geographic region, and study quality on the basis of the Newcastle-Ottawa Scale.Measurements and Results: Sixty-nine studies were included, describing 57,420 adult patients with COVID-19 who received IMV. Overall reported CFR was estimated as 45% (95% confidence interval [CI], 39-52%). Fifty-four of 69 studies stated whether hospital outcomes were available but provided a definitive hospital outcome on only 13,120 (22.8%) of the total IMV patient population. Among studies in which age-stratified CFR was available, pooled CFR estimates ranged from 47.9% (95% CI, 46.4-49.4%) in younger patients (age ≤40 yr) to 84.4% (95% CI, 83.3-85.4%) in older patients (age >80 yr). CFR was also higher in early COVID-19 epicenters. Overall heterogeneity is high (I2 >90%), with nonsignificant Egger's regression test suggesting no publication bias.Conclusions: Almost half of patients with COVID-19 receiving IMV died based on the reported CFR, but variable CFR reporting methods resulted in a wide range of CFRs between studies. The reported CFR was higher in older patients and in early pandemic epicenters, which may be influenced by limited ICU resources. Reporting of definitive outcomes on all patients would facilitate comparisons between studies.Systematic review registered with PROSPERO (CRD42020186997).}, } @article {pmid33087037, year = {2020}, author = {Aranda, P and Wicklein, B and Ruiz-Garcia, C and Martín-Sampedro, R and Darder, M and Del Real, G and Ruiz-Hitzky, E}, title = {Research and Patents on Coronavirus and COVID-19: A Review.}, journal = {Recent patents on nanotechnology}, volume = {14}, number = {4}, pages = {328-350}, doi = {10.2174/1872210514666201021145735}, pmid = {33087037}, issn = {2212-4020}, mesh = {Antiviral Agents/*therapeutic use ; *COVID-19/drug therapy/epidemiology ; *Nanotechnology ; *Pandemics ; Patents as Topic ; *SARS-CoV-2 ; }, abstract = {BACKGROUND: COVID-19 pandemic is a global problem that requires the point of view of basic sciences and medicine as well as social, economics and politics disciplines. Viral particles of coronaviruses including SARS-CoV-2 as well as other enveloped viruses like influenza virus could be considered as an approximation to functional core-shell nanoparticles and therefore, their study enters the realm of nanotechnology. In this context, nanotechnology can contribute to alleviate some of the current challenges posed by COVID-19 pandemic.

METHODS: The present analysis contributed to diverse sources of general information, databases on scientific literature and patents to produce a review affording information on relevant areas where as nanotechnology has offered response to coronavirus challenges in the past and may be relevant now, and has offered an update of the current information on SARS-CoV-2 and COVID-19 issues.

RESULTS: This review contribution includes specific information including: 1) An introduction to current research on nanotechnology and related recent patents for COVID-19 responses; 2) Analysis of nonimmunogenic and immunogenic prophylaxis of COVID-19 using Nanotechnology; 3) Tools devoted to detection & diagnosis of coronaviruses and COVID-19: the role of Nanotechnology; and 4) A compilation on the research and patents on nanotechnology dealing with therapeutics & treatments of COVID-19.

CONCLUSION: Among the increasing literature on COVID-19, there are few works analyzing the relevance of Nanotechnology, and giving an analysis on patents dealing with coronaviruses that may provide useful information on the area. This review offers a general view of the current research investigation and recent patents dealing with aspects of immunogenic and non-immunogenic prophylaxis, detection and diagnosis as well as therapeutics and treatments.}, } @article {pmid33026419, year = {2021}, author = {Teitelbaum, S and Diaz, J and Singer, R}, title = {Can Outpatient Plastic Surgery Be Done Safely During a COVID-19 Surge? Results of a July 2020 Los Angeles Survey and Literature Review.}, journal = {Aesthetic surgery journal}, volume = {41}, number = {1}, pages = {98-108}, pmid = {33026419}, issn = {1527-330X}, mesh = {*COVID-19 ; Elective Surgical Procedures ; Humans ; Los Angeles/epidemiology ; Outpatients ; SARS-CoV-2 ; *Surgery, Plastic/adverse effects ; Surveys and Questionnaires ; }, abstract = {BACKGROUND: A moratorium was placed on nonurgent surgery throughout much of the United States in mid-March 2020 due to surging numbers of COVID-19 cases. Several months later, and with new safety precautions in place, elective surgery gradually resumed. However, no data exist on the safety of plastic surgery during the pandemic.

OBJECTIVES: This aim of this survey was to assess the safety of plastic surgery during the pandemic by quantifying: (1) the preoperative prevalence of SARS-CoV-2; (2) the risk of postoperative COVID-19; (3) outcomes and precious resource utilization for such cases; and (4) the risks to office staff.

METHODS: Los Angeles plastic surgeons certified by the American Board of Plastic Surgery (ABPS) were sent an online survey in July 2020, during a local COVID-19 surge, querying about the number of procedures performed in the 8- to 10-week period since reopening, testing policies, surgical complications, and cases among staff.

RESULTS: In total, 112 surgeons reported 5633 surgeries since resuming elective surgery. Of these, 103 (91.96%) surgeons obtained a preoperative SARS-CoV-2 polymerase chain reaction (PCR) test for every patient. The preoperative PCR test was positive in 41/5881 (0.69%). Positive tests within 2 weeks postoperation occurred in 7/5380 (0.13%) of surgical patients, 3/8506 (0.04%) of injection patients, and 6/2519 (0.24%) of energy therapy patients. Nine offices reported at least 1 staff member who developed COVID-19. All cases were mild, with no hospitalizations or deaths.

CONCLUSIONS: These data demonstrate that plastic surgery can be performed safely during a COVID-19 surge by ABPS diplomates. This has profound impact for patients, plastic surgeons, and health policy regulators.}, } @article {pmid33021144, year = {2021}, author = {Fudulu, DP and Angelini, GD and Vohra, HA}, title = {Minimally invasive cardiac valve surgery during the COVID-19 pandemic: to do or not to do, that is the question.}, journal = {Perfusion}, volume = {36}, number = {1}, pages = {8-10}, doi = {10.1177/0267659120961936}, pmid = {33021144}, issn = {1477-111X}, mesh = {COVID-19/*epidemiology ; Comorbidity ; Global Health ; Heart Valve Diseases/epidemiology/*surgery ; Heart Valve Prosthesis Implantation/*statistics & numerical data ; Heart Valves/*surgery ; Humans ; Minimally Invasive Surgical Procedures/*statistics & numerical data ; *Pandemics ; SARS-CoV-2 ; Treatment Outcome ; }, } @article {pmid33003177, year = {2021}, author = {Rimensberger, PC and Kneyber, MCJ and Deep, A and Bansal, M and Hoskote, A and Javouhey, E and Jourdain, G and Latten, L and MacLaren, G and Morin, L and Pons-Odena, M and Ricci, Z and Singh, Y and Schlapbach, LJ and Scholefield, BR and Terheggen, U and Tissières, P and Tume, LN and Verbruggen, S and Brierley, J and , }, title = {Caring for Critically Ill Children With Suspected or Proven Coronavirus Disease 2019 Infection: Recommendations by the Scientific Sections' Collaborative of the European Society of Pediatric and Neonatal Intensive Care.}, journal = {Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies}, volume = {22}, number = {1}, pages = {56-67}, pmid = {33003177}, issn = {1529-7535}, mesh = {*COVID-19 ; Child ; Critical Care ; *Critical Illness/therapy ; Humans ; Infant, Newborn ; Intensive Care, Neonatal ; SARS-CoV-2 ; Systemic Inflammatory Response Syndrome ; }, abstract = {OBJECTIVES: In children, coronavirus disease 2019 is usually mild but can develop severe hypoxemic failure or a severe multisystem inflammatory syndrome, the latter considered to be a postinfectious syndrome, with cardiac involvement alone or together with a toxic shock like-presentation. Given the novelty of severe acute respiratory syndrome coronavirus 2, the causative agent of the recent coronavirus disease 2019 pandemic, little is known about the pathophysiology and phenotypic expressions of this new infectious disease nor the optimal treatment approach.

STUDY SELECTION: From inception to July 10, 2020, repeated PubMed and open Web searches have been done by the scientific section collaborative group members of the European Society of Pediatric and Neonatal Intensive Care.

DATA EXTRACTION: There is little in the way of clinical research in children affected by coronavirus disease 2019, apart from descriptive data and epidemiology.

DATA SYNTHESIS: Even though basic treatment and organ support considerations seem not to differ much from other critical illness, such as pediatric septic shock and multiple organ failure, seen in PICUs, some specific issues must be considered when caring for children with severe coronavirus disease 2019 disease.

CONCLUSIONS: In this clinical guidance article, we review the current clinical knowledge of coronavirus disease 2019 disease in critically ill children and discuss some specific treatment concepts based mainly on expert opinion based on limited experience and the lack of any completed controlled trials in children at this time.}, } @article {pmid33429331, year = {2020}, author = {Molaei, S and Dadkhah, M and Asghariazar, V and Karami, C and Safarzadeh, E}, title = {The immune response and immune evasion characteristics in SARS-CoV, MERS-CoV, and SARS-CoV-2: Vaccine design strategies.}, journal = {International immunopharmacology}, volume = {92}, number = {}, pages = {107051}, doi = {10.1016/j.intimp.2020.107051}, pmid = {33429331}, issn = {1878-1705}, abstract = {The worldwide outbreak of SARS-CoV-2, severe acute respiratory syndrome coronavirus 2 as a novel human coronavirus, was the worrying news at the beginning of 2020. Since its emergence complicated more than 870,000 individuals and led to more than 43,000 deaths worldwide. Considering to the potential threat of a pandemic and transmission severity of it, there is an urgent need to evaluate and realize this new virus's structure and behavior and the immunopathology of this disease to find potential therapeutic protocols and to design and develop effective vaccines. This disease is able to agitate the response of the immune system in the infected patients, so ARDS, as a common consequence of immunopathological events for infections with Middle East respiratory syndrome coronavirus (MERS-CoV), SARS-CoV, and SARS-CoV-2, could be the main reason for death. Here, we summarized the immune response and immune evasion characteristics in SARS-CoV, MERS-CoV, and SARS-CoV-2 and therapeutic and prophylactic strategies with a focus on vaccine development and its challenges.}, } @article {pmid33428981, year = {2021}, author = {Safari, F and Afarid, M and Rastegari, B and Haghighi, AB and Barekati-Mowahed, M and Behbahani, AB}, title = {CRISPR systems: Novel approaches for detection and combating COVID-19.}, journal = {Virus research}, volume = {}, number = {}, pages = {198282}, doi = {10.1016/j.virusres.2020.198282}, pmid = {33428981}, issn = {1872-7492}, abstract = {Type V and VI CRISPR enzymes are RNA-guided, DNA and RNA-targeting effectors that allow specific gene knockdown. Cas12 and Cas13 are CRISPR proteins that are efficient agents for diagnosis and combating single-stranded RNA (ssRNA) viruses. The programmability of these proteins paves the way for the detection and degradation of RNA viruses by targeting RNAs complementary to its CRISPR RNA (crRNA). Approximately two-thirds of viruses causing diseases contain ssRNA genomes. The Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) has caused the outbreak of the coronavirus disease 2019 (COVID-19), which has infected more than fifty million people worldwide with near 1.3 million deaths since December 2019. Thus, accurate and rapid diagnostic and therapeutic tools are essential for early detection and treatment of this widespread infectious disease. For us, the CRISPR based platforms seem to be a plausible new approach for an accurate detection and treatment of SARS-CoV-2. In this review, we talk about Cas12 and Cas13 CRISPR systems and their applications in diagnosis and treatment of RNA virus mediated diseases. In continue, the SARS-CoV-2 pathogenicity, and its conventional diagnostics and antivirals will be discussed. Moreover, we highlight novel CRISPR based diagnostic platforms and therapies for COVID-19. We also discuss the challenges of diagnostic CRISPR based platforms as well as clarifying the proposed solution for high efficient selective in vivo delivery of CRISPR components into SARS-CoV-2-infected cells.}, } @article {pmid33428900, year = {2021}, author = {Palaz, F and Kerem Kalkan, A and Tozluyurt, A and Ozsoz, M}, title = {CRISPR-based tools: alternative methods for the diagnosis of COVID-19.}, journal = {Clinical biochemistry}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.clinbiochem.2020.12.011}, pmid = {33428900}, issn = {1873-2933}, abstract = {The recently emerged severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) spread all over the world rapidly and caused a global pandemic. To prevent the virus from spreading to more individuals, it is of great importance to identify and isolate infected individuals through testing. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) is the gold standard method for the diagnosis of coronavirus disease (COVID-19) worldwide. However, performing RT-qPCR is limited to centralized laboratories because of the need for sophisticated laboratory equipment and skilled personnel. Further, it can sometimes give false negative or uncertain results. Recently, new methods have been developed for nucleic acid detection and pathogen diagnosis using CRISPR-Cas systems. These methods present rapid and cost-effective diagnostic platforms that provide high sensitivity and specificity without the need for complex instrumentation. Using the CRISPR-based SARS-CoV-2 detection methods, it is possible to increase the number of daily tests in existing laboratories, reduce false negative or uncertain result rates obtained with RT-qPCR, and perform testing in resource-limited settings or at points of need where performing RT-qPCR is not feasible. Here, we briefly describe the RT-qPCR method, and discuss its limitations in meeting the current diagnostic needs. We explain how the unique properties of various CRISPR-associated enzymes are utilized for nucleic acid detection and pathogen diagnosis. Then, we highlight the important features of CRISPR-based diagnostic methods developed for SARS-CoV-2 detection. Finally, we examine the advantages and limitations of these methods, and discuss how they can contribute to improving the efficiency of the current testing systems for combating SARS-CoV-2.}, } @article {pmid33428898, year = {2021}, author = {Noreen, S and Maqbool, I and Madni, A}, title = {Dexamethasone: Therapeutic potential, risks, and future projection during COVID-19 pandemic.}, journal = {European journal of pharmacology}, volume = {}, number = {}, pages = {173854}, doi = {10.1016/j.ejphar.2021.173854}, pmid = {33428898}, issn = {1879-0712}, abstract = {The current outbreak of novel COVID-19 challenges the development of an efficient treatment plan as soon as possible. Several promising treatment options stand out as potential therapy of COVID-19, including plasma-derived drugs, monoclonal antibodies, antivirals, antimalarial, cell therapy, and corticosteroids. Dexamethasone an approved corticosteroid medication, acting as an anti-inflammatory and immunosuppressant agent. In the current pandemic, dexamethasone is declared a "major development" in the fight against COVID-19. Steroidal dexamethasone was presented as the recent advancement that significantly reduces the mortality rate among severe COVID-19 cases. This review summarizes the preliminary opinion about the dexamethasone outbreak, therapeutic potential, risks, and strategies during the COVID-19 pandemic.}, } @article {pmid33428055, year = {2021}, author = {Desai, I and Manchanda, R and Kumar, N and Tiwari, A and Kumar, M}, title = {Neurological manifestations of coronavirus disease 2019: exploring past to understand present.}, journal = {Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology}, volume = {}, number = {}, pages = {}, pmid = {33428055}, issn = {1590-3478}, abstract = {SARS-CoV-2 infection, resulting in Coronavirus disease 2019 (COVID-19), has significantly affected the entire world. It was labelled a pandemic by World Health Organization. Although it commonly produces respiratory symptoms, neurological features have been described. Neurological manifestations may vary from non-specific symptoms such as headache, dizziness, myalgia and/or fatigue, olfactory or taste dysfunction to specific syndromes including meningitis, stroke, acute transverse myelitis and Guillain-Barre syndrome. This review describes potential pathogenetic mechanisms and neurological manifestations of COVID-19 along with its management. Considering structural and pathogenetic similarity of SARS-CoV-2 with SARS-CoV and MERS viruses, we compared their neurological manifestations and mentioned few features expected in COVID-19 in future. Interestingly, many COVID-19 cases may present with pure neurological manifestations at onset with non-neurological features manifesting few days later and we propose the term "Neuro-COVID syndrome" for such cases. Awareness of neurological manifestations may facilitate its management and improve outcome in such patients.}, } @article {pmid33428032, year = {2021}, author = {Li, D and Hu, J and Li, D and Yang, W and Yin, SF and Qiu, R}, title = {Reviews on Biological Activity, Clinical Trial and Synthesis Progress of Small Molecules for the Treatment of COVID-19.}, journal = {Topics in current chemistry (Cham)}, volume = {379}, number = {1}, pages = {4}, pmid = {33428032}, issn = {2364-8961}, support = {21676076//Natural Science Foundation of China/ ; 21878071//Natural Science Foundation of China/ ; 21971060//Natural Science Foundation of China/ ; 2018RS3042//Hu-Xiang High Talent in Hunan Province/ ; WQ20164300353//State Administration of Foreign Experts Affairs (CN)/ ; }, abstract = {COVID-19 has broken out rapidly in nearly all countries worldwide, and has blossomed into a pandemic. Since the beginning of the spread of COVID-19, many scientists have been cooperating to study a vast array of old drugs and new clinical trial drugs to discover potent drugs with anti-COVID-19 activity, including antiviral drugs, antimalarial drugs, immunosuppressants, Chinese medicines, Mpro inhibitors, JAK inhibitors, etc. The most commonly used drugs are antiviral compounds, antimalarial drugs and JAK inhibitors. In this review, we summarize mainly the antimalarial drugs chloroquine and hydroxychloroquine, the antiviral drugs Favipiravir and Remdesivir, and JAK inhibitor Ruxolitinib, discussing their biological activities, clinical trials and synthesis progress.}, } @article {pmid33427404, year = {2021}, author = {Yao, Y and Yuan, X and Wu, L and Guo, N and Yin, L and Li, Y}, title = {COVID-19 and male reproduction: current research and unknown factors.}, journal = {Andrology}, volume = {}, number = {}, pages = {}, doi = {10.1111/andr.12970}, pmid = {33427404}, issn = {2047-2927}, abstract = {BACKGROUND: The testes are suspected target organs of SARS-CoV-2. However, the results of studies on the effect of COVID-19 on male reproduction are controversial.

OBJECTIVE: To summarize current research on the effects of COVID-19 on male reproduction.

METHODS: A systematic review of English literature was performed using PubMed and Ovid Embase up to August 18, 2020. Research articles on the presence of SARS-CoV-2 in semen, the effects of the virus on semen parameters, and any pathological changes in the testes were evaluated.

RESULTS: Fourteen studies were included in this review. Six of 176 survivors (3.4%) and 1 of 13 decedents (7.7%) in 2 of 12 studies were positive for viral RNA in semen and testicular tissue, respectively. After stratification of patient groups, we found that the virus was detected in the relatively early stage of infection, 6-16 days after disease onset, in semen from survivors. Two of 3 studies reported that some participants had substandard semen quality after COVID-19, and 1 study found that COVID-19 may impair semen quality in a severity-related manner. Pathological analyses showed that injuries to the seminiferous tubule occurred in all decedents (N=11). Another study found that orchitic and testis fibrin microthrombi occurred in patients with fatal disease (100%, N=2). Scrotal discomfort of orchiepididymitis or spermatic cord inflammation has also been reported in COVID-19 patients.

CONCLUSION: Current studies suggest that semen is rarely considered a carrier of SARS-CoV-2 genetic material during the infection period but not in the semen of recovered patients. Fatal COVID-19 may cause testicular structure damage without the presence of virus.}, } @article {pmid33427370, year = {2021}, author = {Kinobe, RT and Owens, L}, title = {A systematic review of experimental evidence for antiviral effects of ivermectin and an in-silico analysis of ivermectin's possible mode of action against SARS-CoV-2.}, journal = {Fundamental & clinical pharmacology}, volume = {}, number = {}, pages = {}, doi = {10.1111/fcp.12644}, pmid = {33427370}, issn = {1472-8206}, abstract = {Viral infections remain a major cause of economic loss with an unmet need for novel therapeutic agents. Ivermectin is a putative antiviral compound; the proposed mechanism is the inhibition of nuclear translocation of viral proteins, facilitated by mammalian host importins, a necessary process for propagation of infections. We systematically reviewed the evidence for the applicability of ivermectin against viral infections including SARS-CoV-2 regarding efficacy, mechanisms and selective toxicity. The SARS-CoV-2 genome was mined to determine potential nuclear location signals for ivermectin and meta-analyses for in vivo studies included all comparators over time, dose range and viral replication in multiple organs. Ivermectin inhibited the replication of many viruses including those in Flaviviridae, Circoviridae and Coronaviridae families in vitro. Real and mock nuclear location signals were identified in SARS-CoV-2, a potential target for ivermectin and predicting a sequestration bait for importin β, stopping infected cells from reaching a virus-resistant state. While pharmacokinetic evaluations indicate that ivermectin could be toxic if applied based on in vitro studies, inhibition of viral replication in vivo was shown for Porcine circovirus in piglets and Suid herpesvirus in mice. Overall standardized mean differences; 95% confidence intervals for ivermectin versus controls were: -4.43 (-5.81, -3.04), P < 0.00001. Based on current results, the potential for repurposing ivermectin as an antiviral agent is promising. However, further work is needed to reconcile in vitro studies with clinical efficacy. Developing ivermectin as an additional antiviral agent should be pursued with an emphasis on pre-clinical trials in validated models of infection.}, } @article {pmid33426865, year = {2020}, author = {Ciprandi, G and Aragona, SE}, title = {Non-pharmacological remedies for upper respiratory diseases in the pandemic COVID-19 era.}, journal = {Journal of biological regulators and homeostatic agents}, volume = {34}, number = {6 Suppl. 1}, pages = {41-49}, pmid = {33426865}, issn = {0393-974X}, abstract = {In the pandemic coronavirus disease 2019 (COVID-19) era, the need to use preventive-curative treatments is compelling. A series of non-pharmacological compounds, including supplements (oligoelements and vitamins), probiotics, and nutraceuticals, might affect the risk of COVID-19 or reducing clinical severity. Non-pharmacological remedies are easily available and usually have no relevant side effects. There is evidence that bacterial and molecular substances may potentiate the immune system against respiratory viruses. Moreover, these compounds might exert essential anti-inflammatory and antioxidant activity in COVID-19. Furthermore, nasal lavage may be an additional resource for reducing the viral load and restore the integrity of respiratory patency. Therefore, preventive courses using non-pharmacological remedies could be prescribed to reinforce the immune response and adequate treatment of upper respiratory infection with natural compounds could be considered a reasonable way to manage people in the pandemic COVID-19 era.}, } @article {pmid33426733, year = {2021}, author = {Baldini, T and Asioli, GM and Romoli, M and Carvalho Dias, M and Schulte, EC and Hauer, L and Aguiar De Sousa, D and Sellner, J and Zini, A}, title = {Cerebral venous thrombosis and SARS-CoV-2 infection: a systematic review and meta-analysis.}, journal = {European journal of neurology}, volume = {}, number = {}, pages = {}, doi = {10.1111/ene.14727}, pmid = {33426733}, issn = {1468-1331}, abstract = {BACKGROUND: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection predisposes patients to arterial and venous thrombosis. This study aimed to systematically review the available evidence in the literature for cerebral venous thrombosis (CVT) in association with coronavirus disease-2019 (COVID-19).

METHODS: We searched MEDLINE, EMBASE and Cochrane CENTRAL databases to identify cases of COVID-19-associated CVT. The search period spanned January 1st to December 1st 2020 and the review protocol (PROSPERO-CRD42020214327) followed PRISMA guidelines. Identified studies were evaluated for bias using the Newcastle-Ottawa scale (NOS). Proportion meta-analysis was performed to estimate the frequency of CVT among hospitalized COVID-19 patients.

RESULTS: We identified 57 cases from 28 reports. Study quality was mostly classified as low. CVT symptoms developed after respiratory disease in 90%, the mean interval was 13 days. CVT involved multiple sites in 67% of individuals, the deep venous system was affected in 37% and parenchymal hemorrhage was found in 42%. Predisposing factors for CVT beyond SARS-CoV-2 infection were present in 31%. In-hospital mortality was 40%. Using data from 34331 patients, the estimated frequency of CVT among hospitalized for SARS-CoV-2 infection was 0.08% (95%CI=0.01-0.5). In an in-patient setting, CVT accounted for 4.2% of cerebrovascular disorders in individuals with COVID-19 (cohort of 406 patients, 95%CI=1.47-11.39).

CONCLUSION: CVT in the context of SARS-CoV-2 infection is a rare, although there seems to be an increased relative risk. High suspicion is necessary, since the diagnosis of this potentially life-threatening condition in COVID-19 patients can be challenging. Evidence is still scarce on the pathophysiology and potential prevention of COVID-19 associated CVT.}, } @article {pmid33426683, year = {2021}, author = {Rahman, MM and Hasan, M and Ahmed, A}, title = {Potential detrimental role of soluble ACE2 in severe COVID-19 comorbid patients.}, journal = {Reviews in medical virology}, volume = {}, number = {}, pages = {}, doi = {10.1002/rmv.2213}, pmid = {33426683}, issn = {1099-1654}, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) enters the host cell by binding to angiotensin-converting enzyme 2 (ACE2) receptor. Other important proteins involved in this process include disintegrin and metalloproteinase domain-containing protein 17 (ADAM17) also known as tumour necrosis factor-α-converting enzyme and transmembrane serine protease 2. ACE2 converts angiotensin II (Ang II) to angiotensin (1-7), to balance the renin angiotensin system. Membrane-bound ACE2 ectodomain shedding is mediated by ADAM17 upon viral spike binding, Ang II overproduction and in several diseases. The shed soluble ACE2 (sACE2) retains its catalytic activity, but its precise role in viral entry is still unclear. Therapeutic sACE2 is claimed to exert dual effects; reduction of excess Ang II and blocking viral entry by masking the spike protein. Nevertheless, the paradox is why SARS-CoV-2 comorbid patients struggle to attain such benefit in viral infection despite having a high amount of sACE2. In this review, we discuss the possible detrimental role of sACE2 and speculate on a series of events where protease primed or non-primed virus-sACE2 complex might enter the host cell. As extracellular virus can bind many sACE2 molecules, sACE2 level could be reduced drastically upon endocytosis by the host cell. A consequential rapid rise in Ang II level could potentially aggravate disease severity through Ang II-angiotensin II receptor type 1 (AT1R) axis in comorbid patients. Hence, monitoring sACE2 and Ang II level in coronavirus disease 2019 comorbid patients are crucial to ensure safe and efficient intervention using therapeutic sACE2 and vaccines.}, } @article {pmid33426593, year = {2021}, author = {Gupta, S and Mitra, A}, title = {Challenge of post-COVID era: management of cardiovascular complications in asymptomatic carriers of SARS-CoV-2.}, journal = {Heart failure reviews}, volume = {}, number = {}, pages = {}, pmid = {33426593}, issn = {1573-7322}, abstract = {Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), a highly pathogenic member of family coronaviridae, has caused an exponentially growing global pandemic termed as the coronavirus disease 2019 (COVID-19) with more than 12 million cases worldwide till date. This deadly disease has average fatality rate of 6.5% and even higher among elderly patients and patients with comorbidities. SARS-CoV-2 uses angiotensin-converting enzyme 2 (ACE-2) as the entry receptor into host cell. ACE-2, a type-I transmembrane metallocarboxypeptidase, is a critical regulator of the renin-angiotensin system. The entry of SARS-CoV-2 within host cells results in a reduced availability of ACE-2 on the host cell surface followed by significant downregulation of ACE-2 gene expression. As ACE-2 is a well-known cardio-protective molecule, its downregulation could result in severe cardiac disorders. This review deals with a challenging aspect of SARS-CoV-2 infected patients who are asymptomatic or have mild syndromes similar to influenza infections. These patients are proving to be the Achilles' heel to combat COVID-19 mainly in developing countries of South Asia, where the average number of tests conducted per million individuals is considerably low. Consequently, there is high possibility that individuals with negligible respiratory trouble will not be tested for SARS-CoV-2. Hence, a huge percentage of the population have the risk of developing cardiovascular disorders as a bystander effect of viral infection apart from being potential reservoir of disease transmission. Based on available demographic as well as molecular data, this review predicts a huge spike in cardiovascular disorders among this undetected reservoir in post COVID-19 era.}, } @article {pmid33426530, year = {2021}, author = {Ullah, SMA and Islam, MM and Mahmud, S and Nooruddin, S and Raju, SMTU and Haque, MR}, title = {Scalable Telehealth Services to Combat Novel Coronavirus (COVID-19) Pandemic.}, journal = {SN computer science}, volume = {2}, number = {1}, pages = {18}, doi = {10.1007/s42979-020-00401-x}, pmid = {33426530}, issn = {2661-8907}, abstract = {An ongoing pandemic, the novel coronavirus disease 2019 (COVID-19) is threatening the nations of the world regardless of health infrastructure conditions. In the age of digital electronic information and telecommunication technology, scalable telehealth services are gaining immense importance by helping to maintain social distances while providing necessary healthcare services. This paper aims to review the various types of scalable telehealth services used to support patients infected by COVID-19 and other diseases during this pandemic. Recently published research papers collected from various sources such as Google Scholar, ResearchGate, PubMed, Scopus, and IEEE Xplore databases using the terms "Telehealth", "Coronavirus", "Scalable" and "COVID-19" are reviewed. The input data and relevant reports for the analysis and assessment of the various aspects of telehealth technology in the COVID-19 pandemic are taken from official websites. We described the available telehealth systems based on their communication media such as mobile networks, social media, and software based models throughout the review. A comparative analysis among the reviewed systems along with necessary challenges and possible future directions are also drawn for the proper selection of affordable technologies. The usage of scalable telehealth systems improves the quality of the healthcare system and also reduces the infection rate while keeping both patients and doctors safe during the pandemic.}, } @article {pmid33426467, year = {2021}, author = {Ghaffari, M and Mollazadeh-Bajestani, M and Moztarzadeh, F and Uludağ, H and Hardy, JG and Mozafari, M}, title = {An overview of the use of biomaterials, nanotechnology, and stem cells for detection and treatment of COVID-19: towards a framework to address future global pandemics.}, journal = {Emergent materials}, volume = {}, number = {}, pages = {1-16}, doi = {10.1007/s42247-020-00143-9}, pmid = {33426467}, issn = {2522-574X}, abstract = {A novel SARS-like coronavirus (severe acute respiratory syndrome-related coronavirus-2, SARS-CoV-2) outbreak has recently become a worldwide pandemic. Researchers from various disciplinary backgrounds (social to natural science, health and medicine, etc.) have studied different aspects of the pandemic. The current situation has revealed how the ongoing development of nanotechnology and nanomedicine can accelerate the fight against the novel viruses. A comprehensive solution to this and future pandemic outbreaks includes preventing the spread of the virus through anti-viral personal protective equipment (PPE) and anti-viral surfaces, plus efforts to encourage behavior to minimize risks. Studies of previously introduced anti-viral biomaterials and their optimization to fight against SARS-CoV-2 is the foundation of most of the recent progress. The identification of non-symptomatic patients and symptomatic patients is vital. Reviewing published research highlights the pivotal roles of nanotechnology and biomaterials in the development and efficiency of detection techniques, e.g., by applying nanotechnology and nanomedicine as part of the road map in the treatment of coronavirus disease 2019 (COVID-19) patients. In this review, we discuss efforts to deploy nanotechnology, biomaterials, and stem cells in each step of the fight against SARS-CoV-2, which may provide a framework for future efforts in combating global pandemics.}, } @article {pmid33426426, year = {2021}, author = {Jappe, U and Beckert, H and Bergmann, KC and Gülsen, A and Klimek, L and Philipp, S and Pickert, J and Rauber-Ellinghaus, MM and Renz, H and Taube, C and Treudler, R and Wagenmann, M and Werfel, T and Worm, M and Zuberbier, T}, title = {Biologics for atopic diseases: Indication, side effect management, and new developments.}, journal = {Allergologie select}, volume = {5}, number = {}, pages = {1-25}, doi = {10.5414/ALX02197E}, pmid = {33426426}, issn = {2512-8957}, abstract = {With the advent of biologicals, more and more therapeutics are available that specifically address specific switch points in the pathomechanism of immunologically dominated diseases. Thus, the focus of diagnostics and therapy (precision medicine) is more on the individual disease characteristics of the individual patient. Regarding the different phenotypes of atopic diseases, severe asthma was the first entity for which biologicals were approved, followed by urticaria, and finally atopic dermatitis and chronic rhinosinusitis with nasal polyps. Experience in the treatment of severe bronchial asthma has shown that the intensity of the response to biological therapy depends on the quality of clinical and immunological phenotyping of the patients. This also applies to different diseases of the atopic form, as patients can suffer from several atopic diseases at the same time, each with different characteristics. Biologics are already emerging that may represent a suitable therapy for allergic bronchial asthma, which often occurs together with severe neurodermatitis, and chronic rhinosinusitis with nasal polyps. In practice, however, the question of possible combinations of biologicals for the therapy of complex clinical pictures of individual patients is increasingly arising. In doing so, the side effect profile must be taken into account, including hypersensitivity reactions, whose diagnostic and logistical management must aim at a safe and efficient therapy of the underlying disease. Increased attention must also be paid to biological therapy in pregnancy and planned (predictable) vaccinations as well as existing infections, such as SARS-CoV-2 infection. Before starting a biological therapy, the immune status should be checked with regard to chronic viral and bacterial infections and, if necessary, the vaccination status should be refreshed or missing vaccinations should be made up for before starting therapy. Currently, reliable data on the effect of biologicals on the immunological situation of SARS-CoV-2 infection and COVID-19 are not available. Therefore, research and development of suitable diagnostic methods for detection of immunologically caused side effects as well as detection of potential therapy responders and non-responders is of great importance.}, } @article {pmid33426364, year = {2021}, author = {Pang, J and Liu, M and Ling, W and Jin, T}, title = {Friend or Foe? ACE2 inhibitors and GLP-1R agonists in COVID-19 treatment.}, journal = {Obesity medicine}, volume = {}, number = {}, pages = {100312}, doi = {10.1016/j.obmed.2020.100312}, pmid = {33426364}, issn = {2451-8476}, abstract = {COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has been a pandemic since WHO made the statement on March 11, 2020. The infection is causing a high mortality in old people, especially those with obesity, type 2 diabetes (T2D) or cardiovascular diseases (CVD). Extra cautions are needed in the treatment of those patients. The CVD drugs ACEIs and ARBs, as well as the T2D drugs GLP-1R agonists, were shown to activate angiotensin-converting enzyme 2 (ACE2) expression in experimental animals. Elevated ACE2 expression may accelerate virus entrance into the host cells during the infection for its replication. However, expression of the soluble ACE2, may neutralize the virus to limit the infection and replication. Given that obese, diabetes and CVD patients often take those medicines in the treatment and prevention of blood pressure and glucose elevation, it remains to be determined whether those medicines represent friend or foe in the treatment of COVID-19. We suggest that retrospective studies should be conducted to determine the exact impact of those medicines in obese, diabetic, or CVD patients who had COVID-19. Results obtained will provide guidance whether those drugs can be utilized in COVID-19 patients with obesity, diabetic, or CVD.}, } @article {pmid33426096, year = {2020}, author = {Melgaço, JG and Brito E Cunha, D and Azamor, T and da Silva, AMV and Tubarão, LN and Gonçalves, RB and Monteiro, RQ and Missailidis, S and da Costa Neves, PC and Ano Bom, APD}, title = {Cellular and Molecular Immunology Approaches for the Development of Immunotherapies against the New Coronavirus (SARS-CoV-2): Challenges to Near-Future Breakthroughs.}, journal = {Journal of immunology research}, volume = {2020}, number = {}, pages = {8827670}, doi = {10.1155/2020/8827670}, pmid = {33426096}, issn = {2314-7156}, abstract = {The severe acute respiratory syndrome caused by the new coronavirus (SARS-CoV-2), termed COVID-19, has been highlighted as the most important infectious disease of our time, without a vaccine and treatment available until this moment, with a big impact on health systems worldwide, and with high mortality rates associated with respiratory viral disease. The medical and scientific communities have also been confronted by an urgent need to better understand the mechanism of host-virus interaction aimed at developing therapies and vaccines. Since this viral disease can trigger a strong innate immune response, causing severe damage to the pulmonary tract, immunotherapies have also been explored as a means to verify the immunomodulatory effect and improve clinical outcomes, whilst the comprehensive COVID-19 immunology still remains under investigation. In this review, both cellular and molecular immunopathology as well as hemostatic disorders induced by SARS-CoV-2 are summarized. The immunotherapeutic approaches based on the most recent clinical and nonclinical studies, emphasizing their effects for the treatment of COVID-19, are also addressed. The information presented elucidates helpful insights aiming at filling the knowledge gaps around promising immunotherapies that attempt to control the dysfunction of host factors during the course of this infectious viral disease.}, } @article {pmid33426074, year = {2020}, author = {Mohanta, TK and Sharma, N and Arina, P and Defilippi, P}, title = {Molecular Insights into the MAPK Cascade during Viral Infection: Potential Crosstalk between HCQ and HCQ Analogues.}, journal = {BioMed research international}, volume = {2020}, number = {}, pages = {8827752}, doi = {10.1155/2020/8827752}, pmid = {33426074}, issn = {2314-6141}, abstract = {The mitogen-activated protein kinase (MAPK) pathway links the cell-surface receptors to the transcription machinery, transducing the extracellular signals into several outputs, which may also adapt the host defense mechanism to viral attacks. The Severe Acute Respiratory Syndrome CoronaVirus 2 (SARS-CoV-2) that causes the COrona VIrus Disease 2019 (COVID-19) has infected upwards of nearly 70 million people and worldwide has claimed more than 1,600,000 deaths. So far, there continues to be no specific treatment for this novel coronavirus-induced disease. In the search to control the global COVID-19 pandemic, some eastern and developing countries have approved a variety of treatments with controversial efficacy, among which is the use of the antimalarial hydroxychloroquine (HCQ). Interestingly, prior data had indicated that the HCQ/CQ could influence the MAPK cascade. The main aim of this review is to address molecular mechanisms, beyond drugs, that can be helpful against viral infection for this and future pandemics. We will highlight (1) the contribution of the MAPK cascade in viral infection and (2) the possible use of MAPK inhibitors in curbing viral infections, alone or in combination with HCQ and quinoline analogues. We are convinced that understanding the molecular patterns of viral infections will be critical for new therapeutical approaches to control this and other severe diseases.}, } @article {pmid33426009, year = {2020}, author = {Gorman, S and Weller, RB}, title = {Investigating the Potential for Ultraviolet Light to Modulate Morbidity and Mortality From COVID-19: A Narrative Review and Update.}, journal = {Frontiers in cardiovascular medicine}, volume = {7}, number = {}, pages = {616527}, doi = {10.3389/fcvm.2020.616527}, pmid = {33426009}, issn = {2297-055X}, abstract = {During the COVID-19 (coronavirus disease of 2019) pandemic, researchers have been seeking low-cost and accessible means of providing protection from its harms, particularly for at-risk individuals such as those with cardiovascular disease, diabetes and obesity. One possible way is via safe sun exposure, and/or dietary supplementation with induced beneficial mediators (e.g., vitamin D). In this narrative review, we provide rationale and updated evidence on the potential benefits and harms of sun exposure and ultraviolet (UV) light that may impact COVID-19. We review recent studies that provide new evidence for any benefits (or otherwise) of UV light, sun exposure, and the induced mediators, vitamin D and nitric oxide, and their potential to modulate morbidity and mortality induced by infection with SARS-CoV-2 (severe acute respiratory disease coronavirus-2). We identified substantial interest in this research area, with many commentaries and reviews already published; however, most of these have focused on vitamin D, with less consideration of UV light (or sun exposure) or other mediators such as nitric oxide. Data collected to-date suggest that ambient levels of both UVA and UVB may be beneficial for reducing severity or mortality due to COVID-19, with some inconsistent findings. Currently unresolved are the nature of the associations between blood 25-hydroxyvitamin D and COVID-19 measures, with more prospective data needed that better consider lifestyle factors, such as physical activity and personal sun exposure levels. Another short-coming has been a lack of measurement of sun exposure, and its potential to influence COVID-19 outcomes. We also discuss possible mechanisms by which sun exposure, UV light and induced mediators could affect COVID-19 morbidity and mortality, by focusing on likely effects on viral pathogenesis, immunity and inflammation, and potential cardiometabolic protective mechanisms. Finally, we explore potential issues including the impacts of exposure to high dose UV radiation on COVID-19 and vaccination, and effective and safe doses for vitamin D supplementation.}, } @article {pmid33425995, year = {2020}, author = {Kotta, S and Aldawsari, HM and Badr-Eldin, SM and Alhakamy, NA and Md, S and Nair, AB and Deb, PK}, title = {Exploring the Potential of Carbon Dots to Combat COVID-19.}, journal = {Frontiers in molecular biosciences}, volume = {7}, number = {}, pages = {616575}, doi = {10.3389/fmolb.2020.616575}, pmid = {33425995}, issn = {2296-889X}, abstract = {Viral diseases are considered as a global burden. The eradication of viral diseases is always a challenging task in medical research due to the high infectivity and mutation capability of the virus. The ongoing COVID-19 pandemic is still not under control even after several months of the first reported case and global spread. Neither a specific drug nor a vaccine is available for public use yet. In the pursuit of a promising strategy, carbon dots could be considered as potential nanostructure against this viral pandemic. This review explores the possibility of carbon nano-dots to combat COVID-19 based on some reported studies. Carbon dots are photoluminescent carbon nanoparticles, smaller than 10 nm in dimension with a very attractive photostable and biocompatible properties which can be surfaced modified or functionalized. These photoluminescent tiny particles have captured much attention owing to their functionalization property and biocompatibility. In response to this pandemic outbreak, this review attempts to summarize the potential use of carbon dots in antiviral therapy with particular emphasis on their probable role in the battlefront against COVID-19 including their possible biosensing applications.}, } @article {pmid33425987, year = {2020}, author = {Srivastava, S and Upadhyay, DJ and Srivastava, A}, title = {Next-Generation Molecular Diagnostics Development by CRISPR/Cas Tool: Rapid Detection and Surveillance of Viral Disease Outbreaks.}, journal = {Frontiers in molecular biosciences}, volume = {7}, number = {}, pages = {582499}, doi = {10.3389/fmolb.2020.582499}, pmid = {33425987}, issn = {2296-889X}, abstract = {Virus disease spreads effortlessly mechanically or through minute insect vectors that are extremely challenging to avoid. Emergence and reemergence of new viruses such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), H1N1 influenza virus, avian influenza virus, dengue virus, Citrus tristeza virus, and Tomato yellow leaf curl virus have paralyzed the economy of many countries. The cure for major viral diseases is not feasible; however, early detection and surveillance of the disease can obstruct their spread. Therefore, advances in the field of virus diagnosis and the development of new point-of-care testing kits become necessary globally. Clustered regularly interspaced short palindromic repeats (CRISPR)/CRISPR-associated protein (Cas) is an emerging technology for gene editing and diagnostics development. Several rapid nucleic acid diagnostic kits have been developed and validated using Cas9, Cas12, and Cas13 proteins. This review summarizes the CRISPR/Cas-based next-generation molecular diagnostic techniques and portability of devices for field-based utilization.}, } @article {pmid33425945, year = {2020}, author = {Hashem, H and Abufaraj, M and Tbakhi, A and Sultan, I}, title = {Obstacles and Considerations Related to Clinical Trial Research During the COVID-19 Pandemic.}, journal = {Frontiers in medicine}, volume = {7}, number = {}, pages = {598038}, doi = {10.3389/fmed.2020.598038}, pmid = {33425945}, issn = {2296-858X}, abstract = {The response to the COVID-19 pandemic from the research and science community has been vigorous, with information being released faster than that of any other event in human history. Articles related to the virus were being rapidly published by January 2020. A small fraction of these publications comprised reports of prospective clinical trials (0.25%), and many of these trials have imparted conflicting conclusions, leading to confusion among the public and the scientific community. Additionally, the pandemic has raised many serious scientific and ethical concerns related to clinical research. In this review, we divided the conduct of clinical research trials into three steps and critically reviewed each step, along with the challenges and obstacles arising amid the ongoing crisis. The clinical research steps we reviewed include (1) clinical trial design factors such as social and scientific value, feasibility, single vs. multicenter trials, randomization, control groups, endpoints, off-label and compassionate use of medications, data analysis, and verifying the integrity of data; (2) ethical issues such as committee approvals, efficiency, virtual visits and remote monitoring, informed consent, shipping investigational products, and external monitoring and audits; and (3) publication and sharing of preprints, press releases, social media, and misinformation. The COVID-19 pandemic is adversely affecting existing clinical trials for other ailments and diseases, including cancer, with most trials being delayed or deferred. Although urgency is needed to communicate effective treatment and prevention strategies for COVID-19, research efforts should maintain the same high-quality core ethical principles that governed human subject research before the pandemic. Despite the catastrophic devastation caused by the pandemic, the adoption of more flexible, cost-effective methods of conducting clinical trials (without compromising ethical conduct, safety, or data integrity, while maintaining research efficiency) represents a potential silver lining. Streamlining clinical research will help to congruently address other important health issues, despite the ongoing COVID-19 crisis.}, } @article {pmid33425823, year = {2020}, author = {McMurray, JC and May, JW and Cunningham, MW and Jones, OY}, title = {Multisystem Inflammatory Syndrome in Children (MIS-C), a Post-viral Myocarditis and Systemic Vasculitis-A Critical Review of Its Pathogenesis and Treatment.}, journal = {Frontiers in pediatrics}, volume = {8}, number = {}, pages = {626182}, doi = {10.3389/fped.2020.626182}, pmid = {33425823}, issn = {2296-2360}, abstract = {MIS-C is a newly defined post-viral myocarditis and inflammatory vasculopathy of children following COVID-19 infection. This review summarizes the literature on diagnosis, parameters of disease severity, and current treatment regimens. The clinical perspective was analyzed in light of potential immunopathogenesis and compared to other post-infectious and inflammatory illnesses of children affecting the heart. In this paradigm, the evidence supports the importance of endothelial injury and activation of the IL-1 pathway as a common determinant among MIS-C, Kawasaki disease, and Acute Rheumatic fever.}, } @article {pmid33425659, year = {2021}, author = {Omare, MO and Kibet, JK and Cherutoi, JK and Kengara, FO}, title = {A review of tobacco abuse and its epidemiological consequences.}, journal = {Zeitschrift fur Gesundheitswissenschaften = Journal of public health}, volume = {}, number = {}, pages = {1-16}, doi = {10.1007/s10389-020-01443-4}, pmid = {33425659}, issn = {2198-1833}, abstract = {Aim: The economic burden caused by death and disease in the world is credited mainly to tobacco use-currently linked to approximately 8,000,000 deaths per year with approximately 80% of these faralities reported in low and middle income economies. The World Health Organization (WHO) estimates that nearly 7,000,000 deaths are attributed to direct tobacco use, while approximately 1,200,000 non-smokers exposed to second hand cigarette smoke die every year. Accordingly, tobacco use is a major threat to the public health infrastructure; therefore, proper cessation interventions must be put in place to curb tobacco abuse and ease economic and social burdens caused by the tobacco epidemic.

Methods: A systematic review was conducted to investigate how scientific efforts have been advanced towards harm reduction among smokers and non-smokers. Relevant articles published during the period 2010-2020 in PubMed, Crossref, Google scholar, and Web of Science were used in this study. The articles were selected based on health impacts of cigarette smoking, tobacco cessation and emerging diseases, including Covid-19. Various cessation strategies have been identified although their efficiency is yet to match the desired results.

Results: A series of carcinogenic chemicals are generated during cigarette smoking resulting in serious health complications such as cancer and mutagenesis. The precursors for tobacco induced diseases are toxic and carcinogenic chemicals of the nitrosamine type, aldehydes, polonium-210 and benzo[a]pyrene, which bio-accumulate in the body system during cigarette smoking to cause disease. Rehabilitation facilities, use of drugs to diminish the desire to smoke, heavy taxation of tobacco products and warning labels on cigarettes are some of the cessation strategies employed towards curbing tobacco abuse.

Conclusion: The need for further research to develop better methods and research based policies for safe cigarette smoking and workable cessation strategies must be a priority in order to deal with the tobacco epidemic. Campaigns to promote tobacco cessation and abstinence are recommended in this review as a sure measure to mitigate against the deleterious impacts caused by cigarette smoking and tobacco abuse.}, } @article {pmid33425655, year = {2021}, author = {Fontecha, G and Sánchez, AL}, title = {What Will Happen to Biomedical Research in Low-and-Middle Income Countries in the PostCOVID-19 World?.}, journal = {Current tropical medicine reports}, volume = {}, number = {}, pages = {1-5}, doi = {10.1007/s40475-020-00223-0}, pmid = {33425655}, issn = {2196-3045}, abstract = {Scientific research is essential for a nation's development and is vital for generating solutions to population's health. Individual country's capacities to prevent and respond to public health issues, including health crises, is built with long-term investment in highly qualified professionals, infrastructure, and uninterrupted operating funding. Most Latin American countries, especially those at the bottom of the human development list, have limited capacity even though they are hot spots for tropical and other emerging infectious diseases. This weakness deepens these countries' dependence on nations with higher development and corresponding scientific capacity. The current COVID-19 pandemic has wreaked havoc on the health of the world's population and the global economy. Countries that lagged behind prior to the pandemic now face a myriad of additional challenges. On a more optimistic note, the pandemic could serve as a wake-up call for governments and funding agencies to strengthen scientific capacity around the world, so that we are better prepared to address the public health issues caused by current and prevalent diseases and by future diseases of pandemic potential.}, } @article {pmid33425654, year = {2021}, author = {Ishigami, J and Kou, M and Ding, N and Matsushita, K}, title = {Cardiovascular Disease and Coronavirus Disease 2019: Epidemiology, Management, and Prevention.}, journal = {Current epidemiology reports}, volume = {}, number = {}, pages = {1-8}, doi = {10.1007/s40471-020-00261-2}, pmid = {33425654}, issn = {2196-2995}, abstract = {Purpose of Review: Coronavirus disease 2019 (COVID-19) has become a global pandemic associated with significant morbidity and mortality. This review summarizes findings up to date on the relationship between cardiovascular disease (CVD) and COVID-19.

Recent Findings: Preexisting CVD is a common condition among patients with COVID-19 and is associated with increased disease severity and mortality. Conversely, COVID-19 has various clinical manifestations on cardiovascular system, including thrombotic events and cardiac dysfunction. The pandemic has impacted healthcare utilization among patients with CVD, which may have led to potential delay in access to the healthcare system during acute events not directly COVID-19-related.

Summary: While COVID-19 vaccine is being developed and distributed, controlling CVD risk factors and adherence to recommendations of existing immunization (e.g., influenza vaccine) are key in protecting the health of individuals with CVD during the COVID-19 pandemic. Further research is needed to understand the epidemiological and pathophysiological basis for the interaction between CVD and COVID-19.}, } @article {pmid33425481, year = {2021}, author = {Holland, M and Hawks, J and Morelli, LC and Khan, Z}, title = {Risk Assessment and Crisis Intervention for Youth in a Time of Telehealth.}, journal = {Contemporary school psychology}, volume = {}, number = {}, pages = {1-15}, doi = {10.1007/s40688-020-00341-6}, pmid = {33425481}, issn = {2159-2020}, abstract = {For the last decade, there has been growing concern regarding the rising rates of youth engagement in self-injury and suicide. The worldwide outbreak of the coronavirus disease 2019 (COVID-19) has elevated these concerns due to increased risk factors pertaining to social, family, economic, and health stressors, in addition to changes to typical routines and support systems. Unfortunately, there are many barriers to at-risk youth being able to access evidence-based mental health services including cost, lack of trained providers, transportation issues, and physical distancing due to the pandemic. Providing school-based prevention and intervention programs that promote social, emotional, and behavioral well-being helps to address many of these barriers. This article highlights important considerations to providing these services in a school-based telehealth modality. Symptom clusters that put youth at risk of harm to self are described. Best practice therapeutic modalities that can be disseminated in a school-based telehealth modality, such as cognitive behavior therapy, dialectical behavior therapy, and mindfulness-based approaches, are reviewed. Although there is growing empirical literature for these school-based prevention and intervention approaches, additional research is needed to determine how to best support at-risk youth remotely.}, } @article {pmid33425365, year = {2021}, author = {Tehrani, HA and Darnahal, M and Nadji, SA and Haghighi, S}, title = {COVID-19 re-infection or persistent infection in patient with acute myeloid leukaemia M3: a mini review.}, journal = {New microbes and new infections}, volume = {39}, number = {}, pages = {100830}, doi = {10.1016/j.nmni.2020.100830}, pmid = {33425365}, issn = {2052-2975}, abstract = {Coronavirus disease 2019 (COVID-19) pandemic has affected more than 40 million people worldwide. Some patients had episodes of symptom recurrence after the first episode of infection with variable intervals. There are multiple issues and hypotheses about re-infection or re-activation of the virus, especially in immunocompromised patients. In this paper, we present details of an individual with a recent history of COVID-19 who proceeded to acute myeloid leukaemia M3 and immunosuppression by chemotherapy, then we review some recently published articles about possible re-infection or re-activation.}, } @article {pmid33425283, year = {2021}, author = {Sarkar, PK and Das Mukhopadhyay, C}, title = {Ayurvedic metal nanoparticles could be novel antiviral agents against SARS-CoV-2.}, journal = {International nano letters}, volume = {}, number = {}, pages = {1-7}, doi = {10.1007/s40089-020-00323-9}, pmid = {33425283}, issn = {2008-9295}, abstract = {Purpose of review: The pandemic COVID-19 has affected more than seventy million people globally. The whole world is eagerly waiting for an effective antiviral therapy to combat COVID-19, but it is yet to get. The emergence of COVID-19 makes imperative the need for safe and potent antiviral drugs. Many metal nanoparticles exhibit significant antiviral potential against many viral diseases. The Ayurvedic system of medicine is the treasure of many metal nanoparticulate drugs termed as Bhasma.

Recent findings: Gold, silver, copper, zinc and iron oxide nanoparticles are effective against coronavirus. A possible mechanism of action of the metal nanoparticles against coronavirus is a disruption of outer layers of coronavirus. Swarna Bhasma, Rajata Bhasma, Tamra Bhasma and Yashada Bhasma are recommended for COVID-19 treatment due to the ability to reduce the plasma interleukins, interferons and TNFα levels.

Summary: The Ayurvedic Bhasma preparations are unique metal nanoparticles. These metal nanoparticles are safe, stable in solid state and are having excellent biological activities. Ayurvedic metal nanoparticles, Swarna Bhasma, Rajata Bhasma, Tamra Bhasma and Yashada Bhasma could be proved as novel antiviral agents against SARS-CoV-2 for their anti-inflammatory, immunomodulatory, antiviral and adjuvant activities.}, } @article {pmid33425264, year = {2020}, author = {Hoseini, R}, title = {How to Exercise During Coronavirus Quarantine?.}, journal = {Caspian journal of internal medicine}, volume = {11}, number = {Suppl 1}, pages = {479-483}, doi = {10.22088/cjim.11.0.479}, pmid = {33425264}, issn = {2008-6164}, abstract = {The COVID-19 pandemic caused stress and anxiety in many people that can be reduced by regular physical activity. Regular physical exercise is essential for health. In the absence of COVID-19 symptoms, no limitation in physical activity is recommended. However, parameters such as frequency, intensity, type, and time need to be considered to prescribe the program and obtain the best results. Consequently, the level of physical activity that should be done during the outbreak has always been one of the most important and common questions.}, } @article {pmid33425263, year = {2020}, author = {Moslemifard, M and Gorji, N and Ghadimi, R and Kamalinejad, M and Shirafkan, H and Mozaffarpur, SA}, title = {Hospital diet for COVID-19, an acute respiratory infectious disease: An evidence-based Protocol of a Clinical Trial.}, journal = {Caspian journal of internal medicine}, volume = {11}, number = {Suppl 1}, pages = {466-478}, doi = {10.22088/cjim.11.0.466}, pmid = {33425263}, issn = {2008-6164}, abstract = {Background: COVID-19 caused a global pandemic problem. No confident management is introduced for it yet. This study aimed to propose a dietary protocol for hospitalized patients with the diagnosis of acute respiratory infectious disease caused by COVID-19 based on Persian Medicine.

Methods: This study was conducted in three phases. In the first phase, any diseases that could be matched with the clinical features of infection with COVID-19 were searched in selected PM references. In the second phase, medicinal herbs and foods that were available and could be used in the hospital diet were extracted and summarized. In the third phase, the new documentation of these pharmaceutical and food items was conducted.

Results: The signs and symptoms of infectious respiratory disease caused by COVID-19 can be categorized in the field of Zato al-rieh that can mainly be matched with pneumonia. Based on the described criteria, some nutrients and medicinal materia medica have been introduced for acute respiratory infection including Cydonia oblonga, Honey, Citrus sinensis, Malus domestica, Citrus medica, Crocus sativus, Raisin, Rosa Damas Cena, D.Carota, Camellia Sinensis, Anethum graveolens dhi, Punica granatum, Petroselinum Crispum, Coriandrum sativum, Urtica dioica, Allium sativum, Sesamum indicum.

Conclusion: Most materia medica has documents in current articles including anti-cough suppressants, antiviral properties, anti-bacterial, anti-inflammatory, antioxidant, immunomodulatory etc. A protocol of hospital diet for patients with infectious respiratory syndrome caused by COVID-19 has been introduced in this manuscript.}, } @article {pmid33425262, year = {2020}, author = {Eftekhar, SP and Kazemi, S and Moghadamnia, AA}, title = {A brief review of the latest pharmacological treatments of COVID-19.}, journal = {Caspian journal of internal medicine}, volume = {11}, number = {Suppl 1}, pages = {460-465}, doi = {10.22088/cjim.11.0.460}, pmid = {33425262}, issn = {2008-6164}, abstract = {New Coronavirus which is called 2019-nCoV (2019-Novel-Coronavirus) or SARS-Cov-2 (Severe Acute respiratory Syndrome-Coronavirus 2) causes deadly pneumonia that first appeared in December 2019 in Wuhan city in China. This virus spreads all over the world quickly and made several problems for the community and healthcare system. Several drugs have been tried to manage COVID-19; however, our knowledge of this virus is not complete. At any rate, effective treatment or vaccine for this disease has not been discovered yet. Furthermore, to achieve this goal, more studies are needed on the structure of the virus and its pathogenesis mechanism. In this article, we summarized several articles suggesting treatments of COVID-19.}, } @article {pmid33425204, year = {2021}, author = {Bousquet, J and Le Moing, V and Blain, H and Czarlewski, W and Zuberbier, T and de la Torre, R and Pizarro Lozano, N and Reynes, J and Bedbrook, A and Cristol, JP and Cruz, AA and Fiocchi, A and Haahtela, T and Iaccarino, G and Klimek, L and Kuna, P and Melén, E and Mullol, J and Samolinski, B and Valiulis, A and Anto, JM}, title = {Efficacy of broccoli and glucoraphanin in COVID-19: From hypothesis to proof-of-concept with three experimental clinical cases.}, journal = {The World Allergy Organization journal}, volume = {14}, number = {1}, pages = {100498}, doi = {10.1016/j.waojou.2020.100498}, pmid = {33425204}, issn = {1939-4551}, abstract = {COVID-19 is described in a clinical case involving a patient who proposed the hypothesis that Nuclear factor (erythroid-derived 2)-like 2 (Nrf2)-interacting nutrients may help to prevent severe COVID-19 symptoms. Capsules of broccoli seeds containing glucoraphanin were being taken before the onset of SARS-CoV-2 infection and were continued daily for over a month after the first COVID-19 symptoms. They were found to reduce many of the symptoms rapidly and for a duration of 6-12 h by repeated dosing. When the patient was stable but still suffering from cough and nasal obstruction when not taking the broccoli capsules, a double-blind induced cough challenge confirmed the speed of onset of the capsules (less than 10 min). A second clinical case with lower broccoli doses carried out during the cytokine storm confirmed the clinical benefits already observed. A third clinical case showed similar effects at the onset of symptoms. In the first clinical trial, we used a dose of under 600 μmol per day of glucoraphanin. However, such a high dose may induce pharmacologic effects that require careful examination before the performance of any study. It is likely that the fast onset of action is mediated through the TRPA1 channel. These experimental clinical cases represent a proof-of-concept confirming the hypothesis that Nrf2-interacting nutrients are effective in COVID-19. However, this cannot be used in practice before the availability of further safety data, and confirmation is necessary through proper trials on efficacy and safety.}, } @article {pmid33425182, year = {2020}, author = {Egbi, OG and Adejumo, OA and Akinbodewa, AA}, title = {Coronavirus infection and kidney disease: a review of current and emerging evidence.}, journal = {The Pan African medical journal}, volume = {37}, number = {}, pages = {149}, doi = {10.11604/pamj.2020.37.149.23655}, pmid = {33425182}, issn = {1937-8688}, abstract = {In November 2009, an outbreak of a new strain of coronavirus (later named severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was first noticed in the city of Wuhan in China, rapidly spreading to assume pandemic proportions within a short period of time. The disease was subsequently designated as coronavirus disease-19 (COVID-19). The death toll has continued to rise with grave health and socio-economic implications for individuals, families and nations globally. Although the respiratory tract is primarily involved in this disease, kidney affectation is increasingly reported and has been shown to worsen the prognosis of the disease. Current evidence shows that kidney disease is not uncommon in patients with coronavirus infection especially in those with COVID-19 and may arise from a constellation of factors such as hypotension, sepsis, rhabdomyolysis, multi-organ failure, use of nephrotoxic medications as well as direct infection in some cases. Factors associated with acute kidney injury in coronavirus infected patients may include elderly age, male sex, presence of co-morbidities as well as pre-existing chronic kidney disease and end stage renal disease. Although, there is presently no effective treatment for COVID-19, there is room for conservative management, extracorporeal therapy and renal replacement therapy. The aim of this review was to integrate current and emerging evidences on renal disease resulting from COVID-19 and the previous epidemics of coronavirus infections including the Middle East Respiratory Syndrome (MERS) and the Severe Acute Respiratory Syndrome (SARS) caused by other strains of the virus.}, } @article {pmid33425157, year = {2020}, author = {Sanicas, M and Sanicas, M and Diop, D and Montomoli, E}, title = {A review of COVID-19 vaccines in development: 6 months into the pandemic.}, journal = {The Pan African medical journal}, volume = {37}, number = {}, pages = {124}, doi = {10.11604/pamj.2020.37.124.24973}, pmid = {33425157}, issn = {1937-8688}, abstract = {The advent of the COVID-19 pandemic and the dynamics of its spread is unprecedented. Therefore, the need for a vaccine against the virus is huge. Researchers worldwide are working around the clock to find a vaccine. Experts estimate that a fast-tracked vaccine development process could speed a successful candidate to market in approximately 12-18 months. The objective of this review was to describe the coronavirus vaccines candidates in development and the important considerations. The review was conducted through a thematic analysis of the literature on COVID-19 vaccines in development. It only included data until the end of June 2020, 6 months after the emergence of the COVID-19. Different approaches are currently used to develop COVID-19 vaccines from traditional live-attenuated, inactivated, subunit vaccines, to more novel technologies such as DNA or mRNA vaccines. The race is on to find both medicines and vaccines for the COVID-19 pandemic. As with drugs, vaccine candidates go through pre-clinical testing first before they go through the three phases of clinical trials in humans. Of the over 130 vaccine candidates, 17 are in clinical trials while others are expected to move to clinical testing after the animal studies.}, } @article {pmid33425089, year = {2021}, author = {Yu, J and Kuwentrai, C and Huang, JD and Xu, C}, title = {Carbon-based nanomaterials for viral infection management.}, journal = {Biomicrofluidics}, volume = {15}, number = {1}, pages = {011501}, doi = {10.1063/5.0032427}, pmid = {33425089}, issn = {1932-1058}, abstract = {Carbon-based nanomaterials such as graphene and nanodiamonds have demonstrated impressive physical and chemical properties, such as remarkable strength, corrosion resistance, and excellent electrical and thermal conductivity, and stability. Because of these unique characteristics, carbon nanomaterials are explored in a wide range of fields, including the diagnosis and treatment of viruses. As there are emerging concerns about the control of virus including Middle East respiratory syndrome virus (MERS), severe acute respiratory syndrome coronavirus (SARS-CoV), and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), this review highlights the recent development of carbon based-nanomaterials for the management of viral infections.}, } @article {pmid33424917, year = {2020}, author = {Visvikis-Siest, S and Theodoridou, D and Kontoe, MS and Kumar, S and Marschler, M}, title = {Milestones in Personalized Medicine: From the Ancient Time to Nowadays-the Provocation of COVID-19.}, journal = {Frontiers in genetics}, volume = {11}, number = {}, pages = {569175}, doi = {10.3389/fgene.2020.569175}, pmid = {33424917}, issn = {1664-8021}, abstract = {The first evidence of individual targeting medicine appeared in ancient times thousands of years ago. Various therapeutic approaches have been established since then. However, even nowadays, conventional therapies do not take into consideration individuals' idiosyncrasy and genetic make-up, failing thus to be effective in some cases. Over time, the necessity of a more precise and effective treatment resulted in the development of a scientific field currently known as "personalized medicine." The numerous technological breakthroughs in this field have acknowledged personalized medicine as the next generation of diagnosis and treatment. Although personalized medicine has attracted a lot of attention the last years, there are still several obstacles hindering its application in clinical practice. These limitations have come to light recently, due to the COVID-19 pandemic. This review describes the "journey" of personalized medicine over time, emphasizing on important milestones achieved through time. Starting from the treatment of malaria, as a first more personalized therapeutic approach, it highlights the need of new diagnostic tools and therapeutic regimens based on individuals' genetic background. Furthermore, it aims at raising global awareness regarding the current limitations and the necessity of a personalized strategy to overpass healthcare problems and hence, the current crisis.}, } @article {pmid33424848, year = {2020}, author = {Zhao, J and Zhao, S and Ou, J and Zhang, J and Lan, W and Guan, W and Wu, X and Yan, Y and Zhao, W and Wu, J and Chodosh, J and Zhang, Q}, title = {COVID-19: Coronavirus Vaccine Development Updates.}, journal = {Frontiers in immunology}, volume = {11}, number = {}, pages = {602256}, doi = {10.3389/fimmu.2020.602256}, pmid = {33424848}, issn = {1664-3224}, abstract = {Coronavirus Disease 2019 (COVID-19) is caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), a newly emerged coronavirus, and has been pandemic since March 2020 and led to many fatalities. Vaccines represent the most efficient means to control and stop the pandemic of COVID-19. However, currently there is no effective COVID-19 vaccine approved to use worldwide except for two human adenovirus vector vaccines, three inactivated vaccines, and one peptide vaccine for early or limited use in China and Russia. Safe and effective vaccines against COVID-19 are in urgent need. Researchers around the world are developing 213 COVID-19 candidate vaccines, among which 44 are in human trials. In this review, we summarize and analyze vaccine progress against SARS-CoV, Middle-East respiratory syndrome Coronavirus (MERS-CoV), and SARS-CoV-2, including inactivated vaccines, live attenuated vaccines, subunit vaccines, virus like particles, nucleic acid vaccines, and viral vector vaccines. As SARS-CoV-2, SARS-CoV, and MERS-CoV share the common genus, Betacoronavirus, this review of the major research progress will provide a reference and new insights into the COVID-19 vaccine design and development.}, } @article {pmid33424377, year = {2021}, author = {Khaled, JMA}, title = {Probiotics, prebiotics, and COVID-19 infection: A review article.}, journal = {Saudi journal of biological sciences}, volume = {28}, number = {1}, pages = {865-869}, doi = {10.1016/j.sjbs.2020.11.025}, pmid = {33424377}, issn = {1319-562X}, abstract = {The beneficial live microbes of humans and animals are termed probiotics, and the chemical compounds that improve the growth of probiotics are known as prebiotics. Paraprobiotics and postbiotics refer to dead or inactivated living cells of probiotics and healthful metabolic products that are produced by the living cells of probiotics, respectively. Although the healthful, functional, nutritional, and immune benefits of probiotics and prebiotics are scientifically well established beyond a reasonable doubt, their potential biological roles against COVID-19 infection still warrant further clinical and laboratory investigation.}, } @article {pmid33424182, year = {2021}, author = {Agrawal, V and Yadav, SK and Agarwal, P and Sharma, D}, title = {Strategies for Optimizing the Use of PPE During Surgery in COVID-19 Pandemic: Rapid Scoping Review of Guidelines.}, journal = {The Indian journal of surgery}, volume = {}, number = {}, pages = {1-11}, doi = {10.1007/s12262-020-02713-x}, pmid = {33424182}, issn = {0972-2068}, abstract = {Personal protective equipment (PPE) plays a fundamental role in the prevention of spread to Health Care Professionals (HCP) ; especially in a surgical setting. This scoping review of surgery guidelines was performed to appraise the quality of appropriate PPE recommendations and propose a strategy to optimize the PPE usage. This rapid scoping review of guidelines on surgery during COVID-19 was conducted according to Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews protocol. Important databases were searched from January 1, 2020 to July 31, 2020, for relevant studies produced by a national/international academic association/organization, in English literature, using relevant keywords. Quality of evidence was graded according to GRADE guidelines. The searches yielded a total of 1725 studies, out of these 41 guidelines on surgery during COVID-19 matching with pre-defined criteria were evaluated. The level of evidence was uniformly rated "low," as assessed by GRADE guidelines and recommendations provided by them were mostly non-specific covering a narrow range of items. The crucial issue of optimization of PPE was not addressed at all. Economic implications demand optimization of PPE and conservation of resources. A simple decision-making algorithm addressing all the limitations of guidelines can be constructed, which allows HCPs to safeguard themselves and at the same time optimize/ conserving resources.}, } @article {pmid33424145, year = {2021}, author = {Rathi, H and Burman, V and Datta, SK and Rana, SV and Mirza, AA and Saha, S and Kumar, R and Naithani, M}, title = {Review on COVID-19 Etiopathogenesis, Clinical Presentation and Treatment Available with Emphasis on ACE2.}, journal = {Indian journal of clinical biochemistry : IJCB}, volume = {}, number = {}, pages = {1-20}, doi = {10.1007/s12291-020-00953-y}, pmid = {33424145}, issn = {0970-1915}, abstract = {In December 2019, Wuhan city in the Hubei province of China reported for the first time a cluster of patients infected with a novel coronavirus, since then there has been an outburst of this disease across the globe affecting millions of human inhabitants. Severe acute respiratory syndrome coronavirus type-2 (SARS-CoV-2), is a member of beta coronavirus family which upon exposure caused a highly infectious disease called novel coronavirus disease-2019 (COVID-19). COVID-19, a probably bat originated disease was declared by World Health Organization (WHO) as a global pandemic in March 2020. Since then, despite rigorous global containment and quarantine efforts, the disease has affected nearly 56,261,952 laboratory confirmed human population and caused deaths of over 1,349,506 lives worldwide. Virus passes in majority through respiratory droplets and then enters lung epithelial cells by binding to angiotensin converting enzyme 2 (ACE2) receptor and there it undergoes replication and targeting host cells causing severe pathogenesis. Majority of human population exposed to SARS-CoV-2 having fully functional immune system undergo asymptomatic infection while 5-10% are symptomatic and only 1-2% are critically affected and requires ventilation support. Older people or people with co-morbidities are severely affected by COVID-19. These categories of patients also display cytokine storm due to dysfunctional immune response which brutally destroys the affected organs and may lead to death in some. Real time PCR is still considered as standard method of diagnosis along with other serology, radiological and biochemical investigations. Till date, no specific validated medication is available for the treatment of COVID-19 patients. Thus, this review provides detailed knowledge about the different landscapes of disease incidence, etiopathogenesis, involvement of various organs, diagnostic criteria's and treatment guidelines followed for management of COVID-19 infection since its inception. In conclusion, extensive research to recognize novel pathways and their cross talk to combat this virus in precarious settings is our future positive hope.}, } @article {pmid33424125, year = {2021}, author = {Barbosa, JR and de Carvalho Junior, RN}, title = {Polysaccharides obtained from natural edible sources and their role in modulating the immune system: Biologically active potential that can be exploited against COVID-19.}, journal = {Trends in food science & technology}, volume = {108}, number = {}, pages = {223-235}, doi = {10.1016/j.tifs.2020.12.026}, pmid = {33424125}, issn = {0924-2244}, abstract = {Background: The global crisis caused by the outbreak of severe acute respiratory syndrome caused by the SARS-CoV-2 virus, better known as COVID-19, brought the need to improve the population's immunity. The foods rich in polysaccharides with immunomodulation properties are among the most highly rated to be used as immune response modulators. Thus, the use of polysaccharides obtained from food offers an innovative strategy to prevent serious side effects of viral infections.

