Early living donor liver transplantation for alcohol-associated hepatitis.

INTRODUCTION AND OBJECTIVES: Lately, there has been a steady increase in early liver transplantation for alcohol-associated hepatitis (AAH). Although several studies have reported favorable outcomes with cadaveric early liver transplantation, the experiences with early living donor liver transplantation (eLDLT) are limited. The primary objective was to assess one-year survival in patients with AAH who underwent eLDLT. The secondary objectives were to describe the donor characteristics, assess the complications following eLDLT, and the rate of alcohol relapse. MATERIALS AND METHODS: This single-center retrospective study was conducted at AIG Hospitals, Hyderabad, India, between April 1, 2020, and December 31, 2021. RESULTS: Twenty-five patients underwent eLDLT. The mean time from abstinence to eLDLT was 92.4 ± 42.94 days. The mean model for end-stage liver disease and discriminant function score at eLDLT were 28.16 ± 2.89 and 104 ± 34.56, respectively. The mean graft-to-recipient weight ratio was 0.85 ± 0.12. Survival was 72% (95%CI, 50.61-88) after a median follow-up of 551 (23-932) days post-LT. Of the 18 women donors,11 were the wives of the recipient. Six of the nine infected recipients died: three of fungal sepsis, two of bacterial sepsis, and one of COVID-19. One patient developed hepatic artery thrombosis and died of early graft dysfunction. Twenty percent had alcohol relapse. CONCLUSIONS: eLDLT is a reasonable treatment option for patients with AAH, with a survival of 72% in our experience. Infections early on post-LT accounted for mortality, and thus a high index of suspicion of infections and vigorous surveillance, in a condition prone to infections, are needed to improve outcomes.

Association of underlying comorbidities and progression of COVID-19 infection amongst 2586 patients hospitalised in the National Capital Region of India: a retrospective cohort study.

This study is conducted to observe the association of diabetes (DM), hypertension (HTN) and chronic kidney disease (CKD) on the prognosis and mortality of COVID-19 infection in hospital admitted patients with above mentioned comorbidities. This is a single centre, observational, retrospective study carried out at Sir Ganga Ram Hospital, Delhi, India. The burden of comorbidities on the prognosis and clinical outcome of COVID-19 patients admitted patients from April 8, 2020, to October 4, 2020. Chi-square and relative risk test were used to observe the association of comorbidities and disease prognosis. A total of 2586 patients were included in the study consisting of 69.6% of male patients. All the comorbidities were significantly associated with ICU admission and mortality. The relative risk showed that CKD is most prone to severity as well as mortality of the COVID-19 infection followed by HTN and DM. Further with the increase in number of underlying comorbidities, the risk of ICU admission and mortality also increases. Relative risk of the severity of COVID-19 infection in younger patients with underlying comorbidities are relatively at higher risk of severity of disease as well as to mortality compared to the elderly patients with similar underlying condition. Similarly, it is found that females are relatively at higher risk of mortality as compared to the males having same comorbid conditions except for the hypertensive patients. Diabetes, hypertension and CKD, all are associated with progression of COVID-19 disease to severity and higher mortality risk. The number of underlying comorbid condition is directly proportional to the progression of disease severity and mortality.

Computed tomography severity score as a predictor of disease severity and mortality in COVID-19 patients: A systematic review and meta-analysis.

BACKGROUND: Prediction of outcomes in severe COVID-19 patients using chest computed tomography severity score (CTSS) may enable more effective clinical management and early, timely ICU admission. We conducted a systematic review and meta-analysis to determine the predictive accuracy of the CTSS for disease severity and mortality in severe COVID-19 subjects. METHODS: The electronic databases PubMed, Google Scholar, Web of Science, and the Cochrane Library were searched to find eligible studies that investigated the impact of CTSS on disease severity and mortality in COVID-19 patients between 7 January 2020 and 15 June 2021. Two independent authors looked into the risk of bias using the Quality in Prognosis Studies (QUIPS) tool. RESULTS: Seventeen studies involving 2788 patients reported the predictive value of CTSS for disease severity. The pooled sensitivity, specificity, and summary area under the curve (sAUC) of CTSS were 0.85 (95% CI 0.78-0.90, I2 =83), 0.86 (95% CI 0.76-0.92, I2 =96) and 0.91 (95% CI 0.89-0.94), respectively. Six studies involving 1403 patients reported the predictive values of CTSS for COVID-19 mortality. The pooled sensitivity, specificity, and sAUC of CTSS were 0.77 (95% CI 0.69-0.83, I2 = 41), 0.79 (95% CI 0.72-0.85, I2 = 88), and 0.84 (95% CI 0.81-0.87), respectively. DISCUSSION: Early prediction of prognosis is needed to deliver the better care to patients and stratify them as soon as possible. Because different CTSS thresholds have been reported in various studies, clinicians are still determining whether CTSS thresholds should be used to define disease severity and predict prognosis. CONCLUSION: Early prediction of prognosis is needed to deliver optimal care and timely stratification of patients.  CTSS has strong discriminating power for the prediction of disease severity and mortality in patients with COVID-19.

