Role of SARS-COV2 antigen as a diagnostic test for COVID-19

Background: Successive waves of SARS-CoV-2 infections with increasing transmission rates may burden the laboratories performing molecular diagnostic testing. Alternative diagnostic methods may provide additional diagnostic capacity. Chemiluminescent totally automated antigen detection test for SARS-CoV-2 (Ortho VITROS SARS-CoV-2 antigen test) could be satisfactory replacement for reverse-transcription quantitative polymerase chain reaction (RT-qPCR) for mass screening during outbreaks. Methods: RT-qPCR and the VITROS® SARS-CoV-2 antigen were compared. Antigen detection test was assessed using clinical samples (nasopharyngeal swabs in viral transport medium) withdrawn from 668 patients suspected to have SARS-CoV-2 infection. Results: From 668 samples, 303 showed SARS-CoV-2 antigens positive and 365 SARS-CoV-2 antigens negative in comparison with RT-qPCR, the sensitivity was 89.11% and the specificity was 100.0% (PPV 100.0 and NPV 91.7). Ct value of 16.0 was the limit of detection of the assay. Conclusion: The given results show that VITROS® assay was acceptable for the detection of patients having contagious COVID-19 in the clinical setting. This test showed high sensitivity and specificity in the SARS-CoV-2 detection in samples with a Ct value of 32 or less. Chemiluminescent full automated antigen detection test for SARS-CoV-2 is a feasible substitute to (RT-qPCR) for mass screening. © 2020 The author (s).

SARS-CoV-2: Evaluation and Evolution

The emerging new COVID 2019 pandemic, which started in 2019 in China (Wuhan) and is caused by SARS-CoV-2, raises critical concerns due to high morbidity and mortality. As many patients are infected and the numbers still increase, this may suggest that there are different variants of the virus and some of them are more pathogenic. Besides, the virus is suspected to have various evolutionary pathways since SARS-CoV-2 belongs to the RNA viruses' family, which is characterized by a high mutation rate. Additionally, it is crucial to understand the life cycle of the virus to be able to urge antiviral studies. Genotyping studies about viruses are also important in order to understand the transmission and evolution of the virus. The genome of SARS-CoV-2 has a furin-like cleavage site in its S protein that may affect its pathogenicity. It was found that insertions and deletions in S protein have an impact on the transmission and fusion of the virus. The single nucleotide polymorphisms (SNP) genotypes are used to track the relationship of virus isolates. Se-quence alignment revealed the presence of hundreds of inter-host mutations during person-to-per-son transmission. Furthermore, genetic recombination provided a second mechanism for virus evo-lution. In this review, we highlight the life cycle of the virus and methods of virus evolution caused by mutations or recombination of viral genomes.Copyright © 2021 Bentham Science Publishers.

Psychological impact of the COVID-19 pandemic on waitlisted pre-bariatric surgery patients in Saudi Arabia: A cross-sectional study.

Background: During the COVID-19 pandemic, the number of bariatric surgeries was decreased to ensure patient safety. This study aimed to evaluate the effect of such delays on the psychological status and weight management behaviors of waitlisted pre-bariatric surgery patients in Jeddah, Saudi Arabia. Materials and methods: A web-based cross-sectional survey was conducted. Results were then evaluated with simple descriptive statistics and inferential analyses through the Chi-square test, one-way ANOVA, and the general linear regression model. Results: Of 437 patients, 208 successfully completed the survey. Approximately half of the participants reported weight change (46.6%, n = 97), while other weight management behaviors remained unchanged. The mean Patient Health Questionnaire-9 (PHQ-9) total score of the respondents was 8.29 ± 6.3, indicating mild depression. Higher PHQ-9 scores were associated with being a student, unhealthy dietary habits, physical inactivity, worsened psychological status, and weight gain. Among these factors, being a student was the strongest predictor of the total PHQ-9 score. Conclusion: The COVID-19 pandemic significantly affected the psychological status of patients with obesity on the bariatric surgery waitlist. Since delays in bariatric surgeries could worsen patients' psychological status, as substantiated in this study, the provision of virtual care through telemedicine and the development of policies for reintroducing bariatric surgeries for future lockdowns are highly recommended.

Perception of primary caregiver toward virtual pediatric clinics for type 1 diabetes mellitus during COVID-19 pandemic in Jeddah, Saudi Arabia: A cross-sectional study.