Scope and approach: This review revisits the current studies on the pathophysiology of SARS-CoV-2, its characteristics, target cell interactions, and the possibility of using polysaccharides from functional foods as activators of the immune response. Several natural foods are explored for the possibility of being used to obtain polysaccharides with immunomodulatory potential. And finally, we address expectations for the use of polysaccharides in the development of potential therapies and vaccines.

Key findings and conclusions: The negative consequences of the SARS-CoV-2 pandemic across the world are unprecedented, thousands of lives lost, increasing inequalities, and incalculable economic losses. On the other hand, great scientific advances have been made regarding the understanding of the disease and forms of treatment. Polysaccharides, due to their characteristics, have the potential to be used as potential drugs with the ability to modulate the immune response. In addition, they can be used safely, as they have no toxic effects, are biocompatible and biodegradable. Finally, these biopolymers can still be used in the development of new therapies and vaccines.}, } @article {pmid33424033, year = {2021}, author = {Thulasiraman, V and Nandagopal, MSG and Kothakota, A}, title = {Need for a balance between short food supply chains and integrated food processing sectors: COVID-19 takeaways from India.}, journal = {Journal of food science and technology}, volume = {}, number = {}, pages = {1-9}, doi = {10.1007/s13197-020-04942-0}, pmid = {33424033}, issn = {0022-1155}, abstract = {India is an agrarian country with a long history of traditional food processing practices and Short food supply chains (SFSC). However, last few decades saw a huge investment and steady increase in large scale integrated food processing units to combat globalization, food security and India's export demands. Recent outbreak of COVID-19 has manifested the drawbacks in the existing production and supply chain system with a wide range of issues and enforces the need for a more balanced approach. This scenario can be commonly observed in many other agrarian developing nations. This article discusses various issues concerning the existing integrated food processing sectors such as high energy consumption, greenhouse gas emissions and food insecurity during disasters and pandemic outbreaks. Moreover, we emphasise a more sustainable approach with a better balance and understanding between SFSC and integrated food processing. A potential solution in this scenario would be, rejuvenating SFSC and traditional food processing approaches along with integrated food processing units. An approach of this kind, opens up new possibilities for a next generation process-supply system.}, } @article {pmid33423931, year = {2021}, author = {Culbertson, EM and Culotta, VC}, title = {Copper in infectious disease: Using both sides of the penny.}, journal = {Seminars in cell & developmental biology}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.semcdb.2020.12.003}, pmid = {33423931}, issn = {1096-3634}, abstract = {The transition metal Cu is an essential micronutrient that serves as a co-factor for numerous enzymes involved in redox and oxygen chemistry. However, Cu is also a potentially toxic metal, especially to unicellular microbes that are in direct contact with their environment. Since 400 BCE, Cu toxicity has been leveraged for its antimicrobial properties and even today, Cu based materials are being explored as effective antimicrobials against human pathogens spanning bacteria, fungi, and viruses, including the SARS-CoV-2 agent of the 2019-2020 pandemic. Given that Cu has the double-edged property of being both highly toxic and an essential micronutrient, it plays an active and complicated role at the host-pathogen interface. Humans have evolved methods of incorporating Cu into innate and adaptive immune processes and both sides of the penny (Cu toxicity and Cu as a nutrient) are employed. Here we review the evolution of Cu in biology and its multi-faceted roles in infectious disease, from the viewpoints of the microbial pathogens as well as the animal hosts they infect.}, } @article {pmid33423925, year = {2020}, author = {Jones, H and Gendre, A and Walshe, P and Walsh, M and Glynn, F and Lacy, P and Gaffney, R and McConn Walsh, R and Mamdouh, S and O'Rourke, J and Morgan, R and O'Brien, ME and Shine, N and Curley, GF and O'Neill, JP}, title = {The Royal College of surgeons multidisciplinary guidelines on elective tracheostomy insertion in COVID-19 ventilated patients.}, journal = {The surgeon : journal of the Royal Colleges of Surgeons of Edinburgh and Ireland}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.surge.2020.12.002}, pmid = {33423925}, issn = {1479-666X}, abstract = {BACKGROUND: The current COVID-19 pandemic has placed enormous strain on healthcare systems worldwide. Understanding of COVID-19 is rapidly evolving. Pneumonia associated with COVID-19 may lead to respiratory failure requiring mechanical ventilation. The rise in patients requiring mechanical ventilation may lead to an increase in tracheostomies being performed in patients with COVID-19. Performing tracheostomy in patients with active SARS-CoV-2 infection poses a number of challenges.

METHODS: These guidelines were written following multidisciplinary agreement between Otolaryngology, Head and Neck Surgery, Respiratory Medicine and the Department of Anaesthetics and Critical Care Medicine in the Royal College of Surgeons in Ireland. A literature review was performed and a guideline for elective tracheostomy insertion in patients with COVID-19 proposed.

CONCLUSION: The decision to perform tracheostomy in patients with COVID-19 should be undertaken by senior members of the multidisciplinary team. Steps should be taken to minimise risks to healthcare workers.}, } @article {pmid33423804, year = {2020}, author = {Arigondam, AK and Hakeem, AR and Reddy, MS and Rela, M}, title = {An Evidence-based Protocol for Minimising Thromboembolic Events in SARS-CoV-2 Infection.}, journal = {Archives of medical research}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.arcmed.2020.11.002}, pmid = {33423804}, issn = {1873-5487}, abstract = {Coronavirus Disease 2019 (COVID-19) is complicated by significant coagulopathy, that manifests in the form of both pulmonary artery microthromboses and systemic venous thromboembolism (VTE) leading to excess mortality. Dysregulated innate immune response in the lung due to viral-entry mediated angiotensin-I-converting enzyme 2 (ACE2) receptor downregulation causes endothelial injury in the pulmonary vasculature, inflammatory cytokine release, increased thrombin generation and impaired fibrinolysis. The inflammatory disease process, immobilization with prolonged hospital stay, hypoxia due to extensive lung injury and pre-existing comorbidities can contribute to thromboembolic episodes (TE). The observed risk for TE in COVID-19 is high despite anticoagulation, particularly in intensive care unit (ICU) patients. A high level of clinical suspicion, lower threshold for diagnostic imaging and aggressive early and extended thromboprophylaxis is indicated. The available evidence on the optimal strategies to prevent, diagnose, and treat VTE in patients with COVID-19 is heterogenous, but rapidly evolving. We propose an evidence-based, risk-stratified protocol in approaching the risk of TE episodes in COVID-19 patients.}, } @article {pmid33406806, year = {2021}, author = {Lopez-Fernandez, O}, title = {Emerging Health and Education Issues Related to Internet Technologies and Addictive Problems.}, journal = {International journal of environmental research and public health}, volume = {18}, number = {1}, pages = {}, pmid = {33406806}, issn = {1660-4601}, mesh = {Adult ; *Behavior, Addictive/epidemiology ; COVID-19 ; Humans ; *Internet ; Pandemics ; *Smartphone ; }, abstract = {This timely editorial paper outlines some of the main emerging research on technological topics on health and education approaches to Internet use-related problems before and during the beginning of coronavirus disease 2019 (COVID-19).

BACKGROUND: The aim is to provide a brief overview to facilitate a rapid comprehensive and practical approach to these new trends to promote research, interventions, education, and prevention.

METHODS: The rapid review includes an analysis of both health and education technologies studies on Internet use-related addiction problems included in the Special Issue "Internet and Smartphone Use-Related Addiction Health Problems: Treatment, Education and Research" to extract recent findings and a few reflections about the development of the field before and during the first wave of the COVID-19.

RESULTS: Main findings highlighted studies which tended to be empirical, with a relational type associating specific addictive problems with individual and a few contextual factors in adult populations. Psychometric studies about scales are prevalent, but predictive and mixed methods ones are starting to emerge, together with reviews about conceptualisation, measure, treatment, and prevention.

CONCLUSIONS: From the arrival of Internet, our societies have converged in a global culture which has impacted health and educational domains. Internet use-related addiction problems have globally emerged and common knowledge, advances, and strategies exist to overcome challenges which are starting to be tested, and prevention interest has arisen in a pandemic situation with global health problems holistically tackled.}, } @article {pmid33399741, year = {2020}, author = {Quiroz S, V and Amarales O, C}, title = {[Neurologic compromise in pediatric COVID-19 infection].}, journal = {Revista chilena de pediatria}, volume = {91}, number = {4}, pages = {614-619}, doi = {10.32641/rchped.vi91i4.2526}, pmid = {33399741}, issn = {0717-6228}, mesh = {Age Factors ; Angiotensin-Converting Enzyme 2/*metabolism ; COVID-19/*complications ; Child ; Encephalitis/virology ; Headache/virology ; Humans ; Nervous System Diseases/physiopathology/*virology ; Pediatrics ; }, abstract = {Coronavirus disease has extended its involvement beyond the respiratory system, with increasing reports of involving different systems, such as Nervous System. The neuroinvasive potential of this pathogen would be explained by its neurotropism given the presence of ACE2 receptors in the brain and spinal cord, in addition to the important systemic inflammatory involvement. The neu rological involvement due to infection is divided between the central nervous system, highlighting non-specific and mild symptoms such as dizziness and headache, as well as severe symptoms with encephalitis and cerebrovascular pathology, and the peripheral nervous system, which mainly pre sents anosmia, ageusia, and myositis. Clinical symptomatology in pediatric patients seems to be less than in adults, but there is a growing report in the literature regarding these findings. There fore, it is very important to have an adequate registry and anamnesis that allow early identification of neurological involvement.}, } @article {pmid33399724, year = {2020}, author = {Vega Toro, S and Novoa Sotta, F}, title = {[Ethical aspects of the COVID-19 pandemic in pediatrics].}, journal = {Revista chilena de pediatria}, volume = {91}, number = {4}, pages = {495-499}, doi = {10.32641/rchped.vi91i4.2466}, pmid = {33399724}, issn = {0717-6228}, mesh = {Ambulatory Care/organization & administration ; COVID-19/*epidemiology/therapy ; Child ; *Ethics, Medical ; Humans ; Patient Care/*ethics ; Pediatrics/ethics ; }, abstract = {The COVID-19 pandemic has highlighted different ethical dilemmas inday-to-day patient care. We analyzed the crisis caused by the pandemic and evaluate general aspects of ethical analysis in clinical practice and the context of the health crisis. In addition, we review some relevant ethical aspects related to the proportionality of the implemented measures, the palliative care management, and the challenges generated due to the lack of resources and professional duties, in relation to patients infected with COVID-19 and those chronic patients whose outpatient control is delayed.}, } @article {pmid33399646, year = {2020}, author = {Bórquez P, B and Luengo-Charath, MX and Anguita M, V and Bascuñán R, ML and Pacheco M, IM and Michaud Ch, P and Vacarezza Y, R}, title = {[The responsible use and dissemination of information in a pandemic: an ethical imperative].}, journal = {Revista chilena de pediatria}, volume = {91}, number = {5}, pages = {794-799}, doi = {10.32641/rchped.vi91i5.2420}, pmid = {33399646}, issn = {0717-6228}, mesh = {*Bioethical Issues ; Bioethics ; *COVID-19 ; Communication ; Decision Making ; Humans ; Information Dissemination/*ethics/legislation & jurisprudence ; }, abstract = {The current COVID-19 pandemic is producing an unprecedented impact in the different spheres of life, at the same time that it has highlighted the importance that the Bioethics discipline has in analyzing and deliberating of emerging ethical challenges, before making reasonable and prudent decisions. The management and communication of information on this crisis has not been properly addressed, where it is considered that its negative effects may lead not only to interfere with the communication channels with citizens but also affect the expected adherence of the population to the indications that they need to follow. This issue is especially complex when experiencing a period of information explosion, a phenomenon called 'infodemic' by the World Health Organization. This article, claiming the ethical and legal imperative to act responsibly in collecting, using, and disse minating the information that helps any authority that plays a social function, proposes a series of recommendations to achieve its effectiveness in practice.}, } @article {pmid33384971, year = {2020}, author = {Damiano, S and Sozio, C and La Rosa, G and Santillo, M}, title = {NOX-Dependent Signaling Dysregulation in Severe COVID-19: Clues to Effective Treatments.}, journal = {Frontiers in cellular and infection microbiology}, volume = {10}, number = {}, pages = {608435}, pmid = {33384971}, issn = {2235-2988}, mesh = {Angiotensin-Converting Enzyme 2/metabolism ; COVID-19/drug therapy/epidemiology/*metabolism ; Cardiovascular Diseases/enzymology/epidemiology ; Comorbidity ; Diabetes Mellitus, Type 2/enzymology/epidemiology ; Enzyme Activation ; Enzyme Inhibitors/pharmacology/therapeutic use ; Humans ; Metformin/pharmacology/therapeutic use ; NADPH Oxidase 2/physiology ; NADPH Oxidases/*physiology ; Obesity/enzymology/epidemiology ; Oxidation-Reduction ; *Oxidative Stress ; Proto-Oncogene Proteins/metabolism ; Reactive Oxygen Species/metabolism ; Receptors, G-Protein-Coupled/metabolism ; Receptors, Virus/metabolism ; Renin-Angiotensin System ; *SARS-CoV-2/physiology ; Signal Transduction/*physiology ; }, } @article {pmid33382727, year = {2020}, author = {Melluso, N and Bonaccorsi, A and Chiarello, F and Fantoni, G}, title = {Rapid detection of fast innovation under the pressure of COVID-19.}, journal = {PloS one}, volume = {15}, number = {12}, pages = {e0244175}, doi = {10.1371/journal.pone.0244175}, pmid = {33382727}, issn = {1932-6203}, mesh = {*COVID-19/diagnosis/epidemiology/prevention & control ; *COVID-19 Testing ; Humans ; *Pandemics ; *SARS-CoV-2 ; *Teleworking ; }, abstract = {Covid-19 has rapidly redefined the agenda of technological research and development both for academics and practitioners. If the medical scientific publication system has promptly reacted to this new situation, other domains, particularly in new technologies, struggle to map what is happening in their contexts. The pandemic has created the need for a rapid detection of technological convergence phenomena, but at the same time it has made clear that this task is impossible on the basis of traditional patent and publication indicators. This paper presents a novel methodology to perform a rapid detection of the fast technological convergence phenomenon that is occurring under the pressure of the Covid-19 pandemic. The fast detection has been performed thanks to the use of a novel source: the online blogging platform Medium. We demonstrate that the hybrid structure of this social journalism platform allows a rapid detection of innovation phenomena, unlike other traditional sources. The technological convergence phenomenon has been modelled through a network-based approach, analysing the differences of networks computed during two time periods (pre and post COVID-19). The results led us to discuss the repurposing of technologies regarding "Remote Control", "Remote Working", "Health" and "Remote Learning".}, } @article {pmid33351538, year = {2021}, author = {Haraf, RH and Faghy, MA and Carlin, B and Josephson, RA}, title = {The Physiological Impact of Masking Is Insignificant and Should Not Preclude Routine Use During Daily Activities, Exercise, and Rehabilitation.}, journal = {Journal of cardiopulmonary rehabilitation and prevention}, volume = {41}, number = {1}, pages = {1-5}, pmid = {33351538}, issn = {1932-751X}, mesh = {Activities of Daily Living ; COVID-19/*prevention & control ; Exercise/physiology ; Humans ; Lung/*physiology ; *Masks/adverse effects ; Rehabilitation ; Rest/physiology ; SARS-CoV-2 ; }, abstract = {PURPOSE: Masking has been employed as a strategy for reducing transmission of a variety of communicable diseases. With the outbreak of SARS-CoV-2, many countries have implemented mandatory public masking. However, the perceived impact of mask use on pulmonary function has been a deterrent to public compliance with recommendations. COVID-19 has shed light on the impact that comorbid cardiac and pulmonary conditions may have on disease severity. This knowledge has led to increased primary and secondary prevention efforts for which exercise and rehabilitation are central. The importance of safe methods of exercise while mitigating risk of viral transmission is paramount to global recovery from the pandemic and prevention of future outbreaks.

METHODS: We constructed a focused literature review of the impact of various masks on pulmonary function at rest and with exercise. This was then incorporated into recommendations for the integration of masks with exercise and rehabilitation in the COVID-19 era.

RESULTS: While there is a paucity of evidence, we identified the physiological effects of masking at rest and during exercise to be negligible. The perceived impact appears to be far greater than the measured impact, and increased frequency of mask use leads to a physiological and psychological adaptive response.

CONCLUSIONS: Masking during daily activities, exercise, and rehabilitation is safe in both healthy individuals and those with underlying cardiopulmonary disease. Rehabilitation participants should be reassured that the benefits of masking during COVID-19 far outweigh the risks, and increased frequency of mask use invokes adaptive responses that make long-term masking tolerable.}, } @article {pmid33337614, year = {2021}, author = {Harbeck, N}, title = {Risk-adapted adjuvant therapy of luminal early breast cancer in 2020.}, journal = {Current opinion in obstetrics & gynecology}, volume = {33}, number = {1}, pages = {53-58}, pmid = {33337614}, issn = {1473-656X}, mesh = {Aminopyridines/therapeutic use ; Antineoplastic Agents, Hormonal/*therapeutic use ; Benzimidazoles/therapeutic use ; Breast Neoplasms/*drug therapy/*genetics/pathology/surgery ; COVID-19/*epidemiology ; Female ; Gene Expression Profiling ; Humans ; Ki-67 Antigen/metabolism ; Neoadjuvant Therapy ; Piperazines/therapeutic use ; Protein Kinase Inhibitors/*therapeutic use ; Pyridines/therapeutic use ; Receptor, ErbB-2/genetics/metabolism ; Receptors, Estrogen/genetics/metabolism ; Receptors, Progesterone/genetics/metabolism ; Risk Assessment ; SARS-CoV-2 ; }, abstract = {PURPOSE OF REVIEW: The present review summarizes recent original publications addressing the topic of risk-adapted adjuvant therapy in early breast cancer (EBC). As neoadjuvant therapy has become a standard for triple negative and HER2+ EBC, it focusses on luminal EBC.

RECENT FINDINGS: Gene expression assays have become standard of care in luminal EBC, at least for patients with node negative disease. Two prospective randomized clinical trials, TAILORx (Oncotype DX) and MINDACT (MammaPrint) have presented additional analyses underlining the clinical utility of the tests. In times of COVID-19, immunohistochemically determined ER, PR, and Ki67 and early Ki67 response to endocrine therapy can be used to safely allocate patients for preoperative endocrine therapy and delay surgeries if resources are scarce. In patients with luminal high-risk disease, adding a CDK 4/6 inhibitor (abemaciclib) improves patient outcome already after short-term follow-up.

SUMMARY: Determination of recurrence risk will remain important in luminal EBC for optimal therapy decisions. In the future, risk-adapted treatment concepts will include decision making for chemotherapy but also for endocrine-based approaches.}, } @article {pmid33337399, year = {2020}, author = {Dehghani, F and Omidi, F and Yousefinejad, S and Taheri, E}, title = {The hierarchy of preventive measures to protect workers against the COVID-19 pandemic: A review.}, journal = {Work (Reading, Mass.)}, volume = {67}, number = {4}, pages = {771-777}, doi = {10.3233/WOR-203330}, pmid = {33337399}, issn = {1875-9270}, mesh = {Air Filters ; Architectural Accessibility ; COVID-19/*prevention & control/*transmission ; Humans ; Occupational Diseases/*prevention & control ; *Occupational Exposure ; Pandemics ; Personal Protective Equipment ; SARS-CoV-2 ; Ventilation/methods ; Workplace/*organization & administration ; }, abstract = {BACKGROUND: The high spread rate of coronaviruses, specifically severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has raised concerns about the spread of the disease in crowded occupational environments. The risk of occupational exposure to coronavirus depends on the type of industry and the nature of work. Currently, most countries are working for reactivating their economies and need to improve working conditions for a safe situation during the COVID-19 pandemic.

OBJECTIVE: The present work aimed to investigate the current engineering and administrative control measures, which are necessary to protect workers against COVID-19 in workplaces.

METHODS: The current strategies, including engineering control, administrative control, personal protective equipment, and their efficiencies, were reviewed and discussed.

RESULTS: Reviewing the literature indicated that a collection of control approaches should be implemented for an effective control of the virus. Control measures could be selected based on the risk of exposure to COVID-19. The results also revealed that relying solely on a specific control measure could not effectively control the outbreak.

CONCLUSION: In conclusion, employers and health professionals must continually monitor international and local guidelines to identify changes in recommendations to make their workplaces safer. Establishment of an expert team in any workplace for the implementation of more effective control measures is warranted, as well.}, } @article {pmid33332343, year = {2020}, author = {Nghiem, N and Mizdrak, A and Wilson, N}, title = {Increased unemployment from the COVID-19 pandemic, what might be the adverse impacts on cardiovascular disease in Aotearoa/New Zealand and how might this be prevented?.}, journal = {The New Zealand medical journal}, volume = {133}, number = {1526}, pages = {89-98}, pmid = {33332343}, issn = {1175-8716}, mesh = {Adult ; COVID-19/*epidemiology ; Cardiovascular Diseases/*epidemiology/mortality/*prevention & control ; Female ; *Health Policy ; Healthcare Disparities ; Humans ; Incidence ; Male ; Middle Aged ; New Zealand/epidemiology ; *Pandemics ; SARS-CoV-2 ; Unemployment/*statistics & numerical data ; }, abstract = {Despite success with eliminating the COVID-19 pandemic in Aotearoa New Zealand (at least to early August 2020), the response to the pandemic threat has resulted in a range of negative social and economic impacts, including job losses. Understanding the health consequences of these impacts will be increasingly important in the 'recovery' phase. This article contributes to this understanding by exploring the relationship between unemployment and cardiovascular disease (CVD)-a major contributor to health loss in Aotearoa New Zealand. We reviewed the literature about the impact of unemployment on CVD. The totality of the evidence suggested that increased unemployment arising from economic shocks is associated with increased CVD incidence, particularly for middle-aged men. Continued monitoring and active policy responses are required to prevent increases in CVD (and other health outcomes) as a result of the COVID-19 pandemic response. For example, quantifying the CVD-related health loss from pandemic-associated unemployment, along with the health costs and impact on health inequalities, could help with government decision-making to reduce CVD burdens. This could be via intensifying tobacco control, regulating the food supply (eg, to reduce salt/sodium levels), and improving uptake of CVD preventive medications such as statins and anti-hypertensives.}, } @article {pmid33326405, year = {2021}, author = {Syeda, HB and Syed, M and Sexton, KW and Syed, S and Begum, S and Syed, F and Prior, F and Yu, F}, title = {Role of Machine Learning Techniques to Tackle the COVID-19 Crisis: Systematic Review.}, journal = {JMIR medical informatics}, volume = {9}, number = {1}, pages = {e23811}, doi = {10.2196/23811}, pmid = {33326405}, issn = {2291-9694}, abstract = {BACKGROUND: SARS-CoV-2, the novel coronavirus responsible for COVID-19, has caused havoc worldwide, with patients presenting a spectrum of complications that have pushed health care experts to explore new technological solutions and treatment plans. Artificial Intelligence (AI)-based technologies have played a substantial role in solving complex problems, and several organizations have been swift to adopt and customize these technologies in response to the challenges posed by the COVID-19 pandemic.

OBJECTIVE: The objective of this study was to conduct a systematic review of the literature on the role of AI as a comprehensive and decisive technology to fight the COVID-19 crisis in the fields of epidemiology, diagnosis, and disease progression.

METHODS: A systematic search of PubMed, Web of Science, and CINAHL databases was performed according to PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines to identify all potentially relevant studies published and made available online between December 1, 2019, and June 27, 2020. The search syntax was built using keywords specific to COVID-19 and AI.

RESULTS: The search strategy resulted in 419 articles published and made available online during the aforementioned period. Of these, 130 publications were selected for further analyses. These publications were classified into 3 themes based on AI applications employed to combat the COVID-19 crisis: Computational Epidemiology, Early Detection and Diagnosis, and Disease Progression. Of the 130 studies, 71 (54.6%) focused on predicting the COVID-19 outbreak, the impact of containment policies, and potential drug discoveries, which were classified under the Computational Epidemiology theme. Next, 40 of 130 (30.8%) studies that applied AI techniques to detect COVID-19 by using patients' radiological images or laboratory test results were classified under the Early Detection and Diagnosis theme. Finally, 19 of the 130 studies (14.6%) that focused on predicting disease progression, outcomes (ie, recovery and mortality), length of hospital stay, and number of days spent in the intensive care unit for patients with COVID-19 were classified under the Disease Progression theme.

CONCLUSIONS: In this systematic review, we assembled studies in the current COVID-19 literature that utilized AI-based methods to provide insights into different COVID-19 themes. Our findings highlight important variables, data types, and available COVID-19 resources that can assist in facilitating clinical and translational research.}, } @article {pmid33325428, year = {2020}, author = {Prabhu, N and Issrani, R}, title = {Dilemma in the foreign lands during COVID-19: An outlook of expat health care professionals with a take on a social perspective.}, journal = {Work (Reading, Mass.)}, volume = {67}, number = {4}, pages = {779-782}, doi = {10.3233/WOR-203331}, pmid = {33325428}, issn = {1875-9270}, mesh = {*Attitude of Health Personnel ; COVID-19/*prevention & control/transmission ; Contact Tracing ; Dentists/psychology ; Education, Dental ; Education, Distance ; Foreign Professional Personnel/*psychology ; Humans ; Pandemics/*prevention & control ; Physical Distancing ; Quarantine ; SARS-CoV-2 ; Saudi Arabia/epidemiology ; Travel ; }, abstract = {BACKGROUND: The World Health Organization (WHO) has declared novel coronavirus (COVID-19) infection a global pandemic due to the fast transmission of this disease worldwide. To prevent and slow the transmission of this contagious illness, the public health officials of many affected countries scrambled to introduce measures aimed at controlling its spread. As a result, unprecedented interventions/measures, including strict contact tracing, quarantine of entire towns/cities, closing of borders and travel restrictions, have been implemented by most of the affected countries including the Kingdom of Saudi Arabia.

OBJECTIVES: The aim of this paper is to share health care professionals' perspectives who are experiencing COVID19 firsthand in a foreign land. In addition, the role of the Saudi governance to combat the current situation is also discussed.

DISCUSSION: Personal and previous experiences as related to Middle East respiratory syndrome coronavirus (MERS-CoV) by the authors has been compared to the current situation and how it affected our thoughts and management. A review of the evidence-based literature was conducted to investigate the demographics of the region; and to understand the awareness of the various tools that are available and how they were utilized in the present situation of pandemic.

CONCLUSIONS: Saudi Arabia has been challenged during the pandemic as are other countries.}, } @article {pmid33166178, year = {2021}, author = {Alsaied, T and Tremoulet, AH and Burns, JC and Saidi, A and Dionne, A and Lang, SM and Newburger, JW and de Ferranti, S and Friedman, KG}, title = {Review of Cardiac Involvement in Multisystem Inflammatory Syndrome in Children.}, journal = {Circulation}, volume = {143}, number = {1}, pages = {78-88}, doi = {10.1161/CIRCULATIONAHA.120.049836}, pmid = {33166178}, issn = {1524-4539}, mesh = {*COVID-19/blood/complications/drug therapy/epidemiology ; *Cardiovascular Diseases/blood/epidemiology/etiology ; Child ; Female ; Humans ; Immunoglobulins, Intravenous/therapeutic use ; Immunologic Factors/therapeutic use ; Male ; *SARS-CoV-2 ; Steroids/therapeutic use ; *Systemic Inflammatory Response Syndrome/blood/complications/drug therapy/epidemiology ; }, abstract = {Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with substantial cardiovascular implications. Although infection with SARS-CoV-2 is usually mild in children, some children later develop a severe inflammatory disease that can have manifestations similar to toxic shock syndrome or Kawasaki disease. This syndrome has been defined by the US Centers for Disease Control and Prevention as multisystem inflammatory syndrome in children. Although the prevalence is unknown, >600 cases have been reported in the literature. Multisystem inflammatory syndrome in children appears to be more common in Black and Hispanic children in the United States. Multisystem inflammatory syndrome in children typically occurs a few weeks after acute infection and the putative etiology is a dysregulated inflammatory response to SARS-CoV-2 infection. Persistent fever and gastrointestinal symptoms are the most common symptoms. Cardiac manifestations are common, including ventricular dysfunction, coronary artery dilation and aneurysms, arrhythmia, and conduction abnormalities. Severe cases can present as vasodilatory or cardiogenic shock requiring fluid resuscitation, inotropic support, and in the most severe cases, mechanical ventilation and extracorporeal membrane oxygenation. Empirical treatments have aimed at reversing the inflammatory response using immunomodulatory medications. Intravenous immunoglobulin, steroids, and other immunomodulatory agents have been used frequently. Most patients recover within days to a couple of weeks and mortality is rare, although the medium- and long-term sequelae, particularly cardiovascular complications, are not yet known. This review describes the published data on multisystem inflammatory syndrome in children, focusing on cardiac complications, and provides clinical considerations for cardiac evaluation and follow-up.}, } @article {pmid33031017, year = {2020}, author = {Østergaard, L}, title = {Blood flow, capillary transit times, and tissue oxygenation: the centennial of capillary recruitment.}, journal = {Journal of applied physiology (Bethesda, Md. : 1985)}, volume = {129}, number = {6}, pages = {1413-1421}, doi = {10.1152/japplphysiol.00537.2020}, pmid = {33031017}, issn = {1522-1601}, support = {ARCADIA II,grant no. 0026167//VELUX Foundation/International ; grant no. R310-2018-3455//Lundbeckfonden (Lundbeck Foundation)/International ; }, mesh = {Alzheimer Disease/blood/physiopathology ; Anemia, Sickle Cell/blood/physiopathology ; Animals ; Blood Flow Velocity ; Capillaries/*physiology ; Cardiovascular Diseases/blood/physiopathology ; Diffusion ; Humans ; Hypoxia/blood/physiopathology ; *Microcirculation ; *Models, Cardiovascular ; Oxygen/*blood ; *Oxygen Consumption ; Regional Blood Flow ; Time Factors ; }, abstract = {The transport of oxygen between blood and tissue is limited by blood's capillary transit time, understood as the time available for diffusion exchange before blood returns to the heart. If all capillaries contribute equally to tissue oxygenation at all times, this physical limitation would render vasodilation and increased blood flow insufficient means to meet increased metabolic demands in the heart, muscle, and other organs. In 1920, Danish physiologist August Krogh was awarded the Nobel Prize in Physiology or Medicine for his mathematical and quantitative, experimental demonstration of a solution to this conceptual problem: capillary recruitment, the active opening of previously closed capillaries to meet metabolic demands. Today, capillary recruitment is still mentioned in textbooks. When we suspect symptoms might represent hypoxia of a vascular origin, however, we search for relevant, flow-limiting conditions in our patients and rarely ascribe hypoxia or hypoxemia to short capillary transit times. This review describes how natural changes in capillary transit-time heterogeneity (CTH) and capillary hematocrit (HCT) across open capillaries during blood flow increases can account for a match of oxygen availability to metabolic demands in normal tissue. CTH and HCT depend on a number of factors: on blood properties, including plasma viscosity, the number, size, and deformability of blood cells, and blood cell interactions with capillary endothelium; on anatomical factors including glycocalyx, endothelial cells, basement membrane, and pericytes that affect the capillary diameter; and on any external compression. The review describes how risk factor- and disease-related changes in CTH and HCT interfere with flow-metabolism coupling and tissue oxygenation and discusses whether such capillary dysfunction contributes to vascular disease pathology.}, } @article {pmid33423388, year = {2021}, author = {Belančić, A and Kresović, A and Troskot Dijan, M}, title = {Glucagon-like peptide-1 receptor agonists in the era of COVID-19: Friend or foe?.}, journal = {Clinical obesity}, volume = {}, number = {}, pages = {e12439}, doi = {10.1111/cob.12439}, pmid = {33423388}, issn = {1758-8111}, abstract = {The aim of the present manuscript is to discuss on potential pros and cons of glucagon-like peptide-1 receptor agonists (GLP-1RAs) as glucose-lowering agents during COVID-19 pandemic, and what is more to evaluate them as potential candidates for the treatment of patients, affected by COVID-19 infection, with or even without diabetes mellitus type 2. Besides being important glucose-lowering agents, GLP-1RAs pose promising anti-inflammatory and anti-obesogenic properties, pulmonary protective effects, as well as beneficial impact on gut microbiome composition. Hence, taking everything previously mentioned into consideration, GLP-1RAs seem to be potential candidates for the treatment of patients, affected by COVID-19 infection, with or even without type 2 diabetes mellitus, as well as excellent antidiabetic (glucose-lowering) agents during COVID-19 pandemic times.}, } @article {pmid33422642, year = {2021}, author = {Al-Abdouh, A and Bizanti, A and Barbarawi, M and Jabri, A and Kumar, A and Fashanu, OE and Khan, SU and Zhao, D and Antar, AAR and Michos, ED}, title = {Remdesivir for the treatment of COVID-19: A systematic review and meta-analysis of randomized controlled trials.}, journal = {Contemporary clinical trials}, volume = {}, number = {}, pages = {106272}, doi = {10.1016/j.cct.2021.106272}, pmid = {33422642}, issn = {1559-2030}, abstract = {BACKGROUND: The nucleotide analogue prodrug remdesivir was among the first antiviral therapies to be tested in randomized controlled trials (RCTs) for COVID-19. We performed a meta-analysis to understand efficacy and safety.

METHODS: We searched PubMed, EMBASE, Cochrane library, and ClinicalTrials.gov databases (from January 1, 2020 to November 5, 2020). We included RCTs comparing the efficacy and safety of remdesivir to control/placebo in COVID-19. Two independent investigators abstracted data, assessed the quality of evidence, and rated the certainty of evidence.

RESULTS: A total of 4 RCTs with 7334 patients with COVID-19 were included. At a follow-up of 28-29 days from randomization, very low certainty evidence showed that use of remdesivir compared with control group (placebo and/or standard of care) was not associated with a significant decrease in time to clinical improvement (standardized mean difference -0.80 day; [CI, -2.12, 0.53]). However, moderate certainty of evidence showed that remdesivir was associated with higher rates of recovered patients (risk difference [RD] 0.07 [0.05, 0.08]) and discharged patients (RD 0.07 [0.03, 0.11]) and lower rates of developing serious adverse events (RD -0.05 [-0.10, -0.01]) compared with control. Moderate and very low certainty of evidence showed there was no significant difference in deaths at 28-29 days follow-up (RD -0.01 [-0.03, 0.01]) and developing any adverse events (RD 0.01 [-0.17, 0.19]) between both groups, respectively.

CONCLUSION: Patients given remdesivir are more likely to demonstrate recovery and were associated with higher rates of hospital discharge, but not with significant reduction in mean time to clinical improvement or mortality.}, } @article {pmid33422421, year = {2021}, author = {Dhiman, R and Rakheja, V and Saxena, R}, title = {An Ophthalmologist's Insight Into The Viral Pandemics.}, journal = {Journal of optometry}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.optom.2020.10.005}, pmid = {33422421}, issn = {1989-1342}, abstract = {In recent past, major pandemics and epidemics have occurred due to the emergence and resurgence of the novel strains of viruses like Influenza [HINI-A "Spanish Flu", H1N1-Novel A "Swine flu"], Corona [Middle East Respiratory Syndrome (MERS), Severe acute respiratory syndrome (SARS-CoV-1, SARS-CoV-2)] and Ebola virus [Ebola virus disease]. These infectious diseases may have several ocular manifestations and rarely might be the presenting symptom of the underlying disease. The eyes can act as a portal of entry and/or route of viral transmission for these pathogens. Therefore, an ophthalmologist/optometrist needs to act with ample preparedness and responsibility. Establishing a standard of care in ophthalmic practice by modifying the conventional examination techniques and adopting tele-ophthalmology model to triage the patients can control the community spread of the disease. This article aims to elucidate the ocular manifestations in these pandemics and measures that should be adopted in ophthalmic practice to prevent the disease transmission.}, } @article {pmid33421735, year = {2020}, author = {Aapro, M and Lyman, GH and Bokemeyer, C and Rapoport, BL and Mathieson, N and Koptelova, N and Cornes, P and Anderson, R and Gascón, P and Kuderer, NM}, title = {Supportive care in patients with cancer during the COVID-19 pandemic.}, journal = {ESMO open}, volume = {6}, number = {1}, pages = {100038}, doi = {10.1016/j.esmoop.2020.100038}, pmid = {33421735}, issn = {2059-7029}, abstract = {Cancer care has been profoundly impacted by the global pandemic of severe acute respiratory syndrome coronavirus 2 disease (coronavirus disease 2019, COVID-19), resulting in unprecedented challenges. Supportive care is an essential component of cancer treatment, seeking to prevent and manage chemotherapy complications such as febrile neutropenia, anaemia, thrombocytopenia/bleeding, thromboembolic events and nausea/vomiting, all of which are common causes of hospitalisation. These adverse events are an essential consideration under routine patient management, but particularly so during a pandemic, a setting in which clinicians aim to minimise patients' risk of infection and need for hospital visits. Professional medical oncology societies have been providing updated guidelines to support health care professionals with the management, treatment and supportive care needs of their patients with cancer under the threat of COVID-19. This paper aims to review the recommendations made by the most prominent medical oncology societies for devising and modifying supportive care strategies during the pandemic.}, } @article {pmid33421734, year = {2021}, author = {Jansen van Vuren, E and Steyn, SF and Brink, CB and Möller, M and Viljoen, FP and Harvey, BH}, title = {The neuropsychiatric manifestations of COVID-19: Interactions with psychiatric illness and pharmacological treatment.}, journal = {Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie}, volume = {135}, number = {}, pages = {111200}, doi = {10.1016/j.biopha.2020.111200}, pmid = {33421734}, issn = {1950-6007}, abstract = {The recent outbreak of the corona virus disease (COVID-19) has had major global impact. The relationship between severe acute respiratory syndrome coronavirus (SARS-CoV-2) infection and psychiatric diseases is of great concern, with an evident link between corona virus infections and various central and peripheral nervous system manifestations. Unmitigated neuro-inflammation has been noted to underlie not only the severe respiratory complications of the disease but is also present in a range of neuro-psychiatric illnesses. Several neurological and psychiatric disorders are characterized by immune-inflammatory states, while treatments for these disorders have distinct anti-inflammatory properties and effects. With inflammation being a common contributing factor in SARS-CoV-2, as well as psychiatric disorders, treatment of either condition may affect disease progression of the other or alter response to pharmacological treatment. In this review, we elucidate how viral infections could affect pre-existing psychiatric conditions and how pharmacological treatments of these conditions may affect overall progress and outcome in the treatment of SARS-CoV-2. We address whether any treatment-induced benefits and potential adverse effects may ultimately affect the overall treatment approach, considering the underlying dysregulated neuro-inflammatory processes and potential drug interactions. Finally, we suggest adjunctive treatment options for SARS-CoV-2-associated neuro-psychiatric symptoms.}, } @article {pmid33421580, year = {2021}, author = {Eyal, N and Lipsitch, M}, title = {Testing SARS-CoV-2 vaccine efficacy through deliberate natural viral exposure.}, journal = {Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.cmi.2020.12.032}, pmid = {33421580}, issn = {1469-0691}, abstract = {BACKGROUND: A vaccine trial with a conventional challenge design can be very fast once it starts, but it requires a long prior process, in part, to grow and standardize challenge virus in the laboratory. This detracts somewhat from its overall promise for accelerated efficacy testing of SARS-CoV-2 vaccine candidates, and from the ability of developing countries and small companies to conduct it.

OBJECTIVES: We set out to identify a challenge design that avoids this part of the long prior process.

SOURCES: Literature in trial design (including a proof of concept flu challenge trial by B. Killingley et al), vaccinology, medical ethics, and various aspects of COVID response.

CONTENT: A challenge design with deliberate natural viral exposure avoids the need to grow culture. This new design is described and compared both to a conventional challenge design and to a conventional phase III field trial. In comparison, the propsed design has ethical, scientific, and feasibility strengths.

IMPLICATIONS: The proposed new design should be considered for future vaccine trials.}, } @article {pmid33421475, year = {2021}, author = {Pollet, J and Chen, WH and Strych, U}, title = {Recombinant protein vaccines, a proven approach against coronavirus pandemics.}, journal = {Advanced drug delivery reviews}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.addr.2021.01.001}, pmid = {33421475}, issn = {1872-8294}, abstract = {With the COVID-19 pandemic now ongoing for close to a year, people all over the world are still waiting for a vaccine to become available. The initial focus of accelerated global research and development efforts to bring a vaccine to market as soon as possible was on novel platform technologies that promised speed but had limited history in the clinic. In contrast, recombinant protein vaccines, with numerous examples in the clinic for many years, missed out on the early wave of investments from government and industry. Emerging data are now surfacing suggesting that recombinant protein vaccines indeed might offer an advantage or complement to the nucleic acid or viral vector vaccines that will likely reach the clinic faster. Here, we summarize the current public information on the nature and on the development status of recombinant subunit antigens and adjuvants targeting SARS-CoV-2 infections.}, } @article {pmid33421462, year = {2021}, author = {Mazilu, L and Katsiki, N and Nikolouzakis, TK and Aslanidis, MI and Lazopoulos, G and Kouretas, D and Tsatsakis, A and Suceveanu, AI and Stoian, AP and Parepa, IR and Voinea, F and Suceveanu, AP and Arsene, AL and Velescu, BȘ and Vesa, C and Nitipir, C}, title = {THROMBOSIS AND HAEMOSTASIS CHALLENGES IN COVID-19 - THERAPEUTIC PERSPECTIVES OF HEPARIN AND TISSUE-TYPE PLASMINOGEN ACTIVATOR AND POTENTIAL TOXICOLOGICAL REACTIONS-A MINI REVIEW.}, journal = {Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association}, volume = {}, number = {}, pages = {111974}, doi = {10.1016/j.fct.2021.111974}, pmid = {33421462}, issn = {1873-6351}, abstract = {The coronavirus disease (COVID)-19 pandemic is a major challenge for the health systems worldwide. Acute respiratory distress syndrome (ARDS), is one of the most common complications of the COVID-19 infection. The activation of the coagulation system plays an important role in the pathogenesis of ARDS. The development of lung coagulopathy involves thrombin generation and fibrinolysis inhibition. Unfractionated heparin and its recently introduced counterpart low molecular weight heparin (LMWH), are widely used anticoagulants with a variety of clinical indications allowing for limited and manageable physio-toxicologic side effects while the use of protamine sulfate, heparin's effective antidote, has made their use even safer. Tissue-type plasminogen activator (tPA) is approved as intravenous thrombolytic treatment. The present narrative review discusses the use of heparin and tPA in the treatment of COVID-19-induced ARDS and their related potential physio-toxicologic side effects. The article is a quick review of articles on anticoagulation in COVID infection and the potential toxicologic reactions associated with these drugs.}, } @article {pmid33421440, year = {2021}, author = {Napoli, C and Benincasa, G and Criscuolo, C and Faenza, M and Liberato, C and Rusciano, M}, title = {Immune reactivity during COVID-19: Implications for treatment.}, journal = {Immunology letters}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.imlet.2021.01.001}, pmid = {33421440}, issn = {1879-0542}, abstract = {Clinical symptoms of COVID-19 include fever, cough, and fatigue which may progress to acute respiratory distress syndrome (ARDS). The main hematological laboratory findings associated with the severe form of disease are represented by lymphopenia and eosinopenia which mostly occur in the elderly population characterized by cardiovascular comorbidities and immunosenescence. Besides, increased levels of D-dimer, procalcitonin, and C reactive protein (CRP) seem to be powerful prognostic biomarkers helping to predict the onset of coagulopathy. The host immune response to COVID-19 can lead to an aberrant inflammatory response or "cytokine storm" which contributes to the severity of illness. At immunological level, patients affected by a severe form of COVID-19 show poor clinical trajectories characterized by differential "immunotypes" for which T cell response seems to play a critical role in understanding pathogenic mechanisms of disease. Also, patients with mild to severe COVID-19 displayed macrophage activation syndrome (MAS), very low human leukocyte antigen D related (HLA-DR) expression with a parallel reduction of CD04+ lymphocytes, CD19 lymphocytes, and natural killer (NK) cells. Corticosteroids resulted the best therapy for the immune dysregulation whereas repurposing of tocilizumab (IL-6 receptor antagonist) did not provide a benefit in patients with COVID-19. Besides, anticoagulative therapy is associated with reduced in-hospital mortality and need of intubation among COVID-19 patients. Also, the use of intravenous immunoglobulin (IVIG) and passive immunotherapy with convalescent plasma need to be validated in large controlled clinical trials. In this review, we summarize the main hematological parameters with a prognostic value in COVID-19 and the bases of immunological reactivity during COVID-19, with a focus on ongoing clinical trials evaluating immune targets as possible therapeutic strategies.}, } @article {pmid33421351, year = {2021}, author = {Nazari, S and Azari Jafari, A and Mirmoeeni, S and Sadeghian, S and Heidari, ME and Sadeghian, S and Assarzadegan, F and Puormand, SM and Ebadi, H and Fathi, D and Dalvand, S}, title = {Central nervous system manifestations in COVID-19 patients: A systematic review and meta-analysis.}, journal = {Brain and behavior}, volume = {}, number = {}, pages = {e02025}, doi = {10.1002/brb3.2025}, pmid = {33421351}, issn = {2162-3279}, abstract = {BACKGROUND: At the end of December 2019, a novel respiratory infection, initially reported in China, known as COVID-19 initially reported in China, and later known as COVID-19, led to a global pandemic. Despite many studies reporting respiratory infections as the primary manifestations of this illness, an increasing number of investigations have focused on the central nervous system (CNS) manifestations in COVID-19. In this study, we aimed to evaluate the CNS presentations in COVID-19 patients in an attempt to identify the common CNS features and provide a better overview to tackle this new pandemic.

METHODS: In this systematic review and meta-analysis, we searched PubMed, Web of Science, Ovid, EMBASE, Scopus, and Google Scholar. Included studies were publications that reported the CNS features between 1 January 2020 and 20 April 2020. The data of selected studies were screened and extracted independently by four reviewers. Extracted data analyzed by using STATA statistical software. The study protocol registered with PROSPERO (CRD42020184456).

RESULTS: Of 2,353 retrieved studies, we selected 64 studies with 11,687 patients after screening. Most of the studies were conducted in China (58 studies). The most common CNS symptom of COVID-19 was headache (8.69%, 95%CI: 6.76%-10.82%), dizziness (5.94%, 95%CI: 3.66%-8.22%), and impaired consciousness (1.90%, 95%CI: 1.0%-2.79%).

CONCLUSIONS: The growing number of studies has reported COVID-19, CNS presentations as remarkable manifestations that happen. Hence, understanding the CNS characteristics of COVID-19 can help us for better diagnosis and ultimately prevention of worse outcomes.}, } @article {pmid33421347, year = {2021}, author = {Rezaee, H and Pourkarim, F and Pourtaghi-Anvarian, S and Entezari-Maleki, T and Asvadi-Kermani, T and Nouri-Vaskeh, M}, title = {Drug-drug interactions with candidate medications used for COVID-19 treatment: An overview.}, journal = {Pharmacology research & perspectives}, volume = {9}, number = {1}, pages = {e00705}, doi = {10.1002/prp2.705}, pmid = {33421347}, issn = {2052-1707}, abstract = {Drug-drug interaction (DDI) is a common clinical problem that has occurred as a result of the concomitant use of multiple drugs. DDI may occur in patients under treatment with medications used for coronavirus disease 2019 (COVID-19; i.e., chloroquine, lopinavir/ritonavir, ribavirin, tocilizumab, and remdesivir) and increase the risk of serious adverse reactions such as QT-prolongation, retinopathy, increased risk of infection, and hepatotoxicity. This review focuses on summarizing DDIs for candidate medications used for COVID-19 in order to minimize the adverse reactions.}, } @article {pmid33420917, year = {2021}, author = {Lander, MM and Aldweib, N and Abraham, WT}, title = {Wireless Hemodynamic Monitoring in Patients with Heart Failure.}, journal = {Current heart failure reports}, volume = {}, number = {}, pages = {}, pmid = {33420917}, issn = {1546-9549}, abstract = {PURPOSE OF REVIEW: Wireless hemodynamic monitoring in heart failure patients allows for volume assessment without the need for physical exam. Data obtained from these devices is used to assist patient management and avoid heart failure hospitalizations. In this review, we outline the various devices, mechanisms they utilize, and effects on heart failure patients.

RECENT FINDINGS: New applications of these devices to specific populations may expand the pool of patients that may benefit. In the COVID-19 pandemic with a growing emphasis on virtual visits, remote monitoring can add vital ancillary data. Wireless hemodynamic monitoring with a pulmonary artery pressure sensor is a highly effective and safe method to assess for worsening intracardiac pressures that may predict heart failure events, giving lead time that is valuable to keep patients optimized. Implantation of this device has been found to improve outcomes in heart failure patients regardless of preserved or reduced ejection fraction.}, } @article {pmid33420420, year = {2021}, author = {Dorn, SD}, title = {Backslide or forward progress? Virtual care at U.S. healthcare systems beyond the COVID-19 pandemic.}, journal = {NPJ digital medicine}, volume = {4}, number = {1}, pages = {6}, pmid = {33420420}, issn = {2398-6352}, abstract = {The COVID-19 pandemic forced most U.S. healthcare systems to quickly pivot to virtual care. However, since peaking in late April, care has largely shifted back to in-person. Health systems are now challenged to further develop and integrate useful, usable, and sustainable virtual care tools into their broader care model in ways that benefit their organizations and the communities they serve.}, } @article {pmid33419929, year = {2021}, author = {Reñosa, MDC and Mwamba, C and Meghani, A and West, NS and Hariyani, S and Ddaaki, W and Sharma, A and Beres, LK and McMahon, S}, title = {Selfie consents, remote rapport, and Zoom debriefings: collecting qualitative data amid a pandemic in four resource-constrained settings.}, journal = {BMJ global health}, volume = {6}, number = {1}, pages = {}, doi = {10.1136/bmjgh-2020-004193}, pmid = {33419929}, issn = {2059-7908}, abstract = {In-person interactions have traditionally been the gold standard for qualitative data collection. The COVID-19 pandemic required researchers to consider if remote data collection can meet research objectives, while retaining the same level of data quality and participant protections. We use four case studies from the Philippines, Zambia, India and Uganda to assess the challenges and opportunities of remote data collection during COVID-19. We present lessons learned that may inform practice in similar settings, as well as reflections for the field of qualitative inquiry in the post-COVID-19 era. Key challenges and strategies to overcome them included the need for adapted researcher training in the use of technologies and consent procedures, preparation for abbreviated interviews due to connectivity concerns, and the adoption of regular researcher debriefings. Participant outreach to allay suspicions ranged from communicating study information through multiple channels to highlighting associations with local institutions to boost credibility. Interviews were largely successful, and contained a meaningful level of depth, nuance and conviction that allowed teams to meet study objectives. Rapport still benefitted from conventional interviewer skills, including attentiveness and fluency with interview guides. While differently abled populations may encounter different barriers, the included case studies, which varied in geography and aims, all experienced more rapid recruitment and robust enrollment. Reduced in-person travel lowered interview costs and increased participation among groups who may not have otherwise attended. In our view, remote data collection is not a replacement for in-person endeavours, but a highly beneficial complement. It may increase accessibility and equity in participant contributions and lower costs, while maintaining rich data collection in multiple study target populations and settings.}, } @article {pmid33419869, year = {2021}, author = {Zimmerman, KO and Akinboyo, IC and Brookhart, MA and Boutzoukas, AE and McGann, K and Smith, MJ and Maradiaga Panayotti, G and Armstrong, SC and Bristow, H and Parker, D and Zadrozny, S and Weber, DJ and Benjamin, DK and , }, title = {Incidence and Secondary Transmission of SARS-CoV-2 Infections in Schools.}, journal = {Pediatrics}, volume = {}, number = {}, pages = {}, doi = {10.1542/peds.2020-048090}, pmid = {33419869}, issn = {1098-4275}, } @article {pmid33419786, year = {2021}, author = {Salmasian, H and Beloff, J and Pimentel, MP and Resnick, A and Rhee, C and Baker, MA and Klompas, M}, title = {Rethinking standardised infection rates and risk adjustment in the COVID-19 era.}, journal = {BMJ quality & safety}, volume = {}, number = {}, pages = {}, doi = {10.1136/bmjqs-2020-012074}, pmid = {33419786}, issn = {2044-5423}, } @article {pmid33419456, year = {2021}, author = {Leasa, D and Cameron, P and Honarmand, K and Mele, T and Bosma, KJ and , }, title = {Knowledge translation tools to guide care of non-intubated patients with acute respiratory illness during the COVID-19 Pandemic.}, journal = {Critical care (London, England)}, volume = {25}, number = {1}, pages = {22}, pmid = {33419456}, issn = {1466-609X}, abstract = {Providing optimal care to patients with acute respiratory illness while preventing hospital transmission of COVID-19 is of paramount importance during the pandemic; the challenge lies in achieving both goals simultaneously. Controversy exists regarding the role of early intubation versus use of non-invasive respiratory support measures to avoid intubation. This review summarizes available evidence and provides a clinical decision algorithm with risk mitigation techniques to guide clinicians in care of the hypoxemic, non-intubated, patient during the COVID-19 pandemic. Although aerosolization of droplets may occur with aerosol-generating medical procedures (AGMP), including high flow nasal oxygen and non-invasive ventilation, the risk of using these AGMP is outweighed by the benefit in carefully selected patients, particularly if care is taken to mitigate risk of viral transmission. Non-invasive support measures should not be denied for conditions where previously proven effective and may be used even while there is suspicion of COVID-19 infection. Patients with de novo acute respiratory illness with suspected/confirmed COVID-19 may also benefit. These techniques may improve oxygenation sufficiently to allow some patients to avoid intubation; however, patients must be carefully monitored for signs of increased work of breathing. Patients showing signs of clinical deterioration or high work of breathing not alleviated by non-invasive support should proceed promptly to intubation and invasive lung protective ventilation strategy. With adherence to these principles, risk of viral spread can be minimized.}, } @article {pmid33419216, year = {2021}, author = {McClymont, H and Hu, W}, title = {Weather Variability and COVID-19 Transmission: A Review of Recent Research.}, journal = {International journal of environmental research and public health}, volume = {18}, number = {2}, pages = {}, doi = {10.3390/ijerph18020396}, pmid = {33419216}, issn = {1660-4601}, abstract = {Weather and climate play a significant role in infectious disease transmission, through changes to transmission dynamics, host susceptibility and virus survival in the environment. Exploring the association of weather variables and COVID-19 transmission is vital in understanding the potential for seasonality and future outbreaks and developing early warning systems. Previous research examined the effects of weather on COVID-19, but the findings appeared inconsistent. This review aims to summarize the currently available literature on the association between weather and COVID-19 incidence and provide possible suggestions for developing weather-based early warning system for COVID-19 transmission. Studies eligible for inclusion used ecological methods to evaluate associations between weather (i.e., temperature, humidity, wind speed and rainfall) and COVID-19 transmission. The review showed that temperature was reported as significant in the greatest number of studies, with COVID-19 incidence increasing as temperature decreased and the highest incidence reported in the temperature range of 0-17 °C. Humidity was also significantly associated with COVID-19 incidence, though the reported results were mixed, with studies reporting positive and negative correlation. A significant interaction between humidity and temperature was also reported. Wind speed and rainfall results were not consistent across studies. Weather variables including temperature and humidity can contribute to increased transmission of COVID-19, particularly in winter conditions through increased host susceptibility and viability of the virus. While there is less indication of an association with wind speed and rainfall, these may contribute to behavioral changes that decrease exposure and risk of infection. Understanding the implications of associations with weather variables and seasonal variations for monitoring and control of future outbreaks is essential for early warning systems.}, } @article {pmid33419194, year = {2021}, author = {Wang, X and Wong, YD and Yuen, KF}, title = {Rise of 'Lonely' Consumers in the Post-COVID-19 Era: A Synthesised Review on Psychological, Commercial and Social Implications.}, journal = {International journal of environmental research and public health}, volume = {18}, number = {2}, pages = {}, doi = {10.3390/ijerph18020404}, pmid = {33419194}, issn = {1660-4601}, abstract = {Loneliness is a pervasive problem recognised as a serious social issue, and the prevailing COVID-19 pandemic has exacerbated loneliness to greater prominence and concern. We expect a rise of a massive group of 'lonely' consumers who are deeply entrenched in the social isolation caused by COVID-19. There is an urgent need to revisit the phenomenon of lonely consumers to better prepare academic researchers, public policy makers and commercial managers in the post-COVID-19 era. Thus, this study conducts a synthesised review on past studies of lonely consumers. Based on an inductive analysis of 56 articles, 74 key themes are identified. These key themes are further categorised into five major clusters by way of a co-occurrence network analysis. Respectively, the five clusters address the psychological implications related to the dynamics between nonhuman attachment and consumers' loneliness, the commercial implications related to the paradoxical motivations of affiliation and self-affirmation in product selection and the dual information processing mechanism in response to advertisement appeals, and the social implications related to consumers' well-being in an ageing society and the anthropomorphic companionship in a virtual world. A list of research questions is proposed that concludes the review study.}, } @article {pmid33419142, year = {2021}, author = {Delikhoon, M and Guzman, MI and Nabizadeh, R and Norouzian Baghani, A}, title = {Modes of Transmission of Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) and Factors Influencing on the Airborne Transmission: A Review.}, journal = {International journal of environmental research and public health}, volume = {18}, number = {2}, pages = {}, doi = {10.3390/ijerph18020395}, pmid = {33419142}, issn = {1660-4601}, abstract = {The multiple modes of SARS-CoV-2 transmission including airborne, droplet, contact, and fecal-oral transmissions that cause coronavirus disease 2019 (COVID-19) contribute to a public threat to the lives of people worldwide. Herein, different databases are reviewed to evaluate modes of transmission of SARS-CoV-2 and study the effects of negative pressure ventilation, air conditioning system, and related protection approaches of this virus. Droplet transmission was commonly reported to occur in particles with diameter >5 µm that can quickly settle gravitationally on surfaces (1-2 m). Instead, fine and ultrafine particles (airborne transmission) can stay suspended for an extended period of time (≥2 h) and be transported further, e.g., up to 8 m through simple diffusion and convection mechanisms. Droplet and airborne transmission of SARS-CoV-2 can be limited indoors with adequate ventilation of rooms, by routine disinfection of toilets, using negative pressure rooms, using face masks, and maintaining social distancing. Other preventive measures recommended include increasing the number of screening tests of suspected carriers of SARS-CoV-2, reducing the number of persons in a room to minimize sharing indoor air, and monitoring people's temperature before accessing a building. The work reviews a body of literature supporting the transmission of SARS-CoV-2 through air, causing COVID-19 disease, which requires coordinated worldwide strategies.}, } @article {pmid33418463, year = {2020}, author = {Stewart, T and Lambourne, J and Thorp-Jones, D and Thomas, DW}, title = {Implementation of early management of iron deficiency in pregnancy during the SARS-CoV-2 pandemic.}, journal = {European journal of obstetrics, gynecology, and reproductive biology}, volume = {258}, number = {}, pages = {60-62}, doi = {10.1016/j.ejogrb.2020.12.055}, pmid = {33418463}, issn = {1872-7654}, abstract = {Iron deficiency is the commonest cause for anaemia worldwide making it a formidable issue particularly during pregnancy because of increased iron demands. This study looked at establishing a lower limit of normal for haemoglobin concentration (Hb) in our population and to proactively address potentially symptomatic iron deficiency during the current SARS-CoV-2 pandemic. The lower limit of normal for Hb in our 1715 first trimester pregnancy cohort was 116 g/L. This is in contrast with guidance suggesting Hb levels down to 110 g/L are normal. In addition there was evidence of limited testing performed to look for iron deficiency with only 18 % having a serum ferritin checked. Most anaemia was normocytic suggesting that microcytosis is only a late marker of iron deficiency lacking sensitivity. A strategy to avoid hospital contact during the COVID-19 pandemic is proposed.}, } @article {pmid33418320, year = {2020}, author = {Moulson, AJ and Av-Gay, Y}, title = {BCG immunomodulation: From the 'hygiene hypothesis' to COVID-19.}, journal = {Immunobiology}, volume = {226}, number = {1}, pages = {152052}, doi = {10.1016/j.imbio.2020.152052}, pmid = {33418320}, issn = {1878-3279}, abstract = {The century-old tuberculosis vaccine BCG has been the focus of renewed interest due to its well-documented ability to protect against various non-TB pathogens. Much of these broad spectrum protective effects are attributed to trained immunity, the epigenetic and metabolic reprogramming of innate immune cells. As BCG vaccine is safe, cheap, widely available, amendable to use as a recombinant vector, and immunogenic, it has immense potential for use as an immunotherapeutic agent for various conditions including autoimmune, allergic, neurodegenerative, and neoplastic diseases as well as a preventive measure against infectious agents. Of particular interest is the use of BCG vaccination to counteract the increasing prevalence of autoimmune and allergic conditions in industrialized countries attributable to reduced infectious burden as described by the 'hygiene hypothesis.' Furthermore, BCG vaccination has been proposed as a potential therapy to mitigate spread and disease burden of COVID-19 as a bridge to development of a specific vaccine and recombinant BCG expression vectors may prove useful for the introduction of SARS-CoV-2 antigens (rBCG-SARS-CoV-2) to induce long-term immunity. Understanding the immunomodulatory effects of BCG vaccine in these disease contexts is therefore critical. To that end, we review here BCG-induced immunomodulation focusing specifically on BCG-induced trained immunity and how it relates to the 'hygiene hypothesis' and COVID-19.}, } @article {pmid33418284, year = {2020}, author = {Kahil, K and Cheaito, MA and El Hayek, R and Nofal, M and El Halabi, S and Kudva, KG and Pereira-Sanchez, V and El Hayek, S}, title = {Suicide during COVID-19 and other major international respiratory outbreaks: A systematic review.}, journal = {Asian journal of psychiatry}, volume = {56}, number = {}, pages = {102509}, doi = {10.1016/j.ajp.2020.102509}, pmid = {33418284}, issn = {1876-2026}, abstract = {Coronavirus disease 2019 (COVID-19) was recently declared a pandemic by the WHO. This outbreak threatens not only physical health but also has significant repercussions on mental health. In recent world history, major infectious outbreaks were associated with severe mental health sequelae, including suicide. In this study, we systematically review the literature on suicidal outcomes during major international respiratory outbreaks, including COVID-19. We reviewed descriptive and analytic articles addressing suicide during major international respiratory outbreaks. We searched PubMed, Medline, Embase, Scopus, and PsycInfo databases and then utilized an independent method for study selection by a pair of reviewers. Two reviewers completed data abstraction and conducted a narrative summary of the findings. Our search generated 2,153 articles. Nine studies (three descriptive, five analytical, and one with mixed methodology) were eligible. The included studies were heterogeneous, divergent in methods, and with a low degree of evidence. Deducing an association between pandemics, suicide, and suicide-related outcomes remains thus poorly supported. Future research with better methodological characteristics, the use of longitudinal studies, and a focus on suicide as the primary outcome would allow for an in-depth understanding and formulation of the scope of this problem.}, } @article {pmid33418248, year = {2020}, author = {Motta, NAV and Autran, LJ and Brazão, SC and Lopes, RO and Scaramello, CBV and Lima, GF and Brito, FCF}, title = {Could cilostazol be beneficial in COVID-19 treatment? Thinking about phosphodiesterase-3 as a therapeutic target.}, journal = {International immunopharmacology}, volume = {92}, number = {}, pages = {107336}, doi = {10.1016/j.intimp.2020.107336}, pmid = {33418248}, issn = {1878-1705}, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19) that has emerged and rapidly spread across the world. The COVID-19 severity is associated to viral pneumonia with additional extrapulmonary complications. Hyperinflammation, dysfunctional immune response and hypercoagulability state are associated to poor prognosis. Therefore, the repositioning of multi-target drugs to control the hyperinflammation represents an important challenge for the scientific community. Cilostazol, a selective phosphodiesterase type-3 inhibitor (PDE-3), is an antiplatelet and vasodilator drug, that presents a range of pleiotropic effects, such as antiapoptotic, anti-inflammatory, antioxidant, and cardioprotective activities. Cilostazol also can inhibit the adenosine uptake, which enhances intracellular cAMP levels. In the lungs, elevated cAMP promotes anti-fibrotic, vasodilator, antiproliferative effects, as well as mitigating inflammatory events. Interestingly, a recent study evaluated antiplatelet FDA-approved drugs through molecular docking-based virtual screening on viral target proteins. This study revealed that cilostazol is a promising drug against COVID-19 by inhibiting both main protease (Mpro) and Spike glycoprotein, reinforcing its use as a promising therapeutic approach for COVID-19. Considering the complexity associated to COVID-19 pathophysiology and observing its main mechanisms, this article raises the hypothesis that cilostazol may act on important targets in development of the disease. This review highlights the importance of drug repurposing to address such an urgent clinical demand safely, effectively and at low cost, reinforcing the main pharmacological actions, to support the hypothesis that a multi-target drug such as cilostazol could play an important role in the treatment of COVID-19.}, } @article {pmid33418105, year = {2020}, author = {Das Mukhopadhyay, C and Sharma, P and Sinha, K and Rajarshi, K}, title = {Recent trends in analytical and digital techniques for the detection of the SARS-Cov-2.}, journal = {Biophysical chemistry}, volume = {270}, number = {}, pages = {106538}, doi = {10.1016/j.bpc.2020.106538}, pmid = {33418105}, issn = {1873-4200}, abstract = {The current global outbreak of COVID-19 due to SARS-CoV-2 is an unprecedented humanitarian crisis. Considering the gravity of its impact there is an immediate need to develop a detection technique that is sensitive, specific, fast, and affordable for the clinical diagnosis of the disease. Real time Polymerase Chain Reaction (RT-PCR)-based detection platforms are contemplated to be the gold standard to detect viral RNA. However, that may be susceptible to errors, and there is a risk of obtaining false results, which ultimately compromises the strategy of efficient disease management. Several modern techniques exhibiting assured results with enhanced sensitivity and specificity against the SARS-CoV-2 associated viral components or immune response against it have been developed and may be implemented. The review deals with the conventional RT-PCR detection techniques and compares them to other detection platforms viz., biosensor based detection of antigens, fluorescent or colorimetric detection systems including CRISPR-Cas 13 based SHERLOCK kit, CRISPR Cas-9 based FELUDA test kit, CRISPR DETECTR kit, Next Generation Sequencing or microarray-based kits. These modern techniques are great as a point of care detection methods but should be followed by RT PCR based detection for the confirmation of COVID-19 status.}, } @article {pmid33418017, year = {2021}, author = {Langford, BJ and So, M and Raybardhan, S and Leung, V and Soucy, JR and Westwood, D and Daneman, N and MacFadden, DR}, title = {Antibiotic prescribing in patients with COVID-19: rapid review and meta-analysis.}, journal = {Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.cmi.2020.12.018}, pmid = {33418017}, issn = {1469-0691}, abstract = {OBJECTIVE: The proportion of patients infected with SARS-CoV-2 that are prescribed antibiotics is uncertain, and may contribute to patient harm and global antibiotic resistance. Our objective was to estimate the prevalence and associated factors of antibiotic use in patients with confirmed COVID-19.

