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1.
Infezioni in Medicina ; 30(3):432-439, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-2033632

RESUMO

Introduction: Liposomal amphotericin use is limited in developing countries due to its extremely high cost and availability. Therefore, the study aimed to evaluate deoxycholate amphotericin B’s utility and adverse effect profile in patients with mucormycosis. Methodology: This retrospective cohort study from 2019 to 2021 included patients with proven mucormy-cosis who received deoxycholate amphotericin B for more than or equal to five days and had at least three creatinine values on treatment. Baseline demographic details, risk factors and treatment details of all the patients were recorded. In addition, the details of treat-ment-related adverse effects and outcomes were ascer-tained. Results: Of the 57 included patients, a history of diabe-tes, COVID-19 and steroid use was present in 49 (86%), 43 (75.4%) and 33 (57.9%) patients, respectively. Isolat-ed rhino-orbital mucormycosis was the most common presentation (n=49, 86%). The median time of fol-low-up was 48 (30.5-90) days. A total of 8 (14%) pa-tients died during the hospital stay. The median dura-tion of amphotericin treatment was 21 (14-40) days. Thirty-nine patients (68.4%) developed hypokalaemia on treatment, while 27 (47.4%) patients developed hy-pomagnesaemia. A total of 34 (59.6%) patients developed AKI on treatment. The median day of development of AKI was 6 (4-10) days. The median baseline, highest and final creatinine values were 0.78 (0.59-0.94) mg/dl, 1.27 (0.89-2.16) mg/dl and 0.93 (0.74-1.59) mg/ dl respectively. The median percentage change from baseline to highest value and last follow-up value was 45% (0.43%-161%) and 25% (-4.8%-90.1%) respectively. The final creatinine was less than 150% of the baseline in 36 (63.2%) patients. Conclusion: Deoxycholate amphotericin is an accept-able alternative for treating mucormycosis in re-source-constrained settings.

2.
Infezioni in Medicina ; 30(3):427-431, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-2033631

RESUMO

Reverse Transcription Polymerase Chain Reaction (RT-PCR) conducted on nasopharyngeal swabs is the gold standard in the diagnosis of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). In Italy, recent guidelines indicate that rapid antigen tests (RATs) can be used for the isolation of positive patients or for the interruption of quarantine, but they are often less sensi-tive to detect positive subjects. Indeed, the performance of these RATs depends on the timing and the population on which they are evaluated. Herein, we evaluated the performance of BIOCREDIT COVID-19 Ag and Fluorecare® SARS-CoV-2 Spike Protein Test during a population screening in the Calabria Region, Southern Italy. We report that both antigen test shows low sensitivity in contrast to the high sensitivity declared by manu-facturer (90% and 92%, respectively) and that the area under the curve (AUC) was good for Fluorecare® SARS-CoV-2 Spike Protein Test but very poor for BIOCREDIT COVID-19 Ag. We suggest that these RATs should be re-evaluated in the current pandemic era.

3.
Infezioni in Medicina ; 30(3):412-417, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-2033630

RESUMO

To reduce the overburden in the hospital, during the COVID-19 pandemic, some “COVID Committed Home Medical Teams” (CCHTs) were created in Italy. These units consist of a small pool of general practitioners who aim to evaluate all patients with COVID-19 who require a medical examination directly at home. After the first visit (which can end with patient hospitalisation or home management), CCHTs periodically monitor the patients’ clinical conditions and vital signs (usually a re-valuation every 24-48 hours, except for a sudden wors-ening). However, this strategy-which reduces the pres-sure on hospitals-has never been evaluated for patient safety. Our study aims to determine whether a home-based monitoring and treatment strategy for non-severe COVID-19 patients was safe as direct hospital admis-sion by the emergency department. We conducted a retrospective observational study about 1,182 patients admitted to the hospital for COVID-19 between September 2020 and April 2021, confronting in-hospital and 30-day mortality in both CCHT-referred (n=275) and directly admitted by emergency department (n=907). Patients assessed by the CCHT had lower in-hospital and 30-day mortality (18% vs 28%, p=0.001;and 20% vs 30%, p=0.002);but, in the propensity score matching comparison, there was no characteristic between the two groups turned out significantly different. CCHT did not correlate with in-hospital or 30-day mortality. CCHT is a safe strategy to reduce hospital overburden for COVID-19 during pandemic surges.