Background: Virtual phone clinics were adopted at King Abdulaziz Medical City, Jeddah, Saudi Arabia, as an alternative to in-person routine outpatient visits amid the COVID-19 pandemic. This study aimed to assess primary caregiver perceptions of the virtual phone clinics towards routine care of pediatric patients with type 1 diabetes mellitus (T1DM). Methods: A cross-sectional research design was employed through a web-based research tool where the primary caregivers of pediatric patients with T1DM participated. Data were analyzed descriptively and statistically using independent t-tests and one-way analysis of variance. Results: In total, 214 participants were included in this study. The average primary caregiver perception value towards virtual phone clinics was 66.71 ± 23.1%, which suggested a satisfactory perception of their experience. Statistically significant differences (p > 0.05) were not found between the mean perception values and demographic characteristics. Higher mean primary caregiver perception values were associated with those who: (1) agreed or strongly agreed to be contented with their current state of health, (2) did not ask their physicians to be physically seen during a virtual visit, (3) preferred having four virtual visits or more, and (4) preferred having single to no in-person visits at all. Conclusion: This study revealed a generally acceptable primary caregiver perception regarding virtual clinics. Telemedicine is recommended for routine treatment alongside regular in-clinic appointments to improve the quality of care for pediatric patients with T1DM.

Vaccination Intention against COVID-19 among the Unvaccinated in Jordan during the Early Phase of the Vaccination Drive: A Cross-Sectional Survey.

OBJECTIVE: This study assessed the intention and predictors of accepting the corona virus disease 2019 (COVID-19) vaccine in Jordan. METHOD: A national-level online survey was conducted among adults (≥18 years) in Jordan between June and September 2021. Descriptive analyses were performed to report vaccination intent. In addition, bivariate and multivariate logistic regression analyses were done to evaluate the association between vaccination intent and its predictors. RESULTS: A total of 2307 adults participated. Most of them (83.7%) expressed an intention to receive a COVID-19 vaccine. Their vaccination intention was significantly (p < 0.001) associated with male gender (aOR: 2.6), residence in the Amman region (aOR: 51.8), and no history of COVID-19 infection (aOR: 6.0). In contrast, individuals aged 50-64 years (aOR: 0.2, p < 0.001), Jordanians (aOR: 0.7, p = 0.038), and those with an occupation designated as "other" (unemployed, general workers, housewives) (aOR: 0.2, p < 0.001) were less likely to have a positive vaccination intent. Among the health belief model constructs, perceived future (aOR: 2.8) and present (aOR: 5.0) susceptibility to COVID-19 infection; severity of complications (aOR: 9.9); and benefits (aOR: 100.8) were significantly (p < 0.001) associated with a higher likelihood of having a vaccination intent. On the other hand, individuals who are concerned about the efficacy (aOR: 0.2) and side effects (aOR: 0.2) of the vaccine were less likely to have a positive vaccination intent (p < 0.001). CONCLUSION: Despite having high rates of intention to receive a COVID-19 vaccine, Jordanians, older adults and housewives, general workers and unemployed individuals were less likely to be vaccinated. These findings highlight that need-based public health campaigns are necessary to ensure maximum COVID-19 vaccination uptake in Jordan.

Effectiveness of virtual teaching of diagnostic and interventional imaging fundamentals to Egyptian medical students: an analytical cross-sectional study

Background There is a worldwide deficit in teaching and training in the field of radiology for undergraduate medical students. This educational gap is prominent in many medical schools as most radiology curricula are a part of other specialty trainings, usually provided by non-radiologists. After COVID-19 pandemic, there was an increased trend in online education. However, questions have been raised about the efficacy and acceptance of online education. We developed a course on the principles of radiology and medical imaging basics to target Egyptian medical students. We then assessed the impact of these educational videos through several online surveys. Our "The Principles of Radiology Online Course" was delivered to students at various Egyptian medical schools;it was a prerecorded series composed of nine sessions, and each session followed the sequence of a pre-test, video, and post-test. There was a final survey to assess the overall feedback. Finally, we analyzed the results to give insight onto how teaching radiology through online lectures can help build better physicians. Results Among various medical schools around Egypt, 1396 Egyptian medical students joined this cohort. Cohort population percentage was 56% female and 44% male. Ninety-eight percent of the students agreed that this program increased their understanding of radiology. Eighty-four percent of the students found the platform friendly and easy to use. Seventy-nine percent found these webinars were more convenient compared to in-person education. Statistical significance (p-value < 0.05) was achieved in all sessions after comparing students’ pre and post-test scores, and in students’ confidence and knowledge level before and after the course. Conclusions Radiology is an underrepresented subject for a lot of medical students. Online radiology webinars have proven to be a promising method of teaching medical students key medical imaging concepts. An online course of radiology basics and principles can help improve a medical student’s knowledge and enhance overall future patient care.