METHODS: We searched MEDLINE, OVID Epub and EMBASE for published literature on human subjects in English up to June 9, 2020. Inclusion criteria were any healthcare settings and age groups; randomized controlled trials; cohort studies; case series with >10 patients; experimental or observational design that evaluated antibiotic prescribing. The main outcome of interest was proportion of COVID-19 patients prescribed an antibiotic, stratified by geographical region, severity of illness, and age. We pooled proportion data using random effects meta-analysis.

RESULTS: We screened 7469 studies, from which 154 were included in the final analysis. Antibiotic data were available from 30,623 patients. The prevalence of antibiotic prescribing was 74.6% (95% CI 68.3 to 80.0%). On univariable meta-regression, antibiotic prescribing was lower in children (prescribing prevalence odds ratio (OR) 0.10, 95%CI 0.03 to 0.33) compared to adults. Antibiotic prescribing was higher with increasing patient age (OR 1.45 per 10 year increase, 95%CI 1.18 to 1.77) and higher with increasing proportion of patients requiring mechanical ventilation (OR 1.33 per 10% increase, 95%CI 1.15 to 1.54). Estimated bacterial co-infection was 8.6% (95% CI 4.7-15.2%) from 31 studies.

CONCLUSIONS: Three-quarters of patients with COVID-19 receive antibiotics, prescribing is significantly higher than the estimated prevalence of bacterial co-infection. Unnecessary antibiotic use is likely high in patients with COVID-19.

REGISTRATION: PROSPERO (ID CRD42020192286).}, } @article {pmid33417236, year = {2021}, author = {González-Fraile, E and Ballesteros, J and Rueda, JR and Santos-Zorrozúa, B and Solà, I and McCleery, J}, title = {Remotely delivered information, training and support for informal caregivers of people with dementia.}, journal = {The Cochrane database of systematic reviews}, volume = {1}, number = {}, pages = {CD006440}, pmid = {33417236}, issn = {1469-493X}, abstract = {BACKGROUND: Many people with dementia are cared for at home by unpaid informal caregivers, usually family members. Caregivers may experience a range of physical, emotional, financial and social harms, which are often described collectively as caregiver burden. The degree of burden experienced is associated with characteristics of the caregiver, such as gender, and characteristics of the person with dementia, such as dementia stage, and the presence of behavioural problems or neuropsychiatric disturbances. It is a strong predictor of admission to residential care for people with dementia. Psychoeducational interventions might prevent or reduce caregiver burden. Overall, they are intended to improve caregivers' knowledge about the disease and its care; to increase caregivers' sense of competence and their ability to cope with difficult situations; to relieve feelings of isolation and allow caregivers to attend to their own emotional and physical needs. These interventions are heterogeneous, varying in their theoretical framework, components, and delivery formats. Interventions that are delivered remotely, using printed materials, telephone or video technologies, may be particularly suitable for caregivers who have difficulty accessing face-to-face services because of their own health problems, poor access to transport, or absence of substitute care. During the COVID-19 pandemic, containment measures in many countries required people to be isolated in their homes, including people with dementia and their family carers. In such circumstances, there is no alternative to remote delivery of interventions.

OBJECTIVES: To assess the efficacy and acceptability of remotely delivered interventions aiming to reduce burden and improve mood and quality of life of informal caregivers of people with dementia.

SEARCH METHODS: We searched the Specialised Register of the Cochrane Dementia and Cognitive Improvement Group, MEDLINE, Embase and four other databases, as well as two international trials registries, on 10 April 2020. We also examined the bibliographies of relevant review papers and published trials.

SELECTION CRITERIA: We included only randomised controlled trials that assessed the remote delivery of structured interventions for informal caregivers who were providing care for people with dementia living at home. Caregivers had to be unpaid adults (relatives or members of the person's community). The interventions could be delivered using printed materials, the telephone, the Internet or a mixture of these, but could not involve any face-to-face contact with professionals. We categorised intervention components as information, training or support. Information interventions included two key elements: (i) they provided standardised information, and (ii) the caregiver played a passive role. Support interventions promoted interaction with other people (professionals or peers). Training interventions trained caregivers in practical skills to manage care. We excluded interventions that were primarily individual psychotherapy. Our primary outcomes were caregiver burden, mood, health-related quality of life and dropout for any reason. Secondary outcomes were caregiver knowledge and skills, use of health and social care resources, admission of the person with dementia to institutional care, and quality of life of the person with dementia.

DATA COLLECTION AND ANALYSIS: Study selection, data extraction and assessment of the risk of bias in included studies were done independently by two review authors. We used the Template for Intervention Description and Replication (TIDieR) to describe the interventions. We conducted meta-analyses using a random-effects model to derive estimates of effect size. We used GRADE methods to describe our degree of certainty about effect estimates.

MAIN RESULTS: We included 26 studies in this review (2367 participants). We compared (1) interventions involving training, support or both, with or without information (experimental interventions) with usual treatment, waiting list or attention control (12 studies, 944 participants); and (2) the same experimental interventions with provision of information alone (14 studies, 1423 participants). We downgraded evidence for study limitations and, for some outcomes, for inconsistency between studies. There was a frequent risk of bias from self-rating of subjective outcomes by participants who were not blind to the intervention. Randomisation methods were not always well-reported and there was potential for attrition bias in some studies. Therefore, all evidence was of moderate or low certainty. In the comparison of experimental interventions with usual treatment, waiting list or attention control, we found that the experimental interventions probably have little or no effect on caregiver burden (nine studies, 597 participants; standardised mean difference (SMD) -0.06, 95% confidence interval (CI) -0.35 to 0.23); depressive symptoms (eight studies, 638 participants; SMD -0.05, 95% CI -0.22 to 0.12); or health-related quality of life (two studies, 311 participants; SMD 0.10, 95% CI -0.13 to 0.32). The experimental interventions probably result in little or no difference in dropout for any reason (eight studies, 661 participants; risk ratio (RR) 1.15, 95% CI 0.87 to 1.53). In the comparison of experimental interventions with a control condition of information alone, we found that experimental interventions may result in a slight reduction in caregiver burden (nine studies, 650 participants; SMD -0.24, 95% CI -0.51 to 0.04); probably result in a slight improvement in depressive symptoms (11 studies, 1100 participants; SMD -0.25, 95% CI -0.43 to -0.06); may result in little or no difference in caregiver health-related quality of life (two studies, 257 participants; SMD -0.03, 95% CI -0.28 to 0.21); and probably result in an increase in dropouts for any reason (12 studies, 1266 participants; RR 1.51, 95% CI 1.04 to 2.20).

AUTHORS' CONCLUSIONS: Remotely delivered interventions including support, training or both, with or without information, may slightly reduce caregiver burden and improve caregiver depressive symptoms when compared with provision of information alone, but not when compared with usual treatment, waiting list or attention control. They seem to make little or no difference to health-related quality of life. Caregivers receiving training or support were more likely than those receiving information alone to drop out of the studies, which might limit applicability. The efficacy of these interventions may depend on the nature and availability of usual services in the study settings.}, } @article {pmid33417221, year = {2021}, author = {Dolatshahi, M and Sabahi, M and Aarabi, MH}, title = {Pathophysiological Clues to How the Emergent SARS-CoV-2 Can Potentially Increase the Susceptibility to Neurodegeneration.}, journal = {Molecular neurobiology}, volume = {}, number = {}, pages = {}, pmid = {33417221}, issn = {1559-1182}, abstract = {Along with emergence of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in late 2019, a myriad of neurologic symptoms, associated with structural brain changes, were reported. In this paper, we provide evidence to critically discuss the claim that the survived patients could possibly be at increased risk for neurodegenerative diseases via various mechanisms. This virus can directly invade the brain through olfactory bulb, retrograde axonal transport from peripheral nerve endings, or via hematogenous or lymphatic routes. Infection of the neurons along with peripheral leukocytes activation results in pro-inflammatory cytokine increment, rendering the brain to neurodegenerative changes. Also, occupation of the angiotensin-converting enzyme 2 (ACE-2) with the virus may lead to a decline in ACE-2 activity, which acts as a neuroprotective factor. Furthermore, acute respiratory distress syndrome (ARDS) and septicemia induce hypoxemia and hypoperfusion, which are locally exacerbated due to the hypercoagulable state and micro-thrombosis in brain vessels, leading to oxidative stress and neurodegeneration. Common risk factors for COVID-19 and neurodegenerative diseases, such as metabolic risk factors, genetic predispositions, and even gut microbiota dysbiosis, can contribute to higher occurrence of neurodegenerative diseases in COVID-19 survivors. However, it should be considered that severity of the infection, the extent of neurologic symptoms, and the persistence of viral infection consequences are major determinants of this association. Importantly, whether this pandemic will increase the overall incidence of neurodegeneration is not clear, as a high percentage of patients with severe form of COVID-19 might probably not survive enough to develop neurodegenerative diseases.}, } @article {pmid33417084, year = {2021}, author = {Tentolouris, A and Ntanasis-Stathopoulos, I and Vlachakis, PK and Tsilimigras, DI and Gavriatopoulou, M and Dimopoulos, MA}, title = {COVID-19: time to flatten the infodemic curve.}, journal = {Clinical and experimental medicine}, volume = {}, number = {}, pages = {}, pmid = {33417084}, issn = {1591-9528}, abstract = {Thousands of articles have been published regarding the coronavirus disease of 2019 (COVID-19). Most of them are not original research articles but reviews and editorials, and therefore, the absence of evidence-based guidelines has been evident. In parallel, the quality of manuscripts is questionable since the number of preprints has increased due to the need of fast publication of COVID-19-related articles. Furthermore, the number of retracted articles during the pandemic is exceptionally high. Media have an important role in the distribution of incorrect information, nevertheless individual people and policy makers are also responsible. As misinformation thrives in crisis periods, well-designed studies are needed to flatten the infodemic curve regarding prevention, diagnosis, and long-term complications of COVID-19.}, } @article {pmid33416999, year = {2021}, author = {Chisari, CG and Sgarlata, E and Arena, S and Toscano, S and Luca, M and Patti, F}, title = {Rituximab for the treatment of multiple sclerosis: a review.}, journal = {Journal of neurology}, volume = {}, number = {}, pages = {}, pmid = {33416999}, issn = {1432-1459}, abstract = {In the last decades, evidence suggesting the direct or indirect involvement of B cells on multiple sclerosis (MS) pathogenesis has accumulated. The increased amount of data on the efficacy and safety of B-cell-depleting therapies from several studies has suggested the addition of these drugs as treatment options to the current armamentarium of disease modifying therapies (DMTs) for MS. Particularly, rituximab (RTX), a chimeric monoclonal antibody directed at CD20 positive B lymphocytes resulting in cell-mediated apoptosis, has been demonstrated to reduce inflammatory activity, incidence of relapses and new brain lesions on magnetic resonance imaging (MRI) in patients with relapsing-remitting MS (RRMS). Additional evidence also demonstrated that patients with progressive MS (PMS) may benefit from RTX, which also showed to be well tolerated, with acceptable safety risks and favorable cost-effectiveness profile.Despite these encouraging results, RTX is currently approved for non-Hodgkin's lymphoma, chronic lymphocytic leukemia, several forms of vasculitis and rheumatoid arthritis, while it can only be administered off-label for MS treatment. Between Northern European countries exist different rules for using not licensed drug for treating MS. The Sweden MS register reports a high rate (53.5%) of off-label RTX prescriptions in relation to other annually started DMTs to treat MS patients, while Danish and Norwegian neurologists have to use other anti-CD20 drugs, as ocrelizumab, in most of the cases.In this paper, we review the pharmacokinetics, pharmacodynamics, clinical efficacy, safety profile and cost effectiveness aspects of RTX for the treatment of MS. Particularly, with the approval of new anti-CD20 DMTs, the recent worldwide COVID-19 emergency and the possible increased risk of infection with this class of drugs, this review sheds light on the use of RTX as an alternative treatment option for MS management, while commenting the gaps of knowledge regarding this drug.}, } @article {pmid33415647, year = {2021}, author = {Selvaraj, K and Ravichandran, S and Krishnan, S and Radhakrishnan, RK and Manickam, N and Kandasamy, M}, title = {Testicular Atrophy and Hypothalamic Pathology in COVID-19: Possibility of the Incidence of Male Infertility and HPG Axis Abnormalities.}, journal = {Reproductive sciences (Thousand Oaks, Calif.)}, volume = {}, number = {}, pages = {}, pmid = {33415647}, issn = {1933-7205}, support = {SERB-EEQ/2016/000639 and SERB-ECR/2016/000741//Science and Engineering Research Board/ ; }, abstract = {Coronavirus disease 2019 (COVID-19), which resulted from the pandemic outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causes a massive inflammatory cytokine storm leading to multi-organ damage including that of the brain and testes. While the lungs, heart, and brain are identified as the main targets of SARS-CoV-2-mediated pathogenesis, reports on its testicular infections have been a subject of debate. The brain and testes are physiologically synchronized by the action of gonadotropins and sex steroid hormones. Though the evidence for the presence of the viral particles in the testicular biopsies and semen samples from COVID-19 patients are highly limited, the occurrence of testicular pathology due to abrupt inflammatory responses and hyperthermia has incresingly been evident. The reduced level of testosterone production in COVID-19 is associated with altered secretion of gonadotropins. Moreover, hypothalamic pathology which results from SARS-CoV-2 infection of the brain is also evident in COVID-19 cases. This article revisits and supports the key reports on testicular abnormalities and pathological signatures in the hypothalamus of COVID-19 patients and emphasizes that testicular pathology resulting from inflammation and oxidative stress might lead to infertility in a significant portion of COVID-19 survivors. Further investigations are required to monitor the reproductive health parameters and HPG axis abnormalities related to secondary pathological complications in COVID-19 patients and survivors.}, } @article {pmid33415646, year = {2021}, author = {Sethuram, R and Bai, D and Abu-Soud, HM}, title = {Potential Role of Zinc in the COVID-19 Disease Process and its Probable Impact on Reproduction.}, journal = {Reproductive sciences (Thousand Oaks, Calif.)}, volume = {}, number = {}, pages = {}, pmid = {33415646}, issn = {1933-7205}, abstract = {COVID-19 (coronavirus disease 2019) is the current world health crisis, producing extensive morbidity and mortality across all age groups. Given the established roles of zinc in combating oxidative damage and viral infections, zinc is being trialed as a treatment modality against COVID-19. Zinc also has confirmed roles in both male and female reproduction. The possible depletion of zinc with the oxidative events of COVID-19 is especially relevant to the fertility of affected couples. This review aims to present the pathophysiology of COVID-19, especially in relation to reproductive function; the role of zinc in the COVID-19 disease process; and how zinc depletion in concert with cytokine storm and reactive oxygen species production could affect reproduction. It also highlights research areas to better the understanding of COVID-19 and its impact on fertility and potential ways to mitigate the impact.}, } @article {pmid33415422, year = {2021}, author = {Rahi, MS and Jindal, V and Reyes, SP and Gunasekaran, K and Gupta, R and Jaiyesimi, I}, title = {Hematologic disorders associated with COVID-19: a review.}, journal = {Annals of hematology}, volume = {}, number = {}, pages = {}, pmid = {33415422}, issn = {1432-0584}, abstract = {Coronavirus disease 2019 is caused by severe acute respiratory syndrome coronavirus 2. Primarily an infection of the lower respiratory tract, it is now well known to cause multisystem abnormalities. Hematologic manifestations constitute a significant area of concern. Severe acute respiratory syndrome coronavirus 2 infects monocytes and endothelial cells leading to a complex downstream cascade, cytokine storm, and eventual intravascular thrombosis. Coronavirus disease 2019 causes lymphopenia, neutrophilia, and thrombocytopenia. Prophylactic anticoagulation is vital in patients with coronavirus disease 2019, as its effect on the coagulation system is associated with significant morbidity and mortality. The disease can cause both arterial and venous thromboses, especially pulmonary embolism and pulmonary microthrombi. A high index of suspicion is indispensable in recognizing these complications, and timely institution of therapeutic anticoagulation is vital in treating them. Virus-induced disseminated intravascular coagulation is uncommon but shares some similarities to sepsis-induced disseminated intravascular coagulation. Marked elevations in hematologic biomarkers such as lactate dehydrogenase, D-dimer, ferritin, and C-reactive protein are associated with worse outcomes. Understanding the pathophysiology and recognizing factors associated with poor prognosis are crucial in improving patient outcomes with coronavirus disease 2019.}, } @article {pmid33415126, year = {2020}, author = {Shinu, P and Morsy, MA and Deb, PK and Nair, AB and Goyal, M and Shah, J and Kotta, S}, title = {SARS CoV-2 Organotropism Associated Pathogenic Relationship of Gut-Brain Axis and Illness.}, journal = {Frontiers in molecular biosciences}, volume = {7}, number = {}, pages = {606779}, doi = {10.3389/fmolb.2020.606779}, pmid = {33415126}, issn = {2296-889X}, abstract = {COVID-19 has resulted in a pandemic after its first appearance in a pneumonia patient in China in early December 2019. As per WHO, this global outbreak of novel COVID-19 has resulted in 28,329,790 laboratory-confirmed cases and 911,877 deaths which have been reported from 210 countries as on 12th Sep 2020. The major symptoms at the beginning of COVID-19 are fever (98%), tussis (76%), sore throat (17%), rhinorrhea (2%), chest pain (2%), and myalgia or fatigue (44%). Furthermore, acute respiratory distress syndrome (61.1%), cardiac dysrhythmia (44.4%), shock (30.6%), hemoptysis (5%), stroke (5%), acute cardiac injury (12%), acute kidney injury (36.6%), dermatological symptoms with maculopapular exanthema (36.1%), and death can occur in severe cases. Even though human coronavirus (CoV) is mainly responsible for the infections of the respiratory tract, some studies have shown CoV (in case of Severe Acute Respiratory Syndrome, SARS and Middle East Respiratory Syndrome, MERS) to possess potential to spread to extra-pulmonary organs including the nervous system as well as gastrointestinal tract (GIT). Patients infected with COVID-19 have also shown symptoms associated with neurological and enteric infection like disorders related to smell/taste, loss of appetite, nausea, emesis, diarrhea, and pain in the abdomen. In the present review, we attempt to evaluate the understanding of basic mechanisms involved in clinical manifestations of COVID-19, mainly focusing on interaction of COVID-19 with gut-brain axis. This review combines both biological characteristics of the virus and its clinical manifestations in order to comprehend an insight into the fundamental potential mechanisms of COVID-19 virus infection, and thus endorse in the advancement of prophylactic and treatment strategies.}, } @article {pmid33415115, year = {2020}, author = {Vodovotz, Y and Barnard, N and Hu, FB and Jakicic, J and Lianov, L and Loveland, D and Buysse, D and Szigethy, E and Finkel, T and Sowa, G and Verschure, P and Williams, K and Sanchez, E and Dysinger, W and Maizes, V and Junker, C and Phillips, E and Katz, D and Drant, S and Jackson, RJ and Trasande, L and Woolf, S and Salive, M and South-Paul, J and States, SL and Roth, L and Fraser, G and Stout, R and Parkinson, MD}, title = {Prioritized Research for the Prevention, Treatment, and Reversal of Chronic Disease: Recommendations From the Lifestyle Medicine Research Summit.}, journal = {Frontiers in medicine}, volume = {7}, number = {}, pages = {585744}, doi = {10.3389/fmed.2020.585744}, pmid = {33415115}, issn = {2296-858X}, abstract = {Declining life expectancy and increasing all-cause mortality in the United States have been associated with unhealthy behaviors, socioecological factors, and preventable disease. A growing body of basic science, clinical research, and population health evidence points to the benefits of healthy behaviors, environments and policies to maintain health and prevent, treat, and reverse the root causes of common chronic diseases. Similarly, innovations in research methodologies, standards of evidence, emergence of unique study cohorts, and breakthroughs in data analytics and modeling create new possibilities for producing biomedical knowledge and clinical translation. To understand these advances and inform future directions research, The Lifestyle Medicine Research Summit was convened at the University of Pittsburgh on December 4-5, 2019. The Summit's goal was to review current status and define research priorities in the six core areas of lifestyle medicine: plant-predominant nutrition, physical activity, sleep, stress, addictive behaviors, and positive psychology/social connection. Forty invited subject matter experts (1) reviewed existing knowledge and gaps relating lifestyle behaviors to common chronic diseases, such as cardiovascular disease, diabetes, many cancers, inflammatory- and immune-related disorders and other conditions; and (2) discussed the potential for applying cutting-edge molecular, cellular, epigenetic and emerging science knowledge and computational methodologies, research designs, and study cohorts to accelerate clinical applications across all six domains of lifestyle medicine. Notably, federal health agencies, such as the Department of Defense and Veterans Administration have begun to adopt "whole-person health and performance" models that address these lifestyle and environmental root causes of chronic disease and associated morbidity, mortality, and cost. Recommendations strongly support leveraging emerging research methodologies, systems biology, and computational modeling in order to accelerate effective clinical and population solutions to improve health and reduce societal costs. New and alternative hierarchies of evidence are also be needed in order to assess the quality of evidence and develop evidence-based guidelines on lifestyle medicine. Children and underserved populations were identified as prioritized groups to study. The COVID-19 pandemic, which disproportionately impacts people with chronic diseases that are amenable to effective lifestyle medicine interventions, makes the Summit's findings and recommendations for future research particularly timely and relevant.}, } @article {pmid33414908, year = {2021}, author = {Aran, V and De Marchi, P and Zamboni, M and Ferreira, CG}, title = {Dealing with lung cancer in the COVID-19 scenario (A review).}, journal = {Molecular and clinical oncology}, volume = {14}, number = {2}, pages = {27}, doi = {10.3892/mco.2020.2189}, pmid = {33414908}, issn = {2049-9450}, abstract = {The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which has caused the coronavirus disease 2019 (COVID-19), first appeared in December 2019 in Wuhan (China) and quickly spread worldwide and has since been assigned a pandemic status. This affected the worlds' social interactions, including within medical practices, thus interfering with routine treatments for a variety of diseases including cancer. Different studies have addressed the fact that patients with cancer are often immunocompromised, making them more susceptible to infections. Since COVID-19 frequently causes respiratory distress, patients with lung cancer are considered to be a high-risk group. Genes that have been indicated to mediate viral entry into host cells such as angiotensin-converting enzyme 2 and transmembrane protease serine 2 are expressed in the lung tissue, a fact that could partially explain COVID-19 pathogenesis and lung involvement. Therefore, the current study offers a disease overview including molecular aspects behind the infection and provide a perspective on already published Chinese data plus recommendations for the management of lung cancer patients according to the two main lung cancer types and stages: non-small cell lung cancer and small cell lung cancer. This review aimed to add to the collective effort of selecting the most appropriate guidelines to follow for the treatment of these patients.}, } @article {pmid33414832, year = {2020}, author = {Juárez-Navarro, KJ and Padilla-Camberos, E and Díaz, NF and Miranda-Altamirano, A and Díaz-Martínez, NE}, title = {Human Mesenchymal Stem Cells: The Present Alternative for High-Incidence Diseases, Even SARS-Cov-2.}, journal = {Stem cells international}, volume = {2020}, number = {}, pages = {8892189}, doi = {10.1155/2020/8892189}, pmid = {33414832}, issn = {1687-966X}, abstract = {Mesenchymal stem cells (MSCs), defined as plastic adherent cells with multipotent differentiation capacity in vitro, are an emerging and valuable tool to treat a plethora of diseases due to their therapeutic mechanisms such as their paracrine activity, mitochondrial and organelle transfer, and transfer of therapeutic molecules via exosomes. Nowadays, there are more than a thousand registered clinical trials related to MSC application around the world, highlighting MSC role on difficult-to-treat high-incidence diseases such as the current COVID-19, HIV infections, and autoimmune and metabolic diseases. Here, we summarize a general overview of MSCs and their therapeutic mechanisms; also, we discuss some of the novel clinical trial protocols and their results as well as a comparison between the number of registries, countries, and search portals.}, } @article {pmid33414790, year = {2020}, author = {Sandbrink, JB and Shattock, RJ}, title = {RNA Vaccines: A Suitable Platform for Tackling Emerging Pandemics?.}, journal = {Frontiers in immunology}, volume = {11}, number = {}, pages = {608460}, doi = {10.3389/fimmu.2020.608460}, pmid = {33414790}, issn = {1664-3224}, abstract = {The COVID-19 pandemic demonstrates the ongoing threat of pandemics caused by novel, previously unrecognized, or mutated pathogens with high transmissibility. Currently, vaccine development is too slow for vaccines to be used in the control of emerging pandemics. RNA-based vaccines might be suitable to meet this challenge. The use of an RNA-based delivery mechanism promises fast vaccine development, clinical approval, and production. The simplicity of in vitro transcription of mRNA suggests potential for fast, scalable, and low-cost manufacture. RNA vaccines are safe in theory and have shown acceptable tolerability in first clinical trials. Immunogenicity of SARS-CoV-2 mRNA vaccines in phase 1 trials looks promising, however induction of cellular immunity needs to be confirmed and optimized. Further optimization of RNA vaccine modification and formulation to this end is needed, which may also enable single injection regimens to be achievable. Self-amplifying RNA vaccines, which show high immunogenicity at low doses, might help to improve potency while keeping manufacturing costs low and speed high. With theoretical properties of RNA vaccines looking promising, their clinical efficacy is the key remaining question with regard to their suitability for tackling emerging pandemics. This question might be answered by ongoing efficacy trials of SARS-CoV-2 mRNA vaccines.}, } @article {pmid33414753, year = {2020}, author = {Karimi, L and Sales, C and Crewther, SG and Wijeratne, T}, title = {Acute Ischemic Stroke in SARS-CoV, MERS-CoV, SARS-CoV-2: Neurorehabilitation Implications of Inflammation Induced Immunological Responses Affecting Vascular Systems.}, journal = {Frontiers in neurology}, volume = {11}, number = {}, pages = {565665}, doi = {10.3389/fneur.2020.565665}, pmid = {33414753}, issn = {1664-2295}, abstract = {Coronaviruses (CoVs) are enveloped RNA viruses and have been shown to cause mild to severe respiratory infections in humans, with some severe cases inducing neurological manifestations. The lethality and Neurological effects of the Severe Acute Respiratory Syndrome (SARS-CoV), Middle-East Respiratory Syndrome (MERS-CoV), and recently the Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) have been well documented though currently there is little literature regarding long term effects and the implications for neurorehabilitation. SARS-CoV-2 and MERS-CoV have been linked to the infection associated inflammatory cytokine storms and induced hypercoagulopathic states that affect the entire vascular system including that of the brain. This mini-review provides an overview of the commonalities among studies published on all three types of the coronavirus related to acute ischemic stroke (AIS). The aim was to elucidate the physiological mechanisms underpinning COVID-2 and to reflect the similarities with the chronic inflammation induced symptoms of AIS that are likely to prove a further challenge for neurorehabilitation clinicians post COVID. In terms of increased incidence of COVID and AIS, it is likely that in depth knowledge of increased thrombotic risk in this population will require appropriate anticoagulation treatment, and other therapeutic interventions as well as neurorehabilitation interventions. Lastly the risk of spreading the virus requires further balancing of the provision of neurorehabiliatation services useful to the patient.}, } @article {pmid33414743, year = {2020}, author = {Granieri, A and Bonafede, M and Marinaccio, A and Iavarone, I and Marsili, D and Franzoi, IG}, title = {SARS-CoV-2 and Asbestos Exposure: Can Our Experience With Mesothelioma Patients Help Us Understand the Psychological Consequences of COVID-19 and Develop Interventions?.}, journal = {Frontiers in psychology}, volume = {11}, number = {}, pages = {584320}, doi = {10.3389/fpsyg.2020.584320}, pmid = {33414743}, issn = {1664-1078}, abstract = {Since its emergence, the novel coronavirus disease of 2019 (COVID-19) has had enormous physical, social, and psychological impacts worldwide. The aim of this article was to identify elements of our knowledge on asbestos exposure and malignant mesothelioma (MM) that can provide insight into the psychological impact of the COVID-19 pandemic and be used to develop adequate interventions. Although the etiology of Covid-19 and MM differs, their psychological impacts have common characteristics: in both diseases, there is a feeling of being exposed through aerial contagion to an "invisible killer" without boundaries that can strike even the strongest individuals. In both cases, affected persons can experience personality dysfunction, anxiety, depression, and posttraumatic symptoms; helplessness, hopelessness, and projection of destructive thoughts onto external forces often emerge, while defense mechanisms such as denial, splitting, repression, and reduced emotional expression are used by individuals to contain their overwhelming anxieties. We believe that in both diseases, an integrated multidimensional intervention offered by hospitals and other public health services is the most effective approach to alleviating patients' and caregivers' psychological distress. In particular, we emphasize that in the context of both MM and COVID-19, Brief Psychoanalytic Group therapy can help patients and caregivers attribute meaning to the significant changes in their lives related to the experience of the disease and identify adaptive strategies and more realistic relational modalities to deal with what has happened to them. We also highlight the importance of developing a surveillance system that includes individual anamnestic evaluation of occupational risk factors for COVID-19 disease.}, } @article {pmid33414726, year = {2020}, author = {Sanino, G and Bosco, M and Terrazzano, G}, title = {Physiology of Midkine and Its Potential Pathophysiological Role in COVID-19.}, journal = {Frontiers in physiology}, volume = {11}, number = {}, pages = {616552}, doi = {10.3389/fphys.2020.616552}, pmid = {33414726}, issn = {1664-042X}, abstract = {SARS-CoV2 infection not only causes abnormal severe pneumonia but also induces other relevant pathophysiological effects on several tissues and organs. In this regard, the clinical complications observed in COVID-19 include acute coronary syndrome, pulmonary thromboembolism, myocarditis and, in the severe cases, the occurrence of disseminated intravascular coagulation. Literature on COVID-19 highlighted the central role of the Renin Angiotensin Aldosterone System in the determinism of SARS-CoV2 cellular internalization in the target tissues. Lung degeneration and respiratory distress appear to be dependent on the perturbance of physiological mechanisms, such as the uncontrolled release of pro-inflammatory cytokines, a dysregulation of the fibrinolytic coagulative cascade and the hyperactivation of immune effector cells. In this mini review, we address the physiology of Midkine, a growth factor able to bind heparin, and its pathophysiological potential role in COVID-19 determinism. Midkine increases in many inflammatory and autoimmune conditions and correlates with several dysfunctional immune-inflammatory responses that appear to show similarities with the pathophysiological elicited by SARS-CoV2. Midkine, together with its receptor, could facilitate the virus entry, fostering its accumulation and increasing its affinity with Ace2 receptor. We also focus on Netosis, a particular mechanism of pathogen clearance exerted by neutrophils, which under certain pathological condition becomes dysfunctional and can cause tissue damage. Moreover, we highlight the mechanism of autophagy that the new coronavirus could try to escape in order to replicate itself, as well as on pulmonary fibrosis induced by hypoxia and on the release of cytokines and mediators of inflammation, correlating the interplay between Midkine and SARS-CoV2.}, } @article {pmid33414650, year = {2020}, author = {Hacımustafaoğlu, M}, title = {COVID-19 and re-opening of schools: Opinions with scientific evidence.}, journal = {Turk pediatri arsivi}, volume = {55}, number = {4}, pages = {337-344}, doi = {10.14744/TurkPediatriArs.2020.90018}, pmid = {33414650}, issn = {1306-0015}, abstract = {Due to the COVID-19 pandemic, more than 90% of students worldwide were affected by education loss. Moreover, for school-age children and adolescents, there may be worsening of nutrition, increasing mental health disorders, lack of physical activity, and related deleterious consequences raise concerns about negative habits, child violence, and abuse. Face-to-face education in schools provides positive educational opportunities that cannot be achieved with online education. In studies from various countries, children have milder disease, constituting as little as 1-8% of all laboratory-confirmed COVID-19 cases, with less transmission capacity to household contacts than adults (0.5-7% vs. 10-20%). Symptomatic or asymptomatic children can infect other people less than adults. Also, the transmission of illness between students at school is less than expected, and the transmission of COVID-19 to students is usually acquired from sick adults rather than sick students. Therefore, with suitable measures, infection risk is less than expected and seems not to be higher than in other public places. COVID-19 measures in schools can be summarized as follows: avoiding crowded/close contact environments as much as possible, respecting the protective (social) distance, wearing appropriate masks, hand hygiene, and some essential protective measurements of classrooms and environment. Measurements should be participatory (students, teachers, education staff, parents, administration), applicable, sustainable, and flexible according to the conditions.}, } @article {pmid33414636, year = {2020}, author = {Harahap, Y and Diptasaadya, R and Purwanto, DJ}, title = {Volumetric Absorptive Microsampling as a Sampling Alternative in Clinical Trials and Therapeutic Drug Monitoring During the COVID-19 Pandemic: A Review.}, journal = {Drug design, development and therapy}, volume = {14}, number = {}, pages = {5757-5771}, doi = {10.2147/DDDT.S278892}, pmid = {33414636}, issn = {1177-8881}, abstract = {An infectious disease, COVID-19, caused by a new type of coronavirus, has been discovered recently. This disease can cause respiratory distress, fever, and fatigue. It still has no drug and vaccine for treatment and prevention. Therefore, WHO recommends that people should stay at home to reduce disease transmission. Due to the quarantine, FDA stated that this could hamper drug development clinical trial protocols. Hence, an alternative sampling method that can be applied at home is needed. Currently, volumetric absorptive microsampling (VAMS) has become attention in its use in clinical and bioanalytical fields. This paper discusses the advantages and challenges that might be found in the use of VAMS as an alternative sampling tool in clinical trials and therapeutic drug monitoring (TDM) during the COVID-19 pandemic. VAMS allows easy sampling, can be done at home, storage and delivery at room temperature, and the volume taken is small and minimally invasive. VAMS is also able to absorb a fixed volume that can increase the accuracy and precision of analytical methods, and reduce the hematocrit effects (HCT). The use of VAMS is expected to be implemented immediately in clinical trials and TDM during this pandemic considering the benefits it has.}, } @article {pmid33414238, year = {2021}, author = {Sweeny, KF and Zhang, YJ and Crume, B and Martz, CA and Blessing, MM and Kahn, SA}, title = {Inflammatory Bowel Disease Presenting With Concurrent COVID-19 Multisystem Inflammatory Syndrome.}, journal = {Pediatrics}, volume = {}, number = {}, pages = {}, doi = {10.1542/peds.2020-027763}, pmid = {33414238}, issn = {1098-4275}, } @article {pmid33414153, year = {2021}, author = {Sever, MS and Ortiz, A and Maggiore, U and Bac-García, E and Vanholder, R}, title = {Mass Disasters and Burnout in Nephrology Personnel: From Earthquakes and Hurricanes to COVID-19 Pandemic.}, journal = {Clinical journal of the American Society of Nephrology : CJASN}, volume = {}, number = {}, pages = {}, doi = {10.2215/CJN.08400520}, pmid = {33414153}, issn = {1555-905X}, abstract = {Mass disasters result in extensive health problems and make health care delivery problematic, as has been the case during the COVID-19 pandemic. Although COVID-19 was initially considered a pulmonary problem, it soon became clear that various other organs were involved. Thus, many care providers, including kidney health personnel, were overwhelmed or developed burnout. This review aims to describe the spectrum of burnout in mass disasters and suggests solutions specifically for nephrology personnel by extending previous experience to the COVID-19 pandemic. Burnout (a psychologic response to work-related stress) is already a frequent part of routine nephrology practice and, not surprisingly, is even more common during mass disasters due to increased workload and specific conditions, in addition to individual factors. Avoiding burnout is essential to prevent psychologic and somatic health problems in personnel as well as malpractice, understaffing, and inadequate health care delivery, all of which increase the health care burden of disasters. Burnout may be prevented by predisaster organizational measures, which include developing an overarching plan and optimizing health care infrastructure, and ad hoc disaster-specific measures that encompass both organizational and individual measures. Organizational measures include increasing safety, decreasing workload and fear of malpractice, optimizing medical staffing and material supplies, motivating personnel, providing mental health support, and enabling flexibility in working circumstances. Individual measures include training on coping with stress and problematic conditions, minimizing the stigma of emotional distress, and maintaining physical health. If these measures fall short, asking for external help is mandatory to avoid an inefficient disaster health care response. Minimizing burnout by applying these measures will improve health care provision, thus saving as many lives as possible.}, } @article {pmid33413819, year = {2021}, author = {Lippi, G and Sanchis-Gomar, F and Favaloro, EJ and Lavie, CJ and Henry, BM}, title = {Coronavirus Disease 2019-Associated Coagulopathy.}, journal = {Mayo Clinic proceedings}, volume = {96}, number = {1}, pages = {203-217}, doi = {10.1016/j.mayocp.2020.10.031}, pmid = {33413819}, issn = {1942-5546}, abstract = {Patients with the severe form of coronavirus disease 2019 (COVID-19) have been frequently found to suffer from both arterial and venous thrombotic events due to the perpetuation of a hypercoagulable state. This phenomenon, termed COVID-19-associated coagulopathy, is now considered a major component of the pathophysiology of this novel infectious disease, leading to widespread thrombosis. While at first, the vascular insults may be limited to the pulmonary microvasculature, as the disease progresses, systemic involvement occurs, culminating in distant organ thrombosis and multiorgan dysfunction syndrome. In this review article, we discuss recent insights into the pathophysiologic mechanisms of COVID-19-associated coagulopathy and review the clinical, histopathologic, and laboratory evidence, which leads us to conclude that COVID-19 is both a pulmonary and vascular disorder.}, } @article {pmid33413817, year = {2021}, author = {Huang, C and Soleimani, J and Herasevich, S and Pinevich, Y and Pennington, KM and Dong, Y and Pickering, BW and Barwise, AK}, title = {Clinical Characteristics, Treatment, and Outcomes of Critically Ill Patients With COVID-19: A Scoping Review.}, journal = {Mayo Clinic proceedings}, volume = {96}, number = {1}, pages = {183-202}, doi = {10.1016/j.mayocp.2020.10.022}, pmid = {33413817}, issn = {1942-5546}, abstract = {A growing number of studies on coronavirus disease 2019 (COVID-19) are becoming available, but a synthesis of available data focusing on the critically ill population has not been conducted. We performed a scoping review to synthesize clinical characteristics, treatment, and clinical outcomes among critically ill patients with COVID-19. Between January 1, 2020, and May 15, 2020, we identified high-quality clinical studies describing critically ill patients with a sample size of greater than 20 patients by performing daily searches of the World Health Organization and LitCovid databases on COVID-19. Two reviewers independently reviewed all abstracts (2785 unique articles), full text (218 articles), and abstracted data (92 studies). The 92 studies included 61 from Asia, 16 from Europe, 10 from North and South America, and 5 multinational studies. Notable similarities among critically ill populations across all regions included a higher proportion of older males infected and with severe illness, high frequency of comorbidities (hypertension, diabetes, and cardiovascular disease), abnormal chest imaging findings, and death secondary to respiratory failure. Differences in regions included newly identified complications (eg, pulmonary embolism) and epidemiological risk factors (eg, obesity), less chest computed tomography performed, and increased use of invasive mechanical ventilation (70% to 100% vs 15% to 47% of intensive care unit patients) in Europe and the United States compared with Asia. Future research directions should include proof-of-mechanism studies to better understand organ injuries and large-scale collaborative clinical studies to evaluate the efficacy and safety of antivirals, antibiotics, interleukin 6 receptor blockers, and interferon. The current established predictive models require further verification in other regions outside China.}, } @article {pmid33413815, year = {2021}, author = {Lapid, MI and Meagher, KM and Giunta, HC and Clarke, BL and Ouellette, Y and Armbrust, TL and Sharp, RR and Wright, RS}, title = {Ethical Challenges in COVID-19 Biospecimen Research: Perspectives From Institutional Review Board Members and Bioethicists.}, journal = {Mayo Clinic proceedings}, volume = {96}, number = {1}, pages = {165-173}, doi = {10.1016/j.mayocp.2020.10.021}, pmid = {33413815}, issn = {1942-5546}, abstract = {Biospecimen research is a prominent investigative strategy that aims to provide novel insights into coronavirus disease 2019 (COVID-19), inform clinical trials, and develop effective, life-saving treatments. However, COVID-19 biospecimen research raises accompanying ethical concerns and practical challenges for investigators and participants. In this special article, we discuss the ethical issues that are associated with autonomy, beneficence, and justice in COVID-19 biospecimen research and describe strategies to manage the practical challenges, with an emphasis on protecting the rights and welfare of human research participants during a pandemic response. Appropriate institutional review board oversight and bioethics guidance for COVID-19 biospecimen research must maintain their focus on protecting the rights and welfare of research participants, despite the urgent need for more knowledge about the virus and the threat it poses to communities and nations.}, } @article {pmid33407447, year = {2021}, author = {Tan, MMJ and Han, E and Shrestha, P and Wu, S and Shiraz, F and Koh, GC and McKee, M and Legido-Quigley, H}, title = {Framing global discourses on non-communicable diseases: a scoping review.}, journal = {BMC health services research}, volume = {21}, number = {1}, pages = {20}, pmid = {33407447}, issn = {1472-6963}, support = {NMRC/CG/C026/2017_NUHS//National Medical Research Council/ ; }, mesh = {COVID-19 ; *Global Health ; *Health Policy ; Humans ; *Noncommunicable Diseases ; }, abstract = {BACKGROUND: The choices that policymakers make are shaped by how their problems are framed. At last, non-communicable diseases (NCDs) have risen high on the global policy agenda, but there are many disputed issues. First, what are they? Their name refers not to what they are but what they are not. Second, where do their boundaries lie? What diseases are included? Third, should we view their causes as mainly biomedical, behavioural, or social, or a combination? Our failure to resolve these issues has been invoked as a reason for our limited progress in developing and implementing effective remedies. In this scoping review, we ask "What is known from the existing literature about how NCDs are framed in the global policy discourses?" We answer it by reviewing the frames employed in policy and academic discourses.

METHODS: We searched nine electronic databases for articles published since inception to 31 May 2019. We also reviewed websites of eight international organisations to identify global NCDs policies. We extracted data and synthesised findings to identify key thematic frames.

RESULTS: We included 36 articles and nine policy documents on global NCDs policies. We identified five discursive domains that have been used and where there are differing perspectives. These are: "Expanding the NCDs frame to include mental health and air pollution"; "NCDs and their determinants"; "A rights-based approach to NCDs"; "Approaches to achieving policy coherence in NCDs globally"; and "NCDs as part of Sustainable Socio-economic Development". We further identified 12 frames within the five discursive domains.

CONCLUSIONS: This scoping review identifies issues that remain unresolved and points to a need for alignment of perspectives among global health policy actors, as well as synergies with those working on mental health, maternal health, and child health. The current COVID-19 pandemic warrants greater consideration of its impact on global NCDs policies. Future global strategies for NCDs need to consider explicitly how NCDs are framed in a changing global health discourse and ensure adequate alignment with implementation and global health issues. There is a need for global strategies to recognise the pertinent role of actors in shaping policy discourses.}, } @article {pmid33378059, year = {2020}, author = {Hudzik, B and Nowak, J and Zubelewicz-Szkodzinska, B}, title = {Consideration of immunomodulatory actions of morphine in COVID-19 - Short report.}, journal = {European review for medical and pharmacological sciences}, volume = {24}, number = {24}, pages = {13062-13064}, doi = {10.26355/eurrev_202012_24213}, pmid = {33378059}, issn = {2284-0729}, mesh = {Analgesics, Opioid/*adverse effects/therapeutic use ; COVID-19/immunology/*therapy ; Cytokine Release Syndrome/*immunology ; Cytokines/immunology ; Humans ; *Immunomodulation ; Morphine/*adverse effects/therapeutic use ; Respiration, Artificial ; SARS-CoV-2 ; Shock, Septic/immunology ; }, abstract = {Cytokine storm in COVID-19 is linked to disease severity and mortality. 40% of patients with severe COVID-19 require mechanical ventilation. Analgesia and sedation are used for treatment of pain, facilitation of mechanical ventilation, or management of acute agitation. Herein, we present the immunomodulating actions of morphine that may either improve or worsen the clinical course of COVID-19 once cytokine storm develops. A literature search was performed to find articles on potential immunomodulatory effects of morphine. Taken together, the results of in vitro and in vivo models in non-COVID-19 conditions suggest that morphine could have a beneficial effect by mitigating the cytokine storm in the early stages of severe COVID-19. In contrast, it could be potentially harmful in late stages of severe COVID-19, especially in the presence of septic shock.}, } @article {pmid33378056, year = {2020}, author = {Zhou, YL and Lu, J and Cheng, YB and Xin, N}, title = {Nervous system complications of COVID-19 with a focus on stroke.}, journal = {European review for medical and pharmacological sciences}, volume = {24}, number = {24}, pages = {13044-13048}, doi = {10.26355/eurrev_202012_24210}, pmid = {33378056}, issn = {2284-0729}, mesh = {Angiotensin-Converting Enzyme 2/metabolism ; Anosmia/*physiopathology ; Anticoagulants/therapeutic use ; Blood Coagulation Disorders/complications/physiopathology ; COVID-19/complications/immunology/*physiopathology/therapy ; Consciousness Disorders/physiopathology ; Cytokines/immunology ; Endothelium, Vascular/metabolism/physiopathology ; Headache/*physiopathology ; Humans ; Receptors, Coronavirus/metabolism ; Renin-Angiotensin System ; SARS-CoV-2 ; Stockings, Compression ; Stroke/etiology/immunology/*physiopathology/therapy ; Taste Disorders/*physiopathology ; Thrombolytic Therapy ; }, abstract = {As a severe and highly contagious infection, coronavirus disease (COVID-19) affects all aspects of society and has become a global public health problem. Because of the complexity of the pathology of COVID-19, it is difficult to treat. An increasing number of reports have indicated that COVID-19 may have neurological complications, including stroke. The nervous system complications of COVID-19 have gradually attracted research attention. In this review, we summarize the latest findings related to COVID 19, elaborate on the possible mechanism of COVID 19 related onset of stroke, and summarize current treatment options because an improved understanding and appropriate treatments may improve the prognosis of patients with COVID-19-related stroke.}, } @article {pmid33312511, year = {2020}, author = {Li, X and Xu, W and Dozier, M and He, Y and Kirolos, A and Lang, Z and Song, P and Theodoratou, E and , }, title = {The role of children in the transmission of SARS-CoV2: updated rapid review.}, journal = {Journal of global health}, volume = {10}, number = {2}, pages = {021101}, pmid = {33312511}, issn = {2047-2986}, mesh = {Adolescent ; Age Factors ; COVID-19/*epidemiology/*transmission ; Child ; Child, Preschool ; Disease Outbreaks ; Feces/virology ; Female ; Global Health ; Humans ; Male ; SARS-CoV-2 ; Schools/*statistics & numerical data ; Seroepidemiologic Studies ; Systemic Inflammatory Response Syndrome/epidemiology ; Viral Load ; }, abstract = {Background: Understanding carriage and transmission potential of SARS-CoV-2 in children is of paramount importance to understand the spread of virus in school and community settings.

Methods: We performed an updated rapid review to investigate the role of children in the transmission of SARS-CoV-2. We synthesized evidence for five categories and results are reported narratively.

Results: A total of 33 new studies were included for this review. We did not identify additional studies that reported documented cases of SARS-CoV-2 transmission by children. We identified 15 new studies that demonstrate children's susceptibility and transmission risk of SARS-CoV-2 with evidence provided on the chance of being index or secondary cases, the potential of faecal-oral transmission, and the possibility of asymptomatic transmission. There is little data on the transmission of SARS-CoV-2 in schools. There were three studies reporting COVID-19 school outbreaks in France (Oise), Australia (New South Wales) and Israel. The remaining four studies found that all reported cases did not infect any other pupils or staff. With data from seven studies and governmental websites, the proportion of children among all confirmed COVID-19 patients was estimated for 29 countries, varying from 0.3% (lowest in Spain) up to 13.8% (highest in Argentina). Lastly, we identified seven studies reporting on PIMS-TS linked to COVID-19 among paediatric patients.

Conclusions: There is somewhat limited evidence available for quantifying the extent to which children may contribute to overall transmission, but the balance of evidence so far suggests that children and schools play only a limited role in overall transmission.}, } @article {pmid33140345, year = {2020}, author = {Reinhardt, D}, title = {.}, journal = {MMW Fortschritte der Medizin}, volume = {162}, number = {19}, pages = {28-29}, doi = {10.1007/s15006-020-4536-z}, pmid = {33140345}, issn = {1613-3560}, mesh = {*COVID-19 ; Child ; Ethnic Groups ; Humans ; *SARS-CoV-2 ; Socioeconomic Factors ; }, } @article {pmid33130103, year = {2021}, author = {Penninger, JM and Grant, MB and Sung, JJY}, title = {The Role of Angiotensin Converting Enzyme 2 in Modulating Gut Microbiota, Intestinal Inflammation, and Coronavirus Infection.}, journal = {Gastroenterology}, volume = {160}, number = {1}, pages = {39-46}, doi = {10.1053/j.gastro.2020.07.067}, pmid = {33130103}, issn = {1528-0012}, mesh = {Angiotensin-Converting Enzyme 2/*metabolism/therapeutic use ; Animals ; Anti-Inflammatory Agents/therapeutic use ; Antiviral Agents/therapeutic use ; COVID-19/drug therapy/*enzymology/microbiology/virology ; Feces/microbiology/virology ; Gastroenteritis/drug therapy/*enzymology/microbiology/virology ; *Gastrointestinal Microbiome/drug effects ; Host-Pathogen Interactions ; Humans ; Intestinal Mucosa/drug effects/*enzymology/microbiology/virology ; Receptors, Virus/*metabolism ; Renin-Angiotensin System ; SARS-CoV-2/drug effects/*pathogenicity ; Virus Internalization ; }, abstract = {The role of angiotensin converting enzyme 2 has expanded from regulating the renin angiotensin system to regulating intestinal amino acid homeostasis and the gut microbiome. Recently, angiotensin converting enzyme 2 was identified as a primary receptor for severe acute respiratory syndrome coronaviruses 1 and 2 being expressed in multiple tissues including the luminal surface of the gut. In this brief perspective, we examine the role of angiotensin converting enzyme 2 as the receptor for severe acute respiratory syndrome coronavirus 2 and the impact of coronavirus disease 19 infection on the gut microbiome and on the gut epithelium.}, } @article {pmid33037446, year = {2020}, author = {Hernigou, P}, title = {Bone marrow in orthopaedics (part II): a three hundred and seventy million-year saga from the Devonian to the coronavirus disease 2019 pandemic-osteonecrosis; transplantation; "human chimera"; stem cells, bioreactors, and coronavirus disease.}, journal = {International orthopaedics}, volume = {44}, number = {12}, pages = {2787-2805}, doi = {10.1007/s00264-020-04843-z}, pmid = {33037446}, issn = {1432-5195}, mesh = {Animals ; Bioreactors ; *Bone Marrow ; COVID-19 ; Humans ; Orthopedics ; Osteonecrosis ; Pandemics ; SARS-CoV-2 ; Transplantation Chimera ; }, abstract = {PURPOSE: Three hundred seventy million years ago, bone marrow appeared in skeleton of a fish. More than one hundred years ago, the concept of bone marrow transplantation was proposed to treat human diseases. During the last five decades, this concept became a reality first in hematology and later for orthopaedic diseases.

MATERIAL AND METHODS: These advances were possible due to the comprehension of the three major components of bone marrow: the fat part, the haematologic part, and the stroma part. Each part has a different history, but the three parts are linked in physiology as in history.

RESULTS: During many centuries, bone marrow was considered just as food; however, one hundred years ago, the concept of bone marrow transplantation to treat humans was proposed by the French physician Brown-Séquard. During the last five decades, this concept became a reality first in haematology and later for orthopaedic diseases. Transferring what was known from experimental animal models to humans was met with many challenges, the atomic bomb research, and many deaths. Yet through the recognition and subsequent understanding of fundamental processes, medical resiliency, and the determination of a few pioneers, local bone marrow transplantation in orthopaedic surgery became a therapeutic option first for a limited number of diseases and patients. Over the last two decades, mesenchymal stromal cells (MSCs) have been the focus of intense research by acadaemia and industry due to their unique features. MSCs can be easily isolated and expanded through in vitro culture by taking full advantage of their self-renewing capacity. In addition, MSCs exert immunomodulatory effects and can be differentiated into various lineages, which makes them highly attractive for clinical applications in cell-based therapies.

CONCLUSION: In this review, we attempted to provide a historical overview of bone marrow history, MSC discovery, characterization, and the first clinical studies conducted.}, } @article {pmid33412367, year = {2020}, author = {Ratha, SK and Renuka, N and Rawat, I and Bux, F}, title = {Prospective options of algae-derived nutraceuticals as supplements to combat COVID-19 and human coronavirus diseases.}, journal = {Nutrition (Burbank, Los Angeles County, Calif.)}, volume = {83}, number = {}, pages = {111089}, doi = {10.1016/j.nut.2020.111089}, pmid = {33412367}, issn = {1873-1244}, abstract = {The outbreak of the coronavirus disease of 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 that has created huge trepidation worldwide, has a mortality rate of 0.5% to 1% and is growing incessantly. There are currently no therapies and/or vaccines that may help abate this viral disease, but the use of masks and social distancing can limit the spread. Boosting immunity has been a simple way to resist viral infection and limit fatalities. In this context, the use of nutraceuticals appears to be a potential panacea. The ability of algae-based nutraceuticals, mainly Spirulina, to boost immunity against viral diseases has already been reported clinically. Spirulina-based nutraceuticals boost the adaptive and innate immunity, and bioactive compounds, such as angiotensin-converting enzyme (ACE) inhibitor peptides, phycobiliproteins, sulfated polysaccharides, and calcium-Spirulan, can serve as antiviral agents. The presence of these molecules indicates its potential role in resisting infection and COVID-19 disease progression. This review focuses on the potential role of algal nutraceuticals as immune boosters to combat the human coronavirus and other viral diseases. The potential use of Spirulina-based nutraceuticals for combating COVID-19, its mechanism, and future directions have also been discussed.}, } @article {pmid33412365, year = {2020}, author = {Long, B and Brady, WJ and Bridwell, RE and Ramzy, M and Montrief, T and Singh, M and Gottlieb, M}, title = {Electrocardiographic manifestations of COVID-19.}, journal = {The American journal of emergency medicine}, volume = {41}, number = {}, pages = {96-103}, doi = {10.1016/j.ajem.2020.12.060}, pmid = {33412365}, issn = {1532-8171}, abstract = {INTRODUCTION: Coronavirus disease of 2019 (COVID-19) is a lower respiratory tract infection caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This disease can impact the cardiovascular system and lead to abnormal electrocardiographic (ECG) findings. Emergency clinicians must be aware of the ECG manifestations of COVID-19.

OBJECTIVE: This narrative review outlines the pathophysiology and electrocardiographic findings associated with COVID-19.

DISCUSSION: COVID-19 is a potentially critical illness associated with a variety of ECG abnormalities, with up to 90% of critically ill patients demonstrating at least one abnormality. The ECG abnormalities in COVID-19 may be due to cytokine storm, hypoxic injury, electrolyte abnormalities, plaque rupture, coronary spasm, microthrombi, or direct endothelial or myocardial injury. While sinus tachycardia is the most common abnormality, others include supraventricular tachycardias such as atrial fibrillation or flutter, ventricular arrhythmias such as ventricular tachycardia or fibrillation, various bradycardias, interval and axis changes, and ST segment and T wave changes. Several ECG presentations are associated with poor outcome, including atrial fibrillation, QT interval prolongation, ST segment and T wave changes, and ventricular tachycardia/fibrillation.

CONCLUSIONS: This review summarizes the relevant ECG findings associated with COVID-19. Knowledge of these findings in COVID-19-related electrocardiographic presentations may assist emergency clinicians in the evaluation and management of potentially infected and infected patients.}, } @article {pmid33412360, year = {2020}, author = {Montagnoli, C and Zanconato, G and Ruggeri, S and Cinelli, G and Tozzi, AE}, title = {Restructuring maternal services during the covid-19 pandemic: Early results of a scoping review for non-infected women.}, journal = {Midwifery}, volume = {94}, number = {}, pages = {102916}, doi = {10.1016/j.midw.2020.102916}, pmid = {33412360}, issn = {1532-3099}, abstract = {INTRODUCTION AND OBJECTIVE: The novel coronavirus outbreak has caused substantial changes in societal norms as well as adjustments in health systems worldwide. To date the impact of these pandemic-related variations has yet to be fully understood also in the field of maternal health for which continuity of care is a proven life-saving preventive measure.

DESIGN: Following the PRISMA guidelines for reviews, a literature search was carried out to assess different approaches that combine quality of maternal care with the imposed social-distancing rules. Nine studies were included in the scoping review.

FINDINGS: Reduction of in-person visits is the preferred overall solution. Yet, fewer consultations can still guarantee essential services and appropriate care through integration with telemedicine. Referral to epidemic-free community centres is an alternative option and new paths need to include the interdisciplinary contribution of medical consultants and IT experts, among others. In this context, delaying access for symptomatic expectant mothers is still debated since it carries the potential risk of untimely detection of pregnancy complications.

KEY CONCLUSIONS: Preliminary experiences provide an overview of the different attempts put in place to reshape health services to contain the pandemic hazards.

IMPLICATIONS FOR PRACTICE: These early prototypes may inspire future innovative health solutions compatible with local resources and specific population preferences and needs.}, } @article {pmid33412349, year = {2020}, author = {Piskorz, D and Puente Barragán, A and López Santi, R and Vázquez, G and Solache Ortiz, G and Ramírez Zambrano, L and Méndez Castillo, M and Roa, C and Baños, M and Guzmán Ramos, M and Cabral, L and Sánchez, P and Spitz, B and López Santi, MP and Estrella, J and Velarde González, M and Rafael Horna, E and Alexander, B and Baranchuk, A and , }, title = {Psychological Impact of the Pandemic on Ambulatory Cardiometabolic Patients Without Evidence of SARS-CoV-2 Infection. The CorCOVID Latam Psy Study.}, journal = {Current problems in cardiology}, volume = {46}, number = {4}, pages = {100737}, doi = {10.1016/j.cpcardiol.2020.100737}, pmid = {33412349}, issn = {1535-6280}, abstract = {BACKGROUND: The COVID-19 pandemic's mental health consequences remain unknown.

AIM: To assess the mental health status of ambulatory cardiometabolic patients during COVID-19 pandemic lockdown in Spanish speaking Latin American countries.

METHODS: Cardiometabolic patients without COVID-19 evidence in 13 Latin American countries answered a survey between June 15th and July 15th, 2020. The Diagnosis Manual of Mental Disorders fifth edition was used to identify the presence of major depressive symptoms.

RESULTS: The sample included 4216 patients, 1590 (37.71%; IC95% 36.24-39.19) were considered suffering major depression. Female gender, consuming ≥5 medications day, physical activity <100 minutes weekly, low fruits and vegetables intake, poor treatment adherence, reduced food consumption were independently associated to the presence of major depressive symptoms.

CONCLUSIONS: The CorCOVID Latam Psy study showed that one-third of the Latin American Spanish speaking population is suffering from major depressive symptoms during the COVID-19 outbreak.}, } @article {pmid33412348, year = {2020}, author = {Koh, CH}, title = {Commercial Air Travel for Passengers With Cardiovascular Disease: Recommendations for Less Common Conditions, Considerations for Venous Thromboembolism, and General Guidance.}, journal = {Current problems in cardiology}, volume = {46}, number = {4}, pages = {100782}, doi = {10.1016/j.cpcardiol.2020.100782}, pmid = {33412348}, issn = {1535-6280}, abstract = {The accelerated growth of commercial flights has resulted in a huge upswing of air travelers over the last few decades, including passengers with a wide range of cardiovascular conditions. Notwithstanding the ongoing COVID-19 pandemic that has set back the aviation industry for the next 1-2 years, air travel is expected to rebound fully by 2024. Guidelines and evidence-based recommendations for safe air travel in this group vary, and physicians often encounter situations where opinions and assessments on fitness for flights are sought. This article aims to provide an updated suite of recommendations for the aeromedical disposition of passenger with uncommon cardiovascular conditions, such as congenital heart diseases, inflammatory cardiac conditions (endocarditis/pericarditis/myocarditis), pulmonary hypertension, and venous thromboembolism. In addition, the article also aims to provide practical general guidance for the aeromedical examiner in evaluating, preparing, and optimizing the cardiac status of the patient with cardiovascular ailments for air travel.}, } @article {pmid33412256, year = {2021}, author = {Bouayed, J and Bohn, T}, title = {Adapted sickness behavior - why it is not enough to limit the COVID-19 spread?.}, journal = {Brain, behavior, and immunity}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.bbi.2020.12.028}, pmid = {33412256}, issn = {1090-2139}, } @article {pmid33412255, year = {2021}, author = {Burks, SM and Rosas-Hernandez, H and Alenjandro Ramirez-Lee, M and Cuevas, E and Talpos, JC}, title = {Can SARS-CoV-2 infect the central nervous system via the olfactory bulb or the blood-brain barrier?.}, journal = {Brain, behavior, and immunity}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.bbi.2020.12.031}, pmid = {33412255}, issn = {1090-2139}, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in Wuhan, China in December 2019. On February 11, the World Health Organization (WHO) announced the name for the new illness caused by SARS-CoV-2: COVID-19. By March 11, the outbreak of COVID-19 was declared a pandemic by the WHO. This virus has extensively altered daily life for many across the globe, while claiming hundreds of thousands of lives. While fundamentally a respiratory illness, many infected individuals experience symptoms that involve the central nervous system (CNS). It is likely that many of these symptoms are the result of the virus residing outside of the CNS. However, the current evidence does indicate that the SARS-CoV-2 virus can use olfactory neurons to travel from the periphery into the CNS, and that the virus may also enter the brain through the blood-brain barrier (BBB). We discuss how the virus may use established infection mechanisms (ACE2, TMPRSS2, and Cathepsin L), as well mechanisms still under consideration (NRP1 and BASIGIN) to infect and spread throughout the CNS. Confirming the impact of the virus on the CNS will be crucial in dealing with the long-term consequences of the epidemic.}, } @article {pmid33410987, year = {2021}, author = {Plasencia-García, BO and Rodríguez-Menéndez, G and Rico-Rangel, MI and Rubio-García, A and Torelló-Iserte, J and Crespo-Facorro, B}, title = {Drug-drug interactions between COVID-19 treatments and antipsychotics drugs: integrated evidence from 4 databases and a systematic review.}, journal = {Psychopharmacology}, volume = {}, number = {}, pages = {}, pmid = {33410987}, issn = {1432-2072}, abstract = {RATIONALE: Management of anxiety, delirium, and agitation cannot be neglected in coronavirus disease (COVID-19). Antipsychotics are usually used for the pharmacological management of delirium, and confusion and behavioral disturbances. The concurrent use of treatments for COVID-19 and antipsychotics should consider eventual drug-drug interactions OBJECTIVE: To systematically review evidence-based available on drug-drug interactions between COVID-19 treatments and antipsychotics.

EVIDENCE REVIEW: Three databases were consulted: Lexicomp® Drug Interactions, Micromedex® Solutions Drugs Interactions, and Liverpool© Drug Interaction Group for COVID-19 therapies. To acquire more information on QT prolongation and Torsade de Pointes (TdP), the CredibleMeds® QTDrugs List was searched. The authors made a recommendation agreed to by consensus. Additionally, a systematic review of drug-drug interactions between antipsychotics and COVID-19 treatment was conducted.

RESULTS: The main interactions between COVID-19 drugs and antipsychotics are the risk of QT-prolongation and TdP, and cytochromes P450 interactions. Remdesivir, baricinitib, and anakinra can be used concomitantly with antipsychotics without risk of drug-drug interaction (except for hematological risk with clozapine and baricinitib). Favipiravir only needs caution with chlorpromazine and quetiapine. Tocilizumab is rather safe to use in combination with antipsychotics. The most demanding COVID-19 treatments for coadministration with antipsychotics are chloroquine, hydroxychloroquine, azithromycin, and lopinavir/ritonavir because of the risk of QT prolongation and TdP and cytochromes interactions. The systematic review provides highly probable drug interaction between lopinavir/ritonavir plus quetiapine and ritonavir/indinavir plus risperidone.