T-cell dysfunction as a potential contributing factor in post-COVID-19 mucormycosis.

BACKGROUND: The second wave of COVID-19 in India was followed by large number of mucormycosis cases. Indiscriminate use of immunosuppressive drugs, underlying diseases such as diabetes, cancers, or autoimmune diseases was thought to be the cause. However, the mortality was not as high as that seen in non-COVID mucormycosis. OBJECTIVE: To study the detailed characteristics of T-cells for evaluating the underlying differences in the T-cell immune dysfunction in post-COVID and non-COVID mucor patients. MATERIAL AND METHOD: The study included histopathologically confirmed cases of mucor (13 post-COVID, 13 non-COVID) and 15 healthy individuals (HI). Expression of T-cell activation (CD44, HLADR, CD69, CD38) and exhaustion (CTLA, PD-1, LAG-3 and TIM-3) markers was evaluated by flow cytometry. RESULTS: All cases showed significant depletion of T-cells compared to HI. Both post-COVID and non-COVID groups showed increased activation and exhaustion as compared to HI. Non-COVID mucor group showed significant activation of CD4+ T cells for HLADR and CD38 (p = .025, p = .054) and marked T-cell exhaustion in form of expression of LAG-3 on both CD4+ T and CD8+ T cells in comparison with post-COVID patients (p = .011, p = .036). Additionally, co-expression of PD-1 & LAG-3 and LAG-3 & TIM-3 on CD8+ T cells was statistically significant in non-COVID mucor patients (p = .016, p = .027). CONCLUSION: Immunosuppression in non-COVID mucor showed pronounced exhaustion of T-cells in comparison to post-COVID mucor cases implicating T-cell immune dysfunction is much more severe in non-COVID mucor which are in a state of continuous activation followed by extreme exhaustion leading to poorer outcome.

A novel consensus-based computational pipeline for screening of antibody therapeutics for efficacy against SARS-CoV-2 variants of concern including Omicron variant.

Multiple severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants continue to evolve carrying flexible amino acid substitutions in the spike protein's receptor binding domain (RBD). These substitutions modify the binding of the SARS-CoV-2 to human angiotensin-converting enzyme 2 (hACE2) receptor and have been implicated in altered host fitness, transmissibility, and efficacy against antibody therapeutics and vaccines. Reliably predicting the binding strength of SARS-CoV-2 variants RBD to hACE2 receptor and neutralizing antibodies (NAbs) can help assessing their fitness, and rapid deployment of effective antibody therapeutics, respectively. Here, we introduced a two-step computational framework with 3-fold validation that first identified dissociation constant as a reliable predictor of binding affinity in hetero- dimeric and trimeric protein complexes. The second step implements dissociation constant as descriptor of the binding strengths of SARS-CoV-2 variants RBD to hACE2 and NAbs. Then, we examined several variants of concerns (VOCs) such as Alpha, Beta, Gamma, Delta, and Omicron and demonstrated that these VOCs RBD bind to the hACE2 with enhanced affinity. Furthermore, the binding affinity of Omicron variant's RBD was reduced with majority of the RBD-directed NAbs, which is highly consistent with the experimental neutralization data. By studying the atomic contacts between RBD and NAbs, we revealed the molecular footprints of four NAbs (GH-12, P2B-1A1, Asarnow_3D11, and C118)-that may likely neutralize the recently emerged Omicron variant-facilitating enhanced binding affinity. Finally, our findings suggest a computational pathway that could aid researchers identify a range of current NAbs that may be effective against emerging SARS-CoV-2 variants.

