Insights on Mpox virus infection immunopathogenesis.

An immunocompromised status has been associated with more odds of being infected with Mpox virus (MPXV) and progressing to severe disease. This aligns with the importance of immune competence for MPXV control and clearance. We and others have previously reviewed parallels between MPXV and other viruses belonging to the Poxviridae in affecting the immune system. This article reviews studies providing direct evidence of the MPXV-immune interactions. The wide-ranging effects of MPXV on the immune system, from stimulation to modulation to memory, are broadly categorised, followed by a detailing of these effects on the immune cells and molecules, including natural killer cells, macrophages, neutrophils, lymphocytes, cytokines, interferons, chemokines, and complement.

Subtyping irritable bowel syndrome using cluster analysis: a systematic review.

BACKGROUND: Irritable bowel syndrome (IBS) is a common chronic functional gastrointestinal disorder associated with a wide range of clinical symptoms. Some researchers have used cluster analysis (CA), a group of non-supervised learning methods that identifies homogenous clusters within different entities based on their similarity. OBJECTIVE AND METHODS: This literature review aims to identify published articles that apply CA to IBS patients. We searched relevant keywords in PubMed, Embase, Web of Science, and Scopus. We reviewed studies in terms of the selected variables, participants' characteristics, data collection, methodology, number of clusters, clusters' profiles, and results. RESULTS: Among the 14 articles focused on the heterogeneity of IBS, eight of them utilized K-means Cluster Analysis (K-means CA), four employed Hierarchical Cluster Analysis, and only two studies utilized Latent Class Analysis. Seven studies focused on clinical symptoms, while four articles examined anocolorectal functions. Two studies were centered around immunological findings, and only one study explored microbial composition. The number of clusters obtained ranged from two to seven, showing variation across the studies. Males exhibited lower symptom severity and fewer psychological findings. The association between symptom severity and rectal perception suggests that altered rectal perception serves as a biological indicator of IBS. Ultra-slow waves observed in IBS patients are linked to increased activity of the anal sphincter, higher anal pressure, dystonia, and dyschezia. CONCLUSION: IBS has different subgroups based on different factors. Most IBS patients have low clinical severity, good QoL, high rectal sensitivity, delayed left colon transit time, increased systemic cytokines, and changes in microbial composition, including increased Firmicutes-associated taxa and depleted Bacteroidetes-related taxa. However, the number of clusters is inconsistent across studies due to the methodological heterogeneity. CA, a valuable non-supervised learning method, is sensitive to hyperparameters like the number of clusters and random initialization of cluster centers. The random nature of these parameters leads to diverse outcomes even with the same algorithm. This has implications for future research and practical applications, necessitating further studies to improve our understanding of IBS and develop personalized treatments.

Inosine, gut microbiota, and cancer immunometabolism.

This article briefly reviews cancer immunity and the role of gut microbiota in carcinogenesis, followed by an understanding of mechanisms by which inosine is involved in cancer immunometabolism. The immune system plays a paradoxical role in cancer treatment. Antitumor immunity depends on the T-cell priming against tumor antigens, whereas inflammatory mediators trigger the protumor signaling in the tumor microenvironment. Studies link the microbiome with metabolism and immunity-two main factors implicated in carcinogenesis. Gut microbiota has been shown to affect both antitumor immunity and protumor immune signaling. There is mounting evidence that the human microbiome can play a role in the immunotherapeutic effects, both response and resistance. Inosine-5'-monophosphate dehydrogenase (IMPDH) is a highly conservative enzyme widely expressed in mammals. Cell signaling pathways use molecular inosine, a crucial secondary metabolite in purine metabolism and a molecular messenger. Recent research has identified inosine as a critical regulator of immune checkpoint inhibition (ICI) therapeutic response in various tumor types. Some bacterial species were found to produce inosine or its metabolite hypoxanthine and induce T-helper 1 differentiation and effector functions via the inosine-A2AR-cAMP-PKA pathway upon ICI therapy. Also, inosine acts as a substitute carbon source for T-cell metabolism in glucose-restricted environments, i.e., the tumor microenvironment, assisting T-cell proliferation and differentiation while enhancing sensitivity to ICI, reinforcing the notion that inosine metabolism might contribute to antitumor immunity. Also, inosine is a potent agonist of the adenosine receptor, A2AR, and A2AR signaling can affect T-cell responses and antitumor immunity, making the inosine-A2AR pathway blockage a candidate for cancer treatment. Further research is required to investigate inosine as a cancer immunometabolism therapy.