CONCLUSIONS: Clinicians prescribing antipsychotics should be aware of the likely risk of drug-drug interaction with COVID-19 medication and may benefit from taking into account present recommendations of use to preserve patient safety.}, } @article {pmid33410826, year = {2021}, author = {Huergo, MAC and Thanh, NTK}, title = {Current advances in the detection of COVID-19 and evaluation of the humoral response.}, journal = {The Analyst}, volume = {}, number = {}, pages = {}, doi = {10.1039/d0an01686a}, pmid = {33410826}, issn = {1364-5528}, abstract = {The new outbreak caused by coronavirus SARS-CoV-2 started at the end of 2019 and was declared a pandemic in March 2020. Since then, several diagnostic approaches have been re-adapted, and also improved from the previous detections of SARS and MERS coronavirus. The best strategy to handle this situation seems to rely on a triad of detection methods: (i) highly sensitive and specific techniques as the gold standard method, (ii) easier and faster point of care tests accessible for large population screening, and (iii) serology assays to complement the direct detection and to use for surveillance. In this study, we assessed the techniques and tests described in the literature, their advantages and disadvantages, and the interpretation of the results. Quantitative reverse transcription polymerase chain reaction (RT-qPCR) is undoubtedly the gold standard technique utilized not only for diagnostics, but also as a standard for comparison and validation of newer approaches. Other nucleic acid amplification methods have been shown to be adequate as point of care (POC) diagnostic tests with similar performance as RT-qPCR. The analysis of seroconversion with immunotests shows the complexity of the immune response to COVID-19. The detection of anti-SARS-CoV-2 antibodies can also help to detect previously infected asymptomatic individuals with negative RT-qPCR tests. Nevertheless, more controlled serology cohort studies should be performed as soon as possible to understand the immune response to SARS-CoV-2.}, } @article {pmid33410272, year = {2021}, author = {Gachabayov, M and Lebovics, E and Rojas, A and Felsenreich, DM and Latifi, R and Bergamaschi, R}, title = {Performance Evaluation of Stool DNA Methylation Tests in Colorectal Cancer Screening: A Systematic Review and Meta-analysis.}, journal = {Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland}, volume = {}, number = {}, pages = {}, doi = {10.1111/codi.15521}, pmid = {33410272}, issn = {1463-1318}, abstract = {BACKGROUND: There is not sufficient evidence as to whether stool DNA methylation tests allow prioritizing patients to colonoscopy. Due to the COVID-19 pandemic, there will be a waitlist for rescheduling colonoscopies once the mitigation is lifted. The aim of this meta-analysis was to evaluate the accuracy of stool DNA methylation tests in detecting colorectal cancer.

METHODS: The PubMed, Cochrane Library, and MEDLINE via Ovid were searched. Studies reporting accuracy (Sackett phase 2 or 3) of stool DNA methylation tests to detect sporadic colorectal cancer were included. The DerSimonian-Laird method with random-effects model was utilized for meta-analysis.

RESULTS: Forty-six studies totaling 16,149 patients were included in the meta-analysis. Pooled sensitivity and specificity of all single genes and combinations was 62.7% (57.7%, 67.4%) and 91% (89.5%, 92.2%), respectively. Combinations of genes provided higher sensitivity as compared to single genes [80.8% (75.1%, 85.4%) vs. 57.8% (52.3%, 63.1%)] with no significant decrease in specificity [87.8% (84.1%, 90.7%) vs. 92.1% (90.4%, 93.5%)]. The most accurate single gene was found to be SDC2 with a sensitivity of 83.1% (72.6%, 90.2%) and a specificity of 91.2% (88.6%, 93.2%).

CONCLUSIONS: Stool DNA methylation tests have high specificity (92%) with relatively lower sensitivity (81%). Combining genes increases sensitivity as compared to single gene tests. The single most accurate gene is SDC2, which should be considered for further research.}, } @article {pmid33409846, year = {2021}, author = {Farid, N and Rola, N and Koch, EAT and Nakhoul, N}, title = {Active vitamin D supplementation and COVID-19 infections: review.}, journal = {Irish journal of medical science}, volume = {}, number = {}, pages = {}, pmid = {33409846}, issn = {1863-4362}, abstract = {SARS-CoV-2, causing the lethal disease COVid-19, is a public health emergency in the 2020 global pandemic. The outbreak and fast spreading of SARS-CoV-2 have a high morbidity and mortality specifically in elder patients with chronic diseases such as diabetes mellitus, arterial hypertension, chronic kidney disease, and organ transplanted patients with immunosuppressive therapy. Preliminary results support different treatments such as chloroquine and convalescent plasma infusion in severe cases, with good outcome. On the other hand, the efficacy of supplementation with active vitamin D, an immunomodulator hormone with antiinflammatory and antimicrobial effects, is unproven. A recent study reported that vitamin D attains antiviral effects, via blocking viral replication directly. SARS-CoV-2 primarily uses the immune evasion process during infection via the envelope spike glycoprotein, which is followed by a cytokine storm, causing severe acute respiratory disease syndrome and death. SARS-CoV-2, by using the well-known angiotensin-converting enzyme 2 by the protein spike, as the host receptor to enter into alveolar, myocardial, and renal epithelial cells, can be disrupted by vitamin D. However, the correlation between vitamin D levels and COVID-19 deaths in previous studies was insignificant. Retrospective studies demonstrated a correlation between vitamin D status and COVID-19 severity and mortality, while other studies did not find this correlation. Studies have shown that, vitamin D reduces the risk of acute viral respiratory tract infections and pneumonia via direct inhibition of viral replication, antiinflammatory and immunomodulatory effects. The data available today regarding the beneficial protective effect of vitamin D is unclear and with conflicting results. Large randomized control trials are necessary to test this hypothesis. In this review, we will explain the cross talk between the active vitamin D and the angiotensin-converting enzyme 2, and summarize the data from the literature.}, } @article {pmid33409824, year = {2021}, author = {Iodice, F and Cassano, V and Rossini, PM}, title = {Direct and indirect neurological, cognitive, and behavioral effects of COVID-19 on the healthy elderly, mild-cognitive-impairment, and Alzheimer's disease populations.}, journal = {Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology}, volume = {}, number = {}, pages = {}, pmid = {33409824}, issn = {1590-3478}, abstract = {INTRODUCTION: Healthy elderly, mild cognitive impairment and Alzheimer's disease populations have been among the most affected in the early stages of the COVID-19 pandemic due to the direct effects of the virus, and numerous indirect effects now emerge and will have to be carefully assessed over time.

METHODS: This article reviews the main articles that have been published so far about the direct and indirect effects of the COVID-19 pandemic on these particularly fragile populations.

RESULTS: The pandemic associated to COVID-19 has shifted most of the health resources to the emergency area and has consequently left the three main medical areas dealing with the elderly population (oncology, time-dependent diseases and degenerative disease) temporarily "uncovered". In the phase following the emergency, it will be crucial to guarantee to each area the economic and organizational resources to quickly return to the level of support of the prepandemic state.

CONCLUSIONS: The emergency phase represented a significant occasion of discussion on the possibilities of telemedicine which will inevitably become increasingly important, but all the limits of its use in the elderly population have to be considered. In the post-lockdown recovery phase, alongside the classic medical evaluation, the psychological evaluation must become even more important for doctors caring about people with cognitive decline as well as with their caregivers.}, } @article {pmid33409629, year = {2021}, author = {Zahedi, A and Monis, P and Deere, D and Ryan, U}, title = {Wastewater-based epidemiology-surveillance and early detection of waterborne pathogens with a focus on SARS-CoV-2, Cryptosporidium and Giardia.}, journal = {Parasitology research}, volume = {}, number = {}, pages = {}, pmid = {33409629}, issn = {1432-1955}, abstract = {Waterborne diseases are a major global problem, resulting in high morbidity and mortality, and massive economic costs. The ability to rapidly and reliably detect and monitor the spread of waterborne diseases is vital for early intervention and preventing more widespread disease outbreaks. Pathogens are, however, difficult to detect in water and are not practicably detectable at acceptable concentrations that need to be achieved in treated drinking water (which are of the order one per million litre). Furthermore, current clinical-based surveillance methods have many limitations such as the invasive nature of the testing and the challenges in testing large numbers of people. Wastewater-based epidemiology (WBE), which is based on the analysis of wastewater to monitor the emergence and spread of infectious disease at a population level, has received renewed attention in light of the current coronavirus disease 2019 (COVID-19) pandemic. The present review will focus on the application of WBE for the detection and surveillance of pathogens with a focus on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the waterborne protozoan parasites Cryptosporidium and Giardia. The review highlights the benefits and challenges of WBE and the future of this tool for community-wide infectious disease surveillance.}, } @article {pmid33409414, year = {2020}, author = {Susilowati, IH and Nakatani, H and Nugraha, S and Pengpid, S and Keawpan, W and Hasiholan, BP and Toai, NP and Abdeali, A and Isahak, M and Kamso, S}, title = {COVID-19 handling report for pre-case, case (pre-hospital and hospital), and post-case phases in the elderly as vulnerable populations in 6 Asia Pacific countries.}, journal = {Global health & medicine}, volume = {2}, number = {6}, pages = {350-359}, doi = {10.35772/ghm.2020.01061}, pmid = {33409414}, issn = {2434-9194}, abstract = {In this current COVID-19 pandemic, the elderly (60 years and over) are more vulnerable populations to be infected and become victims. In a disaster cycle, the various parts are usually divided into three stages, consisting of the pre-impact stage, the trans-impact stage, and the post-impact stage. It is necessary to explain how to handle the COVID-19 disaster for the elderly at each step (explain the meaning of pre-case, case (pre-hospital and hospital), and post-case phases, respectively). This paper presents the handling of COVID-19 for elderly in pre-case, case, and post-case phases in six Asia-Pacific countries (Indonesia, Thailand, Singapore, Malaysia, Vietnam, and Japan). The data and information come from COVID-19 official websites of each country, including information from World Health Organization (WHO), United States Centers for Disease Control and Prevention (CDC), mass media, and professional associations. The handling of COVID-19 in the pre-case phase has been done correctly for the elderly, especially in Indonesia, Japan, Thailand, and Singapore. In the case phase (pre-hospital and hospital), only Indonesia, Japan, and Thailand have followed special handling protocols for the elderly, particularly for those who have comorbidities and respiratory diseases. For the post-case phase, all countries have the same treatment protocol for all age groups, with none specific for the elderly.}, } @article {pmid33409264, year = {2020}, author = {Wagner, CE and Prentice, JA and Saad-Roy, CM and Yang, L and Grenfell, BT and Levin, SA and Laxminarayan, R}, title = {Economic and Behavioral Influencers of Vaccination and Antimicrobial Use.}, journal = {Frontiers in public health}, volume = {8}, number = {}, pages = {614113}, doi = {10.3389/fpubh.2020.614113}, pmid = {33409264}, issn = {2296-2565}, abstract = {Despite vast improvements in global vaccination coverage during the last decade, there is a growing trend in vaccine hesitancy and/or refusal globally. This has implications for the acceptance and coverage of a potential vaccine against COVID-19. In the United States, the number of children exempt from vaccination for "philosophical belief-based" non-medical reasons increased in 12 of the 18 states that allowed this policy from 2009 to 2017 (1). Meanwhile, the overuse and misuse of antibiotics, especially in young children, have led to increasing rates of drug resistance that threaten our ability to treat infectious diseases. Vaccine hesitancy and antibiotic overuse exist side-by-side in the same population of young children, and it is unclear why one modality (antibiotics) is universally seen as safe and effective, while the other (vaccines) is seen as potentially hazardous by some. In this review, we consider the drivers shaping the use of vaccines and antibiotics in the context of three factors: individual incentives, risk perceptions, and social norms and group dynamics. We illustrate how these factors contribute to the societal and individual costs of vaccine underuse and antimicrobial overuse. Ultimately, we seek to understand these factors that are at the nexus of infectious disease epidemiology and social science to inform policy-making.}, } @article {pmid33409174, year = {2020}, author = {Parida, SP and Bhatia, V and Roy, A}, title = {Masks in COVID-19 pandemic: Are we doing it right?.}, journal = {Journal of family medicine and primary care}, volume = {9}, number = {10}, pages = {5122-5126}, doi = {10.4103/jfmpc.jfmpc_657_20}, pmid = {33409174}, issn = {2249-4863}, abstract = {The coronavirus (COVID-19) pandemic has caused the world to undergo an unprecedented change in a short period. Personal protective equipment such as the face mask or face cover has become a daily necessity. Moreover, since some states and countries have made the use of face covers or face masks compulsory, one cannot ignore or afford to have a wrong or incomplete awareness about face masks. Current information suggests that the two main routes of transmission of the COVID-19 virus are respiratory droplets and contact. This article aims to review the existing information and highlight the need for the use of face masks or face covers to combat the COVID-19 pandemic and promote and provide necessary recommendations. Many countries have implemented or recommended mask wearing in the community, but recommendation for rational use of masks is being issued, as the crisis and shortage for masks are universally existing. The use of different types of masks has been assigned according to the risk of exposure and should be therefore judiciously used. As this is a novel disease, the guidelines are changing every day and one needs to be updated with correct information so that one can protect themselves and their families from this extreme level of the crisis faced by the world now. The use of face covers or masks should not be discouraged as there has been substantial evidence that its use can help reduce the spread of infection. "Mass masking" along with hand hygiene and social distancing are the only effective recommended measures to prevent the spread of the disease.}, } @article {pmid33409173, year = {2020}, author = {Bamola, VD and Chaudhry, R}, title = {Recent discovery and development on SARS-CoV-2: A review of current literature.}, journal = {Journal of family medicine and primary care}, volume = {9}, number = {10}, pages = {5113-5121}, doi = {10.4103/jfmpc.jfmpc_851_20}, pmid = {33409173}, issn = {2249-4863}, abstract = {The origin and spread of current novel coronavirus had raised serious concerns among stakeholders around the globe. Different speculations that may unfold the mystery in the future are taking roots, but now there is no globally acceptable opinion about the origin and spread of this novel coronavirus. It is reported that Wuhan city of Hubei Province of central China was the epicenter of this outbreak of novel coronavirus. However, initial inadequate preventive measures allowed the infection to cross the borders of China and that pulls the world into drastic public health and economic crisis. This coronavirus disease now named as COVID-19 by World Health Organization (WHO) and the responsible coronavirus is named as "severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)." The spread of SARS-CoV-2 is alarming even after 5 months of inception and WHO further warns the world to be prepared for more intense spread of COVID-19. Different diagnostic tools to detect SARS-CoV-2 are being used around the globe, but the identification of asymptomatic carriers of the disease is a serious challenge in countering the COVID-19 pandemic. There is no specific treatment available, only preventive, symptomatic, and supportive treatments are being used for clinical management of COVID-19. The available knowledge is limited, therefore, any escalation of information on the disease will help to combat this global challenge of COVID-19. In this review, we have discussed and summarized the available multi-factorial information and recent updates on the SARS-CoV-2 which can help support future research and may help in the strategic management of the current COVID-19 pandemic. The articles available online before June 30, 2020, on bioRxiv, medRxiv, ChemRxiv, Google Scholar, and PubMed have been assessed for the compilation of this review. Information on the official portal of WHO, CDC, ICMR, etc., were also assessed and used with due credit.}, } @article {pmid33409171, year = {2020}, author = {Pillai, DDM and Nagappan, N and Dharani, SV and Subramanian, K and Champakesan, B and D'Cruz, TM}, title = {Socio-economic impact of coronavirus disease 2019 (COVID-19) - An Indian outlook.}, journal = {Journal of family medicine and primary care}, volume = {9}, number = {10}, pages = {5103-5106}, doi = {10.4103/jfmpc.jfmpc_835_20}, pmid = {33409171}, issn = {2249-4863}, abstract = {It took only days to a few months, for the coronavirus to spread across the globe from it's place of origin, Wuhan city, China. Though, India is not among the worst affected countries of coronavirus, it is still a major Public Health emergency which pose a serious threat of crippling the nation's economy. A densely populated country like India, cannot afford getting it's population infected with coronavirus, as that will have an enormous strain in existing healthcare facilities. Although the government of India has implemented complete lockdown, there are many economic concerns to be addressed. Even though, relief fund was announced, the nation's huge population could use additional financial support, to take care of their essential needs like groceries, provisions and medicines. The livelihood, employment and income of many citizens remains questionable. This article attempts to give a socio-economic perspective of the coronavirus pandemic in India.}, } @article {pmid33408926, year = {2020}, author = {Dhandapani, M and Dhandapani, S}, title = {Challenges posed by COVID-19 and neurosurgical nursing strategies in developing countries.}, journal = {Surgical neurology international}, volume = {11}, number = {}, pages = {441}, doi = {10.25259/SNI_677_2020}, pmid = {33408926}, issn = {2229-5097}, abstract = {Background: Neurosurgical patients with stroke, trauma, and brain tumors can be among the victims of the COVID-19 pandemic in developing countries, which need to be managed efficiently.

Methods: This is an overview of neurosurgical nurses' challenges and strategies in the current COVID-19 pandemic environment in developing countries.

Results: Here, we reviewed the unique challenges of providing neurosurgical nursing services during the COVID-19 pandemic in developing countries. We address specific issues such as transferring neurosurgical patients, allocating medical supplies, prioritizing neurosurgical services, COVID-19 testing protocols, and patient triage (emergent vs. urgent vs. delayed surgery). Teleconsultation, telenursing services for outpatient treatment, follow-up and virtual teaching strategies associated with neurosurgical nursing are discussed.

Conclusion: Neurosurgical nursing during the COVID-19 pandemic in developing countries requires transparent planning, implementation, and careful consideration of various telemedicine strategies.}, } @article {pmid33408775, year = {2021}, author = {Karpiński, TM and Ożarowski, M and Seremak-Mrozikiewicz, A and Wolski, H and Wlodkowic, D}, title = {The 2020 race towards SARS-CoV-2 specific vaccines.}, journal = {Theranostics}, volume = {11}, number = {4}, pages = {1690-1702}, doi = {10.7150/thno.53691}, pmid = {33408775}, issn = {1838-7640}, abstract = {The global outbreak of a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) highlighted a requirement for two pronged clinical interventions such as development of effective vaccines and acute therapeutic options for medium-to-severe stages of "coronavirus disease 2019" (COVID-19). Effective vaccines, if successfully developed, have been emphasized to become the most effective strategy in the global fight against the COVID-19 pandemic. Basic research advances in biotechnology and genetic engineering have already provided excellent progress and groundbreaking new discoveries in the field of the coronavirus biology and its epidemiology. In particular, for the vaccine development the advances in characterization of a capsid structure and identification of its antigens that can become targets for new vaccines. The development of the experimental vaccines requires a plethora of molecular techniques as well as strict compliance with safety procedures. The research and clinical data integrity, cross-validation of the results, and appropriated studies from the perspective of efficacy and potently side effects have recently become a hotly discussed topic. In this review, we present an update on latest advances and progress in an ongoing race to develop 52 different vaccines against SARS-CoV-2. Our analysis is focused on registered clinical trials (current as of November 04, 2020) that fulfill the international safety and efficacy criteria in the vaccine development. The requirements as well as benefits and risks of diverse types of SARS-CoV-2 vaccines are discussed including those containing whole-virus and live-attenuated vaccines, subunit vaccines, mRNA vaccines, DNA vaccines, live vector vaccines, and also plant-based vaccine formulation containing coronavirus-like particle (VLP). The challenges associated with the vaccine development as well as its distribution, safety and long-term effectiveness have also been highlighted and discussed.}, } @article {pmid33408744, year = {2020}, author = {Lim, JH and Jung, HY and Choi, JY and Park, SH and Kim, CD and Kim, YL and Cho, JH}, title = {Hypertension and Electrolyte Disorders in Patients with COVID-19.}, journal = {Electrolyte & blood pressure : E & BP}, volume = {18}, number = {2}, pages = {23-30}, doi = {10.5049/EBP.2020.18.2.23}, pmid = {33408744}, issn = {1738-5997}, abstract = {The worldwide coronavirus disease 2019 (COVID-19) pandemic is still in progress, but much remains unknown about the disease. In this article, we review the association of hypertension or the renin-angiotensin system (RAS) with COVID-19 and the correlation between electrolyte disorders and disease severity. Underlying hypertension is likely to be associated with severe or critical COVID-19, but the relationship is not clear owing to confounding factors. Angiotensin-converting enzyme 2 (ACE2) plays an important role in the non-classical RAS pathway and binds to a receptor binding domain of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The RAS blockade is known to increase ACE2 levels, but controversy remains regarding the effect of RAS blockade therapy in the course of COVID-19. Some reports have indicated a protective effect of RAS blockade on COVID-19, whereas others have reported an association of RAS blockade therapy with the occurrence of severe complications such as acute kidney injury and admission to the intensive care unit. Electrolyte disorders are not uncommon in patients with COVID-19, and severe COVID-19 has frequently shown hypokalemia, hyponatremia, and hypocalcemia. Electrolyte imbalances are caused by alteration of RAS, gastrointestinal loss, effects of proinflammatory cytokines, and renal tubular dysfunction by the invasion of SARS-CoV-2.}, } @article {pmid33408658, year = {2020}, author = {Pinto, S and Soares, J and Silva, A and Curral, R and Coelho, R}, title = {COVID-19 Suicide Survivors-A Hidden Grieving Population.}, journal = {Frontiers in psychiatry}, volume = {11}, number = {}, pages = {626807}, doi = {10.3389/fpsyt.2020.626807}, pmid = {33408658}, issn = {1664-0640}, abstract = {Present time has been dominated by the COVID-19 pandemic. People are grieving several non-death related situations: the loss of a job, of a status, of a role, of their life. Restrictive measures and uncertainty about the future makes individuals vulnerable to feelings of hopelessness and helplessness. Mental health support has been hindered and teams are reinventing themselves to reach people in need. Nevertheless, decompensation of previous psychiatric disorders, increasing levels of depression and anxiety, economical handicaps and fear of the infection, are prompting several cases of COVID-19 related suicides worldwide. Every suicide affects between 5 and 80 individuals, which are known as suicide survivors. Suicide grief is particularly challenging, with rates of complicated grief as high as 40%. Suicide survivors are at increased risk of developing depression, anxiety disorders and of suicidal behaviors. Moreover, feelings of guilt and shame, as well as social stigma, are major obstacles for them to reach form help. This article aims to review the existing literature on COVID-19 related suicides, complicated grief in suicide survivors and highlight modifiable risk factors for both conditions, as well as propose some public health measures to reduce the impact of the pandemic context on self-inflicted harm and its consequences on families, friends and the community. Obstacles to access to mental health support need to be overcome through the use of technology. Technicians should actively approach populations more vulnerable to develop suicidal ideation. Social media have the obligation to provide accurate an non-sensationalistic information. Families and friends should maintain social proximity, despite the need for physical distancing. When a suicide death occurs, police forces and health staff should be prepared to share the news with the family using an empathic and humane approach and providing psychological support. Funerals, memorials and other services should be held as much as possible. Closer contacts should be signalized and closely followed in order to detect the need for specific interventions. Help seeking behaviors should be promoted. Additionally, people should be educated on suicide and its impacts, in order to reduce stigma.}, } @article {pmid33408539, year = {2020}, author = {Almeharish, A and Assiri, AM and Alfattani, A and De Vol, E}, title = {Coping with the COVID-19 Pandemic's Unique Challenges Associated with Medical Research: A Saudi Institution Approach.}, journal = {Risk management and healthcare policy}, volume = {13}, number = {}, pages = {3173-3178}, doi = {10.2147/RMHP.S283582}, pmid = {33408539}, issn = {1179-1594}, abstract = {The spread of COVID-19 has become a significant threat to economic activity throughout the world, and it has made life particularly difficult for research institutions. According to a report published by Spain's largest public research body, Cybermetrics Labs, King Faisal Specialist Hospital and Research Centre (KFSH&RC) is ranked first among the leading hospitals in the Arab world, and it has instituted a wide range of policy changes to accommodate researchers by providing them with additional flexibility. The aim of this project was to highlight the most prevalent COVID-related global challenges facing research institutions and describe how research protocol at KFSH&RC has been adjusted to minimize the disruption experienced by its researchers.}, } @article {pmid33408440, year = {2020}, author = {Jerome, JTJ and Mercier, F and Mudgal, CS and Arenas-Prat, J and Vinagre, G and Goorens, CK and Rivera-Chavarría, IJ and Sechachalam, S and Mofikoya, B and Thoma, A and Medina, C and , and Rivera-Chavarría, IJ and Henry, M and Afshar, A and Dailiana, ZH and Prasetyono, TOH and Artiaco, S and Madhusudhan, TR and Ukaj, S and Reigstad, O and Hamada, Y and Bedi, R and Poggetti, A and Al-Qattan, MM and Siala, M and Viswanathan, A and Romero-Reveron, R and Hong, JP and Khalid, KA and Bhaskaran, S and Venkatadass, K and Leechavengvongs, S and Goorens, CK and Nazim, S and Georgescu, AV and Tremp, M and Nakarmi, KK and Ellabban, MA and Chan, P and Aristov, A and Patel, S and Moreno-Serrano, CL and Rai, S and Kanna, RM and Malshikare, VA and Tanabe, K and Thomas, S and Gokkus, K and Baek, SH and Brandt, J and Rith, Y and Olazabal, A and Saaiq, M and Patil, V and Jithendran, N and Parekh, H and Minamikawa, Y and Atagawi, AA and Hadi, JA and Berezowsky, CA and Moya-Angeler, J and Altamirano-Cruz, MA and Galvis R, LA and Antezana, A and Paczesny, L and Fernandes, CH and Asadullah, M and Yuan-Shun, L and Makelov, B and Dodakundi, C and Regmi, R and Pereira, GU and Zhang, S and Sayoojianadhan, B and Callupe, I and Rakha, MI and Papes, D and Ganesan, RP and Mohan, M and Jeyaraman, A and Prabhakar, P and Rajniashokan, A and Geethan, I and Chandrasekar, S and Löw, S and Thangavelu, K and Giudici, LD and Palanisamy, Y and Vaidyanathan, S and Boretto, J and Ramirez, MA and Goundar, TS and Kuppusamy, T and Kanniyan, K and Srivastava, A and Chiu, YC and Bhat, AK and Gopinath, NR and Vasudevan, VP and Abraham, V}, title = {Perspectives and Consensus among International Orthopaedic Surgeons during Initial and Mid-lockdown Phases of Coronavirus Disease.}, journal = {Journal of hand and microsurgery}, volume = {12}, number = {3}, pages = {135-162}, doi = {10.1055/s-0040-1713964}, pmid = {33408440}, issn = {0974-3227}, abstract = {With a lot of uncertainty, unclear, and frequently changing management protocols, COVID-19 has significantly impacted the orthopaedic surgical practice during this pandemic crisis. Surgeons around the world needed closed introspection, contemplation, and prospective consensual recommendations for safe surgical practice and prevention of viral contamination. One hundred orthopaedic surgeons from 50 countries were sent a Google online form with a questionnaire explicating protocols for admission, surgeries, discharge, follow-up, relevant information affecting their surgical practices, difficulties faced, and many more important issues that happened during and after the lockdown. Ten surgeons critically construed and interpreted the data to form rationale guidelines and recommendations. Of the total, hand and microsurgery surgeons (52%), trauma surgeons (32%), joint replacement surgeons (20%), and arthroscopy surgeons (14%) actively participated in the survey. Surgeons from national public health care/government college hospitals (44%) and private/semiprivate practitioners (54%) were involved in the study. Countries had lockdown started as early as January 3, 2020 with the implementation of partial or complete lifting of lockdown in few countries while writing this article. Surgeons (58%) did not stop their surgical practice or clinics but preferred only emergency cases during the lockdown. Most of the surgeons (49%) had three-fourths reduction in their total patients turn-up and the remaining cases were managed by conservative (54%) methods. There was a 50 to 75% reduction in the number of surgeries. Surgeons did perform emergency procedures without COVID-19 tests but preferred reverse transcription polymerase chain reaction (RT-PCR; 77%) and computed tomography (CT) scan chest (12%) tests for all elective surgical cases. Open fracture and emergency procedures (60%) and distal radius (55%) fractures were the most commonly performed surgeries. Surgeons preferred full personal protection equipment kits (69%) with a respirator (N95/FFP3), but in the case of unavailability, they used surgical masks and normal gowns. Regional/local anesthesia (70%) remained their choice for surgery to prevent the aerosolized risk of contaminations. Essential surgical follow-up with limited persons and visits was encouraged by 70% of the surgeons, whereas teleconsultation and telerehabilitation by 30% of the surgeons. Despite the protective equipment, one-third of the surgeons were afraid of getting infected and 56% feared of infecting their near and dear ones. Orthopaedic surgeons in private practice did face 50 to 75% financial loss and have to furlough 25% staff and 50% paramedical persons. Orthopaedics meetings were cancelled, and virtual meetings have become the preferred mode of sharing the knowledge and experiences avoiding human contacts. Staying at home, reading, and writing manuscripts became more interesting and an interesting lifestyle change is seen among the surgeons. Unanimously and without any doubt all accepted the fact that COVID-19 pandemic has reached an unprecedented level where personal hygiene, hand washing, social distancing, and safe surgical practices are the viable antidotes, and they have all slowly integrated these practices into their lives. Strict adherence to local authority recommendations and guidelines, uniform and standardized norms for admission, inpatient, and discharge, mandatory RT-PCR tests before surgery and in selective cases with CT scan chest, optimizing and regularizing the surgeries, avoiding and delaying nonemergency surgeries and follow-up protocols, use of teleconsultations cautiously, and working in close association with the World Health Organization and national health care systems will provide a conducive and safe working environment for orthopaedic surgeons and their fraternity and also will prevent the resurgence of COVID-19.}, } @article {pmid33408338, year = {2021}, author = {Talarico, R and Aguilera, S and Alexander, T and Amoura, Z and Antunes, AM and Arnaud, L and Avcin, T and Beretta, L and Bombardieri, S and Burmester, GR and Cannizzo, S and Cavagna, L and Chaigne, B and Cornet, A and Costedoat-Chalumeau, N and Doria, A and Ferraris, A and Fischer-Betz, R and Fonseca, JE and Frank, C and Gaglioti, A and Galetti, I and Grunert, J and Guimarães, V and Hachulla, E and Houssiau, F and Iaccarino, L and Krieg, T and Limper, M and Malfait, F and Mariette, X and Marinello, D and Martin, T and Matthews, L and Matucci-Cerinic, M and Meyer, A and Montecucco, C and Mouthon, L and Müller-Ladner, U and Rednic, S and Romão, VC and Schneider, M and Smith, V and Sulli, A and Tamirou, F and Taruscio, D and Taulaigo, AV and Terol, E and Tincani, A and Ticciati, S and Turchetti, G and van Hagen, PM and van Laar, JM and Vieira, A and de Vries-Bouwstra, JK and Cutolo, M and Mosca, M}, title = {The impact of COVID-19 on rare and complex connective tissue diseases: the experience of ERN ReCONNET.}, journal = {Nature reviews. Rheumatology}, volume = {}, number = {}, pages = {}, pmid = {33408338}, issn = {1759-4804}, abstract = {During the COVID-19 pandemic, the need to provide high-level care for a large number of patients with COVID-19 has affected resourcing for, and limited the routine care of, all other conditions. The impact of this health emergency is particularly relevant in the rare connective tissue diseases (rCTDs) communities, as discussed in this Perspective article by the multi-stakeholder European Reference Network on Rare and Complex Connective Tissue and Musculoskeletal Diseases (ERN ReCONNET). The clinical, organizational and health economic challenges faced by health-care providers, institutions, patients and their families during the SARS-CoV-2 outbreak have demonstrated the importance of ensuring continuity of care in the management of rCTDs, including adequate diagnostics and monitoring protocols, and highlighted the need for a structured emergency strategy. The vulnerability of patients with rCTDs needs to be taken into account when planning future health policies, in preparation for not only the post-COVID era, but also any possible new health emergencies.}, } @article {pmid33408195, year = {2021}, author = {Loo, J and Spittle, DA and Newnham, M}, title = {COVID-19, immunothrombosis and venous thromboembolism: biological mechanisms.}, journal = {Thorax}, volume = {}, number = {}, pages = {}, doi = {10.1136/thoraxjnl-2020-216243}, pmid = {33408195}, issn = {1468-3296}, abstract = {Thrombotic events that frequently occur in COVID-19 are predominantly venous thromboemboli (VTE) and are associated with increasing disease severity and worse clinical outcomes. Distinctive microvascular abnormalities in COVID-19 include endothelial inflammation, disruption of intercellular junctions and microthrombi formation. A distinct COVID-19-associated coagulopathy along with increased cytokines and activation of platelets, endothelium and complement occur in COVID-19, which is more frequent with worsening disease severity. This proinflammatory milieu may result in immunothrombosis, a host defence mechanism that can become dysregulated, leading to excess formation of immunologically mediated thrombi which predominantly affect the microvasculature. The haemostatic and immune systems are intricately linked, and multifactorial processes are likely to contribute to VTE and immunothrombosis in COVID-19. This state-of-the-art review will explore the pathobiological mechanisms of immunothrombosis and VTE in COVID-19 focusing on: COVID-19-associated coagulopathy, pathology, endothelial dysfunction and haemostasis, the immune system and thrombosis, genetic associations and additional thrombotic mechanisms. An understanding of the complex interplay between these processes is necessary for developing and assessing how new treatments affect VTE and immunothrombosis in COVID-19.}, } @article {pmid33407833, year = {2021}, author = {Abbas, M and Robalo Nunes, T and Martischang, R and Zingg, W and Iten, A and Pittet, D and Harbarth, S}, title = {Nosocomial transmission and outbreaks of coronavirus disease 2019: the need to protect both patients and healthcare workers.}, journal = {Antimicrobial resistance and infection control}, volume = {10}, number = {1}, pages = {7}, pmid = {33407833}, issn = {2047-2994}, abstract = {OBJECTIVES: To compile current published reports on nosocomial outbreaks of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), evaluate the role of healthcare workers (HCWs) in transmission, and evaluate outbreak management practices.

METHODS: Narrative literature review.

SHORT CONCLUSION: The coronavirus disease 2019 (COVID-19) pandemic has placed a large burden on hospitals and healthcare providers worldwide, which increases the risk of nosocomial transmission and outbreaks to "non-COVID" patients or residents, who represent the highest-risk population in terms of mortality, as well as HCWs. To date, there are several reports on nosocomial outbreaks of SARS-CoV-2, and although the attack rate is variable, it can be as high as 60%, with high mortality. There is currently little evidence on transmission dynamics, particularly using genomic sequencing, and the role of HCWs in initiating or amplifying nosocomial outbreaks is not elucidated. There has been a paradigm shift in management practices of viral respiratory outbreaks, that includes widespread testing of patients (or residents) and HCWs, including asymptomatic individuals. These expanded testing criteria appear to be crucial in identifying and controlling outbreaks.}, } @article {pmid33406780, year = {2021}, author = {Kousi, T and Mitsi, LC and Simos, J}, title = {The Early Stage of COVID-19 Outbreak in Greece: A Review of the National Response and the Socioeconomic Impact.}, journal = {International journal of environmental research and public health}, volume = {18}, number = {1}, pages = {}, doi = {10.3390/ijerph18010322}, pmid = {33406780}, issn = {1660-4601}, abstract = {Greece is a European-Union country, of around 10 million people, located in the southeast part of Europe. The economy is recovering from a long period of deep recession, due to the economic crisis that started in 2008. The economic problems greatly influenced the structure and resources of the healthcare system of the country. In addition to the economic challenges, the country has been facing a refugee crisis, characterized by many overcrowded hotspots and tensions with neighboring Turkey. The COVID-19 outbreak arrived in Greece on 26 February 2020, at the time that Athens had declared a state of emergency at the Greek/Turkish border. From this point in time the government enforced a series of measurements, aiming to contain the epidemic and avoid the collapse of the healthcare system. The vast majority of the general population complied to the measures and consequently Greece's death toll was low. The impacts of the outbreak are expected to be, as everywhere worldwide, multifaceted and to affect many parts of the economic, social and political life of the country.}, } @article {pmid33406644, year = {2021}, author = {Millioni, R and Mortarino, C}, title = {Test Groups, Not Individuals: A Review of the Pooling Approaches for SARS-CoV-2 Diagnosis.}, journal = {Diagnostics (Basel, Switzerland)}, volume = {11}, number = {1}, pages = {}, doi = {10.3390/diagnostics11010068}, pmid = {33406644}, issn = {2075-4418}, abstract = {Massive molecular testing for SARS-CoV-2 diagnosis is mandatory to manage the spread of COVID-19. Diagnostic screening should be performed at a mass scale, extended to the asymptomatic population, and repeated over time. An accurate diagnostic pipeline for SARS-CoV-2 that could massively increase the laboratory efficiency, while being sustainable in terms of time and costs, should be based on a pooling strategy. In the past few months, researchers from different disciplines had this same idea: test groups, not individuals. This critical review intends to highlight both the general consents-even if the results from different publications have been obtained with different protocols-and the points of disagreement that are creating some interpretative/comprehension difficulties. Different pooling schemes and technical aspects associated to the type of pooling adopted are described and discussed. We hope that this review can consolidate information to support researchers in designing optimized COVID-19 testing protocols based on pooling.}, } @article {pmid33406391, year = {2020}, author = {Jarjour, NN and Masopust, D and Jameson, SC}, title = {T Cell Memory: Understanding COVID-19.}, journal = {Immunity}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.immuni.2020.12.009}, pmid = {33406391}, issn = {1097-4180}, abstract = {As the SARS-CoV-2 pandemic has progressed, increasing attention has focused on establishing natural and vaccine-induced immunity against this coronavirus and the disease, COVID-19, that it causes. In this Primer, we explain the fundamental features of T cell memory and their potential relevance for effective immunity to SARS-CoV-2.}, } @article {pmid33405098, year = {2021}, author = {Mukherjee, S and Pahan, K}, title = {Is COVID-19 Gender-sensitive?.}, journal = {Journal of neuroimmune pharmacology : the official journal of the Society on NeuroImmune Pharmacology}, volume = {}, number = {}, pages = {}, pmid = {33405098}, issn = {1557-1904}, support = {AG050431/AG/NIA NIH HHS/United States ; AG069229/AG/NIA NIH HHS/United States ; AT010980//National Center for Complementary and Alternative Medicine/ ; 1I01BX005002//Office of Academic Affiliations, Department of Veterans Affairs/ ; 1IK6 BX004982//Office of Academic Affiliations, Department of Veterans Affairs/ ; }, abstract = {While clinical characteristics exhibit that susceptibility to COVID-19 infection is equally likely between males and females, clinical outcomes show that males experience both a higher severity and fatality for COVID-19 infection than females. This review examines the evidence for these sex and gender differences and aims to illustrate possible mechanisms behind such sensitivity. Successful entry of SARS-CoV-2 into the body is dependent on the angiotensin-converting enzyme 2 (ACE2) receptor and the transmembrane protease serine 2 (TMPRSS2). Thus, sex-based differences in the expression of the ACE2 receptor and TMPRSS2 may explain the disparities in COVID-19 severity and fatality. Furthermore, these disparities may also be attributed to sex-based difference in immunological responses. Finally, the differences in clinical outcomes of COVID-19 infections between men and women may be due to gendered differences in behaviors, such as smoking, and prevalence to comorbidities. An understanding of the sex and gender sensitivities of COVID-19 infection is a necessary component towards the creation of effective treatment options and therapies for the virus. Graphical abstract.}, } @article {pmid33405001, year = {2021}, author = {Palazzuoli, A and Ruocco, G and Tecson, KM and McCullough, PA}, title = {Screening, detection, and management of heart failure in the SARS-CoV2 (COVID-19) pandemic.}, journal = {Heart failure reviews}, volume = {}, number = {}, pages = {}, pmid = {33405001}, issn = {1573-7322}, abstract = {Observational studies suggest that a heart failure (HF) diagnosis carries a poor prognosis in subjects with severe SARS-CoV2 (COVID-19) infection, but it is unknown whether this association reflects direct myocardial damage due to COVID-19 or the consequence of preexisting cardiac defects and related cardiovascular disease (CVD) risk burden. Although the close relation between CVD and COVID-19 outcomes is well established, contrasting data exists about the occurrence of HF complications during COVID-19 infection. Therefore, a specific algorithm focused on diagnostic differentiation in acute patients distinguishing between acute HF and acute respiratory distress syndrome related to COVID-19 is needed. Further, several concerns exist for the management of patients with an uncertain diagnosis and acute dyspnea, the exact relationship existing between COVID-19 and HF. Therefore, the treatment for subjects with both COVID-19 and HF and which criteria may be defined for domiciliary or hospital management, remain poorly defined. Herein, we describe practices to be adopted in order to address these concerns and avoid further virus spread among patients, l and their familiars involved in such patients' care.}, } @article {pmid33404999, year = {2021}, author = {García-Escobar, A and Jiménez-Valero, S and Galeote, G and Jurado-Román, A and García-Rodríguez, J and Moreno, R}, title = {The soluble catalytic ectodomain of ACE2 a biomarker of cardiac remodelling: new insights for heart failure and COVID19.}, journal = {Heart failure reviews}, volume = {}, number = {}, pages = {}, pmid = {33404999}, issn = {1573-7322}, abstract = {The angiotensin-converting enzyme 2 (ACE2) is a type I integral membrane that was discovered two decades ago. The ACE2 exists as a transmembrane protein and as a soluble catalytic ectodomain of ACE2, also known as the soluble ACE2 that can be found in plasma and other body fluids. ACE2 regulates the local actions of the renin-angiotensin system in cardiovascular tissues, and the ACE2/Angiotensin 1-7 axis exerts protective actions in cardiovascular disease. Increasing soluble ACE2 has been associated with heart failure, cardiovascular disease, and cardiac remodelling. This is a review of the molecular structure and biochemical functions of the ACE2, as well we provided an updated on the evidence, clinical applications, and emerging potential therapies with the ACE2 in heart failure, cardiovascular disease, lung injury, and COVID-19 infection.}, } @article {pmid33404981, year = {2021}, author = {Grolli, RE and Mingoti, MED and Bertollo, AG and Luzardo, AR and Quevedo, J and Réus, GZ and Ignácio, ZM}, title = {Impact of COVID-19 in the Mental Health in Elderly: Psychological and Biological Updates.}, journal = {Molecular neurobiology}, volume = {}, number = {}, pages = {}, pmid = {33404981}, issn = {1559-1182}, abstract = {Since December 2019, the world has been experiencing the challenge of facing coronavirus disease-19 (COVID-19), a severe infectious disease caused by the new coronavirus, SARS-CoV-2. The individuals with the most severe symptoms and the highest risk of death are the elderly and those with chronic illness. Among chronic conditions, those with a certain degree of chronic inflammation may predispose to a more severe evolution of COVID-19. Elderly with psychiatric disorders can present a persistent inflammatory state, a characteristic of the age's immunological senescence, but the disorder can accentuate that. Social isolation is still the safest way to avoid contamination. However, isolated older people may have or worsen mental health conditions due to isolation and health concerns. In this scenario, a SARS-CoV-2 infection may progress to more severe disease. Conversely, COVID-19 can predispose or aggravate psychiatric disorders, as it induces a cytokine storm, causing systemic hyper inflammation. It may damage the blood-brain barrier, resulting in inflammation in the central nervous system. Besides, SARS-CoV-2 is likely to reach and trigger an inflammatory process directly in the nervous system. This review makes an update about research on the mental health of the elderly during the pandemic. Also, it discusses the vulnerability of these individuals in the face of stress and in the case of contracting COVID-19, considering mainly the stress's hormonal and inflammatory mechanisms. Finally, the review points out possible care and attention strategies and entertainment and activities that can reduce the damage to mental and physical health and improve the elderly's quality of life. Graphical abstract Isolation and concerns about COVID-19 may harm elderly mental health. Immunosenescence and pandemic stress increase the risk of psychiatric disorders. Stress and disorders may potentiate the elderly's inflammation and COVID-19 symptoms. SARS-CoV-2 hyperinflammation is a risk factor for elderly psychiatric disorders.}, } @article {pmid33404977, year = {2021}, author = {Hasana, S and Hossain, MF and Jalouli, M and Kabir, MT and Uddin, MG and Wahed, MII and Behl, T and Bin-Jumah, MN and Abdel-Daim, MM and Aleya, L and Uddin, MS}, title = {Genetic Diversity of SARS-CoV2 and Environmental Settings: Possible Association with Neurological Disorders.}, journal = {Molecular neurobiology}, volume = {}, number = {}, pages = {}, pmid = {33404977}, issn = {1559-1182}, abstract = {The new coronavirus (CoV), called novel coronavirus disease 2019 (COVID-19), belongs to the Coronaviridae family which was originated from the sea market in Wuhan city in China, at the end of the year 2019. COVID-19 and severe acute respiratory syndrome (SARS) are belonging to the same family (Coronaviridae). The current outbreak of COVID-19 creates public concern and threats all over the world and now it spreads out to more than 250 countries and territories. The researchers and scientists from all over the world are trying to find out the therapeutic strategies to abate the morbidity and mortality rate of the COVID-19 pandemic. The replication, spreading, and severity of SARS-CoV2 depend on environmental settings. Noteworthy, meteorological parameters are considered as crucial factors that affect respiratory infectious disorders, although the controversial effect of the meteorological parameter is exposed against COVID-19. Besides, COVID-19 accelerates the pathogenesis of the neurological disorders. However, the pathogenic mechanisms between COVID-19 and neurological disorders are still unclear. Hence, this review is focused on the genomics and ecology of SARS-CoV2 and elucidated the effects of climatic factors on the progression of COVID-19. This review also critically finds out the vulnerability between COVID-19 and neurological disorders based on the latest research data.}, } @article {pmid33404925, year = {2021}, author = {Peng, X and Wang, Y and Xi, X and Jia, Y and Tian, J and Yu, B and Tian, J}, title = {Promising Therapy for Heart Failure in Patients with Severe COVID-19: Calming the Cytokine Storm.}, journal = {Cardiovascular drugs and therapy}, volume = {}, number = {}, pages = {}, pmid = {33404925}, issn = {1573-7241}, support = {91739113//National Natural Science Foundation of China/ ; 81971715//National Natural Science Foundation of China/ ; 81827806//National Natural Science Foundation of China/ ; 2016YFC1301100//National Key R&D Program of China/ ; 171032//Fok Ying-Tong Education Foundation for Young Teachers/ ; GKLCDSM-20200101-01//Foundation of Guangxi Key Laboratory of Diabetic Systems Medicine/ ; }, abstract = {The coronavirus disease 19 (COVID-19) pandemic poses a serious global threat to human health and the economy. Based on accumulating evidence, its continuous progression involves not only pulmonary injury but also damage to the cardiovascular system due to intertwined pathophysiological risks. As a point of convergence in the pathophysiologic process between COVID-19 and heart failure (HF), cytokine storm induces the progression of COVID-19 in patients presenting pre-existing or new onset myocardial damage and even HF. Cytokine storm, as a trigger of the progression of HF in patients with COVID-19, has become a novel focus to explore therapies for target populations. In this review, we briefly introduce the basis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and illuminate the mechanism and links among COVID-19, cytokine storm, and HF. Furthermore, we discuss drugs and therapeutic targets for patients with COVID-19 and HF.}, } @article {pmid33404890, year = {2021}, author = {Nan, J and Jia, R and Meng, S and Jin, Y and Chen, W and Hu, H}, title = {The Impact of the COVID-19 Pandemic and the Importance of Telemedicine in Managing Acute ST Segment Elevation Myocardial Infarction Patients: Preliminary Experience and Literature Review.}, journal = {Journal of medical systems}, volume = {45}, number = {1}, pages = {9}, pmid = {33404890}, issn = {1573-689X}, abstract = {The coronavirus disease 2019 (COVID-19), which is caused by a novel coronavirus (SARS-COV-2), has compromised health care systems and normal management of patients with cardiovascular diseases [1-3]. Patients with non-communicable diseases, including acute myocardial infarction (AMI) are vulnerable to this stress [4, 5]. Acute ST segment elevation myocardial infarction (STEMI), the most critical type of AMI, is associated with high mortality even with modern medicine [6-8]. Timely reperfusion therapy is critical for STEMI patients because a short ischemia time is associated with better clinical outcomes and lower acute and long -term mortality [9-12]. The COVID-19 pandemic placed the management of STEMI patients in a difficult situation due to the need to balance timely reperfusion therapy and maintaining strict infection control practices [13, 14]. Telemedicine, which is used to deliver health care services using information or communication technology, provides an opportunity to carry out the evaluation, diagnosis, and even monitor the patients after discharge when social distancing is needed [15]. In this article, we reported our preliminary experience with the usefulness of telemedicine in managing STEMI patients during the COVID-19 pandemic. We also provided a review of this topic.}, } @article {pmid33403528, year = {2021}, author = {Fitzgerald, GE and Maguire, S and Haroon, N}, title = {COVID-19: What Do Rheumatologists Need to Know?.}, journal = {Current rheumatology reports}, volume = {23}, number = {1}, pages = {5}, pmid = {33403528}, issn = {1534-6307}, abstract = {PURPOSE OF REVIEW: Severe acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) emerged in December 2019, rapidly reaching global pandemic proportions. Coronavirus disease 2019 (COVID-19) has presented unique challenges to the rheumatology community. It is known that many individuals with rheumatic disease are at increased risk of severe disease from other infections, sparking a similar fear for COVID-19. In addition, medications routinely used in rheumatology practice are being trialled as treatments, with the potential for drug shortages for rheumatology patients.

RECENT FINDINGS: Underlying comorbidities and active disease are associated with worse COVID-19 outcomes in patients with rheumatic disease. Tocilizumab and hydroxychloroquine have not proven to be effective treatments in the management of COVID-19. Telehealth has become an essential tool for the rheumatology community to monitor patients during the pandemic. In this article, we summarise the available COVID-19 evidence that is of relevance to the rheumatology community. We discuss the risk of contracting COVID-19 in individuals with rheumatic disease, along with presenting features and clinical outcomes. We provide an overview of the treatments for COVID-19 which have significance for rheumatology. We highlight published recommendations which can guide our management of rheumatic disease populations during this pandemic. Finally, we discuss the challenges in delivering effective care virtually and present methods and tools which could be adapted for use.}, } @article {pmid33403500, year = {2021}, author = {Kevadiya, BD and Machhi, J and Herskovitz, J and Oleynikov, MD and Blomberg, WR and Bajwa, N and Soni, D and Das, S and Hasan, M and Patel, M and Senan, AM and Gorantla, S and McMillan, J and Edagwa, B and Eisenberg, R and Gurumurthy, CB and Reid, SPM and Punyadeera, C and Chang, L and Gendelman, HE}, title = {Pharmacotherapeutics of SARS-CoV-2 Infections.}, journal = {Journal of neuroimmune pharmacology : the official journal of the Society on NeuroImmune Pharmacology}, volume = {}, number = {}, pages = {}, pmid = {33403500}, issn = {1557-1904}, support = {R01 AG043530, P01 DA028555, P30 MH062261, R01 MH115860, R01 NS034249, R01 NS036126/NH/NIH HHS/United States ; }, abstract = {The COVID-19 pandemic has affected more than 38 million people world-wide by person to person transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Therapeutic and preventative strategies for SARS-CoV-2 remains a significant challenge. Within the past several months, effective treatment options have emerged and now include repurposed antivirals, corticosteroids and virus-specific antibodies. The latter has included convalescence plasma and monoclonal antibodies. Complete viral eradication will be achieved through an effective, safe and preventative vaccine. To now provide a comprehensive summary for each of the pharmacotherapeutics and preventative strategies being offered or soon to be developed for SARS-CoV-2.}, } @article {pmid33403490, year = {2021}, author = {Bagheri, HS and Karimipour, M and Heidarzadeh, M and Rajabi, H and Sokullu, E and Rahbarghazi, R}, title = {Does the Global Outbreak of COVID-19 or Other Viral Diseases Threaten the Stem Cell Reservoir Inside the Body?.}, journal = {Stem cell reviews and reports}, volume = {}, number = {}, pages = {}, pmid = {33403490}, issn = {2629-3277}, abstract = {The COVID-19 pandemic has profoundly influenced public health and contributed to global economic divergences of unprecedented dimensions. Due to the high prevalence and mortality rates, it is then expected that the consequence and public health challenges will last for long periods. The rapid global spread of COVID-19 and lack of enough data regarding the virus pathogenicity multiplies the complexity and forced governments to react quickly against this pandemic. Stem cells represent a small fraction of cells located in different tissues. These cells play a critical role in the regeneration and restoration of injured sites. Because of their specific niche and a limited number of stem cells, the key question is whether there are different anti-viral mechanisms against viral infection notably COVID-19. Here, we aimed to highlight the intrinsic antiviral resistance in different stem cells against viral infection. These data could help us to understand the possible viral infections in different stem cells and the activation of specific molecular mechanisms upon viral entrance.}, } @article {pmid33403489, year = {2021}, author = {Virant-Klun, I and Strle, F}, title = {Human Oocytes Express Both ACE2 and BSG Genes and Corresponding Proteins: Is SARS-CoV-2 Infection Possible?.}, journal = {Stem cell reviews and reports}, volume = {}, number = {}, pages = {}, pmid = {33403489}, issn = {2629-3277}, abstract = {In addition to a number of scientific and medical questions about SARS-CoV-2 infection that still need to be answered, there is also the question of how this highly virulent virus and COVID-19 disease affect gametogenesis in humans. Even more important is the question of whether the virus can also enter and infect oocytes and possibly alter them in an unknown way, which could also affect the development and status of the human embryo. The answers to these questions are still poorly known, so we reviewed the human oocyte transcriptome and proteome obtained in our previous studies and found that human oocytes from the in vitro fertilization program expressed both the ACE2 and BSG genes and the corresponding ACE2 and BSG proteins. This means that human oocytes possess the molecular 'machinery' to facilitate SARS-CoV-2 entrance and infection. According to various studies, especially in animal models, different viruses can infect oocytes, so infection of the oocyte with SARS-Cov-2 cannot be completely ruled out. A hypothetical model of human oocyte infection with this virus has been proposed.}, } @article {pmid33403480, year = {2021}, author = {Hashimoto, K}, title = {Repurposing of CNS drugs to treat COVID-19 infection: targeting the sigma-1 receptor.}, journal = {European archives of psychiatry and clinical neuroscience}, volume = {}, number = {}, pages = {}, pmid = {33403480}, issn = {1433-8491}, support = {17H04243//Japan Society for the Promotion of Science London/ ; 19H05203//Japan Society for the Promotion of Science/ ; JP20dm0107119//Japan Agency for Medical Research and Development/ ; }, abstract = {The novel coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The escalating number of SARS-CoV-2-infected individuals has conferred the viral spread with the status of global pandemic. However, there are no prophylactic or therapeutic drugs available on the market to treat COVID-19, although several drugs have been approved. Recently, two articles using the comparative viral-human protein-protein interaction map revealed that the sigma-1 receptor in the endoplasmic reticulum plays an important role in SARS-CoV-2 replication in cells. Knockout and knockdown of SIGMAR1 (sigma-1 receptor, encoded by SIGMAR1) caused robust reductions in SARS-CoV-2 replication, which indicates that the sigma-1 receptor is a key therapeutic target for SARS-CoV-2 replication. Interestingly, a recent clinical trial demonstrated that treatment with the antidepressant fluvoxamine, which has a high affinity at the sigma-1 receptor, could prevent clinical deterioration in adult outpatients infected with SARS-CoV-2. In this review, we discuss the brief history of the sigma-1 receptor and its role in SARS-CoV-2 replication in cells. Here, we propose repurposing of traditional central nervous system (CNS) drugs that have a high affinity at the sigma-1 receptor (i.e., fluvoxamine, donepezil, ifenprodil) for the treatment of SARS-CoV-2-infected patients. Finally, we discussed the potential of other CNS candidates such as cutamesine and arketamine.}, } @article {pmid33403359, year = {2020}, author = {Lowe, J and Rumbold, B and Aoun, SM}, title = {Memorialisation during COVID-19: implications for the bereaved, service providers and policy makers.}, journal = {Palliative care and social practice}, volume = {14}, number = {}, pages = {2632352420980456}, doi = {10.1177/2632352420980456}, pmid = {33403359}, issn = {2632-3524}, abstract = {Background: The aim of this rapid perspective review is to capture key changes to memorialisation practices resulting from social distancing rules implemented due to the ongoing COVID-19 pandemic.

Method: As published peer-reviewed research pertaining to memorialisation practices during the COVID-19 pandemic is lacking, this rapid review includes academic literature from the pre-COVID-19 period and international media reports during the pandemic.

Findings: Changes to memorialisation practices were under way before COVID-19, as consumer preferences shifted towards secularisation and personalisation of ritual and ceremony. However, several key changes to memorialisation practices connected with body preparation, funerals, cremation, burials and rituals have taken place as a consequence of the COVID-19 pandemic.

Discussion: Although boundaries between public and private memorialisation practices were already blurred, the COVID-19 pandemic has accelerated this process. Without access to public memorialisation, practices are increasingly private in nature. A number of implications are considered for the bereaved, service providers and policy makers.