Bayesian Molecular Dating Analyses Combined with Mutational Profiling Suggest an Independent Origin and Evolution of SARS-CoV-2 Omicron BA.1 and BA.2 Sub-Lineages.

The ongoing evolution of severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has resulted in the recent emergence of a highly divergent variant of concern (VOC) defined as Omicron or B.1.1.529. This VOC is of particular concern because it has the potential to evade most therapeutic antibodies and has undergone a sustained genetic evolution, resulting in the emergence of five distinct sub-lineages. However, the evolutionary dynamics of the initially identified Omicron BA.1 and BA.2 sub-lineages remain poorly understood. Herein, we combined Bayesian phylogenetic analysis, mutational profiling, and selection pressure analysis to track the virus's genetic changes that drive the early evolutionary dynamics of the Omicron. Based on the Omicron dataset chosen for the improved temporal signals and sampled globally between November 2021 and January 2022, the most recent common ancestor (tMRCA) and substitution rates for BA.1 were estimated to be that of 18 September 2021 (95% highest posterior density (HPD), 4 August-22 October 2021) and 1.435 × 10-3 (95% HPD = 1.021 × 10-3 - 1.869 × 10-3) substitution/site/year, respectively, whereas 3 November 2021 (95% highest posterior density (HPD) 26 September-28 November 2021) and 1.074 × 10-3 (95% HPD = 6.444 × 10-4 - 1.586 × 10-3) substitution/site/year were estimated for the BA.2 sub-lineage. The findings of this study suggest that the Omicron BA.1 and BA.2 sub-lineages originated independently and evolved over time. Furthermore, we identified multiple sites in the spike protein undergoing continued diversifying selection that may alter the neutralization profile of BA.1. This study sheds light on the ongoing global genomic surveillance and Bayesian molecular dating analyses to better understand the evolutionary dynamics of the virus and, as a result, mitigate the impact of emerging variants on public health.

A novel structure-based approach for identification of vertebrate susceptibility to SARS-CoV-2: Implications for future surveillance programmes.

Understanding the origin of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been a highly debatable and unresolved issue for scientific communities all over the world. Understanding the mechanism of virus entry to the host cells is crucial to deciphering the susceptibility profiles of animal species to SARS-CoV-2. The interaction of SARS-CoV-2 ligands (receptor-binding domain on spike protein) with its host cell receptor, angiotensin-converting enzyme 2 (ACE2), is a critical determinant of host range and cross-species transmission. In this study, we developed and implemented a rigorous computational approach for predicting binding affinity between 299 ACE2 orthologs from diverse vertebrate species and the SARS-CoV-2 spike protein. The findings show that the SARS-CoV-2 spike protein can bind to a wide range of vertebrate species carrying evolutionary divergent ACE2, implying a broad host range at the virus entry level, which may contribute to cross-species transmission and further viral evolution. Furthermore, the current study facilitated the identification of genetic determinants that may differentiate susceptible from resistant host species based on the conservation of ACE2-spike protein interacting residues in vertebrate host species known to facilitate SARS-CoV-2 infection; however, these genetic determinants warrant in vivo experimental confirmation. The molecular interactions associated with varied binding affinity of distinct ACE2 isoforms in a specific bat species were identified using protein structure analysis, implying the existence of diversified bat species' susceptibility to SARS-CoV-2. The current study's findings highlight the importance of intensive surveillance programmes aimed at identifying susceptible hosts, especially those with the potential to transmit zoonotic pathogens, in order to prevent future outbreaks.