Exploring the pharmacological versatility of ficus carica: Modulating classical immunometabolism and beyond.

The burden of metabolic disorders is alarmingly increasing globally. On the other hand, sustainability is the key project of the 21st century. Natural products offer a coherent option for the complementary management of both these challenges. Ficus carica (FC), commonly known as the fig fruit, has an experimentally proven potency for the modulation of cell cycle, immunity, inflammation, metabolism, and oxidative stress. Here, we review the potential of FC-derived products (FCDP) in slowing down the progression of cancers, acute/chronic inflammation-related conditions, infections, metabolic disorders, toxicities, neurological and neuromuscular diseases, gastrointestinal disorders, vascular diseases, and skin-stressing conditions, as well as, in boosting normal healthy functions of the endocrine, immune, metabolic, and nervous systems. It reveals a variety of cellular and molecular targets for FCDP: cytokines (TNF-α, IL-1ß, IL-6, IL-10, IL-12, IL-18, IFN-γ), chemokines (CCL2), other inflammatory mediators (CRP, PGE2), immune receptors (TLR-2, TLR-4, FcεRI), oxidative stress-related markers (SOD, GSH, MDA, GPx, catalase, ROS, NO, protein carbonyls), kinases (MAPKs, hexokinase, G6Pase, FBPase, PEPCK, Akt, AMPK, GSK3, CDKs), other enzymes (COX-2, iNOS, MMPs, caspases), growth factors/receptors (VEGF, EGFR), hormones (DHEAS, prolactin, GnRH, FSH, LH, estradiol, DHT, insulin), cell death-related markers (Bcl-2, Bax, Bak, FasL, gasdermins, cytochrome C), glucose transporter protein (Glut4), and transcription factors (NF-κB, HNF-4α, Foxo, PGC-1α, PPAR-γ, C/EBP-α, CREB, NFATC1, STAT3). FCDP cause both activation and inhibition of AMPK, MAPK, and NF-κB signaling to confer condition-specific advantages. Such a broad-range activity might be attributed to different mechanisms of action of FCDP in modulating functions within the classical immunometabolic system, but also beyond.

Microfluidic devices for detection of RNA viruses.

There is a long way to go before the coronavirus disease 2019 (Covid-19) outbreak comes under control. qRT-PCR is currently used for the detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of Covid-19, but it is expensive, time-consuming, and not as sensitive as it should be. Finding a rapid, easy-to-use, and cheap diagnostic method is necessary to help control the current outbreak. Microfluidic systems provide a platform for many diagnostic tests, including RT-PCR, RT-LAMP, nested-PCR, nucleic acid hybridization, ELISA, fluorescence-Based Assays, rolling circle amplification, aptamers, sample preparation multiplexer (SPM), Porous Silicon Nanowire Forest, silica sol-gel coating/bonding, and CRISPR. They promise faster, cheaper, and easy-to-use methods with higher sensitivity, so microfluidic devices have a high potential to be an alternative method for the detection of viral RNA. These devices have previously been used to detect RNA viruses such as H1N1, Zika, HAV, HIV, and norovirus, with acceptable results. This paper provides an overview of microfluidic systems as diagnostic methods for RNA viruses with a focus on SARS-CoV-2.

Computed tomography scan in COVID-19: a systematic review and meta-analysis.