Conclusion: Forms of memorialisation and bereavement support emerging during the pandemic that blend the public and the private are likely to persist in a post-pandemic world.}, } @article {pmid33403227, year = {2020}, author = {Hossain, MS and Hami, I and Sawrav, MSS and Rabbi, MF and Saha, O and Bahadur, NM and Rahaman, MM}, title = {Drug Repurposing for Prevention and Treatment of COVID-19: A Clinical Landscape.}, journal = {Discoveries (Craiova, Romania)}, volume = {8}, number = {4}, pages = {e121}, doi = {10.15190/d.2020.18}, pmid = {33403227}, issn = {2359-7232}, abstract = {SARS-CoV-2, the novel coronavirus strain responsible for the current pandemic of COVID-19, has rendered the entire humanity suffering. Several months have passed since the pandemic has struck. However, the world is still looking for an effective treatment plan to battle the viral infection. The first vaccine just received emergency approval in December 2020 for use in USA and UK. These are excellent news, however, the worldwide distribution of such vaccine, the possibility of virus mutation and the lack of data regarding the long-term effects of such vaccines are a significant concern. In addition, although remdesivir was recently approved by the FDA to be used as a clinical drug against COVID-19, it hasn't stood out yet as a proven form of therapeutics. Such inability to produce a novel therapy has caused enough inconveniences for the affected people worldwide. Repurposing the already available drugs to fight against the virus seems to be a reasonable option amidst such uncertainty. Given the vast collection of potential treatment candidates to be explored against COVID-19, there is a decent chance that a success in this regard will serve the intermediary purpose of clinically treating the infection until a COVID-19 vaccine is widely distributed worldwide and will be able to treat COVID-19 patients that do not adequately respond to vaccines. Such treatments may prove very useful in future coronavirus outbreaks too. Proper research into these repurposing treatments may yield a certain insight into the field of novel treatment production as well. This review study accumulates a relevant set of information about drugs and vaccines against COVID-19, in terms of their repurposing properties and the specific phases of clinical trials they are undergoing across the world. A potential timeline is also suggested to estimate when an effective result can be expected from the ongoing clinical trials for a better anticipation of the drug landscape. This study will hopefully help accelerate investment of resources into development and discovery of drugs and vaccines against the infection.}, } @article {pmid33403218, year = {2020}, author = {Amenta, EM and Spallone, A and Rodriguez-Barradas, MC and El Sahly, HM and Atmar, RL and Kulkarni, PA}, title = {Postacute COVID-19: An Overview and Approach to Classification.}, journal = {Open forum infectious diseases}, volume = {7}, number = {12}, pages = {ofaa509}, doi = {10.1093/ofid/ofaa509}, pmid = {33403218}, issn = {2328-8957}, abstract = {As the coronavirus disease 2019 (COVID-19) pandemic has progressed, a large volume of literature has developed delineating the clinical manifestations of acute infection. Recent reports have also started to describe persistent symptoms extending beyond the period of initial illness or hospitalization. Anecdotes of different signs and symptoms occurring after acute infection have also arisen in the lay press. Here we describe the current existing medical literature on the emerging concept of postacute COVID-19 and suggest an approach to classifying different manifestations of the syndrome. We also review long-term clinical manifestations observed in patients who recovered from infection due to other epidemic coronaviruses and briefly discuss potential mechanisms driving the phenomenon of postacute COVID-19.}, } @article {pmid33403113, year = {2020}, author = {Xue, S and Husain, MI and Ortiz, A and Husain, MO and Daskalakis, ZJ and Mulsant, BH}, title = {COVID-19: Implications for bipolar disorder clinical care and research.}, journal = {SAGE open medicine}, volume = {8}, number = {}, pages = {2050312120981178}, doi = {10.1177/2050312120981178}, pmid = {33403113}, issn = {2050-3121}, abstract = {The COVID-19 pandemic has posed significant challenges to health care globally, and individuals with bipolar disorder are likely disproportionally affected. Based on review of literature and collective clinical experience, we discuss that without special intervention, individuals with bipolar disorder will experience poorer physical and mental health outcomes due to interplay of patient, provider and societal factors. Some risk factors associated with bipolar disorder, including irregular social rhythms, risk-taking behaviours, substantial medical comorbidities, and prevalent substance use, may be compounded by lockdowns, social isolation and decrease in preventive and maintenance care. We further discuss implications for clinical research of bipolar disorders during the pandemic. Finally, we propose mitigation strategies on working with individuals with bipolar disorder in a clinical and research context, focusing on digital medicine strategies to improve quality of and accessibility to service.}, } @article {pmid33403109, year = {2020}, author = {Tran, BX and Vu, GT and Le, HT and Pham, HQ and Phan, HT and Latkin, CA and Ho, RC}, title = {Understanding health seeking behaviors to inform COVID-19 surveillance and detection in resource-scarce settings.}, journal = {Journal of global health}, volume = {10}, number = {2}, pages = {0203106}, doi = {10.7189/jogh.10.0203106}, pmid = {33403109}, issn = {2047-2986}, } @article {pmid33403108, year = {2020}, author = {Danial, M and Arulappen, AL and Ch'ng, ASH and Looi, I}, title = {Mitigation of COVID-19 clusters in Malaysia.}, journal = {Journal of global health}, volume = {10}, number = {2}, pages = {0203105}, doi = {10.7189/jogh.10.0203105}, pmid = {33403108}, issn = {2047-2986}, } @article {pmid33402841, year = {2020}, author = {Majumder, MAA and Rahman, S and Cohall, D and Bharatha, A and Singh, K and Haque, M and Gittens-St Hilaire, M}, title = {Antimicrobial Stewardship: Fighting Antimicrobial Resistance and Protecting Global Public Health.}, journal = {Infection and drug resistance}, volume = {13}, number = {}, pages = {4713-4738}, doi = {10.2147/IDR.S290835}, pmid = {33402841}, issn = {1178-6973}, abstract = {Antimicrobial resistance (AMR) is a serious threat to global public health. It increases morbidity and mortality, and is associated with high economic costs due to its health care burden. Infections with multidrug-resistant (MDR) bacteria also have substantial implications on clinical and economic outcomes. Moreover, increased indiscriminate use of antibiotics during the COVID-19 pandemic will heighten bacterial resistance and ultimately lead to more deaths. This review highlights AMR's scale and consequences, the importance, and implications of an antimicrobial stewardship program (ASP) to fight resistance and protect global health. Antimicrobial stewardship (AMS), an organizational or system-wide health-care strategy, is designed to promote, improve, monitor, and evaluate the rational use of antimicrobials to preserve their future effectiveness, along with the promotion and protection of public health. ASP has been very successful in promoting antimicrobials' appropriate use by implementing evidence-based interventions. The "One Health" approach, a holistic and multisectoral approach, is also needed to address AMR's rising threat. AMS practices, principles, and interventions are critical steps towards containing and mitigating AMR. Evidence-based policies must guide the "One Health" approach, vaccination protocols, health professionals' education, and the public's awareness about AMR.}, } @article {pmid33402839, year = {2020}, author = {Abubakar, AR and Sani, IH and Godman, B and Kumar, S and Islam, S and Jahan, I and Haque, M}, title = {Systematic Review on the Therapeutic Options for COVID-19: Clinical Evidence of Drug Efficacy and Implications.}, journal = {Infection and drug resistance}, volume = {13}, number = {}, pages = {4673-4695}, doi = {10.2147/IDR.S289037}, pmid = {33402839}, issn = {1178-6973}, abstract = {A novel coronavirus-2 (SARS-CoV-2) was first identified in Wuhan, China, and quickly spread globally. Several treatments have been proposed, many of which have proven ineffective. Consequently, there is a need to review the published evidence of drug clinical trials to guide future prescribing. A systematic review of published clinical trials and retrospective observational studies was carried out. The search was made using PubMed, Embase, MEDLINE, and China National Knowledge Infrastructure (CNKI) databases. Articles published between January 2020 and October 2020 and written in the English language were retrieved and included in the study. Researches that used traditional medicine, in-vitro and in-vivo animal studies, as well as reviews were excluded. Seventy-three relevant articles that fulfilled the inclusion criteria were finally selected and reviewed. Hydroxychloroquine, chloroquine, and azithromycin produced no clinical evidence of efficacy in randomized controlled clinical trials (RCT). However, retrospective observational studies reported the efficacy of remdesivir and lopinavir/ritonavir in reducing viral load, although there have been concerns with lopinavir/ritonavir and, more recently, remdesivir. Recently, tocilizumab, dexamethasone, and methylprednisolone significantly relieved lung inflammation and decreased mortality in patients with severe COVID-19. In addition, convalescent plasma was effective in boosting strong immunity among patients with mild COVID-19. There is currently no single worldwide approved therapeutic option for patients with COVID-19 despite the initial hype with medicines, including hydroxychloroquine. Nonetheless, dexamethasone has shown promise in symptomatic treatment and convalescent plasma in boosting immunity. New treatments are currently being researched, and the findings will be reported accordingly to provide evidence-based guidance for prescribers and policymakers.}, } @article {pmid33402610, year = {2021}, author = {Garg, M and Prabhakar, N and Bhalla, AS and Irodi, A and Sehgal, I and Debi, U and Suri, V and Agarwal, R and Yaddanapudi, LN and Puri, GD and Sandhu, MS}, title = {Computed tomography chest in COVID-19: When & why?.}, journal = {The Indian journal of medical research}, volume = {}, number = {}, pages = {}, doi = {10.4103/ijmr.IJMR_3669_20}, pmid = {33402610}, issn = {0971-5916}, abstract = {Computed tomography (CT) of the chest plays an important role in the diagnosis and management of coronavirus disease 2019 (COVID-19), but it should not be used indiscriminately. This review provides indications of CT chest in COVID-19 suspect, positive and recovered patients based on the current scientific evidence and our personal experience. CT chest is not indicated as a routine screening modality due to its poor sensitivity and specificity. However, it is useful in a small subset of COVID-19 suspects who test negative on reverse transcription-polymerase chain reaction (RT-PCR) with normal/indeterminate chest X-ray (CXR) but have moderate-to-severe respiratory symptoms and high index of clinical suspicion. CT chest is not indicated in every RT-PCR-positive patient and should be done only in specific clinical scenarios, where it is expected to significantly contribute in the clinical management such as COVID-19 patients showing unexplained clinical deterioration and/or where other concurrent lung pathology or pulmonary thromboembolism needs exclusion. Serial CXR and point-of-care ultrasound are usually sufficient to evaluate the progression of COVID-19 pneumonia. CT chest is also indicated in COVID-19-positive patients with associated co-morbidities (age> 65 yr, diabetes, hypertension, obesity, cardiovascular disease, chronic respiratory disease, immune-compromise, etc.) who, despite having mild symptoms and normal/indeterminate CXR, record oxygen saturation of < 93 per cent at rest while breathing room air or de-saturate on six-minute walk test. Finally, CT chest plays a crucial role to rule out lung fibrosis in patients recovered from COVID-19 infection who present with hypoxia/impaired lung function on follow up. In conclusion, though CT chest is an indispensable diagnostic tool in COVID-19, it should be used judiciously and only when specifically indicated.}, } @article {pmid33402334, year = {2021}, author = {Pley, CM and McNaughton, AL and Matthews, PC and Lourenço, J}, title = {The global impact of the COVID-19 pandemic on the prevention, diagnosis and treatment of hepatitis B virus (HBV) infection.}, journal = {BMJ global health}, volume = {6}, number = {1}, pages = {}, doi = {10.1136/bmjgh-2020-004275}, pmid = {33402334}, issn = {2059-7908}, abstract = {The COVID-19 pandemic caused by the SARS-CoV-2 virus has resulted in a myriad of interventions with the urgent aim of reducing the public health impact of this virus. However, a wealth of evidence both from high-income and low-income countries is accruing on the broader consequences of such interventions on economic and public health inequalities, as well as on pre-existing programmes targeting endemic pathogens. We provide an overview of the impact of the ongoing COVID-19 pandemic on hepatitis B virus (HBV) programmes globally, focusing on the possible consequences for prevention, diagnosis and treatment. Ongoing disruptions to infrastructure, supply chains, services and interventions for HBV are likely to contribute disproportionately to the short-term incidence of chronic hepatitis B, providing a long-term source of onward transmission to future generations that threatens progress towards the 2030 elimination goals.}, } @article {pmid33402324, year = {2021}, author = {Wong, BLH and Ramsay, ME and Ladhani, SN}, title = {Should children be vaccinated against COVID-19 now?.}, journal = {Archives of disease in childhood}, volume = {}, number = {}, pages = {}, doi = {10.1136/archdischild-2020-321225}, pmid = {33402324}, issn = {1468-2044}, } @article {pmid33402318, year = {2020}, author = {Kurtovic, L and Beeson, JG}, title = {Complement Factors in COVID-19 Therapeutics and Vaccines.}, journal = {Trends in immunology}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.it.2020.12.002}, pmid = {33402318}, issn = {1471-4981}, abstract = {Complement is integral to a healthy functioning immune system and orchestrates various innate and adaptive responses against viruses and other pathogens. Despite its importance, the potential beneficial role of complement in immunity to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been overshadowed by reports of extensive complement activation in severe coronavirus disease 2019 (COVID-19) patients. Here, we hypothesize that complement may also have a protective role and could function to enhance virus neutralization by antibodies, promote virus phagocytosis by immune cells, and lysis of virus. These functions might be exploited in the development of effective therapeutics and vaccines against SARS-CoV-2.}, } @article {pmid33402220, year = {2021}, author = {Li, DD and Li, QH}, title = {SARS-CoV-2: vaccines in the pandemic era.}, journal = {Military Medical Research}, volume = {8}, number = {1}, pages = {1}, pmid = {33402220}, issn = {2054-9369}, abstract = {Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused millions of infections and deaths worldwide since its emergence in December 2019. As there is little or no natural immunity in the human population or specific anti-COVID-19 drugs, researchers from the government, academia and industry are developing vaccines at an unprecedented speed to halt the pandemic. In this review, the results of animal experiments and clinical trials on several vaccine technical platforms are summarized, and several challenges are also discussed to further promote the development, evaluation and application of vaccines during the challenging situation of the global pandemic.}, } @article {pmid33401749, year = {2021}, author = {Wongchitrat, P and Shukla, M and Sharma, R and Govitrapong, P and Reiter, RJ}, title = {Role of Melatonin on Virus-Induced Neuropathogenesis-A Concomitant Therapeutic Strategy to Understand SARS-CoV-2 Infection.}, journal = {Antioxidants (Basel, Switzerland)}, volume = {10}, number = {1}, pages = {}, doi = {10.3390/antiox10010047}, pmid = {33401749}, issn = {2076-3921}, abstract = {Viral infections may cause neurological disorders by directly inducing oxidative stress and interrupting immune system function, both of which contribute to neuronal death. Several reports have described the neurological manifestations in Covid-19 patients where, in severe cases of the infection, brain inflammation and encephalitis are common. Recently, extensive research-based studies have revealed and acknowledged the clinical and preventive roles of melatonin in some viral diseases. Melatonin has been shown to have antiviral properties against several viral infections which are accompanied by neurological symptoms. The beneficial properties of melatonin relate to its properties as a potent antioxidant, anti-inflammatory, and immunoregulatory molecule and its neuroprotective effects. In this review, what is known about the therapeutic role of melatonin in virus-induced neuropathogenesis is summarized and discussed.}, } @article {pmid33401632, year = {2021}, author = {Robba, C and Battaglini, D and Ball, L and Valbusa, A and Porto, I and Della Bona, R and La Malfa, G and Patroniti, N and Brunetti, I and Loconte, M and Bassetti, M and Giacobbe, DR and Vena, A and Silva, CLM and Rocco, PRM and Pelosi, P}, title = {Coagulative Disorders in Critically Ill COVID-19 Patients with Acute Distress Respiratory Syndrome: A Critical Review.}, journal = {Journal of clinical medicine}, volume = {10}, number = {1}, pages = {}, doi = {10.3390/jcm10010140}, pmid = {33401632}, issn = {2077-0383}, abstract = {In critically ill patients with acute respiratory distress syndrome (ARDS) coronavirus disease 2019 (COVID-19), a high incidence of thromboembolic and hemorrhagic events is reported. COVID-19 may lead to impairment of the coagulation cascade, with an imbalance in platelet function and the regulatory mechanisms of coagulation and fibrinolysis. Clinical manifestations vary from a rise in laboratory markers and subclinical microthrombi to thromboembolic events, bleeding, and disseminated intravascular coagulation. After an inflammatory trigger, the mechanism for activation of the coagulation cascade in COVID-19 is the tissue factor pathway, which causes endotoxin and tumor necrosis factor-mediated production of interleukins and platelet activation. The consequent massive infiltration of activated platelets may be responsible for inflammatory infiltrates in the endothelial space, as well as thrombocytopenia. The variety of clinical presentations of the coagulopathy confronts the clinician with the difficult questions of whether and how to provide optimal supportive care. In addition to coagulation tests, advanced laboratory tests such as protein C, protein S, antithrombin, tissue factor pathway inhibitors, D-dimers, activated factor Xa, and quantification of specific coagulation factors can be useful, as can thromboelastography or thromboelastometry. Treatment should be tailored, focusing on the estimated risk of bleeding and thrombosis. The aim of this review is to explore the pathophysiology and clinical evidence of coagulation disorders in severe ARDS-related COVID-19 patients.}, } @article {pmid33401500, year = {2021}, author = {Smirni, D}, title = {Noli Timere: The Role of Reassuring Adults in Dealing with COVID-19 Anxiety in Pediatric Age.}, journal = {Pediatric reports}, volume = {13}, number = {1}, pages = {15-30}, doi = {10.3390/pediatric13010003}, pmid = {33401500}, issn = {2036-749X}, abstract = {Since the earliest stages of the Corona Virus Disease-19 (COVID-19) spread, the elderly has been identified as the most vulnerable and health authorities have rightly focused on that population. Minor attention was paid to pediatric populations and their emotional reactions. Actually, children and adolescents faced severe anxiety, fear and stress conditions. An efficient management of the pandemic, therefore, must take into account the pediatric population which cannot be neglected as a minor matter compared to the elderly, the economy and health care. Since the lockdown time is over, children and adolescents must recover sociality, return to living in the open air, rediscover playing, free time, aiming for the beauty of their everyday life. In order to mitigate the long-term impact of COVID-19, the key response is the reassuring presence of the adult as 'a secure base'. The current study aimed to collect an overview of the recent references that report evidence on the role of adults in containing pandemic anxiety COVID-19 in pediatric populations, suggesting the need to ensure a reassuring presence of the adult, an effective child-parent communication, a child-friendly day and a long-lasting shared time with parents.}, } @article {pmid33401392, year = {2021}, author = {Yu, CY and Chan, KG and Yean, CY and Ang, GY}, title = {Nucleic Acid-Based Diagnostic Tests for the Detection SARS-CoV-2: An Update.}, journal = {Diagnostics (Basel, Switzerland)}, volume = {11}, number = {1}, pages = {}, doi = {10.3390/diagnostics11010053}, pmid = {33401392}, issn = {2075-4418}, support = {600-IRMI/FRGS 5/3 (127/2019) and 304/PPSP/6315459//Ministry of Higher Education Malaysia through FRGS grant and USM Short-term Grant/ ; }, abstract = {The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began as a cluster of pneumonia cases in Wuhan, China before spreading to over 200 countries and territories on six continents in less than six months. Despite rigorous global containment and quarantine efforts to limit the transmission of the virus, COVID-19 cases and deaths have continued to increase, leaving devastating impacts on the lives of many with far-reaching effects on the global society, economy and healthcare system. With over 43 million cases and 1.1 million deaths recorded worldwide, accurate and rapid diagnosis continues to be a cornerstone of pandemic control. In this review, we aim to present an objective overview of the latest nucleic acid-based diagnostic tests for the detection of SARS-CoV-2 that have been authorized by the Food and Drug Administration (FDA) under emergency use authorization (EUA) as of 31 October 2020. We systematically summarize and compare the principles, technologies, protocols and performance characteristics of amplification- and sequencing-based tests that have become alternatives to the CDC 2019-nCoV Real-Time RT-PCR Diagnostic Panel. We highlight the notable features of the tests including authorized settings, along with the advantages and disadvantages of the tests. We conclude with a brief discussion on the current challenges and future perspectives of COVID-19 diagnostics.}, } @article {pmid33395166, year = {2021}, author = {Edwards, PB and Green, K and Sturdivant, MH and Lobaugh-Jin, E and Oden, M and Reynolds, SS}, title = {Collaboration Between Infection Prevention and Clinical Education in Response to COVID-19.}, journal = {Journal for nurses in professional development}, volume = {37}, number = {1}, pages = {66-68}, pmid = {33395166}, issn = {2169-981X}, mesh = {COVID-19/epidemiology/*prevention & control ; *Cooperative Behavior ; Humans ; Infection Control/*organization & administration ; Nursing Staff, Hospital/*education ; Staff Development/*organization & administration ; United States/epidemiology ; }, abstract = {With the rapid escalation of COVID-19 educational needs within hospitals, it was imperative for content experts of the infection prevention departments to lean on the expertise of nursing professional development specialists. This article provides a brief overview of how a clinical education and professional development department was deployed to assist and support the COVID-19 response efforts.}, } @article {pmid33394741, year = {2021}, author = {Murphy, ME and Clay, G and Danziger-Isakov, L and Schulert, G and Paulsen, GC}, title = {Acute severe respiratory syndrome coronavirus-2 treatment overview for pediatrics.}, journal = {Current opinion in pediatrics}, volume = {33}, number = {1}, pages = {129-135}, doi = {10.1097/MOP.0000000000000983}, pmid = {33394741}, issn = {1531-698X}, mesh = {Adult ; Anti-Inflammatory Agents/therapeutic use ; Antiviral Agents/therapeutic use ; COVID-19/*drug therapy ; Child ; Humans ; *Pediatrics ; United States ; }, abstract = {PURPOSE OF REVIEW: The novel severe respiratory syndrome coronavirus-2 (SARS-CoV-2) virus has caused a world-wide pandemic with devastating effects. Fortunately, most children display only mild-to-moderate symptoms, but there are a subset that will have severe symptoms warranting treatment. This review evaluates the current evidence for antiviral and anti-inflammatory treatment of acute SARS-COV-2 infections, including coronavirus disease 2019 in pediatrics.

RECENT FINDINGS: Treatment recommendations continue to evolve with emerging results from clinical trials. Initial therapies were tailored to repurposed medications, and have now transitioned toward more specific antiviral therapy. In addition to specific antiviral therapy, there is also support to modulate the immune system and reduce inflammatory damage seen in coronavirus disease 2019. Much of the data result from adult studies with subsequent extrapolation to pediatrics.

SUMMARY: Recommended therapy will continue to adapt as results return from clinical trials. A continued commitment from the National Institutes of Health and research community to assist in determining optimal therapies for pediatric patients is essential. Until then, most recommendations will likely be informed from the results seen in adult populations.}, } @article {pmid33393315, year = {2021}, author = {Pohanka, M}, title = {COVID-19 molecular level laboratory diagnoses.}, journal = {Bratislavske lekarske listy}, volume = {122}, number = {1}, pages = {11-17}, doi = {10.4149/BLL_2021_025}, pmid = {33393315}, issn = {0006-9248}, mesh = {Antibodies, Viral ; *COVID-19 ; COVID-19 Testing ; Clinical Laboratory Techniques ; Humans ; Molecular Diagnostic Techniques ; Nucleic Acid Amplification Techniques ; SARS-CoV-2 ; }, abstract = {AbstractAIMS: Aims: The Coronavirus Disease 2019 (COVID-19) caused not only global pandemic, but it also pointed at unprepared health care systems and countermeasures were introduced under the pressure of urgent circumstances. This review is focused on discussion and critical evaluation of instrumental tools for COVID-19 diagnosis that were developed in the last months.

METHODS: Survey of actual literature and scientific reports was made. The most substantial analytical and diagnostical methods were identified and described. Principles and limitations of the methods are described, and actual papers are cited in this review.

RESULTS: Analytical and diagnostical methods like Polymerase Chain Reaction (PCR), Loop-mediated isothermal Amplification (LAMP), Lateral Flow Immunochromatography Assay (LFIA), Enzyme-Linked Immunosorbent Assay (ELISA), biosensors and ChemiLuminescence ImmunoAssay (CLIA) are discussed for assay of viral particles, antigens and specific host antibodies in blood, serum, plasma, nasopharyngeal swab and other samples in order to diagnose COVID-19.

CONCLUSIONS: The Coronavirus Disease 2019 (COVID-19) is an emerging disease that has spread over the world since the end of year 2019. The global epidemic pointed at the necessity to introduce sensitive methods for instrumental diagnosis of COVID-19 and distinguishing it from the other viral diseases. (Tab. 2, Ref. 96).}, } @article {pmid33370247, year = {2020}, author = {Bolton, L}, title = {Does Hyperbaric Oxygen Improve Lower Extremity Ulcer Outcomes?.}, journal = {Wounds : a compendium of clinical research and practice}, volume = {32}, number = {10}, pages = {291-293}, pmid = {33370247}, issn = {1943-2704}, mesh = {COVID-19/*epidemiology ; Comorbidity ; Diabetic Foot/epidemiology/*therapy ; Humans ; Hyperbaric Oxygenation/*methods ; *Pandemics ; SARS-CoV-2 ; Treatment Outcome ; *Wound Healing ; }, abstract = {A person with a diabetic foot ulcer (DFU) requires multidisciplinary care, including moist wound healing, consistent offloading of insensate areas, glycemic control, and adequate circulation. This is especially important during the COVID-19 pandemic, as patients with diabetes are at a higher risk of mortality.1 Reviewed in a 2018 installment of Evidence Corner,2 a double-blind, randomized clinical trial (RCT) reported that topical oxygen continuously diffused to DFU tissue resulted in nonhealing DFUs healing more than 20 days faster than those that were similarly treated with standard therapy and a sham device.3 More than twice the DFUs closed in patients receiving continuously diffused topical oxygen in comparison with the sham arm completely healed in 12 weeks (P = .02). It has been hypothesized that intervals of hyperbaric oxygen (HBO)-breathing 100% oxygen at atmosphere absolute (ATA) greater than the 1.0 normal at sea level-may similarly improve lower extremity ulcer healing outcomes. This month's Evidence Corner summarizes 2 studies regarding patients receiving HBO. The first study focused on patients with a DFU on a non-ischemic limb.4 The second studied the effects of HBO on lower extremity ulcers on ischemic limbs in patients with or without diabetes mellitus (DM).5 Read on to discover how informative and beneficial each of these studies can be in furthering best practice as well as which patients may experience improved lower limb ulcer healing in response to interventions that increase tissue oxygenation.}, } @article {pmid33361715, year = {2020}, author = {Teo, JTR and Abidin, NH and Cheah, FC}, title = {Severe acute respiratory syndrome-Coronavirus-2 infection: A review of the clinicalpathological correlations of Coronavirus disease-19 in children.}, journal = {The Malaysian journal of pathology}, volume = {42}, number = {3}, pages = {349-361}, pmid = {33361715}, issn = {0126-8635}, mesh = {COVID-19/diagnosis/*pathology ; Child ; Humans ; SARS-CoV-2/*isolation & purification ; }, abstract = {The coronavirus disease-19 (COVID-19) has become a global pandemic of acute respiratory disease in just less than a year by the middle of 2020. This disease caused by the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), has resulted in significant mortality especially among the older age population and those with health co-morbidities. In contrast, children are relatively spared of this potentially ravaging disease that culminates in the acute respiratory distress syndrome, multi-organ failure and death. SARS-CoV-2 infection induces exuberant release of pro-inflammatory mediators, causing a "cytokine storm" and hypercoagulable states that underlie these complications. The SARS-CoV-2 infection median incubation is 5.1 days, with most developing symptoms by 11.5 days. It is highly infectious, spreading via the horizontal mode of transmission, but there is yet very limited evidence of vertical transmission to the newborn infant occurring either transplacentally or through breastfeeding. This said, various immune factors during childhood may modulate the expression of COVID-19, with the multisystem inflammatory syndrome in children (MIS-C) at the severe end of the disease spectrum. This article gives an overview of the SARS-CoV-2 infection, clinical presentation and laboratory tests of COVID-19 and correlating with the current understanding of the pathological basis of this disease in the paediatric population.}, } @article {pmid33355083, year = {2020}, author = {Cantone, E and Gamerra, M}, title = {The Biometeorology of COVID-19: A Novel Therapeutic Strategy?.}, journal = {Acta medica (Hradec Kralove)}, volume = {63}, number = {4}, pages = {202-204}, doi = {10.14712/18059694.2020.65}, pmid = {33355083}, issn = {1805-9694}, mesh = {COVID-19/epidemiology/*therapy ; *Disease Management ; Humans ; Meteorology/*methods ; *Pandemics ; *Practice Guidelines as Topic ; *SARS-CoV-2 ; }, } @article {pmid33340275, year = {2021}, author = {Millet, GP and Debevec, T and Brocherie, F and Burtscher, M and Burtscher, J}, title = {Altitude and COVID-19: Friend or foe? A narrative review.}, journal = {Physiological reports}, volume = {8}, number = {24}, pages = {e14615}, doi = {10.14814/phy2.14615}, pmid = {33340275}, issn = {2051-817X}, mesh = {*Acclimatization ; *Altitude ; Altitude Sickness/epidemiology/*physiopathology/therapy ; Animals ; COVID-19/epidemiology/*physiopathology/therapy ; Humans ; Prevalence ; Prognosis ; Protective Factors ; Risk Assessment ; Risk Factors ; }, abstract = {Recent reports suggest that high-altitude residence may be beneficial in the novel coronavirus disease (COVID-19) implicating that traveling to high places or using hypoxic conditioning thus could be favorable as well. Physiological high-altitude characteristics and symptoms of altitude illnesses furthermore seem similar to several pathologies associated with COVID-19. As a consequence, high altitude and hypoxia research and related clinical practices are discussed for potential applications in COVID-19 prevention and treatment. We summarize the currently available evidence on the relationship between altitude/hypoxia conditions and COVID-19 epidemiology and pathophysiology. The potential for treatment strategies used for altitude illnesses is evaluated. Symptomatic overlaps in the pathophysiology of COVID-19 induced ARDS and high altitude illnesses (i.e., hypoxemia, dyspnea…) have been reported but are also common to other pathologies (i.e., heart failure, pulmonary embolism, COPD…). Most treatments of altitude illnesses have limited value and may even be detrimental in COVID-19. Some may be efficient, potentially the corticosteroid dexamethasone. Physiological adaptations to altitude/hypoxia can exert diverse effects, depending on the constitution of the target individual and the hypoxic dose. In healthy individuals, they may optimize oxygen supply and increase mitochondrial, antioxidant, and immune system function. It is highly debated if these physiological responses to hypoxia overlap in many instances with SARS-CoV-2 infection and may exert preventive effects under very specific conditions. The temporal overlap of SARS-CoV-2 infection and exposure to altitude/hypoxia may be detrimental. No evidence-based knowledge is presently available on whether and how altitude/hypoxia may prevent, treat or aggravate COVID-19. The reported lower incidence and mortality of COVID-19 in high-altitude places remain to be confirmed. High-altitude illnesses and COVID-19 pathologies exhibit clear pathophysiological differences. While potentially effective as a prophylactic measure, altitude/hypoxia is likely associated with elevated risks for patients with COVID-19. Altogether, the different points discussed in this review are of possibly some relevance for individuals who aim to reach high-altitude areas. However, due to the ever-changing state of understanding of COVID-19, all points discussed in this review may be out of date at the time of its publication.}, } @article {pmid33332927, year = {2021}, author = {Kompala, T and Neinstein, AB}, title = {Telehealth in type 1 diabetes.}, journal = {Current opinion in endocrinology, diabetes, and obesity}, volume = {28}, number = {1}, pages = {21-29}, pmid = {33332927}, issn = {1752-2978}, support = {T32 DK007418/DK/NIDDK NIH HHS/United States ; }, mesh = {COVID-19 ; Delivery of Health Care ; Diabetes Mellitus, Type 1/*therapy ; Humans ; Mental Health ; *Telemedicine/methods ; }, abstract = {PURPOSE OF REVIEW: The role of telehealth in the care of people with type 1 diabetes (T1D) has expanded dramatically during the coronavirus pandemic, and is expected to remain a major care delivery modality going forward. This review explores the landscape of recent evidence for telehealth in T1D care.

RECENT FINDINGS: Telemedicine for routine T1D care has shown equivalence to standard in-person care, with respect to glycemic control, while also increasing access, convenience, and satisfaction. Telehealth use promotes increased engagement of adolescents with T1D. Telehealth platforms have successfully been used in the care of microvascular complications and to support mental health related to diabetes. Machine learning and advanced decision support will increasingly be used to augment T1D care, as recent evidence suggests increasing capabilities to improve glycemic control. A spectrum of digital connected care services are emerging to support people with diabetes with daily management of diabetes. Finally, policy and systems are required that promote data interoperability, telemedicine provision, and reimbursement to support the ongoing growth of telehealth in T1D.

SUMMARY: A developing field of evidence supports use of telehealth in T1D. As this care modality scales, it has the potential to increase access to high-quality diabetes care for many people with T1D.}, } @article {pmid33317385, year = {2021}, author = {Kory, P and Meduri, GU and Iglesias, J and Varon, J and Marik, PE}, title = {Clinical and Scientific Rationale for the "MATH+" Hospital Treatment Protocol for COVID-19.}, journal = {Journal of intensive care medicine}, volume = {36}, number = {2}, pages = {135-156}, doi = {10.1177/0885066620973585}, pmid = {33317385}, issn = {1525-1489}, mesh = {Ascorbic Acid/therapeutic use ; COVID-19/*drug therapy/epidemiology ; *Clinical Protocols ; Drug Therapy, Combination ; Heparin/therapeutic use ; Hospitalization ; Humans ; Intensive Care Units/*organization & administration ; Methylprednisolone/therapeutic use ; Pneumonia, Viral/*drug therapy/epidemiology ; Respiration, Artificial ; SARS-CoV-2 ; Thiamine/therapeutic use ; }, abstract = {In December 2019, COVID-19, a severe respiratory illness caused by the new coronavirus SARS-CoV-2 (COVID-19) emerged in Wuhan, China. The greatest impact that COVID-19 had was on intensive care units (ICUs), given that approximately 20% of hospitalized cases developed acute respiratory failure (ARF) requiring ICU admission. Based on the assumption that COVID-19 represented a viral pneumonia and no anti-coronaviral therapy existed, nearly all national and international health care societies' recommended "supportive care only" avoiding other therapies outside of randomized controlled trials, with a specific prohibition against the use of corticosteroids in treatment. However, early studies of COVID-19-associated ARF reported inexplicably high mortality rates, with frequent prolonged durations of mechanical ventilation (MV), even from centers expert in such supportive care strategies. These reports led the authors to form a clinical expert panel called the Front-Line COVID-19 Critical Care Alliance (www.flccc.net). The panel collaboratively reviewed the emerging clinical, radiographic, and pathological reports of COVID-19 while initiating multiple discussions among a wide clinical network of front-line clinical ICU experts from initial outbreak areas in China, Italy, and New York. Based on the shared early impressions of "what was working and what wasn't working," the increasing medical journal publications and the rapidly accumulating personal clinical experiences with COVID-19 patients, a treatment protocol was created for the hospitalized patients based on the core therapies of methylprednisolone, ascorbic acid, thiamine, heparin and co-interventions (MATH+). This manuscript reviews the scientific and clinical rationale behind MATH+ based on published in-vitro, pre-clinical, and clinical data in support of each medicine, with a special emphasis of studies supporting their use in the treatment of patients with viral syndromes and COVID-19 specifically. The review concludes with a comparison of published multi-national mortality data with MATH+ center outcomes.}, } @article {pmid33315687, year = {2021}, author = {Scaggs Huang, F and Schaffzin, JK}, title = {Rewriting the playbook: infection prevention practices to mitigate nosocomial severe acute respiratory syndrome coronavirus 2 transmission.}, journal = {Current opinion in pediatrics}, volume = {33}, number = {1}, pages = {136-143}, pmid = {33315687}, issn = {1531-698X}, mesh = {*COVID-19 ; *Cross Infection/prevention & control ; Health Personnel ; Humans ; Infectious Disease Transmission, Patient-to-Professional/prevention & control ; SARS-CoV-2 ; }, abstract = {PURPOSE OF REVIEW: Given the limited evidence and experience with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), this novel pathogen has challenged the field of infection prevention. Despite uncertainty, infection prevention principles and experience with similar diseases have helped guide how to best protect providers and patients against disease acquisition.

RECENT FINDINGS: Guidance to date has relied on data from SARS-CoV-1 and MERS-CoV to guide practices on patient isolation and personal protective equipment (PPE) use. Although a face mask and eye protection are likely adequate for most clinical scenarios, published guidelines for PPE can be confusing and conflicting. Consensus for what constitutes a high-risk aerosol-generating procedure (AGP) is lacking, but most agree providers performing procedures such as bronchoscopy, intubation, and cardiopulmonary resuscitation would likely benefit from the use of an N95 respirator and eye protection.

SUMMARY: Needed research to elucidate the predominant SARS-CoV-2 mode of transmission is not likely to be completed in the immediate future. Recommendations for PPE to mitigate procedure-associated risk remain controversial. Nonetheless, implementation of existing measures based on basic infection prevention principles is likely to prevent transmission significantly.}, } @article {pmid33315629, year = {2021}, author = {Boeder, S and Kulasa, K}, title = {Hospital care: improving outcomes in type 1 diabetes.}, journal = {Current opinion in endocrinology, diabetes, and obesity}, volume = {28}, number = {1}, pages = {14-20}, pmid = {33315629}, issn = {1752-2978}, mesh = {Blood Glucose ; COVID-19 ; *Diabetes Mellitus, Type 1/drug therapy ; Hospitals ; Humans ; Risk Factors ; Treatment Outcome ; }, abstract = {PURPOSE OF REVIEW: Caring for patients with type 1 diabetes (T1D) in the hospital presents unique challenges. This review provides an update on significant issues relevant to the inpatient management of T1D. Topics include trends in diabetic ketoacidosis (DKA), hypoglycemia, and adapting ambulatory technologies for inpatient use.

RECENT FINDINGS: Rates of DKA in the United States are rising. Although socioeconomic status, health insurance coverage, and hemoglobin A1c are persistently associated with DKA in individuals with T1D, newer risk factors have also emerged. These include the off-label use of sodium-glucose cotransporter inhibitor medications, immune checkpoint inhibitor-induced diabetes, and infection with severe acute respiratory syndrome coronavirus 2. Hypoglycemia is common among hospitalized patients with T1D. Use of validated hypoglycemia risk prediction models and multidisciplinary care initiatives can reduce the risk of inpatient hypoglycemia. Finally, continuous glucose monitoring is being adapted for use in the hospital setting and has shown promise during the coronavirus disease 2019 (COVID-19) pandemic.

SUMMARY: Evidence-based treatment algorithms, risk prediction calculators, multidisciplinary interventions, and wearable technology hold promise for improved outcomes in hospitalized patients with T1D.}, } @article {pmid33311429, year = {2020}, author = {Bratosiewicz-Wąsik, J and Wąsik, TJ}, title = {Does Virus-Receptor Interplay Influence Human Coronaviruses Infection Outcome?.}, journal = {Medical science monitor : international medical journal of experimental and clinical research}, volume = {26}, number = {}, pages = {e928572}, pmid = {33311429}, issn = {1643-3750}, mesh = {Angiotensin-Converting Enzyme 2/*metabolism ; Animals ; Coronavirus Infections/epidemiology/pathology/transmission/*virology ; Dipeptidyl Peptidase 4/*metabolism ; *Host-Pathogen Interactions ; Humans ; Middle East Respiratory Syndrome Coronavirus/metabolism/pathogenicity ; Pandemics/prevention & control ; SARS Virus/metabolism/pathogenicity ; SARS-CoV-2/metabolism/pathogenicity ; Species Specificity ; Spike Glycoprotein, Coronavirus/*metabolism ; Virus Internalization ; Virus Replication ; Zoonoses/epidemiology/pathology/*virology ; }, abstract = {Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is the third (following SARS-CoV and Middle East Respiratory Syndrome-CoV) zoonotic coronavirus that has crossed the species barrier in the 21st century, resulting in the development of serious human infection. The punishing effect of the recent outbreak of pandemic disease termed COVID-19 (coronavirus disease-19) caused by SARS-CoV-2 impelled us to gather the facts about the nature of coronaviruses. First, we introduce the basic information about coronavirus taxonomy, structure, and replication process to create the basis for more advanced consideration. In the following part of this review, we focused on interactions between the virus and the receptor on the host cell, as this stage is the critical process determining the species and tissue tropism, as well as clinical course of infection. We also illuminate the molecular basis of the strategy used by coronaviruses to cross the species barrier. We give special attention to the cellular receptor's interaction with S protein of different CoVs (dipeptidyl peptidase IV and angiotensin-converting enzyme 2), as well as the cellular proteases involved in proteolysis of this protein. These factors determine the virus entry and replication; thus, even fine quantitative or qualitative differences in their expression may crucially affect outcomes of infection. Understanding virus biology and characterization of the host factors involved in coronavirus transmission and pathogenesis may offer novel options for development of efficient therapeutic and preventive strategies.}, } @article {pmid33302684, year = {2020}, author = {Chen, Y and Guo, X and Zhang, X and Lv, H}, title = {Infection-prevention measures against COVID-19 during anesthesia: a narrative review of current clinical literature.}, journal = {Annals of palliative medicine}, volume = {9}, number = {6}, pages = {4300-4307}, doi = {10.21037/apm-20-2073}, pmid = {33302684}, issn = {2224-5839}, mesh = {*Anesthesia ; COVID-19/epidemiology/*prevention & control/virology ; China/epidemiology ; Humans ; Infection Control/*methods ; Pandemics ; Perioperative Period ; SARS-CoV-2/isolation & purification ; }, abstract = {The outbreak of coronavirus disease 2019 (COVID-19) has increased the risk of infection among medical staff. Anesthetists may have direct or indirect contact with COVID-19 patients' saliva droplets, blood, and other secretions in their daily work. If infection-prevention measures are not appropriate, it will not only cause individual medical staff infection, but also cross-infection among patients and other medical staff. Therefore, it is important to establish infection-control practices for COVID-19 patients during anesthesia. The aim of the present study was to review the infection-prevention measures against COVID-19 during anesthesia. Previously published studies on severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS), as well as current studies on COVID-19, specifically in Wuhan, China, were analyzed. In the present study, we discuss the etiology, epidemiology, pathology, clinical manifestations, diagnosis, and treatment of SARS, MERS, and COVID-19 at first. And then we discuss preoperative preparation which include the preparation of operating room, pre-operative assessment, hand hygiene and staffing and psychological counseling. We also discuss the implementation of anesthesia, including anesthesia types, induction of general anesthesia and endotracheal intubation, postoperative recovery and patient transport. Finally, we consider the proper disposal procedure for anesthetic equipment and medical devices. COVID-19 infection can be effectively reduced by infection-prevention measures during the perioperative period.}, } @article {pmid33278126, year = {2021}, author = {Chang, DJ and Moin, T}, title = {Coronavirus disease 2019 and type 1 diabetes mellitus.}, journal = {Current opinion in endocrinology, diabetes, and obesity}, volume = {28}, number = {1}, pages = {35-42}, pmid = {33278126}, issn = {1752-2978}, mesh = {COVID-19/*complications ; Comorbidity ; Diabetes Mellitus, Type 1/*complications ; Humans ; Hyperglycemia/complications ; SARS-CoV-2 ; }, abstract = {PURPOSE OF REVIEW: Type 2 diabetes (T2DM) is a major comorbidity of coronavirus disease 2019 (COVID-19) but less is known about COVID-19 and type 1 diabetes (T1DM). Thus, our goal was to review the literature on COVID and T1DM.

RECENT FINDINGS: We identified 21 reports focusing on COVID-19 infections among patients with preexisting T1DM (n = 7), incident T1DM presentations during the COVID-19 quarantine (n = 6), and outpatient management of T1DM during the COVID-19 quarantine (n = 8). These studies showed that patients with preexisting T1DM and COVID-19 infection often present with hyperglycemia and/or diabetic ketoacidosis (DKA). Although the risk of in-hospital mortality may be increased, hospitalization rates among patients with T1DM mirror that of the general population. The numbers of patients presenting with incident T1DM during COVID-19 quarantine have remained stable, but cases with severe DKA may have increased. COVID-19 quarantine has also impacted outpatient T1DM management and studies examining changes in glycemic control have shown mixed results.

SUMMARY: COVID-19 has important implications for patients with type 1 diabetes, but additional studies with larger numbers of patients and longer term follow-up are needed to confirm the early findings highlighted in this review.}, } @article {pmid33278112, year = {2021}, author = {Rankin, DA and Talj, R and Howard, LM and Halasa, NB}, title = {Epidemiologic trends and characteristics of SARS-CoV-2 infections among children in the United States.}, journal = {Current opinion in pediatrics}, volume = {33}, number = {1}, pages = {114-121}, pmid = {33278112}, issn = {1531-698X}, mesh = {Adolescent ; *COVID-19 ; Child ; Child, Preschool ; Hospitalization ; Humans ; Incidence ; Pandemics ; *SARS-CoV-2 ; United States/epidemiology ; }, abstract = {PURPOSE OF REVIEW: To review the epidemiological characteristics and clinical features associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections among children in the United States.

RECENT FINDINGS: In the United States, the majority of SARS-CoV-2 infections in children have been mild illnesses, with those 5-17 years of age having the highest frequency. Specifically, the incidence of SARS-CoV-2 in children is two times higher in adolescents (12-17 years) than younger school-aged children (5-11 years). Despite the higher case counts in older children, 10% of pediatric hospitalizations have been in infants less than one year. In addition, severe respiratory and renal complications, hospitalization, and even death have been documented in children.

SUMMARY: Clinical manifestations of SARS-CoV-2 infection in children range from asymptomatic to severe respiratory distress, with mild nonspecific symptoms being the most commonly reported. The broad clinical presentation and the frequency of asymptomatic or minimally symptomatic infections in children pose challenges for controlling and detecting SARS-CoV-2. However, severe disease has been noted in children with associated medical complications and death. Thus, additional active surveillance and research is needed to understand the burden children contribute to the SARS-CoV-2 pandemic in the United States.}, } @article {pmid33278110, year = {2021}, author = {Spearman, P}, title = {Diagnostic testing for SARS-CoV-2/COVID19.}, journal = {Current opinion in pediatrics}, volume = {33}, number = {1}, pages = {122-128}, pmid = {33278110}, issn = {1531-698X}, mesh = {*COVID-19/diagnosis ; COVID-19 Testing ; Diagnostic Techniques and Procedures ; Humans ; SARS-CoV-2 ; Systemic Inflammatory Response Syndrome ; }, abstract = {PURPOSE OF REVIEW: SARS-CoV-2 is the novel human coronavirus responsible for the COVID19 pandemic. Accurate detection of infection with SARS-CoV-2 is an essential component of efforts to treat individual patients and to contain spread of the virus in the community. The purpose of this review is to describe current diagnostic modalities for SARS-CoV-2 and outline their use. Special considerations for pediatric age groups are included.

RECENT FINDINGS: RNA PCR from the upper respiratory tract remains the gold standard for detection of infection with SARS-CoV-2. Antigen testing is being widely deployed as a faster and more convenient alternative to PCR, but is less sensitive and should only be used for diagnosis early after symptom onset. Serologic assays can document prior infection and are helpful in diagnosing multisystem inflammatory syndrome in children. Serologic testing should not be used to diagnose acute or active infection. Immune assays are likely to provide a useful measure of protection against COVID19 in the future as knowledge of protective responses improves.

SUMMARY: A variety of SARS-CoV-2 diagnostics have recently been developed and deployed. Clinicians should understand the appropriate use and interpretation of RNA PCR, antigen testing and immune assays for SARS-CoV-2 in order to diagnose and treat patients in this evolving pandemic.}, } @article {pmid33278108, year = {2021}, author = {Kamidani, S and Rostad, CA and Anderson, EJ}, title = {COVID-19 vaccine development: a pediatric perspective.}, journal = {Current opinion in pediatrics}, volume = {33}, number = {1}, pages = {144-151}, doi = {10.1097/MOP.0000000000000978}, pmid = {33278108}, issn = {1531-698X}, mesh = {*COVID-19 ; *COVID-19 Vaccines ; Child ; Humans ; SARS-CoV-2 ; Vaccination ; }, abstract = {PURPOSE OF REVIEW: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the novel coronavirus that causes coronavirus disease 2019 (COVID-19), has caused substantial morbidity and mortality. Operation Warp Speed aims to accelerate the development of a safe and effective vaccine by early 2021. Multiple vaccine candidates with reassuring safety and efficacy profiles have advanced to phase 3 clinical trials in adults. The purpose of this review is to describe the burden of COVID-19 in children, to update pediatricians about adult COVID-19 vaccine clinical trials, to discuss the importance of COVID-19 vaccine trials in children and to instill confidence in the established vaccine development and licensure processes.

RECENT FINDINGS: Children of all ages are at risk for SARS-CoV-2 infection and severe disease manifestations. Children are also susceptible to downstream effects of COVID-19, including social isolation and interruption in education. Developing a pediatric COVID-19 vaccine could prevent disease, mitigate downstream effects and enable children to re-engage in their world.

SUMMARY: Children could benefit both directly and indirectly from vaccination. In light of the safety and immunogenicity results from recent adult COVID-19 vaccine clinical trials, children should have the opportunity to be included in clinical trials in parallel to ongoing adult phase 3 clinical trials in a manner that is careful, methodical and transparent.}, } @article {pmid33278107, year = {2021}, author = {Soma, VL and Shust, GF and Ratner, AJ}, title = {Multisystem inflammatory syndrome in children.}, journal = {Current opinion in pediatrics}, volume = {33}, number = {1}, pages = {152-158}, pmid = {33278107}, issn = {1531-698X}, mesh = {*COVID-19 ; Child ; Fever ; Humans ; *Mucocutaneous Lymph Node Syndrome/diagnosis/therapy ; SARS-CoV-2 ; }, abstract = {PURPOSE OF REVIEW: Here we summarize current knowledge about multisystem inflammatory syndrome in children (MIS-C), a presumed postinfectious inflammatory condition that has emerged as an important COVID-19-associated complication, to help clinicians identify and manage cases.

RECENT FINDINGS: Clinical presentation of MIS-C is dominated by significant inflammation. Fever, gastrointestinal symptoms, cardiac dysfunction, and hypotension are common features. Kawasaki disease-like findings are common, but epidemiologic data and recent mechanistic studies suggest that distinct inflammatory pathways mediate Kawasaki disease and MIS-C. A broad diagnostic approach is recommended, given overlapping presentations between MIS-C and many other disease processes. Current management of MIS-C is highly variable, depending on illness severity, and can range from supportive care to aggressive immune modulation. A multidisciplinary approach with early involvement of multiple pediatric subspecialists is recommended for complicated cases.

SUMMARY: Several studies have described the clinical manifestations of MIS-C, but definitive diagnosis remains challenging. Robust information about long-term outcomes awaits further study, as do immunologic data to refine diagnostic and therapeutic strategies.}, } @article {pmid33253764, year = {2021}, author = {Thakur, S and Mayank, and Sarkar, B and Ansari, AJ and Khandelwal, A and Arya, A and Poduri, R and Joshi, G}, title = {Exploring the magic bullets to identify Achilles' heel in SARS-CoV-2: Delving deeper into the sea of possible therapeutic options in Covid-19 disease: An update.}, journal = {Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association}, volume = {147}, number = {}, pages = {111887}, doi = {10.1016/j.fct.2020.111887}, pmid = {33253764}, issn = {1873-6351}, mesh = {Antiviral Agents/*pharmacology ; Biological Products ; COVID-19/*drug therapy ; Drug Design ; Drug Discovery ; Humans ; Pandemics ; SARS-CoV-2/chemistry/*drug effects/ultrastructure ; }, abstract = {The symptoms associated with Covid-19 caused by SARS-CoV-2 in severe conditions can cause multiple organ failure and fatality via a plethora of mechanisms, and it is essential to discover the efficacious and safe drug. For this, a successful strategy is to inhibit in different stages of the SARS-CoV-2 life cycle and host cell reactions. The current review briefly put forth the summary of the SARS-CoV-2 pandemic and highlight the critical areas of understanding in genomics, proteomics, medicinal chemistry, and natural products derived drug discovery. The review further extends to briefly put forth the updates in the drug testing system, biologics, biophysics, and their advances concerning SARS-CoV-2. The salient features include information on SARS-CoV-2 morphology, genomic characterization, and pathophysiology along with important protein targets and how they influence the drug design and development against SARS-CoV-2 and a concerted and integrated approach to target these stages. The review also gives the status of drug design and discovery to identify the drugs acting on critical targets in SARS-CoV-2 and host reactions to treat Covid-19.}, } @article {pmid33208691, year = {2021}, author = {Zaidan, M and Legendre, C}, title = {Solid Organ Transplantation in the Era of COVID-19: Lessons from France.}, journal = {Transplantation}, volume = {105}, number = {1}, pages = {61-66}, pmid = {33208691}, issn = {1534-6080}, mesh = {COVID-19/*epidemiology/mortality ; France/epidemiology ; Humans ; Immune Tolerance ; Interleukin-6/antagonists & inhibitors ; *Organ Transplantation/methods/statistics & numerical data ; Patient Selection ; *SARS-CoV-2 ; Telemedicine ; }, abstract = {Coronavirus disease 2019 (COVID-19) outbreak has significantly upended solid organ transplant (SOT) practice around the world. Early reports confirmed the heavy burden of COVID-19 in SOT recipients with mortality rates reaching up to 35%. Because most transplant recipients harbored multiple comorbidities known to be associated with a severe course of COVID-19, the true impact of immunosuppression by itself remained an unsolved issue. Transplant societies have initially recommended to postpone nonurgent renal transplantations, while trying to maintain life-saving transplant programs, such as heart, lung, and liver transplantations. The pandemic thus resulted in an unprecedented and sudden drop of transplant activity worldwide. Moreover, the best treatment strategy in infected patients was challenging. Both reduction of immunosuppression and use of targeted therapies aiming at counteracting severe acute respiratory syndrome coronavirus 2 infection were the 2 faces of the therapeutic armamentarium. Recent controlled studies have better delineated the basis of mitigating and management strategies to improve patients' outcome. Nevertheless, and given the persistence of circulating virus, evidence-based recommendations in SOT recipients remain unclear. The resumption of transplant activity should be tailored with careful selection of both donors and recipients. Transplant decision should be made on a case-by-case basis after thorough assessment of the risks and benefits.}, } @article {pmid33189832, year = {2021}, author = {Icard, P and Lincet, H and Wu, Z and Coquerel, A and Forgez, P and Alifano, M and Fournel, L}, title = {The key role of Warburg effect in SARS-CoV-2 replication and associated inflammatory response.}, journal = {Biochimie}, volume = {180}, number = {}, pages = {169-177}, doi = {10.1016/j.biochi.2020.11.010}, pmid = {33189832}, issn = {1638-6183}, mesh = {COVID-19/*virology ; Glycolysis/*physiology ; Humans ; *Inflammation ; Middle East Respiratory Syndrome Coronavirus/physiology ; SARS-CoV-2/*physiology ; Virus Replication/*physiology ; }, abstract = {Current mortality due to the Covid-19 pandemic (approximately 1.2 million by November 2020) demonstrates the lack of an effective treatment. As replication of many viruses - including MERS-CoV - is supported by enhanced aerobic glycolysis, we hypothesized that SARS-CoV-2 replication in host cells (especially airway cells) is reliant upon altered glucose metabolism. This metabolism is similar to the Warburg effect well studied in cancer. Counteracting two main pathways (PI3K/AKT and MAPK/ERK signaling) sustaining aerobic glycolysis inhibits MERS-CoV replication and thus, very likely that of SARS-CoV-2, which shares many similarities with MERS-CoV. The Warburg effect appears to be involved in several steps of COVID-19 infection. Once induced by hypoxia, the Warburg effect becomes active in lung endothelial cells, particularly in the presence of atherosclerosis, thereby promoting vasoconstriction and micro thrombosis. Aerobic glycolysis also supports activation of pro-inflammatory cells such as neutrophils and M1 macrophages. As the anti-inflammatory response and reparative process is performed by M2 macrophages reliant on oxidative metabolism, we speculated that the switch to oxidative metabolism in M2 macrophages would not occur at the appropriate time due to an uncontrolled pro-inflammatory cascade. Aging, mitochondrial senescence and enzyme dysfunction, AMPK downregulation and p53 inactivation could all play a role in this key biochemical event. Understanding the role of the Warburg effect in COVID-19 can be essential to developing molecules reducing infectivity, arresting endothelial cells activation and the pro-inflammatory cascade.}, } @article {pmid33186186, year = {2021}, author = {Wakabayashi, M and Pawankar, R and Narazaki, H and Ueda, T and Itabashi, T}, title = {Coronavirus disease 2019 and asthma, allergic rhinitis: molecular mechanisms and host-environmental interactions.}, journal = {Current opinion in allergy and clinical immunology}, volume = {21}, number = {1}, pages = {1-7}, pmid = {33186186}, issn = {1473-6322}, mesh = {Air Pollution/*adverse effects ; Angiotensin-Converting Enzyme 2/genetics/metabolism ; Asthma/*epidemiology/*immunology ; COVID-19/*epidemiology/*immunology/virology ; Comorbidity ; Cytokines/metabolism ; Humans ; *Pandemics ; Rhinitis, Allergic/*epidemiology/*immunology ; Risk Factors ; SARS-CoV-2/*physiology ; Th1 Cells/immunology ; Virus Internalization ; }, abstract = {PURPOSE OF REVIEW: Coronavirus disease 2019 (COVID-19), a respiratory infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 virus), is a pandemic in over 120 countries worldwide. Risk factors for severe COVID-19 include older age, ethnicity, sex, comorbidities, and living conditions. Although asthmatics and those with allergies are susceptible to more severe outcomes to viral infections, interestingly, asthma has not been reported to be a major comorbidity of COVID-19. However, there are some conflicting reports on the impact of asthma on COVID-19. The underlying immunological and molecular mechanisms may explain at least in part these observations. Furthermore, environmental factors like air pollution that have detrimental effects on asthma and respiratory illnesses also have an impact on COVID-19.

RECENT FINDINGS: Angiotensin-converting enzyme 2 (ACE2) is the receptor for the attachment and entry of SARS-CoV-2 into the host cells that is upregulated by Th1-mediated responses. In asthmatics, ACE2 gene expression is generally reduced and recent studies have shown a negative correlation between the levels of Th2 cytokines including IL-4, IL-5, and IL-13 in airway epithelial cells and other type 2 biomarkers with ACE2 expression. This may explain in part the potential protective role of asthma on COVID-19. Here, we review the relation of respiratory viral illnesses and asthma, the immune-molecular mechanisms of SARS-CoV-2 infection, the impact of asthma on COVID-19 and that of SARS-CoV-2 on asthma and allergic rhinitis, and the impact of environmental factors like air pollution on COVID-19.

SUMMARY: Expression of ACE2 in airway epithelial cells in SARS-COV-2 is influenced by inflammatory profile. Respiratory allergic diseases like asthma appear to have a protective effect against SARS-COV-2 infection. However, the clinical association between asthma and SARS-COV-2 is not fully established and the underlying immune-molecular mechanisms may explain these observations.}, } @article {pmid33177481, year = {2020}, author = {Wang, F and Kream, RM and Stefano, GB}, title = {Long-Term Respiratory and Neurological Sequelae of COVID-19.}, journal = {Medical science monitor : international medical journal of experimental and clinical research}, volume = {26}, number = {}, pages = {e928996}, pmid = {33177481}, issn = {1643-3750}, mesh = {COVID-19/*complications/epidemiology/immunology/virology ; Disease Progression ; Humans ; Lung Injury/diagnosis/*epidemiology/immunology/prevention & control ; Neurodegenerative Diseases/diagnosis/*epidemiology/immunology/prevention & control ; Pandemics ; Pulmonary Fibrosis/diagnosis/*epidemiology/immunology/prevention & control ; Quality of Life ; SARS-CoV-2/immunology/*pathogenicity ; Time Factors ; }, abstract = {Since the initial reports of coronavirus disease 2019 (COVID-19) in China in late 2019, infections from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) have spread rapidly, resulting in a global pandemic that has caused millions of deaths. Initially, the large number of infected people required the direction of global healthcare resources to provide supportive care for the acutely ill population in an attempt to reduce mortality. While clinical trials for safe and effective antiviral agents are ongoing, and vaccine development programs are being accelerated, long-term sequelae of SARS-CoV-2 infection have become increasingly recognized and concerning. Although the upper and lower respiratory tracts are the main sites of entry of SARS-CoV-2 into the body, resulting in COVID-19 pneumonia as the most common presentation, acute lung damage may be followed by pulmonary fibrosis and chronic impairment of lung function, with impaired quality of life. Also, increasing reports have shown that SARS-CoV-2 infection involves the central nervous system (CNS) and the peripheral nervous system (PNS) and directly or indirectly damages neurons, leading to long-term neurological sequelae. This review aims to provide an update on the mechanisms involved in the development of the long-term sequelae of SARS-CoV-2 infection in the 3 main areas of lung injury, neuronal injury, and neurodegenerative diseases, including Alzheimer disease, Parkinson disease, and multiple sclerosis, and highlights the need for patient monitoring following the acute stage of infection with SARS-CoV-2 to provide a rationale for the prevention, diagnosis, and management of these potential long-term sequelae.}, } @article {pmid33165237, year = {2021}, author = {Domínguez-Gil, B and Fernández-Ruiz, M and Hernández, D and Crespo, M and Colmenero, J and Coll, E and Rubio, JJ}, title = {Organ Donation and Transplantation During the COVID-19 Pandemic: A Summary of the Spanish Experience.}, journal = {Transplantation}, volume = {105}, number = {1}, pages = {29-36}, pmid = {33165237}, issn = {1534-6080}, mesh = {COVID-19/drug therapy/*epidemiology ; Humans ; Immune Tolerance ; *Organ Transplantation ; *SARS-CoV-2 ; Spain/epidemiology ; *Tissue and Organ Procurement ; }, abstract = {BACKGROUND: Spain has been amongst the countries most affected by the COVID-19 pandemic, which has posed significant challenges to the donation and transplantation program. Despite a dramatic decrease of donation and transplantation activities during the critical early weeks of the outbreak, the program has recovered and is learning to cope with COVID-19.

METHODS: We describe the 4 pillars upon which the Spanish donation and transplantation program has been rebuilt.

RESULTS: (1) Standards have been developed and progressively updated for the evaluation and selection of potential donors and recipients with regards to SARS-CoV-2 infection. (2) Spain has been actively generating evidence to assess the validity of our standards and to understand the natural history of the infection in transplant recipients. No case of donor-derived COVID-19 has been reported to date. COVID-19 has been more frequent and has had a more aggressive course in recipients of solid organ transplants than in the general population, but this seems largely explained by the demographics and comorbidity of transplant patients. (3) As a result of this evidence and experience, recommendations have been issued for the management of COVID-19 in solid organ transplant recipients and candidates on the waiting list. (4) Finally, concrete guidance has been issued for centers to manage the donation and transplantation programs in relation to a dynamic and heterogeneous epidemiologic scenario.

CONCLUSIONS: The Spanish experience confronting the impact of COVID-19 upon donation and transplantation may help serve the needs of a broader community in other countries.}, } @article {pmid33164997, year = {2021}, author = {Wang, M and Wang, C and Zhang, L}, title = {Inflammatory endotypes of CRSwNP and responses to COVID-19.}, journal = {Current opinion in allergy and clinical immunology}, volume = {21}, number = {1}, pages = {8-15}, pmid = {33164997}, issn = {1473-6322}, mesh = {Angiotensin-Converting Enzyme 2/metabolism ; COVID-19/*epidemiology/immunology/virology ; Comorbidity ; Goblet Cells/immunology ; Humans ; Inflammation/immunology ; Nasal Polyps/*epidemiology/immunology ; Rhinitis/*epidemiology/immunology ; Risk Factors ; SARS-CoV-2/*physiology ; Sinusitis/*epidemiology/immunology ; Virus Internalization ; }, abstract = {PURPOSE OF REVIEW: Coronavirus disease 2019 (COVID-19), a disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has quickly become a great public health hazard globally. Nasal epithelial cells are an important site for SARS-CoV-2 infection and replication. The purpose of this review is to summarize recent findings on the endotypes of chronic rhinosinusitis with nasal polyps (CRSwNP) and the potential impact of SARS-CoV-2 infection.

RECENT FINDINGS: Endotypes of CRSwNP are characterized by type 1, type 2 and type 3 inflammation according to patterns of inflammatory cells and the cytokines expressed in nasal tissue. Nasal epithelial cells show the highest expression of angiotensin-converting enzyme 2 (ACE2), the receptor for attachment and entry of SARS-CoV-2 into host cells, among all investigated cells in the respiratory tree. SARS-CoV-2 infection likely leads to increased activation of T-helper-1 (Th1) cell responses. Recent studies further suggest that ACE2 may be upregulated by type 1 and downregulated by type 2 inflammatory cytokines in nasal epithelial cells.

SUMMARY: Expression of ACE2 in nasal epithelial cells is influenced by inflammatory endotypes of CRSwNP. Type 1 inflammation in nasal tissue may increase the risk of SARS-CoV-2 infection by upregulating ACE2 expression. However, clinical association between CRSwNP and COVID-19 is still unclear.}, } @article {pmid33156499, year = {2021}, author = {Quinete, N and Hauser-Davis, RA}, title = {Drinking water pollutants may affect the immune system: concerns regarding COVID-19 health effects.}, journal = {Environmental science and pollution research international}, volume = {28}, number = {1}, pages = {1235-1246}, pmid = {33156499}, issn = {1614-7499}, mesh = {*COVID-19 ; *Coronavirus Infections ; *Drinking Water ; Humans ; Immune System ; SARS-CoV-2 ; *Water Pollutants ; }, abstract = {The current coronavirus pandemic is leading to significant impacts on the planet, changing our way of life. Although the COVID-19 virus mechanisms of action and pathogenesis are still under extensive research, immune system effects are evident, leading, in many cases, to respiratory distress. Although apparent pollution reduction has been noticed by the population, environmental and human health impacts due to the increased use of plastic waste and disinfectants is concerning. One of the main routes of human exposure to pollutants is through drinking water. Thus, this point of view discusses some major contaminants in drinking water known to be immunotoxic, exploring sources and drinking water routes and emphasizing the known mechanisms of action that could likely compromise the effective immune response of humans, particularly raising concerns regarding people exposed to the COVID-19 virus. Based on a literature review, metals, plastic components, plasticizers, and per- and polyfluoroalkyl substances may display the potential to exacerbate COVID-19 respiratory symptoms, although epidemiological studies are still required to confirm the synergistic effects between these pollutants and the virus.}, } @article {pmid33148977, year = {2021}, author = {Azzi, Y and Bartash, R and Scalea, J and Loarte-Campos, P and Akalin, E}, title = {COVID-19 and Solid Organ Transplantation: A Review Article.}, journal = {Transplantation}, volume = {105}, number = {1}, pages = {37-55}, pmid = {33148977}, issn = {1534-6080}, mesh = {COVID-19/complications/epidemiology/*immunology/therapy ; Humans ; Immune Tolerance ; Kidney Failure, Chronic/complications ; *Organ Transplantation/ethics/mortality ; SARS-CoV-2/*immunology ; }, abstract = {The coronavirus pandemic has significantly impacted solid organ transplantation (SOT). Early in the outbreak period, transplant societies recommended suspending living kidney transplant programs in communities with widespread transmission to avoid exposing recipients to increased risk of immunosuppression, while recommendations were made to reserve deceased-donor kidney transplantation for likely life-saving indications. SOT recipients may be at high risk from COVID-19 disease due to chronic immunosuppressive treatment and other medical comorbidities. Mortality rates reported between 13 to over 30% in SOT recipients. In addition to high rates of complications and mortality attributable to COVID-19 infections, the pandemic has also led to additional complexities in transplantation including new questions regarding screening of donors and recipients, decision making to accept a patient for kidney transplant or wait after pandemic. The clinical implications of COVID-19 infection may also differ depending on the type of the transplanted organ and recipient comorbidities which further impacts decisions on continuing transplantation during the pandemic. Transplant activity during a pandemic should be tailored with careful selection of both donors and recipients. Furthermore, while tremendous strides have been made in treatment strategies and vaccinations, the impact of these in transplant recipients may be attenuated in the setting of their immunosuppression. In this review, we aim to summarize several aspects of COVID-19 in transplantation, including the immune response to SARS-CoV-2, SARS-CoV-2 diagnostics, clinical outcomes in SOT recipients, and end-stage kidney disease patients, transplant activity during the pandemic, and treatment options for COVID-19 disease.}, } @article {pmid33141806, year = {2021}, author = {Weiss, MJ and Lalani, J and Patriquin-Stoner, C and Dieudé, M and Hartell, D and Hornby, L and Shemie, SD and Wilson, L and Mah, A}, title = {Summary of International Recommendations for Donation and Transplantation Programs During the Coronavirus Disease Pandemic.}, journal = {Transplantation}, volume = {105}, number = {1}, pages = {14-17}, pmid = {33141806}, issn = {1534-6080}, mesh = {COVID-19/*epidemiology ; Guideline Adherence ; Humans ; *Organ Transplantation ; *Practice Guidelines as Topic ; *SARS-CoV-2 ; *Tissue and Organ Procurement ; }, abstract = {BACKGROUND: The COVID-19 pandemic has disrupted all aspects of the international organ donation and transplantation (ODT) system. Multiple organizations have developed guidance, but to date, no comparative summary has emerged to understand differences in existing recommendations.

METHODS: We developed and applied a comparative methodology to a convenience sample of recommendations available on The Transplantation Society website. Document types were classified according to characteristics such as type of organization (eg, governing body or professional society) and geographic region. Recommendations were grouped according to content, and summaries were posted on a public website. This process is ongoing and will be updated as new recommendations become available.

RESULTS: Eighteen documents were extracted in the initial review. All documents were based on expert opinion, and none described a formal literature review or adherence with clinical guideline development processes. Recommendation categories included screening of potential donors, risk assessment of potential recipients, posttransplant risk, living/paired donation, protection of ODT professionals, and ethics/logistics. While many documents included similar recommendations, such as the need to screen and test patients who are potential donors, there was variation on some topics. Type of recommended laboratory testing varied with 64% recommending nasopharyngeal swabs, 43% oropharyngeal, and 24% bronchial aspirates. Updated results are available at https://cdtrp.ca/en/covid-19-international-recommendations-for-odt/.

CONCLUSIONS: The current state of COVID-19 ODT recommendations is limited to expert opinion. Substantial variation exists regarding recommendations, which are based on emerging but currently low-quality evidence. This summary of existing recommendations will serve to inform priorities for evidence-based recommendations.}, } @article {pmid33141805, year = {2021}, author = {Avery, RK}, title = {COVID-19 Therapeutics for Solid Organ Transplant Recipients; 6 Months Into the Pandemic: Where Are We Now?.}, journal = {Transplantation}, volume = {105}, number = {1}, pages = {56-60}, pmid = {33141805}, issn = {1534-6080}, mesh = {Antibodies, Monoclonal, Humanized/therapeutic use ; COVID-19/epidemiology/immunology/*therapy ; Humans ; Hydroxychloroquine/therapeutic use ; Immune Tolerance ; Immunization, Passive ; Immunologic Factors/therapeutic use ; *Organ Transplantation ; *SARS-CoV-2 ; }, abstract = {As in the general population with coronavirus 2019 (COVID-19) infection, therapeutic interventions in solid organ transplant (SOT) recipients have evolved over time. The preceding 6 months of the pandemic can be divided into 2 main therapeutic eras: the early era and the later era. The first era was characterized by the widespread use of drugs such as hydroxychloroquine with or without azithromycin, lopinavir-ritonavir, and tocilizumab. More recently, with the publication of larger trials, there has been increasing use of remdesivir, dexamethasone, and convalescent plasma, with the rapid proliferation of clinical trials including a wide variety of investigational and repurposed agents with antiviral or immunomodulatory effects. This overview focuses on what is known about the effects of different therapies in SOT recipients with COVID-19, mainly from case series and, more recently, larger multicenter registries; as well as outlining the information that will be needed to optimize management and outcomes in SOT recipients with COVID-19 in the future.}, } @article {pmid33098971, year = {2021}, author = {Jansen, C and Baker, JD and Kodaira, E and Ang, L and Bacani, AJ and Aldan, JT and Shimoda, LMN and Salameh, M and Small-Howard, AL and Stokes, AJ and Turner, H and Adra, CN}, title = {Medicine in motion: Opportunities, challenges and data analytics-based solutions for traditional medicine integration into western medical practice.}, journal = {Journal of ethnopharmacology}, volume = {267}, number = {}, pages = {113477}, doi = {10.1016/j.jep.2020.113477}, pmid = {33098971}, issn = {1872-7573}, support = {P20 GM103466/GM/NIGMS NIH HHS/United States ; P20 GM113134/GM/NIGMS NIH HHS/United States ; R15 DA051749/DA/NIDA NIH HHS/United States ; R15 DK100978/DK/NIDDK NIH HHS/United States ; }, mesh = {COVID-19/therapy ; Data Interpretation, Statistical ; *Data Science ; Delivery of Health Care, Integrated/*organization & administration/*trends ; Humans ; Medicine ; Medicine, Traditional/*trends ; Phytotherapy ; }, abstract = {Traditional pharmacopeias have been developed by multiple cultures and evaluated for efficacy and safety through both historical/empirical iteration and more recently through controlled studies using Western scientific paradigms and an increasing emphasis on data science methodologies for network pharmacology. Traditional medicines represent likely sources of relatively inexpensive drugs for symptomatic management as well as potential libraries of new therapeutic approaches. Leveraging this potential requires hard evidence for efficacy that separates science from pseudoscience.

MATERIALS AND METHODS: We performed a review of non-Western medical systems and developed case studies that illustrate the epistemological and practical translative barriers that hamper their transition to integration with Western approaches. We developed a new data analytics approach, in silico convergence analysis, to deconvolve modes of action, and potentially predict desirable components of TM-derived formulations based on computational consensus analysis across cultures and medical systems.

RESULTS: Abstraction, simplification and altered dose and delivery modalities were identified as factors that influence actual and perceived efficacy once a medicine is moved from a non-Western to Western setting. Case studies on these factors highlighted issues with translation between non-Western and Western epistemologies, including those where epistemological and medicinal systems drive markets that can be epicenters for zoonoses such as the novel Coronavirus. The proposed novel data science approach demonstrated the ability to identify and predict desirable medicinal components for a test indication, pain.

CONCLUSIONS: Relegation of traditional therapies to the relatively unregulated nutraceutical industry may lead healthcare providers and patients to underestimate the therapeutic potential of these medicines. We suggest three areas of emphasis for this field: First, vertical integration and embedding of traditional medicines into healthcare systems would subject them to appropriate regulation and evidence-based practice, as viable integrative implementation mode. Second, we offer a new Bradford-Hill-like framework for setting research priorities and evaluating efficacy, with the goal of rescuing potentially valuable therapies from the nutraceutical market and discrediting those that are pseudoscience. Third, data analytics pipelines offer new capacity to generate new types of TMS-inspired medicines that are rationally-designed based on integrated knowledge across cultures, and also provide an evaluative framework against which to test claims of fidelity and efficacy to TMS made for nutraceuticals.}, } @article {pmid33058321, year = {2021}, author = {von Oertzen, TJ and Macerollo, A and Leone, MA and Beghi, E and Crean, M and Oztuk, S and Bassetti, C and Twardzik, A and Bereczki, D and Di Liberto, G and Helbok, R and Oreja-Guevara, C and Pisani, A and Sauerbier, A and Sellner, J and Soffietti, R and Zedde, M and Bianchi, E and Bodini, B and Cavallieri, F and Campiglio, L and Maia, LF and Priori, A and Rakusa, M and Taba, P and Moro, E and Jenkins, TM and , }, title = {EAN consensus statement for management of patients with neurological diseases during the COVID-19 pandemic.}, journal = {European journal of neurology}, volume = {28}, number = {1}, pages = {7-14}, doi = {10.1111/ene.14521}, pmid = {33058321}, issn = {1468-1331}, mesh = {*COVID-19 ; Consensus ; Delphi Technique ; Guidelines as Topic ; Humans ; Nervous System Diseases/*therapy ; Neurology ; *Pandemics ; *Patient Care Management ; }, abstract = {BACKGROUND AND PURPOSE: The recent SARS-CoV-2 pandemic has posed multiple challenges to the practice of clinical neurology including recognition of emerging neurological complications and management of coexistent neurological diseases. In a fast-evolving pandemic, evidence-based studies are lacking in many areas. This paper presents European Academy of Neurology (EAN) expert consensus statements to guide neurologists caring for patients with COVID-19.

METHODS: A refined Delphi methodology was applied. In round 1, statements were provided by EAN scientific panels (SPs). In round 2, these statements were circulated to SP members not involved in writing them, asking for agreement/disagreement. Items with agreement >70% were retained for round 3, in which SP co-chairs rated importance on a five-point Likert scale. Results were graded by importance and reported as consensus statements.

RESULTS: In round one, 70 statements were provided by 23 SPs. In round two, 259/1061 SP member responses were received. Fifty-nine statements obtained >70% agreement and were retained. In round three, responses were received from 55 co-chairs of 29 SPs. Whilst general recommendations related to prevention of COVID-19 transmission had high levels of agreement and importance, opinion was more varied concerning statements related to therapy.

