@article {pmid33471294, year = {2021}, author = {Iba, T and Connors, JM and Spyropoulos, AC and Wada, H and Levy, JH}, title = {Ethnic differences in thromboprophylaxis for COVID-19 patients: should they be considered?.}, journal = {International journal of hematology}, volume = {}, number = {}, pages = {}, pmid = {33471294}, issn = {1865-3774}, abstract = {Thromboembolic events contribute to morbidity and mortality in coronavirus disease 2019 (COVID-19). As a result, thromboprophylaxis using low-molecular-weight heparin (LMWH) is universally recommended for hospitalized patients based on multiple guidelines. However, ethnic differences with respect to thrombogenicity have been reported and the incidence of thromboembolic events is considered to be lower in the Asian population. Despite the importance of thromboprophylaxis, bleeding is also a side effect that should be considered. We examine the data relating to potential ethnic differences in thrombosis and bleeding in COVID-19. Although sufficient data is not yet available, current evidence does not oppose routine anticoagulant use and thromboprophylaxis using a standard dose of LMWH for admitted patients regardless of ethnicity based on our review.}, } @article {pmid33470463, year = {2020}, author = {Linz, W and Andrzejewski, C and Wu, DW and Li, Y and Roberts, T and Ipe, T and Ricci, K and Knight, S and Hodjat, P and Reddy, RL and Hofmann, J}, title = {Apheresis medicine in the era of advanced telehealth technologies: An American Society for Apheresis position paper Part I: Understanding the basic technologies and apheresis medicine practice models.}, journal = {Journal of clinical apheresis}, volume = {35}, number = {5}, pages = {460-468}, doi = {10.1002/jca.21814}, pmid = {33470463}, issn = {1098-1101}, abstract = {The wide spread availability and use of sophisticated high-speed telecommunication networks coupled with inexpensive and easily accessible computing capacity have catalyzed the creation of new tools and strategies for healthcare delivery. Such tools and strategies are of value to apheresis medicine (AM) practitioners if they improve delivery of patient care, enhance safety during a therapeutic apheresis (TA) intervention, facilitate care access, advance technical capabilities of apheresis devices, and/or elevate quality performance within TA programs. In the past several years, healthcare delivery systems' adoption of telecommunication technologies has been fostered by organizational financial and quality improvement objectives. More recently, adoption of telehealth technologies has been catalyzed by the COVID-19 pandemic as these technologies enhance both patient and provider safety in an era of social distancing. These changes will also influence the delivery of TA services which now can be generally viewed in a tripartite model format comprised of traditional hospital-based fixed site locales, mobile TA operations and lately an evolving telemedicine remote management model now reffered to as telapheresis (TLA). This communication developed by the Public Affairs and Advocacy Committee of the American Society for Apheresis (ASFA) and endorsed by its Board of Directors, reviews and describes various aspects of established and evolving electronic technologies related to TLA and the practice of AM. In subsequent companion publications, additional aspects to TLA will be explored and ASFA's vision of reasonable, regulatory compliant and high-quality TLA practices will be expounded.}, } @article {pmid33469692, year = {2021}, author = {Eijkholt, M and Hulsbergen, A and Muskens, I and Mathiesen, TI and Bolger, C and Feldman, Z and Kitchen, N and Samprón, N and Sandvik, U and Tisell, M and Broekman, M}, title = {Should neurosurgeons continue to work in the absence of personal protective equipment during the COVID-19 era?.}, journal = {Acta neurochirurgica}, volume = {}, number = {}, pages = {}, pmid = {33469692}, issn = {0942-0940}, abstract = {The COVID-19 pandemic has resulted in a widespread shortage of personal protective equipment (PPE). Many healthcare workers, including neurosurgeons, have expressed concern about how to safely and adequately perform their medical responsibilities in these challenging circumstances. One of these concerns revolves around the pressing question: should providers continue to work in the absence of adequate PPE? Although the first peak of the COVID-19 crisis seems to have subsided and supply of PPE has increased, concerns about insufficient PPE availability remain. Inconsistent supply, limited efficacy, and continued high demand for PPE, combined with the continued threat of a second COVID-19 wave, mean that the issues surrounding PPE availability remain unresolved, including a duty to work. This paper offers an ethical investigation of whether neurosurgeons should perform their professional responsibilities with limited availability of PPE. We evaluate ethical considerations and conflicting duties and thereby hope to facilitate providers in making a well-considered personal and moral decision about this challenging issue.}, } @article {pmid33469625, year = {2020}, author = {Smith, KG and Cleland, J}, title = {Drastic times need drastic measures: COVID-19 and widening access to medicine.}, journal = {The journal of the Royal College of Physicians of Edinburgh}, volume = {50}, number = {4}, pages = {431-435}, doi = {10.4997/JRCPE.2020.419}, pmid = {33469625}, issn = {2042-8189}, abstract = {In response to COVID-19, schools, colleges and universities across the world have closed or shifted to online/remote or blended teaching, learning and assessment. These changed ways of working pose challenges to students and will likely exacerbate existing educational attainment gaps between different societal groups. Our focus is the potential impact of COVID-19 on widening access to medicine. We provide an account of the process, in the form of comparative cases, of applying for medical school for two applicants from differing backgrounds. Three challenges were identified: family circumstances and support (financial security and parental educational support); staying connected (access to educational material, technology and Wifi); getting the grades and meeting other entry criteria (predicting grades and work experience). We propose that medical schools adopt drastic measures to protect widening access including increasing the use of aptitude tests, contextualised admissions, online multiple mini interviews (MMIs), creative outreach and promotion of alternative means of gaining relevant experience.}, } @article {pmid33469564, year = {2021}, author = {Thapa, BB and Shrestha, D and Bista, S and Thapa, S and Niranjan, V}, title = {Urology during COVID-19 Pandemic Crisis: A Systematic Review.}, journal = {Surgery journal (New York, N.Y.)}, volume = {7}, number = {1}, pages = {e3-e10}, doi = {10.1055/s-0040-1722341}, pmid = {33469564}, issn = {2378-5128}, abstract = {Background Coronavirus disease 2019 (COVID-19) has evolved as a pandemic of unimaginable magnitude. The health care system is facing a tremendous challenge to provide ethical and quality care. The transformation of the patient-based care to population-based care during the COVID-19 pandemic has raised ethical dilemma among urologists. Our objective is to explore the consensus in modified standard urology care, that can be adopted and applied during COVID-19 and similar pandemic. Methods We adopted an exploratory study design using secondary data. The data were extracted from a web-based medical library using keywords "COVID-19," "severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)," and "urology." We identify and extrapolate (screening, eligibility, and inclusion) the data using PRISMA protocol, and summarize pandemic standard urology care under four main themes: (1) general urology care, (2) choice of surgical modality, (3) triage, and (4) urology training. Result We identified 63 academic papers related to our research question. The majority are expert opinions and perspectives on urology care. The common consensus is triage-based urology care and surgeries. Life or organ threatening conditions need immediate attention. Universal protective measures (personal protective equipment, safe operative environment) and protocol-based patient care are necessary to prevent and control SARS-CoV-2 infection. Conservation of the resources and its rational distribution provide an ethical basis for population-based health care during a pandemic. Informed decision making serves best to patients, families, and society during the public health crisis. Conclusion COVID-19 pandemic tends to transform standard urology practice into crisis standard population-based care. The consensus in crisis is drawn from evolving pieces of medical evidence and public health ethics. The provision of urology care during a pandemic is based on the availability of resources; severity of the disease, consequences of deferment of service, and dynamics of the pandemic.}, } @article {pmid33469546, year = {2020}, author = {Petronio Petronio, G and Di Marco, R and Costagliola, C}, title = {Do Ocular Fluids Represent a Transmission Route of SARS-CoV-2 Infection?.}, journal = {Frontiers in medicine}, volume = {7}, number = {}, pages = {620412}, doi = {10.3389/fmed.2020.620412}, pmid = {33469546}, issn = {2296-858X}, abstract = {The spread of the new SARS-CoV-2 is marked by a short timeline. In this scenario, explaining or excluding the possible transmission routes is mandatory to contain and manage the spread of the disease in the community. In the recent pandemic, it is still unclear how coronavirus can end up in ocular fluids. Nevertheless, eye redness and irritation in COVID-19 patients have been reported, suggesting that a possible ocular manifestation of SARS-CoV-2 infection may be conjunctivitis. On the basis of epidemiological data provided by previous SARS-Cove infection, numerous theories have been proposed: (1) conjunctiva as the site of direct inoculation by infected droplets; (2) the nasolacrimal duct as a migration route of the virus to the upper respiratory tract, or (3) haematogenic infection of the tear gland. The demand for further investigations to verify ocular involvement in COVID-19 infection came out from the results of recent meta-analysis studies, so the eye cannot be completely excluded as a transmission route of the infection. Thus, healthcare personnel and all the people that enter in contact with infected or suspected patients must always use the prescribed protective equipment.}, } @article {pmid33469377, year = {2021}, author = {Jacome, LS and Deshmukh, SK and Thulasiraman, P and Holliday, NP and Singh, S}, title = {Impact of COVID-19 Pandemic on Ovarian Cancer Management: Adjusting to the New Normal.}, journal = {Cancer management and research}, volume = {13}, number = {}, pages = {359-366}, doi = {10.2147/CMAR.S287152}, pmid = {33469377}, issn = {1179-1322}, abstract = {COVID-19, also known as the coronavirus disease 2019, is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) declared pandemic by the World Health Organization (WHO). As the world faces the coronavirus disease 2019 crisis, the oncology community is being impacted by unprecedented challenges. During this trying time, patients with ovarian cancer (OC) have been affected by a delay in diagnosis, surgery, chemotherapy and radiation treatments, and oncology follow-ups being conducted via telemedicine instead of in-person visits. OC patients and their oncologists are balancing the fears of COVID-19 and cancer treatment with the consequences of delaying cancer care. The delay in treatment care that women with OC are experiencing has resulted in higher levels of cancer worry, anxiety, and depression. In this article, we succinctly review the impact of the COVID-19 pandemic on the diagnosis and treatment and ongoing clinical trials of OC. We also discuss the psychological effects of COVID-19 on women with OC and alternative therapeutic strategies to limit in-person hospital visits to reduce the spread of the disease, and the impact of COVID-19 on OC patients.}, } @article {pmid33469298, year = {2021}, author = {Alanzi, T}, title = {A Review of Mobile Applications Available in the App and Google Play Stores Used During the COVID-19 Outbreak.}, journal = {Journal of multidisciplinary healthcare}, volume = {14}, number = {}, pages = {45-57}, doi = {10.2147/JMDH.S285014}, pmid = {33469298}, issn = {1178-2390}, abstract = {Purpose: The objective of this paper was to review the functionalities and effectiveness of the free mobile health applications available in the Google Play and App stores used in Saudi Arabia, Italy, Singapore, the United Kingdom, USA, and India during the COVID-19 outbreak.

Methods: This study adopted a systematic search strategy to identify the free mobile applications available in the App and Google Play stores related to the COVID-19 outbreak. According to the PRISMA flowchart of the search, only 12 applications met the inclusion criterion.

Results: The 12 mobile applications that met the inclusion criterion were: Mawid, Tabaud, Tawakkalna, Sehha, Aarogya setu, TraceTogether, COVID safe, Immuni, COVID symptom study, COVID watch, NHS COVID-19, and PathCheck. The following features and functionalities of the apps were described: app overview (price, ratings, android, iOS, developer/owner, country, status), health tools (user status-risk assessment, self-assessment, E-pass integration, test results reporting, online consultation, contact tracing), learning options (personalized notes, educational resources, COVID-19 information), communication tools (query resolution, appointments, social network, notifications), app design (data visualization, program plan), networking tools (location mapping - GPS, connectivity with other devices), and safety and security options (alerts, data protection). Also, the effectiveness of the apps was analyzed.