PURPOSE: Computed tomography (CT) scan is a commonly used tool for the diagnosis of the novel coronavirus disease 2019 (COVID-19), similarly to reverse transcription-polymerase chain reaction (RT-PCR). Because of the limitations of RT-PCR, there is growing interest in the usability of the CT scan. The present systematic review and meta-analysis aims to summarize the available data on the CT scan features of COVID-19. MATERIAL AND METHODS: We conducted a systematic search in electronic databases to find eligible studies published between 1 December 2019 and 4 April 2020, which investigated the computed tomographic features of patients with COVID-19. All preprint and peer-reviewed articles were included. No language limitation was applied. For proportional data, pooled prevalence was calculated using a Freeman-Tukey double arcsine transformation, with a 95% confidence interval (CI). RESULTS: Eighty-six studies were eligible to be included in the meta-analysis. For 7956 patients, the most common CT findings were bilateral pattern of involvement (78%; 95% CI: 0.73-0.82; p < 0.001), involvement of more than 1 lobe (75%; 95% CI: 0.68-0.82; p < 0.001), ground-glass opacities (GGO) (73%; 95% CI: 0.67-0.78; p < 0.001), and peripheral distribution of signs (69%; 95% CI: 0.61-0.76; p < 0.001). Only 5% of patients had a normal CT scan (95% CI:0.03-0.07; p < 0.001). The proportion of paediatric patients (age < 18 years) with unremarkable CT findings was higher (40%; 95% CI: 0.27-0.55; p < 0.001). Subgroup analysis showed that patients with the severe or critical type of COVID-19 were more likely to have pleural effusion (RR 7.77; 95% CI: 3.97-15.18; p < 0.001) and consolidation (RR 3.13; 95% CI: 1.57-6.23; p < 0.001). CT results in patients with COVID-19 were comparable with those of people having pneumonia from other causes, except for the lower incidence of consolidation (RR 0.81; 95% CI: 0.71-0.91; p < 0.001) and higher risk of showing GGO (RR 1.45; 95% CI: 1.13-1.86; p < 0.001). The mortality rate was slightly higher in patients with bilateral involvement (RR 3.19; 95% CI: 1.07-9.49; p = 0.04). CONCLUSIONS: Our study results show that COVID-19 shares some features with other viral types of pneumonia, despite some differences. They commonly present as GGO along with vascular thickening, air bronchogram and consolidations. Normal CT images, lymphadenopathies, and pleural effusions are not common. Consolidations and pleural effusions correlate with more severe disease. CT features are different between COVID-19 and non-COVID-19 pneumonia. Also, they differ by age, disease severity, and outcomes within COVID-19 patients.

Targeted therapy strategies against SARS-CoV-2 cell entry mechanisms: A systematic review of in vitro and in vivo studies.

Due to the rapidly spreading of novel coronavirus disease (COVID-19) worldwide, there is an urgent need to develop efficient vaccines and specific antiviral treatments. Pathways of the viral entry into cells are interesting subjects for targeted therapy of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The present study aims to provide a systematic evaluation of the most recent in vitro and in vivo investigations targeting SARS-CoV-2 cell entry. A systematic search was carried out in major medical sources, including MEDLINE (through PubMed), Web of Science, Scopus, and EMBASE. Combinations of the following search terms were used: SARS-CoV-2, in vitro, in vivo, preclinical, targeted therapy, and cell entry. A modified version of the Consolidated Standards of Reporting Trials and Systematic Review Centre for Laboratory Animal Experimentation assessment tools were applied for evaluating the risk of bias of in vitro and in vivo studies, respectively. A narrative synthesis was performed as a qualitative method for the data synthesis of each outcome measure. A total of 2,649 articles were identified through searching PubMed, Web of Science, Scopus, EMBASE, Google Scholar, and Biorxiv. Finally, 22 studies (one in vivo study and 21 in vitro studies) were included. The spike (S) glycoprotein of the SARS-CoV-2 was the main target of investigation in 19 studies. SARS-CoV-2 can enter into the host cells through endocytosis or independently. SARS-CoV-2 S protein utilizes angiotensin-converting enzyme 2 or CD147 as its cell-surface receptor to attach host cells. It consists of S1 and S2 subunits. The S1 subunit mediates viral attachment to the host cells, while the S2 subunit facilitates virus-host membrane fusion. The cleavage of the S1-S2 protein, which is required for the conformational changes of the S2 subunit and processing of viral fusion, is regulated by the host proteases, including cathepsin L (during endocytosis) and type II membrane serine protease (independently). Targeted therapy strategies against SARS-CoV-2 cell entry mechanisms fall into four main categories: strategies targeting virus receptors on the host, strategies neutralizing SARS-CoV-2 spike protein, strategies targeting virus fusion to host cells, and strategies targeting endosomal and non-endosomal dependent pathways of virus entry. Inhibition of the viral entry by targeting host or virus-related components remains the most potent strategy to prevent and treat COVID-19. Further high-quality investigations are needed to assess the efficacy of the proposed targets and develop specific antivirals against SARS-CoV-2.