COVID-19 cases and their outcome among patients with uncommon co-existing illnesses: A lesson from Northern India

Introduction Newer coexisting conditions should be identified in order to modify newer risk factors. Aim was to identify patients with non-classical or less common coexisting conditions in patients infected of COVID 19. Method Single centred study from June 2020 to May 2021 at a tertiary centre in North India. A preformed questionnaire was used to record clinical and laboratory parameters and to identify cases which are in addition to CDC list and Indian data. Results 0.67% (46) cases out of 6832 patients were identified to have non-classical coexisting illness. It was divided into 2 groups-infections A (60.1%) and non-infections B (39.9%). Group A included-tuberculosis- pulmonary (14.3%) & extra pulmonary (32.9%), bacterial (25.0%) viral infections [dengue, hepatitis B & C] (14.3%), HIV disease (10.7%) and malaria (3.6%). Group B included- organ transplant (27.8%), autoimmune [myasthenia gravis, polymyositis, psoriasis] (22.6%), haematologic [Haemophilia, ITP, Aplastic anaemia, APML, CML] (27.8%), uncommon malignancies [disseminated sacral chordoma and GTN] (11.1%) and snakebite (11.1%). Serum Procalcitonin was not helpful for diagnosis of bacterial infection in COVID-19 disease. Group A had significantly longer duration of illness, hepatitis and elevated CRP. The mortality in group A & B were 32.1% and 43.8% respectively. Death in non-severe COVID cases was in tetanus and snakebite. 30.7% death among tuberculosis patients. More than 70% of deaths were attributable to COVID 19 in both the groups. Conclusion In Indian settings, comorbidities like tuberculosis and bacterial infections can precipitate severe COVID 19 unlike other parts of the world where tuberculosis is relatively uncommon.

Technologically Advanced Reusable 3D Face Shield for Health Workers Confronting COVID19

The probability of medical staff to get affected from COVID19 is much higher due to their working environment which is more exposed to infectious diseases. So, as a preventive measure the body temperature monitoring of medical staff at regular intervals is highly recommended. Infrared temperature sensing guns have proved its effectiveness and therefore such devices are used to monitor the body temperature. These devices are either used on hands or forehead. As a result, there are many issues in monitoring the temperature of frontline healthcare professionals. Firstly, these healthcare professionals keep wearing PPE (Personal Protective Equipment) kits during working hours and as a result it would be very difficult to monitor their body temperature. Secondly, these healthcare professionals also wear face shields and in such cases monitoring temperature by exposing forehead needs removal of face shield. Doing so after regular intervals is surely uncomfortable for healthcare professionals. To avoid such issues, this paper is disclosing a technologically advanced face shield equipped with sensors capable of monitoring body temperature instantly without the hassle of removing the face shield. This face shield is integrated with a built-in infrared temperature sensor. A total of 10 such face shields were printed and assembled within the university lab and then handed over to a group of ten members including faculty and students of nursing and health science department. This sequence was repeated four times and as a result 40 healthcare workers participated in the study. Thereafter, feedback analysis was conducted on questionnaire data and found a significant overall mean score of 4.59 out of 5 which indicates that the product is effective and worthy in every facet. Stress analysis is also performed in the simulated environment and found that the device can easily withstand the typically applied forces. The limitations of this product are difficulty in cleaning the product and comparatively high cost due to the deployment of electronic equipment.

Evaluation of safety profile of ChAdOx1-nCoV-19 Coronavirus (Covisheild) Vaccine among health care professionals in a tertiary care hospital: 6 months follow-up observation

Materials and Methods: This is 6 months follow-up observation of vaccinated individuals, 545 health care workers have taken Covishield Vaccine for a duration of 1 month in a tertiary care hospital in two doses with 28 days apart. ChAdOx1-nCoV-19 Coronavirus (Covishield) Vaccine;Health Care Professionals;Adverse Reactions INTRODUCTION Coronavirus disease 2019 (COVID-19) infection initially emerged in Wuhan city, China, which is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) causing various manifestations mainly respiratory illness ranging from mild to moderate disease (80%) to severe disease (15%), and even critical illness (5%) with high case fatality rate of around 0.5-2.8. Few side effects, particularly rare and very rare onews that are seen in real uncontrolled environment may not be evident. [...]it is necessary to closely monitor the safety and effectiveness of approved vaccines in the market. [7,8] Hence, the Pharmacovigilance committee of a tertiary care hospital followed up the vaccinated individuals for half a year to check for the safety of Covishield vaccine and severity of adverse effects.

Virus related acute pancreatitis and virus superinfection in the 'Dual disease' model of acute pancreatitis and SARS-Co-V2 infection: A multicentre prospective study.