Multidisciplinary approach of teaching radiology to medical students in Egypt: Is this an effective method?

Background In multidisciplinary education, different perspectives from more than one discipline are used to illustrate a certain topic. The aim of this study was to evaluate the effectiveness of an online, multidisciplinary radiology curriculum to teach radiology to medical students in Egypt. A multidisciplinary team of radiologists, surgeons, and internists taught a series of 5 case-based radiology sessions on a web conference platform. Topics included common clinical case scenarios for various body systems. Undergraduate medical students across Egypt were enrolled in the course. A pre-test–post-test design was used to evaluate the efficacy of each session. Upon course completion, students filled out a subjective survey to assess the radiology education series. Results On average, 1000 students attended each session. For each session, an average of 734 students completed both the pre-test and post-test. There was a statistically significant increase in post-test scores compared to pre-test scores across all 5 sessions (p < 0.001) with an overall average score improvement of 63%. A subjective survey at the end of the course was completed by 1027 students. Over 96% of students found the lecture series to be a worthwhile experience that increased their imaging knowledge and interest in radiology, and that the use of a multidisciplinary approach added educational value. About 66% of students also reported that the session topics were “excellent and clinically important.” There was a marked increase in reported confidence levels in radiology competencies before and after attendance of the sessions. Conclusions An online radiology curriculum with a multidisciplinary approach can be implemented successfully to reach a large group of medical students and meet their educational objectives.

Ocular Manifestations of Post-Acute COVID-19 Syndrome, Upper Egypt Early Report.

PURPOSE: To evaluate the ocular manifestations of post-acute COVID-19 syndrome. METHODS: A retrospective, comparative study included 100 patients who had recovered from COVID-19 and 100 controls who were recruited by stratified randomization from hospital registration system and analyzed regarding history, full ophthalmological examination, general examination including internal medicine and neurological evaluation. Laboratory tests were done. RESULTS: Mean±SD of age were 55.5 ± 6.2 in COVID group vs 56.5 ± 5.8 in control group; P value = 0.7. In COVID group, 57 patients (57%) were males vs 51 patients (51%) in control group (P value = 0.39), the other compared parameters including history and risk factors showed non-significant difference except for ESR and D-dimer which were elevated in COVID group. In COVID group, 5 patients (5%) were having retinal vascular occlusion, 2 patients (2%) were having anterior ischemic optic neuropathy AION, 3 patients (3%) were having uveitis and 2 patients (2%) were having central serous chorioretinopathy CSCR. While in control group, 2 patients (2%) were having retinal vascular occlusion, and none had AION, uveitis or CSCR (P value = 0.006). CONCLUSION: Post-acute COVID-19 syndrome could affect the eyes in the form of coagulation problems, neurological morbidities, and other manifestations. This necessitates meticulous follow-up of recovered patients from COVID-19.

Blue Biotechnology: Computational Screening of Sarcophyton Cembranoid Diterpenes for SARS-CoV-2 Main Protease Inhibition.

The coronavirus pandemic has affected more than 150 million people, while over 3.25 million people have died from the coronavirus disease 2019 (COVID-19). As there are no established therapies for COVID-19 treatment, drugs that inhibit viral replication are a promising target; specifically, the main protease (Mpro) that process CoV-encoded polyproteins serves as an Achilles heel for assembly of replication-transcription machinery as well as down-stream viral replication. In the search for potential antiviral drugs that target Mpro, a series of cembranoid diterpenes from the biologically active soft-coral genus Sarcophyton have been examined as SARS-CoV-2 Mpro inhibitors. Over 360 metabolites from the genus were screened using molecular docking calculations. Promising diterpenes were further characterized by molecular dynamics (MD) simulations based on molecular mechanics-generalized Born surface area (MM-GBSA) binding energy calculations. According to in silico calculations, five cembranoid diterpenes manifested adequate binding affinities as Mpro inhibitors with ΔGbinding < -33.0 kcal/mol. Binding energy and structural analyses of the most potent Sarcophyton inhibitor, bislatumlide A (340), was compared to darunavir, an HIV protease inhibitor that has been recently subjected to clinical-trial as an anti-COVID-19 drug. In silico analysis indicates that 340 has a higher binding affinity against Mpro than darunavir with ΔGbinding values of -43.8 and -34.8 kcal/mol, respectively throughout 100 ns MD simulations. Drug-likeness calculations revealed robust bioavailability and protein-protein interactions were identified for 340; biochemical signaling genes included ACE, MAPK14 and ESR1 as identified based on a STRING database. Pathway enrichment analysis combined with reactome mining revealed that 340 has the capability to re-modulate the p38 MAPK pathway hijacked by SARS-CoV-2 and antagonize injurious effects. These findings justify further in vivo and in vitro testing of 340 as an antiviral agent against SARS-CoV-2.