Investigating the possible association between NLRP3 gene polymorphisms and myasthenia gravis.

INTRODUCTION: In this case-control study, we investigated the association between nucleotide oligomerization domain-like receptor family pyrin domain containing 3 (NLRP3) single-nucleotide polymorphisms (SNPs) rs10754558, rs3806265, rs4612666, and rs35829419 and myasthenia gravis (MG). METHODS: Samples from MG patients were selected from a previous study conducted in our neuromuscular clinic, which investigated the association between human leukocyte antigen (HLA) class II genes and MG. Genetic data of controls were also available from another study. The NLRP3 SNPs genotyping was performed using the TaqMan method. RESULTS: A total of 93 blood samples from eligible Iranian patients with MG and 56 samples from healthy controls were obtained. The NLRP3 rs3806265 "C" allele was significantly more frequent in MG patients (P < .001; odd ratio [OR] = 2.33, 95% confidence interval [CI]: 1.4-4.0) than controls. The "CC" genotype of this SNP was found in 18.27% of patients, but none of the controls (P < .001). The distribution of other SNPs was similar between the groups. DISCUSSION: These preliminary results suggest that there might be some associations between the NLRP3 gene polymorphism and MG.

Computational drug discovery and repurposing for the treatment of COVID-19: A systematic review.

BACKGROUND: Since the beginning of the novel coronavirus (SARS-CoV-2) disease outbreak, there has been an increasing interest in finding a potential therapeutic agent for the disease. Considering the matter of time, the computational methods of drug repurposing offer the best chance of selecting one drug from a list of approved drugs for the life-threatening condition of COVID-19. The present systematic review aims to provide an overview of studies that have used computational methods for drug repurposing in COVID-19. METHODS: We undertook a systematic search in five databases and included original articles in English that applied computational methods for drug repurposing in COVID-19. RESULTS: Twenty-one original articles utilizing computational drug methods for COVID-19 drug repurposing were included in the systematic review. Regarding the quality of eligible studies, high-quality items including the use of two or more approved drug databases, analysis of molecular dynamic simulation, multi-target assessment, the use of crystal structure for the generation of the target sequence, and the use of AutoDock Vina combined with other docking tools occurred in about 52%, 38%, 24%, 48%, and 19% of included studies. Studies included repurposed drugs mainly against non-structural proteins of SARS-CoV2: the main 3C-like protease (Lopinavir, Ritonavir, Indinavir, Atazanavir, Nelfinavir, and Clocortolone), RNA-dependent RNA polymerase (Remdesivir and Ribavirin), and the papain-like protease (Mycophenolic acid, Telaprevir, Boceprevir, Grazoprevir, Darunavir, Chloroquine, and Formoterol). The review revealed the best-documented multi-target drugs repurposed by computational methods for COVID-19 therapy as follows: antiviral drugs commonly used to treat AIDS/HIV (Atazanavir, Efavirenz, and Dolutegravir Ritonavir, Raltegravir, and Darunavir, Lopinavir, Saquinavir, Nelfinavir, and Indinavir), HCV (Grazoprevir, Lomibuvir, Asunaprevir, Ribavirin, and Simeprevir), HBV (Entecavir), HSV (Penciclovir), CMV (Ganciclovir), and Ebola (Remdesivir), anticoagulant drug (Dabigatran), and an antifungal drug (Itraconazole). CONCLUSIONS: The present systematic review provides a list of existing drugs that have the potential to influence SARS-CoV2 through different mechanisms of action. For the majority of these drugs, direct clinical evidence on their efficacy for the treatment of COVID-19 is lacking. Future clinical studies examining these drugs might come to conclude, which can be more useful to inhibit COVID-19 progression.