BACKGROUND: SARS-CoV-2 can cause acute pancreatitis (AP) and SARS-CoV-2 superinfection can occur in patients with AP during prolonged hospitalisation. Our objective was to characterize SARS-CoV-2 related AP and study the impact of SARS-CoV-2 superinfection on outcomes in AP. METHODS: In this multicentre prospective study, all patients with AP and SARS-CoV-2 infection between August 2020 and February 2021 were divided into two groups: SARS-CoV-2-related AP and superadded SARS-CoV-2 infection in patients with AP. The two groups were compared with each other and the whole cohort was compared with a non-COVID AP cohort. RESULTS: A total of 85 patients with SARS-CoV-2 and AP (SARS-CoV-2-related AP; n = 18 and AP with SARS-CoV-2 superadded infection; n = 67) were included during the study period. They had a higher mortality [28 (32.9%) vs. 44 (19.1%), aOR 2.8 (95% CI, 1.5-5.3)] than 230 propensity matched non-COVID AP patients. Mortality in SARS-CoV-2 and AP patients was due to critical COVID. SARS-CoV-2-related- AP (n = 18) had a higher but statistically insignificant mortality than SARS-CoV-2 superinfection in AP [8/18 (44.4%) vs 20/67 (29.8%), p = 0.24]. On multivariable analysis, infection with SARS-CoV-2 (aHR 2.3; 95% CI, 1.43.7) was a predictor of in-hospital mortality in addition to organ failure (OF) in patients with AP. CONCLUSION: Patients with AP and SARS-CoV-2 infection had a higher mortality than matched non-COVID AP patients which was largely attributable to the severity of COVID-19. SARS-CoV-2 related AP had higher OF and in-hospital mortality.

Virus induced acute pancreatitis and virus superinfection in the ‘Dual disease’ model of acute pancreatitis and SARS-Co-V2 infection: A multicentre prospective study

Background SARS-CoV-2 can cause acute pancreatitis (AP) and virus superinfection can occur during prolong hospitalisation. Our objective was to characterize SARS-CoV-2 related AP and study the impact of SARS-CoV-2 superinfection on outcomes in AP. Methods In this multicentre prospective study, all patients with AP plus SARS-CoV-2 infection between August 2020 and February 2021 were divided into groups: SARS-CoV-2-related AP and superadded SARS-CoV-2 infection in patients with AP. The two groups were compared with each other and the whole cohort was compared with non-COVID AP cohort. Results A total of 85 patients with SARS-CoV-2 plus AP (SARS-CoV-2-related AP;n = 18 and AP with SARS-CoV-2 superadded infection;n = 67) were included during the study period. They had a higher mortality [28 (32.9%) vs. 44 (19.1%), aOR 2.8 (95% CI, 1.5–5.3)] than 230 propensity matched non-COVID AP patients. Mortality in SARS-CoV-2 plus AP patients was due to critical COVID. SARS-CoV-2-induced AP (n = 18) had a higher but statistically insignificant mortality than AP plus SARS-CoV-2 superinfection [8/18 (44.4%) vs 20/67 (29.8%), p = 0.24]. On multivariable analysis, infection with SARS-CoV-2 (aHR 2.3;95% CI, 1.4–3.7) was a predictor of in-hospital mortality in addition to OF in patients with AP. Conclusion Patients with AP and SARS-CoV-2 infection have a higher mortality than matched non-COVID AP patients largely attributable to the severity of COVID-19. SARS-CoV-2 related AP has higher OF and in-hospital mortality. Graphical Image 1

SARS-CoV-2 in Kidney Transplant Recipients: A Systematic Review

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global healthcare crisis. Kidney transplant (KTx) patients and the patients with chronic kidney disease are two of the most vulnerable populations to the risks of coronavirus disease 2019 (COVID-19). A systematic literature search on PubMed and Web of Science was conducted. We analyzed published case reports, case series and articles on COVID-19’s clinical presentation, management, outcomes and vaccination among kidney transplant recipients. A total of 33 studies were included in the study, which included 1676 KTx recipients and 108 waiting list patients infected with COVID-19. These studies reported the clinical presentation, management and immunosuppressive adjustment among the KTx recipients. The remaining studies focused on other aspects, such as vaccination and transplantation, during the COVID-19 pandemic. Mortality due to COVID-19 was observed to be the highest for KTx recipients, followed by patients on hemodialysis, and lowest in the general population. There is no definitive treatment of COVID-19 yet, and managing transplant patients is enigmatic of this: the treatment is based on symptom management. There is an urgent need for guidelines on managing kidney transplant recipients and immunosuppressive adjustments for the course of COVID-19 treatment.