COVID-19 versus SARS: A comparative review.

The two genetically similar severe acute respiratory syndrome coronaviruses, SARS-CoV-1 and SARS-CoV-2, have each been responsible for global epidemics of vastly different scales. Although both viruses arose from similar origins, they quickly diverged due to differences in their transmission dynamics and spectrum of clinical presentations. The potential involvement of multiple organs systems, including the respiratory, cardiac, gastrointestinal and neurological, during infection necessitates a comprehensive understanding of the clinical pathogenesis of each virus. The management of COVID-19, initially modelled after SARS and other respiratory illnesses, has continued to evolve as we accumulate more knowledge and experience during the pandemic, as well as develop new therapeutics and vaccines. The impact of these two coronaviruses has been profound for our health care and public health systems, and we hope that the lessons learned will not only bring the current pandemic under control, but also prevent and reduce the impact of future pandemics.

Carotane sesquiterpenes from Ferula vesceritensis: in silico analysis as SARS-CoV-2 binding inhibitors.

Two sesquiterpenes, 8α-anisate-dauc-4-ene-3,9-dione (webiol anisate) (1) and 10α-acetoxy-6α-benzoate-jaeschkeanadiol (2) as well as, ten known analogues (3-10), and two sesquiterpene coumarins (11-12) were isolated from an organic root extract of Ferula vesceritensis (Fam. Apiaceae). Chemical structures were elucidated based on IR, 1D- and 2D-NMR and HRMS, spectroscopic analyses. With molecular overlap observed between two protease inhibitors that are being examined as anti-COVID-19 drugs, and sesquiterpenes isolated here, metabolite molecular docking calculations were made using the main protease (Mpro), which is required for viral multiplication as well as RNA-dependent RNA polymerase (RdRp). In silico binding-inhibition analysis predicted that select F. vesceritensis sesquiterpenes can bind to these enzymes required for viral replication. Structures of the isolated constituents were also consistent with the chemo-systematic grouping of F. vesceritensis secondary metabolites with other Ferula species.

Rutin and flavone analogs as prospective SARS-CoV-2 main protease inhibitors: In silico drug discovery study.

Coronavirus disease 2019 (COVID-19) is a new pandemic characterized by quick spreading and illness of the respiratory system. To date, there is no specific therapy for Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2). Flavonoids, especially rutin, have attracted considerable interest as a prospective SARS-CoV-2 main protease (Mpro) inhibitor. In this study, a database containing 2017 flavone analogs was prepared and screened against SARS-CoV-2 Mpro using the molecular docking technique. According to the results, 371 flavone analogs exhibited good potency towards Mpro with docking scores less than -9.0 kcal/mol. Molecular dynamics (MD) simulations, followed by molecular mechanics-generalized Born surface area (MM/GBSA) binding energy calculations, were performed for the top potent analogs in complex with Mpro. Compared to rutin, PubChem-129-716-607 and PubChem-885-071-27 showed better binding affinities against SARS-CoV-2 Mpro over 150 ns MD course with ΔGbinding values of -69.0 and -68.1 kcal/mol, respectively. Structural and energetic analyses demonstrated high stability of the identified analogs inside the SARS-CoV-2 Mpro active site over 150 ns MD simulations. The oral bioavailabilities of probable SARS-CoV-2 Mpro inhibitors were underpinned using drug-likeness parameters. A comparison of the binding affinities demonstrated that the MM/GBSA binding energies of the identified flavone analogs were approximately three and two times less than those of lopinavir and baicalein, respectively. In conclusion, PubChem-129-716-607 and PubChem-885-071-27 are promising anti-COVID-19 drug candidates that warrant further clinical investigations.