4.
Infezioni in Medicina ; 30(3):403-411, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-2033629

RESUMO

Cases with SARS-CoV-2 RT-PCR negative pneumonia are an understudied group with uncertainty remain-ing regarding their treatment approach. We aimed to compare the clinical and radiological characteristics of RT-PCR positive and clinically diagnosed RT-PCR negative COVID-19. This was a single-centre retrospective study conducted at a tertiary care hospital in Western India. All patients (age ≥18 years) with suspicion of COVID-19 with SARI (severe acute respiratory infec-tions) who were subjected to RT-PCR testing (nasal/ oropharyngeal swab) were included. Based on RT-PCR results, patients were categorized and compared for demographic, clinical, and biochemical characteristics and outcomes. Out of 500 patients, 339 (67.8%) found RT-PCR positive. Except for the radiological findings, both groups differ in clinical presentation, disease severity (inflammatory markers), and outcome. RT-PCR-positive patients had raised ferritin, NLR (Neutrophil-Lymphocyte ratio), LDH, and high mortality compared to the swab-negative group. In-hospital mortality was also significantly high in RT-PCR positive group (HR=1.9, 95% CI=1.4-2.5, p=0.001). On mul-tivariate analysis, NLR, ferritin, and d-dimer were the independent predictors of mortality in RT-PCR-posi-tive (p=0.038, 0.054, and 0.023). At the same time, raised TLC (total leukocyte count) and procalcitonin were the risk factors for poor outcomes in RT-PCR-negative patients (p=0.041 and 0.038). We found significantly raised ferritin, NLR, and LDH levels and increased mortality in RT-PCR positive patients compared to RT-PCR neg-ative. Incorporating clinical features, radiological, and biochemical parameters could be prudent while managing the RT-PCR-negative patients.

5.
Infezioni in Medicina ; 30(3):344-352, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-2033628

RESUMO

Multisystem Inflammatory Syndrome in Children (MIS-C), a rare condition, has been reported approxi-mately 2-4 weeks after the onset of COVID-19 in children and adolescents, causing inflammation in multiple systems, including cardiovascular and respiratory, digestive, and central nervous systems. This condition is also known as hyperinflammatory shock, Kawa-saki-like disease, and Pediatric Inflammatory Multi-system Syndrome (PIMS). The signs and symptoms include but are not limited to fever, rash, peripheral edema, gastrointestinal symptoms, conjunctivitis, and shock. Thirty-eight studies met our criteria, with a to-tal of 5822 patients. The most affected population was between 5-18 years of age. We noted that MIS-C pre-sented with a wide range of signs and symptoms that overlap with Kawasaki Disease, including high fever, sore throat, malaise, tachypnea, tachycardia, conjunc-tival injection, mucosal edema, cardiac involvement, and gastrointestinal symptoms. It causes an increase in IL-17A, IL-6, and arterial damage, a distinct differ-ence from Kawasaki disease. The laboratory findings in MIS-C showed an increase in inflammatory markers like CRP, ESR, ferritin, leukocytes, and TNF-α. WHO stated that 23% of affected children with MIS-C had underlying conditions like chronic lung diseases, cardiovascular disease, and immunosuppression. In most affected children, aspirin and IVIG were success-ful, which resulted in a decrease in the inflammatory markers. We find that MIS-C is a rare, but potential-ly fatal pediatric complication, after COVID-19 infec-tion. The aim of this article is to study the emerging relationship between COVID-19 and MIS-C in children and adolescents affected by this condition, to discuss the immunological mechanisms, and explore potential therapies.