Conclusion: The analysis revealed that various applications have been developed for different functions like contact tracing, awareness building, appointment booking, online consultation, etc. However, only a few applications have integrated various functions and features such as self-assessment, consultation, support and access to information. Also, most of the apps are focused on contact tracing, while very few are dedicated to raising awareness and sharing information about the COVID-19 pandemic. Likewise, the majority of applications rely on GPS and Bluetooth technologies for relevant functions. No apps were identified that had built-in social media features. It is suggested to design and develop an integrated mobile health application with most of the features and functionalities analyzed in this study.}, } @article {pmid33469205, year = {2021}, author = {Kim, JH and Marks, F and Clemens, JD}, title = {Looking beyond COVID-19 vaccine phase 3 trials.}, journal = {Nature medicine}, volume = {}, number = {}, pages = {}, pmid = {33469205}, issn = {1546-170X}, abstract = {After the recent announcement of COVID-19 vaccine efficacy in clinical trials by several manufacturers for protection against severe disease, a comprehensive post-efficacy strategy for the next steps to ensure vaccination of the global population is now required. These considerations should include how to manufacture billions of doses of high-quality vaccines, support for vaccine purchase, coordination of supply, the equitable distribution of vaccines and the logistics of global vaccine delivery, all of which are a prelude to a massive vaccination campaign targeting people of all ages. Furthermore, additional scientific questions about the vaccines remain that should be answered to improve vaccine efficacy, including questions regarding the optimization of vaccination regimens, booster doses, the correlates of protection, vaccine effectiveness, safety and enhanced surveillance. The timely and coordinated execution of these post-efficacy tasks will bring the pandemic to an effective, and efficient, close.}, } @article {pmid33469197, year = {2021}, author = {Naidoo, N and Moodley, J and Naicker, T}, title = {Maternal endothelial dysfunction in HIV-associated preeclampsia comorbid with COVID-19: a review.}, journal = {Hypertension research : official journal of the Japanese Society of Hypertension}, volume = {}, number = {}, pages = {}, pmid = {33469197}, issn = {1348-4214}, abstract = {This review assesses markers of endothelial dysfunction (ED) associated with the maternal syndrome of preeclampsia (PE). We evaluate the role of antiretroviral therapy (ART) in human immunodeficiency virus (HIV)-infected preeclamptic women. Furthermore, we briefly discuss the potential of lopinavir/ritonavir (LPV/r), dolutegravir (DTG) and remdesivir (RDV) in drug repurposing and their safety in pregnancy complicated by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In HIV infection, the trans-activator of transcription protein, which has homology with vascular endothelial growth factor, impairs angiogenesis, leading to endothelial injury and possible PE development despite neutralization of their opposing immune states. Markers of ED show strong evidence supporting the adverse role of ART in PE development and mortality compared to treatment-naïve pregnancies. Coronavirus disease 2019 (COVID-19), caused by SARS-CoV-2 infection, exploits angiotensin-converting enzyme 2 (ACE 2) to induce ED and hypertension, thereby mimicking angiotensin II-mediated PE in severe cases of infection. Upregulated ACE 2 in pregnancy is a possible risk factor for SARS-CoV-2 infection and subsequent PE development. The potential effectiveness of LPV/r against COVID-19 is inconclusive; however, defective decidualization, along with elevated markers of ED, was observed. Therefore, the safety of these drugs in HIV-positive pregnancies complicated by COVID-19 requires attention. Despite the observed endothelial protective properties of DTG, there is a lack of evidence of its effects on pregnancy and COVID-19 therapeutics. Understanding RDV-ART interactions and the inclusion of pregnant women in antiviral drug repurposing trials is essential. This review provides a platform for further research on PE in the HIV-COVID-19 syndemic.}, } @article {pmid33468991, year = {2021}, author = {Dhakal, R and O'Connell, C and Gurung, JB and Shah, RP and Adhikari, HP and Chandi, N and Groves, CC}, title = {A team effort in Nepal: experiences from managing a large COVID-19 rehabilitation hospital outbreak.}, journal = {Spinal cord series and cases}, volume = {7}, number = {1}, pages = {5}, doi = {10.1038/s41394-020-00374-2}, pmid = {33468991}, issn = {2058-6124}, } @article {pmid33468694, year = {2021}, author = {Stout, AE and Guo, Q and Millet, JK and de Matos, R and Whittaker, GR}, title = {Coronaviruses Associated with the Superfamily Musteloidea.}, journal = {mBio}, volume = {12}, number = {1}, pages = {}, pmid = {33468694}, issn = {2150-7511}, abstract = {Among the animal superfamily Musteloidea, which includes those commonly known as mustelids, naturally occurring and species-specific alphacoronavirus infections have been observed in both mink (Mustela vison/Neovison vison) and domestic ferrets (Mustela putorius furo). Ferret systemic coronavirus (FRSCV), in particular, has been associated with a rare but fatal systemic disease. In recent months, it has become apparent that both minks and ferrets are susceptible to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a betacoronavirus and the cause of the coronavirus disease 2019 (COVID-19) pandemic. Several mink farms have experienced SARS-CoV-2 outbreaks, and experimental models have demonstrated susceptibility of ferrets to SARS-CoV-2. The potential for pet ferrets to become infected with SARS-CoV-2, however, remains elusive. During the 2002-2003 SARS epidemic, it was also apparent that ferrets were susceptible to SARS-CoV and could be utilized in vaccine development. From a comparative standpoint, understanding the relationships between different infections and disease pathogenesis in the animal superfamily Musteloidea may help elucidate viral infection and transmission mechanisms, as well as treatment and prevention strategies for coronaviruses.}, } @article {pmid33468418, year = {2020}, author = {Grainger, R and Machado, PM and Robinson, PC}, title = {Novel coronavirus disease-2019 (COVID-19) in people with rheumatic disease: Epidemiology and outcomes.}, journal = {Best practice & research. Clinical rheumatology}, volume = {}, number = {}, pages = {101657}, doi = {10.1016/j.berh.2020.101657}, pmid = {33468418}, issn = {1532-1770}, abstract = {There is concern that people with rheumatic disease, often treated with immunosuppressive or immunomodulatory medication, may be at an increased risk of poor outcomes of novel coronavirus disease-2019 (COVID-19). However, hyperinflammation is a major cause of morbidity and mortality in COVID-19 and treatment with glucocorticoids has been shown to improve outcomes in patients with severe COVID-19. Therefore, uncertainty exists about continuing or withholding immune therapies with the risk of infection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This review covers the current knowledge with respect to the risk of infection and outcomes and risk factors for poor outcomes in patients with rheumatic disease. We also discuss data from other immune-mediated diseases and its relevance to patients with rheumatic disease. In addition, we cover the limitations of the research efforts to date and how the current knowledge translates into practice guidance. Finally, we discuss our vision of the future research agenda.}, } @article {pmid33468332, year = {2021}, author = {Shetty, O and Gurav, M and Bapat, P and Karnik, N and Pai, T and Wagh, G and Desai, S}, title = {COVID 19 pandemic testing time - Crisis or opportunity in disguise for India?.}, journal = {Seminars in oncology}, volume = {}, number = {}, pages = {}, doi = {10.1053/j.seminoncol.2020.12.001}, pmid = {33468332}, issn = {1532-8708}, abstract = {The current SARS-CoV-2 infection or the COVID 19 pandemic has taken the world by storm, where the best health care systems in the world seem to be overwhelmed and still this virus is eluding us as we are compelled to explore the preventive and/or therapeutic interventions to control the disease outbreak as well as to prevent deaths. In parallel to clinical services, laboratories have been overwhelmed with task of keeping up with ever increasing demand for testing. Real time PCR detection of COVID19 is the gold standard method, however, has certain shortcomings in terms of availability of infrastructure, reagents, consumables, and technical expertise. All these have paved the way for the alternative testing algorithms and strategies. Countries like United States and Italy have struggled with these issues. India has been criticized for not testing enough and not adopting the right policy, but has been managing the disease within its resource limited health care system to a fair extent. The present review provides the Indian perspective of COVID 19 testing, the journey from not testing enough in the past to a vast expanse and depth of testing in present time.}, } @article {pmid33468160, year = {2021}, author = {Alizadeh, N and Salimi, A}, title = {Multienzymes activity of metals and metal oxide nanomaterials: applications from biotechnology to medicine and environmental engineering.}, journal = {Journal of nanobiotechnology}, volume = {19}, number = {1}, pages = {26}, pmid = {33468160}, issn = {1477-3155}, abstract = {With the rapid advancement and progress of nanotechnology, nanomaterials with enzyme-like catalytic activity have fascinated the remarkable attention of researchers, due to their low cost, high operational stability, adjustable catalytic activity, and ease of recycling and reuse. Nanozymes can catalyze the same reactions as performed by enzymes in nature. In contrast the intrinsic shortcomings of natural enzymes such as high manufacturing cost, low operational stability, production complexity, harsh catalytic conditions and difficulties of recycling, did not limit their wide applications. The broad interest in enzymatic nanomaterial relies on their outstanding properties such as stability, high activity, and rigidity to harsh environments, long-term storage and easy preparation, which make them a convenient substitute instead of the native enzyme. These abilities make the nanozymes suitable for multiple applications in sensing and imaging, tissue engineering, environmental protection, satisfactory tumor diagnostic and therapeutic, because of distinguished properties compared with other artificial enzymes such as high biocompatibility, low toxicity, size dependent catalytic activities, large surface area for further bioconjugation or modification and also smart response to external stimuli. This review summarizes and highlights latest progress in applications of metal and metal oxide nanomaterials with enzyme/multienzyme mimicking activities. We cover the applications of sensing, cancer therapy, water treatment and anti-bacterial efficacy. We also put forward the current challenges and prospects in this research area, hoping to extension of this emerging field. In addition to therapeutic potential of nanozymes for disease prevention, their practical effects in diagnostics, to monitor the presence of SARS-CoV-2 and related biomarkers for future pandemics will be predicted.}, } @article {pmid33467705, year = {2021}, author = {Sanghvi, SK and Schwarzman, LS and Nazir, NT}, title = {Cardiac MRI and Myocardial Injury in COVID-19: Diagnosis, Risk Stratification and Prognosis.}, journal = {Diagnostics (Basel, Switzerland)}, volume = {11}, number = {1}, pages = {}, doi = {10.3390/diagnostics11010130}, pmid = {33467705}, issn = {2075-4418}, abstract = {Myocardial injury is a common complication of the COVID-19 illness and is associated with a worsened prognosis. Systemic hyperinflammation seen in the advanced stage of COVID-19 likely contributes to myocardial injury. Cardiac magnetic resonance imaging (CMR) is the preferred imaging modality for non-invasive evaluation in acute myocarditis, enabling risk stratification and prognostication. Modified scanning protocols in the pandemic setting reduce risk of exposure while providing critical data regarding cardiac tissue inflammation and fibrosis, chamber remodeling, and contractile function. The growing use of CMR in clinical practice to assess myocardial injury will improve understanding of the acute and chronic sequelae of myocardial inflammation from various pathological etiologies.}, } @article {pmid33467642, year = {2021}, author = {Casuso, RA and Huertas, JR}, title = {Mitochondrial Functionality in Inflammatory Pathology-Modulatory Role of Physical Activity.}, journal = {Life (Basel, Switzerland)}, volume = {11}, number = {1}, pages = {}, doi = {10.3390/life11010061}, pmid = {33467642}, issn = {2075-1729}, abstract = {The incidence and severity of metabolic diseases can be reduced by introducing healthy lifestyle habits including moderate exercise. A common observation in age-related metabolic diseases is an increment in systemic inflammation (the so-called inflammaging) where mitochondrial reactive oxygen species (ROS) production may have a key role. Exercise prevents these metabolic pathologies, at least in part, due to its ability to alter immunometabolism, e.g., reducing systemic inflammation and by improving immune cell metabolism. Here, we review how exercise regulates immunometabolism within contracting muscles. In fact, we discuss how circulating and resident macrophages alter their function due to mitochondrial signaling, and we propose how these effects can be triggered within skeletal muscle in response to exercise. Finally, we also describe how exercise-induced mitochondrial adaptations can help to fight against virus infection. Moreover, the fact that moderate exercise increases circulating immune cells must be taken into account by public health agencies, as it may help prevent virus spread. This is of interest in order to face not only acute respiratory-related coronavirus (SARS-CoV) responsible for the COVID-19 pandemic but also for future virus infection challenges.}, } @article {pmid33467617, year = {2021}, author = {Vilibic-Cavlek, T and Barbic, L and Mrzljak, A and Brnic, D and Klobucar, A and Ilic, M and Janev-Holcer, N and Bogdanic, M and Jemersic, L and Stevanovic, V and Tabain, I and Krcmar, S and Vucelja, M and Prpic, J and Boljfetic, M and Jelicic, P and Madic, J and Ferencak, I and Savic, V}, title = {Emerging and Neglected Viruses of Zoonotic Importance in Croatia.}, journal = {Pathogens (Basel, Switzerland)}, volume = {10}, number = {1}, pages = {}, doi = {10.3390/pathogens10010073}, pmid = {33467617}, issn = {2076-0817}, support = {IP-2016-06-6456 and UIP-2017-05-8580//Hrvatska Zaklada za Znanost/ ; }, abstract = {Several arboviruses have emerged in Croatia in recent years. Tick-borne encephalitis is endemic in continental counties; however, new natural micro-foci have been detected. Two autochthonous dengue cases were reported in 2010. West Nile virus emerged in 2012, followed by emergence of Usutu virus in 2013. Although high seroprevalence rates of Toscana virus have been detected among residents of Croatian littoral, the virus remains neglected, with only a few clinical cases of neuroinvasive infections reported. Lymphocytic choriomeningitis virus is a neglected neuroinvasive rodent-borne virus. So far, there are no reports on human clinical cases; however, the seroprevalence studies indicate the virus presence in the Croatian mainland. Puumala and Dobrava hantaviruses are widely distributing rodent-borne viruses with sporadic and epidemic occurrence. Hepatitis E virus is an emerging food-borne virus in Croatia. After the emergence in 2012, cases were regularly recorded. Seropositivity varies greatly by region and population group. Rotaviruses represent a significant healthcare burden since rotavirus vaccination is not included in the Croatian national immunization program. Additionally, rotaviruses are widely distributed in the Croatian ecosystem. A novel coronavirus, SARS-CoV-2, emerged in February 2020 and spread rapidly throughout the country. This review focuses on emerging and neglected viruses of zoonotic importance detected in Croatia.}, } @article {pmid33467522, year = {2021}, author = {Apostolopoulos, V and Bojarska, J and Chai, TT and Elnagdy, S and Kaczmarek, K and Matsoukas, J and New, R and Parang, K and Lopez, OP and Parhiz, H and Perera, CO and Pickholz, M and Remko, M and Saviano, M and Skwarczynski, M and Tang, Y and Wolf, WM and Yoshiya, T and Zabrocki, J and Zielenkiewicz, P and AlKhazindar, M and Barriga, V and Kelaidonis, K and Sarasia, EM and Toth, I}, title = {A Global Review on Short Peptides: Frontiers and Perspectives.}, journal = {Molecules (Basel, Switzerland)}, volume = {26}, number = {2}, pages = {}, doi = {10.3390/molecules26020430}, pmid = {33467522}, issn = {1420-3049}, abstract = {Peptides are fragments of proteins that carry out biological functions. They act as signaling entities via all domains of life and interfere with protein-protein interactions, which are indispensable in bio-processes. Short peptides include fundamental molecular information for a prelude to the symphony of life. They have aroused considerable interest due to their unique features and great promise in innovative bio-therapies. This work focusing on the current state-of-the-art short peptide-based therapeutical developments is the first global review written by researchers from all continents, as a celebration of 100 years of peptide therapeutics since the commencement of insulin therapy in the 1920s. Peptide "drugs" initially played only the role of hormone analogs to balance disorders. Nowadays, they achieve numerous biomedical tasks, can cross membranes, or reach intracellular targets. The role of peptides in bio-processes can hardly be mimicked by other chemical substances. The article is divided into independent sections, which are related to either the progress in short peptide-based theranostics or the problems posing challenge to bio-medicine. In particular, the SWOT analysis of short peptides, their relevance in therapies of diverse diseases, improvements in (bio)synthesis platforms, advanced nano-supramolecular technologies, aptamers, altered peptide ligands and in silico methodologies to overcome peptide limitations, modern smart bio-functional materials, vaccines, and drug/gene-targeted delivery systems are discussed.}, } @article {pmid33467411, year = {2021}, author = {Brown, JM and Wasson, MD and Marcato, P}, title = {Triple-Negative Breast Cancer and the COVID-19 Pandemic: Clinical Management Perspectives and Potential Consequences of Infection.}, journal = {Cancers}, volume = {13}, number = {2}, pages = {}, doi = {10.3390/cancers13020296}, pmid = {33467411}, issn = {2072-6694}, support = {PJT 162313/CAPMC/CIHR/Canada ; }, abstract = {The COVID-19 pandemic has caused the need for prioritization strategies for breast cancer treatment, where patients with aggressive disease, such as triple-negative breast cancer (TNBC) are a high priority for clinical intervention. In this review, we summarize how COVID-19 has thus far impacted the management of TNBC and highlighted where more information is needed to hone shifting guidelines. Due to the immunocompromised state of most TNBC patients receiving treatment, TNBC management during the pandemic presents challenges beyond the constraints of overburdened healthcare systems. We conducted a literature search of treatment recommendations for both primary and targeted TNBC therapeutic strategies during the COVID-19 outbreak and noted changes to treatment timing and drugs of choice. Further, given that SARS-CoV-2 is a respiratory virus, which has systemic consequences, management of TNBC patients with metastatic versus localized disease has additional considerations during the COVID-19 pandemic. Published dataset gene expression analysis of critical SARS-CoV-2 cell entry proteins in TNBCs suggests that the virus could in theory infect metastasized TNBC cells it contacts. This may have unforeseen consequences in terms of both the dynamics of the resulting acute viral infection and the progression of the chronic metastatic disease. Undoubtedly, the results thus far suggest that more research is required to attain a full understanding of the direct and indirect clinical impacts of COVID-19 on TNBC patients.}, } @article {pmid33467131, year = {2021}, author = {Abraham, J and Dowling, K and Florentine, S}, title = {Can Optimum Solar Radiation Exposure or Supplemented Vitamin D Intake Reduce the Severity of COVID-19 Symptoms?.}, journal = {International journal of environmental research and public health}, volume = {18}, number = {2}, pages = {}, doi = {10.3390/ijerph18020740}, pmid = {33467131}, issn = {1660-4601}, abstract = {The foremost mortality-causing symptom associated with COVID-19 is acute respiratory distress syndrome (ARDS). A significant correlation has been identified between the deficiency in vitamin D and the risk of developing ARDS. It has been suggested that if we can reduce or modify ARDS in COVID-19 patients, we may significantly reduce the severity of COVID-19 symptoms and associated mortality rates. The increased mortality of dark-skinned people, who have a reduced UV absorption capacity, may be consistent with diminished vitamin D status. The factors associated with COVID-19 mortality, such as old age, ethnicity, obesity, hypertension, cardiovascular diseases, and diabetes, are all found to be linked with vitamin D deficiency. Based on this review and as a precautionary measure, it is suggested that the adoption of appropriate and safe solar exposure and vitamin D enriched foods and supplements should be considered to reduce the possible severity of COVID-19 symptoms. Safe sun exposure is deemed beneficial globally, specifically in low and middle-income countries, as there is no cost involved. It is also noted that improved solar exposure and vitamin D levels can reduce the impact of other diseases as well, thus assisting in maintaining general human well-being.}, } @article {pmid33467041, year = {2021}, author = {Ingersoll, JG}, title = {Observations on the Occurrence, Transmission and Management of the COVID-19 Pandemic Derived from Physics.}, journal = {Diseases (Basel, Switzerland)}, volume = {9}, number = {1}, pages = {}, doi = {10.3390/diseases9010009}, pmid = {33467041}, issn = {2079-9721}, abstract = {Three important observations derived from the ongoing COVID-19 pandemic could result in the development of novel approaches to deal with it and avoid or at least minimize the occurrence and impact of future outbreaks. First, the dramatic increase in pandemics in the past decade alone suggests that the current relationship of humans with the environment is quickly becoming unstable, with potentially catastrophic consequences. In order to reduce the toll in life and property, we would need to shift our emphasis from control of nature to a symbiosis with nature. This, then, can become the new framework for dealing effectively with environmental issues such as climate change, whereby properly applied medical science would provide the necessary impetus for action. Second, the existence of superspreaders of infection among populations in this pandemic requires that we develop objective tests, most likely of a genetic nature, to identify them rather than apply indiscriminate and draconian controls across the board. Not identifying superspreaders in a timely fashion could allow this pandemic to turn into a black swan event, with a catastrophic impact on society. Third, we need to refocus our efforts in dealing with this pandemic from the virus itself to the human hosts. An objective morbidity risk index can be developed such that most of us can go about our daily business without the fear of becoming seriously ill, while measures can be implemented to protect those who are most vulnerable to this virus. These observations point clearly to a need for a paradigm shift.}, } @article {pmid33467029, year = {2021}, author = {Vougogiannopoulou, K and Corona, A and Tramontano, E and Alexis, MN and Skaltsounis, AL}, title = {Natural and Nature-Derived Products Targeting Human Coronaviruses.}, journal = {Molecules (Basel, Switzerland)}, volume = {26}, number = {2}, pages = {}, doi = {10.3390/molecules26020448}, pmid = {33467029}, issn = {1420-3049}, abstract = {The ongoing pandemic of severe acute respiratory syndrome (SARS), caused by the SARS-CoV-2 human coronavirus (HCoV), has brought the international scientific community before a state of emergency that needs to be addressed with intensive research for the discovery of pharmacological agents with antiviral activity. Potential antiviral natural products (NPs) have been discovered from plants of the global biodiversity, including extracts, compounds and categories of compounds with activity against several viruses of the respiratory tract such as HCoVs. However, the scarcity of natural products (NPs) and small-molecules (SMs) used as antiviral agents, especially for HCoVs, is notable. This is a review of 203 publications, which were selected using PubMed/MEDLINE, Web of Science, Scopus, and Google Scholar, evaluates the available literature since the discovery of the first human coronavirus in the 1960s; it summarizes important aspects of structure, function, and therapeutic targeting of HCoVs as well as NPs (19 total plant extracts and 204 isolated or semi-synthesized pure compounds) with anti-HCoV activity targeting viral and non-viral proteins, while focusing on the advances on the discovery of NPs with anti-SARS-CoV-2 activity, and providing a critical perspective.}, } @article {pmid33466940, year = {2021}, author = {Jiang, P and Klemeš, JJ and Fan, YV and Fu, X and Bee, YM}, title = {More Is Not Enough: A Deeper Understanding of the COVID-19 Impacts on Healthcare, Energy and Environment Is Crucial.}, journal = {International journal of environmental research and public health}, volume = {18}, number = {2}, pages = {}, doi = {10.3390/ijerph18020684}, pmid = {33466940}, issn = {1660-4601}, support = {CZ.02.1.01/0.0/0.0/15_003/0000456//Czech Republic Operational Programme/ ; NRF2017VSG-AT3DCM001-045//National Research Foundation Singapore/ ; H19/01/a0/023 - Diabetes Clinic of the Future//Industry Alignment Fund (Pre-Positioning)/ ; }, abstract = {The coronavirus disease 2019 (COVID-19) pandemic has magnified the insufficient readiness of humans in dealing with such an unexpected occurrence. During the pandemic, sustainable development goals have been hindered severely. Various observations and lessons have been highlighted to emphasise local impacts on a single region or single sector, whilst the holistic and coupling impacts are rarely investigated. This study overviews the structural changes and spatial heterogeneities of changes in healthcare, energy and environment, and offers perspectives for the in-depth understanding of the COVID-19 impacts on the three sectors, in particular the cross-sections of them. Practical observations are summarised through the broad overview. A novel concept of the healthcare-energy-environment nexus under climate change constraints is proposed and discussed, to illustrate the relationships amongst the three sectors and further analyse the dynamics of the attention to healthcare, energy and environment in view of decision-makers. The society is still on the way to understanding the impacts of the whole episode of COVID-19 on healthcare, energy, environment and beyond. The raised nexus thinking could contribute to understanding the complicated COVID-19 impacts and guiding sustainable future planning.}, } @article {pmid33466921, year = {2021}, author = {Xia, X}, title = {Domains and Functions of Spike Protein in Sars-Cov-2 in the Context of Vaccine Design.}, journal = {Viruses}, volume = {13}, number = {1}, pages = {}, doi = {10.3390/v13010109}, pmid = {33466921}, issn = {1999-4915}, support = {RGPIN/2018-03878//Natural Sciences and Engineering Research Council of Canada/ ; }, abstract = {The spike protein in SARS-CoV-2 (SARS-2-S) interacts with the human ACE2 receptor to gain entry into a cell to initiate infection. Both Pfizer/BioNTech's BNT162b2 and Moderna's mRNA-1273 vaccine candidates are based on stabilized mRNA encoding prefusion SARS-2-S that can be produced after the mRNA is delivered into the human cell and translated. SARS-2-S is cleaved into S1 and S2 subunits, with S1 serving the function of receptor-binding and S2 serving the function of membrane fusion. Here, I dissect in detail the various domains of SARS-2-S and their functions discovered through a variety of different experimental and theoretical approaches to build a foundation for a comprehensive mechanistic understanding of how SARS-2-S works to achieve its function of mediating cell entry and subsequent cell-to-cell transmission. The integration of structure and function of SARS-2-S in this review should enhance our understanding of the dynamic processes involving receptor binding, multiple cleavage events, membrane fusion, viral entry, as well as the emergence of new viral variants. I highlighted the relevance of structural domains and dynamics to vaccine development, and discussed reasons for the spike protein to be frequently featured in the conspiracy theory claiming that SARS-CoV-2 is artificially created.}, } @article {pmid33466884, year = {2021}, author = {Martinez-Liu, C and Martínez-Acuña, N and Arellanos-Soto, D and Galan-Huerta, K and Lozano-Sepulveda, S and Martínez-Guzmán, MDC and Rivas-Estilla, AM}, title = {SARS-CoV-2 in Mexico: Beyond Detection Methods, Scope and Limitations.}, journal = {Diagnostics (Basel, Switzerland)}, volume = {11}, number = {1}, pages = {}, doi = {10.3390/diagnostics11010124}, pmid = {33466884}, issn = {2075-4418}, support = {312135//Consejo Nacional de Ciencia y Tecnología/ ; }, abstract = {The new coronavirus that was first identified in December 2019 in Wuhan China, now called SARS-CoV-2, which causes the disease called COVID-19, has spread from China to the entire world in a few months. Due to its contagious potential (R0: 5.7) and because there is still no effective treatment to stop the infection, and a vaccine for prevention it is not yet available to the general population, COVID-19 is currently considered a global health problem. The need to implement sensitive methods for the identification of individuals with COVID-19 has led to the development of different molecular and immunological tests. The importance of a timely and accurate diagnosis is essential to determine the course of the pandemic. The interpretation of the results obtained by each test as well as the factors that affect these results have not been fully described. In this review, we describe and analyze the different SARS-CoV-2 detection methods that have been performed in Mexico and are available worldwide, outlining their strengths and weaknesses. Further, a broader perspective of the correct use and interpretation of the results obtained with these diagnostic tools is proposed to improve the containment strategy and identify the true impact of the pandemic.}, } @article {pmid33466734, year = {2021}, author = {Stasiłowicz, A and Tomala, A and Podolak, I and Cielecka-Piontek, J}, title = {Cannabis sativa L. as a Natural Drug Meeting the Criteria of a Multitarget Approach to Treatment.}, journal = {International journal of molecular sciences}, volume = {22}, number = {2}, pages = {}, doi = {10.3390/ijms22020778}, pmid = {33466734}, issn = {1422-0067}, abstract = {Cannabis sativa L. turned out to be a valuable source of chemical compounds of various structures, showing pharmacological activity. The most important groups of compounds include phytocannabinoids and terpenes. The pharmacological activity of Cannabis (in epilepsy, sclerosis multiplex (SM), vomiting and nausea, pain, appetite loss, inflammatory bowel diseases (IBDs), Parkinson's disease, Tourette's syndrome, schizophrenia, glaucoma, and coronavirus disease 2019 (COVID-19)), which has been proven so far, results from the affinity of these compounds predominantly for the receptors of the endocannabinoid system (the cannabinoid receptor type 1 (CB1), type two (CB2), and the G protein-coupled receptor 55 (GPR55)) but, also, for peroxisome proliferator-activated receptor (PPAR), glycine receptors, serotonin receptors (5-HT), transient receptor potential channels (TRP), and GPR, opioid receptors. The synergism of action of phytochemicals present in Cannabis sp. raw material is also expressed in their increased bioavailability and penetration through the blood-brain barrier. This review provides an overview of phytochemistry and pharmacology of compounds present in Cannabis extracts in the context of the current knowledge about their synergistic actions and the implications of clinical use in the treatment of selected diseases.}, } @article {pmid33466589, year = {2021}, author = {Janiuk, K and Jabłońska, E and Garley, M}, title = {Significance of NETs Formation in COVID-19.}, journal = {Cells}, volume = {10}, number = {1}, pages = {}, doi = {10.3390/cells10010151}, pmid = {33466589}, issn = {2073-4409}, abstract = {Severe contagious respiratory disease-COVID-19-caused by the SARS-CoV-2 coronavirus, can lead to fatal respiratory failure associated with an excessive inflammatory response. Infiltration and spread of SARS-CoV-2 are based on the interaction between the virus' structural protein S and the cell's receptor-angiotensin-converting enzyme 2 (ACE2), with the simultaneous involvement of human trans-membrane protease, serine 2 (TMPRSS2). Many scientific reports stress the importance of elevated recruitment and activity of neutrophils, which can form extracellular neutrophil traps (NETs) playing a significant role in the mechanism of combating pathogens, in the pathogenesis of COVID-19. Excessive generation of NETs during prolonged periods of inflammation predisposes for the occurrence of undesirable reactions including thromboembolic complications and damage to surrounding tissues and organs. Within the present manuscript, we draw attention to the impact of NET generation on the severe course of COVID-19 in patients with concurrent cardiovascular and metabolic diseases. Additionally, we indicate the necessity to explore not only the cellular but also the molecular bases of COVID-19 pathogenesis, which may aid the development of dedicated therapies meant to improve chances for the successful treatment of patients. We also present new directions of research into medications that display NETs formation regulatory properties as potential significant therapeutic strategies in the progress of COVID-19.}, } @article {pmid33466585, year = {2021}, author = {Aquino-Martinez, R and Hernández-Vigueras, S}, title = {Severe COVID-19 Lung Infection in Older People and Periodontitis.}, journal = {Journal of clinical medicine}, volume = {10}, number = {2}, pages = {}, doi = {10.3390/jcm10020279}, pmid = {33466585}, issn = {2077-0383}, abstract = {Periodontal bacteria dissemination into the lower respiratory tract may create favorable conditions for severe COVID-19 lung infection. Once lung tissues are colonized, cells that survive persistent bacterial infection can undergo permanent damage and accelerated cellular senescence. Consequently, several morphological and functional features of senescent lung cells facilitate SARS-CoV-2 replication. The higher risk for severe SARS-CoV-2 infection, the virus that causes COVID-19, and death in older patients has generated the question whether basic aging mechanisms could be implicated in such susceptibility. Mounting evidence indicates that cellular senescence, a manifestation of aging at the cellular level, contributes to the development of age-related lung pathologies and facilitates respiratory infections. Apparently, a relationship between life-threatening COVID-19 lung infection and pre-existing periodontal disease seems improbable. However, periodontal pathogens can be inoculated during endotracheal intubation and/or aspirated into the lower respiratory tract. This review focuses on how the dissemination of periodontal bacteria into the lungs could aggravate age-related senescent cell accumulation and facilitate more efficient SARS-CoV-2 cell attachment and replication. We also consider how periodontal bacteria-induced premature senescence could influence the course of COVID-19 lung infection. Finally, we highlight the role of saliva as a reservoir for both pathogenic bacteria and SARS-CoV-2. Therefore, the identification of active severe periodontitis can be an opportune and valid clinical parameter for risk stratification of old patients with COVID-19.}, } @article {pmid33466289, year = {2021}, author = {Coke, CJ and Davison, B and Fields, N and Fletcher, J and Rollings, J and Roberson, L and Challagundla, KB and Sampath, C and Cade, J and Farmer-Dixon, C and Gangula, PR}, title = {SARS-CoV-2 Infection and Oral Health: Therapeutic Opportunities and Challenges.}, journal = {Journal of clinical medicine}, volume = {10}, number = {1}, pages = {}, doi = {10.3390/jcm10010156}, pmid = {33466289}, issn = {2077-0383}, support = {D34HP00002//HRSA/ ; SC1GM121282/GM/NIGMS NIH HHS/United States ; }, abstract = {The novel corona virus, Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), and the disease it causes, COVID-19 (Coronavirus Disease-2019) have had multi-faceted effects on a number of lives on a global scale both directly and indirectly. A growing body of evidence suggest that COVID-19 patients experience several oral health problems such as dry mouth, mucosal blistering, mouth rash, lip necrosis, and loss of taste and smell. Periodontal disease (PD), a severe inflammatory gum disease, may worsen the symptoms associated with COVID-19. Routine dental and periodontal treatment may help decrease the symptoms of COVID-19. PD is more prevalent among patients experiencing metabolic diseases such as obesity, diabetes mellitus and cardiovascular risk. Studies have shown that these patients are highly susceptible for SARS-CoV-2 infection. Pro-inflammatory cytokines and oxidative stress known to contribute to the development of PD and other metabolic diseases are highly elevated among COVID-19 patients. Periodontal health may help to determine the severity of COVID-19 infection. Accumulating evidence shows that African-Americans (AAs) and vulnerable populations are disproportionately susceptible to PD, metabolic diseases and COVID-19 compared to other ethnicities in the United States. Dentistry and dental healthcare professionals are particularly susceptible to this virus due to the transferability via the oral cavity and the use of aerosol creating instruments that are ubiquitous in this field. In this review, we attempt to provide a comprehensive and updated source of information about SARS-CoV-2/COVID-19 and the various effects it has had on the dental profession and patients visits to dental clinics. Finally, this review is a valuable resource for the management of oral hygiene and reduction of the severity of infection.}, } @article {pmid33466241, year = {2021}, author = {Rzymski, P and Kulus, M and Jankowski, M and Dompe, C and Bryl, R and Petitte, JN and Kempisty, B and Mozdziak, P}, title = {COVID-19 Pandemic Is a Call to Search for Alternative Protein Sources as Food and Feed: A Review of Possibilities.}, journal = {Nutrients}, volume = {13}, number = {1}, pages = {}, doi = {10.3390/nu13010150}, pmid = {33466241}, issn = {2072-6643}, support = {NC-1084//U.S. Department of Agriculture/ ; Cultured Meat Enhancement Fund//Cultured Meat Enhancement Fund/ ; }, abstract = {The coronavirus disease 2019 (COVID-19) pandemic is a global health challenge with substantial adverse effects on the world economy. It is beyond any doubt that it is, again, a call-to-action to minimize the risk of future zoonoses caused by emerging human pathogens. The primary response to contain zoonotic diseases is to call for more strict regulations on wildlife trade and hunting. This is because the origins of coronaviruses such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), SARS-CoV, Middle East respiratory syndrome coronavirus (MERS-CoV), as well as other viral pathogens (e.g., Ebola, HIV) are traceable to wild animals. Although COVID-19 is not related to livestock animals, the pandemic increased general attention given to zoonotic viral infections-the risk of which can also be associated with livestock. Therefore, this paper discusses the potential transformation of industrial livestock farming and the production of animal products, particularly meat, to decrease the risks for transmission of novel human pathogens. Plant-based diets have a number of advantages, but it is unrealistic to consider them as the only solution offered to the problem. Therefore, a search for alternative protein sources in insect-based foods and cultured meat, important technologies enabling safer meat production. Although both of these strategies offer a number of potential advantages, they are also subject to the number of challenges that are discussed in this paper. Importantly, insect-based foods and cultured meat can provide additional benefits in the context of ecological footprint, an aspect important in light of predicted climate changes. Furthermore, cultured meat can be regarded as ethically superior and supports better food security. There is a need to further support the implementation and expansion of all three approaches discussed in this paper, plant-based diets, insect-based foods, and cultured meat, to decrease the epidemiological risks and ensure a sustainable future. Furthermore, cultured meat also offers a number of additional benefits in the context of environmental impact, ethical issues, and food security.}, } @article {pmid33439566, year = {2021}, author = {Andermann, A and Mott, S and Mathew, CM and Kendall, C and Mendonca, O and Harriott, D and McLellan, A and Riddle, A and Saad, A and Iqbal, W and Magwood, O and Pottie, K}, title = {Evidence-informed interventions and best practices for supporting women experiencing or at risk of homelessness: a scoping review with gender and equity analysis.}, journal = {Health promotion and chronic disease prevention in Canada : research, policy and practice}, volume = {41}, number = {1}, pages = {1-13}, doi = {10.24095/hpcdp.41.1.01}, pmid = {33439566}, issn = {2368-738X}, mesh = {Canada ; Female ; *Gender Equity ; *Homeless Persons ; Humans ; }, abstract = {INTRODUCTION: While much of the literature on homelessness is centred on the experience of men, women make up over one-quarter of Canada's homeless population. Research has shown that women experiencing homelessness are often hidden (i.e. provisionally housed) and have different pathways into homelessness and different needs as compared to men. The objective of this research is to identify evidence-based interventions and best practices to better support women experiencing or at risk of homelessness.

METHODS: We conducted a scoping review with a gender and equity analysis. This involved searching MEDLINE, CINAHL, PsycINFO and other databases for systematic reviews and randomized trials, supplementing our search through reference scanning and grey literature, followed by a qualitative synthesis of the evidence that examined gender and equity considerations.

RESULTS: Of the 4102 articles identified on homelessness interventions, only 4 systematic reviews and 9 randomized trials were exclusively conducted on women or published disaggregated data enabling a gender analysis. Interventions with the strongest evidence included post-shelter advocacy counselling for women experiencing homelessness due to intimate partner violence, as well as case management and permanent housing subsidies (e.g. tenant-based rental assistance vouchers), which were shown to reduce homelessness, food insecurity, exposure to violence and psychosocial distress, as well as promote school stability and child well-being.

CONCLUSION: Much of the evidence on interventions to better support women experiencing homelessness focusses on those accessing domestic violence or family shelters. Since many more women are experiencing or at risk of hidden homelessness, population-based strategies are also needed to reduce gender inequity and exposure to violence, which are among the main structural drivers of homelessness among women.}, } @article {pmid33354885, year = {2020}, author = {Almallah, YZ and Doyle, DJ}, title = {Telehealth in the time of Corona: 'doctor in the house'.}, journal = {Internal medicine journal}, volume = {50}, number = {12}, pages = {1578-1583}, doi = {10.1111/imj.15108}, pmid = {33354885}, issn = {1445-5994}, mesh = {COVID-19/*epidemiology/*therapy ; Humans ; Physicians/standards/*trends ; Smartphone/standards/trends ; Telemedicine/*methods/standards/*trends ; Wearable Electronic Devices/standards/trends ; }, abstract = {The COVID-19 pandemic has led to many physicians working from home whenever possible. Although the concept of 'remote' patient care has been around for decades, present circumstances have provided a grand impetus in that direction with a view to protecting both patient and caregiver. In this article, we discuss some of the various challenges to moving forward with telemedicine, drawing in part on our own experiences in dealing with the COVID-19 pandemic. Clinical, technical, financial and cultural barriers to telemedicine are identified, along with a discussion concerning anticipated benefits. We conclude that the COVID-19 pandemic will likely forever change how healthcare is conducted as telemedicine figures increasingly prominently in the clinical landscape.}, } @article {pmid33354883, year = {2020}, author = {Izzedine, H and Brocheriou, I and Arzouk, N and Seilhean, D and Couvert, P and Cluzel, P and Pha, M and Le Monnier, O and Varnous, S and Andreelli, F and Amoura, Z and Mathian, A}, title = {COVID-19-associated collapsing glomerulopathy: a report of two cases and literature review.}, journal = {Internal medicine journal}, volume = {50}, number = {12}, pages = {1551-1558}, doi = {10.1111/imj.15041}, pmid = {33354883}, issn = {1445-5994}, mesh = {Acute Kidney Injury/*diagnosis/*etiology ; Adult ; COVID-19/*complications/*diagnosis ; Female ; Humans ; Kidney Cortex Necrosis/*diagnosis/*etiology ; Middle Aged ; }, abstract = {Nephrotic range proteinuria has been reported during the course of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease (COVID-19). However, the pathological mechanisms underlying this manifestation are unknown. In this article, we present two cases of collapsing glomerulopathy (CG) associated with acute tubular necrosis during the course of COVID-19, and review the literature for similar reports. In our two cases, as in the 14 cases reported so far, the patients were of African ancestry. The 14 patients assessed had an APOL1 high-risk genotype. At the end of the reported period, two patients had died and five patients were still requiring dialysis. The 16 cases detailed in the present report strongly argue in favour of a causal link between SARS-CoV-2 infection and the occurrence of CG in patients homozygous for APOL1 high-risk genotype for which the term COVID-associated nephropathy (COVIDAN) can be put forward.}, } @article {pmid33326409, year = {2021}, author = {Valentine, AZ and Hall, SS and Young, E and Brown, BJ and Groom, MJ and Hollis, C and Hall, CL}, title = {Implementation of Telehealth Services to Assess, Monitor, and Treat Neurodevelopmental Disorders: Systematic Review.}, journal = {Journal of medical Internet research}, volume = {23}, number = {1}, pages = {e22619}, doi = {10.2196/22619}, pmid = {33326409}, issn = {1438-8871}, abstract = {BACKGROUND: In response to COVID-19, there has been increasing momentum in telehealth development and delivery. To assess the anticipated exponential growth in telehealth, it is important to accurately capture how telehealth has been used in specific mental health fields prior to the pandemic.

OBJECTIVE: This systematic review aimed to highlight how telehealth has been used with clinical samples in the neurodevelopmental field, including patients with neurodevelopmental disorders (NDDs), their families, and health care professionals. To identify which technologies show the greatest potential for implementation into health services, we evaluated technologies for effectiveness, economic impact, and readiness for clinical adoption.

METHODS: A systematic search of literature was undertaken in April 2018 and updated until December 2019, by using the Medline, Web of Science, Scopus, CINAHL Plus, EMBASE, and PsycInfo databases. Extracted data included the type of technology, how the technology was used (ie, assessment, treatment, and monitoring), participant characteristics, reported outcomes and authors' views on clinical effectiveness, user impact (ie, feasibility and acceptability), economic impact, and readiness for clinic adoption. A quality review of the research was performed in accordance with the Oxford Centre for Evidence-Based Medicine Levels of Evidence.

RESULTS: A total of 42 studies met the inclusion criteria. These studies included participants and family members with autism spectrum disorders (21/42, 50%), attention deficit hyperactivity disorders (8/42, 19%), attention deficit hyperactivity or autism spectrum disorders (3/42, 7%), communication disorders (7/42, 17%), and tic disorders (2/42, 5%). The focus of most studies (33/42, 79%) was on treatment, rather than assessment (4/42, 10%) or monitoring (5/42, 12%). Telehealth services demonstrated promise for being clinically effective, predominantly in relation to diagnosing and monitoring NDDs. In terms of NDD treatment, telehealth services were usually equivalent to control groups. There was some evidence of positive user and economic impacts, including increased service delivery efficiency (eg, increased treatment availability and decreased waiting times). However, these factors were not widely recorded across the studies. Telehealth was demonstrated to be cost-effective in the few studies that considered cost-effectiveness. Study quality varied, as many studies had small sample sizes and inadequate control groups. Of the 42 studies, only 11 (26%) were randomized controlled trials, 12 (29%) were case studies or case series, 6 (14%) were qualitative studies, and 5 (12%) were noncomparative trials.