Dynamic Antibody Response: a Biomarker for COVID-19.

BACKGROUND: Novel coronavirus disease 2019 (COVID-19) is the cause of the third pneumonia-like outbreak of coronaviruses in humans during the 21st century. The status of the host immune system is a critical factor that affects the severity and outcomes of COVID-19. In particular, antibody responses are an indicator of the anti-viral defense; so, a delayed or inappropriate induction of these responses would correlate with a defect in the viral clearance. METHODS: This is a rapid synthesis of literature investigating antibody responses in patients with the severe acute respiratory syndrome (SARS) and COVID-19. RESULTS: Lessons learned from severe acute respiratory syndrome (SARS), along with the direct evidence of antibody responses in COVID-19, pose the potentials of dynamic antibody responses for screening and prognostic purposes in COVID-19. Also, neutralizing antibodies extracted from recovered patients and monoclonal antibodies targeting cytokines offer therapeutic support for COVID-19. CONCLUSIONS: Altogether, the dynamics of antibody responses help to determine the effectiveness of treatments for COVID-19. Of note, it might be helpful for the evaluation of the efficacy of immunotherapy and vaccination - the dreams for the future of COVID-19. Further studies are necessary to investigate the possibility and efficacy of antibody extraction from animal subjects. Finally, numerous factors affect antibody response such as race, nutrition status, and virus mutations in viral infections, which need to be considered in the context of COVID-19.

How COVID-19 Has Globalized: Unknown Origin, Rapid Transmission, and the Immune System Nourishment.

The novel coronavirus disease (COVID-19) profoundly influences T-cell immunity. The counts of total T cells and T-cell subsets, especially CD4+ and CD8+ T cells, are decreased in patients with COVID-19. Also, the function of these cells becomes less effective as the expression of immune inhibitory receptors, such as Tim3 and PD-1, increases over time during the disease. Kinetic analyses show that the T-cell profile changes dynamically, so does the COVID-19 stages. As COVID-19 continues to deteriorate and progresses to severe/critical condition, the lymphocyte count steadily decreases. Therefore, the ability of COVID-19 to escape the immune system might lie in its power to profoundly diminish T-cell effective function, which is necessary for the establishment of a robust antiviral immunity. Also, COVID-19 is associated with increased numbers of monocytes and macrophages, and as the disease progresses from a mild form to a severe/critical condition, the macrophage population becomes denser. Monitoring the expression of cytokines associated with macrophage activation, mainly interleukin (IL)-6 and IL-10, indicates that the course of COVID-19 consists of two stages and the transition between disease stages occurs by the end of the first week after onset of symptoms. At the initial stage, the immune military recognizes the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) as nonself and thus fires macrophages at the lungs against the virus. The first flame can control disease progression effectively. However, a trained immunocompetent system would maintain the fire of macrophages over an extended time. It lies in its immune memory in tissue-resident macrophages, especially alveolar macrophages, making a professionally trained immune system more likely to be feared by COVID-19 than an untrained immune system. In this manner, the trained immunocompetent system commits such a failure that causes the lungs to come down rapidly. The fact that younger age groups, including neonates and children, are less susceptible to COVID-19 than older age groups reflects that the natural affinities of the immune system that has not been trained thoroughly would be standard in combatting against COVID-19 whereas the higher affinities of the trained immune system for rapid activation of immune responses might raise faults - the lungs come down.