6.
Anales de la Real Academia Nacional de Farmacia ; 88(2):123-130, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-2033626

RESUMO

Objetive: Description of the different isolated microorganisms and their prevalence in infections associated with health care, in addition to determining their patterns of resistance to antibiotics in patients admitted with a confirmed or suspected diagnosis of COVID-19 in the Intensive Care Unit, during a third-level medical center with hospital reconversion. Method: Patient demographic data was obtained from the clinical record, with defined criteria. Antibiotic resistance patterns were evaluated as well as the identification of isolated bacteria in cultures of expectoration, pleural fluid, catheter tips. For bacterial identification and resistance mechanisms, automated equipment and phenotypic tests were used, following the CLSI (Clinical & Laboratory Standards Institute) criteria. Results: A total of 100 patients with bacterial infection added to the main COVID-19 picture were obtained, representing pneumonia, urinary tract infection, catheter infections and bacteremia. A total of 100 strains were isolated, of which 84 are Extremely Drug Resistant, 12 Multidrug Resistant and only 4 variable sensitivity. The bacteria with the highest prevalence is Staphylococcus aureus with, followed by Pseudonomas aeruginosa and Stenotrophomonas maltophilia. 100% of the patients admitted to the ICU (Intensive Care Unit) had death. Conclusion: The increase in resistance to antibiotics in the COVID-19 pandemic has set off alarms due to the complication that this brings, and the improper use of drugs as prophylaxis or attempted treatment only generates selective pressure that leads to an increase in resistance as observed in the isolated strains in this study, where the vast majority present enzymes as well as other resistance mechanisms that confer them to be XDR (Extremely Drug Resistant).

7.
Pakistan Journal of Medical and Health Sciences ; 16(7):485-487, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-2033625

RESUMO

Background: Because of the recent outbreak of Covid-19, the globe is now facing a number of difficult challenges. The morbidity and mortality rate varies depending upon numerous factors. Objective: The objective of the study was to find out the mortality and morbidity rate of Covid-19 in a tertiary care hospital of Swat Methodology: This descriptive cross-sectional study was carried out at the Department of Pathology, Swat Teaching Hospital, Swat, Khyber Pakhtunkha Pakistan for duration of one year from April 2020 to March 2021. Nasopharyngeal or Oropharyngeal swabs were taken from all the enrolled patients and sent to the national institute of health Islamabad or swat public health laboratory for the diagnosis of Covid-19. The rate of morbidity and mortality for all the enrolled patients was recorded. All the data analysis was done by using IBM SPSS version 23. Results: In the current study, totally 11609 patients were enrolled. There were 7329 (63.13%) males and 4280 (36.87%) females. The overall morbidity rate of covid-19 was 18.25% (n= 2089) whereas the overall mortality rate was13.16% (n=275) patients. Conclusion: Our study concludes that the rate of morbidity and mortality of covid-19 is high in district Swat Khyber Pakhtunkhwa, Pakistan. The burden of covid-19 was high in males as compared to females and the mortality rate increases with the increase in age. All the people residing in the district Swat should be vaccinated to decrease both the morbidity and mortality rate of covid-19.

8.
Pakistan Journal of Medical and Health Sciences ; 16(7):474-478, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-2033624

RESUMO

Objective: Healthcare providers (HCPs) are at the forefront and are at risk of being exposed to suspected cases of COVID-19. The objective of our study was to evaluate knowledge, attitude and practices of HCPs about COVID-19 in Khyber Pakhtunkhwa (KPK) province of Pakistan. Methods: A cross-sectional survey was conducted online among HCPs that included physicians, dentists, pharmacists, nurses and technicians in KPK province. The validated questionnaire (Cronbach alpha= 0.61 & 0.69 respectively for knowledge & practice sections) related to COVID-19 including socio-demographics was asked. Data was analyzed using SPSS version 22.0. Result: Out of 480 HCPs, 83.8% (n=402) were physicians & dentist, while 12.5% (n= 60) were pharmacist, nurses and technicians. We found that 86% of the HCPs had adequate knowledge. Most common reason for being worried about COVID- 19 was risk to members of family and friends (98%), followed by dangers of disease itself (93%). Fear of infection and carrying it home was as high as 93% and 97% respectively. Around 75% of the HCPs had adequate score about practices. Conclusion: HCPs in Pakistan has good knowledge and attitude related to COVID-19. However, one-fourth of the HCPs did not report good practices, which is alarming. There is a need to reinforce knowledge and monitor practices of HCPs regarding standard infection control practice.