CONCLUSIONS: Telehealth has the potential to increase treatment availability, decrease diagnosis waiting times, and aid in NDD monitoring. Further research with more robust and adequately powered study designs that consider cost-effectiveness and increased efficiency is needed. This systematic review highlights the extent of telehealth technology use prior to the COVID-19 pandemic and the movement for investing in remote access to treatments.

TRIAL REGISTRATION: PROSPERO International Prospective Register of Systematic Reviews CRD42018091156; https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42018091156.}, } @article {pmid33284964, year = {2020}, author = {Wilder-Smith, A and Osman, S}, title = {Public health emergencies of international concern: a historic overview.}, journal = {Journal of travel medicine}, volume = {27}, number = {8}, pages = {}, doi = {10.1093/jtm/taaa227}, pmid = {33284964}, issn = {1708-8305}, mesh = {*COVID-19/epidemiology/prevention & control ; *Communicable Disease Control/organization & administration/trends ; Communicable Diseases/epidemiology ; Disease Outbreaks/*prevention & control ; Global Health ; Humans ; International Cooperation ; Public Health ; SARS-CoV-2 ; *Travel Medicine/methods/standards/trends ; }, abstract = {RATIONALE: The International Health Regulations (IHR) have been the governing framework for global health security since 2007. Declaring public health emergencies of international concern (PHEIC) is a cornerstone of the IHR. Here we review how PHEIC are formally declared, the diseases for which such declarations have been made from 2007 to 2020 and justifications for such declarations.

KEY FINDINGS: Six events were declared PHEIC between 2007 and 2020: the 2009 H1N1 influenza pandemic, Ebola (West African outbreak 2013-2015, outbreak in Democratic Republic of Congo 2018-2020), poliomyelitis (2014 to present), Zika (2016) and COVID-19 (2020 to present). Poliomyelitis is the longest PHEIC. Zika was the first PHEIC for an arboviral disease. For several other emerging diseases a PHEIC was not declared despite the fact that the public health impact of the event was considered serious and associated with potential for international spread.

RECOMMENDATIONS: The binary nature of a PHEIC declaration is often not helpful for events where a tiered or graded approach is needed. The strength of PHEIC declarations is the ability to rapidly mobilize international coordination, streamline funding and accelerate the advancement of the development of vaccines, therapeutics and diagnostics under emergency use authorization. The ultimate purpose of such declaration is to catalyse timely evidence-based action, to limit the public health and societal impacts of emerging and re-emerging disease risks while preventing unwarranted travel and trade restrictions.}, } @article {pmid33247586, year = {2020}, author = {Hamer, DH and Rizwan, A and Freedman, DO and Kozarsky, P and Libman, M}, title = {GeoSentinel: past, present and future†.}, journal = {Journal of travel medicine}, volume = {27}, number = {8}, pages = {}, doi = {10.1093/jtm/taaa219}, pmid = {33247586}, issn = {1708-8305}, mesh = {*COVID-19/epidemiology/prevention & control ; Centers for Disease Control and Prevention, U.S. ; Geographic Information Systems ; Humans ; *International Cooperation ; SARS-CoV-2 ; *Sentinel Surveillance ; *Travel Medicine/methods/trends ; Travel-Related Illness ; United States ; }, abstract = {RATIONALE FOR REVIEW: In response to increased concerns about emerging infectious diseases, GeoSentinel, the Global Surveillance Network of the International Society of Travel Medicine in partnership with the US Centers for Disease Control and Prevention (CDC), was established in 1995 in order to serve as a global provider-based emerging infections sentinel network, conduct surveillance for travel-related infections and communicate and assist global public health responses. This review summarizes the history, past achievements and future directions of the GeoSentinel Network.

KEY FINDINGS: Funded by the US CDC in 1996, GeoSentinel has grown from a group of eight US-based travel and tropical medicine centers to a global network, which currently consists of 68 sites in 28 countries. GeoSentinel has provided important contributions that have enhanced the ability to use destination-specific differences to guide diagnosis and treatment of returning travelers, migrants and refugees. During the last two decades, GeoSentinel has identified a number of sentinel infectious disease events including previously unrecognized outbreaks and occurrence of diseases in locations thought not to harbor certain infectious agents. GeoSentinel has also provided useful insight into illnesses affecting different traveling populations such as migrants, business travelers and students, while characterizing in greater detail the epidemiology of infectious diseases such as typhoid fever, leishmaniasis and Zika virus disease.

CONCLUSIONS: Surveillance of travel- and migration-related infectious diseases has been the main focus of GeoSentinel for the last 25 years. However, GeoSentinel is now evolving into a network that will conduct both research and surveillance. The large number of participating sites and excellent geographic coverage for identification of both common and illnesses in individuals who have traversed international borders uniquely position GeoSentinel to make important contributions of travel-related infectious diseases in the years to come.}, } @article {pmid33227417, year = {2021}, author = {Bellam, N and Denfeld, QE and Kamdar, F and Alexy, T and Breathett, K and Patel, PA and Faulkenberg, K and Moyer, B and Psotka, MA and Ginwalla, M}, title = {Navigating Early Careers in Heart Failure in the Era of Novel Coronavirus Disease-2019.}, journal = {Journal of cardiac failure}, volume = {27}, number = {1}, pages = {97-99}, pmid = {33227417}, issn = {1532-8414}, support = {K01 HL142848/HL/NHLBI NIH HHS/United States ; K12 HD043488/HD/NICHD NIH HHS/United States ; L30 HL148881/HL/NHLBI NIH HHS/United States ; R25 HL126146/HL/NHLBI NIH HHS/United States ; }, mesh = {COVID-19/*epidemiology/therapy ; *Career Choice ; Career Mobility ; Health Personnel/*trends ; Heart Failure/*epidemiology/therapy ; Humans ; Telemedicine/methods/*trends ; }, } @article {pmid33184655, year = {2020}, author = {Khatib, AN and Carvalho, AM and Primavesi, R and To, K and Poirier, V}, title = {Navigating the risks of flying during COVID-19: a review for safe air travel.}, journal = {Journal of travel medicine}, volume = {27}, number = {8}, pages = {}, doi = {10.1093/jtm/taaa212}, pmid = {33184655}, issn = {1708-8305}, mesh = {Air Travel/*trends ; *COVID-19/epidemiology/prevention & control/psychology ; Disease Transmission, Infectious/*prevention & control ; Humans ; Risk Assessment/*methods ; *Risk Reduction Behavior ; SARS-CoV-2 ; Travel Medicine ; }, abstract = {RATIONALE FOR REVIEW: With air travel restarting, there has been much discourse about the safety of flying during the pandemic. In travel medicine, risk assessment includes estimating baseline risk to the traveller, recognizing factors that may modify that risk, considering the role of interventions to decrease that risk and accounting for a traveller's perception and tolerance of risk. The goals of this review are to identify the in-flight transmission risks of commercial air travel, provide recommendations about the risks of flying during the pandemic and propose strategies to mitigate the spread of COVID-19.

KEY FINDINGS: The airline industry has taken a layered approach to increase passenger safety through effective onboard ventilation, extended ventilation at the gate, boarding and deplaning strategies, improved aircraft disinfection and pre-flight screening such as temperature checks and COVID-19 testing. Proximity to an index case may contribute to the risk of transmission more than the seat type or location. The use of face masks has significantly reduced onboard transmission, and mandatory in-flight mask-wearing policies are being enforced. Innovations such as digital health passports may help standardize screening entry requirements at airports and borders, allowing for a safer return to travel.

RECOMMENDATIONS: In-flight transmission of SARS-CoV-2 is a real risk, which may be minimized by combining mitigation strategies and infection prevention measures including mandatory masking onboard, minimizing unmasked time while eating, turning on gasper airflow in-flight, frequent hand sanitizing, disinfecting high touch surfaces, promoting distancing while boarding and deplaning, limiting onboard passenger movement, implementing effective pre-flight screening measures and enhancing contact tracing capability. Assessing risk is a cornerstone of travel medicine. It is important to evaluate the multiple factors contributing to the cumulative risk of an individual traveller during the COVID-19 pandemic and to employ a multi-pronged approach to reduce that risk.}, } @article {pmid33465727, year = {2021}, author = {Linehan, L and O'Donoghue, K and Dineen, S and White, J and Higgins, JR and Fitzgerald, B}, title = {SARS-CoV-2 placentitis: An uncommon complication of maternal COVID-19.}, journal = {Placenta}, volume = {104}, number = {}, pages = {261-266}, doi = {10.1016/j.placenta.2021.01.012}, pmid = {33465727}, issn = {1532-3102}, abstract = {We present a case of third trimester pregnancy complicated by SARS-CoV-2 infection and subsequent reduced fetal movements, resulting in emergency Caesarean delivery with demonstrable placental SARS-CoV-2 placentitis. We show through illustration of this case and literature review that SARS-Co-V-2 placentitis is an uncommon but readily recognisable complication of maternal SARS-CoV-2 infection that may be a marker of potential vertical transmission and that may have the capacity to cause fetal compromise through a direct injurious effect on the placenta.}, } @article {pmid33465472, year = {2021}, author = {Ning, L and Rong, J and Zhang, Z and Xu, Y}, title = {Therapeutic approaches targeting renin-angiotensin system in sepsis and its complications.}, journal = {Pharmacological research}, volume = {}, number = {}, pages = {105409}, doi = {10.1016/j.phrs.2020.105409}, pmid = {33465472}, issn = {1096-1186}, abstract = {Sepsis, caused by the inappropriate host response to infection, is characterized by excessive inflammation response and organ dysfunction, continues to be a critical clinical problem. Commonly, sepsis may progress to septic shock and have a high risk of complications, including acute kidney injury (AKI), acute respiratory distress syndrome (ARDS), sepsis-induced myocardial dysfunction (SIMD), liver dysfunction, cerebral dysfunction, and skeletal muscle atrophy, predominantly contributing to high mortality. Additionally, viral sepsis may be critical for the pathogenesis of coronavirus disease 2019 (COVID-19). Renin-angiotensin system (RAS) may represent as an effective therapeutic target for sepsis therapies. The role of RAS involved in the pathogenesis of sepsis has been spotlighted and some preclinical and clinical trials studies targeted at RAS for sepsis treatment have shown promising results. Herein, we attempt to review the effects and mechanisms of RAS manipulation on sepsis and provide new insights into optimization RAS modulation for this terrible heterogeneous syndrome.}, } @article {pmid33465451, year = {2021}, author = {Sohail, MS and Ahmed, SF and Quadeer, AA and McKay, MR}, title = {In silico T cell epitope identification for SARS-CoV-2: Progress and perspectives.}, journal = {Advanced drug delivery reviews}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.addr.2021.01.007}, pmid = {33465451}, issn = {1872-8294}, abstract = {Growing evidence suggests that T cells may play a critical role in combating severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Hence, COVID-19 vaccines that can elicit a robust T cell response may be particularly important. The design, development and experimental evaluation of such vaccines is aided by an understanding of the landscape of T cell epitopes of SARS-CoV-2, which is largely unknown. Due to the challenges of identifying epitopes experimentally, many studies have proposed the use of in silico methods. Here, we present a review of the in silico methods that have been used for the prediction of SARS-CoV-2 T cell epitopes. These methods employ a diverse set of technical approaches, often rooted in machine learning. A performance comparison is provided based on the ability to identify a specific set of immunogenic epitopes that have been determined experimentally to be targeted by T cells in convalescent COVID-19 patients, shedding light on the relative performance merits of the different approaches adopted by the in silico studies. The review also puts forward perspectives for future research directions.}, } @article {pmid33465335, year = {2021}, author = {Bleich, SN and Ard, JD}, title = {COVID-19, Obesity, and Structural Racism: Understanding the Past and Identifying Solutions for the Future.}, journal = {Cell metabolism}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.cmet.2021.01.010}, pmid = {33465335}, issn = {1932-7420}, abstract = {Long-standing systemic inequalities-fueling unequal access to critical resources such as healthcare, housing, education, and employment opportunities-are largely responsible for the significant race disparities in obesity and COVID-19. Because of this legacy, public health emergencies like the COVID-19 pandemic disproportionately impact communities of color, exacerbated by high rates of pre-existing chronic diseases like obesity. Learning from this history is instructive for understanding our present situation and for crafting effective solutions that promote health equity. Critical action is needed now to meaningfully address the disproportionate impact of these major public health problems on Black and Brown populations.}, } @article {pmid33464639, year = {2021}, author = {Kalia, V and Studzinski, GP and Sarkar, S}, title = {Role of vitamin D in regulating COVID-19 severity-An immunological perspective.}, journal = {Journal of leukocyte biology}, volume = {}, number = {}, pages = {}, doi = {10.1002/JLB.4COVR1020-698R}, pmid = {33464639}, issn = {1938-3673}, abstract = {Vitamin D, a key nutrient/prohormone classically associated with skeletal health, is also an important immunomodulator, with pleotropic effects on innate and adaptive immune cells. Outcomes of several chronic, autoimmune, and infectious diseases are linked to vitamin D. Emergent correlations of vitamin D insufficiency with coronavirus-induced disease 2019 (COVID-19) severity, alongside empirical and clinical evidence of immunoregulation by vitamin D in other pulmonary diseases, have prompted proposals of vitamin D supplementation to curb the COVID-19 public health toll. In this review paper, we engage an immunological lens to discuss potential mechanisms by which vitamin D signals might regulate respiratory disease severity in severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infections, vis a vis other pulmonary infections. It is proposed that vitamin D signals temper lung inflammatory cascades during SARS-CoV2 infection, and insufficiency of vitamin D causes increased inflammatory cytokine storm, thus leading to exacerbated respiratory disease. Additionally, analogous to studies of reduced cancer incidence, the dosage of vitamin D compounds administered to patients near the upper limit of safety may serve to maximize immune health benefits and mitigate inflammation and disease severity in SARS-CoV2 infections. We further deliberate on the importance of statistically powered clinical correlative and interventional studies, and the need for in-depth basic research into vitamin D-dependent host determinants of respiratory disease severity.}, } @article {pmid33464546, year = {2021}, author = {Taher, T and Sheikh, AB and Anwar, F and Khosa, F}, title = {SARS-CoV-2: its potential neurological manifestations and plausible mechanism: a review article.}, journal = {Acta neurologica Belgica}, volume = {}, number = {}, pages = {}, pmid = {33464546}, issn = {2240-2993}, abstract = {Coronavirus disease (COVID-19) was first identified in late December 2019. The disease began in Wuhan, Hubei province in China and since then it has spread quickly to many countries all over the world. COVID-19 is caused by a novel coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The virus was majorly seen to overwhelm the respiratory system with mild to severe acute respiratory syndrome considered pathognomic for the disease. However, with time a plethora of symptoms was observed in the patients infected with COVID-19 including strong evidence for neurological symptoms. Evidence suggests that the virus has both central and peripheral nervous system manifestations. Patients, particularly those who suffer from a severe illness, have a central nervous system (CNS) involvement and neurological manifestations. There is precise and targeted documentation of neurological symptoms with details of clinical, neurological, and electrophysiological findings. This review article thus gives an insight into the neuro-invasive potential of COVID-19 and discusses the possible pathogenesis.}, } @article {pmid33464535, year = {2021}, author = {Jha, NK and Ojha, S and Jha, SK and Dureja, H and Singh, SK and Shukla, SD and Chellappan, DK and Gupta, G and Bhardwaj, S and Kumar, N and Jeyaraman, M and Jain, R and Muthu, S and Kar, R and Kumar, D and Goswami, VK and Ruokolainen, J and Kesari, KK and Singh, SK and Dua, K}, title = {Evidence of Coronavirus (CoV) Pathogenesis and Emerging Pathogen SARS-CoV-2 in the Nervous System: A Review on Neurological Impairments and Manifestations.}, journal = {Journal of molecular neuroscience : MN}, volume = {}, number = {}, pages = {}, pmid = {33464535}, issn = {1559-1166}, abstract = {The coronavirus disease 2019 (COVID-19) pandemic is an issue of global significance that has taken the lives of many across the world. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus responsible for its pathogenesis. The pulmonary manifestations of COVID-19 have been well described in the literature. Initially, it was thought to be limited to the respiratory system; however, we now recognize that COVID-19 also affects several other organs, including the nervous system. Two similar human coronaviruses (CoV) that cause severe acute respiratory syndrome (SARS-CoV-1) and Middle East respiratory syndrome (MERS-CoV) are also known to cause disease in the nervous system. The neurological manifestations of SARS-CoV-2 infection are growing rapidly, as evidenced by several reports. There are several mechanisms responsible for such manifestations in the nervous system. For instance, post-infectious immune-mediated processes, direct virus infection of the central nervous system (CNS), and virus-induced hyperinflammatory and hypercoagulable states are commonly involved. Guillain-Barré syndrome (GBS) and its variants, dysfunction of taste and smell, and muscle injury are numerous examples of COVID-19 PNS (peripheral nervous system) disease. Likewise, hemorrhagic and ischemic stroke, encephalitis, meningitis, encephalopathy acute disseminated encephalomyelitis, endothelialitis, and venous sinus thrombosis are some instances of COVID-19 CNS disease. Due to multifactorial and complicated pathogenic mechanisms, COVID-19 poses a large-scale threat to the whole nervous system. A complete understanding of SARS-CoV-2 neurological impairments is still lacking, but our knowledge base is rapidly expanding. Therefore, we anticipate that this comprehensive review will provide valuable insights and facilitate the work of neuroscientists in unfolding different neurological dimensions of COVID-19 and other CoV associated abnormalities.}, } @article {pmid33464513, year = {2021}, author = {Gosch, M and Heppner, HJ and Singler, K}, title = {[Recommendations for the management of COVID-19 pandemic in long term care facilities].}, journal = {MMW Fortschritte der Medizin}, volume = {163}, number = {1}, pages = {52-57}, doi = {10.1007/s15006-020-9524-9}, pmid = {33464513}, issn = {1613-3560}, } @article {pmid33464512, year = {2021}, author = {Worm, M and Ring, J and Klimek, L and Jakob, T and Lange, L and Treudler, R and Beyer, K and Werfel, T and Biedermann, T and Bircher, A and Fischer, M and Fuchs, T and Heller, AR and Hoffmann, F and Huttegger, I and Kopp, MV and Kugler, C and Lommatzsch, M and Pfaar, O and Rietschel, E and Rueff, F and Schnadt, S and Seifert, R and Stöcker, B and Vogelberg, C and Sitter, H and Gieler, U and Brockow, K}, title = {[Covid-19 vaccination and risk of anaphylaxis - Recommendations for practical management].}, journal = {MMW Fortschritte der Medizin}, volume = {163}, number = {1}, pages = {48-51}, doi = {10.1007/s15006-021-9530-6}, pmid = {33464512}, issn = {1613-3560}, } @article {pmid33464511, year = {2021}, author = {Parhofer, KG}, title = {[Diabetes mellitus in the time of COVID-19].}, journal = {MMW Fortschritte der Medizin}, volume = {163}, number = {1}, pages = {45-47}, doi = {10.1007/s15006-020-9506-y}, pmid = {33464511}, issn = {1613-3560}, } @article {pmid33464510, year = {2021}, author = {Gross, M and Op den Winkel, P and Aksoy, J}, title = {[Gastrointestinal manifestations in patients with COVID-19].}, journal = {MMW Fortschritte der Medizin}, volume = {163}, number = {1}, pages = {42-44}, doi = {10.1007/s15006-020-9512-0}, pmid = {33464510}, issn = {1613-3560}, } @article {pmid33464509, year = {2021}, author = {Diener, HC and Berlit, P}, title = {[COVID-19 and neurology].}, journal = {MMW Fortschritte der Medizin}, volume = {163}, number = {1}, pages = {40-41}, doi = {10.1007/s15006-020-9505-z}, pmid = {33464509}, issn = {1613-3560}, } @article {pmid33464508, year = {2021}, author = {Dutsch, A and Lechner, K and Schunkert, H}, title = {[Cardiovascular manifestations of COVID-19].}, journal = {MMW Fortschritte der Medizin}, volume = {163}, number = {1}, pages = {36-39}, doi = {10.1007/s15006-020-9511-1}, pmid = {33464508}, issn = {1613-3560}, } @article {pmid33464482, year = {2021}, author = {Bedenkov, A and Moreno, C and Agustin, L and Jain, N and Newman, A and Feng, L and Kostello, G}, title = {Customer Centricity in Medical Affairs Needs Human-centric Artificial Intelligence.}, journal = {Pharmaceutical medicine}, volume = {}, number = {}, pages = {}, pmid = {33464482}, issn = {1178-2595}, abstract = {The evolution of healthcare, together with the changing behaviour of healthcare professionals, means that medical affairs functions of pharmaceutical organisations are constantly reinventing themselves. The emergence of digital ways of working, expedited by the COVID-19 pandemic, means that pharmaceutical-healthcare relationships are evolving to operate in an increasingly virtual world. The value of the pharmaceutical medical affairs function is dependent on understanding customers' needs and providing the right knowledge at the right time to physicians. This requires a human-centric artificial intelligence (AI) approach for medical affairs, which allows the function to query internal and external data sets in a conversational format and receive timely, accurate and concise intelligence on their customers.}, } @article {pmid33464439, year = {2021}, author = {do Vale, B and Lopes, AP and Fontes, MDC and Silvestre, M and Cardoso, L and Coelho, AC}, title = {Bats, pangolins, minks and other animals - villains or victims of SARS-CoV-2?.}, journal = {Veterinary research communications}, volume = {}, number = {}, pages = {}, pmid = {33464439}, issn = {1573-7446}, support = {UIDB/CVT/00772/2020//Fundação para a Ciência e a Tecnologia/ ; UIDB/CVT/00772/2020//Fundação para a Ciência e a Tecnologia/ ; UIDB/CVT/00772/2020//Fundação para a Ciência e a Tecnologia/ ; UIDB/CVT/00772/2020//Fundação para a Ciência e a Tecnologia/ ; UIDB/CVT/00772/2020//Fundação para a Ciência e a Tecnologia/ ; }, abstract = {Coronavirus disease-19 (COVID-19) is caused by the severe acute Respiratory syndrome coronavirus-2 (SARS-CoV-2), which has become unstoppable, spreading rapidly worldwide and, consequently, reaching a pandemic level. This review aims to provide the information available so far on the likely animal origin of SARS-CoV-2 and its possible hosts/reservoirs as well as all natural animal infections and experimental evidence using animal models. Horseshoe bats from the species Rhinolophus affinis seem to be a natural reservoir and pangolins (Manis javanica) appear to be an intermediate host of SARS-CoV-2. Humans remain the most likely spreading source of SARS-CoV-2 to other humans and also to domestic, zoo and farm animals. Indeed, human-to-animal transmission has been reported in cats, dogs, tigers, lions, a puma and minks. Animal-to-human transmission is not a sustained pathway, although mink-to-human transmission remains to be elucidated. Through experimental infections, other animals seem also to be susceptible hosts for SARS-CoV-2, namely ferrets, some non-human primate species, hamsters and transgenic mice, while dogs, pigs and poultry are resistant. A One Health perspective must be implemented in order to develop epidemiological surveillance and establish disease control mechanisms to limit zoonotic transmission. Moreover, research in this field is important to better understand SARS-CoV-2 and to obtain the long-awaited vaccine and specific treatment.}, } @article {pmid33463727, year = {2021}, author = {Kheirabadi, D and Haddad, F and Mousavi-Roknabadi, RS and Rezaeisadrabadi, M and Dehghan, H and Fazlzadeh, A}, title = {A complementary critical appraisal on systematic reviews regarding the most efficient therapeutic strategies for current COVID-19 (SARS-CoV-2) pandemic.}, journal = {Journal of medical virology}, volume = {}, number = {}, pages = {}, doi = {10.1002/jmv.26811}, pmid = {33463727}, issn = {1096-9071}, abstract = {BACKGROUND: This critical appraisal aims to clarify which systematic reviews on COVID-19 treatment are based on high-value evidence. Hereby, the most profitable medicines can be suggested.

METHODS: The Mesh term of "COVID-19 drug treatment" [Supplementary Concept] and "COVID-19 drug treatment" sequentially utilized as search strategies in Medline and Science direct on October 18th , 2020.Searches were confined to systematic reviews/meta-analysis. Cochrane database was searched on November 1st , 2020 by "COVID". With adding up 4 articles from other resources, 84 systematic reviews considered for initial screening. Finally, 22 articles fulfilled the criteria and were assessed using PRISMA guidelines.

RESULTS: increasing number of clinical trials from onset of COVID-19 pandemic has revealed that hydroxychloroquine and chloroquine are not only profitable but also deleterious. Lopinavir/ritonavir failed to maintain their initial efficacy in improving clinical symptoms and mortality rate. Steroids and tocilizumab were suggested in patients with intensely severe symptoms. Steroids reduced mechanical ventilation and death in severely ill patients. Plasma or immunoglobulins effects are absolutely controversial. Favorable impressions of remdesivir have been relied on for the early onset of this drug. Hypotension and abnormal liver function tests realized as its side effects. Favipiravir has resulted in higher viral clearance than remdesivir. However, this claim needs to be proved with subsequent clinical trials.