Geriatrics and COVID-19.

Since December 2019, a novel coronavirus called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has begun to infect people. The virus first occurred in Wuhan, China, but the whole world is now struggling with the pandemic. Over 13 million confirmed cases and 571,000 deaths have been reported so far, and this number is growing. Older people, who constitute a notable proportion of the world population, are at an increased risk of infection because of altered immunity and chronic comorbidities. Thus, appropriate health care is necessary to control fatalities and spread of the disease in this specific population. The chapter provides an overview of diagnostic methods, laboratory and imaging findings, clinical features, and management of COVID-19 in aged people. Possible mechanisms behind the behavior of SARS-CoV-2 in the elderly include immunosenescence and related impaired antiviral immunity, mature immunity and related hyper-inflammatory responses, comorbidities and their effects on the functioning of critical organs/systems, and the altered expression of angiotensin-converting enzyme 2 (ACE2) that acts as an entry receptor for SARS-CoV-2. This evidence defines the herding behavior of COVID-19 in relation to ACE2 under the influence of immune dysregulation. Then, identifying the immunogenetic factors that affect the disease susceptibility and severity and as well as key inflammatory pathways that have the potential to serve as therapeutic targets needs to remain an active area of research.

How Prevalent Is Cancer in Confirmed Cases with Coronaviruses and Severe Acute Respiratory Syndromes?

Novel coronavirus disease 2019 (COVID-19) has posed a crucial hazard to global health. The new species share similarities with the two previously emerged entities: severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS) that have caused outbreaks in 2002 and 2012, respectively. Interestingly, all of these coronaviruses can cause potentially fatal respiratory syndromes, though behave differently in patients with cancer compared to patients without cancer. Accordingly, the present chapter aims to, through a systematic investigation, estimate the prevalence of cancer among COVID-19, SARS, and MERS confirmed cases. Our analysis based on data from 78 studies with SARS, MERS, and COVID-19 confirmed cases showed that the prevalence of cancer (4.94%) stands at fourth place after hypertension (20.8%), diabetes (11.39%), and cardiovascular diseases (7.46%). According to the findings of the present study, comorbidities are significantly more common in patients with MERS compared to patients with COVID-19 and SARS, and this was the cancer case as well. Further studies need to address whether or not patients with coronaviruses and cancer are different from patients with coronaviruses without cancer in terms of clinical manifestations, laboratory findings, outcomes, and men to women ratio.

COVID-19 Pandemic: The Influence of Culture and Lessons for Collaborative Activities.

The rapid epidemiological shift from an epidemic/outbreak in Wuhan, China, to a global pandemic of COVID-19 in less than 3 months came with lessons the world's health system should learn to prepare for the future outbreaks. Since February 20, 2020, the total number of confirmed cases of COVID-19 has been increased very slowly in the countries of East Asia, including Japan, South Korea, and China, when compared with those in the Western countries. This chapter begins with an overview of the impact of COVID-19 on healthcare workers and public health facilities, followed by immediate global actions and research in response to the newly emerged pandemic. It includes an evaluation of the potential influence of culture on the implementation of different protective measures to combat the COVID-19 pandemic while at the same time offering suggestions that will make it easier for all populations to adapt protective steps against COVID-19 and other respiratory infectious diseases. Finally, the chapter provides a detailed discussion of lessons we have learned from the pandemic, leading to the conclusion that the transition from individualism to collaborative efforts is the treatment of universal pandemics.

Clinical and Laboratory Predictors of Severity, Criticality, and Mortality in COVID-19: A Multisystem Disease.