9.
JAMS Journal of Acupuncture and Meridian Studies ; 15(4):247-254, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-2033620

RESUMO

Background: Coronavirus disease 2019 (COVID-19) is an infectious disease caused by a coronavirus (SARS-CoV-2) that can induce cytokine storm. To this point, no specific drug has been effective for curing COVID-19. Objectives: The aim of this study was to determine the effects of a combination of acupuncture intervention and pharmacologic treatment in hospitalized COVID-19 patients with mild-moderate symptoms. Methods: A single-blinded randomized controlled clinical trial of hospitalized COVID-19 patients confirmed by RT-PCR examination with mild-moderate symptoms was conducted from August to September 2020. Participants were assigned to the treatment group (receiving pharmacologic treatment and manual acupuncture intervention) or the control group (receiving only pharmacologic treatment). Laboratory outcomes, including complete blood count, C-reactive protein (CRP) and ferritin levels, and erythrocyte sedimentation rate (ESR), were measured before and after the intervention. For clinical outcomes, we evaluated the duration of the cough symptom. Results: We found that participants in the treatment group had a shorter duration of the cough symptom compared to the control group, and the difference was statistically significant. In the treatment group, we found an increase in the percentage of lymphocyte count and ESR, while in the control group, both parameters were decreased;however, the differences were not statistically significant. There was a decrease in the mean of CRP and ferritin levels in both groups, and the differences were not statistically significant. Conclusion: Our study has shown promising results for the effects of combined treatment of acupuncture and pharmacologic treatment on the duration of the cough symptom in hospitalized COVID-19 patients with mild-moderate symptoms. Further large-scale studies with rigorous design are needed to examine these preliminary results

10.
Indian Journal of Forensic Medicine and Toxicology ; 16(3):208-213, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-2033603

RESUMO

Background: The COVID-19 pandemic has spread worldwide, forcing governments to implement quarantines as a preventive measure against the spread of the virus. Quarantine causes changes in lifestyle and anthropometry status among communities. Objective: To describe the lifestyle and anthropometric status of medical students batch 2018 FM UA during the pandemic. Methods: This was a descriptive study using online questionnaires from September 2020 to February 2021. Results: There were variations in students’ anthropometry. Students’ average height is 161.110 cm, the average weight is 60.308 cm, the average body mass index is 23.193 cm, the average upper arm circumference is 27.846 cm, and the average abdominal circumference is 79.621 cm. Furthermore, 145 respondents (81.9%) stated that they experienced changes in their lifestyle during the pandemic. A total of 89 respondents (50.3%) continued to exercise and the other 88 respondents (49.7%) did not. Regarding the sleep pattern, 108 respondents (61%) had quite good sleep quality and 50 respondents (28.2%) had quite poor sleep quality. For the food consumption pattern, 46 respondents (26%) ate more sweet foods. Furthermore, 156 respondents (88.1%) did sedentary activities, with 77 respondents (43.5%) doing sedentary behavior for more than 6 hours a day. Conclusion: During the COVID-19 pandemic, the anthropometric status of medical students batch 2018 FMUA varied;and tend to maintain their physical activity, have quite good sleep quality, prefer eating sweet foods, and do a sedentary behavior for a longer duration

11.
Indian Journal of Forensic Medicine and Toxicology ; 16(3):165-172, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-2033602

RESUMO

Background: The respiratory system is most affected by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV2). However, COVID-19 can appear in a variety of ways. It has found a link between higher liver enzymes and COVID-19 infection, implying that the virus can induce liver damage through direct hepatotoxic injury, medication toxicity, or an immune-mediated response. Materials and Methods: In the southern Iraqi province of Basra, a cross-sectional observational study is being conducted in a single center (Basra teaching hospital) to estimate the prevalence of liver damage among hospitalized patients and identify those at risk. Results: The study found that most of the patients have a normal liver function test at the time of diagnosis and or admission, but after hospitalization, there is a statistically significant increase in the liver enzymes that is positively related to the disease severity and cytokine storm and also lead to more extended hospital staying and further mortality. Fortunately, the degree of liver damage is of mild severity in the majority of patients. Still, the severe form of liver damage was also noticed in some patients, especially those with a higher degree of lung involvement and severely desaturates with raised inflammatory markers. Conclusions: Elevated liver enzymes are prevalent, but the majority is mild with COVID-19 disease. Liver function abnormalities, particularly increased levels of AST and ALT, are not only common in COVID-19, but they are also linked to poor outcomes, mainly if severe liver damage has occurred.