CONCLUSIONS: currently, remdesivir and favipiravir are advantageous drugs that should be administered in the early phases. Their side effects are not well known and need to be found in following research projects. Steroids and tocilizumab have been considered beneficial in the cytokine storm phase. This article is protected by copyright. All rights reserved.}, } @article {pmid33462852, year = {2021}, author = {Zhang, L and Zetter, MA and Guerra, EC and Hernández, VS and Mahata, SK and Eiden, LE}, title = {ACE2 in the second act of COVID-19 syndrome: Peptide dysregulation and possible correction with oestrogen.}, journal = {Journal of neuroendocrinology}, volume = {}, number = {}, pages = {e12935}, doi = {10.1111/jne.12935}, pmid = {33462852}, issn = {1365-2826}, support = {#013-2020//ALIANZA UCMX / Innova UNAM/ ; }, abstract = {Coronavirus disease 2019 (COVID-19) has become the most critical pandemic of the 21st Century and the most severe since the 1918 influenza pandemic. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects the host by binding to angiotensin-converting enzyme 2 (ACE2). The role of ACE2 in the pathophysiology of coronavirus disease 2019 (COVID-19) is a topic of debate, with clinical and experimental evidence indicating a multifaceted relationship between ACE2 activity and disease severity. Here, we review the mechanisms by which the peptidergic substrates and products of ACE and ACE2 contribute to physiological and pathophysiological processes and hypothesise how down-regulation of ACE2 by SARS-CoV-2 cellular entry disrupts homeostasis. A better understanding of the endocrinology of the disease, in particular the neuroendocrinology of ACE2 during COVID-19, may contribute to the timely design of new therapeutic strategies, including the regulation of ACE2 itself by steroid hormones, to ameliorate the severity of COVID-19.}, } @article {pmid33462776, year = {2021}, author = {Simões, JLB and Bagatini, MD}, title = {Purinergic Signaling of ATP in COVID-19 Associated Guillain-Barré Syndrome.}, journal = {Journal of neuroimmune pharmacology : the official journal of the Society on NeuroImmune Pharmacology}, volume = {}, number = {}, pages = {}, pmid = {33462776}, issn = {1557-1904}, abstract = {Declared as a global public health emergency, coronavirus disease 2019 (COVID-19) is presented as a disease of the respiratory tract, although severe cases can affect the entire organism. Several studies have shown neurological symptoms, ranging from dizziness and loss of consciousness to cerebrovascular and neurodegenerative diseases. In this context, Guillain-Barré syndrome, an immune-mediated inflammatory neuropathy, has been closely associated with critical cases of infection with "severe acute respiratory syndrome of coronavirus 2" (SARS-CoV-2), the etiological agent of COVID-19. Its pathophysiology is related to a generalized inflammation that affects the nervous system, but neurotropism was also revealed by the new coronavirus, which may increase the risk of neurological sequel, as well as the mortality of the disease. Thus, considering the comorbidities that SARS-CoV-2 infection can promote, the modulation of purinergic signaling can be applied as a potential therapy. In this perspective, given the role of adenosine triphosphate (ATP) in neural intercommunication, the P2X7 receptor (P2X7R) acts on microglia cells and its inhibition may be able to reduce the inflammatory condition of neurodegenerative diseases. Finally, alternative measures to circumvent the reality of the COVID-19 pandemic need to be considered, given the severity of critical cases and the viral involvement of multiple organs.}, } @article {pmid33462701, year = {2021}, author = {Münzel, T and Hahad, O and Daiber, A and Lelieveld, J}, title = {[Air pollution and cardiovascular diseases].}, journal = {Herz}, volume = {}, number = {}, pages = {}, pmid = {33462701}, issn = {1615-6692}, abstract = {Air pollution in the environment and in households is responsible worldwide for almost 9 million preventable premature deaths per year and almost 800,000 such deaths within Europe. Air pollution therefore shortens life expectancy worldwide by almost 3 years. Smoking, a proven cardiovascular risk factor, shortens the mean life expectancy by 2.2 years. Epidemiological studies have shown that air pollution from fine and coarse particulate matter is associated with increased cardiovascular morbidity and mortality. Responsible for this are mainly cardiovascular diseases, such as coronary heart disease, heart attack, heart failure, stroke, hypertension and also diabetes, which are mainly caused or aggravated by fine particulate matter. After inhalation fine particulate matter can reach the brain directly and also reach the bloodstream via a transition process. There, the particles are absorbed by the blood vessels where they stimulate the formation of reactive oxygen species (ROS) in the vascular wall. They therefore promote the formation of atherosclerotic changes and in this way increase the cardiovascular risks, especially an increase in chronic ischemic heart disease and stroke. Recent studies also reported that in coronavirus disease 2019 (COVID-19) patients a high degree of air pollution is correlated with severe disease courses with cardiovascular complications and pulmonary diseases. This necessitates preventive measures, such as lowering of the upper limits for air pollutants. Individual measures to mitigate the health consequences of fine particulate matter are also discussed.}, } @article {pmid33462671, year = {2021}, author = {Hemmat, N and Asadzadeh, Z and Ahangar, NK and Alemohammad, H and Najafzadeh, B and Derakhshani, A and Baghbanzadeh, A and Baghi, HB and Javadrashid, D and Najafi, S and Ar Gouilh, M and Baradaran, B}, title = {The roles of signaling pathways in SARS-CoV-2 infection; lessons learned from SARS-CoV and MERS-CoV.}, journal = {Archives of virology}, volume = {}, number = {}, pages = {}, pmid = {33462671}, issn = {1432-8798}, abstract = {The number of descriptions of emerging viruses has grown at an unprecedented rate since the beginning of the 21st century. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), is the third highly pathogenic coronavirus that has introduced itself into the human population in the current era, after SARS-CoV and Middle East respiratory syndrome coronavirus (MERS-CoV). Molecular and cellular studies of the pathogenesis of this novel coronavirus are still in the early stages of research; however, based on similarities of SARS-CoV-2 to other coronaviruses, it can be hypothesized that the NF-κB, cytokine regulation, ERK, and TNF-α signaling pathways are the likely causes of inflammation at the onset of COVID-19. Several drugs have been prescribed and used to alleviate the adverse effects of these inflammatory cellular signaling pathways, and these might be beneficial for developing novel therapeutic modalities against COVID-19. In this review, we briefly summarize alterations of cellular signaling pathways that are associated with coronavirus infection, particularly SARS-CoV and MERS-CoV, and tabulate the therapeutic agents that are currently approved for treating other human diseases.}, } @article {pmid33462654, year = {2021}, author = {Bogdan, C}, title = {[STIKO vaccination recommendations : Vaccination of immunodeficient patients and vaccination against COVID-19].}, journal = {Der Hautarzt; Zeitschrift fur Dermatologie, Venerologie, und verwandte Gebiete}, volume = {}, number = {}, pages = {}, pmid = {33462654}, issn = {1432-1173}, abstract = {BACKGROUND: The working methods of the Standing Committee on Vaccination (STIKO) and its recommendations are only partially known by medical professionals and the public.

OBJECTIVES: Methodology of the standard operating procedure of the STIKO, annual vaccination recommendations, normal vaccination reaction versus vaccination side effects, instructions for vaccination in case of immunodeficiency, and recommendation for COVID-19 vaccination are presented.

MATERIALS AND METHODS: Presentation of the path to a vaccination recommendation, differences between recommendations and instructions for action, key statements on vaccination in immunodeficiency, and summary of the data situation on COVID-19 mRNA vaccination.

RESULTS: The STIKO works purely on an evidence-based basis by systematically evaluating the existing preclinical and clinical studies results for a vaccine using the GRADE method. Only vaccination complications and vaccination injuries are notifiable. Immunodeficient patients can receive inactivated vaccines at any time, but generally not live vaccines. Based on current knowledge, the COVID-19 mRNA vaccination can be described as safe and effective.

CONCLUSIONS: The STIKO vaccination recommendations are considered as the medical standard. The published current instructions for vaccination of immunodeficient patients and the recently published recommendation for COVID-19 vaccination, together with their scientific backgrounds and reasons, represent a valuable basis for medical action in the field of vaccination against infectious diseases.}, } @article {pmid33462564, year = {2021}, author = {Ganesh, B and Rajakumar, T and Malathi, M and Manikandan, N and Nagaraj, J and Santhakumar, A and Elangovan, A and Malik, YS}, title = {Epidemiology and pathobiology of SARS-CoV-2 (COVID-19) in comparison with SARS, MERS: An updated overview of current knowledge and future perspectives.}, journal = {Clinical epidemiology and global health}, volume = {}, number = {}, pages = {100694}, doi = {10.1016/j.cegh.2020.100694}, pmid = {33462564}, issn = {2452-0918}, abstract = {Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) is the causative etiology of 'Coronavirus Disease-2019' (COVID-19); formerly referred as 'novel-Coronavirus-2019'. It was originated in Wuhan city, Hubei province, China in early December 2019. The World Health Organization (WHO) declared it as 'Public Health Emergency of International Concern' due to their rapid transmission and causing public and health-care-related casualties worldwide. This review provides an updated overview of COVID-19 (SARS-CoV-2), in comparison with the etiologies of the same group viz. SARS and MERS and also, its future perspectives for planning appropriate strategies for prevention, control and treatment modalities to avert similar catastrophe in near future.}, } @article {pmid33462562, year = {2021}, author = {Rahman, MM and Mosaddik, A and Alam, AK}, title = {Traditional foods with their constituent's antiviral and immune system modulating properties.}, journal = {Heliyon}, volume = {7}, number = {1}, pages = {e05957}, doi = {10.1016/j.heliyon.2021.e05957}, pmid = {33462562}, issn = {2405-8440}, abstract = {Background: Viruses are responsible for several diseases, including severe acute respiratory syndrome, a condition caused by today's pandemic coronavirus disease (COVID-19). A negotiated immune system is a common risk factor for all viral infections, including COVID-19. To date, no specific therapies or vaccines have been approved for coronavirus. In these circumstances, antiviral and immune boosting foods may ensure protection against viral infections, especially SARS-CoV-2 by reducing risk and ensuring fast healing of SARS-CoV-2 illness.

Scope and approach: In this review, we have conducted an online search using several search engines (Google Scholar, PubMed, Web of Science and Science Direct) to find out some traditional foods (plant, animal and fungi species), which have antiviral and immune-boosting properties against numerous viral infections, particularly coronaviruses (CoVs) and others RNA-virus infections. Our review indicated some foods to be considered as potential immune enhancers, which may help individuals to overcome viral infections like COVID-19 by modulating immune systems and reducing respiratory problems. Furthermore, this review will provide information regarding biological properties of conventional foods and their ingredients to uphold general health.

Key Findings and Conclusions: We observed some foods with antiviral and immune-boosting properties, which possess bioactive compounds that showed significant antiviral properties against different viruses, particularly RNA viruses such as CoVs. Interestingly, some antiviral and immune-boosting mechanisms were very much similar to the antiviral drug of COVID-19 homologous SARS (Severe Acute Respiratory Syndrome Coronavirus) and MERS (Middle East Respiratory Syndrome Coronavirus). The transient nature and the devastating spreading capability of COVID-19 lead to ineffectiveness of many curative therapies. Therefore, body shielding and immune-modulating foods, which have previous scientific recognition, have been discussed in this review to discern the efficacy of these foods against viral infections, especially SARS-CoV-2.}, } @article {pmid33462561, year = {2021}, author = {Mukherjee, S and Boral, S and Siddiqi, H and Mishra, A and Meikap, BC}, title = {Present cum future of SARS-CoV-2 virus and its associated control of virus-laden air pollutants leading to potential environmental threat - A Review.}, journal = {Journal of environmental chemical engineering}, volume = {}, number = {}, pages = {104973}, doi = {10.1016/j.jece.2020.104973}, pmid = {33462561}, issn = {2213-2929}, abstract = {The world is presently infected by the biological fever of COVID-19 caused by SARS-CoV-2 virus. The present study is mainly related to the airborne transmission of novel coronavirus through airway. Similarly, our mother planet is suffering from drastic effects of air pollution. There are sufficient probabilities or evidences proven for contagious virus transmission through polluted airborne-pathway in formed aerosol molecules. The pathways and sources of spread are detailed along with the best possible green control technologies or ideas to hinder further transmission. The combined effects of such root causes and unwanted outcomes are similar in nature leading to acute cardiac arrest of our planet. To maintain environmental sustainability, the prior future of such emerging unknown biological hazardous air emissions is to be thoroughly researched. So it is high time to deal with the future of hazardous air pollution and work on its preventive measures. The lifetime of such an airborne virus continues for several hours, thus imposing severe threat even during post-lockdown phase. The world waits eagerly for the development of successful vaccination or medication but the possible outcome is quite uncertain in terms of equivalent economy distribution and biomedical availability. Thus, risk assessments are to be carried out even during the post-vaccination period with proper environmental surveillance and monitoring. The skilled techniques of disinfection, sanitization, and other viable wayouts are to be modified with time, place, and prevailing climatic conditions, handling the pandemic efficiently. A healthy atmosphere makes the earth a better place to dwell, ensuring its future lifecycle.}, } @article {pmid33462543, year = {2021}, author = {Chen, B and Jia, P and Han, J}, title = {Role of indoor aerosols for COVID-19 viral transmission: a review.}, journal = {Environmental chemistry letters}, volume = {}, number = {}, pages = {1-18}, doi = {10.1007/s10311-020-01174-8}, pmid = {33462543}, issn = {1610-3653}, abstract = {The relationship between outdoor atmospheric pollution by particulate matter and the morbidity and mortality of coronavirus disease 2019 (COVID-19) infections was recently disclosed, yet the role of indoor aerosols is poorly known . Since people spend most of their time indoor, indoor aerosols are closer to human occupants than outdoors, thus favoring airborne transmission of COVID-19. Therefore, here we review the characteristics of aerosol particles emitted from indoor sources, and how exposure to particles affects human respiratory infections and transport of airborne pathogens. We found that tobacco smoking, cooking, vacuum cleaning, laser printing, burning candles, mosquito coils and incenses generate large quantities of particles, mostly in the ultrafine range below 100 nm. These tiny particles stay airborne, are deposited in the deeper regions of human airways and are difficult to be removed by the respiratory system. As a consequence, adverse effects can be induced by inhaled aerosol particles via oxidative stress and inflammation. Early epidemiological evidence and animal studies have revealed the adverse effects of particle exposure in respiratory infections. In particular, inhaled particles can impair human respiratory systems and immune functions, and induce the upregulation of angiotensin-converting enzyme 2, thus inducing higher vulnerability to COVID-19 infection. Moreover, co-production of inflammation mediators by COVID-19 infection and particle exposure magnifies the cytokine storm and aggravates symptoms in patients. We also discuss the role of indoor aerosol particles as virus carriers. Although many hypotheses were proposed, there is still few knowledge on interactions between aerosol articles and virus-laden droplets or droplet nuclei.}, } @article {pmid33462404, year = {2021}, author = {Orzechowski, M and Schochow, M and Steger, F}, title = {Balancing public health and civil liberties in times of pandemic.}, journal = {Journal of public health policy}, volume = {}, number = {}, pages = {}, pmid = {33462404}, issn = {1745-655X}, abstract = {The ongoing COVID-19 pandemic constitutes not only a danger for public health, but may also threaten civil liberties. Looking at the examples of recent events in Poland and Hungary, the authors argue that governments may misuse pandemic for their political advantage, thus endangering public health. Political decisions taken to stem the spread of pandemics should be limited and strictly proportionate to the situation.}, } @article {pmid33462340, year = {2021}, author = {Wilcox, W and Bajaj, K and Rossberg, MC and Knight, C and Wieland, D and Malhotra, Y}, title = {Lessons learnt in transitioning from universal screening to universal testing of pregnant patients for SARS-CoV-2 at the largest municipal health system in America.}, journal = {Journal of perinatology : official journal of the California Perinatal Association}, volume = {}, number = {}, pages = {}, pmid = {33462340}, issn = {1476-5543}, } @article {pmid33461842, year = {2021}, author = {Pillet, S and Gueudin, M and Plantier, JC and Vabret, A}, title = {[Virological diagnosis of lower respiratory tract infections].}, journal = {Revue des maladies respiratoires}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.rmr.2020.11.002}, pmid = {33461842}, issn = {1776-2588}, abstract = {INTRODUCTION: The etiological diagnosis of bronchopulmonary infections cannot be assessed with clinical, radiological and epidemiological data alone. Viruses have been demonstrated to cause a large proportion of these infections, both in children and adults.

BACKGROUND: The diagnosis of viral bronchopulmonary infections is based on the analysis of secretions, collected from the lower respiratory tract when possible, by techniques that detect either influenza and respiratory syncytial viruses, or a large panel of viruses that can be responsible for respiratory disease. The latter, called multiplex PCR assays, allow a syndromic approach to respiratory infection. Their high cost for the laboratory raises the question of their place in the management of patients in terms of antibiotic economy and isolation. In the absence of clear recommendations, the strategy and equipment are very unevenly distributed in France.

OUTLOOK: Medico-economic analyses need to be performed in France to evaluate the place of these tests in the management of patients. The evaluation of the role of the different viruses often detected in co-infection, especially in children, also deserves the attention of virologists and clinicians.

CONCLUSIONS: The availability of new diagnostic technologies, the recent emergence of SARS-CoV-2, together with the availability of new antiviral drugs are likely to impact future recommendations for the management of viral bronchopulmonary infections.}, } @article {pmid33461715, year = {2021}, author = {Everitt, ML and Tillery, A and David, MG and Singh, N and Borison, A and White, IM}, title = {A critical review of point-of-care diagnostic technologies to combat viral pandemics.}, journal = {Analytica chimica acta}, volume = {1146}, number = {}, pages = {184-199}, doi = {10.1016/j.aca.2020.10.009}, pmid = {33461715}, issn = {1873-4324}, abstract = {The COVID-19 global pandemic of 2019-2020 pointedly revealed the lack of diagnostic solutions that are able to keep pace with the rapid spread of the virus. Despite the promise of decades of lab-on-a-chip research, no commercial products were available to deliver rapid results or enable testing in the field at the onset of the pandemic. In this critical review, we assess the current state of progress on the development of point-of-care technologies for the diagnosis of viral diseases that cause pandemics. While many previous reviews have reported on progress in various lab-on-a-chip technologies, here we address the literature from the perspective of the testing needs of a rapidly expanding pandemic. First, we recommend a set of requirements to heed when designing point-of-care diagnostic technologies to address the testing needs of a pandemic. We then review the current state of assay technologies with a focus on isothermal amplification and lateral-flow immunoassays. Though there is much progress on assay development, we argue that the largest roadblock to deployment exists in sample preparation. We summarize current approaches to automate sample preparation and discuss both the progress and shortcomings of these developments. Finally, we provide our recommendations to the field of specific challenges to address in order to prepare for the next pandemic.}, } @article {pmid33461593, year = {2021}, author = {Kotlar, B and Gerson, E and Petrillo, S and Langer, A and Tiemeier, H}, title = {The impact of the COVID-19 pandemic on maternal and perinatal health: a scoping review.}, journal = {Reproductive health}, volume = {18}, number = {1}, pages = {10}, pmid = {33461593}, issn = {1742-4755}, support = {T76 MC000010//Maternal and Child Health Bureau/ ; }, abstract = {INTRODUCTION: The Covid-19 pandemic affects maternal health both directly and indirectly, and direct and indirect effects are intertwined. To provide a comprehensive overview on this broad topic in a rapid format behooving an emergent pandemic we conducted a scoping review.

METHODS: A scoping review was conducted to compile evidence on direct and indirect impacts of the pandemic on maternal health and provide an overview of the most significant outcomes thus far. Working papers and news articles were considered appropriate evidence along with peer-reviewed publications in order to capture rapidly evolving updates. Literature in English published from January 1st to September 11 2020 was included if it pertained to the direct or indirect effects of the COVID-19 pandemic on the physical, mental, economic, or social health and wellbeing of pregnant people. Narrative descriptions were written about subject areas for which the authors found the most evidence.

RESULTS: The search yielded 396 publications, of which 95 were included. Pregnant individuals were found to be at a heightened risk of more severe symptoms than people who are not pregnant. Intrauterine, vertical, and breastmilk transmission were unlikely. Labor, delivery, and breastfeeding guidelines for COVID-19 positive patients varied. Severe increases in maternal mental health issues, such as clinically relevant anxiety and depression, were reported. Domestic violence appeared to spike. Prenatal care visits decreased, healthcare infrastructure was strained, and potentially harmful policies implemented with little evidence. Women were more likely to lose their income due to the pandemic than men, and working mothers struggled with increased childcare demands.

CONCLUSION: Pregnant women and mothers were not found to be at higher risk for COVID-19 infection than people who are not pregnant, however pregnant people with symptomatic COVID-19 may experience more adverse outcomes compared to non-pregnant people and seem to face disproportionate adverse socio-economic consequences. High income and low- and middle-income countries alike faced significant struggles. Further resources should be directed towards quality epidemiological studies. The Covid-19 pandemic impacts reproductive and perinatal health both directly through infection itself but also indirectly as a consequence of changes in health care, social policy, or social and economic circumstances. The direct and indirect consequences of COVID-19 on maternal health are intertwined. To provide a comprehensive overview on this broad topic we conducted a scoping review. Pregnant women who have symptomatic COVID-19 may experience more severe outcomes than people who are not pregnant. Intrauterine and breastmilk transmission, and the passage of the virus from mother to baby during delivery are unlikely. The guidelines for labor, delivery, and breastfeeding for COVID-19 positive patients vary, and this variability could create uncertainty and unnecessary harm. Prenatal care visits decreased, healthcare infrastructure was strained, and potentially harmful policies are implemented with little evidence in high and low/middle income countries. The social and economic impact of COVID-19 on maternal health is marked. A high frequency of maternal mental health problems, such as clinically relevant anxiety and depression, during the epidemic are reported in many countries. This likely reflects an increase in problems, but studies demonstrating a true change are lacking. Domestic violence appeared to spike. Women were more vulnerable to losing their income due to the pandemic than men, and working mothers struggled with increased childcare demands. We make several recommendations: more resources should be directed to epidemiological studies, health and social services for pregnant women and mothers should not be diminished, and more focus on maternal mental health during the epidemic is needed.}, } @article {pmid33461573, year = {2021}, author = {Rabaan, AA and Al-Ahmed, SH and Sah, R and Alqumber, MA and Haque, S and Patel, SK and Pathak, M and Tiwari, R and Yatoo, MI and Haq, AU and Bilal, M and Dhama, K and Rodriguez-Morales, AJ}, title = {MERS-CoV: epidemiology, molecular dynamics, therapeutics, and future challenges.}, journal = {Annals of clinical microbiology and antimicrobials}, volume = {20}, number = {1}, pages = {8}, pmid = {33461573}, issn = {1476-0711}, abstract = {The Severe Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has gained research attention worldwide, given the current pandemic. Nevertheless, a previous zoonotic and highly pathogenic coronavirus, the Middle East Respiratory Syndrome coronavirus (MERS-CoV), is still causing concern, especially in Saudi Arabia and neighbour countries. The MERS-CoV has been reported from respiratory samples in more than 27 countries, and around 2500 cases have been reported with an approximate fatality rate of 35%. After its emergence in 2012 intermittent, sporadic cases, nosocomial infections and many community clusters of MERS continued to occur in many countries. Human-to-human transmission resulted in the large outbreaks in Saudi Arabia. The inherent genetic variability among various clads of the MERS-CoV might have probably paved the events of cross-species transmission along with changes in the inter-species and intra-species tropism. The current review is drafted using an extensive review of literature on various databases, selecting of publications irrespective of favouring or opposing, assessing the merit of study, the abstraction of data and analysing data. The genome of MERS-CoV contains around thirty thousand nucleotides having seven predicted open reading frames. Spike (S), envelope (E), membrane (M), and nucleocapsid (N) proteins are the four main structural proteins. The surface located spike protein (S) of betacoronaviruses has been established to be one of the significant factors in their zoonotic transmission through virus-receptor recognition mediation and subsequent initiation of viral infection. Three regions in Saudi Arabia (KSA), Eastern Province, Riyadh and Makkah were affected severely. The epidemic progression had been the highest in 2014 in Makkah and Riyadh and Eastern Province in 2013. With a lurking epidemic scare, there is a crucial need for effective therapeutic and immunological remedies constructed on sound molecular investigations.}, } @article {pmid33454883, year = {2021}, author = {McNeely, JA}, title = {Nature and COVID-19: The pandemic, the environment, and the way ahead.}, journal = {Ambio}, volume = {}, number = {}, pages = {}, pmid = {33454883}, issn = {1654-7209}, abstract = {The COVID-19 pandemic has brought profound social, political, economic, and environmental challenges to the world. The virus may have emerged from wildlife reservoirs linked to environmental disruption, was transmitted to humans via the wildlife trade, and its spread was facilitated by economic globalization. The pandemic arrived at a time when wildfires, high temperatures, floods, and storms amplified human suffering. These challenges call for a powerful response to COVID-19 that addresses social and economic development, climate change, and biodiversity together, offering an opportunity to bring transformational change to the structure and functioning of the global economy. This biodefense can include a "One Health" approach in all relevant sectors; a greener approach to agriculture that minimizes greenhouse gas emissions and leads to healthier diets; sustainable forms of energy; more effective international environmental agreements; post-COVID development that is equitable and sustainable; and nature-compatible international trade. Restoring and enhancing protected areas as part of devoting 50% of the planet's land to environmentally sound management that conserves biodiversity would also support adaptation to climate change and limit human contact with zoonotic pathogens. The essential links between human health and well-being, biodiversity, and climate change could inspire a new generation of innovators to provide green solutions to enable humans to live in a healthy balance with nature leading to a long-term resilient future.}, } @article {pmid33454715, year = {2021}, author = {Khan, MT and Irfan, M and Ahsan, H and Ahmed, A and Kaushik, AC and Khan, AS and Chinnasamy, S and Ali, A and Wei, DQ}, title = {Structures of SARS-CoV-2 RNA-Binding Proteins and Therapeutic Targets.}, journal = {Intervirology}, volume = {}, number = {}, pages = {1-14}, doi = {10.1159/000513686}, pmid = {33454715}, issn = {1423-0100}, abstract = {BACKGROUND: The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) epidemic has resulted in thousands of infections and deaths worldwide. Several therapies are currently undergoing clinical trials for the treatment of SARS-CoV-2 infection. However, the development of new drugs and the repositioning of existing drugs can only be achieved after the identification of potential therapeutic targets within structures, as this strategy provides the most precise solution for developing treatments for sudden epidemic infectious diseases.