CONCLUSION: This is the first structured consensus statement on good clinical practice in patients with neurological disease during the COVID-19 pandemic that provides immediate guidance for neurologists. In this fast-evolving pandemic, a rapid response using refined Delphi methodology is possible, but guidance may be subject to change as further evidence emerges.}, } @article {pmid33401333, year = {2021}, author = {Levi-Schaffer, F and de Marco, A}, title = {COVID-19 and the revival of passive immunization: Antibody therapy for inhibiting SARS-CoV-2 and preventing host cell infection - IUPHAR review "X".}, journal = {British journal of pharmacology}, volume = {}, number = {}, pages = {}, doi = {10.1111/bph.15359}, pmid = {33401333}, issn = {1476-5381}, abstract = {The COVID-19 pandemic urged both scientific community and health care companies to undertake an unprecedented effort with the aim of understanding the molecular mechanisms of SARS-CoV-2 infection and developing effective therapeutic solutions. The peculiar immune response triggered by such virus, that seems to last only few months, induced to look for alternatives such as passive immunization in addition to conventional vaccinations. Convalescent sera, monoclonal antibodies selected among the most potent neutralizing binders induced by the virus infection, recombinant human single-domain antibodies and binders of variable scaffold and different origin have been tested alone or in combination exploiting mono and multivalent/multispecific formats. In this review we analyze the state of the advancement of the research in this field and present a summary of the ongoing projects finalized to identify suitable molecules for therapies based on passive immunization.}, } @article {pmid33401205, year = {2020}, author = {Chen, H and Zhang, X and Liu, W and Xue, M and Liao, C and Huang, Z and Hu, H and Sun, B}, title = {The role of serum specific- SARS-CoV-2 antibody in COVID-19 patients.}, journal = {International immunopharmacology}, volume = {91}, number = {}, pages = {107325}, doi = {10.1016/j.intimp.2020.107325}, pmid = {33401205}, issn = {1878-1705}, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), responsible for coronavirus disease 2019 (COVID-19), has rapidly spread, resulting in considerable casualties and serious economic loss worldwide. Disease severity and related symptoms markedly vary among individuals. A large number of patients present atypical symptoms, which represent a big challenge for early diagnosis and prompt infection source isolation. Currently, COVID-19 diagnosis predominantly depends on nucleic acid tests (NAT) for SARS-CoV-2 in respiratory specimens, but this method presents a high rate of false negative results. Therefore, serum antibody measurement has been rapidly developed as a supplementary method with the aim of improving diagnostic accuracy. Further, serum antibody levels might help to identify the infection stage, asymptomatic carriers, and patients with diverging severities and to monitor convalescent plasma therapy. In the current review, we aim to present comprehensive evidence to clarify the utility of SARS-CoV-2 antibodies in COVID-19 patients as a reference for use in the clinic.}, } @article {pmid33401171, year = {2020}, author = {Novelli, L and Motta, F and De Santis, M and Ansari, AA and Gershwin, ME and Selmi, C}, title = {The JANUS of chronic inflammatory and autoimmune diseases onset during COVID-19 - A systematic review of the literature.}, journal = {Journal of autoimmunity}, volume = {117}, number = {}, pages = {102592}, doi = {10.1016/j.jaut.2020.102592}, pmid = {33401171}, issn = {1095-9157}, abstract = {The diverse clinical manifestations of COVID-19 is emerging as a hallmark of the Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection. While the initial target of SARS-CoV-2 is the respiratory tract, it is becoming increasingly clear that there is a complex interaction between the virus and the immune system ranging from mild to controlling responses to exuberant and dysfunctional multi-tissue directed autoimmune responses. The immune system plays a dual role in COVID-19, being implicated in both the anti-viral response and in the acute progression of the disease, with a dysregulated response represented by the marked cytokine release syndrome, macrophage activation, and systemic hyperinflammation. It has been speculated that these immunological changes may induce the loss of tolerance and/or trigger chronic inflammation. In particular, molecular mimicry, bystander activation and epitope spreading are well-established proposed mechanisms to explain this correlation with the likely contribution of HLA alleles. We performed a systematic literature review to evaluate the COVID-19-related autoimmune/rheumatic disorders reported between January and September 2020. In particular, we investigated the cases of incident hematological autoimmune manifestations, connective tissue diseases, antiphospholipid syndrome/antibodies, vasculitis, Kawasaki-like syndromes, acute arthritis, autoimmune-like skin lesions, and neurologic autoimmune conditions such as Guillain-Barré syndrome. We screened 6263 articles and report herein the findings of 382 select reports which allow us to conclude that there are 2 faces of the immune response against SARS-CoV-2, that include a benign virus controlling immune response and a many faceted range of dysregulated multi-tissue and organ directed autoimmune responses that provides a major challenge in the management of this viral disease. The number of cases for each disease varied significantly while there were no reported cases of adult onset Still disease, systemic sclerosis, or inflammatory myositis.}, } @article {pmid33401078, year = {2020}, author = {Hawkins, M and Sockalingam, S and Bonato, S and Rajaratnam, T and Ravindran, M and Gosse, P and Sheehan, KA}, title = {A rapid review of the pathoetiology, presentation, and management of delirium in adults with COVID-19.}, journal = {Journal of psychosomatic research}, volume = {141}, number = {}, pages = {110350}, doi = {10.1016/j.jpsychores.2020.110350}, pmid = {33401078}, issn = {1879-1360}, abstract = {Background COVID-19 causes significant morbidity and mortality. Despite the high prevalence of delirium and delirium-related symptoms in COVID-19 patients, data and evidence-based recommendations on the pathophysiology and management of delirium are limited. Objective We conducted a rapid review of COVID-19-related delirium literature to provide a synthesis of literature on the prevalence, pathoetiology, and management of delirium in these patients. Methods Systematic searches of Medline, Embase, PsycInfo, LitCovid, WHO-COVID-19, and Web of Science electronic databases were conducted. Grey literature was also reviewed, including preprint servers, archives, and websites of relevant organizations. Search results were limited to the English language. We included literature focused on adults with COVID-19 and delirium. Papers were excluded if they did not mention signs or symptoms of delirium. Results 229 studies described prevalence, pathoetiology, and/or management of delirium in adults with COVID-19. Delirium was rarely assessed with validated tools. Delirium affected >50% of all patients with COVID-19 admitted to the ICU. The etiology of COVID-19 delirium is likely multifactorial, with some evidence of direct brain effect. Prevention remains the cornerstone of management in these patients. To date, there is no evidence to suggest specific pharmacological strategies. Discussion Delirium is common in COVID-19 and may manifest from both indirect and direct effects on the central nervous system. Further research is required to investigate contributing mechanisms. As there is limited empirical literature on delirium management in COVID-19, management with non-pharmacological measures and judicious use of pharmacotherapy is suggested.}, } @article {pmid33401034, year = {2021}, author = {Liu, N and Sun, J and Wang, X and Zhang, T and Zhao, M and Li, H}, title = {Low vitamin D status is associated with coronavirus disease 2019 outcomes: A systematic review and meta-analysis.}, journal = {International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.ijid.2020.12.077}, pmid = {33401034}, issn = {1878-3511}, abstract = {BACKGROUND: Observational studies suggest that the risk and clinical prognosis of coronavirus disease 2019 (COVID-19) are related to low vitamin D status; however, the data are inconsistent.

OBJECTIVES: We conducted a systematic review and meta-analysis to assess the association between low vitamin D status and COVID-19.

METHODS: The systematic search was conducted with PubMed, Embase, and the Cochrane Library from database inception to September 25, 2020. The standardized mean difference (SMD) or odds ratio (OR) and corresponding 95% confidence interval (CI) were applied to estimate pooled results. Random - or fixed - effect models based on heterogeneity were used for the meta-analysis. Funnel plots and Egger regression tests were used to assess publication bias.

RESULTS: A total of 10 articles with 361, 934 participants were selected for meta-analysis. Overall, the pooled OR in the fixed-effect model showed that vitamin D deficiency or insufficiency was associated with an increased risk of COVID-19 (OR = 1.43, 95% CI 1.00 to 2.05). In addition, COVID-19-positive individuals had lower vitamin D levels than those with COVID-19-negative individuals (SMD = -0.37, 95% CI = -0.52 to -0.21). Significant heterogeneity existed in both endpoints. Funnel plots and Egger regression tests revealed significant publication bias.

CONCLUSIONS: This systematic review and meta-analysis indicated that low vitamin D status may be associated with an increased risk of COVID-19 infection. Further studies are needed to evaluate the impact of vitamin D supplementation on the clinical severity and prognosis in patients with COVID-19.

PROSPERO registration no: CRD42020216740.}, } @article {pmid33400975, year = {2021}, author = {Pavia, CS and Wormser, GP}, title = {Passive immunization and its rebirth in the era of the COVID-19 pandemic.}, journal = {International journal of antimicrobial agents}, volume = {}, number = {}, pages = {106275}, doi = {10.1016/j.ijantimicag.2020.106275}, pmid = {33400975}, issn = {1872-7913}, abstract = {The current COVID-19 pandemic, caused by SARS-CoV-2, has led to a rapid search for therapeutic and preventive measures. The impetus for this is the potentially severe course of infection. In regard to drug therapies, the antiviral drug, remdesivir, and the anti-inflammatory agent, dexamethasone, have shown some beneficial effects. Since a COVID-19 vaccine is not currently available, various additional treatment options are being evaluated. One of these, passive immunization, has shown promise in some studies. More research, however, is needed to determine the utility of immunotherapy with convalescent plasma or artificially produced monoclonal antibodies, for the treatment of symptomatic patients and potentially for use as post-exposure prophylaxis, at least until more effective drugs or a safe and effective vaccine become available.}, } @article {pmid33400957, year = {2021}, author = {Kim, J and Eygeris, Y and Gupta, M and Sahay, G}, title = {Self-assembled mRNA vaccines.}, journal = {Advanced drug delivery reviews}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.addr.2020.12.014}, pmid = {33400957}, issn = {1872-8294}, abstract = {mRNA vaccines have evolved from being a mere curiosity to emerging as COVID-19 vaccine front-runners. Recent advancements in the field of RNA technology, vaccinology, and nanotechnology have generated interest in delivering safe and effective mRNA therapeutics. In this review, we discuss design and self-assembly of mRNA vaccines. Self-assembly, a spontaneous organization of individual molecules, allows for design of nanoparticles with customizable properties. We highlight the materials commonly utilized to deliver mRNA, their physicochemical characteristics, and other relevant considerations, such as mRNA optimization, routes of administration, cellular fate, and immune activation, that are important for successful mRNA vaccination. We also examine the COVID-19 mRNA vaccines currently in clinical trials. mRNA vaccines are ready for the clinic, showing tremendous promise in the COVID-19 vaccine race, and have pushed the boundaries of gene therapy.}, } @article {pmid33400642, year = {2021}, author = {Swadi, T and Geoghegan, JL and Devine, T and McElnay, C and Sherwood, J and Shoemack, P and Ren, X and Storey, M and Jefferies, S and Smit, E and Hadfield, J and Kenny, A and Jelley, L and Sporle, A and McNeill, A and Reynolds, GE and Mouldey, K and Lowe, L and Sonder, G and Drummond, AJ and Huang, S and Welch, D and Holmes, EC and French, N and Simpson, CR and de Ligt, J}, title = {Genomic Evidence of In-Flight Transmission of SARS-CoV-2 Despite Predeparture Testing.}, journal = {Emerging infectious diseases}, volume = {27}, number = {3}, pages = {}, doi = {10.3201/eid2703.204714}, pmid = {33400642}, issn = {1080-6059}, abstract = {Since the first wave of coronavirus disease in March 2020, citizens and permanent residents returning to New Zealand have been required to undergo managed isolation and quarantine (MIQ) for 14 days and mandatory testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). As of October 20, 2020, of 62,698 arrivals, testing of persons in MIQ had identified 215 cases of SARS-CoV-2 infection. Among 86 passengers on a flight from Dubai, United Arab Emirates, that arrived in New Zealand on September 29, test results were positive for 7 persons in MIQ. These passengers originated from 5 different countries before a layover in Dubai; 5 had negative predeparture SARS-CoV-2 test results. To assess possible points of infection, we analyzed information about their journeys, disease progression, and virus genomic data. All 7 SARS-CoV-2 genomes were genetically identical, except for a single mutation in 1 sample. Despite predeparture testing, multiple instances of in-flight SARS-CoV-2 transmission are likely.}, } @article {pmid33400393, year = {2021}, author = {Chen, CC and Yu, X and Kuo, CJ and Min, J and Chen, S and Wu, S and Ma, L and Liu, K and Guo, RT}, title = {Overview of antiviral drug candidates targeting coronaviral 3C-like main proteases.}, journal = {The FEBS journal}, volume = {}, number = {}, pages = {}, doi = {10.1111/febs.15696}, pmid = {33400393}, issn = {1742-4658}, abstract = {Coronaviruses (CoVs) are positive single-stranded RNA viruses that cause severe respiratory syndromes in humans, including Severe Acute Respiratory Syndrome (SARS) and Middle East Respiratory Syndrome (MERS). Coronavirus Disease 2019 (COVID-19) caused by a novel Severe Acute Respiratory Syndrome CoV (SARS-CoV-2) at the end of 2019 became a global pandemic. The 3C-like cysteine protease (3CLpro) process viral polyproteins to yield mature non-structural proteins, thus playing an important role in the CoV life cycle and therefore is considered a prominent target for anti-viral drugs. To date, many 3CLpro inhibitors have been reported, and their molecular mechanisms have been illustrated. Here, we briefly introduce the structural features of 3CLpro of the human-related SARS-CoV, MERS-CoV and SARS-CoV-2, and explore the potency and mechanism of their cognate inhibitors. This information will shed light on the development and optimization of CoV 3CLpro inhibitors, which may benefit further designation of therapeutic strategies to treat CoV diseases.}, } @article {pmid33400086, year = {2021}, author = {Tripathi, N and Tripathi, N and Goshisht, MK}, title = {COVID-19: inflammatory responses, structure-based drug design and potential therapeutics.}, journal = {Molecular diversity}, volume = {}, number = {}, pages = {}, pmid = {33400086}, issn = {1573-501X}, abstract = {The COVID-19 pandemic caused by SARS-CoV-2 is responsible for the global health emergency. Here, we explore the diverse mechanisms of SARS-CoV-induced inflammation. We presume that SARS-CoV-2 likely contributes analogous inflammatory responses. Possible therapeutic mechanisms for reducing SARS-CoV-2-mediated inflammatory responses comprise FcR inactivation. Currently, there is no specific remedy available against the SARS-CoV-2. Consequently, recognizing efficacious antiviral leads to combat the virus is crucially desired. The coronavirus (CoV) main protease (Mpro also called 3CLpro), which plays an indispensable role in viral replication and transcription, is an interesting target for drug design. This review compiles the latest advances in biological and structural research, along with development of inhibitors targeting CoV Mpros. It is anticipated that inhibitors targeting CoV Mpros could be advanced into wide-spectrum antiviral drugs in case of COVID-19 and other CoV-related diseases. The crystal structural and docking results have shown that Ebselen, N3, TDZD-8 and α-ketoamide (13b) inhibitors can bind to the substrate-binding pocket of COVID-19 Mpro. α-ketoamide-based inhibitor 13b inhibits the replication of SARS-CoV-2 in human Calu3 lung cells. Quantitative real-time RT-PCR (qRT-PCR) showed that the treatment with Ebselen, TDZD-8 and N3 reduced the amounts of SARS-CoV-2, respectively, 20.3-, 10.19- and 8.4-fold compared to the treatment in the absence of inhibitor. Moreover, repurposing of already present drugs to treat COVID-19 serves as one of the competent and economic therapeutic strategies. Several anti-malarial, anti-HIV and anti-inflammatory drugs as mentioned in Table 2 were found effective for the COVID-19 treatment. Further, hydroxychloroquine (HCQ) was found more potent than chloroquine (CQ) in inhibiting SARS-CoV-2 in vitro. Furthermore, convalescent plasma from patients who have recuperated from viral infections can be employed as a therapy without the appearance of severe adverse events. Hence, it might be valuable to examine the safety and efficacy of convalescent plasma transfusion in SARS-CoV-2-infected patients.}, } @article {pmid33400058, year = {2021}, author = {Majumder, J and Minko, T}, title = {Recent Developments on Therapeutic and Diagnostic Approaches for COVID-19.}, journal = {The AAPS journal}, volume = {23}, number = {1}, pages = {14}, pmid = {33400058}, issn = {1550-7416}, abstract = {The ongoing pandemic of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has made a serious public health threat worldwide with millions of people at risk in a growing number of countries. Though there are no clinically approved antiviral drugs and vaccines for COVID-19, attempts are ongoing for clinical trials of several known antiviral drugs, their combination, as well as development of vaccines in patients with confirmed COVID-19. This review focuses on the latest approaches to diagnostics and therapy of COVID-19. We have summarized recent progress on the conventional therapeutics such as antiviral drugs, vaccines, anti-SARS-CoV-2 antibody treatments, and convalescent plasma therapy which are currently under extensive research and clinical trials for the treatment of COVID-19. The developments of nanoparticle-based therapeutic and diagnostic approaches have been also discussed for COVID-19. We have assessed recent literature data on this topic and made a summary of current development and future perspectives.}, } @article {pmid33398692, year = {2021}, author = {Lee, C and Choi, WJ}, title = {Overview of COVID-19 inflammatory pathogenesis from the therapeutic perspective.}, journal = {Archives of pharmacal research}, volume = {}, number = {}, pages = {}, pmid = {33398692}, issn = {0253-6269}, support = {NRF-2019R1F1A1058628//National Research Foundation of Korea/ ; }, abstract = {The novel beta coronavirus (SARS-CoV-2, designated as COVID-19) that is responsible for severe acute respiratory syndrome has devastated the global economy and health care system. Since COVID-19 changed the definition of "normal" in ordinary life around the world, the development of effective therapeutics and preventive measures is desperately needed to fight SARS-CoV-2 infection and restore normalcy. A clear understanding of COVID-19 pathogenesis is crucial in providing the scientific rationale necessary to develop anti-COVID19 drugs and vaccines. According to the most recently published literature, COVID-19 pathogenesis was postulated to occur in three sequential phases: pulmonary, proinflammatory, and prothrombic. Herein, virus-host interactions, potential pathogenic mechanisms, and clinical manifestations are described for each phase. Additionally, based on this pathogenesis model, various therapeutic strategies involving current clinical trials are presented with an explanation of their modes of action and example drugs. This review is a thorough, updated summary of COVID-19 pathogenesis and the therapeutic options available for this disease.}, } @article {pmid33398691, year = {2021}, author = {Lee, CH}, title = {Role of specialized pro-resolving lipid mediators and their receptors in virus infection: a promising therapeutic strategy for SARS-CoV-2 cytokine storm.}, journal = {Archives of pharmacal research}, volume = {}, number = {}, pages = {}, pmid = {33398691}, issn = {0253-6269}, support = {NRF 2018R1E1A2A02057995//National Research Foundation of Korea/ ; NRF-2018R1A5A 2023127//National Research Foundation of Korea/ ; NRF-2020R1A2C3004973//National Research Foundation of Korea/ ; NRF-2020M3E5E2038356//National Research Foundation of Korea/ ; }, abstract = {Unexpected viral infections outbreaks, significantly affect human health, leading to increased mortality and life disruption. Among them is the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which emerged as a deadly pandemic, calling for intense research efforts on its pathogenicity mechanism and development of therapeutic strategies. In the SARS-CoV-2 cytokine storm, systemic inflammation has been associated with severe illness and mortality. Recent studies have demonstrated special pro-resolving lipids mediators (SPMs) lipoxins, resolvins, maresins, and protectins as potential therapeutic options for abnormal viral-triggered inflammation. Pro-resolving lipids mediators have shown great promise for the treatment of Herpes simplex virus, respiratory syncytial virus, human immunodeficiency virus, and hepatitis C virus. Based on this, studies are being conducted on their therapeutic effects in SARS-CoV-2 infection. In this review, we discussed SPMs and reviewed evidence from recent studies on SPMs as therapeutic options for viral infections, including SARS-CoV2. Based on our analysis of the previous study, we argue that SPMs are a potential treatment for SARS-CoV-2 infection and other viral infections. We expect further research on how SPMs modulate viral-triggered inflammation through G-protein-coupled receptors (GPCRs), and chemical stability and druggability of SPMs.}, } @article {pmid33398609, year = {2021}, author = {Bartoli, A and Gabrielli, F and Alicandro, T and Nascimbeni, F and Andreone, P}, title = {COVID-19 treatment options: a difficult journey between failed attempts and experimental drugs.}, journal = {Internal and emergency medicine}, volume = {}, number = {}, pages = {}, pmid = {33398609}, issn = {1970-9366}, abstract = {Since its outbreak in China in December 2019 a novel Coronavirus, named SARS-CoV-2, has spread worldwide causing many cases of severe pneumonia, referred to as COVID-19 disease, leading the World Health Organization to declare a pandemic emergency in March 2020. Up to now, no specific therapy against COVID-19 disease exists. This paper aims to review COVID-19 treatment options currently under investigation. We divided the studied drugs into three categories (antiviral, immunomodulatory and other drugs). For each molecule, we discussed the putative mechanisms by which the drug may act against SARS-CoV-2 or may affect COVID-19 pathogenesis and the main clinical studies performed so far. The published clinical studies suffer from methodological limitations due to the emergency setting in which they have been conducted. Nevertheless, it seems that the timing of administration of the diverse categories of drugs is crucial in determining clinical efficacy. Antiviral drugs, in particular Remdesivir, should be administered soon after symptoms onset, in the viraemic phase of the disease; whereas, immunomodulatory agents, such as tocilizumab, anakinra and steroids, may have better results if administered in pneumonia/hyperinflammatory phases. Low-molecular-weight heparin may also have a role when facing COVID-19-related coagulopathy. Up to now, treatment choices have been inferred from the experience with other coronaviruses or viral infection outbreaks. Hopefully, in the near future, new treatment strategies will be available thanks to increased knowledge on SARS-CoV2 virus and COVID-19 pathogenesis. In the meanwhile, further well-designed clinical trials are urgently needed to establish a standard of care in COVID-19 disease.}, } @article {pmid33398242, year = {2020}, author = {Farshbaf, A and Mohtasham, N and Zare, R and Mohajertehran, F and Rezaee, SA}, title = {Potential therapeutic approaches of microRNAs for COVID-19: Challenges and opportunities.}, journal = {Journal of oral biology and craniofacial research}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.jobcr.2020.12.006}, pmid = {33398242}, issn = {2212-4268}, abstract = {The coronavirus disease 2019 (COVID-19) emerges as current outbreak cause by Novel Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2). This infection affects respiratory system and provides uncontrolled systemic inflammatory response as cytokine storm. The main concern about SARS-CoV-2 pandemic is high viral pathogenicity with no specific drugs. MicroRNAs (miRs) as small non-coding RNAs (21-25 nt) regulate gene expression. The SARS-CoV-2 encoded-miRs affect human genes that involved in transcription, translation, apoptosis, immune response and inflammation. Also, they alter self-gene regulation and hijacked host miRs that provide protective environment to maintain its latency. On the other hand, Host miRs play critical role in viral gene expression to restrict infection. Over expression/inhibition of miRs might result in cell cycle irregularity, impaired immune response or cancer. In this manner, exact role of each miR should be specified. Mimic encoded-miRs like antagomirs showed successful result in phases of clinical trial prevent from negative effects of viral encoded-miRs. Products of mimic miRs are inexpensive corresponds to synthesis of primer; they are short and nanoscale in size. Although SARS-CoV-2 genome is undergoing evaluation, detection of exact molecular pathogenesis open up opportunities to for vaccine development. Salivaomics can evaluate SARS-CoV-2 genome, transcriptome, proteome and biomarkers like miRs in oral related and cancer disease. In this review, we studied the challenge and opportunities of miRs in therapeutic approach for SARS-CoV-2 infection, then overviewed the role of miRs in saliva droplet during SARS-CoV-2 infection and related cancer.}, } @article {pmid33398233, year = {2020}, author = {Rehman, MFU and Fariha, C and Anwar, A and Shahzad, N and Ahmad, M and Mukhtar, S and Haque, MFU}, title = {Novel coronavirus disease (COVID-19) pandemic: A recent mini review.}, journal = {Computational and structural biotechnology journal}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.csbj.2020.12.033}, pmid = {33398233}, issn = {2001-0370}, abstract = {The COVID-19, caused by a novel coronavirus, was declared as a global pandemic by WHO more than five months ago, and we are still experiencing a state of global emergency. More than 74.30 million confirmed cases of the COVID-19 have been reported globally so far, with an average fatality rate of almost 3.0%. Seven different types of coronaviruses had been detected from humans; three of them have resulted in severe outbreaks, i.e., MERS-CoV, SARS-CoV, and SARS-CoV-2. Phylogenetic analysis of the genomes suggests the possible occurrence of recombination between SARS-like-CoVs from pangolin and bat might have led to the origin of SARS-CoV-2 and the COVID-19 outbreak. Coronaviruses are positive-sense, single-stranded RNA viruses and harbour a genome (30 kb) consisting of two terminal untranslated regions and twelve putative functional open reading frames (ORFs), encoding for non-structural and structural proteins. There are sixteen putative non-structural proteins, including proteases, RNA-dependent RNA polymerase, helicase, other proteins involved in the transcription and replication of SARS-CoV-2, and four structural proteins, including spike protein (S), envelope (E), membrane (M), and nucleocapsid (N). SARS-CoV-2 infection, with a heavy viral load in the body, destroys the human lungs through cytokine storm, especially in elderly persons and people with immunosuppressed disorders. A number of drugs have been repurposed and employed, but still, no specific antiviral medicine has been approved by the FDA to treat this disease. This review provides a current status of the COVID-19, epidemiology, an overview of phylogeny, mode of action, diagnosis, and possible treatment methods and vaccines.}, } @article {pmid33398228, year = {2020}, author = {Faruque Ahmad, M}, title = {A Novel Perspective Approach to Explore Pros and Cons of Face Mask in Prevention the Spread of SARS-CoV-2 and other pathogens.}, journal = {Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.jsps.2020.12.014}, pmid = {33398228}, issn = {1319-0164}, abstract = {Corona virus disease 2019 (COVID-19) outbreak has become a severe community health threat across the world. Covid-19 is a major illness, presently there is no as such any medicine and vaccine those can claim for complete treatment. It is spreading particularly in a feeble immune people and casualties are expanding abruptly and put the health system under strain. Among the strategic measures face mask is one of the most used measures to prevent spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Wearing a face mask possibly create a false sense of security lead to decline others measures. Face mask could be risk for the people of under lying medical conditions, old age group, outdoor exercise, acute and chronic respiratory disorders and feeble innate immune. Restrictive airflow due to face mask is the main cause of retention of CO2 called hypercapnia that can lead to respiratory failure with symptoms of tachycardia, flushed skin, dizziness, papilledema, seizure and depression. According to latest updates face shield and social distancing could be better substitute of face mask.}, } @article {pmid33398223, year = {2020}, author = {Praveen, S and Ashish, K and Anikhindi, SA and Naresh, B and Vikas, S and Khare, S and Anil, A}, title = {Effect of COVID-19 on pre-existing liver disease: What Hepatologist should know?.}, journal = {Journal of clinical and experimental hepatology}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.jceh.2020.12.006}, pmid = {33398223}, issn = {0973-6883}, abstract = {COVID-19 is characterized by predominant respiratory and gastrointestinal symptoms. Liver enzymes derangement is seen in 15-55% of the patients. Advanced age, hypertension, diabetes, obesity, malignancy and, cardiovascular disease predispose them to severe disease and the need for hospitalization. Data on preexisting liver disease in patients with COVID -19 is limited and most studies had only 3-8% of these patients. Patients with metabolic dysfunction associated fatty liver (MAFLD) had shown 4-6 fold increase in severity of COVID-19 and its severity and mortality increased in patients with higher fibrosis score. Patients with chronic liver disease had shown that cirrhosis is an independent predictor of severity of COVID-19 with increased hospitalization and mortality. Increase in Child Turcotte Pugh (CTP) score and model for end-stage liver disease (MELD) score increases the mortality in these patients. Few case reports had shown SARS-CoV-2 as an acute event in the decompensation of underlying chronic liver disease. Immunosuppression should be reduced prophylactically in patients with autoimmune liver disease and post-transplantation with no COVID-19. Hydroxychloroquine and remdesivir is found to be safe in limited studies in a patient with cirrhosis and COVID-19. For hepatologist cirrhosis with COVID-19 is a pertinent issue as the present pandemic will have severe disease in patients with chronic liver disease leading to more hospitalisation and decompensation.}, } @article {pmid33398129, year = {2021}, author = {Harschnitz, O and Studer, L}, title = {Human stem cell models to study host-virus interactions in the central nervous system.}, journal = {Nature reviews. Immunology}, volume = {}, number = {}, pages = {}, pmid = {33398129}, issn = {1474-1741}, abstract = {Advancements in human pluripotent stem cell technology offer a unique opportunity for the neuroimmunology field to study host-virus interactions directly in disease-relevant cells of the human central nervous system (CNS). Viral encephalitis is most commonly caused by herpesviruses, arboviruses and enteroviruses targeting distinct CNS cell types and often leading to severe neurological damage with poor clinical outcomes. Furthermore, different neurotropic viruses will affect the CNS at distinct developmental stages, from early prenatal brain development to the aged brain. With the unique flexibility and scalability of human pluripotent stem cell technology, it is now possible to examine the molecular mechanisms underlying acute infection and latency, determine which CNS subpopulations are specifically infected, study temporal aspects of viral susceptibility, perform high-throughput chemical or genetic screens for viral restriction factors and explore complex cell-non-autonomous disease mechanisms. Therefore, human pluripotent stem cell technology has the potential to address key unanswered questions about antiviral immunity in the CNS, including emerging questions on the potential CNS tropism of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).}, } @article {pmid33397626, year = {2021}, author = {O'Brien, B and Goodridge, L and Ronholm, J and Nasheri, N}, title = {Exploring the potential of foodborne transmission of respiratory viruses.}, journal = {Food microbiology}, volume = {95}, number = {}, pages = {103709}, doi = {10.1016/j.fm.2020.103709}, pmid = {33397626}, issn = {1095-9998}, abstract = {The ongoing pandemic involving severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has raised the question whether this virus, which is known to be spread primarily though respiratory droplets, could be spread through the fecal-oral route or via contaminated food. In this article, we present a critical review of the literature exploring the potential foodborne transmission of several respiratory viruses including human coronaviruses, avian influenza virus (AVI), parainfluenza viruses, human respiratory syncytial virus, adenoviruses, rhinoviruses, and Nipah virus. Multiple lines of evidence, including documented expression of receptor proteins on gastrointestinal epithelial cells, in vivo viral replication in gastrointestinal epithelial cell lines, extended fecal shedding of respiratory viruses, and the ability to remain infectious in food environments for extended periods of time raises the theoretical ability of some human respiratory viruses, particularly human coronaviruses and AVI, to spread via food. However, to date, neither epidemiological data nor case reports of clear foodborne transmission of either viruses exist. Thus, foodborne transmission of human respiratory viruses remains only a theoretical possibility.}, } @article {pmid33397585, year = {2020}, author = {Barros, I and Silva, A and de Almeida, LP and Miranda, CO}, title = {Mesenchymal stromal cells to fight SARS-CoV-2: Taking advantage of a pleiotropic therapy.}, journal = {Cytokine & growth factor reviews}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.cytogfr.2020.12.002}, pmid = {33397585}, issn = {1879-0305}, abstract = {The devastating global impact of the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has prompted scientists to develop novel strategies to fight Coronavirus Disease of 2019 (COVID-19), including the examination of pre-existing treatments for other viral infections in COVID-19 patients. This review provides a reasoned discussion of the possible use of Mesenchymal Stromal Cells (MSC) or their products as a treatment in SARS-CoV-2-infected patients. The main benefits and concerns of using this cellular therapy, guided by preclinical and clinical data obtained from similar pathologies will be reviewed. MSC represent a highly immunomodulatory cell population and their use may be safe according to clinical studies developed in other pathologies. Notably, four clinical trials and four case reports that have already been performed in COVID-19 patients obtained promising results. The clinical application of MSC in COVID-19 is very preliminary and further investigational studies are required to determine the efficacy of the MSC therapy. Nevertheless, these preliminary studies were important to understand the therapeutic potential of MSC in COVID-19. Based on these encouraging results, the United States Food and Drug Administration (FDA) authorized the compassionate use of MSC, but only in patients with Acute Respiratory Distress Syndrome (ARDS) and a poor prognosis. In fact, patients with severe SARS-CoV-2 can present infection and tissue damage in different organs, such as lung, heart, liver, kidney, gut and brain, affecting their function. MSC may have pleiotropic activities in COVID-19, with the capacity to fight inflammation and repair lesions in several organs.}, } @article {pmid33397510, year = {2021}, author = {Ehrenberg, JP and Utzinger, J and Fontes, G and da Rocha, EMM and Ehrenberg, N and Zhou, XN and Steinmann, P}, title = {Efforts to mitigate the economic impact of the COVID-19 pandemic: potential entry points for neglected tropical diseases.}, journal = {Infectious diseases of poverty}, volume = {10}, number = {1}, pages = {2}, pmid = {33397510}, issn = {2049-9957}, abstract = {BACKGROUND: The damage inflicted by the coronavirus diseases 2019 (COVID-19) pandemic upon humanity is and will continue to be considerable. Unprecedented progress made in global health over the past 20 years has reverted and economic growth has already evaporated, giving rise to a global recession, the likes of which we may not have experienced since the Second World War. Our aim is to draw the attention of the neglected tropical disease (NTD) community towards some of the major emerging economic opportunities which are quickly appearing on the horizon as a result of COVID-19.

MAIN TEXT: This scoping review relied on a literature search comprised of a sample of articles, statements, and press releases on initiatives aimed at mitigating the impact of COVID-19, while supporting economic recovery. Of note, the donor scenario and economic development agendas are highly dynamic and expected to change rapidly as the COVID-19 pandemic unfolds, as are donor and lender priorities.

CONCLUSIONS: The NTD community, particularly in low- and middle-income countries (LMICs), will need to work quickly, diligently, and in close collaboration with decision-makers and key stakeholders, across sectors at national and international level to secure its position. Doing so might enhance the odds of grasping potential opportunities to access some of the massive resources that are now available in the form of contributions from corporate foundations, trust funds, loans, debt relieve schemes, and other financial mechanisms, as part of the ongoing and future economic development agendas and public health priorities driven by the COVID-19 pandemic. This paper should serve as a starting point for the NTD community to seek much needed financial support in order to sustain and revitalize control and elimination efforts pertaining to NTDs in LMICs.}, } @article {pmid33397467, year = {2021}, author = {Mazini, L and Ezzoubi, M and Malka, G}, title = {Overview of current adipose-derived stem cell (ADSCs) processing involved in therapeutic advancements: flow chart and regulation updates before and after COVID-19.}, journal = {Stem cell research & therapy}, volume = {12}, number = {1}, pages = {1}, pmid = {33397467}, issn = {1757-6512}, abstract = {Adipose-derived stem cells (ADSCs) have raised big interest in therapeutic applications in regenerative medicine and appear to fulfill the criteria for a successful cell therapy. Their low immunogenicity and their ability to self-renew, to differentiate into different tissue-specific progenitors, to migrate into damaged sites, and to act through autocrine and paracrine pathways have been altogether testified as the main mechanisms whereby cell repair and regeneration occur. The absence of standardization protocols in cell management within laboratories or facilities added to the new technologies improved at patient's bedside and the discrepancies in cell outcomes and engraftment increase the limitations on their widespread use by balancing their real benefit versus the patient safety and security. Also, comparisons across pooled patients are particularly difficult in the fact that multiple medical devices are used and there is absence of harmonized assessment assays despite meeting regulations agencies and efficient GMP protocols. Moreover, the emergence of the COVID-19 breakdown added to the complexity of implementing standardization. Cell- and tissue-based therapies are completely dependent on the biological manifestations and parameters associated to and induced by this virus where the scope is still unknown. The initial flow chart identified for stem cell therapies should be reformulated and updated to overcome patient infection and avoid significant variability, thus enabling more patient safety and therapeutic efficiency. The aim of this work is to highlight the major guidelines and differences in ADSC processing meeting the current good manufacturing practices (cGMP) and the cellular therapy-related policies. Specific insights on standardization of ADSCs proceeding at different check points are also presented as a setup for the cord blood and bone marrow.}, } @article {pmid33396832, year = {2020}, author = {Lin, C and Tu, P and Beitsch, LM}, title = {Confidence and Receptivity for COVID-19 Vaccines: A Rapid Systematic Review.}, journal = {Vaccines}, volume = {9}, number = {1}, pages = {}, doi = {10.3390/vaccines9010016}, pmid = {33396832}, issn = {2076-393X}, abstract = {While COVID-19 continues raging worldwide, effective vaccines are highly anticipated. However, vaccine hesitancy is widespread. Survey results on uptake intentions vary and continue to change. This review compared trends and synthesized findings in vaccination receptivity over time across US and international polls, assessing survey design influences and evaluating context to inform policies and practices. Data sources included academic literature (PubMed, Embase, and PsycINFO following PRISMA guidelines), news and official reports published by 20 October 2020. Two researchers independently screened potential peer-reviewed articles and syndicated polls for eligibility; 126 studies and surveys were selected. Declining vaccine acceptance (from >70% in March to <50% in October) with demographic, socioeconomic, and partisan divides was observed. Perceived risk, concerns over vaccine safety and effectiveness, doctors' recommendations, and inoculation history were common factors. Impacts of regional infection rates, gender, and personal COVID-19 experience were inconclusive. Unique COVID-19 factors included political party orientation, doubts toward expedited development/approval process, and perceived political interference. Many receptive participants preferred to wait until others have taken the vaccine; mandates could increase resistance. Survey wording and answer options showed influence on responses. To achieve herd immunity, communication campaigns are immediately needed, focusing on transparency and restoring trust in health authorities.}, } @article {pmid33396667, year = {2020}, author = {Mahmood, N and Nasir, SB and Hefferon, K}, title = {Plant-Based Drugs and Vaccines for COVID-19.}, journal = {Vaccines}, volume = {9}, number = {1}, pages = {}, doi = {10.3390/vaccines9010015}, pmid = {33396667}, issn = {2076-393X}, abstract = {The coronavirus SARS-CoV-2 has turned our own health and the world economy upside down. While several vaccine candidates are currently under development, antivirals with the potential to limit virus transmission or block infection are also being explored. Plant production platforms are being used to generate vaccines and antiviral proteins inexpensively and at mass scale. The following review discusses the biology and origins of the current coronavirus pandemic, and describes some of the conventional, synthetic, and plant-based approaches to address the challenge that it presents to our way of life.}, } @article {pmid33396592, year = {2020}, author = {Grześk, G and Woźniak-Wiśniewska, A and Błażejewski, J and Górny, B and Wołowiec, Ł and Rogowicz, D and Nowaczyk, A}, title = {The Interactions of Nintedanib and Oral Anticoagulants-Molecular Mechanisms and Clinical Implications.}, journal = {International journal of molecular sciences}, volume = {22}, number = {1}, pages = {}, doi = {10.3390/ijms22010282}, pmid = {33396592}, issn = {1422-0067}, abstract = {Nintedanib is a synthetic orally active tyrosine kinase inhibitor, whose main action is to inhibit the receptors of the platelet-derived growth factor, fibroblast growth factor and vascular endothelial growth factor families. The drug also affects other kinases, including Src, Flt-3, LCK, LYN. Nintedanib is used in the treatment of idiopathic pulmonary fibrosis, chronic fibrosing interstitial lung diseases and lung cancer. The mechanism of action suggests that nintedanib should be considered one of the potential agents for inhibiting and revising the fibrosis process related to COVID-19 infections. Due to the known induction of coagulation pathways during COVID-19 infections, possible interaction between nintedanib and anticoagulant seems to be an extremely important issue. In theory, nintedanib could increase the bleeding risk, thrombosis and lead to thrombocytopenia. The data from clinical trials on the concomitant use of nintedanib and antithrombotic agents is very limited as this patient group was within the standard exclusion criteria. Nintedanib is an important therapeutic option, despite its interaction with anticoagulants. If anticoagulant therapy is necessary, the more effective and safer option is the concomitant administration of DOACs and nintedanib, especially when drug-monitored therapy will be used in patients at high risk of bleeding complications.}, } @article {pmid33396584, year = {2020}, author = {Fakhroo, AD and Al Thani, AA and Yassine, HM}, title = {Markers Associated with COVID-19 Susceptibility, Resistance, and Severity.}, journal = {Viruses}, volume = {13}, number = {1}, pages = {}, doi = {10.3390/v13010045}, pmid = {33396584}, issn = {1999-4915}, support = {QUHI-BRC-20/21-1//Qatar University/ ; }, abstract = {In December 2019, the latest member of the coronavirus family, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), emerged in Wuhan, China, leading to the outbreak of an unusual viral pneumonia known as coronavirus disease 2019 (COVID-19). COVID-19 was then declared as a pandemic in March 2020 by the World Health Organization (WHO). The initial mortality rate of COVID-19 declared by WHO was 2%; however, this rate has increased to 3.4% as of 3 March 2020. People of all ages can be infected with SARS-CoV-2, but those aged 60 or above and those with underlying medical conditions are more prone to develop severe symptoms that may lead to death. Patients with severe infection usually experience a hyper pro-inflammatory immune reaction (i.e., cytokine storm) causing acute respiratory distress syndrome (ARDS), which has been shown to be the leading cause of death in COVID-19 patients. However, the factors associated with COVID-19 susceptibility, resistance and severity remain poorly understood. In this review, we thoroughly explore the correlation between various host, viral and environmental markers, and SARS-CoV-2 in terms of susceptibility and severity.}, } @article {pmid33396557, year = {2020}, author = {O'Leary, VB and Dolly, OJ and Höschl, C and Černa, M and Ovsepian, SV}, title = {Unpacking Pandora From Its Box: Deciphering the Molecular Basis of the SARS-CoV-2 Coronavirus.}, journal = {International journal of molecular sciences}, volume = {22}, number = {1}, pages = {}, doi = {10.3390/ijms22010386}, pmid = {33396557}, issn = {1422-0067}, abstract = {An enigmatic localized pneumonia escalated into a worldwide COVID-19 pandemic from Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). This review aims to consolidate the extensive biological minutiae of SARS-CoV-2 which requires decipherment. Having one of the largest RNA viral genomes, the single strand contains the genes ORF1ab, S, E,M, N and ten open reading frames. Highlighting unique features such as stem-loop formation, slippery frameshifting sequences and ribosomal mimicry, SARS-CoV-2 represents a formidable cellular invader. Hijacking the hosts translational engine, it produces two polyprotein repositories (pp1a and pp1ab), armed with self-cleavage capacity for production of sixteen non-structural proteins. Novel glycosylation sites on the spike trimer reveal unique SARS-CoV-2 features for shielding and cellular internalization. Affording complexity for superior fitness and camouflage, SARS-CoV-2 challenges diagnosis and vaccine vigilance. This review serves the scientific community seeking in-depth molecular details when designing drugs to curb transmission of this biological armament.}, } @article {pmid33396519, year = {2020}, author = {Dave, PK and Rojas-Cessa, R and Dong, Z and Umpaichitra, V}, title = {Survey of Saliva Components and Virus Sensors for Prevention of COVID-19 and Infectious Diseases.}, journal = {Biosensors}, volume = {11}, number = {1}, pages = {}, doi = {10.3390/bios11010014}, pmid = {33396519}, issn = {2079-6374}, abstract = {The United States Centers for Disease Control and Prevention considers saliva contact the lead transmission means of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes the coronavirus disease 2019 (COVID-19). Saliva droplets or aerosols expelled by heavy breathing, talking, sneezing, and coughing may carry this virus. People in close distance may be exposed directly or indirectly to these droplets, especially those droplets that fall on surrounding surfaces and people may end up contracting COVID-19 after touching the mucosa tissue on their faces. It is of great interest to quickly and effectively detect the presence of SARS-CoV-2 in an environment, but the existing methods only work in laboratory settings, to the best of our knowledge. However, it may be possible to detect the presence of saliva in the environment and proceed with prevention measures. However, detecting saliva itself has not been documented in the literature. On the other hand, many sensors that detect different organic components in saliva to monitor a person's health and diagnose different diseases that range from diabetes to dental health have been proposed and they may be used to detect the presence of saliva. This paper surveys sensors that detect organic and inorganic components of human saliva. Humidity sensors are also considered in the detection of saliva because a large portion of saliva is water. Moreover, sensors that detect infectious viruses are also included as they may also be embedded into saliva sensors for a confirmation of the virus' presence. A classification of sensors by their working principle and the substance they detect is presented. This comparison lists their specifications, sample size, and sensitivity. Indications of which sensors are portable and suitable for field application are presented. This paper also discusses future research and challenges that must be resolved to realize practical saliva sensors. Such sensors may help minimize the spread of not only COVID-19 but also other infectious diseases.}, } @article {pmid33396343, year = {2020}, author = {Tumban, E}, title = {Lead SARS-CoV-2 Candidate Vaccines: Expectations from Phase III Trials and Recommendations Post-Vaccine Approval.}, journal = {Viruses}, volume = {13}, number = {1}, pages = {}, doi = {10.3390/v13010054}, pmid = {33396343}, issn = {1999-4915}, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is transmitted primarily through respiratory droplets/aerosols and it causes COVID-19. The virus infects epithelial cells by using the spike protein on its surface to bind to angiotensin-converting enzyme 2 receptor on the cells. Thus, candidate vaccines targeting the spike protein are currently being developed to prevent against infections. Approximately 44 SARS-CoV-2 candidate vaccines are in clinical trials (phase I-III) and an additional 164 candidates are in preclinical stages. The efficacy data from phase I/II trials of lead candidate vaccines look very promising with virus-neutralizing geometric mean antibody titers in the range of 16.6-3906. Most recently, two SARS-CoV-2 candidate vaccines, BNT162b2 and mRNA-1273, have been granted the first emergency use authorization (EUA) in the U.S.; BNT162b2 has also been granted an EUA in the United Kingdom, Canada, and in the European Union. This review assesses whether SARS-CoV-2 candidate vaccines (with approved EUA or in phase III trials) meet the criteria for an ideal SARS-CoV-2 vaccine. The review concludes with expectations from phase III trials and recommendations for phase IV studies (post-vaccine approval).}, } @article {pmid33396184, year = {2020}, author = {Pang, XC and Zhang, HX and Zhang, Z and Rinkiko, S and Cui, YM and Zhu, YZ}, title = {The Two-Way Switch Role of ACE2 in the Treatment of Novel Coronavirus Pneumonia and Underlying Comorbidities.}, journal = {Molecules (Basel, Switzerland)}, volume = {26}, number = {1}, pages = {}, doi = {10.3390/molecules26010142}, pmid = {33396184}, issn = {1420-3049}, support = {No.2016YFC0904900//National Key R&D Program of China/ ; No.81973320//National Natural Science Foundation of PR China/ ; No.81673509//National Natural Science Foundation of PR China/ ; No.81573504//National Natural Science Foundation of PR China/ ; No.81903714//National Natural Science Foundation of PR China/ ; No.7171012//Beijing Municipal Natural Science Foundation/ ; No.7204317//Beijing Municipal Natural Science Foundation/ ; No.2019SF05//Scientific research fund of Peking University First Hospital/ ; No.2019CR19//Scientific research fund of Peking University First Hospital/ ; FDCT 067/2018/A2//Macau Science and Technology Development fund/ ; FDCT 033/2017/AMJ//Macau Science and Technology Development fund/ ; FDCT 0007/2019/AKP//Macau Science and Technology Development fund/ ; }, abstract = {December 2019 saw the emergence of the coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which has spread across the globe. The high infectivity and ongoing mortality of SARS-CoV-2 emphasize the demand of drug discovery. Angiotensin-converting enzyme II (ACE2) is the functional receptor for SARS-CoV-2 entry into host cells. ACE2 exists as a membrane-bound protein on major viral target pulmonary epithelial cells, and its peptidase domain (PD) interacts SARS-CoV-2 spike protein with higher affinity. Therefore, targeting ACE2 is an important pharmacological intervention for a SARS-CoV-2 infection. In this review, we described the two-way switch role of ACE2 in the treatment of novel coronavirus pneumonia and underlying comorbidities, and discussed the potential effect of the ACE inhibitor and angiotensin receptor blocker on a hypertension patient with the SARS-CoV-2 infection. In addition, we analyzed the S-protein-binding site on ACE2 and suggested that blocking hot spot-31 and hot spot-353 on ACE2 could be a therapeutic strategy for preventing the spread of SARS-CoV-2. Besides, the recombinant ACE2 protein could be another potential treatment option for SARS-CoV-2 induced acute severe lung failure. This review could provide beneficial information for the development of anti-SARS-CoV-2 agents via targeting ACE2 and the clinical usage of renin-angiotensin system (RAS) drugs for novel coronavirus pneumonia treatment.}, } @article {pmid33395782, year = {2020}, author = {Boddu, SK and Aurangabadkar, G and Kuchay, MS}, title = {New onset diabetes, type 1 diabetes and COVID-19.}, journal = {Diabetes & metabolic syndrome}, volume = {14}, number = {6}, pages = {2211-2217}, doi = {10.1016/j.dsx.2020.11.012}, pmid = {33395782}, issn = {1878-0334}, abstract = {BACKGROUND AND AIMS: New data has emerged regarding higher risk of coronavirus disease 2019 (COVID-19), and its severity and complications in patients with type 2 diabetes mellitus (T2DM). However, there is a dearth of evidence regarding type 1 diabetes mellitus (T1DM). This article explores the possibility of COVID 19 induced diabetes and highlights a potential bidirectional link between COVID 19 and T1DM.

METHODS: A literature search was performed with Medline (PubMed), Scopus, and Google Scholar electronic databases till October 2020, using relevant keywords (COVID-19 induced diabetes; COVID-19 and type 1 diabetes; COVID-19 induced DKA; new-onset diabetes after SARS-CoV-2 infection) to extract relevant studies describing relationship between COVID-19 and T1DM.

RESULTS: Past lessons and new data teach us that severe acute respiratory syndrome coronaviruses (SARS-CoV and SARS-CoV-2) can enter islet cells via angiotensin converting enzyme-2 (ACE-2) receptors and cause reversible β-cell damage and transient hyperglycemia. There have been postulations regarding the potential new-onset T1DM triggered by COVID-19. This article reviews the available evidence regarding the impact and interlink between COVID-19 and Τ1DM. We also explore the mechanisms behind the viral etiology of Τ1DM.

CONCLUSIONS: SARS-CoV-2 can trigger severe diabetic ketoacidosis at presentation in individuals with new-onset diabetes. However, at present, there is no hard evidence that SARS-CoV-2 induces T1DM on it's own accord. Long term follow-up of children and adults presenting with new-onset diabetes during this pandemic is required to fully understand the type of diabetes induced by COVID-19.}, } @article {pmid33377754, year = {2020}, author = {Kurosaka, A and Payton, J}, title = {Prevention Strategies to Cope with Nurse Burnout in Nephrology Settings.}, journal = {Nephrology nursing journal : journal of the American Nephrology Nurses' Association}, volume = {47}, number = {6}, pages = {539-563}, pmid = {33377754}, issn = {1526-744X}, mesh = {*Adaptation, Psychological ; *Burnout, Professional/prevention & control ; Cross-Sectional Studies ; Humans ; *Nephrology ; Nurses/*psychology ; Surveys and Questionnaires ; }, abstract = {Nurses in nephrology are susceptible to nurse burnout. This article discusses the causes, signs, and symptoms associated with burnout. Prevention strategies, as well as patient and nurse safety, are reviewed.}, } @article {pmid33373996, year = {2020}, author = {Bandyopadhyay, SK and Goyal, V and Dutta, S}, title = {Problems and Solutions Due to Mental Anxiety of IT Professionals Work at Home during COVID-19.}, journal = {Psychiatria Danubina}, volume = {32}, number = {3-4}, pages = {604-605}, pmid = {33373996}, issn = {0353-5053}, mesh = {Anxiety/psychology/*therapy ; *COVID-19/epidemiology/psychology ; Depression/psychology/*therapy ; *Housing ; Humans ; *Information Technology ; Occupational Stress/*psychology/*therapy ; }, } @article {pmid33373995, year = {2020}, author = {Aslam, N and Ahmed, A}, title = {Prospective Impact of COVID-19 on Adolescents: Guidelines for Interventions.}, journal = {Psychiatria Danubina}, volume = {32}, number = {3-4}, pages = {603-604}, pmid = {33373995}, issn = {0353-5053}, mesh = {Adolescent ; *Adolescent Behavior ; *COVID-19/epidemiology/psychology ; Humans ; Mental Health/*statistics & numerical data ; Prospective Studies ; }, } @article {pmid33373994, year = {2020}, author = {Rigucci, S}, title = {From Lockdown to Release: The Impact of Different Phases of COVID-19 Pandemic on People Suffering from Psychiatric Disorders.}, journal = {Psychiatria Danubina}, volume = {32}, number = {3-4}, pages = {601-602}, pmid = {33373994}, issn = {0353-5053}, mesh = {*COVID-19/epidemiology/psychology ; Humans ; Mental Disorders/epidemiology/*psychology ; *Pandemics ; *Physical Distancing ; SARS-CoV-2 ; }, } @article {pmid33373993, year = {2020}, author = {Jamali, M and Zubairi, MBA and Ullah, I and de Filippis, R}, title = {Mental Health Situation in Pakistan during the COVID-19 Pandemic.}, journal = {Psychiatria Danubina}, volume = {32}, number = {3-4}, pages = {600-601}, pmid = {33373993}, issn = {0353-5053}, mesh = {*COVID-19/epidemiology ; Humans ; Mental Health/*statistics & numerical data ; Pakistan/epidemiology ; *Pandemics ; }, } @article {pmid33373992, year = {2020}, author = {Mazhar, K and Hussain, S and Ullah, R and Raza, H and Aamir, A and Asif, A and Memon, FS and Haider, J and Anas, M}, title = {Mental Health Crisis in Pregnant Women during Current COVID-19 Pandemic.}, journal = {Psychiatria Danubina}, volume = {32}, number = {3-4}, pages = {598-599}, pmid = {33373992}, issn = {0353-5053}, mesh = {*COVID-19/epidemiology ; Female ; Humans ; Mental Health/*statistics & numerical data ; *Pandemics ; Pregnancy ; Pregnant Women/*psychology ; }, } @article {pmid33373991, year = {2020}, author = {Rana, U}, title = {Parental Mental Health Crisis during COVID-19 Pandemic.}, journal = {Psychiatria Danubina}, volume = {32}, number = {3-4}, pages = {596-597}, pmid = {33373991}, issn = {0353-5053}, mesh = {*COVID-19/epidemiology ; Humans ; Mental Health/*statistics & numerical data ; *Pandemics ; Parents/*psychology ; }, } @article {pmid33373990, year = {2020}, author = {Nath, S and Mishra, BR and Padhy, SK and Ranjan, R}, title = {Meeting the Unmet Mental Health Needs during COVID-19: Where Does Telemedicine Stands during These Times in India?.}, journal = {Psychiatria Danubina}, volume = {32}, number = {3-4}, pages = {594-595}, pmid = {33373990}, issn = {0353-5053}, mesh = {*COVID-19/epidemiology ; Health Services Needs and Demand/*statistics & numerical data ; Humans ; India/epidemiology ; Mental Health/*statistics & numerical data ; *Telemedicine ; }, } @article {pmid33373989, year = {2020}, author = {Mendes, MS}, title = {Pandemic Events and Psychiatry: Some Specificities and Singularities in COVID-19.}, journal = {Psychiatria Danubina}, volume = {32}, number = {3-4}, pages = {592-593}, pmid = {33373989}, issn = {0353-5053}, mesh = {*COVID-19/psychology ; Humans ; Pandemics ; *Psychiatry ; }, } @article {pmid33373988, year = {2020}, author = {Rana, U}, title = {Psychosocial Consequences of COVID-19 on Sex Workers: A Global Perspective.}, journal = {Psychiatria Danubina}, volume = {32}, number = {3-4}, pages = {590-592}, pmid = {33373988}, issn = {0353-5053}, mesh = {COVID-19/*epidemiology/transmission ; Humans ; SARS-CoV-2 ; Sex Workers/*psychology/*statistics & numerical data ; }, } @article {pmid33373987, year = {2020}, author = {Huang, X and Wei, F and Hu, L and Wen, L and Liao, G and Su, J and Chen, K}, title = {The Post-Traumatic Stress Disorder Impact of the COVID-19 Pandemic.}, journal = {Psychiatria Danubina}, volume = {32}, number = {3-4}, pages = {587-589}, pmid = {33373987}, issn = {0353-5053}, mesh = {COVID-19/*epidemiology ; Humans ; Pandemics ; Stress Disorders, Post-Traumatic/*epidemiology ; }, } @article {pmid33370766, year = {2020}, author = {Waris Nawaz, M and Imtiaz, S and Kausar, E}, title = {Self-care of Frontline Health Care Workers: During COVID-19 Pandemic.}, journal = {Psychiatria Danubina}, volume = {32}, number = {3-4}, pages = {557-562}, doi = {10.24869/psyd.2020.557}, pmid = {33370766}, issn = {0353-5053}, mesh = {*COVID-19 ; Communicable Disease Control ; Health Personnel ; Humans ; Pandemics ; SARS-CoV-2 ; Self Care ; }, abstract = {The world is amidst the COVID-19 pandemic that has used social distancing as a tool for containing the virus from spreading exponentially among other individuals. Previous literature suggests that human contact and attachment is a key for well-being which is why punishments like solitary confinement in detention centers like jail has always been debated as being torturous (Wolfendal 2020). With this notion, anxiety and stress may become more prevalent in individuals who experience self-isolation or are under a forced lockdown. For health-care workers like doctors and psychologists, who advocate for physical health, mental health and wellbeing; the challenges might increase during the pandemic phase as they are expected to go through the crises just like others while simultaneously contributing in rendering services related to dealing with physical and psychological health issues present in patients and clients with their continued practice from either on-site or online platforms. Although all health care professional's training inoculates the ill effects of compassion fatigue by other's overwhelming situations and discussions but they might still be prone to vicarious burnout, trauma and stress. Hence, they may become exposed to being at risk of experiencing anxiety more than the general population. This review discusses facets of the importance of self-care as mental health first aid tool for health care professionals including doctors and psychologists using research and supportive techniques to help them process stress and anxiety during and after the global pandemic.}, } @article {pmid33257595, year = {2020}, author = {Lazary, J}, title = {[Acute effects of the first period of COVID-19 pandemic on mental state].}, journal = {Neuropsychopharmacologia Hungarica : a Magyar Pszichofarmakologiai Egyesulet lapja = official journal of the Hungarian Association of Psychopharmacology}, volume = {22}, number = {4}, pages = {172-177}, pmid = {33257595}, issn = {1419-8711}, mesh = {*COVID-19 ; Communicable Disease Control ; Humans ; *Mental Disorders/epidemiology ; Pandemics ; SARS-CoV-2 ; }, abstract = {The COVID-19 pandemic causes psychological trauma in the whole society, thus investigation of the epidemiology of psychiatric symptoms is an outstanding research field during this period. Fear of infection, exposure to updated data on death figures, social isolation, adaptation to new restricting rules, existential crisis, reduction of health care availability poses dangers for mental health. Currently published papers focus on the acute effect of first wave of COVID-19 pandemic, however, further studies on long-term consequences can make this picture more complex and sophisticated. In this review a summary is provided on the most important results concerning frequency of psychiatric symptoms during the first lockdown of COVID-19. In light of the results it can be stated that psychiatric patients showed more common and more intensive symptoms, the number of relapses is increased and the adherence is reduced. Notably, more than the half of the general population produced measurable psychiatric symptoms. Furthermore, a worrying portion of frontline healthcare workers started manifesting mental symptoms. The overall picture suggests that the mental health state shows a global decline on the level of the general society which highlights the urgent need for targeted and complex mental support programs.}, } @article {pmid33249077, year = {2021}, author = {Mouffouk, C and Mouffouk, S and Mouffouk, S and Hambaba, L and Haba, H}, title = {Flavonols as potential antiviral drugs targeting SARS-CoV-2 proteases (3CLpro and PLpro), spike protein, RNA-dependent RNA polymerase (RdRp) and angiotensin-converting enzyme II receptor (ACE2).}, journal = {European journal of pharmacology}, volume = {891}, number = {}, pages = {173759}, doi = {10.1016/j.ejphar.2020.173759}, pmid = {33249077}, issn = {1879-0712}, mesh = {Angiotensin-Converting Enzyme 2/metabolism ; Antiviral Agents/pharmacology ; *COVID-19/drug therapy/metabolism ; Coronavirus 3C Proteases/metabolism ; Coronavirus RNA-Dependent RNA Polymerase/metabolism ; Drug Development ; Flavonols/*pharmacology ; Humans ; Phytochemicals/pharmacology ; *SARS-CoV-2/drug effects/physiology ; Spike Glycoprotein, Coronavirus/metabolism ; }, abstract = {The novel coronavirus outbreak (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) represents the actual greatest global public health crisis. The lack of efficacious drugs and vaccines against this viral infection created a challenge for scientific researchers in order to find effective solutions. One of the promising therapeutic approaches is the search for bioactive molecules with few side effects that display antiviral properties in natural sources like medicinal plants and vegetables. Several computational and experimental studies indicated that flavonoids especially flavonols and their derivatives constitute effective viral enzyme inhibitors and possess interesting antiviral activities. In this context, the present study reviews the efficacy of many dietary flavonols as potential antiviral drugs targeting the SARS-CoV-2 enzymes and proteins including Chymotrypsin-Like Protease (3CLpro), Papain Like protease (PLpro), Spike protein (S protein) and RNA-dependent RNA polymerase (RdRp), and also their ability to interact with the angiotensin-converting enzyme II (ACE2) receptor. The relationship between flavonol structures and their SARS-CoV-2 antiviral effects were discussed. On the other hand, the immunomodulatory, the anti-inflammatory and the antiviral effects of secondary metabolites from this class of flavonoids were reported. Also, their bioavailability limitations and toxicity were predicted.}, } @article {pmid33227285, year = {2021}, author = {Lokhande, AS and Devarajan, PV}, title = {A review on possible mechanistic insights of Nitazoxanide for repurposing in COVID-19.}, journal = {European journal of pharmacology}, volume = {891}, number = {}, pages = {173748}, doi = {10.1016/j.ejphar.2020.173748}, pmid = {33227285}, issn = {1879-0712}, mesh = {Antiprotozoal Agents/pharmacology ; *COVID-19/drug therapy/immunology ; Clinical Trials as Topic ; *Drug Repositioning ; Humans ; Immunity, Innate/drug effects ; *SARS-CoV-2/drug effects/physiology ; Thiazoles/*pharmacology ; }, abstract = {The global pandemic of Coronavirus Disease 2019 (COVID-19) has brought the world to a grinding halt. A major cause of concern is the respiratory distress associated mortality attributed to the cytokine storm. Despite myriad rapidly approved clinical trials with repurposed drugs, and time needed to develop a vaccine, accelerated search for repurposed therapeutics is still ongoing. In this review, we present Nitazoxanide a US-FDA approved antiprotozoal drug, as one such promising candidate. Nitazoxanide which is reported to exert broad-spectrum antiviral activity against various viral infections, revealed good in vitro activity against SARS-CoV-2 in cell culture assays, suggesting potential for repurposing in COVID-19. Furthermore, nitazoxanide displays the potential to boost host innate immune responses and thereby tackle the life-threatening cytokine storm. Possibilities of improving lung, as well as multiple organ damage and providing value addition to COVID-19 patients with comorbidities, are other important facets of the drug. The review juxtaposes the role of nitazoxanide in fighting COVID-19 pathogenesis at multiple levels highlighting the great promise the drug exhibits. The in silico data and in vitro efficacy in cell lines confirms the promise of nitazoxanide. Several approved clinical trials world over further substantiate leveraging nitazoxanide for COVID-19 therapy.}, } @article {pmid33395576, year = {2021}, author = {O'Leary, TJ}, title = {Relative Sensitivity of Saliva and Upper Airway Swabs for Initial Detection of SARS-CoV-2 in Ambulatory Patients: Rapid Review.}, journal = {The Journal of molecular diagnostics : JMD}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.jmoldx.2020.12.008}, pmid = {33395576}, issn = {1943-7811}, abstract = {Saliva has been proposed as an alternative to upper airway swabs when testing for SARS-CoV-2. Although some studies have suggested a higher viral loads and clinical sensitivity when testing saliva, studies have been relatively small and have given rise to contradictory results. To better understand the relative performance characteristics of saliva and upper airway samples, I performed a rapid systematic review (registered on PROSPERO as CRD42020205035), focusing on studies that included at least 20 subjects who provided diagnostic saliva and upper airway samples on the same day which were tested by nucleic acid amplification methods, and for which a confusion matrix could be constructed for based on a composite reference standard. Nineteen studies comprising 21 cohorts that met predetermined acceptance criteria were identified following a search of PubMed, medRxiv and bioRxiv. Seven of these cohorts were incorporated into a meta-analysis using a random effects model, which suggests that NP swabs are somewhat more sensitive than saliva samples for the diagnosis of early disease in ambulatory patients, such as in drive-through centers or community health centers. Nevertheless, the difference is small, and the reduced need for personal protective equipment for saliva sampling may justify the difference. Conclusions are limited by the significant heterogeneity of disease prevalence in the study populations and variation in the approaches to saliva sample collection.}, } @article {pmid33395426, year = {2021}, author = {Mayi, BS and Leibowitz, JA and Woods, AT and Ammon, KA and Liu, AE and Raja, A}, title = {The role of Neuropilin-1 in COVID-19.}, journal = {PLoS pathogens}, volume = {17}, number = {1}, pages = {e1009153}, doi = {10.1371/journal.ppat.1009153}, pmid = {33395426}, issn = {1553-7374}, abstract = {Neuropilin-1 (NRP-1), a member of a family of signaling proteins, was shown to serve as an entry factor and potentiate SARS Coronavirus 2 (SARS-CoV-2) infectivity in vitro. This cell surface receptor with its disseminated expression is important in angiogenesis, tumor progression, viral entry, axonal guidance, and immune function. NRP-1 is implicated in several aspects of a SARS-CoV-2 infection including possible spread through the olfactory bulb and into the central nervous system and increased NRP-1 RNA expression in lungs of severe Coronavirus Disease 2019 (COVID-19). Up-regulation of NRP-1 protein in diabetic kidney cells hint at its importance in a population at risk of severe COVID-19. Involvement of NRP-1 in immune function is compelling, given the role of an exaggerated immune response in disease severity and deaths due to COVID-19. NRP-1 has been suggested to be an immune checkpoint of T cell memory. It is unknown whether involvement and up-regulation of NRP-1 in COVID-19 may translate into disease outcome and long-term consequences, including possible immune dysfunction. It is prudent to further research NRP-1 and its possibility of serving as a therapeutic target in SARS-CoV-2 infections. We anticipate that widespread expression, abundance in the respiratory and olfactory epithelium, and the functionalities of NRP-1 factor into the multiple systemic effects of COVID-19 and challenges we face in management of disease and potential long-term sequelae.}, } @article {pmid33395417, year = {2021}, author = {Joachimiak, MP}, title = {Zinc against COVID-19? Symptom surveillance and deficiency risk groups.}, journal = {PLoS neglected tropical diseases}, volume = {15}, number = {1}, pages = {e0008895}, doi = {10.1371/journal.pntd.0008895}, pmid = {33395417}, issn = {1935-2735}, abstract = {A wide variety of symptoms is associated with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, and these symptoms can overlap with other conditions and diseases. Knowing the distribution of symptoms across diseases and individuals can support clinical actions on timelines shorter than those for drug and vaccine development. Here, we focus on zinc deficiency symptoms, symptom overlap with other conditions, as well as zinc effects on immune health and mechanistic zinc deficiency risk groups. There are well-studied beneficial effects of zinc on the immune system including a decreased susceptibility to and improved clinical outcomes for infectious pathogens including multiple viruses. Zinc is also an anti-inflammatory and anti-oxidative stress agent, relevant to some severe Coronavirus Disease 2019 (COVID-19) symptoms. Unfortunately, zinc deficiency is common worldwide and not exclusive to the developing world. Lifestyle choices and preexisting conditions alone can result in zinc deficiency, and we compile zinc risk groups based on a review of the literature. It is also important to distinguish chronic zinc deficiency from deficiency acquired upon viral infection and immune response and their different supplementation strategies. Zinc is being considered as prophylactic or adjunct therapy for COVID-19, with 12 clinical trials underway, highlighting the relevance of this trace element for global pandemics. Using the example of zinc, we show that there is a critical need for a deeper understanding of essential trace elements in human health, and the resulting deficiency symptoms and their overlap with other conditions. This knowledge will directly support human immune health for decreasing susceptibility, shortening illness duration, and preventing progression to severe cases in the current and future pandemics.}, } @article {pmid33394568, year = {2021}, author = {Saksena, S and Chattopadhyay, P}, title = {Illuminating the immunopathology of SARS-CoV-2.}, journal = {Cytometry. Part B, Clinical cytometry}, volume = {}, number = {}, pages = {}, doi = {10.1002/cyto.b.21988}, pmid = {33394568}, issn = {1552-4957}, abstract = {Over a remarkably short period of time, a great deal of knowledge about severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection has been acquired, through the focused and cooperative effort of the international scientific community. Much has become known about how the immune response is coordinated to fight infection, and how it becomes dysregulated in severe disease. In this review, we take an in-depth look at the many immune features associated with the host response to SARS-CoV2, as well as those that appear to mark severe disease.}, } @article {pmid33394459, year = {2021}, author = {Bhatt, H}, title = {Should COVID-19 Mother Breastfeed her Newborn Child? A Literature Review on the Safety of Breastfeeding for Pregnant Women with COVID-19.}, journal = {Current nutrition reports}, volume = {}, number = {}, pages = {}, pmid = {33394459}, issn = {2161-3311}, abstract = {PURPOSE OF REVIEW: Breastfeeding is beneficial to both the newborn and the mother. During the COVID-19 pandemic, concerns have been raised on whether the SARS-CoV-2 virus could be transmitted from COVID-19 positive mother to the newborn through breastmilk. The purpose of this review is to examine the available evidence on the risks of transmission of infection from COVID-19 mothers to their newborns through breastfeeding.