12.
Acta Pharmaceutica Hungarica ; 91(3-4):120, 2021.
Artigo em Inglês | EMBASE | ID: covidwho-2033589

RESUMO

A drawback of the current mRNA-lipid nanoparticle (LNP) COVID-19 vaccines is that they have to be stored at (ultra)low temperatures (2). Understanding the root cause of the instability of these vaccines may help to rationally improve mRNALNP product stability and thereby ease the temperature conditions for storage. In this presentation we discuss proposed structures of mRNALNPs, factors that impact mRNA-LNP stability and strategies to optimize mRNA-LNP product stability. Analysis of mRNA-LNP structures reveals that mRNA, the ionizable cationic lipid and water are present in the LNP core. The neutral helper lipids are mainly positioned in the outer, encapsulating, wall. mRNA hydrolysis is an important driver for mRNA-LNP instability. It is currently a matter of debate whether water in the LNP core can freely interact with the mRNA and to what extent the degradation prone sites of mRNA are protected through a coat of ionizable cationic lipids. To improve the stability of mRNALNP vaccines, optimization of the mRNA nucleotide composition should be prioritized. Secondly, a better understanding of the milieu the mRNA is exposed to in the core of LNPs may help to rationalize adjustments to the LNP structure to preserve mRNA integrity. Moreover, drying techniques, such as lyophilization, are promising options still to be explored. As vaccines turn out to be the major weapon against the COVID-19 viral attack, the urge to develop more stable formulations is still growing and alternative, not-mRNA based products, may come to the forefront in situations where the (ultra) cold chain cannot be guaranteed. (Table Presented).

13.
Acta Pharmaceutica Hungarica ; 91(3-4):95-96, 2021.
Artigo em Inglês | EMBASE | ID: covidwho-2033587

RESUMO

Introduction Pfizer-BioNTech collaboration started in 2018 in order to develop mRNA flu vaccine. Because of the covid19 pandemic the two companies started to focus on mRNA vaccine development for the prevention of covid19 infection. In March they signed the Letters of Intent. Initially there were four vaccine candidates including unmodified mRNA, nucleoside-modified mRNA and self-amplifying mRNA. For further development the nucleoside- modified mRNA was chosen. In April Phase 1/2 study was completed in Germany and in May in the USA. Two 30 μg doses 3 weeks apart induced neutralizing antibody titers comparable to natural infection and strong CD4+ and CD8+ Tcell responses were observed. Phase 2b/3 clinical trial started in July involving more than 43.000 participants in 153 sites. The result showed 95% efficacy with mild and moderate local and systemic events. For safety reason all participants will be followed for 2 years after the second dose. Based on rolling review regulatory agencies were able to approve within a short period of time in December 2020, first MHRA in UK, then FDA authorized for Emergency Use and EMA granted Conditional Marketing Authorization on 21 December 2021 for 16 years old and older. The first shipments were sent all European countries on 27 December. Direct shipments to vaccination centers on ultra-low temperature (minus 9060 degree of centigrade) using dry ice. Each thermal shipping container has a temperature monitoring device. All shipments are tracked via GPS monitoring device to ensure end-to-end distribution within required temperatures. In May EMA granted an extension of indication for covid-19 vaccine to include in children aged 12-15. The effect of vaccine was investigated in 2260 children aged 12-15, about half of them received dummy injection. Of the 1,005 children receiving the vaccine, none developed COVID-19 compared to 16 children out of the 978 who received the dummy injection. This means that, in this study, the vaccine was 100% effective at preventing COVID-19. The most common side effects in children aged 12 to 15 are similar like those in people aged 16 and above. They include pain at the injection site, tiredness, headache, muscle and joint pain, chills and fever. These effects are usually mild or moderate and improve within a few days from the vaccination. EMA granted approval for booster dose (third dose) for immune weakened people 28 days after the second dose, and 6 months after the second dose for 18 years of age and older. Approval is based on the clinical program evaluating the safety, tolerability and immunogenicity of a booster dose of covid-19 vaccine. A booster dose of the vaccine elicited significantly higher neutralizing antibody titers against the initial SARS-CoV-2 virus (wild type), as well as the Beta and Delta variants, when compared with the levels observed after the two-dose primary series. The reactogenicity profile within seven days after the booster dose was typically mild to moderate, and the frequency of reactions was similar to or lower than after dose two. The efficacy is this trial was 95,6%. In October 2021 FDA authorized for emergency use of covid-19 for children 5 through 111 years of age. For this age group, the vaccine is to be admin-istered in a two-dose regimen of 10 μg (0,2 ml) doses given 21 days apart. EUA is supported by clinical data showing a favorable safety profile and high vaccine efficacy of 90.7% in children 5 through 11 years of age during a period when Delta was the prevalent strain. In 2021 we have already distributed 1,8B doses to 146 countries by end of September. In 2022 we plan to distribute 4B doses. (Figure Presented).