SUMMARY: In the current investigation, crystal and cryo-electron microscopy structures encoded by the SARS-CoV-2 genome were systematically examined for the identification of potential drug targets. These structures include nonstructural proteins (Nsp-9; Nsp-12; and Nsp-15), nucleocapsid (N) proteins, and the main protease (Mpro). Key Message: The structural information reveals the presence of many potential alternative therapeutic targets, primarily involved in interaction between N protein and Nsp3, forming replication-transcription complexes (RTCs) which might be a potential drug target for effective control of current SARS-CoV-2 pandemic. RTCs consist of 16 nonstructural proteins (Nsp1-16) that play the most essential role in the synthesis of viral RNA. Targeting the physical linkage between the envelope and single-stranded positive RNA, a process facilitated by matrix proteins may provide a good alternative strategy. Our current study provides useful information for the development of new lead compounds against SARS-CoV-2 infections.}, } @article {pmid33454595, year = {2021}, author = {Habib, HM and Ibrahim, S and Zaim, A and Ibrahim, WH}, title = {The role of iron in the pathogenesis of COVID-19 and possible treatment with lactoferrin and other iron chelators.}, journal = {Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie}, volume = {136}, number = {}, pages = {111228}, doi = {10.1016/j.biopha.2021.111228}, pmid = {33454595}, issn = {1950-6007}, abstract = {Iron overload is increasingly implicated as a contributor to the pathogenesis of COVID-19. Indeed, several of the manifestations of COVID-19, such as inflammation, hypercoagulation, hyperferritinemia, and immune dysfunction are also reminiscent of iron overload. Although iron is essential for all living cells, free unbound iron, resulting from iron dysregulation and overload, is very reactive and potentially toxic due to its role in the generation of reactive oxygen species (ROS). ROS react with and damage cellular lipids, nucleic acids, and proteins, with consequent activation of either acute or chronic inflammatory processes implicated in multiple clinical conditions. Moreover, iron-catalyzed lipid damage exerts a direct causative effect on the newly discovered nonapoptotic cell death known as ferroptosis. Unlike apoptosis, ferroptosis is immunogenic and not only leads to amplified cell death but also promotes a series of reactions associated with inflammation. Iron chelators are generally safe and are proven to protect patients in clinical conditions characterized by iron overload. There is also an abundance of evidence that iron chelators possess antiviral activities. Furthermore, the naturally occurring iron chelator lactoferrin (Lf) exerts immunomodulatory as well as anti-inflammatory effects and can bind to several receptors used by coronaviruses thereby blocking their entry into host cells. Iron chelators may consequently be of high therapeutic value during the present COVID-19 pandemic.}, } @article {pmid33454368, year = {2021}, author = {Meidaninikjeh, S and Sabouni, N and Marzouni, HZ and Bengar, S and Khalili, A and Jafari, R}, title = {Monocytes and macrophages in COVID-19: Friends and foes.}, journal = {Life sciences}, volume = {269}, number = {}, pages = {119010}, doi = {10.1016/j.lfs.2020.119010}, pmid = {33454368}, issn = {1879-0631}, abstract = {The COVID-19 is a novel infectious disease caused by SARS-CoV-2 and is known as a pandemic emergency that has led to a high rate of mortality throughout the world. Evidence has indicated that hyperinflammatory responses triggered by SARS-CoV-2 are the main cause of pathogenicity in the severe cases of patients who have died during the current viral disease. Monocytes and macrophages as the most important cells of the innate arm of the immune system play a substantial part in the body's defense against viral infections. They mainly respond to the microbial antigens by producing inflammatory mediators to remove pathogens and repair tissue injury. Nevertheless, aberrant alterations in their function such as cytokine storm can be so harmful to the host in the acute respiratory distress syndrome cases caused by SARS-CoV-2. Moreover, inflammatory responses stimulated by SARS-CoV-2 have affected the other vital organs of the body including the heart. As cardiovascular complications in COVID-19 patients have been reported in several studies. During the infection, monocytes and macrophages may be involved in the hypersensitive and exacerbated reactions that contribute to the tissue damage, especially lung injury resulted in its dysfunction and respiratory disorder. In this review, we discuss both advantageous and disadvantageous about the pathological potential of monocytes and macrophages during the infection of SARS-CoV-2 to clarify their mutual effects on immune processing as a fist line defender in the current disease.}, } @article {pmid33454328, year = {2021}, author = {Tompa, DR and Immanuel, A and Srikanth, S and Kadhirvel, S}, title = {Trends and strategies to combat viral infections: A review on FDA approved antiviral drugs.}, journal = {International journal of biological macromolecules}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.ijbiomac.2021.01.076}, pmid = {33454328}, issn = {1879-0003}, abstract = {The infectious microscopic viruses invade living cells to reproduce themselves, and causes chronic infections such as HIV/AIDS, hepatitis B and C, flu, etc. in humans which may lead to death if not treated. Different strategies have been utilized to develop new and superior antiviral drugs to counter the viral infections. The FDA approval of HIV nucleoside reverse transcriptase inhibitor, zidovudine in 1987 boosted the development of antiviral agents against different viruses. Currently, there are a number of combination drugs developed against various viral infections to arrest the activity of same or different viral macromolecules at multiple stages of its life cycle; among which majority are targeted to interfere with the replication of viral genome. Besides these, other type of antiviral molecules includes entry inhibitors, integrase inhibitors, protease inhibitors, interferons, immunomodulators, etc. The antiviral drugs can be toxic to human cells, particularly in case of administration of combination drugs, and on the other hand viruses can grow resistant to the antiviral drugs. Furthermore, emergence of new viruses like Ebola, coronaviruses (SARS-CoV, SARS-CoV-2) emphasizes the need for more innovative strategies to develop better antiviral drugs to fight the existing and the emerging viral infections. Hence, we reviewed the strategic enhancements in developing antiviral drugs for the treatment of different viral infections over the years.}, } @article {pmid33454213, year = {2020}, author = {Triposkiadis, F and Starling, RC and Xanthopoulos, A and Butler, J and Boudoulas, H}, title = {The Counter Regulatory Axis of the Lung Renin-Angiotensin System in Severe COVID-19: Physiopathology and Clinical Implications.}, journal = {Heart, lung & circulation}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.hlc.2020.11.008}, pmid = {33454213}, issn = {1444-2892}, abstract = {The severe acute respiratory syndrome coronavirus (SARS-CoV)-2, which is responsible for coronavirus disease 2019 (COVID-19), uses angiotensin (ANG)-converting enzyme 2 (ACE2) as the entrance receptor. Although most COVID-19 cases are mild, some are severe or critical, predominantly due to acute lung injury. It has been widely accepted that a counter regulatory renin-angiotensin system (RAS) axis including the ACE2/ANG [1-7]/Mas protects the lungs from acute lung injury. However, recent evidence suggests that the generation of protective ANG [1-7] in the lungs is predominantly mediated by proinflammatory prolyloligopeptidase (POP), which has been repeatedly demonstrated to be involved in lung pathology. This review contends that acute lung injury in severe COVID-19 is characterised by a) ACE2 downregulation and malfunction (inflammatory signalling) due to viral occupation, and b) dysregulation of the protective RAS axis, predominantly due to increased activity of proinflammatory POP. It follows that a reasonable treatment strategy in COVID-19-related acute lung injury would be delivering functional recombinant (r) ACE2 forms to trap the virus. Additionally, or alternatively to rACE2 delivery, the potential benefits resulting from lowering POP activity should also be explored. These treatment strategies deserve further investigation.}, } @article {pmid33461019, year = {2021}, author = {Oz, M and Lorke, DE}, title = {Multifunctional angiotensin converting enzyme 2, the SARS-CoV-2 entry receptor, and critical appraisal of its role in acute lung injury.}, journal = {Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie}, volume = {136}, number = {}, pages = {111193}, doi = {10.1016/j.biopha.2020.111193}, pmid = {33461019}, issn = {1950-6007}, abstract = {The recent emergence of coronavirus disease-2019 (COVID-19) as a pandemic affecting millions of individuals has raised great concern throughout the world, and the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) was identified as the causative agent for COVID-19. The multifunctional protein angiotensin converting enzyme 2 (ACE2) is accepted as its primary target for entry into host cells. In its enzymatic function, ACE2, like its homologue ACE, regulates the renin-angiotensin system (RAS) critical for cardiovascular and renal homeostasis in mammals. Unlike ACE, however, ACE2 drives an alternative RAS pathway by degrading Ang-II and thus operates to balance RAS homeostasis in the context of hypertension, heart failure, and cardiovascular as well as renal complications of diabetes. Outside the RAS, ACE2 hydrolyzes key peptides, such as amyloid-β, apelin, and [des-Arg9]-bradykinin. In addition to its enzymatic functions, ACE2 is found to regulate intestinal amino acid homeostasis and the gut microbiome. Although the non-enzymatic function of ACE2 as the entry receptor for SARS-CoV-2 has been well established, the contribution of enzymatic functions of ACE2 to the pathogenesis of COVID-19-related lung injury has been a matter of debate. A complete understanding of this central enzyme may begin to explain the various symptoms and pathologies seen in SARS-CoV-2 infected individuals, and may aid in the development of novel treatments for COVID-19.}, } @article {pmid33460486, year = {2021}, author = {Sellner, J and Jenkins, TM and von Oertzen, TJ and Bassetti, CL and Beghi, E and Bereczki, D and Bodini, B and Cavallieri, F and Di Liberto, G and Helbok, R and Macerollo, A and Maia, LF and Oreja-Guevara, C and Özturk, S and Rakusa, M and Pisani, A and Priori, A and Sauerbier, A and Soffietti, R and Taba, P and Zedde, M and Crean, M and Burlica, A and Twardzik, A and Moro, E and , }, title = {A plea for equitable global access to COVID-19 diagnostics, vaccination and therapy: the NeuroCOVID-19 task Force of the european Academy of neurology.}, journal = {European journal of neurology}, volume = {}, number = {}, pages = {}, doi = {10.1111/ene.14741}, pmid = {33460486}, issn = {1468-1331}, abstract = {Coronavirus disease 2019 (COVID-19), a multi-organ disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), continues to challenge health and care systems around the globe. The pandemic has disrupted acute neurology services and routine patient care and has impacted the clinical course in patients with chronic neurologic disease. COVID-19 appears to have exposed inequalities of societies and healthcare systems and had disproportionate impact on already vulnerable communities. The next challenge will be to set up initiatives to stop disparities in all aspects related to COVID-19. From the medical perspective, there is a need to consider inequalities in prevention, treatment, and long-term consequences. Some of the issues of direct relevance to neurologists are summarised. With this appraisal, the European Academy of Neurology NeuroCOVID-19 Task Force intends to raise awareness of the potential impact of COVID-19 on inequalities in healthcare and calls for action to prevent disparity at individual, national and supranational level.}, } @article {pmid33460213, year = {2021}, author = {Xiong, M and Su, H and Zhao, W and Xie, H and Shao, Q and Xu, Y}, title = {What coronavirus 3C-like protease tells us: From structure, substrate selectivity, to inhibitor design.}, journal = {Medicinal research reviews}, volume = {}, number = {}, pages = {}, doi = {10.1002/med.21783}, pmid = {33460213}, issn = {1098-1128}, support = {20430780300//Science and Technology Commission of Shanghai Municipality/ ; 21877122 and 32071248//National Natural Science Foundation of China/ ; }, abstract = {The emergence of a variety of coronaviruses (CoVs) in the last decades has posed huge threats to human health. Especially, the ongoing pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to more than 70 million infections and over 1.6 million of deaths worldwide in the past few months. None of the efficacious antiviral agents against human CoVs have been approved yet. 3C-like protease (3CLpro) is an attractive target for antiviral intervention due to its essential role in processing polyproteins translated from viral RNA, and its conserved structural feature and substrate specificity among CoVs in spite of the sequence variation. This review focuses on all available crystal structures of 12 CoV 3CLpro s and their inhibitors, and intends to provide a comprehensive understanding of this protease from multiple aspects including its structural features, substrate specificity, inhibitor binding modes, and more importantly, to recapitulate the similarity and diversity among different CoV 3CLpro s and the structure-activity relationship of various types of inhibitors. Such an attempt could gain a deep insight into the inhibition mechanisms and drive future structure-based drug discovery targeting 3CLpro s.}, } @article {pmid33460172, year = {2021}, author = {Kadam, SB and Sukhramani, GS and Bishnoi, P and Pable, AA and Barvkar, VT}, title = {SARS-CoV-2, the pandemic coronavirus: Molecular and structural insights.}, journal = {Journal of basic microbiology}, volume = {}, number = {}, pages = {}, doi = {10.1002/jobm.202000537}, pmid = {33460172}, issn = {1521-4028}, abstract = {The outbreak of a novel coronavirus associated with acute respiratory disease, called COVID-19, marked the introduction of the third spillover of an animal coronavirus (CoV) to humans in the last two decades. The genome analysis with various bioinformatics tools revealed that the causative pathogen (SARS-CoV-2) belongs to the subgenus Sarbecovirus of the genus Betacoronavirus, with highly similar genome as bat coronavirus and receptor-binding domain (RBD) of spike glycoprotein as Malayan pangolin coronavirus. Based on its genetic proximity, SARS-CoV-2 is likely to have originated from bat-derived CoV and transmitted to humans via an unknown intermediate mammalian host, probably Malayan pangolin. Further, spike protein S1/S2 cleavage site of SARS-CoV-2 has acquired polybasic furin cleavage site which is absent in bat and pangolin suggesting natural selection either in an animal host before zoonotic transfer or in humans following zoonotic transfer. In the current review, we recapitulate a preliminary opinion about the disease, origin and life cycle of SARS-CoV-2, roles of virus proteins in pathogenesis, commonalities, and differences between different corona viruses. Moreover, the crystal structures of SARS-CoV-2 proteins with unique characteristics differentiating it from other CoVs are discussed. Our review also provides comprehensive information on the molecular aspects of SARS-CoV-2 including secondary structures in the genome and protein-protein interactions which can be useful to understand the aggressive spread of the SARS-CoV-2. The mutations and the haplotypes reported in the SARS-CoV-2 genome are summarized to understand the virus evolution.}, } @article {pmid33460020, year = {2021}, author = {Moisan, P and Barimani, B and Antoniou, J}, title = {Orthopedic Surgery and Telemedicine in Times of COVID-19 and Beyond: a Review.}, journal = {Current reviews in musculoskeletal medicine}, volume = {}, number = {}, pages = {}, pmid = {33460020}, issn = {1935-973X}, abstract = {PURPOSE OF REVIEW: This review article presents the current knowledge on the use of telemedicine and summarizes the literature highlighting the advantages and limitations of this technology in the field of orthopedic surgery during the COVID-19 pandemic and beyond.

RECENT FINDINGS: Orthopedic surgery is the surgical specialty that has seen the highest proportion of its procedures cancelled due to the pandemic. In this context and onward, telemedicine seems to be a reasonable option for the orthopedic surgeon. Multiple studies have described its safety and a similar patient satisfaction compared to in-person consultations. It has a potential to increase productivity and decrease wait times by providing easier access to the clinician and by decreasing travel-associated limitations and costs. Authors have described the possibility to conduct a reliable virtual assessment of the patient range of motion. Some of the limitations to the use of this technology are technological literacy and access to virtual consultation platforms, the inability to conduct a complete physical examination, potential reduction in identification of intimate and child abuse victims, and limited knowledge about the legal implications of this technology. Telemedicine in orthopedic surgery has a potential to increase productivity, reduce costs, and increase the access to healthcare. Identified limitations include risk of misdiagnosis, required technologic literacy, unknown legal implications, and failure to identify victims of abuse. In order to use this technology judiciously, the clinician must take into consideration the patient's condition and his technological literacy and be aware of the advantages and disadvantages.}, } @article {pmid33459975, year = {2021}, author = {Wang, Y and Yang, Q}, title = {Post Abortion Care and Management After Induced Abortion During the COVID-19 Pandemic: A Chinese Expert Consensus.}, journal = {Advances in therapy}, volume = {}, number = {}, pages = {}, pmid = {33459975}, issn = {1865-8652}, abstract = {The rapid spread of novel coronavirus (COVID-19) has posed complex challenges to global public health. During this pandemic period, access to essential services including post-abortion care (PAC) has been disrupted. Along with the clinical management of the disease in women, protection of the healthcare workers and medical staff from nosocomial infection is important to ensure infection control. Thus, in order to implement the proper contraceptive measures and to reduce the rate of repeated abortion, the family planning group of minimally invasive gynecological branch of the Liaoning Medical Association organized a committee of experts to formulate guidance and suggestions to ensure the timely treatment and surgery of women opting for abortion, the implementation of PAC, implementation of safe contraceptive measures after surgery, and the protection of healthcare professionals and medical staff from infection. We believe these guidelines might be helpful for obstetrics and gynecology departments in China and globally, as well for women who wish to undergo abortion during these unprecedented times.}, } @article {pmid33459797, year = {2021}, author = {Meyding-Lamadé, U and Bassa, B and Tibitanzl, P and Davtyan, A and Lamadé, EK and Craemer, EM}, title = {[Telerehabilitation: from the virtual world to reality-Medicine in the twenty-first century : Video-assisted treatment in times of COVID-19].}, journal = {Der Nervenarzt}, volume = {}, number = {}, pages = {}, pmid = {33459797}, issn = {1433-0407}, abstract = {Neurological diseases are the most common cause of disability worldwide. In addition to physical limitations, they often lead to cognitive deficits that make active participation in professional and social life difficult. Due to physical and cognitive deficits, it is often difficult for neurological patients to gain access to specialized knowledge or to receive specialized treatment and is associated with greatly increased effort. Neurological diseases account for 11.6% of global disability-adjusted life years (DALYs, a measure for quantifying disease burden) and 16.5% of deaths, and remain the leading cause of DALYs and the second leading cause of death worldwide. Neurorehabilitation encompasses the goal of reintegrating patients with neurological dysfunctions into everyday life. The ongoing situation in the context of the COVID-19 pandemic poses new challenges for the healthcare system. Social distancing and quarantine have deprived many people with neurological disorders of access to routine medical care. The corona pandemic is a catalyst for the widespread use of telemedicine in the field of neurology and neurorehabilitation. Projects such as the Brunei project of the Nordwest Krankenhaus Frankfurt as well as an MS clinic in Canada show that highly specialized medicine and neurorehabilitation can be delivered to remote areas or in the living room of patients or any doctor's office. Telemedical, telerehabilitative and teletherapeutic applications offer the opportunity to supplement and optimize existing care structures and with modern technology to make a new and contemporary interpretation of old-fashioned medical and therapeutic home visits.}, } @article {pmid33459706, year = {2021}, author = {Clark, IA and Vissel, B}, title = {Broader Insights into Understanding Tumor Necrosis Factor and Neurodegenerative Disease Pathogenesis Infer New Therapeutic Approaches.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {}, number = {}, pages = {}, doi = {10.3233/JAD-201186}, pmid = {33459706}, issn = {1875-8908}, abstract = {Proinflammatory cytokines such as tumor necrosis factor (TNF), with its now appreciated key roles in neurophysiology as well as neuropathophysiology, are sufficiently well-documented to be useful tools for enquiry into the natural history of neurodegenerative diseases. We review the broader literature on TNF to rationalize why abruptly-acquired neurodegenerative states do not exhibit the remorseless clinical progression seen in those states with gradual onsets. We propose that the three typically non-worsening neurodegenerative syndromes, post-stroke, post- traumatic brain injury (TBI), and post cardiac arrest, usually become and remain static because of excess cerebral TNF induced by the initial dramatic peak keeping microglia chronically activated through an autocrine loop of microglial activation through excess cerebral TNF. The existence of this autocrine loop rationalizes post-damage repair with perispinal etanercept and proposes a treatment for cerebral aspects of COVID-19 chronicity. Another insufficiently considered aspect of cerebral proinflammatory cytokines is the fitness of the endogenous cerebral anti-TNF system provided by norepinephrine (NE), generated and distributed throughout the brain from the locus coeruleus (LC). We propose that an intact LC, and therefore an intact NE-mediated endogenous anti-cerebral TNF system, plus the DAMP (damage or danger-associated molecular pattern) input having diminished, is what allows post-stroke, post-TBI, and post cardiac arrest patients a strong long-term survival advantage over Alzheimer's disease and Parkinson's disease sufferers. In contrast, Alzheimer's disease and Parkinson's disease patients remorselessly worsen, being handicapped by sustained, accumulating, DAMP and PAMP (pathogen-associated molecular patterns) input, as well as loss of the LC-origin, NE-mediated, endogenous anti-cerebral TNF system. Adrenergic receptor agonists may counter this.}, } @article {pmid33458987, year = {2021}, author = {Taffarel, P and Jorro Barón, F and Rodríguez, AP and Widmer, J and Meregallia, C}, title = {Multisystem inflammatory syndrome in children related to COVID-19: An update regarding the presentation of two critically ill patients.}, journal = {Archivos argentinos de pediatria}, volume = {119}, number = {1}, pages = {e26-e35}, doi = {10.5546/aap.2021.eng.e26}, pmid = {33458987}, issn = {1668-3501}, abstract = {Multisystem inflammatory syndrome in children related to COVID-19 is defined as the presence of persistent fever, inflammation, and organ dysfunction, with evidence of past or recent severe acute respiratory syndrome coronavirus 2 infection, and excluding other microbial causes. It overlaps with other inflammatory diseases (Kawasaki disease and toxic shock syndrome) and shares some features with hypercytokinemia conditions (hemophagocytic lymphohistiocytosis and macrophage activation syndrome). It differs from these and severe acute COVID-19 in its clinical presentation and laboratory parameters. It has a potentially severe course and may occur with cardiovascular failure; mortality is low (2 %). Here we provide an update on this syndrome and describe the presentation of two clinical cases with cardiovascular dysfunction who required vasoactive support and invasive ventilation. Serum lab tests showed inflammation parameters. Both patients were treated with intravenous immunoglobulin and systemic corticosteroids and had a favorable course.}, } @article {pmid33458958, year = {2021}, author = {Ho, W and Gao, M and Li, F and Li, Z and Zhang, XQ and Xu, X}, title = {Next-Generation Vaccines: Nanoparticle-Mediated DNA and mRNA Delivery.}, journal = {Advanced healthcare materials}, volume = {}, number = {}, pages = {e2001812}, doi = {10.1002/adhm.202001812}, pmid = {33458958}, issn = {2192-2659}, support = {19AIREA34380849//American Heart Association/ ; 2001606//National Science Foundation/ ; ZH2018ZDA36 (19 × 190020006)//Interdisciplinary Program of Shanghai Jiao Tong University/ ; 2019TPA10//Shanghai Jiao Tong University Scientific and Technological Innovation Funds/ ; }, abstract = {Nucleic acid vaccines are a method of immunization aiming to elicit immune responses akin to live attenuated vaccines. In this method, DNA or messenger RNA (mRNA) sequences are delivered to the body to generate proteins, which mimic disease antigens to stimulate the immune response. Advantages of nucleic acid vaccines include stimulation of both cell-mediated and humoral immunity, ease of design, rapid adaptability to changing pathogen strains, and customizable multiantigen vaccines. To combat the SARS-CoV-2 pandemic, and many other diseases, nucleic acid vaccines appear to be a promising method. However, aid is needed in delivering the fragile DNA/mRNA payload. Many delivery strategies have been developed to elicit effective immune stimulation, yet no nucleic acid vaccine has been FDA-approved for human use. Nanoparticles (NPs) are one of the top candidates to mediate successful DNA/mRNA vaccine delivery due to their unique properties, including unlimited possibilities for formulations, protective capacity, simultaneous loading, and delivery potential of multiple DNA/mRNA vaccines. This review will summarize the many varieties of novel NP formulations for DNA and mRNA vaccine delivery as well as give the reader a brief synopsis of NP vaccine clinical trials. Finally, the future perspectives and challenges for NP-mediated nucleic acid vaccines will be explored.}, } @article {pmid33458853, year = {2021}, author = {Oyagbemi, AA and Ajibade, TO and Aboua, YG and Gbadamosi, IT and Adedapo, ADA and Aro, AO and Adejumobi, OA and Thamahane-Katengua, E and Omobowale, TO and Falayi, OO and Oyagbemi, TO and Ogunpolu, BS and Hassan, FO and Ogunmiluyi, IO and Ola-Davies, OE and Saba, AB and Adedapo, AA and Nkadimeng, SM and McGaw, LJ and Kayoka-Kabongo, PN and Oguntibeju, OO and Yakubu, MA}, title = {Potential health benefits of zinc supplementation for the management of COVID-19 pandemic.}, journal = {Journal of food biochemistry}, volume = {}, number = {}, pages = {e13604}, doi = {10.1111/jfbc.13604}, pmid = {33458853}, issn = {1745-4514}, abstract = {The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the etiological agent for the Coronavirus Disease 2019 (COVID-19). The COVID-19 pandemic has created unimaginable and unprecedented global health crisis. Since the outbreak of COVID-19, millions of dollars have been spent, hospitalization overstretched with increasing morbidity and mortality. All these have resulted in unprecedented global economic catastrophe. Several drugs and vaccines are currently being evaluated, tested, and administered in the frantic efforts to stem the dire consequences of COVID-19 with varying degrees of successes. Zinc possesses potential health benefits against COVID-19 pandemic by improving immune response, minimizing infection and inflammation, preventing lung injury, inhibiting viral replication through the interference of the viral genome transcription, protein translation, attachment, and host infectivity. However, this review focuses on the various mechanisms of action of zinc and its supplementation as adjuvant for vaccines an effective therapeutic regimen in the management of the ravaging COVID-19 pandemic. PRACTICAL APPLICATIONS: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiological agent for the Coronavirus Disease 2019 (COVID-19), has brought unprecedented untold hardship to both developing and developed countries. The global race for vaccine development against COVID-19 continues with success in sight with attendant increasing hospitalization, morbidity, and mortality. Available drugs with anti-inflammatory actions have become alternative to stem the tide of COVID-19 with attendant global financial crises. However, Zinc is known to modulate several physiological functions including intracellular signaling, enzyme function, gustation, and olfaction, as well as reproductive, skeletal, neuronal, and cardiovascular systems. Hence, achieving a significant therapeutic approach against COVID-19 could imply the use of zinc as a supplement together with available drugs and vaccines waiting for emergency authorization to win the battle of COVID-19. Together, it becomes innovative and creative to supplement zinc with currently available drugs and vaccines.}, } @article {pmid33458647, year = {2021}, author = {Ungogo, MA and Mohammed, M and Umar, BN and Bala, AA and Khalid, GM}, title = {Review of pharmacologic and immunologic agents in the management of COVID-19.}, journal = {Biosafety and health}, volume = {}, number = {}, pages = {}, pmid = {33458647}, issn = {2590-0536}, abstract = {The novel coronavirus disease 2019 (COVID-19) is the third coronavirus outbreaks in the last two decades. Emerging and re-emerging infections like COVID-19 pose serious challenges of paucity of information and lack of specific cure or vaccines. This leaves utilisation of existing scientific data on related viral infections and repurposing relevant aetiologic and supportive therapies as the best control approach while novel strategies are developed and trialled. Many promising antiviral agents including lopinavir, ritonavir, remdesivir, umifenovir, darunavir, and oseltamivir have been repurposed and are currently trialled in the care for COVID-19 patients. Adjunct therapies for the management of symptoms and to provide support especially in severe and critically ill patients have also been identified. This review provides an appraisal of the current evidence for rational use of frontline therapeutics in the management of COVID-19. It also includes updates regarding COVID-19 immunotherapy and vaccine development.}, } @article {pmid33458630, year = {2021}, author = {Levett, JY and Raparelli, V and Mardigyan, V and Eisenberg, MJ}, title = {Cardiovascular Pathophysiology, Epidemiology, and Treatment Considerations of Coronavirus Disease 2019 (COVID-19): A Review.}, journal = {CJC open}, volume = {3}, number = {1}, pages = {28-40}, pmid = {33458630}, issn = {2589-790X}, abstract = {The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is rapidly evolving, with important cardiovascular considerations. The presence of underlying cardiovascular risk factors and established cardiovascular disease (CVD) may affect the severity and clinical management of patients with COVID-19. We conducted a review of the literature to summarize the cardiovascular pathophysiology, risk factors, clinical presentations, and treatment considerations of COVID-19 patients with underlying CVD. Angiotensin-converting enzyme 2 (ACE2) has been identified as a functional receptor for the SARS-CoV-2 virus, and it is associated with the cardiovascular system. Hypertension, diabetes, and CVD are the most common comorbidities in COVID-19 patients, and these factors have been associated with the progression and severity of COVID-19. However, elderly populations, who develop more-severe COVID-19 complications, are naturally exposed to these comorbidities, underscoring the possible confounding of age. Observational data support international cardiovascular societies' recommendations to not discontinue ACE inhibitor/angiotensin-receptor blocker therapy in patients with guideline indications for fear of the increased risk of SARS-CoV-2 infection, severe disease, or death. In addition to the cardiotoxicity of experimental antivirals and potential interactions of experimental therapies with cardiovascular drugs, several strategies for cardiovascular protection have been recommended in COVID-19 patients with underlying CVD. Troponin elevation is associated with increased risk of in-hospital mortality and adverse outcomes in patients with COVID-19. Cardiovascular care teams should have a high index of suspicion for fulminant myocarditis-like presentations being SARS-CoV-2 positive, and remain vigilant for cardiovascular complications in COVID-19 patients.}, } @article {pmid33458567, year = {2021}, author = {Sharma, K and Desai, HD and Patoliya, JV and Jadeja, DM and Gadhiya, D}, title = {Takotsubo Syndrome a Rare Entity in COVID-19: a Systemic Review-Focus on Biomarkers, Imaging, Treatment, and Outcome.}, journal = {SN comprehensive clinical medicine}, volume = {}, number = {}, pages = {1-11}, pmid = {33458567}, issn = {2523-8973}, abstract = {Takotsubo syndrome(TTS) is attributed to catecholamine surge, which is also observed in COVID-19 disease due to the cytokine storm. We performed a systematic literature search using PubMed, Embase, and the Cochrane Central Register of Controlled Trials retrospectively to identify COVID-19-associated TTS case reports and evaluated patient-level demographics, laboratory markers clinical attributes, treatment given, and outcomes. There are 27 cases reported of TTS associated with COVID-19 infection of which 44.5% were male. Reported median age was 57 years (IQR: 39-65) and 62.95 years (IQR: 50.5-73.5) in case series and individual patients' cases in database, respectively. The time interval from the symptom onset to TTS diagnosis was median 6.5 days (IQR: 1.0-8.0) in case series and 6.7 days (IQR: 4-10) in individual patients' database. The median LVEF was 36% (IQR: 35-37) and 38.15%(IQR: 30-42.5%-[male: 40.33% (IQR: 33-44.2)] and female [37.15% (IQR: 30-40)] in case series and individual-patients' database, respectively. Troponin was elevated in all patients except one patient. 77.2% patients of TTS with COVID-19 had an elevated C-reactive protein and/or D-dimer. Twelve out of 22 (54.5%) patients developed cardiac complication such as cardiogenic-shock, atrial fibrillation, acute heart failure, supraventricular tachycardia, and biventricular heart failure. Nineteen out of 26 (73.07%) patients were discharged, and three were hospitalized due to acute respiratory distress syndrome and needed extracorporeal membrane oxygenation or ongoing maternal age. There were 4 (14.8%) mortality. There was no major gender difference observed in development of TTS in COVID-19 unlike COVID-19 per se. Older median age group for TTS in COVID-19 patients irrespective of cardiovascular comorbidities and gender probably reflects age as an independent risk factor. Patients who developed TTS had higher mortality rate especially if they developed cardiogenic shock.}, } @article {pmid33458558, year = {2021}, author = {McFarland, AJ and Yousuf, MS and Shiers, S and Price, TJ}, title = {Neurobiology of SARS-CoV-2 interactions with the peripheral nervous system: implications for COVID-19 and pain.}, journal = {Pain reports}, volume = {6}, number = {1}, pages = {e885}, pmid = {33458558}, issn = {2471-2531}, abstract = {SARS-CoV-2 is a novel coronavirus that infects cells through the angiotensin-converting enzyme 2 receptor, aided by proteases that prime the spike protein of the virus to enhance cellular entry. Neuropilin 1 and 2 (NRP1 and NRP2) act as additional viral entry factors. SARS-CoV-2 infection causes COVID-19 disease. There is now strong evidence for neurological impacts of COVID-19, with pain as an important symptom, both in the acute phase of the disease and at later stages that are colloquially referred to as "long COVID." In this narrative review, we discuss how COVID-19 may interact with the peripheral nervous system to cause pain in the early and late stages of the disease. We begin with a review of the state of the science on how viruses cause pain through direct and indirect interactions with nociceptors. We then cover what we currently know about how the unique cytokine profiles of moderate and severe COVID-19 may drive plasticity in nociceptors to promote pain and worsen existing pain states. Finally, we review evidence for direct infection of nociceptors by SARS-CoV-2 and the implications of this potential neurotropism. The state of the science points to multiple potential mechanisms through which COVID-19 could induce changes in nociceptor excitability that would be expected to promote pain, induce neuropathies, and worsen existing pain states.}, } @article {pmid33458449, year = {2021}, author = {Wang, Y and Xue, Q}, title = {The implications of COVID-19 in the ambient environment and psychological conditions.}, journal = {NanoImpact}, volume = {}, number = {}, pages = {100295}, pmid = {33458449}, issn = {2452-0748}, abstract = {The COVID-19 pandemic caused by SARS-CoV-2 has posed a huge threat to mankind, deeply endangering healthy states and influencing economic development. COVID-19 has important impacts on the environment as anthropic interventions to nature has been largely reduced after almost all countries implemented partial or complete blockade to curb the spread of the virus. Up to now, a series of studies have focused on the relationship between COVID-19 and the environment from different cities. In this review, we summarized the latest data on the correlation between COVID-19 and environmental changes. As a result, imposing necessary restrictions can help suppress the virus chain while improving air quality in some countries. The significant reduction in NO2 emission, PM2.5 level and other hazardous factors reflected the promising consequence of the efforts made during the lockdown period. It is, sometimes dark clouds have silver linings. It is worth noting that along with these positive outcomes, secondary pollutants such as ozone, however, remained unchanged or even increased significantly. Additionally, medical wastes and plastics pollutants would be increased substantially. The extensive use of masks in daily life and other medical materials is bound to increase the burden of waste disposal and environmental degradation. For the general public, in addition to the physical lesions caused by SARS-CoV-2, confirmed/suspected cases and even the normal group may suffer from mental problems. Based on those mentioned impacts, the way forward depends largely on our attitude and decision. It is indispensable to assess potential deleterious effects and to take preventive measures in time to respond to the post-pandemic era. In this way, potential silver linings will not become temporary.}, } @article {pmid33457487, year = {2021}, author = {Rice, SM and Ferree, SD and Atanaskova Mesinkovska, N and Shadi Kourosh, A}, title = {The Art of Prevention: COVID-19 Vaccine Preparedness for the Dermatologist.}, journal = {International journal of women's dermatology}, volume = {}, number = {}, pages = {}, pmid = {33457487}, issn = {2352-6475}, abstract = {As COVID-19 vaccinations begin, dermatologists must be aware of the cutaneous adverse events reported in the clinical trials, including injection site and hypersensitivity reactions, and emerging evidence of dermal filler injection reactions following vaccination. The filler reaction may represent development of a delayed-type hypersensitivity in the setting of another immunologic trigger, i.e. the vaccine. Upon literature review of similar reactions, their pathophysiology and management, we present a set of timely clinical considerations for counseling, prevention and management of the possible cutaneous sequelae of the COVID-19 vaccine, and encourage documentation of vaccine-related reactions to aid the safety-data collection in the Vaccine Adverse Event Reporting System and the American Academy of Dermatology COVID-19 Registry.}, } @article {pmid33457307, year = {2020}, author = {Xu, H and Zhou, Y and Sun, R and Liu, X and Diao, M and Ren, X and Li, L}, title = {A narrative review of the challenges and countermeasures in hepatoblastoma management during COVID-19 epidemic.}, journal = {Translational pediatrics}, volume = {9}, number = {6}, pages = {840-848}, pmid = {33457307}, issn = {2224-4344}, abstract = {An infectious disease named "coronavirus disease 2019" (COVID-19) currently has brought a threat to global health security and trends to be more and more severe in many countries. It also has introduced great challenges to the diagnosis and management of children with hepatoblastoma (HB). During the COVID-19 pandemic, pediatric surgeons should not only develop personalized treatment plans for HB therapy, but also emphasize the diagnosis, prevention, and treatment of this virus. Children with both HB and COVID-19 are recommended to undertake multidisciplinary assessment. Anti-SARS-CoV-2 therapy may be a preferred treatment for the infected without presenting a surgical emergency. However, emergent operation may be necessary for HB children with concurrent COVID-19 who developed a life-threatening surgical emergency condition. Otherwise, for children with negative virus examination results, treatment advice should be based on the impact of the epidemic and regional economic considerations. A "wait and see" strategy is recommended for children with resectable tumors after new adjuvant chemotherapy treatment (NACT). Assessment of liver transplantation is recommended for children with HB whose tumors cannot be resected after NACT. Children with HB with pulmonary metastasis may have abnormal findings on chest imaging due to COVID-19. Besides, the detailed therapeutic regimens may vary for children with HB with or without an emergency presentation. Based on previous consensus, current research, and the experiences of our hospital, we aim to offer available management plans for the above-mentioned concerns.}, } @article {pmid33457195, year = {2020}, author = {Al-Dayan, N and Venugopal, D and Dhanasekaran, S}, title = {Footprint of the COVID-19 Pandemic in India: A Study of Immune Landscape and Other Factors Shielding Mortality.}, journal = {Analytical cellular pathology (Amsterdam)}, volume = {2020}, number = {}, pages = {6692739}, pmid = {33457195}, issn = {2210-7185}, abstract = {The impact of the SARS-CoV-2 pandemic has significantly affected global health and created a world crisis. The exponentially increasing numbers of infection and mortality have made preventive measures challenging. India being a highly populated nation has so far effectively counteracted the pandemic outbreak with a significantly lower rate of mortality despite the high infection rates. The genetic architecture of the immune response genes in the Indian population, BCG vaccination, the predominantly young age group of people, and their traditional food habits might contribute to the lower rate of mortality. Human leukocyte antigens (HLA) play a vital role in triggering T cells, and natural killer (NK) cells can immediately react to eliminate infected cells. Activation of virus-specific CD4+ T cells and CD8+ cytotoxic T cells selectively targets the infected cells and strengthens the immunoregulatory system. The checkpoint for NK cell function is the engagement of killer Ig-like receptors (KIR) molecules with their respective HLA ligands overexpressed or expressed on the compromised virus-infected cells which have shown polymorphism among different ethnic groups. Here, we explore if certain KIR-HLA motifs grant Indians a survival advantage in terms of the low rate of mortality. Additionally, enhanced immunity through BCG vaccination may favor fruitful eradication of SARS-CoV-2 and provide the way out as in therapeutic intervention and vaccination strategies.}, } @article {pmid33457174, year = {2021}, author = {Khan, H and Kushwah, KK and Singh, S and Urkude, H and Maurya, MR and Sadasivuni, KK}, title = {Smart technologies driven approaches to tackle COVID-19 pandemic: a review.}, journal = {3 Biotech}, volume = {11}, number = {2}, pages = {50}, pmid = {33457174}, issn = {2190-572X}, abstract = {The novel coronavirus infection (COVID-19) is not diminishing without vaccine, but it impinges on human safety and economy can be minimized by adopting smart technology to combat pandemic situation. The implementation of new innovations and novel tactics has proven to be effective in curbing the risk of COVID-19. The present study covers the role of smart technology in mitigating the spread of COVID-19 with specific focus on advancement in the field of drone, robotics, artificial intelligence (AI), mask, and sensor technology. The findings shed light on the robotics and drone technology-driven approaches that have been applied for assisting health system, surveillance, and disinfection process, etc. The AI technology strategies and framework is highlighted in terms of bulk data computing, predicting infection threats, providing medical assistance, and analyzing diagnosis results. Besides this, the technological shift in mask and sensor technology during the pandemic have been illustrated, which includes fabrication method like 3D printing and optical sensing, respectively. Furthermore, the strength, weakness, opportunities, and possible threats that have been shaped by the rigorous implementation of these technologies are also covered in detail.}, } @article {pmid33457170, year = {2021}, author = {Lobo-Galo, N and Gálvez-Ruíz, JC and Balderrama-Carmona, AP and Silva-Beltrán, NP and Ruiz-Bustos, E}, title = {Recent biotechnological advances as potential intervention strategies against COVID-19.}, journal = {3 Biotech}, volume = {11}, number = {2}, pages = {41}, pmid = {33457170}, issn = {2190-572X}, abstract = {The emerging SARS-CoV-2 viral disease (COVID-19) has caused a global health alert due to its high rate of infection and mortality in individuals with chronic cardiovascular comorbidities, in addition to generating complex clinical conditions. This has forced the scientific community to explore different strategies that allow combating this viral infection as well as treating life-threatening systemic effect of the infection on the individual. In this work, we have reviewed the most recent scientific evidence to provide a comprehensive panorama regarding the biotechnological strategies that have been proposed to combat this new viral infection. We have focused our analysis on vaccine production, nanotechnology applications, repurposing of know drugs for unrelated pathologies, and the search for bioactive molecules obtained from natural products. The goals include safely use as potential prophylactic or therapeutic treatments, based on in silico and in vivo studies, including clinical trials around the world for the correct and timely diagnosis of the infection. This review aims to highlight the development of new ideas that can decrease the time lines for research output and improve research quality while at the same time, keeping in mind the efficacy and safety aspects of these potential biotechnological strategies.}, } @article {pmid33457109, year = {2021}, author = {Ellis, P and Somogyvári, F and Virok, DP and Noseda, M and McLean, GR}, title = {Decoding Covid-19 with the SARS-CoV-2 Genome.}, journal = {Current genetic medicine reports}, volume = {}, number = {}, pages = {1-12}, pmid = {33457109}, issn = {2167-4876}, abstract = {Purpose of Review: SARS-CoV-2, the recently emerged coronavirus (CoV) that is responsible for the current global pandemic Covid-19, first appeared in late 2019 in Wuhan, China. Here, we summarise details of the SARS-CoV-2 genome to assist understanding of the emergence, evolution and diagnosis of this deadly new virus.