RECENT FINDINGS: Data is very limited in this regard, with only a few smaller case series, and case reports have been published so far. In most of the studies, breastmilk samples from COVID-19 mothers tested negative for the virus. In the case reports where the virus was detected in breastmilk and the infants were diagnosed with COVID-19, it remained unclear whether the disease was transmitted through breastmilk or direct contact or through delivery. Another hypothesis is that the viral antibodies could pass to the newborn passively through breastmilk of COVID-19 positive mothers and give immunity to the child, but data is minimal. Based on the currently available limited evidence and recognizing the benefits of breastfeeding, it may be concluded that if the health of the mother and her newborn allows, direct breastfeeding or extracted breastmilk should be encouraged by the healthcare providers after a careful discussion of the risks of vertical transmission to the mother and her family. Preventive measures should be taken by COVID-19 mothers to prevent droplet transmission of infection to the infants while breastfeeding.}, } @article {pmid33394351, year = {2021}, author = {Chen, J and Huang, R and Nie, Y and Wen, X and Wu, Y}, title = {Human Monoclonal Antibodies: On the Menu of Targeted Therapeutics Against COVID-19.}, journal = {Virologica Sinica}, volume = {}, number = {}, pages = {}, pmid = {33394351}, issn = {1995-820X}, abstract = {Coronavirus disease 2019 (COVID-19), reminiscent of the severe acute respiratory syndrome (SARS) outbreak in 2003, has been a tragic disaster to people all over the world. As there is no specific drug for COVID-19, neutralizing antibodies are attracting more and more attention as one of the most effective means to combat the pandemic. Here, we introduced the etiological and serological characteristics of COVID-19, discussed the current stage of development of human monoclonal antibodies against SARS-CoV-2 and summarized the antigenic epitopes in the S glycoprotein, which may deepen the understanding of the profile of immune recognition and response against SARS-CoV-2 and provide insight for the design of effective vaccines and antibody-based therapies.}, } @article {pmid33394313, year = {2021}, author = {Baj, J and Ciesielka, M and Buszewicz, G and Maciejewski, R and Budzyńska, B and Listos, P and Teresiński, G}, title = {COVID-19 in the autopsy room-requirements, safety, recommendations and pathological findings.}, journal = {Forensic science, medicine, and pathology}, volume = {}, number = {}, pages = {}, pmid = {33394313}, issn = {1556-2891}, abstract = {Modern technologies enable the exchange of information about the expansion of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the continually increasing number of the coronavirus disease 2019 (COVID-19) cases almost in real time. The gravity of a current epidemiological situation is represented by the mortality rates, which are scrupulously updated daily. Performing autopsies on patients with either suspected or confirmed COVID-19 is of high importance since these might not only improve clinical management but also reduce the risk of SARS-CoV-2 infection expansion. The following paper aimed to present the most crucial aspects of SARS-CoV-2 infection from the point of view of forensic experts and pathologists, recommendations and safety precautions regarding autopsies, autopsy room requirements, possible techniques, examinations used for effective viral detection, recommendations regarding burials, and gross and microscopic pathological findings of the deceased who died due to SARS-CoV-2 infection. Autopsies remain the gold standard for determining the cause of death. Therefore, it would be beneficial to perform autopsies on patients with both suspected and confirmed COVID-19, especially those with coexisting comorbidities.}, } @article {pmid33394144, year = {2021}, author = {Rai, P and Kumar, BK and Deekshit, VK and Karunasagar, I and Karunasagar, I}, title = {Detection technologies and recent developments in the diagnosis of COVID-19 infection.}, journal = {Applied microbiology and biotechnology}, volume = {}, number = {}, pages = {}, pmid = {33394144}, issn = {1432-0614}, abstract = {COVID-19 is a disease caused by SARS-CoV-2 capable of causing mild to severe infections in humans. Since its first appearance in China in December 2019, the pandemic has spread rapidly throughout the world. Despite considerable efforts made to contain the disease, the virus has continued its prevalence in many countries with varying degrees of clinical manifestations. To contain this pandemic, collaborative approach involving accurate diagnosis, epidemiology, surveillance, and prophylaxis is essential. However, proper diagnosis using rapid technologies plays a crucial role. With increasing incidence of COVID-19 cases, the accurate and early detection of the SARS-CoV-2 is need of the hour for effective prevention and management of COVID-19 cases as well as to curb its spread. RT-qPCR assay is considered to be the gold standard for the early detection of virus, but this protocol has limited application to use as bedside test because of its technical complexity. To address these challenges, several POC assays have been developed to facilitate the COVID-19 diagnosis outside the centralized testing laboratories as well to accelerate the clinical decision making with a least turnaround time. Hence, in this report, we review different nucleic acid-based and serological techniques available for the diagnosis and effective prevention of COVID-19. KEY POINTS : • Provides comprehensive information on the different diagnostic tools available for COVID-19 • Nucleic acid based tests or antigen detection tests are used for diagnostic purpose • Accurate diagnosis is essential for the efficient management of COVID-19.}, } @article {pmid33394093, year = {2021}, author = {, and , }, title = {[Recommendations from the German Ophthalmological Society and the Professional Association of Ophthalmologists in Germany on perimetry during the SARS-CoV-2 pandemic : Status: 30 November 2020].}, journal = {Der Ophthalmologe : Zeitschrift der Deutschen Ophthalmologischen Gesellschaft}, volume = {}, number = {}, pages = {}, doi = {10.1007/s00347-020-01299-9}, pmid = {33394093}, issn = {1433-0423}, } @article {pmid33394058, year = {2021}, author = {Schieffer, E and Schieffer, B and Hilfiker-Kleiner, D}, title = {[Cardiovascular diseases and COVID-19 : Pathophysiology, complications and treatment].}, journal = {Herz}, volume = {}, number = {}, pages = {}, pmid = {33394058}, issn = {1615-6692}, abstract = {The coronavirus disease 2019 (COVID-19) pandemic is a challenge for our healthcare system but at the same time is one of the excellent catalyzers and promoters of successful translational research. The COVID-19 is not only a simple viral infection of the bronchial system but is also a pandemic hyperinflammatory multiorgan disease. The cardiovascular system plays a causal role in this context, as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) invades host cells via the angiotensin-converting enzyme 2 (ACE-2), an enzyme in the renin-angiotensin system. Furthermore, cardiovascular comorbidities and risk factors, such as hypertension, diabetes and obesity play an important role in the severity of the course of the disease. Additional risk factors, such as gender, age, genetics and air pollution modulate both the severity of the SARS-CoV‑2 infection as well as cardiovascular diseases. As sequelae of COVID-19, increased thrombosis, myocardial infarction, myocardial inflammation and vasculitis occur, which directly damage the cardiovascular system and substantially contribute to the high morbidity and mortality. Knowledge gained from many studies on the course of the disease in patients infected with SARS-CoV‑2 has led to improved treatment possibilities, which now in the second wave are partly standardized and were, and are, in particular adapted to complications of the cardiovascular system. In this review we provide a short overview on the pathophysiology of the SARS-CoV‑2 in general and also specifically on the cardiovascular system. Furthermore, we summarize the current treatment approaches and their pathophysiological principles (status November 2020).}, } @article {pmid33393161, year = {2021}, author = {Pujić, I and Perreault, H}, title = {Recent advancements in glycoproteomic studies: Glycopeptide enrichment and derivatization, characterization of glycosylation in SARS CoV2, and interacting glycoproteins.}, journal = {Mass spectrometry reviews}, volume = {}, number = {}, pages = {}, doi = {10.1002/mas.21679}, pmid = {33393161}, issn = {1098-2787}, abstract = {Proteomics studies allow for the determination of the identity, amount, and interactions of proteins under specific conditions that allow the biological state of an organism to ultimately change. These conditions can be either beneficial or detrimental. Diseases are due to detrimental changes caused by either protein overexpression or underexpression caused by as a result of a mutation or posttranslational modifications (PTM), among other factors. Identification of disease biomarkers through proteomics can be potentially used as clinical information for diagnostics. Common biomarkers to look for include PTM. For example, aberrant glycosylation of proteins is a common marker and will be a focus of interest in this review. A common way to analyze glycoproteins is by glycoproteomics involving mass spectrometry. Due to factors such as micro- and macroheterogeneity which result in a lower abundance of each version of a glycoprotein, it is difficult to obtain meaningful results unless rigorous sample preparation procedures are in place. Microheterogeneity represents the diversity of glycans at a single site, whereas macroheterogeneity depicts glycosylation levels at each site of a protein. Enrichment and derivatization of glycopeptides help to overcome these limitations. Over the time range of 2016 to 2020, several methods have been proposed in the literature and have contributed to drastically improve the outcome of glycosylation analysis, as presented in the sampling surveyed in this review. As a current topic in 2020, glycoproteins carried by pathogens can also cause disease and this is seen with SARS CoV2, causing the COVID-19 pandemic. This review will discuss glycoproteomic studies of the spike glycoprotein and interacting proteins such as the ACE2 receptor.}, } @article {pmid33393116, year = {2021}, author = {Wu, Y and Li, Z and Zhao, YS and Huang, YY and Jiang, MY and Luo, HB}, title = {Therapeutic targets and potential agents for the treatment of COVID-19.}, journal = {Medicinal research reviews}, volume = {}, number = {}, pages = {}, doi = {10.1002/med.21776}, pmid = {33393116}, issn = {1098-1128}, support = {201904020023//Science Foundation of Guangzhou City/ ; 21877134//National Natural Science Foundation of China/ ; 21977127 and 22077143//National Natural Science Foundation of China/ ; 2020A111128007//Science Foundation of Guangdong Province/ ; }, abstract = {The outbreak of coronavirus disease 2019 (COVID-19), which is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, has become a global crisis. As of November 9, COVID-19 has already spread to more than 190 countries with 50,000,000 infections and 1,250,000 deaths. Effective therapeutics and drugs are in high demand. The structure of SARS-CoV-2 is highly conserved with those of SARS-CoV and Middle East respiratory syndrome-CoV. Enzymes, including RdRp, Mpro /3CLpro , and PLpro , which play important roles in viral transcription and replication, have been regarded as key targets for therapies against coronaviruses, including SARS-CoV-2. The identification of readily available drugs for repositioning in COVID-19 therapy is a relatively rapid approach for clinical treatment, and a series of approved or candidate drugs have been proven to be efficient against COVID-19 in preclinical or clinical studies. This review summarizes recent progress in the development of drugs against SARS-CoV-2 and the targets involved.}, } @article {pmid33393082, year = {2021}, author = {Furtado, GE and Letieri, RV and Caldo, A and Sardão, V and Teixeira, AM and de Barros, MP and Vieira, RP and Bachi, ALL}, title = {Sustaining efficient immune functions with regular physical exercise in the COVID-19 era and beyond.}, journal = {European journal of clinical investigation}, volume = {}, number = {}, pages = {e13485}, doi = {10.1111/eci.13485}, pmid = {33393082}, issn = {1365-2362}, abstract = {The new coronavirus (SARS-CoV-2) appearance in Wuhan, China, did rise the new virus disease (COVID-19), which spread globally in a short time, leading the World Health Organization to declare a new global pandemic. To contain and mitigate the spread of SARS-CoV-2, specific public health procedures were implemented in virtually all countries, with a significant impact on society, making it difficult to keep the regular practice of physical activity. It is widely accepted that an active lifestyle contributes to the improvement of general health and preservation of cardiovascular, respiratory, osteo-muscular, and immune system capacities. The positive effects of regular physical activity on the immune system have emerged as a pivotal trigger of general health, underlying the beneficial effects of physical activity on multiple physiological systems. Accordingly, recent studies have already pointed out the negative impact of physical inactivity caused by the social isolation imposed by the public sanitary authorities due to COVID-19. Nevertheless, there are still no current narrative reviews evaluating the real impact of COVID-19 on active lifestyle or even discussing the possible beneficial effects of exercise-promoted immune upgrade against the severity or progression of COVID-19. Based on the consensus in the scientific literature, in this review, we discuss how an exercise adherence could adequately improve immune responses in times of the "COVID-19 Era and beyond".}, } @article {pmid33393066, year = {2021}, author = {Binnie, A and Fernandes, E and Almeida-Lousada, H and de Mello, RA and Castelo-Branco, P}, title = {CRISPR-based strategies in infectious disease diagnosis and therapy.}, journal = {Infection}, volume = {}, number = {}, pages = {}, pmid = {33393066}, issn = {1439-0973}, support = {UID/BIM/04773/2013//Fundação para a Ciência e a Tecnologia/ ; }, abstract = {PURPOSE: CRISPR gene-editing technology has the potential to transform the diagnosis and treatment of infectious diseases, but most clinicians are unaware of its broad applicability. Derived from an ancient microbial defence system, these so-called "molecular scissors" enable precise gene editing with a low error rate. However, CRISPR systems can also be targeted against pathogenic DNA or RNA sequences. This potential is being combined with innovative delivery systems to develop new therapeutic approaches to infectious diseases.

METHODS: We searched Pubmed and Google Scholar for CRISPR-based strategies in the diagnosis and treatment of infectious diseases. Reference lists were reviewed and synthesized for narrative review.

RESULTS: CRISPR-based strategies represent a novel approach to many challenging infectious diseases. CRISPR technologies can be harnessed to create rapid, low-cost diagnostic systems, as well as to identify drug-resistance genes. Therapeutic strategies, such as CRISPR systems that cleave integrated viral genomes or that target resistant bacteria, are in development. CRISPR-based therapies for emerging viruses, such as SARS-CoV-2, have also been proposed. Finally, CRISPR systems can be used to reprogram human B cells to produce neutralizing antibodies. The risks of CRISPR-based therapies include off-target and on-target modifications. Strategies to control these risks are being developed and a phase 1 clinical trials of CRISPR-based therapies for cancer and monogenic diseases are already underway.

CONCLUSIONS: CRISPR systems have broad applicability in the field of infectious diseases and may offer solutions to many of the most challenging human infections.}, } @article {pmid33392967, year = {2021}, author = {Shukla, A and Parmar, P and Kapoor, G and Goswami, D and Jha, CK and Patel, B and Saraf, M}, title = {Curse of La Corona: unravelling the scientific and psychological conundrums of the 21st century pandemic.}, journal = {Molecular diversity}, volume = {}, number = {}, pages = {}, pmid = {33392967}, issn = {1573-501X}, abstract = {Microbes possess a tremendous potential to interact with their surroundings and have continued to shape the future of all life forms existing on earth. Of all the groups of microbes, viruses are the most nefarious creatures which cannot be solely classified as living or non-living but still pose the greatest threats to the biosphere. Viruses are minuscule, diverse and are probably the only entities that exhibit non-mutualistic association with other lifeforms while retaining their ability to infect and hijack any of the existing living being on the planet. The latest global devastation, caused by novel SARS-CoV-2, is unparalleled in the last century. This review encompasses the mysterious origin of this virus by tracking its lineage, which may help to decode the conundrum of SARS-CoV-2 and shed more light on its epidemiology. The implications and the challenge posed by this virus to the scientific community to the medical community and the economy at large are reflected. Also discussed is the paradigm shift brought upon by the COVID-19 pandemic on the human psyche and their behaviour.}, } @article {pmid33392670, year = {2021}, author = {Bhattacharjee, A and Saha, M and Halder, A and Debnath, A and Mukherjee, O}, title = {Therapeutics and Vaccines: Strengthening Our Fight Against the Global Pandemic COVID-19.}, journal = {Current microbiology}, volume = {}, number = {}, pages = {}, pmid = {33392670}, issn = {1432-0991}, abstract = {The newly identified 2019 novel coronavirus (SARS-CoV-2) has become a public health concern globally posing a significant threat to human health and economy and creating an unprecedented crisis in all spheres of the global life. Emergence of new genotypes of SARS-CoV during the last few years has pointed out the limited efficacy of available vaccines and antivirals, constraining the global response to the COVID-19 outburst to largely monitoring/containment. There is high priority for treatment regimes and new potential therapeutic and vaccine strategies. Several candidates have shown promising outcomes in various in vitro and in vivo models. In addition, clinical trials are in progress to test conceivable therapies showing promising outcomes in various in vivo studies. Unfortunately, very little information is available in the scientific scope which offers details to the diverse strategies being targeted to fight the pandemic, particularly with respect to the molecular targets. This review article summarizes and highlights the ongoing advances and approaches that are being carried out across the globe in designing vaccines and novel therapeutics, with particular reference to the previous knowledge gained from other viral infections like with the earlier SARS and MERS-CoV. A detailed knowledge may pave the way to combat this pandemic COVID-19 as well as prevent similar deadly epidemics in future.}, } @article {pmid33392546, year = {2020}, author = {Gutiérrez-Zarate, D and Rosas-Sánchez, K and Flores-Carrillo, JC and Medrano-Ahumada, S and Martínez-Franco, M}, title = {Early management of critically ill patients with COVID-19.}, journal = {Journal of the American College of Emergency Physicians open}, volume = {1}, number = {6}, pages = {1418-1426}, doi = {10.1002/emp2.12294}, pmid = {33392546}, issn = {2688-1152}, abstract = {Coronavirus disease 2019 (COVID-19) is associated with a severe acute respiratory condition requiring respiratory support and mechanical ventilation. Based on the pathophysiology and clinical course of the disease, a therapeutic approach can be adapted. Three phases have been identified, in which different strategies are recommended in a stepwise invasiveness approach. In the second or acute phase, patients are frequently admitted to the ICU for severe pneumonia and hypoxemia with evidence of a proinflammatory and hypercoagulable state. This stage is an opportunity to intervene early in the disease. Medical strategies and mechanical ventilation should be individualized to improve outcomes.}, } @article {pmid33392545, year = {2020}, author = {Henzel, MK and Shultz, JM and Dyson-Hudson, TA and Svircev, JN and DiMarco, AF and Gater, DR}, title = {Initial assessment and management of respiratory infections in persons with spinal cord injuries and disorders in the COVID-19 era.}, journal = {Journal of the American College of Emergency Physicians open}, volume = {1}, number = {6}, pages = {1404-1412}, doi = {10.1002/emp2.12282}, pmid = {33392545}, issn = {2688-1152}, abstract = {As the COVID-19 pandemic unfolds, emergency department (ED) personnel will face a higher caseload, including those with special medical needs such as persons living with spinal cord injuries and disorders (SCI/D). Individuals with SCI/D who develop COVID-19 are at higher risk for rapid decompensation and development of acute respiratory failure during respiratory infections due to the combination of chronic respiratory muscle paralysis and autonomic dysregulation causing neurogenic restrictive/obstructive lung disease and chronic immune dysfunction. Often, acute respiratory infections will lead to significant mucus production in individuals with SCI/D, and aggressive secretion management is an important component of successful medical treatment. Secretion management techniques include nebulized bronchodilators, chest percussion/drainage techniques, manually assisted coughing techniques, nasotracheal suctioning, and mechanical insufflation-exsufflation. ED professionals, including respiratory therapists, should be familiar with the significant comorbidities associated with SCI/D and the customized secretion management procedures and techniques required for optimal medical management and prevention of respiratory failure. Importantly, protocols should also be implemented to minimize potential COVID-19 spread during aerosol-generating procedures.}, } @article {pmid33392263, year = {2020}, author = {Aigner, L and Pietrantonio, F and Bessa de Sousa, DM and Michael, J and Schuster, D and Reitsamer, HA and Zerbe, H and Studnicka, M}, title = {The Leukotriene Receptor Antagonist Montelukast as a Potential COVID-19 Therapeutic.}, journal = {Frontiers in molecular biosciences}, volume = {7}, number = {}, pages = {610132}, doi = {10.3389/fmolb.2020.610132}, pmid = {33392263}, issn = {2296-889X}, abstract = {The emergence and global impact of COVID-19 has focused the scientific and medical community on the pivotal influential role of respiratory viruses as causes of severe pneumonia, on the understanding of the underlying pathomechanisms, and on potential treatment for COVID-19. The latter concentrates on four different strategies: (i) antiviral treatments to limit the entry of the virus into the cell and its propagation, (ii) anti-inflammatory treatment to reduce the impact of COVID-19 associated inflammation and cytokine storm, (iii) treatment using cardiovascular medication to reduce COVID-19 associated thrombosis and vascular damage, and (iv) treatment to reduce the COVID-19 associated lung injury. Ideally, effective COVID-19 treatment should target as many of these mechanisms as possible arguing for the search of common denominators as potential drug targets. Leukotrienes and their receptors qualify as such targets: they are lipid mediators of inflammation and tissue damage and well-established targets in respiratory diseases like asthma. Besides their role in inflammation, they are involved in various other aspects of lung pathologies like vascular damage, thrombosis, and fibrotic response, in brain and retinal damages, and in cardiovascular disease. In consequence, leukotriene receptor antagonists might be potential candidates for COVID-19 therapeutics. This review summarizes the current knowledge on the potential involvement of leukotrienes in COVID-19, and the rational for the use of the leukotriene receptor antagonist montelukast as a COVID-19 therapeutic.}, } @article {pmid33392262, year = {2020}, author = {Mariano, G and Farthing, RJ and Lale-Farjat, SLM and Bergeron, JRC}, title = {Structural Characterization of SARS-CoV-2: Where We Are, and Where We Need to Be.}, journal = {Frontiers in molecular biosciences}, volume = {7}, number = {}, pages = {605236}, doi = {10.3389/fmolb.2020.605236}, pmid = {33392262}, issn = {2296-889X}, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly spread in humans in almost every country, causing the disease COVID-19. Since the start of the COVID-19 pandemic, research efforts have been strongly directed towards obtaining a full understanding of the biology of the viral infection, in order to develop a vaccine and therapeutic approaches. In particular, structural studies have allowed to comprehend the molecular basis underlying the role of many of the SARS-CoV-2 proteins, and to make rapid progress towards treatment and preventive therapeutics. Despite the great advances that have been provided by these studies, many knowledge gaps on the biology and molecular basis of SARS-CoV-2 infection still remain. Filling these gaps will be the key to tackle this pandemic, through development of effective treatments and specific vaccination strategies.}, } @article {pmid33392257, year = {2020}, author = {Halder, A and Anto, A and Subramanyan, V and Bhattacharyya, M and Vishveshwara, S and Vishveshwara, S}, title = {Surveying the Side-Chain Network Approach to Protein Structure and Dynamics: The SARS-CoV-2 Spike Protein as an Illustrative Case.}, journal = {Frontiers in molecular biosciences}, volume = {7}, number = {}, pages = {596945}, doi = {10.3389/fmolb.2020.596945}, pmid = {33392257}, issn = {2296-889X}, abstract = {Network theory-based approaches provide valuable insights into the variations in global structural connectivity between different dynamical states of proteins. Our objective is to review network-based analyses to elucidate such variations, especially in the context of subtle conformational changes. We present technical details of the construction and analyses of protein structure networks, encompassing both the non-covalent connectivity and dynamics. We examine the selection of optimal criteria for connectivity based on the physical concept of percolation. We highlight the advantages of using side-chain-based network metrics in contrast to backbone measurements. As an illustrative example, we apply the described network approach to investigate the global conformational changes between the closed and partially open states of the SARS-CoV-2 spike protein. These conformational changes in the spike protein is crucial for coronavirus entry and fusion into human cells. Our analysis reveals global structural reorientations between the two states of the spike protein despite small changes between the two states at the backbone level. We also observe some differences at strategic locations in the structures, correlating with their functions, asserting the advantages of the side-chain network analysis. Finally, we present a view of allostery as a subtle synergistic-global change between the ligand and the receptor, the incorporation of which would enhance drug design strategies.}, } @article {pmid33392206, year = {2020}, author = {Preissner, KT and Fischer, S and Deindl, E}, title = {Extracellular RNA as a Versatile DAMP and Alarm Signal That Influences Leukocyte Recruitment in Inflammation and Infection.}, journal = {Frontiers in cell and developmental biology}, volume = {8}, number = {}, pages = {619221}, doi = {10.3389/fcell.2020.619221}, pmid = {33392206}, issn = {2296-634X}, abstract = {Upon vascular injury, tissue damage, ischemia, or microbial infection, intracellular material such as nucleic acids and histones is liberated and comes into contact with the vessel wall and circulating blood cells. Such "Danger-associated molecular patterns" (DAMPs) may thus have an enduring influence on the inflammatory defense process that involves leukocyte recruitment and wound healing reactions. While different species of extracellular RNA (exRNA), including microRNAs and long non-coding RNAs, have been implicated to influence inflammatory processes at different levels, recent in vitro and in vivo work has demonstrated a major impact of ribosomal exRNA as a prominent DAMP on various steps of leukocyte recruitment within the innate immune response. This includes the induction of vascular hyper-permeability and vasogenic edema by exRNA via the activation of the "vascular endothelial growth factor" (VEGF) receptor-2 system, as well as the recruitment of leukocytes to the inflamed endothelium, the M1-type polarization of inflammatory macrophages, or the role of exRNA as a pro-thrombotic cofactor to promote thrombosis. Beyond sterile inflammation, exRNA also augments the docking of bacteria to host cells and the subsequent microbial invasion. Moreover, upon vessel occlusion and ischemia, the shear stress-induced release of exRNA initiates arteriogenesis (i.e., formation of natural vessel bypasses) in a multistep process that resembles leukocyte recruitment. Although exRNA can be counteracted for by natural circulating RNase1, under the conditions mentioned, only the administration of exogenous, thermostable, non-toxic RNase1 provides an effective and safe therapeutic regimen for treating the damaging activities of exRNA. It remains to be investigated whether exRNA may also influence viral infections (including COVID-19), e.g., by supporting the interaction of host cells with viral particles and their subsequent invasion. In fact, as a consequence of the viral infection cycle, massive amounts of exRNA are liberated, which can provoke further tissue damage and enhance virus dissemination. Whether the application of RNase1 in this scenario may help to limit the extent of viral infections like COVID-19 and impact on leukocyte recruitment and emigration steps in immune defense in order to limit the extent of associated cardiovascular diseases remains to be studied.}, } @article {pmid33392139, year = {2020}, author = {Chatterjee, P and Tesis, A and Cymberknop, LJ and Armentano, RL}, title = {Internet of Things and Artificial Intelligence in Healthcare During COVID-19 Pandemic-A South American Perspective.}, journal = {Frontiers in public health}, volume = {8}, number = {}, pages = {600213}, doi = {10.3389/fpubh.2020.600213}, pmid = {33392139}, issn = {2296-2565}, abstract = {The shudders of the COVID-19 pandemic have projected newer challenges in the healthcare domain across the world. In South American scenario, severe issues and difficulties have been noticed in areas like patient consultations, remote monitoring, medical resources, healthcare personnel etc. This work is aimed at providing a holistic view to the digital healthcare during the times of COVID-19 pandemic in South America. It includes different initiatives like mobile apps, web-platforms and intelligent analyses toward early detection and overall healthcare management. In addition to discussing briefly the key issues toward extensive implementation of eHealth paradigms, this work also sheds light on some key aspects of Artificial Intelligence and the Internet of Things along their potential applications like clinical decision support systems and predictive risk modeling, especially in the direction of combating the emergent challenges due to the COVID-19 pandemic.}, } @article {pmid33392127, year = {2020}, author = {Hagan, JE and Ahinkorah, BO and Seidu, AA and Ameyaw, EK and Schack, T}, title = {Africa's COVID-19 Situation in Focus and Recent Happenings: A Mini Review.}, journal = {Frontiers in public health}, volume = {8}, number = {}, pages = {573636}, doi = {10.3389/fpubh.2020.573636}, pmid = {33392127}, issn = {2296-2565}, abstract = {Given that COVID-19 (SARS-CoV-2) has crept into Africa, a major public health crisis or threat continues to linger on the continent. Many local governments and various stakeholders have stepped up efforts for early detection and management of COVID-19. This mini review highlights the current trend in Africa, history and general epidemiological information on the virus. Current ongoing efforts (e.g., improving testing capacity) and some effective ways (e.g., intensified surveillance, quick detection, contact tracing, isolation measures [e.g., quarantine], and social distancing) of preventing and managing COVID-19 in Africa are described. The review concludes by emphasizing the need for public health infrastructure development (e.g., laboratories, infectious disease centers, regional hospitals) and human capacity building for combating COVID-19 and potential future outbreaks. Additionally, regular public health educational campaigns are urgently required. Future epidemiological studies to ascertain case fatality and mortality trends across the continent for policy directions are necessary.}, } @article {pmid33391762, year = {2021}, author = {Griffin, M and Sohrabi, C and Alsafi, Z and Nicola, M and Kerwan, A and Mathew, G and Agha, R}, title = {Preparing for COVID-19 exit strategies.}, journal = {Annals of medicine and surgery (2012)}, volume = {61}, number = {}, pages = {88-92}, doi = {10.1016/j.amsu.2020.12.012}, pmid = {33391762}, issn = {2049-0801}, abstract = {The COVID-19 pandemic has affected 20 million people worldwide with over 732,000 deaths and trillions of dollars of lost economic productivity. It has put many countries into lockdown to contain the virus and save lives. As COVID-19 cases in some countries start to plateau and societies work hard to 'flatten the curve', leaders are being asked to formulate plans for safe and staged 'exit strategies' to reopen society. Each country will decide on their own exit strategy but many plans are considering similar vital healthcare principles including the maintenance of social distancing to prevent ongoing community transmission, testing capacity, protection of the healthcare systems and the health of their care workers. This review aims to provide an overview of essential factors that plans for exit strategy should consider and their effect on the societies' social and healthcare life.}, } @article {pmid33391760, year = {2021}, author = {Ahmad, K and Khaleeq, T and Hanif, U and Ahmad, N}, title = {Addressing the failures of undergraduate anatomy education: Dissecting the issue and innovating a solution.}, journal = {Annals of medicine and surgery (2012)}, volume = {61}, number = {}, pages = {81-84}, doi = {10.1016/j.amsu.2020.12.024}, pmid = {33391760}, issn = {2049-0801}, abstract = {Background: Reduced time allocation, changes in teaching methods and Covid-19 have resulted in undergraduate anatomy teaching being marginalised.This has implications on patient safety, litigation, student satisfaction and surgical workforce planning.

Aims: The aim of this study is to survey a cohort of recent English medical graduates to attain their perspective on anatomy training and to propose an innovative solution to solve existing problems in undergraduate anatomy training.

Methods: An online survey was sent out to 40 foundation doctors to offer insights into their undergraduate anatomy training. We asked participants to rate their perceived importance of anatomy, the importance offered to anatomy teaching at undergraduate level, preparation for clinical practice and future career plans.

Results: 22 participants responded to the online survey. All trained across England with equal spread between Northern and Southern medical schools. All participants perceived anatomy to be either important or very important in the survey. 20/22 felt that their undergraduate anatomy teaching was given very low to average importance by their institutions. 8/22 were confident or very confident with their anatomy knowledge on beginning clinical practice. Of the 22, 5 planned surgical careers, 10 did not know or gave other responses and 7 wanted to do General Practice. 16/22 said anatomy training had or will impact their decision on choosing a speciality.

Conclusion: The current literature and above survey highlight the deficiencies that current doctors are facing.We suggest implementation of a standardised anatomy curriculum and the development of an online anatomy course.}, } @article {pmid33391531, year = {2021}, author = {Han, YJ and Lee, KH and Yoon, S and Nam, SW and Ryu, S and Seong, D and Kim, JS and Lee, JY and Yang, JW and Lee, J and Koyanagi, A and Hong, SH and Dragioti, E and Radua, J and Smith, L and Oh, H and Ghayda, RA and Kronbichler, A and Effenberger, M and Kresse, D and Denicolò, S and Kang, W and Jacob, L and Shin, H and Shin, JI}, title = {Treatment of severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and coronavirus disease 2019 (COVID-19): a systematic review of in vitro, in vivo, and clinical trials.}, journal = {Theranostics}, volume = {11}, number = {3}, pages = {1207-1231}, doi = {10.7150/thno.48342}, pmid = {33391531}, issn = {1838-7640}, abstract = {Rationale: Coronavirus disease 2019 (COVID-19) has spread worldwide and poses a threat to humanity. However, no specific therapy has been established for this disease yet. We conducted a systematic review to highlight therapeutic agents that might be effective in treating COVID-19. Methods: We searched Medline, Medrxiv.org, and reference lists of relevant publications to identify articles of in vitro, in vivo, and clinical studies on treatments for severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and COVID-19 published in English until the last update on October 11, 2020. Results: We included 36 studies on SARS, 30 studies on MERS, and 10 meta-analyses on SARS and MERS in this study. Through 12,200 title and 830 full-text screenings for COVID-19, eight in vitro studies, 46 randomized controlled trials (RCTs) on 6,886 patients, and 29 meta-analyses were obtained and investigated. There was no therapeutic agent that consistently resulted in positive outcomes across SARS, MERS, and COVID-19. Remdesivir showed a therapeutic effect for COVID-19 in two RCTs involving the largest number of total participants (n = 1,461). Other therapies that showed an effect in at least two RCTs for COVID-19 were sofosbuvir/daclatasvir (n = 114), colchicine (n = 140), IFN-β1b (n = 193), and convalescent plasma therapy (n = 126). Conclusions: This review provides information to help establish treatment and research directions for COVID-19 based on currently available evidence. Further RCTs are required.}, } @article {pmid33391502, year = {2021}, author = {Pathania, AS and Prathipati, P and Abdul, BA and Chava, S and Katta, SS and Gupta, SC and Gangula, PR and Pandey, MK and Durden, DL and Byrareddy, SN and Challagundla, KB}, title = {COVID-19 and Cancer Comorbidity: Therapeutic Opportunities and Challenges.}, journal = {Theranostics}, volume = {11}, number = {2}, pages = {731-753}, doi = {10.7150/thno.51471}, pmid = {33391502}, issn = {1838-7640}, abstract = {The coronavirus disease 2019 (COVID-19) is a viral disease caused by a novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that affects the respiratory system of infected individuals. COVID-19 spreads between humans through respiratory droplets produced when an infected person coughs or sneezes. The COVID-19 outbreak originated in Wuhan, China at the end of 2019. As of 29 Sept 2020, over 235 countries, areas or territories across the globe reported a total of 33,441,919 confirmed cases, and 1,003,497 confirmed deaths due to COVID-19. Individuals of all ages are at risk for infection, but in most cases disease severity is associated with age and pre-existing diseases that compromise immunity, like cancer. Numerous reports suggest that people with cancer can be at higher risk of severe illness and related deaths from COVID-19. Therefore, managing cancer care under this pandemic is challenging and requires a collaborative multidisciplinary approach for optimal care of cancer patients in hospital settings. In this comprehensive review, we discuss the impact of the COVID-19 pandemic on cancer patients, their care, and treatment. Further, this review covers the SARS-CoV-2 pandemic, genome characterization, COVID-19 pathophysiology, and associated signaling pathways in cancer, and the choice of anticancer agents as repurposed drugs for treating COVID-19.}, } @article {pmid33391477, year = {2021}, author = {Kim, JS and Lee, JY and Yang, JW and Lee, KH and Effenberger, M and Szpirt, W and Kronbichler, A and Shin, JI}, title = {Immunopathogenesis and treatment of cytokine storm in COVID-19.}, journal = {Theranostics}, volume = {11}, number = {1}, pages = {316-329}, doi = {10.7150/thno.49713}, pmid = {33391477}, issn = {1838-7640}, abstract = {Severe coronavirus disease 2019 (COVID-19) is characterized by systemic hyper-inflammation, acute respiratory distress syndrome, and multiple organ failure. Cytokine storm refers to a set of clinical conditions caused by excessive immune reactions and has been recognized as a leading cause of severe COVID-19. While comparisons have been made between COVID-19 cytokine storm and other kinds of cytokine storm such as hemophagocytic lymphohistiocytosis and cytokine release syndrome, the pathogenesis of cytokine storm has not been clearly elucidated yet. Recent studies have shown that impaired response of type-1 IFNs in early stage of COVID-19 infection played a major role in the development of cytokine storm, and various cytokines such as IL-6 and IL-1 were involved in severe COVID-19. Furthermore, many clinical evidences have indicated the importance of anti-inflammatory therapy in severe COVID-19. Several approaches are currently being used to treat the observed cytokine storm associated with COVID-19, and expectations are especially high for new cytokine-targeted therapies, such as tocilizumab, anakinra, and baricitinib. Although a number of studies have been conducted on anti-inflammatory treatments for severe COVID-19, no specific recommendations have been made on which drugs should be used for which patients and when. In this review, we provide an overview of cytokine storm in COVID-19 and treatments currently being used to address it. In addition, we discuss the potential therapeutic role of extracorporeal cytokine removal to treat the cytokine storm associated with COVID-19.}, } @article {pmid33391394, year = {2020}, author = {Bracey, T and Arif, S and Ralte, AM and Shaaban, AM and Ganesan, R}, title = {Histopathology during the COVID-19 pandemic: resilience through adaptation and innovation.}, journal = {Diagnostic histopathology (Oxford, England)}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.mpdhp.2020.12.003}, pmid = {33391394}, issn = {1756-2317}, abstract = {Histopathology departments have adapted to the challenges posed by the COVID-19 pandemic by a variety of changes including working pattern alterations, technology adoptions and incorporation of techniques. This article summarizes these adaptations and provides references to guide pathologists through the continuing pandemic.}, } @article {pmid33391390, year = {2020}, author = {Evans, C and Davies, P}, title = {SARS-CoV-2 paediatric inflammatory syndrome.}, journal = {Paediatrics and child health}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.paed.2020.12.003}, pmid = {33391390}, issn = {1751-7222}, abstract = {The novel post SARS-COV2 Paediatric Inflammatory Syndrome, first recognised in April 2020, took worldwide clinicians by surprise. There rapidly followed a plethora of case definitions, nomenclatures, descriptive papers, and guidelines on treatment. There has been controversy around this condition. Is it really new? Is it an atypical form of a known disease? How should we communicate and report such cases? What is the pathogenesis? Which treatments are given, and which are effective? What are the short and long-term outcomes? We are all learning fast. The clinical and immunological patterns seen are unique. There are significant differences in both presentation and pathogenesis to any known condition, including Kawasaki's disease. This implies that treatments are not necessarily transferrable: and indeed it is unknown which treatments are effective at all. Outcomes, as far as are known, are good, but long term data is lacking. The international cooperation has been an example of how today's connected medicine can be a force for good, however calm assessment of evidence remains necessary to ensure the best outcomes for our patients. This short article identifies what we have learnt from the first surge of COVID-19 cases about paediatric inflammatory syndrome and how it affects children.}, } @article {pmid33391281, year = {2020}, author = {Galipeau, Y and Greig, M and Liu, G and Driedger, M and Langlois, MA}, title = {Humoral Responses and Serological Assays in SARS-CoV-2 Infections.}, journal = {Frontiers in immunology}, volume = {11}, number = {}, pages = {610688}, doi = {10.3389/fimmu.2020.610688}, pmid = {33391281}, issn = {1664-3224}, abstract = {In December 2019, the novel betacoronavirus Severe Acute Respiratory Disease Coronavirus 2 (SARS-CoV-2) was first detected in Wuhan, China. SARS-CoV-2 has since become a pandemic virus resulting in hundreds of thousands of deaths and deep socioeconomic implications worldwide. In recent months, efforts have been directed towards detecting, tracking, and better understanding human humoral responses to SARS-CoV-2 infection. It has become critical to develop robust and reliable serological assays to characterize the abundance, neutralization efficiency, and duration of antibodies in virus-exposed individuals. Here we review the latest knowledge on humoral immune responses to SARS-CoV-2 infection, along with the benefits and limitations of currently available commercial and laboratory-based serological assays. We also highlight important serological considerations, such as antibody expression levels, stability and neutralization dynamics, as well as cross-reactivity and possible immunological back-boosting by seasonal coronaviruses. The ability to accurately detect, measure and characterize the various antibodies specific to SARS-CoV-2 is necessary for vaccine development, manage risk and exposure for healthcare and at-risk workers, and for monitoring reinfections with genetic variants and new strains of the virus. Having a thorough understanding of the benefits and cautions of standardized serological testing at a community level remains critically important in the design and implementation of future vaccination campaigns, epidemiological models of immunity, and public health measures that rely heavily on up-to-date knowledge of transmission dynamics.}, } @article {pmid33391135, year = {2020}, author = {Chiu, R}, title = {Functions of Music Making Under Lockdown: A Trans-Historical Perspective Across Two Pandemics.}, journal = {Frontiers in psychology}, volume = {11}, number = {}, pages = {616499}, doi = {10.3389/fpsyg.2020.616499}, pmid = {33391135}, issn = {1664-1078}, abstract = {This paper describes how music fulfills two of its broadly recognized functions-"mood regulation" and "social cohesion"-in times of pandemics and social isolation. Through a trans-historical comparison of the musical activities of the Milanese during an outbreak of plague in 1576 with the musical activities observed during the COVID lockdowns in 2020 (such as balcony-singing and playlist-making), this paper suggests a framework for understanding the role of music in the care of the biological body and the social body in times of medical disaster.}, } @article {pmid33391099, year = {2020}, author = {Clemente-Suárez, VJ and Dalamitros, AA and Beltran-Velasco, AI and Mielgo-Ayuso, J and Tornero-Aguilera, JF}, title = {Social and Psychophysiological Consequences of the COVID-19 Pandemic: An Extensive Literature Review.}, journal = {Frontiers in psychology}, volume = {11}, number = {}, pages = {580225}, doi = {10.3389/fpsyg.2020.580225}, pmid = {33391099}, issn = {1664-1078}, abstract = {The Coronavirus Disease 2019 (COVID-19) pandemic, now a global health crisis, has surprised health authorities around the world. Recent studies suggest that the measures taken to curb the spread of the COVID-19 outbreak have generated issues throughout the population. Thus, it is necessary to establish and identify the possible risk factors related to the psychosocial and psychophysiological strain during the COVID-19 outbreak. The present extensive literature review assesses the social, psychological, and physiological consequences of COVID-19, reviewing the impact of quarantine measures, isolation, vast human loss, social and financial consequences in the family's economies, and its impact on the psychological health of the population. We also discussed the effect of psychophysiological factors, considering the impact of physical inactivity and modifications in nutritional habits, at psychological and physiological levels. The present review includes an actualized to date bibliography, articles for which were methodologically analyzed to verify they met the standards of quality and scientific accuracy. Authors understand the pandemic as a multifactorial event for which only a profound and extensive analysis would lead to better compression and efficient intervention in the near future.}, } @article {pmid33391048, year = {2020}, author = {Gonçalves, PD and Moura, HF and do Amaral, RA and Castaldelli-Maia, JM and Malbergier, A}, title = {Alcohol Use and COVID-19: Can we Predict the Impact of the Pandemic on Alcohol Use Based on the Previous Crises in the 21st Century? A Brief Review.}, journal = {Frontiers in psychiatry}, volume = {11}, number = {}, pages = {581113}, doi = {10.3389/fpsyt.2020.581113}, pmid = {33391048}, issn = {1664-0640}, abstract = {The enormous health and economic challenges precipitated by the 2019 coronavirus disease (COVID-19) pandemic are comparable or even greater than those associated with previous historical world crises. Alcohol use, especially drinking to cope with stress, is a concern, as an increase in its sales has been reported in some countries during the quarantine. This study aims to provide a better understanding of what to expect in terms of alcohol consumption, risk factors for excessive use, and its potential consequences during this pandemic based on previous experiences. We investigated how traumatic events related to alcohol consumption. Studies on mass traumatic events (i.e., terrorism as 9/11), epidemic outbreaks (i.e., severe acute respiratory syndrome [SARS] in 2003), economic crises (such as 2008's Great Recession), and COVID-19 were selected. The main keywords used to select the studies were alcohol use, drinking patterns, alcohol use disorders, and alcohol-related consequences. Previous studies reported increases in alcohol use associated with those events mediated, at least partially, by anxiety and depressive symptoms, and posttraumatic stress disorder (PTSD). Being male, young, and single also seems to be associated with a higher vulnerability to develop risky drinking behavior after those tragic events. The discussion of previous risk and protective factors can contribute to elaborate more specific public health policies to mitigate the impact of the current pandemic on people's mental health, especially alcohol-related problems.}, } @article {pmid33391014, year = {2020}, author = {Jacob, G and Aharon, A and Brenner, B}, title = {COVID-19-Associated Hyper-Fibrinolysis: Mechanism and Implementations.}, journal = {Frontiers in physiology}, volume = {11}, number = {}, pages = {596057}, doi = {10.3389/fphys.2020.596057}, pmid = {33391014}, issn = {1664-042X}, abstract = {The emerging novel coronavirus disease (COVID-19), which is caused by the SARS-CoV-2 presents with high infectivity, morbidity and mortality. It presenting a need for immediate understanding of its pathogenicity. Inflammation and coagulation systems are over-activated in COVID-19. SARS-CoV-2 damages endothelial cell and pneumocyte, resulting in hemostatic disorder and ARDS. An influential biomarkers of poor outcome in COVID-19 are high circulating cytokines and D-dimer level. This latter is due to hyper-fibrinolysis and hyper-coagulation. Plasmin is a key player in fibrinolysis and is involved in the cleavage of many viruses envelop proteins, including SARS-CoV. This function is similar to that of TMPRSS2, which underpins the entry of viruses into the host cell. In addition, plasmin is involved in the pathophysiology of ARDS in SARS and promotes secretion of cytokine, such as IL-6 and TNF, from activated macrophages. Here, we suggest an out-of-the-box treatment for alleviating fibrinolysis and the ARDS of COVID-19 patients. This proposed treatment is concomitant administration of an anti-fibrinolytic drug and the anticoagulant.}, } @article {pmid33390994, year = {2020}, author = {Boulkrane, MS and Ilina, V and Melchakov, R and Fedotova, J and Drago, F and Gozzo, L and Das, UN and Abd El-Aty, AM and Baranenko, D}, title = {COVID-19 Disease and Vitamin D: A Mini-Review.}, journal = {Frontiers in pharmacology}, volume = {11}, number = {}, pages = {604579}, doi = {10.3389/fphar.2020.604579}, pmid = {33390994}, issn = {1663-9812}, abstract = {Novel coronavirus disease (COVID-19) pandemic caused by SARS-CoV-2, for which there is no effective treatment except employing prevention strategies, has already instituted significant number of deaths. In this review, we provide a scientific view on the potential role of vitamin D in SARS-CoV-2 virus/COVID-19 disease. Vitamin D is well-known to play a significant role in maintaining the immune health of an individual. Moreover, it induces antimicrobial peptide expression that can decrease viral replication and regulate the levels of pro-inflammatory/anti-inflammatory cytokines. Therefore, supplementation of vitamin D has the potential to reduce the incidence, severity and the risk of death from pneumonia resulting from the cytokine storm of many viral infections including COVID-19. We suggest that supplementation of subjects at high risk of COVID-19 with vitamin D (1.000 to 3.000 IU) to maintain its optimum serum concentrations may be of significant benefit for both in the prevention and treatment of the COVID-19.}, } @article {pmid33390974, year = {2020}, author = {Agarwal, M and Ranjan, P and Baitha, U and Mittal, A}, title = {Hydroxychloroquine as a Chemoprophylactic Agent for COVID-19: A Clinico-Pharmacological Review.}, journal = {Frontiers in pharmacology}, volume = {11}, number = {}, pages = {593099}, doi = {10.3389/fphar.2020.593099}, pmid = {33390974}, issn = {1663-9812}, abstract = {Hydroxychloroquine has gained much attention as one of the candidate drugs that can be repurposed as a prophylactic agent against SARS-CoV-2, the agent responsible for the COVID-19 pandemic. Due to high transmissibility and presence of asymptomatic carriers and presymptomatic transmission, there is need for a chemoprophylactic agent to protect the high-risk population. In this review, we dissect the currently available evidence on hydroxychloroquine prophylaxis from a clinical and pharmacological point of view. In vitro studies on Vero cells show that hydroxychloroquine effectively inhibits SARS-CoV-2 by affecting viral entry and viral transport via endolysosomes. However, this efficacy has failed to replicate in in vivo animal models as well as in most clinical observational studies and clinical trials assessing pre-exposure prophylaxis and postexposure prophylaxis in healthcare workers. An analysis of the pharmacology of HCQ in COVID-19 reveals certain possible reasons for this failure-a pharmacokinetic failure due to failure to achieve adequate drug concentration at the target site and attenuation of its inhibitory effect due to the presence of TMPRSS2 in airway epithelial cells. Currently, many clinical trials on HCQ prophylaxis in HCW are ongoing; these factors should be taken into account. Using higher doses of HCQ for prophylaxis is likely to be associated with increased safety concerns; thus, it may be worthwhile to focus on other possible interventions.}, } @article {pmid33390967, year = {2020}, author = {Andrade, BS and Rangel, FS and Santos, NO and Freitas, ADS and Soares, WRA and Siqueira, S and Barh, D and Góes-Neto, A and Birbrair, A and Azevedo, VAC}, title = {Repurposing Approved Drugs for Guiding COVID-19 Prophylaxis: A Systematic Review.}, journal = {Frontiers in pharmacology}, volume = {11}, number = {}, pages = {590598}, doi = {10.3389/fphar.2020.590598}, pmid = {33390967}, issn = {1663-9812}, abstract = {The SARS-CoV-2 outbreak originally appeared in China in December 2019 and became a global pandemic in March 2020. This infectious disease has directly affected public health and the world economy. Several palliative therapeutic treatments and prophylaxis strategies have been used to control the progress of this viral infection, including pre-(PrEP) and post-exposure prophylaxis. On the other hand, research groups around the world are still studying novel drug prophylaxis and treatment using repurposing approaches, as well as vaccination options, which are in different pre-clinical and clinical testing phases. This systematic review evaluated 1,228 articles from the PubMed and Scopus indexing databases, following the Kitchenham bibliographic searching protocol, with the aim to list drug candidates, potentially approved to be used as new options for SARS-CoV-2 prophylaxis clinical trials and medical protocols. In searching protocol, we used the following keywords: "Covid-19 or SARS-CoV-2" or "Coronavirus or 2019 nCoV," "prophylaxis," "prophylactic," "pre-exposure," "COVID-19 or SARS-CoV-2 Chemoprophylaxis," "repurposed," "strategies," "clinical," "trials," "anti-SARS-CoV-2," "anti-covid-19," "Antiviral," "Therapy prevention in vitro," in cells "and" human testing. After all protocol steps, we selected 60 articles that included: 15 studies with clinical data, 22 studies that used in vitro experiments, seven studies using animal models, and 18 studies performed with in silico experiments. Additionally, we included more 22 compounds between FDA approved drugs and drug-like like molecules, which were tested in large-scale screenings, as well as those repurposed approved drugs with new mechanism of actions. The drugs selected in this review can assist clinical studies and medical guidelines on the rational repurposing of known antiviral drugs for COVID-19 prophylaxis.}, } @article {pmid33390836, year = {2021}, author = {Awadasseid, A and Wu, Y and Tanaka, Y and Zhang, W}, title = {SARS-CoV-2 variants evolved during the early stage of the pandemic and effects of mutations on adaptation in Wuhan populations.}, journal = {International journal of biological sciences}, volume = {17}, number = {1}, pages = {97-106}, doi = {10.7150/ijbs.47827}, pmid = {33390836}, issn = {1449-2288}, abstract = {The outbreak of the coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The pandemic apparently started in December 2019 in Wuhan, China, and has since affected many countries worldwide, turning into a major global threat. Chinese researchers reported that SARS-CoV-2 could be classified into two major variants. They suggest that investigating the variations and characteristics of these variants might help assess risks and develop better treatment and prevention strategies. The two variants were named L-type and S-type, in which L-type was prevailed in an initial outbreak in Wuhan, Central China's Hubei Province, and S-type was phylogenetically older than L-type and less prevalent at an early stage, but with a later increase in frequency in Wuhan. There were 149 mutations in 103 sequenced SARS-CoV-2 genomes, 83 of which were nonsynonymous, leading to alteration in the amino acid sequence of proteins. Much effort is currently being devoted to elucidate whether or not these mutations affect viral transmissibility and virulence. In this review, we summarize the mutations in SARS-CoV-2 during the early phase of virus evolution and discuss the significance of the gene alterations in infections.}, } @article {pmid33390833, year = {2021}, author = {Goud, PT and Bai, D and Abu-Soud, HM}, title = {A Multiple-Hit Hypothesis Involving Reactive Oxygen Species and Myeloperoxidase Explains Clinical Deterioration and Fatality in COVID-19.}, journal = {International journal of biological sciences}, volume = {17}, number = {1}, pages = {62-72}, doi = {10.7150/ijbs.51811}, pmid = {33390833}, issn = {1449-2288}, abstract = {Multi-system involvement and rapid clinical deterioration are hallmarks of coronavirus disease 2019 (COVID-19) related mortality. The unique clinical phenomena in severe COVID-19 can be perplexing, and they include disproportionately severe hypoxemia relative to lung alveolar-parenchymal pathology and rapid clinical deterioration, with poor response to O2 supplementation, despite preserved lung mechanics. Factors such as microvascular injury, thromboembolism, pulmonary hypertension, and alteration in hemoglobin structure and function could play important roles. Overwhelming immune response associated with "cytokine storms" could activate reactive oxygen species (ROS), which may result in consumption of nitric oxide (NO), a critical vasodilation regulator. In other inflammatory infections, activated neutrophils are known to release myeloperoxidase (MPO) in a natural immune response, which contributes to production of hypochlorous acid (HOCl). However, during overwhelming inflammation, HOCl competes with O2 at heme binding sites, decreasing O2 saturation. Moreover, HOCl contributes to several oxidative reactions, including hemoglobin-heme iron oxidation, heme destruction, and subsequent release of free iron, which mediates toxic tissue injury through additional generation of ROS and NO consumption. Connecting these reactions in a multi-hit model can explain generalized tissue damage, vasoconstriction, severe hypoxia, and precipitous clinical deterioration in critically ill COVID-19 patients. Understanding these mechanisms is critical to develop therapeutic strategies to combat COVID-19.}, } @article {pmid33390829, year = {2021}, author = {Awadasseid, A and Wu, Y and Tanaka, Y and Zhang, W}, title = {Current advances in the development of SARS-CoV-2 vaccines.}, journal = {International journal of biological sciences}, volume = {17}, number = {1}, pages = {8-19}, doi = {10.7150/ijbs.52569}, pmid = {33390829}, issn = {1449-2288}, abstract = {Coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is now a global pandemic that has wreaked havoc globally, which has put a heavy toll on public health, lives, and the world economy. Vaccination is considered as one of the greatest successes in medical history. Based on prior experience with the development of SARS-CoV vaccines, all COVID-19 vaccines must be subjected to the tests for protective effects and harmful risks derived from antibody-dependent enhancement that may contribute to augmented infectivity and/or eosinophilic infiltration. The SARS-CoV-2 vaccine is now being developed urgently in several different ways. China is regarded as one of the world's leading countries in SARS-CoV-2 vaccine development, up to date the last inactivated vaccine international clinical (Phase III) trial was launched in the United Arab Emirates by Sinopharm China National Biotec Group (CNBG). In this review, we outline the current status of vaccine development against clinically relevant SARS-CoV-2 strains, anticipating that such attempts would help create efficacious and sage SARS-CoV-2 vaccines.}, } @article {pmid33390810, year = {2021}, author = {Han, J and Sun, J and Zhang, G and Chen, H}, title = {DCs-based therapies: potential strategies in severe SARS-CoV-2 infection.}, journal = {International journal of medical sciences}, volume = {18}, number = {2}, pages = {406-418}, doi = {10.7150/ijms.47706}, pmid = {33390810}, issn = {1449-1907}, abstract = {Pneumonia caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is spreading globally. There have been strenuous efforts to reveal the mechanisms that the host defends itself against invasion by this virus. The immune system could play a crucial role in virus infection. Dendritic cell as sentinel of the immune system plays an irreplaceable role. Dendritic cells-based therapeutic approach may be a potential strategy for SARS-CoV-2 infection. In this review, the characteristics of coronavirus are described briefly. We focus on the essential functions of dendritic cell in severe SARS-CoV-2 infection. Basis of treatment based dendritic cells to combat coronavirus infections is summarized. Finally, we propose that the combination of DCs based vaccine and other therapy is worth further study.}, } @article {pmid33390800, year = {2021}, author = {Ho, P and Zheng, JQ and Wu, CC and Hou, YC and Liu, WC and Lu, CL and Zheng, CM and Lu, KC and Chao, YC}, title = {Perspective Adjunctive Therapies for COVID-19: Beyond Antiviral Therapy.}, journal = {International journal of medical sciences}, volume = {18}, number = {2}, pages = {314-324}, doi = {10.7150/ijms.51935}, pmid = {33390800}, issn = {1449-1907}, abstract = {The coronavirus disease 2019 (COVID-19) pandemic is the largest health crisis ever faced worldwide. It has resulted in great health and economic costs because no effective treatment is currently available. Since infected persons vary in presentation from healthy asymptomatic mild symptoms to those who need intensive care support and eventually succumb to the disease, this illness is considered to depend primarily on individual immunity. Demographic distribution and disease severity in several regions of the world vary; therefore, it is believed that natural inherent immunity provided through dietary sources and traditional medicines could play an important role in infection prevention and disease progression. People can boost their immunity to prevent them from infection after COVID-19 exposure and can reduce their inflammatory reactions to protect their organ deterioration in case suffering from the disease. Some drugs with in-situ immunomodulatory and anti-inflammatory activity are also identified as adjunctive therapy in the COVID-19 era. This review discusses the importance of COVID-19 interactions with immune cells and inflammatory cells; and further emphasizes the possible pathways related with traditional herbs, medications and nutritional products. We believe that such pathophysiological pathway approach treatment is rational and important for future development of new therapeutic agents for prevention or cure of COVID-19 infection.}, } @article {pmid33390766, year = {2020}, author = {Borri, A and Palumbo, P and Papa, F and Possieri, C}, title = {Optimal design of lock-down and reopening policies for early-stage epidemics through SIR-D models.}, journal = {Annual reviews in control}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.arcontrol.2020.12.002}, pmid = {33390766}, issn = {1367-5788}, abstract = {The diffusion of COVID-19 represents a real threat for the health and economic system of a country. Therefore the governments have to adopt fast containment measures in order to stop its spread and to prevent the related devastating consequences. In this paper, a technique is proposed to optimally design the lock-down and reopening policies so as to minimize an aggregate cost function accounting for the number of individuals that decease due to the spread of COVID-19. A constraint on the maximal number of concomitant infected patients is also taken into account in order to prevent the collapse of the health system. The optimal procedure is built on the basis of a simple SIR model that describes the outbreak of a generic disease, without attempting to accurately reproduce all the COVID-19 epidemic features. This modeling choice is motivated by the fact that the containing measurements are actuated during the very first period of the outbreak, when the characteristics of the new emergent disease are not known but timely containment actions are required. In fact, as a consequence of dealing with poor preliminary data, the simplest modeling choice is able to reduce unidentifiability problems. Further, the relative simplicity of this model allows to compute explicitly its solutions and to derive closed-form expressions for the maximum number of infected and for the steady-state value of deceased individuals. These expressions can be then used to design static optimization problems so to determine the (open-loop) optimal lock-down and reopening policies for early-stage epidemics accounting for both the health and economic costs.}, } @article {pmid33390762, year = {2020}, author = {Ghati, A and Dam, P and Tasdemir, D and Kati, A and Sellami, H and Sezgin, GC and Ildiz, N and Franco, OL and Mandal, AK and Ocsoy, I}, title = {Exogenous pulmonary surfactant: a review focused on adjunctive therapy for SARS CoV-2 including SP-A and SP-D as added clinical marker.}, journal = {Current opinion in colloid & interface science}, volume = {}, number = {}, pages = {101413}, doi = {10.1016/j.cocis.2020.101413}, pmid = {33390762}, issn = {1359-0294}, abstract = {Type I and Type II pneumocytes are two forms of epithelial cells found lining the alveoli in the lungs. Type II pneumocytes exclusively secrete 'pulmonary surfactants', a lipo-protein complex made up of 90% lipids (mainly phospholipids) and 10% surfactant proteins (SP-A, SP-B, SP-C, and SP-D). Respiratory diseases like influenza, SARS-CoV and SARS-CoV-2 are reported to preferentially attack type II pneumocytes of the lungs. After viral invasion, consequent viral propagation and destruction of type II pneumocytes causes altered surfactant production, resulting in dyspnea and Acute respiratory distress syndrome (ARDS) in COVID-19 patients. Exogenous animal-derived or synthetic pulmonary surfactant therapy has already shown immense success in the treatment of neonatal respiratory distress syndrome (RDS) and has the potential to contribute efficiently to repairing damaged alveoli and preventing SARS-CoV-2-associated respiratory failure. Furthermore, the early detection of surfactant collectins (SP-A and SP-D) in the circulatory system can be a significant clinical marker for disease prognosis in the near future.}, } @article {pmid33390724, year = {2020}, author = {Widyadharma, IPE and Sari, NNSP and Pradnyaswari, KE and Yuwana, KT and Adikarya, IPGD and Tertia, C and Wijayanti, IAS and Indrayani, IAS and Utami, DKI}, title = {Pain as clinical manifestations of COVID-19 infection and its management in the pandemic era: a literature review.}, journal = {The Egyptian journal of neurology, psychiatry and neurosurgery}, volume = {56}, number = {1}, pages = {121}, doi = {10.1186/s41983-020-00258-0}, pmid = {33390724}, issn = {1110-1083}, abstract = {Coronavirus disease 2019 (COVID-19) is a current global pandemic. The case number has increased since December 31, 2019. It has been reported that COVID-19 patients have been giving pain complaints, one of which is muscular pain. Other types of pain that have also been reported by COVID-19 patients are joint pain, stomach pain, and testicular pain. Neuropathic pain is the rarest case among others. COVID-19 mechanisms in the nerve and musculoskeletal damage are believed to be caused by the expression and distribution of angiotensin-converting enzyme 2 (ACE-2). Patients with pain, especially neuropathic pain, normally do not respond well to various therapies, and experience psychiatric disorders such as depression, which leads to a decrease in the patient's quality of life. Important considerations for health professionals in terms of pain management during this pandemic include ensuring treatment continuity, painkillers, utilization of telemedicine, biopsychosocial management approach, and modifying therapy needs to reduce the risks of COVID-19 complications.}, } @article {pmid33390627, year = {2020}, author = {Nile, SH and Kai, G}, title = {Recent Clinical Trials on Natural Products and Traditional Chinese Medicine Combating the COVID-19.}, journal = {Indian journal of microbiology}, volume = {}, number = {}, pages = {1-6}, doi = {10.1007/s12088-020-00919-x}, pmid = {33390627}, issn = {0046-8991}, abstract = {The novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing potentially fatal coronavirus disease-19 (COVID-19), with a significant health and economic burden around the globe. Currently many clinical studies are undergoing but still there is no any specific approved therapy or drug established for effective treatment of COVID-19. This review aimed to analyses various clinical studies which have been registered in www.clinicaltrials.gov and http://www.chictr.org.cn were registered with natural plant-based medicines and Traditional Chinese medicine (TCM) for discovering effective treatment and prevention of COVID-19. Total 46 and 64 natural drug and TCM interventions were identified which mainly determined the preventive strategies and possible treatments for COVID-19 infection. We identified that most of the clinical trial undergoing on natural compound like heparin and vitamin C as therapeutic agents and immune boosters for against COVID-19. Traditional Chinese medicines and herbal medicines can be effectively used as a preventive therapy against COVID-19 and after successful clinical trials and these potential therapies can be promoted by countries around the world.

Supplementary Information: The online version contains supplementary material available at (10.1007/s12088-020-00919-x).}, } @article {pmid33390355, year = {2020}, author = {de Moraes, ÉB and Santos Garcia, JB and de Macedo Antunes, J and Daher, DV and Seixas, FL and Muniz Ferrari, MF}, title = {Chronic Pain Management during the Covid-19 Pandemic: A Scoping Review.}, journal = {Pain management nursing : official journal of the American Society of Pain Management Nurses}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.pmn.2020.11.010}, pmid = {33390355}, issn = {1532-8635}, abstract = {BACKGROUND: The COVID-19 pandemic has led caregivers to modify patient healthcare, with a high impact on patients with chronic pain.

AIMS: To map recommendations for the management of chronic pain patients during the COVID-19 pandemic and propose a workflow for the management of these patients.

DESIGN: This was a scoping review.

METHODS: The databases searched were PubMed, Embase, CINAHL, Scopus, Cochrane Library, and LILACS. The studies were examined by two independent reviewers. The disagreements between reviewers were resolved through discussion or with a third reviewer.

RESULTS: We presented the results in the form of a table, a workflow, and a narrative summary. The search resulted in 13 studies selected for full reading, including one consensus, five guidance documents, two expert panels, one joint statement, two educational flyers, and two free comments. We considered new technologies, including telemedicine. Each pain service needs to establish a screening model, classifying patients according to corresponding severity. Particular attention should be given to patients who use opioids and are at risk of misusing them. Nonpharmacological approaches and pain education should be maintained, considering the use of telehealth.

CONCLUSIONS: Recommendations for the management of chronic pain during COVID-19 include adjustments to the patient care model. The workflow proposes the use of telemedicine, screening for painful intensity, and the use of color-signaled intervention packages according to severity (green, yellow, and red).}, } @article {pmid33390183, year = {2021}, author = {Mohammad, S and Aziz, R and Al Mahri, S and Malik, SS and Haji, E and Khan, AH and Khatlani, TS and Bouchama, A}, title = {Obesity and COVID-19: what makes obese host so vulnerable?.}, journal = {Immunity & ageing : I & A}, volume = {18}, number = {1}, pages = {1}, pmid = {33390183}, issn = {1742-4933}, support = {RC13/268R//King Abdullah International Medical Research Center/ ; }, abstract = {The disease (COVID-19) novel coronavirus pandemic has so far infected millions resulting in the death of over a million people as of Oct 2020. More than 90% of those infected with COVID-19 show mild or no symptoms but the rest of the infected cases show severe symptoms resulting in significant mortality. Age has emerged as a major factor to predict the severity of the disease and mortality rates are significantly higher in elderly patients. Besides, patients with underlying conditions like Type 2 diabetes, cardiovascular diseases, hypertension, and cancer have an increased risk of severe disease and death due to COVID-19 infection. Obesity has emerged as a novel risk factor for hospitalization and death due to COVID-19. Several independent studies have observed that people with obesity are at a greater risk of severe disease and death due to COVID-19. Here we review the published data related to obesity and overweight to assess the possible risk and outcome in Covid-19 patients based on their body weight. Besides, we explore how the obese host provides a unique microenvironment for disease pathogenesis, resulting in increased severity of the disease and poor outcome.}, } @article {pmid33390179, year = {2021}, author = {Li, M and Schifanella, L and Larsen, PA}, title = {Alu retrotransposons and COVID-19 susceptibility and morbidity.}, journal = {Human genomics}, volume = {15}, number = {1}, pages = {2}, pmid = {33390179}, issn = {1479-7364}, abstract = {SARS-CoV-2 has spread rapidly across the world and is negatively impacting the global human population. COVID-19 patients display a wide variety of symptoms and clinical outcomes, including those attributed to genetic ancestry. Alu retrotransposons have played an important role in human evolution, and their variants influence host response to viral infection. Intronic Alus regulate gene expression through several mechanisms, including both genetic and epigenetic pathways. With respect to SARS-CoV-2, an intronic Alu within the ACE gene is hypothesized to be associated with COVID-19 susceptibility and morbidity. Here, we review specific Alu polymorphisms that are of particular interest when considering host response to SARS-CoV-2 infection, especially polymorphic Alu insertions in genes associated with immune response and coagulation/fibrinolysis cascade. We posit that additional research focused on Alu-related pathways could yield novel biomarkers capable of predicting clinical outcomes as well as patient-specific treatment strategies for COVID-19 and related infectious diseases.}, } @article {pmid33353545, year = {2020}, author = {Rogani, S and Calsolaro, V and Franchi, R and Calabrese, AM and Okoye, C and Monzani, F}, title = {Spontaneous muscle hematoma in older patients with COVID-19: two case reports and literature review.}, journal = {BMC geriatrics}, volume = {20}, number = {1}, pages = {539}, pmid = {33353545}, issn = {1471-2318}, mesh = {Aged ; Aged, 80 and over ; *COVID-19/complications ; China ; Female ; *Hematoma/diagnosis/etiology ; Heparin, Low-Molecular-Weight ; Humans ; Male ; Muscles ; SARS-CoV-2 ; }, abstract = {BACKGROUND: In late December 2019, a cluster of pneumonia cases due to a novel betacoronavirus, SARS-CoV-2 was reported in China. The so-called COVID 19 is responsible not only for respiratory symptoms, from mild up to pneumonia and even acute respiratory distress syndrome, but also for extrapulmonary involvement.