14.
Acta Pharmaceutica Hungarica ; 90(2-3):109, 2020.
Artigo em Inglês | EMBASE | ID: covidwho-2033586

RESUMO

Background: As we have seen in the last six months, emerging and re-emerging viruses could be the biggest threat for the human population nowadays in our modern, accelerated and globalized world. Both of influenza and coronaviruses have the potential to cause serious pandemics worldwide. Unfortunately, there are no effective enough medications against most of these viruses. Aims: As some glycopeptide antibiotics and their derivatives proved to be effective against several viruses1, therefore we planned to synthesize some new derivatives equipped with highly fluorinated lipophilic groups. Methods: Perfluorobutyl and perfluorooctyl groups were conjugated to the N-terminus of teicoplanin pseudoaglycone and vancomycin aglycone derivatives through ethylene glycol and tetraethylene glycol linkers by means of photoinitiated addition and azide-alkyne click reaction. The effect of the derivatives were evaluated against several viruses including influenza and human coronavirus. Results: Vancomycin aglycone derivatives were inactive against all of the studied influenza strains, while 3 out of the 4 perfluorobutyl and perfluorooctyl derivatives of teicoplanin pseudoaglycone displayed very good activity against influenza H1N1, H3N2 and B strains. Two of the derivatives were active against human coronavirus as well. Conclusion: We hope that these results can open a new way in finding more effective antivirals based on glycopeptide antibiotics.

15.
Acta Pharmaceutica Hungarica ; 90(2-3):61, 2020.
Artigo em Inglês | EMBASE | ID: covidwho-2033585

RESUMO

Vaccines, currently used for prophylactic purposes, prevent more than three million deaths every year from diseases like diphtheria, pertussis, tetanus, poliomyelitis, measles and influenza. The general six stages of the development of a new vaccine are: i) Exploratory stage;ii) Pre-clinical stage;iii) Clinical development;iv) Regulatory review and approval;v) Manufacturing;vi) Quality control. Clinical development is a three/four-phase process. During Phase I, small groups of people receive the trial vaccine. In Phase II, the clinical study is expanded. In Phase III, the vaccine is given to thousands of people and tested for efficacy and safety. Many vaccines undergo Phase IV formal, ongoing studies after the vaccine is approved and licensed. Phase IV studies, also referred to as postmarketing surveillance studies (PMS). These processes are very similar to drug developments. However, there are several differences compared to drug development, namely: i) unlike drugs, which are given to patients, vaccines are received by healthy individuals, thus the safety margin should be very high;ii) as vaccines have to be stored under refrigeration, there are always logistical challenges during clinical trials;iii) Adjuvants are incorporated into vaccine formulations to modulate and improve the immune response (antigen/adjuvant formulation are important aspects of clinical development);iv) The immune response primarily measured during early stages of vaccine development (Phase I/II) should evaluate: Humoral/ cell-mediated/ cross-reactive antibodies or immune complexes/ immune landscape. A challenge in responding to pandemic diseases is that vaccines may not exist for them. For newly emerging threats without licensed vaccines, such as SARS, MERS, Marburg virus, Nipah virus, SARS CoV-2 and the like, the time required to develop and produce a safe, effective vaccine is unknown and would depend on the nature of the threat and the state of current vaccine research for that threat. In almost all cases, several months would be needed to respond with the first doses of vaccines. Unfortunately, six month later than WHO declared the public health emergency of international concern (27/01/2020) there are five important questions, essential for vaccine development that remain open for scientists, namely: 1) Why do people respond so differently to infection? 2)Has the virus developed any worrying mutations? 3)How well will a vaccine work? 4)Can we develop immunity and if so, how long does it last? 5)What is the origin of the virus? Until a safe, effective vaccine was ready, other public health and medical measures (social distancing, quarantine, and aspecific medications) would need to be employed to try to limit disease spread.