Recent Findings: Based on high similarities in the genome sequences, the virus is thought to have arisen from SARS-like CoVs in bats but the lack of an intermediate species containing a CoV with even greater similarity has so far eluded discovery. The critical determinant of the SARS-CoV-2 genome is the spike (S) gene encoding the viral structural protein that interacts with the host cell entry receptor ACE2. The S protein is sufficiently adapted to bind human ACE2 much more readily than SARS-CoV, the most closely related human CoV.

Summary: Although the SARS-CoV-2 genome is undergoing subtle evolution in humans through mutation that may enhance transmission, there is limited evidence for attenuation that might weaken the virus. It is also still unclear as to the events that led to the virus' emergence from bats. Importantly, current diagnosis requires specific recognition and amplification of the SARS-CoV-2 RNA genome by qPCR, despite these ongoing viral genome changes. Alternative diagnostic procedures relying on immunoassay are becoming more prevalent.}, } @article {pmid33456721, year = {2021}, author = {Zhong, W and Zhang, X and Zeng, Y and Lin, D and Wu, J}, title = {Recent applications and strategies in nanotechnology for lung diseases.}, journal = {Nano research}, volume = {}, number = {}, pages = {1-23}, pmid = {33456721}, issn = {1998-0124}, abstract = {Lung diseases, including COVID-19 and lung cancers, is a huge threat to human health. However, for the treatment and diagnosis of various lung diseases, such as pneumonia, asthma, cancer, and pulmonary tuberculosis, are becoming increasingly challenging. Currently, several types of treatments and/or diagnostic methods are used to treat lung diseases; however, the occurrence of adverse reactions to chemotherapy, drug-resistant bacteria, side effects that can be significantly toxic, and poor drug delivery necessitates the development of more promising treatments. Nanotechnology, as an emerging technology, has been extensively studied in medicine. Several studies have shown that nano-delivery systems can significantly enhance the targeting of drug delivery. When compared to traditional delivery methods, several nanoparticle delivery strategies are used to improve the detection methods and drug treatment efficacy. Transporting nanoparticles to the lungs, loading appropriate therapeutic drugs, and the incorporation of intelligent functions to overcome various lung barriers have broad prospects as they can aid in locating target tissues and can enhance the therapeutic effect while minimizing systemic side effects. In addition, as a new and highly contagious respiratory infection disease, COVID-19 is spreading worldwide. However, there is no specific drug for COVID-19. Clinical trials are being conducted in several countries to develop antiviral drugs or vaccines. In recent years, nanotechnology has provided a feasible platform for improving the diagnosis and treatment of diseases, nanotechnology-based strategies may have broad prospects in the diagnosis and treatment of COVID-19. This article reviews the latest developments in nanotechnology drug delivery strategies in the lungs in recent years and studies the clinical application value of nanomedicine in the drug delivery strategy pertaining to the lung.}, } @article {pmid33456543, year = {2021}, author = {Tang, J and Li, Y and Lu, Q and Xie, W and Zhou, S and Liu, Y and Zeng, Q and Li, X}, title = {Risk factors and prevention strategies for the occupational exposure of medical staff during the coronavirus disease-19 pandemic (Review).}, journal = {Experimental and therapeutic medicine}, volume = {21}, number = {2}, pages = {176}, pmid = {33456543}, issn = {1792-0981}, abstract = {During the sudden epidemic of this novel coronavirus-induced pneumonia, a number of medical staff were infected and even succumbed to coronavirus disease-19 (COVID-19). Based on the experience of medical professionals from The Hubei 672 Orthopedics Hospital of Integrated Chinese and Western Medicine on this COVID-19 pandemic, the present review summarizes the risk factors associated with the occupational exposure of front-line medical staff. Challenges encountered include insufficient understanding, lack of early protection, environmental factors and routine procedures and the lack of adequate prevention strategies. Overcoming these challenges can potentially enhance awareness of COVID-19 prevention and control among medical staff, in addition to strengthening the personal protection of front-line medical staff, rational area layout, regular disinfection, standardization of daily procedures, reasonable scheduling and early psychological intervention. The present article may serve as a referencing point for the prevention and control of this epidemic.}, } @article {pmid33456522, year = {2021}, author = {Wang, R and Luo, X and Liu, F and Luo, S}, title = {Confronting the threat of SARS-CoV-2: Realities, challenges and therapeutic strategies (Review).}, journal = {Experimental and therapeutic medicine}, volume = {21}, number = {2}, pages = {155}, pmid = {33456522}, issn = {1792-0981}, abstract = {The novel coronavirus (SARS-CoV-2) appeared in2019 in Wuhan, China, and rapidly developed into a global pandemic. The disease has affected not only health care systems and economies worldwide but has also changed the lifestyles and habits of the majority of the world's population. Among the potential targets for SARS-CoV-2 therapy, the viral spike glycoprotein has been studied most intensely, due to its key role in mediating viral entry into target cells and inducing a protective antibody response in infected individuals. In the present manuscript the molecular mechanisms that are responsible for SARS-CoV-2 infection are described and a progress report on the status of SARS-CoV-2 research is provided. A brief review of the clinical symptoms of the condition and current diagnostic methods and treatment plans for SARS-CoV-2 are also presented and the progress of preclinical research into medical intervention against SARS-CoV-2 infection are discussed.}, } @article {pmid33456428, year = {2021}, author = {Kaya, HO and Cetin, AE and Azimzadeh, M and Topkaya, SN}, title = {Pathogen detection with electrochemical biosensors: Advantages, challenges and future perspectives.}, journal = {Journal of electroanalytical chemistry (Lausanne, Switzerland)}, volume = {882}, number = {}, pages = {114989}, pmid = {33456428}, issn = {1572-6657}, abstract = {Detection of pathogens, e.g., bacteria and viruses, is still a big challenge in analytical medicine due to their vast number and variety. Developing strategies for rapid, inexpensive, specific, and sensitive detection of the pathogens using nanomaterials, integrating with microfluidics devices, amplification methods, or even combining these strategies have received significant attention. Especially, after the health-threatening COVID-19 outbreak, rapid and sensitive detection of pathogens became very critical. Detection of pathogens could be realized with electrochemical, optical, mass sensitive, or thermal methods. Among them, electrochemical methods are very promising by bringing different advantages, i.e., they exhibit more versatile detection schemes and real-time quantification as well as label-free measurements, which provides a broader application perspective. In this review, we discuss the recent advances for the detection of bacteria and viruses using electrochemical biosensors. Moreover, electrochemical biosensors for pathogen detection were broadly reviewed in terms of analyte, bio-recognition and transduction elements. Different fabrication techniques, detection principles, and applications of various pathogens with the electrochemical biosensors were also discussed.}, } @article {pmid33456421, year = {2021}, author = {Smirmaul, BPC and Chamon, RF and de Moraes, FM and Rozin, G and Moreira, ASB and de Almeida, R and Guimarães, ST}, title = {Lifestyle Medicine During (and After) the COVID-19 Pandemic.}, journal = {American journal of lifestyle medicine}, volume = {15}, number = {1}, pages = {60-67}, pmid = {33456421}, issn = {1559-8284}, abstract = {The COVID-19 pandemic has made it challenging for individuals and families to maintain a healthy lifestyle, quality of life, and well-being. Preliminary evidence have suggested that higher odds of both mortality and severity of the COVID-19 are closely associated to unhealthy lifestyle behaviors. Thus, in an effort to contribute to this challenging global situation, we joined a group of lifestyle medicine researchers and/or practitioners to provide scientifically sound information, recommendations, resources, and suggestions related to the main pillars of lifestyle medicine (healthy eating, physical activity, sleep, tobacco/alcohol, stress management, relationships, and planetary health) that may help health practitioners to support clients and patients maintain a healthy lifestyle during (and after) the COVID-19 crisis.}, } @article {pmid33456304, year = {2021}, author = {Ibrahim Fouad, G}, title = {The neuropathological impact of COVID-19: a review.}, journal = {Bulletin of the National Research Centre}, volume = {45}, number = {1}, pages = {19}, pmid = {33456304}, issn = {2522-8307}, abstract = {Background: The Coronavirus disease 2019 (COVID-19) outbreak has become a challenging global issue after its emergence in December 2019. Due to the high adaptation of the virus, COVID-19 demonstrated a high transmission and infectivity potentials. Several studies demonstrated that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induce deleterious neurological manifestations through interacting with the central nervous system (CNS).

Main body: The neuroinvasive potential of SARS-CoV-2 might contribute to its fatal behavior. Understanding the underlying mechanisms of this novel neuropathogen might contribute to the development of effective therapeutic strategies. The manifestations of neural damage in COVID-19 patients ranged from headache to severe encephalopathy and progression of preexisting neural disorders, it is speculated that neuroinvasion is strongly linked to the fatal respiratory dysfunction. The underlying neuropathological impact of emerging pneumonia (COVID-19) is still unclear.

Conclusion: This review demonstrated the urgent need to understand the neuropathology of COVID-19, to manage the current borderless viral outbreak of SARS-CoV-2 and its comorbidities. Moreover, SARS-CoV-2 could be regarded as an opportunistic neuropathogen that affects several vital functions in the human body.}, } @article {pmid33456205, year = {2021}, author = {Han, S and Roy, PK and Hossain, MI and Byun, KH and Choi, C and Ha, SD}, title = {COVID-19 pandemic crisis and food safety: Implications and inactivation strategies.}, journal = {Trends in food science & technology}, volume = {109}, number = {}, pages = {25-36}, pmid = {33456205}, issn = {0924-2244}, abstract = {Background: The COVID-19 pandemic that emerged in 2019 has imposed huge consequences, including economic losses and threats to human health, which are still affecting many aspects throughout the world.

Scope and approach: This review provides an overview of SARS-CoV-2 infection, the cause of COVID-19, and explores its impact on the food supply system and food safety. This review examines the potential risk of transmission through food and environmental surfaces before discussing an effective inactivation strategy to control the COVID-19 pandemic in the aspect of food safety. This article also suggests effective food safety management post-COVID-19.

Key findings and conclusions: Respiratory viruses including SARS-CoV-2 are responsible for huge impacts on the global economy and human health. Although food and water are not currently considered priority transmission routes of SARS-CoV-2, infection through contaminated food and environmental surfaces where the virus can persist for several days cannot be ignored, particularly when the surrounding environment is unhygienic. This approach could help determine the exact transmission route of SARS-CoV-2 and prepare for the post-COVID-19 era in the food safety sector.}, } @article {pmid33456150, year = {2020}, author = {Rao, S and Ali, K and Berdine, G and Test, V and Nugent, K}, title = {The evolution of health care in the Texas correctional system and the impact of COVID-19.}, journal = {Proceedings (Baylor University. Medical Center)}, volume = {34}, number = {1}, pages = {76-80}, pmid = {33456150}, issn = {0899-8280}, abstract = {Health care under the jurisdiction of the Texas Department of Criminal Justice has evolved over time to provide prisoners greater access to medical care, including psychiatric care and substance abuse assistance. Mental illness and chronic conditions, such as hypertension, chronic obstructive pulmonary disease, diabetes, and heart disease, are common in prisoners in Texas and across the nation and increase the cost of health care. The average annual health care cost per prisoner in Texas was $4077 in 2015. Although the Texas prison system has undergone changes, such as the use of telemedicine and protocols for preventive measures, to address the varying medical needs of prisoners in correctional facilities, there is still considerable criticism regarding prison policies and incomplete access to medical care. In addition, the ongoing COVID-19 pandemic has added significant stress to correctional health care in Texas and highlights the importance of organized health care for prisoners. This report reviews the history and evolution of health care delivery in Texas's correctional facilities, outlines ongoing efforts to improve medical care in prison facilities, and describes current policies to limit COVID-19 infections in Texas prisons.}, } @article {pmid33456149, year = {2020}, author = {Abdelnabi, M and Leelaviwat, N and Eshak, N and Mekraksakit, P and Nugent, K and Payne, JD}, title = {COVID-19 discharge and follow-up recommendations.}, journal = {Proceedings (Baylor University. Medical Center)}, volume = {34}, number = {1}, pages = {73-75}, pmid = {33456149}, issn = {0899-8280}, abstract = {Currently, the world is facing a global pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), also known as COVID-19. So far, there are no clear recommendations regarding hospital discharge and aftercare for COVID-19. Here, we briefly discuss the current understanding of recommendations for discharge criteria, discharge treatment regimens, and follow-up.}, } @article {pmid33456148, year = {2020}, author = {Kopel, J and Goyal, H and Perisetti, A}, title = {Antibody tests for COVID-19.}, journal = {Proceedings (Baylor University. Medical Center)}, volume = {34}, number = {1}, pages = {63-72}, pmid = {33456148}, issn = {0899-8280}, abstract = {The SARS-CoV-2 virus caused a globally growing pandemic called coronavirus disease 2019 (COVID-19) that has disrupted social, political, and medical environments around the world. Nations are assessing ways to reopen businesses while trying to balance health care risks and economic fallouts. Strategies involving antibody testing have been proposed before phased reopening of the economy. Therefore, assessing the sensitivity and specificity of antibody tests for symptomatic and asymptomatic COVID-19 patients remains paramount to prevent COVID-19 outbreaks. The antibody tests for SARS-CoV-2 detect the presence of IgA, IgM, or IgG antibodies produced by B cells. There are four major types of antibody tests: rapid diagnostic tests, enzyme-linked immunosorbent assays, neutralization assays, and chemiluminescent immunoassays. Currently, there is no standard antibody test for detecting SARS-CoV-2 antibodies during or after exposure or infection. The antibody tests for SARS-CoV-2 have a low specificity within the first week of exposure and increase in the second and third weeks. The current data on antibody tests have several limitations in quality and the presence of bias. Specifically, many antibody tests have a high false-negative rate and a high risk of bias for participant selection, application of index tests, reference standard used, and flow and timing for antibody tests that may incorrectly report the accuracy of COVID-19 antibody tests. In this review, we summarize the current methods, sensitivity/specificity, and gaps in knowledge concerning COVID-19 antibody testing.}, } @article {pmid33455825, year = {2021}, author = {Wittenberg, E and Goldsmith, JV and Chen, C and Prince-Paul, M and Johnson, RR}, title = {Opportunities to improve COVID-19 provider communication resources: A systematic review.}, journal = {Patient education and counseling}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.pec.2020.12.031}, pmid = {33455825}, issn = {1873-5134}, abstract = {OBJECTIVE: Communication related to COVID-19 between provider and the patient/family is impacted by isolation requirements, time limitations, and lack of family/partner access. Our goal was to determine the content of provider communication resources and peer-reviewed articles on COVID-19 communication in order to identify opportunities for developing future COVID-19 communication curricula and support tools.

METHODS: A systematic review was conducted using the UpToDate clinical decision support resource database, CINAHL, PubMed, PsycInfo, and Web of Science. The grey literature review was conducted in September 2020 and articles published between January-September 2020 written in English were included.

RESULTS: A total of 89 sources were included in the review, (n = 36 provider communication resources, n = 53 peer-reviewed articles). Resources were available for all providers, mainly physicians, and consisted of general approaches to COVID-19 communication with care planning as the most common topic. Only four resources met best practices for patient-centered communication. All but three articles described physician communication where a general emphasis on patient communication was the most prevalent topic. Reduced communication channels, absence of family, time, burnout, telemedicine, and reduced patient-centered care were identified as communication barriers. Communication facilitators were team communication, time, patient-centered and family communication, and available training resources.

CONCLUSIONS: Overall, resources lack content that address non-physician providers, communication with family, and strategies for telehealth communication to promote family engagement. The gaps identified in this review reveal a need to develop more materials on the following topics: provider moral distress, prevention communication, empathy and compassion, and grief and bereavement. An evidence-base and theoretical grounding in communication theory is also needed.