Coronavirus disease 2019 (COVID-19) pandemic continues devastating effects on healthcare systems. Such a crisis calls for an urgent need to develop a risk stratification tool. The present chapter aimed to identify laboratory and clinical correlates of adverse outcomes in patients with COVID-19. To this end, we conducted a systematic evaluation of studies that investigated laboratory abnormalities in patients with COVID-19 and compared i. patients with a severe form of disease and patients with a non-severe form of the disease, ii. patients who were in critical condition and patients who were not in critical condition, and iii. patients who survived and patients who died. We included 54 studies in the data synthesis. Compared to patients with a non-severe form of COVID-19, patients who had a severe form of disease revealed higher values for white blood cells (WBC), polymorphonuclear leukocytes (PMN), total bilirubin, alanine aminotransferase (ALT), creatinine, troponin, procalcitonin, lactate dehydrogenase (LDH), and D-dimer. By contrast, platelet count, lymphocyte count, and albumin levels were decreased in patients with a severe form of COVID-19. Also, patients with a severe phenotype of disease were more likely to have diabetes, chronic heart disease, chronic obstructive pulmonary disease (COPD), cerebrovascular disease, hypertension, chronic kidney disease (CKD), and malignancy. Compared to patients who survived, patients who died had higher WBC, PMN, total bilirubin, ALT, procalcitonin, IL-6, creatinine, PT, lymphocyte count, platelet count, and albumin. Also, non-survivors revealed a higher prevalence of diabetes, chronic heart disease, COPD, cerebrovascular disease, and CKD. Meta-analyses identified several laboratory parameters that might help the prediction of severe, critical, and lethal phenotypes of COVID-19. These parameters correlate with the immune system function, inflammation, coagulation, and liver and kidney function.

Exploration of the Epidemiological and Emotional Impact of Quarantine and Isolation During the COVID-19 Pandemic.

Starting in December 2019 in Wuhan Municipal Health Commission, the coronavirus disease 2019 (COVID-19) has crossed the borders forming a pandemic in 2020. The absence of pharmacological interventions has pushed governments to apply different sets of old, non-pharmacological interventions, which are, though temporary, helpful to prevent further pandemic propagation. In the context of COVID-19, research confirms that quarantine is useful, mainly if applied early and if combined with other public health measures. However, the efficacy of quarantine and isolation is limited in many ways, ranging from legal issues and suspension of economic activities to mental health considerations. This chapter is an exploration of (i) epidemiological impact of isolation and quarantine; (ii) emotional impact of isolation and quarantine; and (iii) the possible effect of culture on quarantine experience.

Introduction on Coronavirus Disease (COVID-19) Pandemic: The Global Challenge.

By driving the ongoing pandemic of coronavirus disease 2019 (COVID-19), coronaviruses have become a significant change in twenty-first-century medicine, healthcare systems, education, and the global economy. This chapter rapidly reviews the origin, immunopathogenesis, epidemiology, diagnosis, clinical manifestations, and potential therapeutics of COVID-19. It would also explore the effects of the introduction of a single virus, the so-called severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), on the public health preparedness planning.

Health and Art (HEART): Integrating Science and Art to Fight COVID-19.

Netting individuals separated from each other by vast distances; the present condition of COVID-19 needs art and its extraordinary capacity to connect human beings and integrate scientific disciplines. We can predict that the COVID-19 pandemic would leave the mind lonely and vulnerable to diseases, for, on the one hand, the COVID-19 pandemic and related problems, in particular social isolation, are itself stressor. On the other hand, studies confirm the potential of COVID-19 to involve the central nervous system by affecting the immune system, either directly or indirectly. The COVID-19 condition, thus, calls for a necessary compensation of loneliness to reduce the psychological impact of the pandemic. Not only art can fulfill this purpose by meeting social affiliation needs, but also its related creativity is a definite achievement of the performer while acting as a motivation facilitator of creation for the observer. Besides, artworks that illustrate effective hygiene behaviors and physical distancing in an easy-to-understand manner could help health information systems to control the spread of COVID-19. The integration of art with biomedical science applied for simulation of the infected population, lung imaging data, and the viral surface has been useful for prediction of the spread of disease and earlier diagnosis of COVID-19 by imaging techniques and might be a contributor to drug discovery for COVID-19. Also, arts admirably influence the immunoemotional regulatory system so that not only would it enable humanity to tolerate quarantine but also enhance antiviral immunity. More interestingly, the effects of dance have been observed in children, elderly, healthcare workers, and pregnant women, which have been of special attention during the COVID-19 pandemic. In summary, arts provide us powerful tools for tolerating the quarantine time and enhancing the immune system, educating behavioral tips for hygiene practices and physical distancing and in psychosocial care of vulnerable populations during the pandemic.