S-adenosylmethionine-dependent methyltransferase inhibitor DZNep blocks transcription and translation of SARS-CoV-2 genome with a low tendency to select for drug-resistant viral variants.

We report the in vitro antiviral activity of DZNep (3-Deazaneplanocin A; an inhibitor of S-adenosylmethionine-dependent methyltransferase) against SARS-CoV-2, besides demonstrating its protective efficacy against lethal infection of infectious bronchitis virus (IBV, a member of the Coronaviridae family). DZNep treatment resulted in reduced synthesis of SARS-CoV-2 RNA and proteins without affecting other steps of viral life cycle. We demonstrated that deposition of N6-methyl adenosine (m6A) in SARS-CoV-2 RNA in the infected cells recruits heterogeneous nuclear ribonucleoprotein A1 (hnRNPA1), an RNA binding protein which serves as a m6A reader. DZNep inhibited the recruitment of hnRNPA1 at m6A-modified SARS-CoV-2 RNA which eventually suppressed the synthesis of the viral genome. In addition, m6A-marked RNA and hnRNPA1 interaction was also shown to regulate early translation to replication switch of SARS-CoV-2 genome. Furthermore, abrogation of methylation by DZNep also resulted in defective synthesis of the 5' cap of viral RNA, thereby resulting in its failure to interact with eIF4E (a cap-binding protein), eventually leading to a decreased synthesis of viral proteins. Most importantly, DZNep-resistant mutants could not be observed upon long-term sequential passage of SARS-CoV-2 in cell culture. In summary, we report the novel role of methylation in the life cycle of SARS-CoV-2 and propose that targeting the methylome using DZNep could be of significant therapeutic value against SARS-CoV-2 infection.

Impact of COVID-19 Pandemic on Cancer Surgical Services-AIIMS, New Delhi Experience.

COVID pandemic has impacted cancer care delivery and cancer surgical services globally. There is an urgent need to study the extent of the impact of COVID on cancer surgery and individual institutional response and strategies adopted to counter the adverse impact. A review of administrative and clinical policy changes adopted at the tertiary cancer center to combat COVID pandemic and resume cancer surgical services were performed. A retrospective comparative analysis of cancer out-patient census during COVID pandemic affected year and the preceding normal year along with cancer surgery data audit for the same periods was performed to assess the impact of the pandemic on cancer surgery. In addition, COVID infection rates among cancer surgery patients and healthcare workers were evaluated. There was approximately a 50% reduction in cancer outpatient registrations during COVID pandemic affected year. A trend of increasing footfalls was noted with decreasing COVID intensity and opening of lockdowns. There was a 33% reduction in major elective surgery and a 41% reduction in emergency surgery performed during the COVID period. As far as cancer surgeries are concerned, there was a 12-50% reduction in volumes involving different subsites. Overall COVID positivity rates among cancer surgery patients was low (8.17%), and approximately 30% of healthcare workers involved in cancer surgery were tested positive for COVID during the study period. Results of the current study indicate a significant impact of COVID pandemic on cancer surgical services. There was a significant impact on outpatient visits and cancer surgery volumes. However, a multidisciplinary-coordinated team approach, effective administrative and policy implementation, adoption of revised surgical safety and anesthesia protocols, COVID screening, and testing protocols facilitated resumption of cancer surgical services without adverse impact on surgical outcomes.

Studies on Growth Characteristics and Cross-Neutralization of Wild-Type and Delta SARS-CoV-2 From Hisar (India).