In Silico Evaluation of Prospective Anti-COVID-19 Drug Candidates as Potential SARS-CoV-2 Main Protease Inhibitors.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a recently emanating human infectious coronavirus that causes COVID-19 disease. On 11th March 2020, it has been announced as a pandemic by the World Health Organization (WHO). Recently, several repositioned drugs have been subjected to clinical investigations as anti-COVID-19 drugs. Here, in silico drug discovery tools were utilized to evaluate the binding affinities and features of eighteen anti-COVID-19 drug candidates against SARS-CoV-2 main protease (Mpro). Molecular docking calculations using Autodock Vina showed considerable binding affinities of the investigated drugs with docking scores ranging from - 5.3 to - 8.3 kcal/mol, with higher binding affinities for HIV drugs compared to the other antiviral drugs. Molecular dynamics (MD) simulations were performed for the predicted drug-Mpro complexes for 50 ns, followed by binding energy calculations utilizing molecular mechanics-generalized Born surface area (MM-GBSA) approach. MM-GBSA calculations demonstrated promising binding affinities of TMC-310911 and ritonavir towards SARS-CoV-2 Mpro, with binding energy values of - 52.8 and - 49.4 kcal/mol, respectively. Surpass potentialities of TMC-310911 and ritonavir are returned to their capabilities of forming multiple hydrogen bonds with the proximal amino acids inside Mpro's binding site. Structural and energetic analyses involving root-mean-square deviation, binding energy per-frame, center-of-mass distance, and hydrogen bond length demonstrated the stability of TMC-310911 and ritonavir inside the Mpro's active site over the 50 ns MD simulation. This study sheds light on HIV protease drugs as prospective SARS-CoV-2 Mpro inhibitors.

Managing Type 1 Diabetes among Saudi adults on insulin pump therapy during the COVID-19 lockdown.

BACKGROUND AND AIMS: The coronavirus disease 2019 (COVID-19) pandemic has affected people's lives including patients with type 1 diabetes mellitus (T1DM). We aimed to investigate the impact of the COVID-19 lockdown on psychological status, self-management behaviors, and diabetes care maintenance among Saudi adults with T1DM using insulin pump therapy. METHODS: This cross-sectional study used a web survey to collect data on Saudi adults with T1DM who were treated in the specialized insulin pump clinic at King Abdulaziz Medical City-Jeddah, Saudi Arabia. We used the Patient Health Questionnaire-9 and General Anxiety Disorder-7 scales to measure depression and anxiety. RESULTS: Of the 70 patients who received the survey, 65 completed it. Overall, 23.1% and 29.2% of the patients reported moderate to severe and mild depression, respectively; 18.5% and 24.6% reported moderate to severe and mild anxiety, respectively. Compared with pre-lockdown, adherence to a healthy diet and regular physical activity decreased in 67.7% and 41.5% of the patients, respectively. Most patients maintained their adherence to insulin pump behaviors; frequent self-monitoring of blood glucose increased in 47% of glucometer users. Most patients benefited from phone visits or virtual education sessions, but 66.2% of the patients reported difficulty obtaining at least one type of insulin pump supply. CONCLUSIONS: Promoting self-management behaviors and psychological wellbeing of patients with T1DM using insulin pump therapy is crucial during a lockdown. Telemedicine is a useful alternative to in-person appointments, but strategies to ensure that patients have access to adequate resources during lockdown must be developed.

WILL NOVEL CORONAVIRUS (COVID-19) PANDEMIC IMPACT AGRICULTURE, FOOD SECURITY AND ANIMAL SECTORS?

The whole world is in a great danger due to the novel coronavirus (COVID-19) pandemic. In December 2019, the outbreak of COVID-19 took place in Wuhan, China and then rapidly spread all over the world. The current study provides potential expectations for the adverse impact of ( COVID-19). The global infection affected globe on agricultural level such as agriculture, food supplies and animal production sectors. Till today, 29th April 2020, there is no vaccine available for treating novel coronavirus, consequently, the outbreak resulted in closing borders and reducing production following social distancing measures. This short communication illustrates the possible implications and expected outcomes of the outbreak of coronavirus (COVID-19) on agricultural, food security, integrated pest management (IPM), animal productivity;and it predicts, as well, the possible adverse impacts on the economy worldwide. Brazil has one of the most important tropical agriculture in the world, being a leader in soybean production in the world. This chain impacts others such as meat and eggs. The impact of COVID-19 will be positive, encouraging the country to consolidate its leadership in the world market, stimulating exports, the machinery, inputs and fertilizers market, as well as generating employment and income in the country.