A systematic review of pregnant women with COVID-19 and their neonates.

BACKGROUND: In December 2019, a novel coronavirus disease (COVID-19) emerged in Wuhan, China, with an incredible contagion rate. However, the vertical transmission of COVID-19 is uncertain. OBJECTIVES: This is a systematic review of published studies concerning pregnant women with confirmed COVID-19 and their neonates. SEARCH STRATEGY: We carried out a systematic search in multiple databases, including PubMed, Web of Science, Google Scholar, Scopus, and WHO COVID-19 database using the following keywords: (Coronavirus) OR (novel coronavirus) OR (COVID-19) OR (COVID19) OR (COVID 19) OR (SARS-CoV2) OR (2019-nCoV)) and ((pregnancy) OR (pregnant) OR (vertical transmission) OR (neonate) OR (newborn) OR (placenta) OR (fetus) OR (Fetal)). The search took place in April 2020. SELECTION CRITERIA: Original articles published in English were eligible if they included pregnant patients infected with COVID-19 and their newborns. DATA COLLECTION AND ANALYSES: The outcomes of interest consisted of clinical manifestations of COVID-19 in pregnant patients with COVID-19 and also the effect of COVID-19 on neonatal and pregnancy outcomes. MAIN RESULTS: 37 articles involving 364 pregnant women with COVID-19 and 302 neonates were included. The vast majority of pregnant patients were in their third trimester of pregnancy, and only 45 cases were in the first or second trimester (12.4%). Most mothers described mild to moderate manifestations of COVID-19. Of 364 pregnant women, 25 were asymptomatic at the time of admission. The most common symptoms were fever (62.4%) and cough (45.3%). Two maternal deaths occurred. Some pregnant patients (12.1%) had a negative SARS-CoV-2 test but displayed clinical manifestations and abnormalities in computed tomography (CT) scan related to COVID-19. Twenty-two (6.0%) pregnant patients developed severe pneumonia. Two maternal deaths occurred from severe pneumonia and multiple organ dysfunction. Studies included a total of 302 neonates from mothers with COVID-19. Of the studies that provided data on the timing of birth, there were 65 (23.6%) preterm neonates. One baby was born dead from a mother who also died from COVID-19. Of the babies born alive from mothers with COVID-19, five newborns faced critical conditions, and two later died. A total of 219 neonates underwent nasopharyngeal specimen collection for SARS-CoV-2, of which 11 tested positive (5%). Seventeen studies examined samples of the placenta, breast milk, umbilical cord, and amniotic fluid, and all tested negative except one amniotic fluid sample. CONCLUSIONS: A systematic review of published studies confirm that the course of COVID-19 in pregnant women resembles that of other populations. However, there is not sufficient evidence to establish an idea that COVID-19 would not complicate pregnancy.

Human Coronaviruses SARS-CoV, MERS-CoV, and SARS-CoV-2 in Children.

The novel coronavirus, known as 2019-nCoV or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has caused an epidemic with high mortality and morbidity since December 2019, in Wuhan, China. The infection has now been transmitted to more than 210 countries worldwide and caused more than 200,000 deaths. Similar to other coronaviruses such as Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and the Middle East Respiratory Syndrome Coronavirus (MERS-CoV), SARS-CoV-2 appears to less commonly affect pediatrics and to cause less severe disease along with fewer symptoms compared to adults. Available data suggest that the pediatric population is just as likely as adults to become infected with SARS-CoV-2. However, they may be asymptotic or have milder symptoms than adults; they can be potential carriers of the disease. This article reviews the present understanding of SARS-CoV-2 infection in the pediatric age group in comparison with MERS-CoV and SARS-CoV.