CASES PRESENTATION: Here we present two cases of spontaneous muscle hematoma in patients with SARS-CoV-2 infection, both on therapeutic LMWH for atrial fibrillation: the first one was an 86-year-old Caucasian female with a history of hypertensive cardiomyopathy and the second one was an 81-year-old Caucasian male with a history of hypertension, diabetes and ischemic heart disease. Blood tests revealed a considerable drop of hemoglobin and alterations of coagulation system. In both cases, embolization of femoral artery was performed. A few other cases of bleeding manifestations are reported in literature, while a lot has been published about the hypercoagulability related to COVID-19.

CONCLUSIONS: Our reports and literature review highlight the need of active surveillance for possible hemorrhagic complications in patients with SARS-CoV-2 infection.}, } @article {pmid33351362, year = {2020}, author = {Rozhivanov, RV and Andreeva, EN and Melnichenko, GA and Mokrysheva, NG}, title = {[Androgens and Antiandrogens influence on COVID-19 disease in men].}, journal = {Problemy endokrinologii}, volume = {66}, number = {4}, pages = {77-81}, doi = {10.14341/probl12500}, pmid = {33351362}, issn = {2308-1430}, mesh = {Androgen Antagonists/therapeutic use ; Androgens/*genetics ; COVID-19/complications/drug therapy/*genetics/virology ; Humans ; Hyperandrogenism/complications/drug therapy/*epidemiology/virology ; Male ; Pandemics ; SARS-CoV-2/pathogenicity ; Serine Endopeptidases/*genetics ; }, abstract = {The WHO has declared a SARS-CoV-2 pandemic. During a pandemic, the researches aimed at finding the new treatments for SARS-CoV-2 become relevant. The review focuses on studies of androgens and antiandrogens in this disease. Since the beginning of the COVID-19 epidemic, it has been noted that men have more severe forms of infection and higher mortality. The main cause of both the severity of the disease and the high mortality of men from COVID-19 are associated with androgens. It was found that patients receiving androgen deprivation are less likely to become infected and easily tolerate COVID-19. The researchers explain the effect of the therapy by the effect on the TMPRSS2 protein. It was found that both TMPRSS2 expression and a more severe course of coronavirus infection are observed in men with hyperandrogenism - androgenic alopecia, acne, excessive facial hair growth and increased skin oiliness. In this regard, some researchers suggest to use androgen deprivation for men at high risk of developing COVID-19. Steroid and non-steroidal antiandrogens are used for androgen deprivation. At the same time, obtaned scientific data on the relationship of severe forms and mortality of COVID-19 with low testosterone levels leads to a hypothesis about the possibility of a positive effect not of androgen devrivation therapy but of androgen replacement therapy in case of hypogonadism have diagnosed. These studies have not been completed recently, and data on the effectiveness and safety of antiandrogens and androgens in the treatment of a new coronavirus infection require clarification.}, } @article {pmid33351354, year = {2020}, author = {Troshina, EA and Yukina, MY and Nuralieva, NF and Mokrysheva, NG}, title = {[The role of HLA genes: from autoimmune diseases to COVID-19].}, journal = {Problemy endokrinologii}, volume = {66}, number = {4}, pages = {9-15}, doi = {10.14341/probl12470}, pmid = {33351354}, issn = {2308-1430}, mesh = {Alleles ; Autoimmune Diseases/epidemiology/genetics/*immunology/virology ; COVID-19/epidemiology/*genetics/immunology/virology ; Cytokine Release Syndrome/*genetics/immunology/virology ; Genetic Predisposition to Disease ; HLA Antigens/genetics/*immunology ; Humans ; SARS-CoV-2/genetics/pathogenicity ; }, abstract = {Genes of HLA system (Human Leukocyte Antigen) play an essential role in the normal functioning of the immune system. There are three classes of genes: I, II, and III. The function of HLA molecules class I is to present antigens of peptides from the cytoplasm to T-lymphocytes on the cell surface, and class II - to present antigens of peptides from the extracellular space. In the classical view, the pathological activation of the immune system in patients with a genetic predisposition can result in the development of autoimmune diseases. However, the influence of this system on the development of non-autoimmune diseases, their severity and prognosis, has been recently considered. Besides, HLA molecules provide a presentation of various infectious agents. In this connection, the loci of the main histocompatibility complex can be considered candidates for determining the genetic predisposition to infectious diseases themselves and their course. This review hypothesizes that specific variants of HLA genes may cause the formation of a «cytokine storm» in patients with COVID-19. Identification of a group of patients with particular genetic variations that cause violation of immune tolerance and hyperresponse in the setting of viral infection will help to optimize the algorithm for disease prevention and treatment of such patients and, as a result, to reduce the severity of the epidemiological situation.}, } @article {pmid33351308, year = {2020}, author = {Mokrysheva, NG and Galstyan, GR and Kirzhakov, MA and Eremkina, AK and Pigarova, EA and Melnichenko, GA}, title = {[COVID-19 pandemic and endocrinopathies].}, journal = {Problemy endokrinologii}, volume = {66}, number = {1}, pages = {7-13}, doi = {10.14341/probl12376}, pmid = {33351308}, issn = {2308-1430}, mesh = {Aged ; Aged, 80 and over ; Ambulatory Care ; COVID-19/complications/*epidemiology/virology ; Endocrine System Diseases/complications/*epidemiology/virology ; Female ; Humans ; Male ; Middle Aged ; *Pandemics ; Physicians ; Risk Factors ; SARS-CoV-2/*pathogenicity ; }, abstract = {Many endocrinopathies have chronic course; patients with endocrinopathies (above all diabetes mellitus and thyroid diseases) who receive outpatient care on a regular basis amount up to 80% of patients with chronic diseases. Endocrinologists most likely play the role of general practitioners for these patients; therefore, they should quickly and efficiently explain the patients with diabetes, thyroid, hypophysis and adrenal diseases how to behave in new setting of COVID19 pandemic (coronavirus infection). The most severe course of the infection can be observed in patients older than 65 years with chronic diseases, especially endocrinopathies. This review sums up the currently available data on the disease pathogenesis and progression. It also provides information about patient responsibility to prevent infection, special aspects of communication between the patient and the physician in the setting of self-isolation and quarantine, additional care needed in case of COVID19 in patients with most severe endocrinopathies.}, } @article {pmid33350622, year = {2021}, author = {White, D and Gee, PO and Temple, T}, title = {COVID-19: The Patients' Perspectives.}, journal = {Transplantation}, volume = {105}, number = {1}, pages = {4-5}, doi = {10.1097/TP.0000000000003525}, pmid = {33350622}, issn = {1534-6080}, mesh = {COVID-19/*epidemiology ; Comorbidity ; Humans ; Organ Transplantation/*methods ; *Pandemics ; *SARS-CoV-2 ; Surveys and Questionnaires ; Transplant Recipients/*statistics & numerical data ; }, } @article {pmid33345626, year = {2021}, author = {Adu-Amankwaah, J and Mprah, R and Adekunle, AO and Ndzie Noah, ML and Adzika, GK and Machuki, JO and Sun, H}, title = {The cardiovascular aspect of COVID-19.}, journal = {Annals of medicine}, volume = {53}, number = {1}, pages = {227-236}, doi = {10.1080/07853890.2020.1861644}, pmid = {33345626}, issn = {1365-2060}, mesh = {Angiotensin-Converting Enzyme 2/*metabolism ; COVID-19/*metabolism/physiopathology ; Coronavirus Infections/*metabolism/physiopathology ; Endothelium, Vascular/*metabolism ; Humans ; Renin-Angiotensin System ; SARS-CoV-2/*metabolism ; }, abstract = {The coronavirus disease-2019 (COVID-19), an infectious disease caused by Severe Acute Respiratory Syndrome Coronavirus 2(SARS-CoV-2), has hit the world very hard by affecting millions of people across countries hence posing a major health threat on a global scale. This novel virus is thought to enter and cause infection in its host through the attachment of its structural protein known as the S-glycoprotein to angiotensin-converting enzyme 2 (ACE2). Given the rapid spread of COVID-19 with its consequences globally, it is mandatory that health caregivers and researchers across all disciplines abreast themselves with the potential effects that this novel virus may have on their fields and the medical society at large. During the infection, the cardiovascular system is affected by unknown pathomechanistic processes, hence accounting for an increased prevalence of cardiovascular diseases (CVDs) among COVID-19 patients. As cardiovascular researchers, we are more concerned about the cardiovascular aspect of SARS-CoV-2/COVID-19. Hence, this concise review addresses these aspects where CVD as a risk factor of COVID-19, the prevalence of CVDs in COVID-19, and the potential cardiovascular disorders which may evolve owing to COVID-19 are discussed. A better understanding of these issues will be pivotal to improve cardiovascular health during this SARS-CoV-2/COVID-19 pandemic and beyond.}, } @article {pmid33338073, year = {2020}, author = {Kathree, BA and Khan, SB and Ahmed, R and Maart, R and Layloo, N and Asia-Michaels, W}, title = {COVID-19 and its impact in the dental setting: A scoping review.}, journal = {PloS one}, volume = {15}, number = {12}, pages = {e0244352}, doi = {10.1371/journal.pone.0244352}, pmid = {33338073}, issn = {1932-6203}, mesh = {COVID-19/*epidemiology/*prevention & control ; Dentistry/*methods/*trends ; Disinfection ; Ethics, Medical ; Humans ; Infection Control/*methods ; Pandemics ; Practice Guidelines as Topic ; United States ; }, abstract = {INTRODUCTION: The scoping review examined the evidence related to infection control and transmission measures of the SARS-CoV-2 virus in a dental setting during this pandemic. Dental practitioners are normally guided in practice by set ethical principles, thus the researchers wanted to determine how these rules are managed during this pandemic.

METHODS: A protocol specific for the objectives of this study was developed according to the criteria for a scoping review. Relevant databases (Pubmed, Scopus, Elsevier, Science Direct, Wiley), including online access to health/ dental organizations (World Health Organization/ American Dental Association), were searched to identify evidence which was restricted to the English language for the period 2015-2020. Predetermined eligibility criteria were applied, evidence was assessed and data extracted for each included article. Relevant outcomes assessed were: infection control measures, transmission of the SARS-CoV-2 virus, such as modes and sources of transmission and the ethical principles related to the dental setting with a focus on the COVID-19 pandemic.

RESULTS: Searches yielded a total of 402 articles: 387 from electronic databases and 15 from other sources. Of these, 231 were unrelated to the objectives of the current scoping review. The full text of 69 studies was assessed for eligibility, of which 26 were finalized for inclusion following the objectives and inclusion criteria set for the scoping review. Most of the included articles were reviews, recommendations and guidelines for dentists. A narrative explanation of the pre-specified outcomes is reported for the 3 areas covered for this review. There is no clinical evidence available that can support the recommendations by individuals, dental organizations or health authorities related to the objectives of this review, but these may be considered as the much needed guidelines during the unprecedented COVID-19 pandemic. A different ethical framework is required during a pandemic and these must be informed by evidence.}, } @article {pmid33337934, year = {2020}, author = {Xia, H and Shi, PY}, title = {Antagonism of Type I Interferon by Severe Acute Respiratory Syndrome Coronavirus 2.}, journal = {Journal of interferon & cytokine research : the official journal of the International Society for Interferon and Cytokine Research}, volume = {40}, number = {12}, pages = {543-548}, pmid = {33337934}, issn = {1557-7465}, support = {U19 AI142759/AI/NIAID NIH HHS/United States ; R01 AI134907/AI/NIAID NIH HHS/United States ; R43 AI145617/AI/NIAID NIH HHS/United States ; UL1 TR001439/TR/NCATS NIH HHS/United States ; }, mesh = {Antiviral Agents/therapeutic use ; COVID-19/*immunology ; COVID-19 Vaccines ; Humans ; Immune System ; *Immunity, Innate ; Interferon Type I/*immunology ; Mutation ; Phosphorylation ; SARS-CoV-2/*immunology/physiology ; Signal Transduction ; Viral Nonstructural Proteins/*immunology ; Virus Replication ; }, abstract = {The coronavirus disease 2019 (COVID-19) pandemic is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), warranting urgent study of the molecular mechanisms of SARS-CoV-2 infection and host immune response. Type I interferon (IFN-I) is a key component of host innate immune system responsible for eliminating the virus at the early stage of infection. In contrast, SARS-CoV-2 has evolved multiple strategies to evade innate immune response to facilitate viral replication, transmission, and pathogenesis. This review summarizes the recent progresses on SARS-CoV-2 proteins that antagonize host IFN-I production and/or signaling. These progresses have provided knowledge for new vaccine and antiviral development to prevent and control COVID-19.}, } @article {pmid33337932, year = {2020}, author = {Liu, BM and Hill, HR}, title = {Role of Host Immune and Inflammatory Responses in COVID-19 Cases with Underlying Primary Immunodeficiency: A Review.}, journal = {Journal of interferon & cytokine research : the official journal of the International Society for Interferon and Cytokine Research}, volume = {40}, number = {12}, pages = {549-554}, pmid = {33337932}, issn = {1557-7465}, mesh = {COVID-19/*complications/*immunology ; Comorbidity ; Disease Susceptibility ; Humans ; *Immune System ; Immunity, Innate ; Immunoglobulins, Intravenous/metabolism ; *Inflammation ; Interferon Regulatory Factor-7/metabolism ; Pandemics ; Primary Immunodeficiency Diseases/*complications/*immunology ; Receptor, Interferon alpha-beta/metabolism ; Risk ; Toll-Like Receptor 3/metabolism ; Toll-Like Receptor 7/metabolism ; }, abstract = {Coronavirus disease 2019 (COVID-19) has spread rapidly and become a pandemic. Caused by a novel human coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), severe COVID-19 is characterized by cytokine storm syndromes due to innate immune activation. Primary immunodeficiency (PID) cases represent a special patient population whose impaired immune system might make them susceptible to severe infections, posing a higher risk to COVID-19, but this could also lead to suppressed inflammatory responses and cytokine storm. It remains an open question as to whether the impaired immune system constitutes a predisposing or protective factor for PID patients when facing SARS-CoV-2 infection. After literature review, it was found that, similar to other patient populations with different comorbidities, PID patients may be susceptible to SARS-CoV-2 infection. Their varied immune status, however, may lead to different disease severity and outcomes after SARS-CoV-2 infection. PID patients with deficiency in antiviral innate immune signaling [eg, Toll-like receptor (TLR)3, TLR7, or interferon regulatory factor 7 (IRF7)] or interferon signaling (IFNAR2) may be linked to severe COVID-19. Because of its anti-infection, anti-inflammatory, and immunomodulatory effects, routine intravenous immunoglobulin therapy may provide some protective effects to the PID patients.}, } @article {pmid33332288, year = {2020}, author = {Gao, J and Quan, L}, title = {Current Status of Diagnostic Testing for SARS-CoV-2 Infection and Future Developments: A Review.}, journal = {Medical science monitor : international medical journal of experimental and clinical research}, volume = {26}, number = {}, pages = {e928552}, pmid = {33332288}, issn = {1643-3750}, mesh = {COVID-19/*diagnosis ; COVID-19 Testing/*methods ; COVID-19 Vaccines ; Clinical Laboratory Techniques/methods ; Diagnostic Techniques and Procedures ; Diagnostic Tests, Routine/methods ; Humans ; Pandemics/prevention & control ; SARS-CoV-2/*genetics/*immunology/pathogenicity ; Viral Load ; Virus Replication ; }, abstract = {The coronavirus disease 2019 (COVID-19) caused by a novel coronavirus, SARS-CoV-2, has infected more than 50.6 million individuals and caused over 1.2 million deaths globally, raising a major health concern. To date, no specific antiviral treatment or vaccine for COVID-19 has been approved by the Food and Drug Administration (FDA). Highly sensitive and specific laboratory diagnostics are therefore critical for controlling the rapidly evolving COVID-19 pandemic and optimizing clinical care, infection control, and public health interventions. The FDA has issued emergency use authorization (EUA) for hundreds of COVID-19 diagnostic tests of different classes. Whereas nucleic acid testing (NAT) such as RT-PCR remains the criterion standard for COVID-19 diagnosis, serological antibody and antigen tests are increasingly being developed. Tests based on the novel RNA sensing techniques (e.g., SHERLOCK, DETECTR, and Toehold Switch) are promising due to their relatively low cost, high accuracy, and rapid detection time. Diagnostic testing results for SARS-CoV-2 should be interpreted with caution, since they depend heavily on factors such as viral load, virus replication, the source and timing of sample collection, sample extraction, and characteristics of various testing methods. This review aims to present the current status of common diagnostic testing for SARS-CoV-2 infection, review the current regulatory requirements, and identify future directions in the development of improved diagnostics that are more accurate, accessible, and rapid.}, } @article {pmid33315637, year = {2021}, author = {Florio, G and Zanella, A and Pesenti, A}, title = {Preparedness of ICU networks for pandemics.}, journal = {Current opinion in critical care}, volume = {27}, number = {1}, pages = {13-19}, doi = {10.1097/MCC.0000000000000792}, pmid = {33315637}, issn = {1531-7072}, mesh = {*COVID-19 ; *Civil Defense ; Critical Care ; Humans ; *Intensive Care Units ; *Pandemics ; SARS-CoV-2 ; }, abstract = {PURPOSE OF REVIEW: The recent COVID-19 outbreak has clearly shown how epidemics/pandemics can challenge developed countries' healthcare systems. Proper management of equipment and human resources is critical to provide adequate medical care to all patients admitted to the hospital and the ICU for both pandemic-related and unrelated reasons.

RECENT FINDINGS: Appropriate separate paths for infected and noninfected patients and prompt isolation of infected critical patients in dedicated ICUs play a pivotal role in limiting the contagions and optimizing resources during pandemics. The key to handle these challenging events is to learn from past experiences and to be prepared for future occurrences. Hospital space should be redesigned to quickly increase medical and critical care capacity, and healthcare workers (critical and noncritical) should be trained in advance.

SUMMARY: A targeted improvement of hospital and ICU protocols will increase medical care quality for patients admitted to the hospital for any clinical reasons during a pandemic.}, } @article {pmid33315636, year = {2021}, author = {Grasselli, G and Cattaneo, E and Scaravilli, V}, title = {Ventilation of coronavirus disease 2019 patients.}, journal = {Current opinion in critical care}, volume = {27}, number = {1}, pages = {6-12}, pmid = {33315636}, issn = {1531-7072}, mesh = {*COVID-19 ; Humans ; Lung ; *Respiration, Artificial ; *Respiratory Distress Syndrome/therapy ; SARS-CoV-2 ; Tidal Volume ; }, abstract = {PURPOSE OF REVIEW: To summarize the current knowledge of pathophysiology and ventilatory management of acute respiratory failure in COVID-19.

RECENT FINDINGS: Early reports suggested that COVID-19 is an 'atypical ARDS' with profound hypoxemia with normal respiratory system compliance (Crs). Contrarily, several more populated analyses showed that COVID-19 ARDS has pathophysiological features similar to non-COVID-19 ARDS, with reduced Crs, and high heterogeneity of respiratory mechanics, hypoxemia severity, and lung recruitability. There is no evidence supporting COVID-19-specific ventilatory settings, and the vast amount of available literature suggests that evidence-based, lung-protective ventilation (i.e. tidal volume ≤6 ml/kg, plateau pressure ≤30 cmH2O) should be enforced in all mechanically ventilated patients with COVID-19 ARDS. Mild and moderate COVID-19 can be managed outside of ICUs by noninvasive ventilation in dedicated respiratory units, and no evidence support an early vs. late intubation strategy. Despite widely employed, there is no evidence supporting the efficacy of rescue therapies, such as pronation, inhaled vasodilators, or extracorporeal membrane oxygenation.

SUMMARY: Given the lack of evidence-based specific ventilatory strategies and a large amount of literature showing pathophysiological features similar to non-COVID-19 ARDS, evidence-based lung-protective ventilatory strategies should be pursued in all patients with COVID-19 ARDS.}, } @article {pmid33308504, year = {2020}, author = {Truong, T and Dittmar, M and Ghaffari, A and Lin, E}, title = {Policy and Pandemic: The Changing Practice of Nephrology During the Coronavirus Disease-2019 Outbreak.}, journal = {Advances in chronic kidney disease}, volume = {27}, number = {5}, pages = {390-396}, pmid = {33308504}, issn = {1548-5609}, support = {K08 DK118213/DK/NIDDK NIH HHS/United States ; }, mesh = {Ambulatory Care Facilities ; Anastomosis, Surgical ; Arteries/surgery ; Blood Vessel Prosthesis Implantation ; *COVID-19 ; Centers for Medicare and Medicaid Services, U.S. ; Computer Security ; Delivery of Health Care/methods/standards ; Disaster Planning ; *Health Policy ; Health Services Accessibility ; Hemodialysis Solutions/supply & distribution ; Hemodialysis, Home/methods/standards ; Humans ; Kidney Failure, Chronic/*therapy ; *Nephrology ; Organization and Administration/standards ; Personal Autonomy ; Personal Protective Equipment ; Quality Assurance, Health Care ; Reimbursement Mechanisms ; Renal Dialysis/instrumentation/*methods/standards ; SARS-CoV-2 ; Telemedicine/*methods/standards ; United States ; Veins/surgery ; }, abstract = {The coronavirus (coronavirus disease-2019) pandemic has changed care delivery for patients with end-stage kidney disease. We explore the US healthcare system as it pertains to dialysis care, including existing policies, modifications implemented in response to the coronavirus disease-2019 crisis, and possible next steps for policy makers and nephrologists. This includes policies related to resource management, use of telemedicine, prioritization of dialysis access procedures, expansion of home dialysis modalities, administrative duties, and quality assessment. The government has already established policies that have instated some flexibilities to help providers focus their response to the crisis. However, future policy during and after the coronavirus disease-2019 pandemic can bolster our ability to optimize care for patients with end-stage kidney disease. Key themes in this perspective are the importance of policy flexibility, clear strategies for emergency preparedness, and robust health systems that maximize accessibility and patient autonomy.}, } @article {pmid33278160, year = {2021}, author = {Scully, EP}, title = {Hidden in plain sight: sex and gender in global pandemics.}, journal = {Current opinion in HIV and AIDS}, volume = {16}, number = {1}, pages = {48-53}, doi = {10.1097/COH.0000000000000661}, pmid = {33278160}, issn = {1746-6318}, support = {K08 AI116344/AI/NIAID NIH HHS/United States ; R01 AI154541/AI/NIAID NIH HHS/United States ; }, mesh = {Animals ; COVID-19/epidemiology/*virology ; Female ; HIV/genetics/physiology ; HIV Infections/virology ; Humans ; Male ; Pandemics ; SARS-CoV-2/genetics/*physiology ; Sex Factors ; }, abstract = {PURPOSE OF REVIEW: The global pandemic caused by the severe acute respiratory virus coronavirus 2 (SARS-CoV-2) has a male bias in mortality likely driven by both gender and sex-based differences between male and female individuals. This is consistent with sex and gender-based features of HIV infection and overlap between the two diseases will highlight potential mechanistic pathways of disease and guide research questions and policy interventions. In this review, the emerging findings from SARS-CoV-2 infection will be placed in the context of sex and gender research in the more mature HIV epidemic.

RECENT FINDINGS: This review will focus on the new field of literature on prevention, immunopathogenesis and treatment of SARS-CoV-2 referencing relevant articles in HIV for context from a broader time period, consistent with the evolving understanding of sex and gender in HIV infection. Sex-specific features of epidemiology and immunopathogenesis reported in COVID-19 disease will be discussed and potential sex and gender-specific factors of relevance to prevention and treatment will be emphasized.

SUMMARY: Multilayered impacts of sex and gender on HIV infection have illuminated pathways of disease and identified important goals for public health interventions. SARS-CoV-2 has strong evidence for a male bias in disease severity and exploring that difference will yield important insights.}, } @article {pmid33278121, year = {2021}, author = {Gonzalez, H and Horie, S and Laffey, JG}, title = {Emerging cellular and pharmacologic therapies for acute respiratory distress syndrome.}, journal = {Current opinion in critical care}, volume = {27}, number = {1}, pages = {20-28}, doi = {10.1097/MCC.0000000000000784}, pmid = {33278121}, issn = {1531-7072}, mesh = {*COVID-19/complications ; Humans ; *Hydroxymethylglutaryl-CoA Reductase Inhibitors/therapeutic use ; *Mesenchymal Stem Cells ; *Respiratory Distress Syndrome/complications/drug therapy ; SARS-CoV-2 ; }, abstract = {PURPOSE OF REVIEW: Advances in our understanding of the pathophysiology and biology of ARDS has identified a number of promising cellular and pharmacological therapies. These emerging therapeutics can modulate the immune response, reduce epithelial injury, target endothelial and vascular dysfunction, have anticoagulant effects, and enhance ARDS resolution.

RECENT FINDINGS: Mesenchymal stromal cell therapy shows promise in earlier phase clinical testing, whereas a number of issues regarding clinical translation, such as donor and effect variability, are currently being optimized to enable larger scale clinical trials. Furthermore, a number of promising mesenchymal stromal cell therapy clinical studies for COVID-19-induced ARDS are underway. Recent studies provide support for several emerging ARDS pharmacotherapies, including steroids, statins, vitamins, anticoagulants, interferons, and carbon monoxide. The history of unsuccessful clinical trials of potential therapies highlights the challenges to successful translation for this heterogeneous clinical syndrome. Given this, attention has focused on the potential to identify biologically homogenous subtypes within ARDS, to enable us to target more specific therapies, i.e. 'precision medicines'.

SUMMARY: Mesenchymal stromal cells, steroids, statins, vitamins, anticoagulants, interferons and carbon monoxide have therapeutic promise for ARDS. Identifying ARDS sub-populations most likely to benefit from targeted therapies may facilitate future advances.}, } @article {pmid33274643, year = {2020}, author = {Dawoud, D and Chalkidou, K and Sullivan, R and Ruiz, FJ and Adler, A}, title = {USA stockpiling of remdesivir: How should the world respond?.}, journal = {Journal of comparative effectiveness research}, volume = {9}, number = {18}, pages = {1243-1246}, doi = {10.2217/cer-2020-0174}, pmid = {33274643}, issn = {2042-6313}, mesh = {Adenosine Monophosphate/*analogs & derivatives/therapeutic use ; Alanine/*analogs & derivatives/therapeutic use ; Antiviral Agents/*therapeutic use ; COVID-19/*drug therapy ; Humans ; *International Cooperation ; *Internationality ; SARS-CoV-2 ; Strategic Stockpile/*methods ; United States ; }, abstract = {The race to find an effective treatment for coronavirus disease 2019 (COVID-19) is still on, with only two treatment options currently authorized for emergency use and/or recommended for patients hospitalized with severe respiratory symptoms: low-dose dexamethasone and remdesivir. The USA decision to stockpile the latter has resulted in widespread condemnation and in similar action being taken by some other countries. In this commentary we discuss whether stockpiling remdesivir is justified in light of the currently available evidence.}, } @article {pmid33245242, year = {2020}, author = {Rafiullah, M and Siddiqui, K}, title = {Corticosteroid use in viral pneumonia: experience so far and the dexamethasone breakthrough in coronavirus disease-2019.}, journal = {Journal of comparative effectiveness research}, volume = {9}, number = {18}, pages = {1247-1254}, doi = {10.2217/cer-2020-0146}, pmid = {33245242}, issn = {2042-6313}, mesh = {Adrenal Cortex Hormones/*therapeutic use ; COVID-19/*diagnostic imaging ; Dexamethasone/*therapeutic use ; Female ; Humans ; Pneumonia, Viral/*drug therapy ; Retrospective Studies ; SARS-CoV-2 ; Treatment Outcome ; }, abstract = {Dexamethasone was shown to decrease the mortality in coronavirus disease-2019 (COVID-19) recently. Use of corticosteroids was harmful in other coronavirus infections previously. WHO recommended against routine use of corticosteroids in COVID-19. In view of these, we reviewed the evidence about the use of corticosteroids in virus-induced acute respiratory distress syndrome (ARDS). Corticosteroids are beneficial in ARDS regardless of etiology. However, they increased the mortality rate in influenza-associated ARDS. In SARS and the Middle East respiratory syndrome, corticosteroids increased the mortality, delayed the viral clearance and increased the length of hospital stay. In the case of COVID-19, the available evidence from retrospective and observational studies is inconclusive about the corticosteroid use. Low-dose therapies appear to be effective. Evidence from a randomized control study found dexamethasone is effective in decreasing mortality in severe COVID-19 cases. More studies are needed to validate the benefit of corticosteroids in COVID-19.}, } @article {pmid33229949, year = {2021}, author = {Mendoza, P and Lorenzi, JCC and Gaebler, C}, title = {COVID-19 antibody development fueled by HIV-1 broadly neutralizing antibody research.}, journal = {Current opinion in HIV and AIDS}, volume = {16}, number = {1}, pages = {25-35}, doi = {10.1097/COH.0000000000000657}, pmid = {33229949}, issn = {1746-6318}, support = {UL1 TR001866/TR/NCATS NIH HHS/United States ; }, mesh = {Animals ; Antibodies, Viral/administration & dosage/*immunology ; Biomedical Research/trends ; Broadly Neutralizing Antibodies/administration & dosage/*immunology ; COVID-19/drug therapy/immunology/*virology ; HIV Infections/*immunology/virology ; HIV-1/genetics/*immunology ; Humans ; SARS-CoV-2/genetics/*immunology ; }, abstract = {PURPOSE OF REVIEW: The coronavirus disease 2019 (COVID-19) pandemic has caught the world unprepared, with no prevention or treatment strategies in place. In addition to the efforts to develop an effective vaccine, alternative approaches are essential to control this pandemic, which will most likely require multiple readily available solutions. Among them, monoclonal anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies have been isolated by multiple laboratories in record time facilitated by techniques that were first pioneered for HIV-1 antibody discovery. Here, we summarize how lessons learned from anti-HIV-1 antibody discovery have provided fundamental knowledge for the rapid development of anti-SARS-CoV-2 antibodies.

RECENT FINDINGS: Research laboratories that successfully identified potent broadly neutralizing antibodies against HIV-1 have harnessed their antibody discovery techniques to isolate novel potent anti-SARS-CoV-2 antibodies, which have efficacy in animal models. These antibodies represent promising clinical candidates for treatment or prevention of COVID-19.

SUMMARY: Passive transfer of antibodies is a promising approach when the elicitation of protective immune responses is difficult, as in the case of HIV-1 infection. Antibodies can also play a significant role in post-exposure prophylaxis, in high-risk populations that may not mount robust immune responses after vaccination, and in therapy. We provide a review of the recent approaches used for anti-SARS-CoV-2 antibody discovery and upcoming challenges in the field.}, } @article {pmid33216637, year = {2021}, author = {Dewan, A and Mitra, S and Aggarwal, S and Barik, S and Kaur, I and Umesh, P and Dewan, R}, title = {Management of cervical cancer during the corona virus disease-19 (COVID-19) era.}, journal = {The British journal of radiology}, volume = {94}, number = {1117}, pages = {20200686}, doi = {10.1259/bjr.20200686}, pmid = {33216637}, issn = {1748-880X}, mesh = {*COVID-19/prevention & control/transmission ; Female ; Humans ; Infectious Disease Transmission, Patient-to-Professional/prevention & control ; Uterine Cervical Neoplasms/*radiotherapy ; }, abstract = {COVID-19 pandemic has had a catastrophic impact on the society, economy and heath-care system all over the globe with virus showing no signs of losing potency. As the situation appears to worsen, extra burden on other specialities like oncology seems to increase. Specific recommendations are necessary for management of cervical cancer in the current context. All concerned specialities must work together in the best interest of the patient. Attempts should be made at managing cervical cancer while limiting the viral spread among the patients and health-care workers without the loss of opportunity. Surgical intervention for early cervical cancer should be postponed or alternative modalities be considered. In a locally advanced disease, concurrent chemoradiation is the treatment of choice. In addition, the following under mentioned suggestions aim to discuss ways of minimizing infection spread, workload rationalization and providing guidance for management of cervical cancer in the presence of COVID-19 infection.}, } @article {pmid33190321, year = {2021}, author = {Cabibbo, G and Rizzo, GEM and Stornello, C and Craxì, A}, title = {SARS-CoV-2 infection in patients with a normal or abnormal liver.}, journal = {Journal of viral hepatitis}, volume = {28}, number = {1}, pages = {4-11}, pmid = {33190321}, issn = {1365-2893}, mesh = {COVID-19/*complications/epidemiology/prevention & control/therapy ; COVID-19 Vaccines/administration & dosage ; Chronic Disease ; Humans ; Liver/*injuries/virology ; Liver Cirrhosis/complications/epidemiology/therapy ; Liver Diseases/*complications/epidemiology/therapy ; Risk ; SARS-CoV-2/*pathogenicity ; }, abstract = {Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), a novel coronavirus causing coronavirus disease 19 (COVID-19), with an estimated 22 million people infected worldwide so far although involving primarily the respiratory tract, has a remarkable tropism for the liver and the biliary tract. Patients with SARS-CoV-2 infection and no antecedent liver disease may display evidence of cytolytic liver damage, proportional to the severity of COVID-19 but rarely of clinical significance. The mechanism of hepatocellular injury is unclear and possibly multifactorial. The clinical impact of SARS-CoV-2 infection in patients with underlying chronic liver disease, a cohort whose global size is difficult to estimate, has been assessed appropriately only recently and data are still evolving. Patients with cirrhosis are at higher risk of developing severe COVID-19 and worse liver-related outcomes as compared to those with non-cirrhotic liver disease. OLT patients have an intermediate risk. Specific interventions in order to reduce the risk of transmission of infection among this high-risk population have been outlined by international societies, together with recommendations for modified treatment and follow-up regimens during the COVID-19 pandemic. When a vaccine against SARS-CoV-2 becomes available, patients with fibrotic liver disease and those with OLT should be considered as prime targets for prophylaxis of COVID-19, as all other highly susceptible subjects.}, } @article {pmid33187758, year = {2021}, author = {Luo, Y and Yuan, J and Liu, M and Fang, N and Bai, J and Fei, X and Deng, Y and Yu, T and Mao, J and Zhu, H and Li, C and Peng, Q and Zhang, M and Zeng, S and Xu, G and Niu, C and Dong, T and He, W and Tang, J}, title = {Chinese Expert Consensus on Protection for Ultrasound Healthcare Workers against COVID-19.}, journal = {Ultrasound in medicine & biology}, volume = {47}, number = {2}, pages = {222-229}, doi = {10.1016/j.ultrasmedbio.2020.10.006}, pmid = {33187758}, issn = {1879-291X}, mesh = {COVID-19/*prevention & control ; China ; Consensus ; Disinfection ; *Health Personnel ; Humans ; Infectious Disease Transmission, Patient-to-Professional/*prevention & control ; Occupational Exposure/prevention & control ; Personal Protective Equipment ; Quarantine ; Triage ; Ultrasonography/*methods ; }, abstract = {Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has caused a worldwide pandemic and poses a serious public health risk. It has been proven that lung ultrasound can be extremely valuable in the diagnosis and treatment of the disease, which could also minimize the number of exposed healthcare workers and equipment. Because healthcare workers in ultrasound departments are in close contact with patients who might be infected or virus carriers, it is extremely important that they be provided sufficient protection. Extremely aggressive protection should be avoided because it might lead to a lack of protection equipment for the hospital. Guidance on proper protection management should be provided in detail, for example, how to choose personal protective equipment, how to disinfect the environment. To address these problems, on behalf of the Chinese Ultrasound Doctors Association, Chinese PLA Professional Committee of Ultrasound in Medicine, Beijing Institute of Ultrasound in Medicine and Chinese Research Hospital Association Ultrasound Professional Committee, the authors have summarized the recommendations for effective protection according to existing hygienic standards, their experience and available literature. After the recommendations were completed, two online conferences were held on January 31, 2020 and February 7, 2020, at which the recommendations were discussed in detail. A modified version of the work was circulated and finally approved by all authors, and is the present Chinese Expert Consensus on Protection for Ultrasound Healthcare Workers against COVID-19.}, } @article {pmid33186231, year = {2021}, author = {Ge, J and Zhang, S and Zhang, L and Wang, X}, title = {Structural basis of severe acute respiratory syndrome coronavirus 2 infection.}, journal = {Current opinion in HIV and AIDS}, volume = {16}, number = {1}, pages = {74-81}, doi = {10.1097/COH.0000000000000658}, pmid = {33186231}, issn = {1746-6318}, mesh = {Angiotensin-Converting Enzyme 2/chemistry/genetics/metabolism ; Animals ; Binding Sites ; COVID-19/enzymology/genetics/*virology ; Humans ; Protein Binding ; SARS-CoV-2/chemistry/genetics/*metabolism ; Spike Glycoprotein, Coronavirus/*chemistry/genetics/metabolism ; }, abstract = {PURPOSE OF REVIEW: The spike glycoprotein plays a critical role in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection by recognizing the angiotensin converting enzyme 2 (ACE2) receptor and mediating fusion of the viral envelope with the cell membrane. It is also the major target for neutralizing antibodies and vaccines. This review summarizes recent studies on the structure and function of spike glycoprotein, which revealed the structural basis of SARS-CoV-2 infection.

RECENT FINDINGS: SARS-CoV-2 spike glycoprotein, similar to those of SARS-CoV and Middle East respiratory syndrome coronavirus, spontaneously samples different prefusion states with the receptor-binding domain (RBD) adopting 'up' or 'down' conformations, and the RBD 'down' to 'up' conformational change is required for ACE2 binding. Receptor binding and spike glycoprotein priming by host proteases such as furin and transmembrane protease serine 2 induce pre to postfusion conformational changes of the spike trimer that enable membrane fusion. Interactions between SARS-CoV-2 RBD and ACE2 were elucidated at atomic resolution using high-resolution crystal structures. These structures, together with adapted and remodeled SARS-CoV-2 strains, further revealed critical residues of the spike glycoprotein for SARS-CoV-2 infection and cross-species transmission.

SUMMARY: Recent studies on SARS-CoV-2 spike glycoprotein provide important structural knowledge for a better understanding of the molecular mechanisms of SARS-CoV-2 infection and cross-species transmission.}, } @article {pmid33186230, year = {2021}, author = {Lorenzo-Redondo, R and Ozer, EA and Achenbach, CJ and D'Aquila, RT and Hultquist, JF}, title = {Molecular epidemiology in the HIV and SARS-CoV-2 pandemics.}, journal = {Current opinion in HIV and AIDS}, volume = {16}, number = {1}, pages = {11-24}, pmid = {33186230}, issn = {1746-6318}, support = {K22 AI136691/AI/NIAID NIH HHS/United States ; }, mesh = {COVID-19/epidemiology/*virology ; HIV/classification/*genetics/isolation & purification ; HIV Infections/epidemiology/*virology ; Humans ; Molecular Epidemiology ; Pandemics ; SARS-CoV-2/classification/*genetics/isolation & purification ; }, abstract = {PURPOSE OF REVIEW: The aim of this review was to compare and contrast the application of molecular epidemiology approaches for the improved management and understanding of the HIV versus SARS-CoV-2 epidemics.

RECENT FINDINGS: Molecular biology approaches, including PCR and whole genome sequencing (WGS), have become powerful tools for epidemiological investigation. PCR approaches form the basis for many high-sensitivity diagnostic tests and can supplement traditional contact tracing and surveillance strategies to define risk networks and transmission patterns. WGS approaches can further define the causative agents of disease, trace the origins of the pathogen, and clarify routes of transmission. When coupled with clinical datasets, such as electronic medical record data, these approaches can investigate co-correlates of disease and pathogenesis. In the ongoing HIV epidemic, these approaches have been effectively deployed to identify treatment gaps, transmission clusters and risk factors, though significant barriers to rapid or real-time implementation remain critical to overcome. Likewise, these approaches have been successful in addressing some questions of SARS-CoV-2 transmission and pathogenesis, but the nature and rapid spread of the virus have posed additional challenges.

SUMMARY: Overall, molecular epidemiology approaches offer unique advantages and challenges that complement traditional epidemiological tools for the improved understanding and management of epidemics.}, } @article {pmid33186229, year = {2021}, author = {Brown, LB and Spinelli, MA and Gandhi, M}, title = {The interplay between HIV and COVID-19: summary of the data and responses to date.}, journal = {Current opinion in HIV and AIDS}, volume = {16}, number = {1}, pages = {63-73}, pmid = {33186229}, issn = {1746-6318}, support = {R01 AI158013/AI/NIAID NIH HHS/United States ; }, mesh = {COVID-19/complications/epidemiology/mortality/*virology ; Europe/epidemiology ; HIV/genetics/*physiology ; HIV Infections/complications/epidemiology/mortality/*virology ; Humans ; Pandemics ; SARS-CoV-2/genetics/*physiology ; South Africa/epidemiology ; United States/epidemiology ; }, abstract = {PURPOSE OF REVIEW: We examine the interplay between the HIV and COVID-19 epidemics, including the impact of HIV on COVID-19 susceptibility and severe disease, the effect of the COVID-19 epidemic on HIV prevention and treatment, and the influence of the HIV epidemic on responses to COVID-19.

RECENT FINDINGS: Evidence to date does not suggest that people living with HIV (PLWH) have a markedly higher susceptibility to SARS-CoV-2 infection, with disparities in the social determinants of health and comorbidities likely having a greater influence. The majority of literature has not supported a higher risk for severe disease among PLWH in Europe and the United States, although a large, population-based study in South Africa reported a higher rate of death due to COVID-19. Higher rates of comorbidities associated with COVID-19 disease severity among PLWH is an urgent concern. COVID-19 is leading to decreased access to HIV prevention services and HIV testing, and worsening HIV treatment access and virologic suppression, which could lead to worsening HIV epidemic control.

CONCLUSION: COVID-19 is threatening gains against the HIV epidemic, including the U.S. Ending the HIV Epidemic goals. The ongoing collision of these two global pandemics will continue to need both study and interventions to mitigate the effects of COVID-19 on HIV efforts worldwide.}, } @article {pmid33186228, year = {2021}, author = {McCormick, KD and Mellors, JW and Jacobs, JL}, title = {Adaptation of advanced clinical virology assays from HIV-1 to SARS-CoV-2.}, journal = {Current opinion in HIV and AIDS}, volume = {16}, number = {1}, pages = {3-10}, pmid = {33186228}, issn = {1746-6318}, mesh = {COVID-19/blood/diagnosis/*virology ; HIV Infections/blood/diagnosis/*virology ; HIV-1/genetics/*isolation & purification ; Humans ; RNA, Viral/blood/*genetics ; SARS-CoV-2/genetics/*isolation & purification ; }, abstract = {PURPOSE OF REVIEW: In response to the HIV-AIDS pandemic, great strides have been made in developing molecular methods that accurately quantify nucleic acid products of HIV-1 at different stages of viral replication and to assess HIV-1 sequence diversity and its effect on susceptibility to small molecule inhibitors and neutralizing antibodies. Here, we review how knowledge gained from these approaches, including viral RNA quantification and sequence analyses, have been rapidly applied to study SARS-CoV-2 and the COVID-19 pandemic.

RECENT FINDINGS: Recent studies have shown detection of SARS-CoV-2 RNA in blood of infected individuals by reverse transcriptase PCR (RT-PCR); and, as in HIV-1 infection, there is growing evidence that the level of viral RNA in plasma may be related to COVID disease severity. Unlike HIV-1, SARS-CoV-2 sequences are highly conserved limiting SARS-CoV-2 sequencing applications to investigating interpatient genetic diversity for phylogenetic analysis. Sensitive sequencing technologies, originally developed for HIV-1, will be needed to investigate intrapatient SARS-CoV-2 genetic variation in response to antiviral therapeutics and vaccines.

SUMMARY: Methods used for HIV-1 have been rapidly applied to SARS-CoV-2/COVID-19 to understand pathogenesis and prognosis. Further application of such methods should improve precision of therapy and outcome.}, } @article {pmid33165008, year = {2021}, author = {Collora, JA and Liu, R and Albrecht, K and Ho, YC}, title = {The single-cell landscape of immunological responses of CD4+ T cells in HIV versus severe acute respiratory syndrome coronavirus 2.}, journal = {Current opinion in HIV and AIDS}, volume = {16}, number = {1}, pages = {36-47}, doi = {10.1097/COH.0000000000000655}, pmid = {33165008}, issn = {1746-6318}, support = {R01 AI141009/AI/NIAID NIH HHS/United States ; R61 DA047037/DA/NIDA NIH HHS/United States ; R37 AI147868/AI/NIAID NIH HHS/United States ; R01 DA051906/DA/NIDA NIH HHS/United States ; UM1 DA051410/DA/NIDA NIH HHS/United States ; P50 AI150464/AI/NIAID NIH HHS/United States ; UM1 AI126620/AI/NIAID NIH HHS/United States ; T32 AI055403/AI/NIAID NIH HHS/United States ; }, mesh = {Animals ; CD4-Positive T-Lymphocytes/*immunology ; COVID-19/genetics/*immunology/virology ; Cytokines/genetics/immunology ; HIV Infections/genetics/*immunology/virology ; Humans ; Pandemics ; SARS-CoV-2/genetics/*immunology ; }, abstract = {PURPOSE OF REVIEW: CD4 T cell loss is the hallmark of uncontrolled HIV-1 infection. Strikingly, CD4 T cell depletion is a strong indicator for disease severity in the recently emerged coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. We reviewed recent single-cell immune profiling studies in HIV-1 infection and COVID-19 to provide critical insight in virus-induced immunopathogenesis.

RECENT FINDINGS: Cytokine dysregulation in HIV-1 leads to chronic inflammation, while severe SARS-CoV-2 infection induces cytokine release syndrome and increased mortality. HIV-1-specific CD4 T cells are dysfunctional, while SARS-CoV-2-specific CD4 T cells exhibit robust Th1 function and correlate with protective antibody responses. In HIV-1 infection, follicular helper T cells (TFH) are susceptible to HIV-1 infection and persist in immune-sanctuary sites in lymphoid tissues as an HIV-1 reservoir. In severe SARS-CoV-2 infection, TFH are absent in lymphoid tissues and are associated with diminished protective immunity. Advancement in HIV-1 DNA, RNA, and protein-based single-cell capture methods can overcome the rarity and heterogeneity of HIV-1-infected cells and identify mechanisms of HIV-1 persistence and clonal expansion dynamics.

SUMMARY: Single-cell immune profiling identifies a high-resolution picture of immune dysregulation in HIV-1 and SARS-CoV-2 infection and informs outcome prediction and therapeutic interventions.}, } @article {pmid33165007, year = {2021}, author = {Johnston, R}, title = {The first 6 months of HIV-SARS-CoV-2 coinfection: outcomes for 6947 individuals.}, journal = {Current opinion in HIV and AIDS}, volume = {16}, number = {1}, pages = {54-62}, doi = {10.1097/COH.0000000000000654}, pmid = {33165007}, issn = {1746-6318}, mesh = {Animals ; COVID-19/epidemiology/*virology ; Coinfection/epidemiology/*virology ; HIV/genetics/*physiology ; HIV Infections/epidemiology/*virology ; Humans ; Pandemics ; SARS-CoV-2/genetics/*physiology ; }, abstract = {PURPOSE OF REVIEW: The aim of this review is to summarize the clinical outcomes of people living with HIV (PWH) coinfected with SARS-CoV-2 during the first six months of the COVID-19 pandemic.

RECENT FINDINGS: Several reports from single centers have described increased, decreased, or no difference in outcomes of COVID-19 in PWH. These studies have come from a range of locations, each with different underlying HIV prevalence and access to various antiretroviral therapy (ART) regimens. Differences in healthcare quality, access and policies may also affect reported outcomes in PWH across different locations, making interpretation of results more challenging. Meanwhile, different components of ART have been proposed to protect against SARS-CoV-2 acquisition or disease progression.

SUMMARY: The current review considers 6 months of data across geographic regions with a range of healthcare quality and access and ART regimens to generate a wider view of COVID-19 outcomes in PWH. Taken together, these studies indicate that HIV infection may be associated with increased risk of COVID-19 diagnosis, but comorbidities appear to play a larger role than HIV-specific variables in outcomes of COVID-19 among PWH. ART does not appear to protect from COVID-19 disease acquisition, progression or death.}, } @article {pmid33153930, year = {2020}, author = {Martini, C and Nicolò, M and Tombolesi, A and Negri, J and Brazzo, O and Di Feo, D and Devetti, A and Rigott, IG and Risoli, C and Antonucci, GW and Durante, S and Migliorini, M}, title = {Phase 3 of COVID-19: Treat your patients and care for your radiographers. A designed projection for an aware and innovative radiology department.}, journal = {Journal of medical imaging and radiation sciences}, volume = {51}, number = {4}, pages = {531-534}, doi = {10.1016/j.jmir.2020.08.019}, pmid = {33153930}, issn = {1876-7982}, mesh = {*Allied Health Personnel ; COVID-19/*diagnostic imaging/*prevention & control/therapy ; Humans ; Infectious Disease Transmission, Patient-to-Professional/*prevention & control ; Lung/diagnostic imaging ; Personal Protective Equipment ; *Radiology Department, Hospital ; Tomography, X-Ray Computed/methods ; }, } @article {pmid33086903, year = {2021}, author = {Stroebe, M and Schut, H}, title = {Bereavement in Times of COVID-19: A Review and Theoretical Framework.}, journal = {Omega}, volume = {82}, number = {3}, pages = {500-522}, doi = {10.1177/0030222820966928}, pmid = {33086903}, issn = {1541-3764}, mesh = {*Adaptation, Psychological ; *Bereavement ; COVID-19/*psychology ; Humans ; Quarantine/*psychology ; }, abstract = {A review of the literature on adaptation to bereavement during the COVID-19 pandemic was conducted to assess the current state of knowledge. Scopus, Web of Science and Google Scholar databases were searched for studies published during the first 6 months of the COVID-19 outbreak. 44 articles were included in the review. Narrative synthesis showed that knowledge was largely based on expert assessments of prior bereavement research and professional experience; there is so far absence of empirical evidence linking features of COVID-19 bereavement situations to health outcomes. Severe negative consequences have been consistently predicted by authors. There is still relatively little consideration of positive or compensatory processes or the possibility that these could alleviate the effect of the shocking, traumatic circumstances. With two notable exceptions, there has been lack of attention to the role of theoretical models for guiding research and practice. A theoretical perspective (the Dual Process Model, DPM) was applied to the information derived from the available articles. Two features of the DPM framework illustrated its relevance: 1. It enables systematic assessment of the range of loss- and restoration-related challenges for the bereaved; 2. It speaks for extension of psychotherapeutic intervention to manage secondary, restoration- as well as primary, loss-oriented stressors; studies have demonstrated that this may increase the effectiveness of intervention. Directions for future research and DPM application are suggested.}, } @article {pmid33086867, year = {2021}, author = {Gao, Y and Galis, ZS}, title = {Exploring the Role of Endothelial Cell Resilience in Cardiovascular Health and Disease.}, journal = {Arteriosclerosis, thrombosis, and vascular biology}, volume = {41}, number = {1}, pages = {179-185}, doi = {10.1161/ATVBAHA.120.314346}, pmid = {33086867}, issn = {1524-4636}, mesh = {Animals ; Cardiovascular Diseases/*physiopathology ; Endothelium, Vascular/*physiopathology ; Humans ; Risk Factors ; Vasodilation/*physiology ; }, abstract = {Traditionally, much research effort has been invested into focusing on disease, understanding pathogenic mechanisms, identifying risk factors, and developing effective treatments. A few recent studies unraveling the basis for absence of disease, including cardiovascular disease, despite existing risk factors, a phenomenon commonly known as resilience, are adding new knowledge and suggesting novel therapeutic approaches. Given the central role of endothelial function in cardiovascular health, we herein provide a number of considerations that warrant future research and considering a paradigm shift toward identifying the molecular underpinnings of endothelial resilience.}, } @article {pmid33086866, year = {2021}, author = {Sakamoto, A and Kawakami, R and Kawai, K and Gianatti, A and Pellegrini, D and Kutys, R and Guo, L and Mori, M and Cornelissen, A and Sato, Y and Bellasi, A and Faggi, L and Hong, C and Romero, M and Guagliumi, G and Virmani, R and Finn, AV}, title = {ACE2 (Angiotensin-Converting Enzyme 2) and TMPRSS2 (Transmembrane Serine Protease 2) Expression and Localization of SARS-CoV-2 Infection in the Human Heart.}, journal = {Arteriosclerosis, thrombosis, and vascular biology}, volume = {41}, number = {1}, pages = {542-544}, doi = {10.1161/ATVBAHA.120.315229}, pmid = {33086866}, issn = {1524-4636}, mesh = {Angiotensin-Converting Enzyme 2/biosynthesis/*genetics ; COVID-19/epidemiology/*metabolism ; *Gene Expression Regulation ; Humans ; Myocardium/*metabolism ; Pandemics ; RNA/*genetics ; *SARS-CoV-2 ; Serine Endopeptidases/biosynthesis/*genetics ; }, } @article {pmid33012053, year = {2021}, author = {Anjorin, AA and Abioye, AI and Asowata, OE and Soipe, A and Kazeem, MI and Adesanya, IO and Raji, MA and Adesanya, M and Oke, FA and Lawal, FJ and Kasali, BA and Omotayo, MO}, title = {Comorbidities and the COVID-19 pandemic dynamics in Africa.}, journal = {Tropical medicine & international health : TM & IH}, volume = {26}, number = {1}, pages = {2-13}, doi = {10.1111/tmi.13504}, pmid = {33012053}, issn = {1365-3156}, abstract = {The debate around the COVID-19 response in Africa has mostly focused on effects and implications of public health measures, in light of the socio-economic peculiarities of the continent. However, there has been limited exploration of the impact of differences in epidemiology of key comorbidities, and related healthcare factors, on the course and parameters of the pandemic. We summarise what is known about (a) the pathophysiological processes underlying the interaction of coinfections and comorbidities in shaping prognosis of COVID-19 patients, (b) the epidemiology of key coinfections and comorbidities, and the state of related healthcare infrastructure that might shape the course of the pandemic, and (c) implications of (a) and (b) for pandemic management and post-pandemic priorities. There is a critical need to generate empirical data on clinical profiles and the predictors of morbidity and mortality from COVID-19. Improved protocols for acute febrile illness and access to diagnostic facilities, not just for SARS-CoV-2 but also other viral infections, are of urgent importance. The role of malaria, HIV/TB and chronic malnutrition on pandemic dynamics should be further investigated. Although chronic non-communicable diseases account for a relatively lighter burden, they have a significant effect on COVID-19 prognosis, and the fragility of care delivery systems implies that adjustments to clinical procedures and re-organisation of care delivery that have been useful in other regions are unlikely to be feasible. Africa is a large region with local variations in factors that can shape pandemic dynamics. A one-size-fits-all response is not optimal, but there are broad lessons relating to differences in epidemiology and healthcare delivery factors, that should be considered as part of a regional COVID-19 response framework.}, } @article {pmid33012020, year = {2021}, author = {Wibawa, T}, title = {COVID-19 vaccine research and development: ethical issues.}, journal = {Tropical medicine & international health : TM & IH}, volume = {26}, number = {1}, pages = {14-19}, doi = {10.1111/tmi.13503}, pmid = {33012020}, issn = {1365-3156}, abstract = {The achievements of vaccine research and development bring a hope to our societies that we may cope with the COVID-19 pandemic. There are two aspects that should be maintained in balance: the immediate necessity for speed of vaccine research and the inherent need for protection of research subjects, which is the foremost concern of research ethics. This narrative review highlights ethical issues in COVID-19 vaccine research and development that every stakeholder needs to be aware of and to consider.}, } @article {pmid32981889, year = {2020}, author = {Currie, G and Hewis, J and Nelson, T and Chandler, A and Nabasenja, C and Spuur, K and Barry, K and Frame, N and Kilgour, A}, title = {COVID-19 impact on undergraduate teaching: Medical radiation science teaching team experience.}, journal = {Journal of medical imaging and radiation sciences}, volume = {51}, number = {4}, pages = {518-527}, doi = {10.1016/j.jmir.2020.09.002}, pmid = {32981889}, issn = {1876-7982}, mesh = {Australia ; COVID-19/*prevention & control ; Education, Distance/*methods ; Education, Medical, Undergraduate/*methods ; *Faculty ; Humans ; Radiology/*education ; }, abstract = {The COVID-19 crisis has caused a number of significant challenges to the higher education sector. Universities worldwide have been forced to rapidly transition to online delivery, working at home, and disruption to research while concurrently facing the longer-term impacts in institution financial reform. Here, the impact of COVID-19 on academic staff in the medical radiation science (MRS) teaching team at Charles Sturt University are explored. While COVID-19 imposes potentially the greatest challenge many of us will experience in our personal and professional lifetimes, it also affords the opportunity to objectively re-evaluate and, where appropriate, re-design learning and teaching in higher education. Technology has allowed rapid assimilation to online learning environments with additional benefits that allow flexible, mobile, agile, sustainable, culturally safe and equitable learning focussed educational environments in the post-COVID-19 "new normal".}, } @article {pmid32981180, year = {2021}, author = {Stroman, L and Cathcart, P and Lamb, A and Challacombe, B and Popert, R}, title = {A cross-section of UK prostate cancer diagnostics during the coronavirus disease 2019 (COVID-19) era - a shifting paradigm?.}, journal = {BJU international}, volume = {127}, number = {1}, pages = {30-34}, doi = {10.1111/bju.15259}, pmid = {32981180}, issn = {1464-410X}, mesh = {COVID-19/*epidemiology ; Comorbidity ; Humans ; Incidence ; Male ; Neoplasm Staging/*methods ; Prostate/*pathology ; Prostatic Neoplasms/*diagnosis/epidemiology ; *SARS-CoV-2 ; United Kingdom/epidemiology ; }, } @article {pmid32943234, year = {2021}, author = {Graham, RNJ and Woodhead, T}, title = {Leadership for continuous improvement in healthcare during the time of COVID-19.}, journal = {Clinical radiology}, volume = {76}, number = {1}, pages = {67-72}, doi = {10.1016/j.crad.2020.08.008}, pmid = {32943234}, issn = {1365-229X}, mesh = {COVID-19/*therapy ; Humans ; *Leadership ; Pandemics ; Quality Improvement/*organization & administration ; }, abstract = {Designing safe, effective, efficient, equitable, and person-centred services normally takes some time and a great deal of stakeholder engagement and shared understanding to gain traction. This year has seen a significant acceleration of these activities plus new organisational and clinical collaborations and rapid cycle learning systems as a result of the challenges associated with the COVID-19 pandemic response. Whether it is a WhatsApp group where clinician's share their real-time understanding of a new disease or a collaboration of manufacturing organisations and clinicians to develop new/more equipment, change and innovation are working at an accelerating pace. We have built upon the NHS leadership guide we used in the College's leadership development programme and 2019 webinars, Developing People, Improving Care. We explain how using the guide and new evidence in support of the approach along with the learning from 2020 could ensure that excellent innovations and ways of working remain while others are adapted as the crisis evolves to a new normal. Our intention is to provide a road map and personal and team strategies that will deliver ongoing and strong clinical leadership as well as improved quality of care.}, } @article {pmid32907790, year = {2020}, author = {Heng, AL and Ooi, CC and Wen Eu, BJ and San Kiew, Y and Wong, ASK and Da Zhuang, K}, title = {The bug stops with me: Prevention of COVID-19 nosocomial transmission during radiographic procedures.}, journal = {Journal of medical imaging and radiation sciences}, volume = {51}, number = {4}, pages = {540-545}, doi = {10.1016/j.jmir.2020.07.054}, pmid = {32907790}, issn = {1876-7982}, mesh = {COVID-19/*prevention & control ; Cross Infection/*prevention & control ; Humans ; Infection Control/*methods ; Personal Protective Equipment ; *Radiography ; Singapore ; }, abstract = {INTRODUCTION: Nosocomial transmission of Coronavirus Disease 2019 (COVID-19) is a preventable risk to the patient population and radiographer workforce. This article aims to describe the prevention of COVID-19 nosocomial transmission during radiographic procedures by the utilization of stringent infection prevention measures at a leading tertiary hospital in Singapore.

METHODS: The implemented measures are the appropriate use of personal protective equipment, staff education, infection controls measures such as equipment disinfection, physical distancing and segregation of staff and patients.

RESULTS: Despite the handling of 1637 COVID-19 cases as of July 25, 2020, there has not been a single case of known nosocomial transmission of the disease in the institution.

DISCUSSION: The absence of nosocomial transmission suggests that the implemented measures are adequate. These measures will need to be sustainable for the long term in order to ensure continued success.

CONCLUSION: Radiographers are a crucial part of the team in the fight against COVID-19 and are at risk of contracting COVID-19. Strict adherence to appropriate infection control measures is essential for the safety of Radiology staff and their patients, and the successful control of this pandemic.}, } @article {pmid33389725, year = {2021}, author = {Kaur, H and Shekhar, N and Sharma, S and Sarma, P and Prakash, A and Medhi, B}, title = {Ivermectin as a potential drug for treatment of COVID-19: an in-sync review with clinical and computational attributes.}, journal = {Pharmacological reports : PR}, volume = {}, number = {}, pages = {}, pmid = {33389725}, issn = {1734-1140}, abstract = {INTRODUCTION: COVID-19 cases are on surge; however, there is no efficient treatment or vaccine that can be used for its management. Numerous clinical trials are being reviewed for use of different drugs, biologics, and vaccines in COVID-19. A much empirical approach will be to repurpose existing drugs for which pharmacokinetic and safety data are available, because this will facilitate the process of drug development. The article discusses the evidence available for the use of Ivermectin, an anti-parasitic drug with antiviral properties, in COVID-19.

METHODS: A rational review of the drugs was carried out utilizing their clinically significant attributes. A more thorough understanding was met by virtual embodiment of the drug structure and realizable viral targets using artificial intelligence (AI)-based and molecular dynamics (MD)-simulation-based study.

CONCLUSION: Certain studies have highlighted the significance of ivermectin in COVID-19; however, it requires evidences from more Randomised Controlled Trials (RCTs) and dose- response studies to support its use. In silico-based analysis of ivermectin's molecular interaction specificity using AI and classical mechanics simulation-based methods indicates positive interaction of ivermectin with viral protein targets, which is leading for SARS-CoV 2 N-protein NTD (nucleocapsid protein N-terminal domain).}, } @article {pmid33389724, year = {2021}, author = {Singh, A and Gupta, V}, title = {SARS-CoV-2 therapeutics: how far do we stand from a remedy?.}, journal = {Pharmacological reports : PR}, volume = {}, number = {}, pages = {}, pmid = {33389724}, issn = {1734-1140}, abstract = {The SARS-CoV-2 has affected millions worldwide and has posed an immediate need for effective pharmacological interventions. Ever since the outbreak was declared, the medical fraternity across the world is facing a unique situation of offering assistance and simultaneously generating reliable data with high-quality evidence to extend the scope of finding a treatment. With no proven vaccine or other interventions available hitherto, there is a frenzied urgency of sharing preliminary data from laboratories and trials to shape a global response against the virus. Several clinical trials with investigational and approved repurposed therapeutics have shown promising results. This review aims to compile the information of the reported molecules approved for emergency use and those under clinical trials and still others with good results in the studies conducted so far. Being an RNA virus, SARS-CoV-2 is prone to mutation; thus, the possibility of gaining resistance to available drugs is high. Consequently, a cocktail therapy based on drug interaction with different stages of its replicative cycle is desirable to reduce the chances of evolving drug resistance. Since this virus encodes several proteins, including 16 nonstructural and 4 structural proteins, this review also offers an insight into potential drug targets within SARS-CoV-2.}, } @article {pmid33389708, year = {2021}, author = {Lin, HXJ and Cho, S and Meyyur Aravamudan, V and Sanda, HY and Palraj, R and Molton, JS and Venkatachalam, I}, title = {Remdesivir in Coronavirus Disease 2019 (COVID-19) treatment: a review of evidence.}, journal = {Infection}, volume = {}, number = {}, pages = {}, pmid = {33389708}, issn = {1439-0973}, abstract = {COVID-19 is an infectious disease caused by a novel β-coronavirus, belonging to the same subgenus as the Severe Acute Respiratory Syndrome (SARS) virus. Remdesivir, an investigational broad-spectrum antiviral agent has previously demonstrated in vitro activity against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), and in vivo efficacy against other related coronaviruses in animal models. Its safety profile has been tested in a compassionate use setting for patients with COVID-19. The current therapeutic studies demonstrate clinical effectiveness of remdesivir in COVID-19 patients by shortening time to clinical recovery, and hospital stay. In this review, we critically analyze the current evidence of remdesivir against COVID-19 and dissect the aspects over its safety and efficacy. Based on existing data, remdesivir can be regarded as a potential therapeutic agent against COVID-19. Further large-scale, randomized placebo-controlled clinical trials are, however, awaited to validate these findings.}, } @article {pmid33389508, year = {2021}, author = {Cai, R and Zhang, J and Zhu, Y and Liu, L and Liu, Y and He, Q}, title = {Mortality in chronic kidney disease patients with COVID-19: a systematic review and meta-analysis.}, journal = {International urology and nephrology}, volume = {}, number = {}, pages = {}, pmid = {33389508}, issn = {1573-2584}, support = {2017KY213//the General Project Funds from the Health Department of Zhejiang Province/ ; LQ19H050003//the Natural Science Foundation of Zhejiang Province/ ; }, abstract = {At the beginning of 2020, the outbreak of coronavirus disease 2019 (COVID-19) led to a worldwide pandemic and mass panic. The number of infected people has been increasing exponentially since, and the mortality rate has also been concomitantly increasing. At present, no study has summarized the mortality risk of COVID-19 in patients with chronic kidney disease (CKD). Therefore, the aim of the present study was to conduct a literature review and meta-analysis to understand the frequency of mortality among CKD patients infected with COVID-19. A comprehensive systematic search was conducted on the PubMed, Embase, and Cochrane databases to find articles published until May 15, 2020. Study quality was assessed using a modified version of the Newcastle-Ottawa Scale. After careful screening based on the inclusion and exclusion criteria, 3,867,367 patients from 12 studies were included. The mortality rate was significantly higher among CKD patients with COVID-19 infection than among CKD patients without COVID-19 infection, as indicated by a pooled OR of 5.81 (95% CI 3.78-8.94, P