16.
Journal of Advances in Medical and Biomedical Research ; 30(142):452-457, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-2033568

RESUMO

Background & Objective: Individuals with opioid use disorder are a marginalized population in any society. They commonly have a weaker immune system, greater stress vulnerability, poorer health, more high-risk behaviors, and less access to healthcare services compared to the general population, which can expose them to a risk of severe COVID-19 complications. This study aimed to evaluate the effects of opioid use disorder on mortality in patients with SARS-CoV-2. Materials & Methods: This registry-based retrospective cohort study was conducted on 2362 consecutive inpatients with a confirmed diagnosis of SARS-CoV-2 between March 5, 2020 and March 21, 2021, presenting to a university hospital in Ilam in the southwest of Iran. Forty-five patients with opioid use disorder were identified in this study and matched to 100 patients without opium addiction. All patients with a history of opium addiction were included in the study group, and age-and sex-matched patients without opioid use disorder were randomly recruited as the controls. After adjusting for the effects of age and comorbidities, data were analyzed in STATA version 10, using logistic regression models. Results: The mortality of patients with opioid use disorder increased following COVID-19 (adjusted OR: 6.59;95% CI: 1.84–23.59;P=0.004). Hypertension (adjusted OR: 8.17;95% CI: 2.21–30.15;P=0.002) and advancing age (OR: 1.06;95% CI: 1.01–1.11;P=0.01) were significantly associated with increased COVID-19 mortality. Conclusion: Based on the present findings, opioid use disorder is a possible risk factor for mortality following COVID-19. The findings of the present study can be applied in the implementation of preventive measures and policies and prioritization of COVID-19 vaccination. However, further relevant research is recommended.

17.
Tropical Journal of Natural Product Research ; 6(8):1336-1342, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-2033553

RESUMO

The COVID-19 pandemic, caused by the SARS-CoV-2, has prompted international concern. This research aims to find bioactive phytocompounds from the traditional herb Icacina trichantha (Oliv) that could be used as a possible SARS-CoV-2 nonstructural protein inhibitor. GC-MS analysis identified fifteen (15) phytocompounds. In silico molecular docking, drug-likeness, toxicity and prediction of these compounds’ substance activity spectra (PASS) were evaluated. The phytocompounds all have good binding energies, according to molecular docking. The phytocompound, 9,12-octadecanoic acid gave the best binding affinity of-24.98 kcal/mole. All of the identified compounds conformed to Lipinski’s Rule of Five (RO5). This showed that the identified I. trichantha (Oliv) compounds would have lower attrition rates during clinical trials and thus have a better chance of being marketed. The current findings suggest that the discovered phytocompounds of I. trichantha (Oliv) could be developed as a novel COVID-19 medication.

18.
Tropical Journal of Natural Product Research ; 6(8):1233-1240, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-2033551

RESUMO

The coronavirus disease 2019 (COVID-19) is caused by the recently discovered coronavirus and affects several countries worldwide. Some medications may alleviate or minimize some of the disease symptoms, but no drug have been proven to prevent or cure it. However, this study was aimed at investigating the role of some medicinal plants as potent inhibitors of COVID-19 main protease (MPro). More than 250 plant extracts with antiviral activity were exploited for their potential SARS-CoV2 medication using molecular docking. The conformational stability of the compounds extracted from the plants with MPro interactions was evaluated using molecular dynamics simulations. Then, the plant extracts with the highest binding energies were used for treatments by administering them to 50 COVID-19 patients, while the other 50 cases received only the drug without the plant extracts. The results of the theoretical analysis revealed high binding energies for seven compounds. Alliin stabilized COVID-19’s MPro while retaining critical connections and remained stable throughout the simulations. Marrubin and thymoquinone are also capable of protein stabilization over the simulated time. The test plants were observed to be effective against the virus in the COVID-19 patients, with a disease symptom improvement response rate of 78-86 and 60-72% for the first and second groups, respectively. Also, the percentage of oxygen increased from the second day after taking the extracts. Ground-glass opacity disappeared from the second group that received the plant extracts. The findings of this study suggest that these compounds have a great potential for therapeutic activity if isolated and administered alone.