PRACTICE IMPLICATIONS: Future development of COVID-19 communication resources for providers should address members of the interdisciplinary team, communication with family, engagement strategies for culturally-sensitive telehealth interactions, and support for provider moral distress.}, } @article {pmid33455681, year = {2021}, author = {Michelini, C}, title = {[Reinforcement in a COVID resuscitation unit in the Grand-Est region].}, journal = {Revue de l'infirmiere}, volume = {70}, number = {267}, pages = {40-41}, doi = {10.1016/j.revinf.2020.11.014}, pmid = {33455681}, issn = {1293-8505}, abstract = {Available and voluntary, with ten years' experience in the intensive care unit, a nurse testifies to the reinforcement she brought to the Grand-Est region last April, when her nursing colleagues from the hospitals were facing the surge of patients struck by serious forms of COVID-19. A memorable experience.}, } @article {pmid33445936, year = {2020}, author = {Smetanová, J and Střížová, Z and Bartůňková, J and Milota, T}, title = {Principles and new perspectives in the vaccination against SARS-CoV-2 virus.}, journal = {Casopis lekaru ceskych}, volume = {159}, number = {7-8}, pages = {298-302}, pmid = {33445936}, issn = {0008-7335}, mesh = {Aged ; *COVID-19 ; COVID-19 Vaccines ; Czech Republic ; Europe ; Humans ; *SARS-CoV-2 ; United Kingdom ; Vaccination ; }, abstract = {It has been a year since the first person on Earth became infected with a new type of coronavirus SARS-CoV-2, causing infectious acute respiratory disease COVID-19 with relatively high morbidity and mortality. The most endangered population by coronavirus SARS-CoV-2 are healthcare professionals, the elderly and people with associated comorbidities. Due to the fast community spread, governments of different European countries introduced precaution measures including limited socializing of people, closing of most public services and introducing mandatory facial protection. The hope for a return to the life before the pandemic is the development of an effective and safe vaccine against SARS-CoV-2 which would presumably reduce the incidence of severe forms of COVID-19 and prevent the massive spread of the disease. At the end of November, we have 13 clinical trials in phase III involving SARS-CoV-2 vaccines based on inactivated viruses, recombinant non-pathogenic viral vectors and proteins. The first mRNA-based vaccine is currently being evaluated in phase II/III clinical trial and is already being distributed and applied to high-risk population in the United Kingdom, the United States, and Israel, followed by the countries of the European Union, including the Czech Republic. In the review article we present currently ongoing clinical studies with a special focus on the phase III clinical trials and discuss the mechanisms of action of each type of vaccine.}, } @article {pmid33443839, year = {2021}, author = {Nawej Tshikung, O and Buvelot, H and Calmy, A and Cavassini, M}, title = {[HIV in the time of COVID-19 : the meeting between two pandemics].}, journal = {Revue medicale suisse}, volume = {17}, number = {720-1}, pages = {95-101}, pmid = {33443839}, issn = {1660-9379}, mesh = {*COVID-19 ; Coinfection ; *HIV Infections/drug therapy/epidemiology ; Humans ; Pandemics ; Risk Factors ; }, abstract = {The current COVID-19 pandemic is the main topic of news worldwide by its magnitude and consequences across the entire planet. From a medical point of view, several risk factors for developing severe illness have been reported in the literature, notably an immunosuppressed status. For people living with HIV, several questions have been raised concerning not only their vulnerability, but also in relation to an eventual protection conferred by antiretroviral therapy. This article will address these two pandemics by looking at the potential impact of SARS-CoV-2 on people living with HIV and, in parallel, exploring similarities and differences in terms of treatment, potential for recovery, prevention and their impact on clinical research. We review also future novel therapies for the treatment of HIV.}, } @article {pmid33443837, year = {2021}, author = {Khazaal, Y and Elowe, J and Kloucek, P and Preisig, M and Tadri, M and Vandeleur, C and Vandenberghe, F and Verloo, H and Ros, T and Von Guntenb, A}, title = {[Psychiatry].}, journal = {Revue medicale suisse}, volume = {17}, number = {720-1}, pages = {85-89}, pmid = {33443837}, issn = {1660-9379}, mesh = {COVID-19 ; Depressive Disorder, Treatment-Resistant/drug therapy ; Humans ; Ketamine/administration & dosage ; Neurofeedback ; Pandemics ; Psychiatry/*trends ; *Telemedicine ; }, abstract = {The Covid-19 pandemic has a major impact on psychiatry by its social consequences and possible direct effect of certain forms of Covid-19 on mental health. During this crisis, the accessibility of technology meets a state of necessity, which has propelled telepsychiatry from the shadows into the light. The contribution of several technologies (i.e. virtual reality, actigraphy, computational psychiatry) combining clinical data and neuroscience underlines the great neurobehavioural variability even within the same diagnostic category, calling for greater precision in therapeutic offers as suggested e.g. by developments in neurofeedback. The place of intranasal esketamin in the panoply of antidepressent drug treatments for resistant depression has not yet been defined.}, } @article {pmid33443836, year = {2021}, author = {Ekobena, P and Ivanyuk, A and Livio, F}, title = {[Pharmacovigilance update].}, journal = {Revue medicale suisse}, volume = {17}, number = {720-1}, pages = {80-84}, pmid = {33443836}, issn = {1660-9379}, mesh = {Adenosine Monophosphate/analogs & derivatives/therapeutic use ; Alanine/analogs & derivatives/therapeutic use ; COVID-19/drug therapy ; Cleft Lip/prevention & control ; Contraindications, Drug ; Cytokine Release Syndrome/virology ; Female ; Fingolimod Hydrochloride/adverse effects ; Humans ; Hydroxychloroquine/adverse effects ; Leiomyoma/drug therapy ; Norpregnadienes/therapeutic use ; Pharmacokinetics ; *Pharmacovigilance ; Pregnancy ; Ranitidine/adverse effects ; Safety-Based Drug Withdrawals ; Skin Neoplasms/chemically induced ; }, abstract = {The main pharmacovigilance updates in 2020 are reviewed. Remdesivir in COVID-19: relatively safe but turns out to be less effective than expected. Hydroxychloroquine in COVID-19 : lack of efficacy and risk of arrhythmias. Cytokines storm in COVID-19: may impact pharmacokinetics. VEGF inhibitors: risk of aneurysm and artery dissection. Tofacitinib: dose-dependant risk of venous thromboembolic events. Ondansetron in the first trimester of pregnancy : a highly debated risk of orofacial cleft defects. Fingolimod : contraindicated during pregnancy due to suspected risk of congenital malformations. Ranitidine: global market withdrawal due to contamination with nitrosamines. Ulipristal for uterine fibroids : market withdrawal due to risk of severe liver injury. Ingenol mebutate : market withdrawal due to paradoxical risk of skin cancers.}, } @article {pmid33443830, year = {2021}, author = {Nguyen, A and Posfay-Barbe, K and Blanchard-Rohner, G and Buvelot, H and Eberhardt, C and Huttner, B and Negro, F and Pham, TT and Schibler, M and Vetter, P and Wagner, N and Zanella, MC and Jacquérioz, F and Huttner, A}, title = {.}, journal = {Revue medicale suisse}, volume = {17}, number = {720-1}, pages = {42-49}, pmid = {33443830}, issn = {1660-9379}, mesh = {Anti-Bacterial Agents/administration & dosage ; Antiviral Agents/therapeutic use ; C-Reactive Protein/analysis ; COVID-19 ; Child ; Communicable Diseases/drug therapy ; Humans ; Infectious Disease Medicine/*trends ; Influenza, Human/drug therapy ; Pandemics ; Tuberculosis/prevention & control ; Vitamin D/administration & dosage ; }, abstract = {What's new in infectious diseases in 2020 ? This year has been marked by the COVID-19 pandemic, prompting a review of the current knowledge on SARS-CoV-2 and its management in this article. The results of the Swiss project « PIRATE » indicate non-inferiority between CRP-guided antibiotic durations or fixed 7-day durations and 14-day durations for Gram-negative bacteremia. A Mongolian study did not show any benefit of vitamin D substitution in protecting children from tuberculosis. Baloxavir, a new antiviral against the flu, has been approved by Swissmedic. Finally, new American recommendations for therapeutic monitoring of vancomycin and universal screening for hepatitis C virus have been published.}, } @article {pmid33443827, year = {2021}, author = {Artru, F and Fraga, M and Godat, S and Schoepfer, AM and Moradpour, D}, title = {[Advances in gastroenterology and hepatology 2020].}, journal = {Revue medicale suisse}, volume = {17}, number = {720-1}, pages = {29-32}, pmid = {33443827}, issn = {1660-9379}, mesh = {COVID-19 ; Gastroenterology/*trends ; Humans ; Pandemics ; }, abstract = {The year 2020 has been dominated by the coronavirus disease 2019 (COVID-19) pandemic, with important lessons learned also in gastroenterology and hepatology. Major advances, however, have also been made in other areas, a selection of which is highlighted in this article.}, } @article {pmid33439990, year = {2021}, author = {Burslem, GM}, title = {The role of chemical biology in the fight against SARS-CoV-2.}, journal = {The Biochemical journal}, volume = {478}, number = {1}, pages = {157-177}, doi = {10.1042/BCJ20200514}, pmid = {33439990}, issn = {1470-8728}, mesh = {Animals ; Antiviral Agents/*chemistry/pharmacology ; COVID-19/drug therapy/*virology ; Drug Design ; Drug Discovery ; Humans ; SARS-CoV-2/drug effects/genetics/*physiology ; }, abstract = {Since late 2019, biomedical labs all over the world have been struggling to cope with the 'new normal' and to find ways in which they can contribute to the fight against COVID-19. In this unique situation where a biomedical issue dominates people's lives and the news cycle, chemical biology has a great deal to contribute. This review will describe the importance of science at the chemistry/biology interface to both understand and combat the SARS-CoV-2 pandemic.}, } @article {pmid33437221, year = {2021}, author = {Illanes-Álvarez, F and Márquez-Ruiz, D and Márquez-Coello, M and Cuesta-Sancho, S and Girón-González, JA}, title = {Similarities and differences between HIV and SARS-CoV-2.}, journal = {International journal of medical sciences}, volume = {18}, number = {3}, pages = {846-851}, pmid = {33437221}, issn = {1449-1907}, mesh = {COVID-19/*epidemiology/immunology/psychology/transmission ; Cytokines/blood/immunology ; Extracellular Traps/immunology/metabolism ; Fear ; Global Burden of Disease/statistics & numerical data ; HIV Infections/*epidemiology/immunology/psychology/transmission ; HIV-1/immunology/isolation & purification/*pathogenicity ; History, 20th Century ; History, 21st Century ; Host-Pathogen Interactions/immunology ; Humans ; Inflammation Mediators/blood/immunology ; Mortality ; Neutrophils/immunology/metabolism ; Pandemics/*history/statistics & numerical data ; Prognosis ; SARS-CoV-2/immunology/isolation & purification/*pathogenicity ; }, abstract = {In the last 50 years we have experienced two big pandemics, the HIV pandemic and the pandemic caused by SARS-CoV-2. Both pandemics are caused by RNA viruses and have reached us from animals. These two viruses are different in the transmission mode and in the symptoms they generate. However, they have important similarities: the fear in the population, increase in proinflammatory cytokines that generate intestinal microbiota modifications or NETosis production by polymorphonuclear neutrophils, among others. They have been implicated in the clinical, prognostic and therapeutic attitudes.}, } @article {pmid33430881, year = {2021}, author = {Casey, P and Ang, Y and Sultan, J}, title = {COVID-19-induced sarcopenia and physical deconditioning may require reassessment of surgical risk for patients with cancer.}, journal = {World journal of surgical oncology}, volume = {19}, number = {1}, pages = {8}, pmid = {33430881}, issn = {1477-7819}, mesh = {COVID-19/*complications/physiopathology ; Humans ; Myalgia/etiology ; Neoplasms/*surgery ; *Physical Functional Performance ; *SARS-CoV-2 ; Sarcopenia/*etiology ; Surgical Procedures, Operative/adverse effects ; }, abstract = {BACKGROUND: The long-term physiological consequences of SARS-CoV-2 (severe acute respiratory syndrome coronavirus) infection are not known. The ability of COVID-19 to cause chronic illness, sarcopenia, and physical deconditioning may be underestimated and go beyond the anticipated respiratory sequelae. Myalgia, lethargy, and anorexia are common symptoms even in mild to moderate cases and have the potential to exacerbate frailty. How this impacts on risk-stratification for patients requiring surgery for time-critical conditions, such as malignancy, requires further urgent investigation.

MAIN BODY: The deleterious effect of sarcopenia and poor physical capacity are well recognised in cancer surgery. This review commentary highlights current evidence which suggests skeletal muscle as an under recognised cause of COVID-19-related functional deconditioning. The mechanisms behind this are via direct (viral induced myositis, nutritional decline, cytokine-mediated myopathy) and indirect mechanisms (social isolation, inactivity, and psychological consequences).

CONCLUSION: Further mechanistic research is required to explore the processes behind the deconditioning effects of SARS-CoV-2 infection and how this impacts on treatment of malignant disease.}, } @article {pmid33429407, year = {2020}, author = {}, title = {Timing of remdesivir for COVID-19.}, journal = {The Medical letter on drugs and therapeutics}, volume = {62}, number = {1609}, pages = {161}, pmid = {33429407}, issn = {1523-2859}, mesh = {Adenosine Monophosphate/administration & dosage/*analogs & derivatives ; Administration, Intravenous ; Alanine/administration & dosage/*analogs & derivatives ; Antiviral Agents/*administration & dosage ; COVID-19/diagnosis/*drug therapy ; Clinical Trials as Topic/methods ; Hospitalization/trends ; Humans ; Recovery of Function/*drug effects/physiology ; Time Factors ; }, } @article {pmid33414261, year = {2021}, author = {Wu, F and Burt, J and Chowdhury, T and Fitzpatrick, R and Martin, G and van der Scheer, JW and Hurst, JR}, title = {Specialty COPD care during COVID-19: patient and clinician perspectives on remote delivery.}, journal = {BMJ open respiratory research}, volume = {8}, number = {1}, pages = {}, pmid = {33414261}, issn = {2052-4439}, mesh = {Adult ; Aged ; *Attitude of Health Personnel ; Attitude to Health ; COVID-19 ; Delivery of Health Care/methods ; Female ; Humans ; Male ; Middle Aged ; Nurses ; Patient Acceptance of Health Care ; *Patient Education as Topic ; Physical Therapists ; Physicians ; Practice Patterns, Nurses' ; *Practice Patterns, Physicians' ; Pulmonary Disease, Chronic Obstructive/physiopathology/*therapy ; SARS-CoV-2 ; *Self-Management ; Severity of Illness Index ; *Smoking Cessation ; Surveys and Questionnaires ; Telemedicine/*methods ; United Kingdom ; }, abstract = {INTRODUCTION: The COVID-19 pandemic has impacted specialty chronic obstructive pulmonary disease (COPD) care. We examined the degree to which care has moved to remote approaches, eliciting clinician and patient perspectives on what is appropriate for ongoing remote delivery.

METHODS: Using an online research platform, we conducted a survey and consensus-building process involving clinicians and patients with COPD.

RESULTS: Fifty-five clinicians and 19 patients responded. The majority of clinicians felt able to assess symptom severity (n=52, 95%), reinforce smoking cessation (n=46, 84%) and signpost to other healthcare resources (n=44, 80%). Patients reported that assessing COPD severity and starting new medications were being addressed through remote care. Forty-three and 31 respondents participated in the first and second consensus-building rounds, respectively. When asked to rate the appropriateness of using remote delivery for specific care activities, respondents reached consensus on 5 of 14 items: collecting information about COPD and overall health status (77%), providing COPD education and developing a self-management plan (74%), reinforcing smoking cessation (81%), deciding whether patients should seek in-person care (72%) and initiating a rescue pack (76%).

CONCLUSION: Adoption of remote care delivery appears high, with many care activities partially or completely delivered remotely. Our work identifies strengths and limitations of remote care delivery.}, } @article {pmid33412795, year = {2020}, author = {Caristia, S and Ferranti, M and Skrami, E and Raffetti, E and Pierannunzio, D and Palladino, R and Carle, F and Saracci, R and Badaloni, C and Barone-Adesi, F and Belleudi, V and Ancona, C and , }, title = {Effect of national and local lockdowns on the control of COVID-19 pandemic: a rapid review.}, journal = {Epidemiologia e prevenzione}, volume = {44}, number = {5-6 Suppl 2}, pages = {60-68}, doi = {10.19191/EP20.5-6.S2.104}, pmid = {33412795}, issn = {1120-9763}, mesh = {Americas/epidemiology ; Australia/epidemiology ; COVID-19/epidemiology/*prevention & control/transmission ; China/epidemiology ; Communicable Disease Control/*methods/statistics & numerical data ; Europe/epidemiology ; Forecasting ; Health Policy ; Humans ; Iran/epidemiology ; Italy/epidemiology ; Pandemics/*prevention & control ; *Physical Distancing ; Program Evaluation ; *Quarantine/statistics & numerical data ; *SARS-CoV-2 ; }, abstract = {OBJECTIVES: to describe and compare the effectiveness of national and local lockdowns in controlling the spread of COVID-19.

METHODS: a rapid review of published and grey literature on COVID-19 pandemic was conducted following predefined eligibility criteria by searching electronic databases, repositories of pre-print articles, websites and databases of international health, and research related institutions and organisations.

RESULTS: of 584 initially identified records up to 5 July 2020, 19 articles met the inclusion criteria and were included in the review. Most of the studies (No. 11) used the reproduction number (Rt) as a measure of effect and in all of them areduction of the estimated value at post-intervention period was found. The implementation of lockdown in 11 European countries was associated with an average 82% reduction of Rt, ranging from a posterior Rt of 0.44 (95%CI 0.26-0.61) for Norway to a posterior Rt of 0.82 (95%CI 0.73- 0.93) for Belgium. Changes in infection rates and transmission rates were estimated in 8 studies. Daily changes in infection rates ranged from -0.6% (Sweden) to -11.3% (Hubei and Guangdong provinces). Additionally, other studies reported a change in the trend of hospitalizations (Italy, Spain) and positive effects on the doubling time of cases (Hubei, China) after lockdown.

CONCLUSIONS: results of this rapid review suggest a positive effect of the containment measures on the spread of COVID-19 pandemic, with a major effect in countries where lockdown started early and was more restrictive. Rigorous research is warranted to evaluate which approach is the most effective in each stage of the epidemic and in specific social contexts, in particular addressing if these approaches should be implemented on the whole population or target specific risk groups.}, } @article {pmid33412794, year = {2020}, author = {Ciccone, G and Deandrea, S and Clavenna, A and Kirchmayer, U and Simeon, V and Acampora, A and Agabiti, N and Angelici, L and Banzi, R and Cadum, E and Castiglione, A and Chiodini, P and Colombo, C and Ferroni, E and Migliore, E and Nisticò, L and Pagano, E and Sabelli, AM and Sacerdote, C and Silvestri, C and Soldati, S and Stranges, S and Tirani, M and Davoli, M and Galassi, C and Forastiere, F}, title = {[Covid-19 and clinical-epidemiological research in Italy: proposal of a research agenda on priority topics by the Italian association of epidemiology].}, journal = {Epidemiologia e prevenzione}, volume = {44}, number = {5-6 Suppl 2}, pages = {51-59}, doi = {10.19191/EP20.5-6.S2.103}, pmid = {33412794}, issn = {1120-9763}, mesh = {Adult ; Aged ; COVID-19/drug therapy/*epidemiology/therapy ; Child ; *Epidemiologic Research Design ; Epidemiology/organization & administration ; Female ; Humans ; Italy/epidemiology ; Male ; Middle Aged ; *Pandemics ; Pregnancy ; Pregnancy Complications, Infectious/epidemiology ; Prognosis ; *Research ; *SARS-CoV-2 ; Societies, Scientific ; Therapeutic Equipoise ; }, abstract = {BACKGROUND: the Covid-19 pandemic has provoked a huge of clinical and epidemiological research initiatives, especially in the most involved countries. However, this very large effort was characterized by several methodological weaknesses, both in the field of discovering effective treatments (with too many small and uncontrolled trials) and in the field of identifying preventable risks and prognostic factors (with too few large, representative and well-designed cohorts or case-control studies).

OBJECTIVES: in response to the fragmented and uncoordinated research production on Covid-19, the italian Association of Epidemiology (AIE) stimulated the formation of a working group (WG) with the aims of identifying the most important gaps in knowledge and to propose a structured research agenda of clinical and epidemiological studies considered at high priority on Covid-19, including recommendations on the preferable methodology.

METHODS: the WG was composed by 25 subjects, mainly epidemiologists, statisticians, and other experts in specific fields, who have voluntarily agreed to the proposal. The agreement on a list of main research questions and on the structure of the specific documents to be produced were defined through few meetings and cycles of document exchanges.

RESULTS: twelve main research questions on Covid-19 were identified, covering aetiology, prognosis, interventions, follow-up and impact on general and specific populations (children, pregnant women). For each of them, a two-page form was developed, structured in: background, main topics, methods (with recommendations on preferred study design and warnings for bias prevention) and an essential bibliography.