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly evolved to generate several antigenic variants. These variants have raised concerns whether pre-existing immunity to vaccination or prior infection would be able to protect against the newly emerging SARS-CoV-2 variants or not. We isolated SARS-CoV-2 from the coronavirus disease 2019 (COVID-19)-confirmed patients in the beginning of the first (April/May 2020) and second (April/May 2021) waves of COVID-19 in India (Hisar, Haryana). Upon complete nucleotide sequencing, the viruses were found to be genetically related with wild-type (WT) and Delta variants of SARS-CoV-2, respectively. The Delta variant of SARS-CoV-2 produced a rapid cytopathic effect (24-36 h as compared to 48-72 h in WT) and had bigger plaque size but a shorter life cycle (~6 h as compared to the ~8 h in WT). Furthermore, the Delta variant achieved peak viral titers within 24 h as compared to the 48 h in WT. These evidence suggested that the Delta variant replicates significantly faster than the WT SARS-CoV-2. The virus neutralization experiments indicated that antibodies elicited by vaccination are more efficacious in neutralizing the WT virus but significantly less potent against the Delta variant. Our findings have implications in devising suitable vaccination, diagnostic and therapeutic strategies, besides providing insights into understanding virus replication and transmission.

Association of ABO and Rh Blood Group in Susceptibility, Severity, and Mortality of Coronavirus Disease 2019: A Hospital-Based Study From Delhi, India.

Background: ABO and Rh blood group systems are associated with many diseases including cancerous, infectious, non-infectious, bacterial and viral diseases. Studies have shown association of blood groups A and O with higher and lower odds for coronavirus disease 2019 positivity, respectively. Methods: This is a single-center, retrospective study conducted at Sir Ganga Ram Hospital, Delhi. We investigated the association of ABO and Rh blood groups with susceptibility to coronavirus disease 2019 infection, severity of disease, recovery period, and mortality of patients. Patients were enrolled from April 8, 2020 to October 4, 2020. A total of 2,586 real-time PCR (RT-PCR)-confirmed coronavirus disease 2019 (COVID-19) patients were recruited. Data was analyzed using chi-square test, odds ratio, and Mann-Whitney test to determine the association of blood groups. Results: In the 2,586 COVID-19-infected patients, the frequencies of A, B, O, and AB were 29.93%, 41.80%, 21.19%, and 7.98%, respectively. Of the patients, 98.07% were Rh positive. Blood group A (odds ratio, 1.53; CI, 1.40-1.66; p < 0.001) and B (odds ratio, 1.15; CI, 1.06-1.24; p < 0.001) is observed to be significantly associated with COVID-19 susceptibility, whereas blood group O (odds ratio, 0.65; CI, 0.59-0.71; p < 0.001) and AB (odds ratio, 0.66; CI, 0.59-0.71; p < 0.001) have low risk of COVID-19 infection. Conclusion: A, B, and Rh+ are found to be more susceptible to COVID-19 infection, whereas blood groups O, AB, and Rh- are at a lower risk of COVID-19 infection. No association was found between blood groups and susceptibility to severity of disease and mortality.

SARS-CoV-2 Delta Variant among Asiatic Lions, India.

In May 2021, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was detected in Asiatic lions in a zoological park in India. Sequence and phylogenetic analyses showed the SARS-CoV-2 strains were the B.1.617.2 (Delta) variant. To reduce transmission of variants of concern, surveillance of SARS-CoV-2 in wild animal populations should be increased.

A Comprehensive Overview on COVID-19: Future Perspectives.

The outbreak of COVID-19 has proven to be an unprecedented disaster for the whole world. The virus has inflicted billion of lives across the globe in all aspects-physically, psychologically, as well as socially. Compared to the previous strains of ß-CoV genera- MERS and SARS, SARS-CoV-2 has significantly higher transmissibility and worst post-recovery implications. A frequent mutation in the initial SARS-CoV-2 strain has been a major cause of mortalities (approx. 3 million deaths) and uncontrolled virulence (approx. 1 billion positive cases). As far as clinical manifestations are concerned, this particular virus has exhibited deleterious impacts on systems other than the respiratory system (primary target organ), such as the brain, hematological system, liver, kidneys, endocrine system, etc. with no promising curatives to date. Lack of emergency treatments and shortage of life-saving drugs has promoted the repurposing of existing therapeutics along with the emergence of vaccines with the combined efforts of scientists and industrial experts in this short span. This review summarizes every detail on COVID-19 and emphasizes undermining the future approaches to minimize its prevalence to the remaining lives.