19.
Voprosy Ginekologii, Akusherstva i Perinatologii ; 21(3):28-35, 2022.
Artigo em Russo | EMBASE | ID: covidwho-2033519

RESUMO

Objective. To assess the effectiveness of different preventive measures for novel coronavirus infection in pregnant women. Patients and Methods. This study included 125 pregnant women hospitalized with moderate to severe laboratory-confirmed SARS-CoV-2 infection between September and November 2021 (the fourth pandemic wave), and 175 pregnant women who were not infected with COVID-19 during the same period. All women in these two groups were comparable for gestational age (II–III trimesters, 24–39 weeks), age (20–40 years), social status, parity, body mass index, and had no known COVID-19 risk factors. Results. Our findings revealed that vaccination 3-5 months before pregnancy (OR = 4.12;95% CI 1.28–13.27;χ2 = 0.022), inconsistent use and/or non-timely replacement of face masks (OR = 5.71;95% CI 2.83–11.51) were associated with the increased risk of COVID-19 in the second and third trimesters of gestation. It was showed that systematic (once in the morning at 24–48-hour intervals) intranasal administration of recombinant interferon alpha-2b (IFN-α;Grippferon) as compared with a single application after exposure to COVID-19 reduced the disease incidence rate and there was no evident risk of illness (OR = 0.08;95% CI 0.05–0.14;19.2% vs 74,3%, p < 0.001). This can be explained by the fact that women were mostly infected in unpredictable conditions (e.g., 29.2% of pregnant women were infected from family members, 23.9% had unknown source of exposure). The use of umifenovir, not currently authorised for the medication-assisted prevention of COVID-19 in pregnant women, and rectal administration of IFN-α suppositories did not reduce the disease incidence rate. Rectal use of IFN-α suppositories by pregnant women off-label increased the incidence (32.0 vs 15.4%, p = 0.001) and risk of developing novel coronavirus infection (OR = 2.58;95% CI 1.48–4.50). Conclusion. There is a need to improve awareness among pregnant women about the mandatory and timely vaccination against COVID-19 during pregnancy and the importance of strict adherence to wearing face masks. Increased efforts should be made to monitor and inform pregnant women about the use of only authorised medication-assisted preventive measures of SARS-CoV-2 infection, such as intranasal administration of recombinant IFN α-2b (Grippferon). During the epidemic rise in COVID-19 cases, the systematic intranasal administration of recombinant interferon-based medication Grippferon (once in the morning at 24–48-hour intervals) is recommended for pregnant women.

20.
Iranian Journal of Parasitology ; 17(2):393-401, 2022.
Artigo em Inglês | EMBASE | ID: covidwho-2033509

RESUMO

Background: Dermatoparasitic infestations due to the mites Demodex spp. and Sarcoptes scabie are prevalent dermatological disorders worldwide. Methods: Referral patients from the Departments of Dermatology, Infectious Diseases, and from the psychologists, in some cases, to the laboratory of Medical Helminthology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran were examined and documented for demodicosis and scabies from March 2009 to December 2020. All patients’ data were collected and then analyzed statistically by SDATA version 14, using the Chi-square test. Results: Out of 494-suspected patients suffering from dermal disorders, 99 patients (20.04%) and 20 cases (4.04%) were found infested with demodicosis and scabies, respectively. Most demodicosis cases belonged to the 46-60 year age group while the infestation rate of scabies was higher in the age group under 5 years (P=<0.0001). Demodicosis was seen more prevalent in women than men, and scabies were higher in men (P=0.15). The cases of demodicosis in fall and scabies in winter and spring were more frequent. Demodicosis picked up in 2015 and 2017 (P=0.03), while the prevalent year for scabies was in 2016 (P=0.77). Both current ectoparasites declined dramatically by Covid-19 pandemic. Conclusion: Demodicosis and scabies have been found correlated with age, and no statistical association was seen between the gender and seasonal factors. Besides, the obvious decline of demodicosis and scabies infestation rates during the Covid-19 outbreak can mention that social distance and hygiene standards have negative effects on dermatoparasites transmission.

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