CONCLUSIONS: this research agenda represents an initial contribution to direct clinical and epidemiological research efforts on high priority topics with a focus on methodological aspects. Further development and refinements of this agenda by Public Health Authorities are encouraged.}, } @article {pmid33403962, year = {2020}, author = {Mustafa, F and Giles, R and Pepper, MS}, title = {Rapid evolution of our understanding of the pathogenesis of COVID-19: Implications for therapy.}, journal = {South African medical journal = Suid-Afrikaanse tydskrif vir geneeskunde}, volume = {110}, number = {12}, pages = {1180-1185}, doi = {10.7196/SAMJ.2020.v110i12.15328}, pmid = {33403962}, issn = {2078-5135}, mesh = {Adrenal Cortex Hormones/therapeutic use ; Age Factors ; Anti-Inflammatory Agents/therapeutic use ; Anticoagulants/therapeutic use ; Antiviral Agents/therapeutic use ; COVID-19/blood/drug therapy/*immunology/physiopathology/therapy ; Cytokine Release Syndrome/blood/drug therapy/*immunology ; HLA Antigens/genetics ; Humans ; Immunization, Passive ; Inflammation/blood/drug therapy/*immunology ; NAD ; Oxidative Stress ; Respiratory Distress Syndrome/drug therapy/immunology/physiopathology ; SARS-CoV-2 ; Severity of Illness Index ; Systemic Inflammatory Response Syndrome/blood/immunology/physiopathology/therapy ; Thrombophilia/*blood/drug therapy/physiopathology ; Vitamins/therapeutic use ; }, abstract = {COVID-19 severity appears to lie in its propensity to cause a hyperinflammatory response, attributed to the cytokine release syndrome (CRS) or 'cytokine storm', although the exact role of the CRS remains to be fully elucidated. Hyperinflammation triggers a hypercoagulable state, also thought to play a key role in COVID-19 pathogenesis. Disease severity is linked to age, sex and comorbid conditions, which in turn may be linked to oxidative stress and pre-existing depletion of nicotinamide adenine dinucleotide (NAD+). There is increasing evidence that the host genome may determine disease outcome. Since most information pertaining to COVID-19 has thus far been extrapolated from the 'global North', similar studies in African populations are warranted. Many studies are aimed at finding a therapeutic strategy based on scientific rationale. Some promising results have emerged, e.g. the use of corticosteroids in severe acute respiratory distress syndrome (ARDS).}, } @article {pmid33382450, year = {2020}, author = {Eberli, FR and Kurz, D}, title = {Cardiovascular aspects of COVID-19.}, journal = {Swiss medical weekly}, volume = {150}, number = {}, pages = {w20417}, doi = {10.4414/smw.2020.20417}, pmid = {33382450}, issn = {1424-3997}, mesh = {Age Factors ; Angiotensin-Converting Enzyme 2/metabolism ; Angiotensin-Converting Enzyme Inhibitors ; Biomarkers ; COVID-19/drug therapy/*epidemiology/*physiopathology ; Cardiovascular Diseases/*epidemiology/*physiopathology ; Comorbidity ; Humans ; Inflammation/physiopathology ; Inflammation Mediators/metabolism ; Myocardial Infarction/physiopathology ; Myocardium/pathology ; Renin-Angiotensin System/physiology ; Sex Factors ; Systemic Inflammatory Response Syndrome/physiopathology ; }, abstract = {Coronavirus disease 2019 (COVID-19) is primarily a pulmonary disease, but also affects the cardiovascular system in multiple ways. In this review, we will summarise and put into perspective findings and debates relating to the diverse aspects of cardiovascular involvement of COVID-19. We will review evidence for the role of the renin-angiotensin-aldosterone system (RAAS), the risk of pre-existing cardiovascular disease in COVID-19 susceptibility and course, and the mechanism of acute and long-term myocardial injury. The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) uses membrane-bound angiotensin converting-enzyme-2 (ACE2) as a receptor for cell entry. ACE2 is part of an important counter-regulatory circuit antagonising the harmful effects of angiotensin II on lung and heart. Modulation of ACE2 may therefore affect disease susceptibility and disease course. However, observational clinical studies and one randomised trial have so far not yielded evidence for harmful or beneficial effects of blockers of the RAAS during COVID-19. Age, gender, and multi-morbidity all increase susceptibility to SARS-CoV-2. In contrast, pre-existing cardiovascular diseases do so only minimally, but they may aggravate the disease course. Direct SARS-CoV-2 infection of the heart tissue and myocytes is rare. Nevertheless, COVID-19 may lead to myocarditis-like acute cardiac injury, characterised by myocardial oedema, but lacking extensive myocyte loss and lymphocytic infiltration. Independent of this, increases in cardiac biomarkers (troponin, N-terminal pro-brain natriuretic peptide, D-dimer) are frequent, especially in the phase of severe systemic inflammation and acute respiratory distress syndrome, and quantitatively associated with poor outcome. The pulmonary infection may result initially in right ventricular dysfunction, but in cases with severe systemic infection hypoxia, hyperinflammation and cytokine storm heart failure may eventually ensue. Unlike other infections and inflammatory states, COVID-19 does not appear to trigger acute coronary syndromes. In children, even mild COVID-19 can induce a multisystem inflammatory syndrome with Kawasaki-like symptoms frequently accompanied by cardiogenic shock.}, } @article {pmid33371667, year = {2021}, author = {Pandey, A and Nikam, AN and Mutalik, SP and Fernandes, G and Shreya, AB and Padya, BS and Raychaudhuri, R and Kulkarni, S and Prassl, R and Subramanian, S and Korde, A and Mutalik, S}, title = {Architectured Therapeutic and Diagnostic Nanoplatforms for Combating SARS-CoV-2: Role of Inorganic, Organic, and Radioactive Materials.}, journal = {ACS biomaterials science & engineering}, volume = {7}, number = {1}, pages = {31-54}, pmid = {33371667}, issn = {2373-9878}, mesh = {Animals ; Antiviral Agents/*therapeutic use ; COVID-19/*diagnosis/*drug therapy/radiotherapy/therapy ; COVID-19 Vaccines/therapeutic use ; Disinfectants/pharmacology ; Humans ; Metal Nanoparticles/*therapeutic use ; Radiopharmaceuticals/therapeutic use ; Respiratory Protective Devices ; SARS-CoV-2/*drug effects/immunology ; }, abstract = {Although extensive research is being done to combat SARS-CoV-2, we are yet far away from a robust conclusion or strategy. With an increased amount of vaccine research, nanotechnology has found its way into vaccine technology. Researchers have explored the use of various nanostructures for delivering the vaccines for enhanced efficacy. Apart from acting as delivery platforms, multiple studies have shown the application of inorganic nanoparticles in suppressing the growth as well as transmission of the virus. The present review gives a detailed description of various inorganic nanomaterials which are being explored for combating SARS-CoV-2 along with their role in suppressing the transmission of the virus either through air or by contact with inanimate surfaces. The review further discusses the use of nanoparticles for development of an antiviral coating that may decrease adhesion of SARS-CoV-2. A separate section has been included describing the role of nanostructures in biosensing and diagnosis of SARS-CoV-2. The role of nanotechnology in providing an alternative therapeutic platform along with the role of radionuclides in SARS-CoV-2 has been described briefly. Based on ongoing research and commercialization of this nanoplatform for a viral disease, the nanomaterials show the potential in therapy, biosensing, and diagnosis of SARS-CoV-2.}, } @article {pmid33347311, year = {2021}, author = {Zhang, Y and Tang, LV}, title = {Overview of Targets and Potential Drugs of SARS-CoV-2 According to the Viral Replication.}, journal = {Journal of proteome research}, volume = {20}, number = {1}, pages = {49-59}, pmid = {33347311}, issn = {1535-3907}, mesh = {Angiotensin-Converting Enzyme 2/metabolism ; Animals ; Antiviral Agents/chemistry/*pharmacology ; Basigin/metabolism ; Coronavirus 3C Proteases/antagonists & inhibitors/metabolism ; Coronavirus Nucleocapsid Proteins/chemistry/metabolism ; Coronavirus RNA-Dependent RNA Polymerase/metabolism ; Dipeptidyl Peptidase 4/metabolism ; Furin/antagonists & inhibitors/metabolism ; Host-Pathogen Interactions/drug effects ; Humans ; SARS-CoV-2/*drug effects/pathogenicity/physiology ; Serine Endopeptidases/metabolism ; Small Molecule Libraries/pharmacology ; Spike Glycoprotein, Coronavirus/chemistry/metabolism ; Virus Replication/*drug effects ; }, abstract = {Since the novel coronavirus pandemic, people around the world have been touched in varying degrees, and this pandemic has raised a major global health concern. As there is no effective drug or vaccine, it is urgent to find therapeutic drugs that can serve to deal with the current epidemic situation in all countries and regions. We searched drugs and response measures for SARS-CoV-2 in the PubMed database, and then updated the potential targets and therapeutic drugs from the perspective of the viral replication cycle. The drug research studies of the viral replication cycle are predominantly focused on the process of the virus entering cells, proteases, and RdRp. The inhibitors of the virus entry to cells and RdRp, such as Arbidol, remdesivir, favipiravir, EIDD-2081, and ribavirin, are in clinical trials, while most of the protease inhibitors are mainly calculated by molecular docking technology, which needs in vivo and in vitro experiments to prove the effect for SARS-CoV-2. This review summarizes the drugs targeting the viral replication process and provides a basis and directions for future drug development and reuse on the protein level of COVID-19.}, } @article {pmid33301685, year = {2021}, author = {Chakravarty, S}, title = {COVID-19: The Effect of Host Genetic Variations on Host-Virus Interactions.}, journal = {Journal of proteome research}, volume = {20}, number = {1}, pages = {139-153}, pmid = {33301685}, issn = {1535-3907}, support = {R15 GM116040/GM/NIGMS NIH HHS/United States ; R15 GM134502/GM/NIGMS NIH HHS/United States ; }, mesh = {Angiotensin-Converting Enzyme 2/chemistry/genetics/metabolism ; COVID-19/*genetics/immunology ; *Genetic Variation ; Host-Pathogen Interactions/*genetics ; Humans ; Immunity, Innate/genetics ; Quantitative Trait Loci ; RNA, Viral/metabolism ; SARS-CoV-2/*pathogenicity ; Toll-Like Receptor 3/genetics ; Toll-Like Receptor 7/genetics ; Virus Internalization ; }, abstract = {Spurred into action by the COVID-19 pandemic, the global scientific community has, in a short of period of time, made astonishing progress in understanding and combating COVID-19. Given the known human protein machinery for (a) SARS-CoV-2 entry, (b) the host innate immune response, and (c) virus-host interactions (protein-protein and RNA-protein), the potential effects of human genetic variation in this machinery, which may contribute to clinical differences in SARS-CoV-2 pathogenesis and help determine individual risk for COVID-19 infection, are explored. The Genome Aggregation Database (gnomAD) was used to show that several rare germline exome variants of proteins in these pathways occur in the human population, suggesting that carriers of these rare variants (especially for proteins of innate immunity pathways) are at risk for severe symptoms (like the severe symptoms in patients who are known to be rare variant carriers), whereas carriers of other variants could have a protective advantage against infection. The occurrence of genetic variation is thus expected to motivate the experimental probing of natural variants to understand the mechanistic differences in SARS-CoV-2 pathogenesis from one individual to another.}, } @article {pmid33295289, year = {2020}, author = {Dang, A and Vallish, BN and Dang, S}, title = {Hydroxychloroquine and Remdesivir in COVID-19: A critical analysis of recent events.}, journal = {Indian journal of medical ethics}, volume = {V}, number = {3}, pages = {202-207}, doi = {10.20529/IJME.2020.068}, pmid = {33295289}, issn = {0975-5691}, mesh = {Adenosine Monophosphate/adverse effects/*analogs & derivatives/therapeutic use ; Alanine/adverse effects/*analogs & derivatives/therapeutic use ; Antimalarials/adverse effects/therapeutic use ; Antiviral Agents/adverse effects/therapeutic use ; COVID-19/*drug therapy/virology ; *Emergencies ; *Ethics ; Humans ; Hydroxychloroquine/adverse effects/*therapeutic use ; Off-Label Use ; Pandemics ; Patient Safety ; SARS-CoV-2 ; Treatment Outcome ; }, abstract = {The world is going through an unprecedented medical emergency with no effective remedy for the SARS-CoV2 virus causing Covid-19. Two drugs used for other indications in the past, hydroxychloroquine (HCQ) and remdesivir (RDV), are sought to be repurposed to treat Covid-19. Both these drugs have received emergency use authorisation by the US Food and Drug Administration. In this review, we critically analyse the identification of and subsequent events concerning these two drugs as potential treatment options for Covid-19, and conclude by raising some ethical issues that require serious thought from the global scientific community concerned with using these two drugs against Covid-19. Key Words: Covid-19, hydroxychloroquine, remdesivir, USFDA, emergency use authorisation.}, } @article {pmid33284046, year = {2020}, author = {Broad, JD and Luthans, F}, title = {Positive resources for psychiatry in the fourth industrial revolution: building patient and family focused psychological capital (PsyCap).}, journal = {International review of psychiatry (Abingdon, England)}, volume = {32}, number = {7-8}, pages = {542-554}, doi = {10.1080/09540261.2020.1796600}, pmid = {33284046}, issn = {1369-1627}, mesh = {*COVID-19 ; *Hope ; Humans ; *Optimism ; *Psychiatry/methods ; *Psychology, Positive ; *Resilience, Psychological ; }, abstract = {COVID-19 is altering the world, impacting every facet of life, and driving an associated global paradigm shift. Threats to our individual, family, team, community, and global well-being consume our attention at the potential price of our well-being and performance. The time to respond with scientific approaches to protect our most precious assets - people - is now. COVID-19, unstable geopolitical systems, and accelerated scientific and technological breakthroughs are characteristic of what has been identified as a Fourth Industrial Revolution (4IR). This 4IR is placing a premium on solutions that are validated to increase well-being, especially those that simultaneously significantly increase performance. Psychological Capital or simply PsyCap has emerged as a leading evidence-based positive approach to human development, drawing from previously largely untapped psychological resources (Hope, Efficacy, Resilience and Optimism or the HERO within). Although there is an extensive, growing body of PsyCap academic research in all levels of analysis and domains, there is still a void in PsyCap's applications within psychiatry. The purpose of this article is to review PsyCap applications and its implications for the practice of psychiatry, especially within the context of 4IR and the second wave of Positive Psychology (PP 2.0). Specific attention is given to evidence-based, non-stigma applications for the effective practice of psychiatry.}, } @article {pmid33279984, year = {2021}, author = {Apple, FS and Fantz, CR and Collinson, PO and , }, title = {Implementation of High-Sensitivity and Point-of-Care Cardiac Troponin Assays into Practice: Some Different Thoughts.}, journal = {Clinical chemistry}, volume = {67}, number = {1}, pages = {70-78}, doi = {10.1093/clinchem/hvaa264}, pmid = {33279984}, issn = {1530-8561}, mesh = {Biomarkers/blood ; COVID-19/epidemiology/virology ; *Clinical Chemistry Tests ; Humans ; Limit of Detection ; Myocardial Infarction/blood/*diagnosis ; *Point-of-Care Systems ; SARS-CoV-2/isolation & purification ; Troponin I/*blood ; Troponin T/*blood ; }, abstract = {BACKGROUND: The primary role of the International Federation of Clinical Chemistry (IFCC) Committee on Clinical Application of Cardiac Bio-Markers (C-CB) is to provide educational materials about cardiac biomarker use, emphasizing high-sensitivity cardiac troponin assays.

CONTENT: This mini-review, regarding high-sensitivity cardiac and point-of-care troponin assays, addresses 1) new IFCC C-CB/AACC Academy laboratory practice recommendations; 2) new and updated concepts from the Fourth Universal Definition of Myocardial Infarction; 3) the role of point-of-care assays in practice and research; 4) regulatory challenges concerning point-of-care assays; e) testing in the COVID-19 world.

SUMMARY: Implementation of high-sensitivity cardiac troponin assays makes a difference now and into the future in clinical practice and research. Providing point-of-care high-sensitivity cardiac troponin assays and optimizing studies to allow clearance of these assays by regulatory agencies, in a timely fashion, may provide improved patient management and outcomes.}, } @article {pmid33252073, year = {2021}, author = {Radhakrishnan, NS and Mufti, M and Ortiz, D and Maye, ST and Melara, J and Lim, D and Rosenberg, EI and Price, CC}, title = {Implementing Delirium Prevention in the Era of COVID-19.}, journal = {Journal of Alzheimer's disease : JAD}, volume = {79}, number = {1}, pages = {31-36}, doi = {10.3233/JAD-200696}, pmid = {33252073}, issn = {1875-8908}, support = {K07 AG066813/AG/NIA NIH HHS/United States ; UL1 TR001427/TR/NCATS NIH HHS/United States ; }, mesh = {Aged ; Alzheimer Disease/*diagnosis/psychology/*therapy ; COVID-19/epidemiology/*prevention & control/psychology ; Delirium/epidemiology/*prevention & control/psychology ; Humans ; Male ; }, abstract = {Patients admitted with COVID-19 can develop delirium due to predisposing factors, isolation, and the illness itself. Standard delirium prevention methods focus on interaction and stimulation. It can be challenging to deliver these methods of care in COVID settings where it is necessary to increase patient isolation. This paper presents a typical clinical vignette of representative patients in a tertiary care hospital and how a medical team modified an evidence-based delirium prevention model to deliver high-quality care to COVID-19 patients. The implemented model focuses on four areas of delirium-prevention: Mobility, Sleep, Cognitive Stimulation, and Nutrition. Future studies will be needed to track quantitative outcome measures.}, } @article {pmid33248018, year = {2021}, author = {Donath, MY}, title = {Glucose or Insulin, Which Is the Culprit in Patients with COVID-19 and Diabetes?.}, journal = {Cell metabolism}, volume = {33}, number = {1}, pages = {2-4}, pmid = {33248018}, issn = {1932-7420}, mesh = {COVID-19/complications/drug therapy/*metabolism ; Diabetes Mellitus, Type 2/complications/drug therapy/*metabolism ; Female ; Glucose/*metabolism ; Humans ; Inflammation/complications/drug therapy/metabolism ; Insulins/adverse effects/*metabolism/therapeutic use ; Male ; SARS-CoV-2/*metabolism ; }, abstract = {Patients with a metabolic syndrome (overweight, diabetes, hypertension, and dyslipidemia) have a particularly bad outcome if infected with SARS-CoV-2. Yu et al. (2020) suggest that insulin therapy itself may promote fatality in patients with COVID-19 and diabetes.}, } @article {pmid33247907, year = {2021}, author = {Lieberman, JA and Cannon, CA and Bourassa, LA}, title = {Laboratory Perspective on Racial Disparities in Sexually Transmitted Infections.}, journal = {The journal of applied laboratory medicine}, volume = {6}, number = {1}, pages = {264-273}, doi = {10.1093/jalm/jfaa163}, pmid = {33247907}, issn = {2576-9456}, support = {T32 AI007140/AI/NIAID NIH HHS/United States ; }, mesh = {COVID-19/economics/epidemiology/prevention & control ; COVID-19 Testing/economics/statistics & numerical data ; Continental Population Groups/statistics & numerical data ; Cost of Illness ; Ethnic Groups/statistics & numerical data ; Health Care Rationing/trends ; Health Services Accessibility/economics/*statistics & numerical data ; *Health Status Disparities ; Healthcare Disparities/economics/*statistics & numerical data ; Humans ; Incidence ; Laboratories/economics/*statistics & numerical data/trends ; Minority Groups/statistics & numerical data ; Pandemics/economics/prevention & control ; Sexually Transmitted Diseases/*diagnosis/epidemiology ; Social Determinants of Health/economics/statistics & numerical data ; United States/epidemiology ; }, abstract = {BACKGROUND: Rates of sexually transmitted infections (STI) have risen steadily in recent years, and racial and ethnic minorities have borne the disproportionate burden of STI increases in the United States. Historical inequities and social determinants of health are significant contributors to observed disparities and affect access to diagnostic testing for STI.

CONTENT: Public health systems rely heavily on laboratory medicine professionals for diagnosis and reporting of STI. Therefore, it is imperative that clinicians and laboratory professionals be familiar with issues underlying disparities in STI incidence and barriers to reliable diagnostic testing. In this mini-review, we will summarize contributors to racial/ethnic disparity in STI, highlight current epidemiologic trends for gonorrhea, chlamydia, and syphilis, discuss policy issues that affect laboratory and public health funding, and identify specific analytic challenges for diagnostic laboratories.

SUMMARY: Racial and ethnic disparities in STI in the US are striking and are due to complex interactions of myriad social determinants of health. Budgetary cuts for laboratory and public health services and competition for resources during the COVID-19 pandemic are major challenges. Laboratory professionals must be aware of these underlying issues and work to maximize efforts to ensure equitable access to diagnostic STI testing for all persons, particularly those most disproportionately burdened by STI.}, } @article {pmid33243857, year = {2020}, author = {Brini, E and Simmerling, C and Dill, K}, title = {Protein storytelling through physics.}, journal = {Science (New York, N.Y.)}, volume = {370}, number = {6520}, pages = {}, doi = {10.1126/science.aaz3041}, pmid = {33243857}, issn = {1095-9203}, support = {R01 GM107104/GM/NIGMS NIH HHS/United States ; R01 GM125813/GM/NIGMS NIH HHS/United States ; RM1 GM135136/GM/NIGMS NIH HHS/United States ; }, mesh = {Angiotensin-Converting Enzyme 2 ; COVID-19 ; *Computer Simulation ; Humans ; *Models, Molecular ; Protein Domains ; *Proteins ; Spike Glycoprotein, Coronavirus ; }, abstract = {Every protein has a story-how it folds, what it binds, its biological actions, and how it misbehaves in aging or disease. Stories are often inferred from a protein's shape (i.e., its structure). But increasingly, stories are told using computational molecular physics (CMP). CMP is rooted in the principled physics of driving forces and reveals granular detail of conformational populations in space and time. Recent advances are accessing longer time scales, larger actions, and blind testing, enabling more of biology's stories to be told in the language of atomistic physics.}, } @article {pmid33205536, year = {2021}, author = {Bleier, B and Workman, A and Burks, C and Maxfield, A and Stack, BC and Nathan, CA and McCammon, S and Varvares, M and Schmalbach, C and Wang, S and Califano, J and Shnayder, Y and Gillespie, MB and Enepekides, D and Witterick, I and El-Sayed, I and Lin, D and Patel, U and Kraus, D and Randolph, G}, title = {AHNS endocrine surgery section consensus statement on nasopharyngolaryngoscopy and clinic reopening during COVID-19: How to get back to optimal safe care.}, journal = {Head & neck}, volume = {43}, number = {2}, pages = {733-738}, doi = {10.1002/hed.26525}, pmid = {33205536}, issn = {1097-0347}, mesh = {COVID-19/diagnosis/*prevention & control/transmission ; COVID-19 Testing/standards ; Disease Transmission, Infectious/*prevention & control ; Endocrinology/standards ; Humans ; Mass Screening/standards ; Nasal Surgical Procedures/standards ; Otolaryngology/*standards ; Personal Protective Equipment ; Risk ; SARS-CoV-2 ; }, abstract = {This article provides best practice guidelines regarding nasopharyngolaryngoscopy and OHNS clinic reopening during the COVID-19 pandemic. The aim is to provide evidence-based recommendations defining the risks of COVID-19 in clinic, the importance of pre-visit screening in addition to testing, along with ways to adhere to CDC guidelines for environmental, source, and engineering controls.}, } @article {pmid33185145, year = {2020}, author = {Gentles, AD and Guth, S and Rozins, C and Brook, CE}, title = {A review of mechanistic models of viral dynamics in bat reservoirs for zoonotic disease.}, journal = {Pathogens and global health}, volume = {114}, number = {8}, pages = {407-425}, pmid = {33185145}, issn = {2047-7732}, mesh = {Animals ; COVID-19/transmission/*virology ; Chiroptera/*virology ; Disease Reservoirs/*virology ; Humans ; SARS-CoV-2/genetics/isolation & purification/*physiology ; Zoonoses/transmission/*virology ; }, abstract = {The emergence of SARS-CoV-2, a coronavirus with suspected bat origins, highlights a critical need for heightened understanding of the mechanisms by which bats maintain potentially zoonotic viruses at the population level and transmit these pathogens across species. We review mechanistic models, which test hypotheses of the transmission dynamics that underpin viral maintenance in bat systems. A search of the literature identified only twenty-five mechanistic models of bat-virus systems published to date, derived from twenty-three original studies. Most models focused on rabies and related lyssaviruses (eleven), followed by Ebola-like filoviruses (seven), Hendra and Nipah-like henipaviruses (five), and coronaviruses (two). The vast majority of studies has modelled bat virus transmission dynamics at the population level, though a few nested within-host models of viral pathogenesis in population-level frameworks, and one study focused on purely within-host dynamics. Population-level studies described bat virus systems from every continent but Antarctica, though most were concentrated in North America and Africa; indeed, only one simulation model with no associated data was derived from an Asian bat-virus system. In fact, of the twenty-five models identified, only ten population-level models were fitted to data - emphasizing an overall dearth of empirically derived epidemiological inference in bat virus systems. Within the data fitted subset, the vast majority of models were fitted to serological data only, highlighting extensive uncertainty in our understanding of the transmission status of a wild bat. Here, we discuss similarities and differences in the approach and findings of previously published bat virus models and make recommendations for improvement in future work.}, } @article {pmid33176395, year = {2021}, author = {Breining, P and Frølund, AL and Højen, JF and Gunst, JD and Staerke, NB and Saedder, E and Cases-Thomas, M and Little, P and Nielsen, LP and Søgaard, OS and Kjolby, M}, title = {Camostat mesylate against SARS-CoV-2 and COVID-19-Rationale, dosing and safety.}, journal = {Basic & clinical pharmacology & toxicology}, volume = {128}, number = {2}, pages = {204-212}, doi = {10.1111/bcpt.13533}, pmid = {33176395}, issn = {1742-7843}, support = {//Lundbeckfonden/ ; }, abstract = {The coronavirus responsible for COVID-19, SARS-CoV-2, utilizes a viral membrane spike protein for host cell entry. For the virus to engage in host membrane fusion, SARS-CoV-2 utilizes the human transmembrane surface protease, TMPRSS2, to cleave and activate the spike protein. Camostat mesylate, an orally available well-known serine protease inhibitor, is a potent inhibitor of TMPRSS2 and has been hypothesized as a potential antiviral drug against COVID-19. In vitro human cell and animal studies have shown that camostat mesylate inhibits virus-cell membrane fusion and hence viral replication. In mice, camostat mesylate treatment during acute infection with influenza, also dependent on TMPRSS2, leads to a reduced viral load. The decreased viral load may be associated with an improved patient outcome. Because camostat mesylate is administered as an oral drug, it may be used in outpatients as well as inpatients at all disease stages of SARS-CoV-2 infection if it is shown to be an effective antiviral agent. Clinical trials are currently ongoing to test whether this well-known drug could be repurposed and utilized to combat the current pandemic. In the following, we will review current knowledge on camostat mesylate mode of action, potential benefits as an antiviral agent and ongoing clinical trials.}, } @article {pmid33115334, year = {2021}, author = {DeKosky, ST and Kochanek, PM and Valadka, AB and Clark, RSB and Chou, SH and Au, AK and Horvat, C and Jha, RM and Mannix, R and Wisniewski, SR and Wintermark, M and Rowell, SE and Welch, RD and Lewis, L and House, S and Tanzi, RE and Smith, DR and Vittor, AY and Denslow, ND and Davis, MD and Glushakova, OY and Hayes, RL}, title = {Blood Biomarkers for Detection of Brain Injury in COVID-19 Patients.}, journal = {Journal of neurotrauma}, volume = {38}, number = {1}, pages = {1-43}, pmid = {33115334}, issn = {1557-9042}, support = {P01 HL128192/HL/NHLBI NIH HHS/United States ; K23 HD099331/HD/NICHD NIH HHS/United States ; }, mesh = {Biomarkers/blood ; Brain/*metabolism/pathology ; Brain Injuries/*blood/*diagnosis/etiology ; COVID-19/*blood/complications/*diagnosis ; Humans ; Nervous System Diseases/blood/diagnosis/etiology ; Prospective Studies ; Retrospective Studies ; }, abstract = {The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus attacks multiple organs of coronavirus disease 2019 (COVID-19) patients, including the brain. There are worldwide descriptions of neurological deficits in COVID-19 patients. Central nervous system (CNS) symptoms can be present early in the course of the disease. As many as 55% of hospitalized COVID-19 patients have been reported to have neurological disturbances three months after infection by SARS-CoV-2. The mutability of the SARS-COV-2 virus and its potential to directly affect the CNS highlight the urgency of developing technology to diagnose, manage, and treat brain injury in COVID-19 patients. The pathobiology of CNS infection by SARS-CoV-2 and the associated neurological sequelae of this infection remain poorly understood. In this review, we outline the rationale for the use of blood biomarkers (BBs) for diagnosis of brain injury in COVID-19 patients, the research needed to incorporate their use into clinical practice, and the improvements in patient management and outcomes that can result. BBs of brain injury could potentially provide tools for detection of brain injury in COVID-19 patients. Elevations of BBs have been reported in cerebrospinal fluid (CSF) and blood of COVID-19 patients. BB proteins have been analyzed in CSF to detect CNS involvement in patients with infectious diseases, including human immunodeficiency virus and tuberculous meningitis. BBs are approved by the U.S. Food and Drug Administration for diagnosis of mild versus moderate traumatic brain injury and have identified brain injury after stroke, cardiac arrest, hypoxia, and epilepsy. BBs, integrated with other diagnostic tools, could enhance understanding of viral mechanisms of brain injury, predict severity of neurological deficits, guide triage of patients and assignment to appropriate medical pathways, and assess efficacy of therapeutic interventions in COVID-19 patients.}, } @article {pmid33084879, year = {2021}, author = {Tanwar, V and Adelstein, JM and Wold, LE}, title = {Double trouble: combined cardiovascular effects of particulate matter exposure and coronavirus disease 2019.}, journal = {Cardiovascular research}, volume = {117}, number = {1}, pages = {85-95}, doi = {10.1093/cvr/cvaa293}, pmid = {33084879}, issn = {1755-3245}, support = {R01 AG057046/AG/NIA NIH HHS/United States ; R01 HL139348/HL/NHLBI NIH HHS/United States ; R01 ES019923/ES/NIEHS NIH HHS/United States ; }, mesh = {Angiotensin Receptor Antagonists/therapeutic use ; Angiotensin-Converting Enzyme 2/physiology ; Angiotensin-Converting Enzyme Inhibitors/therapeutic use ; COVID-19/*complications/mortality ; Cardiovascular Diseases/*etiology ; Humans ; Particulate Matter/*toxicity ; *SARS-CoV-2 ; Virus Internalization ; }, abstract = {The coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has rapidly grown into a pandemic. According to initial reports, the lungs were thought to be the primary target, but recent case studies have shown its reach can extend to other organs including the heart and blood vessels. The severity of cardiac complications of COVID-19 depends on multiple underlying factors, with air pollutant exposure being one of them, as reported by several recent studies. Airborne particulate matter (PM) attracts heightened attention due to its implication in various diseases, especially respiratory and cardiovascular diseases. Inhaled PM not only carries microorganisms inside the body but also elicits local and systemic inflammatory responses resulting in altering the host's immunity and increasing susceptibility to infection. Previous and recent studies have documented that PM acts as a 'carrier' for the virus and aids in spreading viral infections. This review presents the mechanisms and effects of viral entry and how pollution can potentially modulate pathophysiological processes in the heart. We aimed to concisely summarize studies examining cardiovascular outcomes in COVID-19 patients and postulate on how PM can influence these outcomes. We have also reviewed evidence on the use of renin-angiotensin system inhibitors, namely angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, in patients with COVID-19. The interplay of pollution and SARS-CoV-2 is essential to understanding the effects of accentuated cardiovascular effects of COVID-19 and deserves in-depth experimental investigations.}, } @article {pmid33079828, year = {2021}, author = {Suvorava, T and Kaesemeyer, W}, title = {Targeting the Vascular Endothelium in the Treatment of COVID-19.}, journal = {Journal of cardiovascular pharmacology}, volume = {77}, number = {1}, pages = {1-3}, doi = {10.1097/FJC.0000000000000932}, pmid = {33079828}, issn = {1533-4023}, mesh = {Angiotensin II/administration & dosage ; Angiotensin-Converting Enzyme 2/antagonists & inhibitors/metabolism ; COVID-19/drug therapy/*metabolism ; Cytokine Release Syndrome/drug therapy/*metabolism ; Drug Delivery Systems/*methods/trends ; Endothelium, Vascular/drug effects/*metabolism ; Humans ; }, abstract = {ABSTRACT: The involvement of the vascular endothelium in the complications of coronavirus disease 2019 is now recognized. Chief among these are pulmonary endotheliitis, cytokine storm, endotoxic shock, and cardiovascular collapse. This Perspectives article is focused on therapeutical strategies to reduce the risk of these complications by targeting the vascular endothelium as a part of the overall treatment of coronavirus disease 2019.}, } @article {pmid33071183, year = {2021}, author = {Tan, EK and Albanese, A and Chaudhuri, K and Lim, SY and Oey, NE and Shan Chan, CH and Wu, YC and Jeon, B and Truong, D and Poewe, W and Pal, PK and Tan, L and Opal, P and Colosimo, C and Jinnah, HA and Cardoso, F}, title = {Adapting to post-COVID19 research in Parkinson's disease: Lessons from a multinational experience.}, journal = {Parkinsonism & related disorders}, volume = {82}, number = {}, pages = {146-149}, doi = {10.1016/j.parkreldis.2020.10.009}, pmid = {33071183}, issn = {1873-5126}, mesh = {Biomedical Research/methods/*trends ; COVID-19/*epidemiology/therapy ; Humans ; *Internationality ; Parkinson Disease/*epidemiology/therapy ; }, } @article {pmid33045044, year = {2021}, author = {Kavsak, PA and Hammarsten, O and Worster, A and Smith, SW and Apple, FS}, title = {Cardiac Troponin Testing in Patients with COVID-19: A Strategy for Testing and Reporting Results.}, journal = {Clinical chemistry}, volume = {67}, number = {1}, pages = {107-113}, doi = {10.1093/clinchem/hvaa225}, pmid = {33045044}, issn = {1530-8561}, mesh = {Biomarkers/blood ; COVID-19/*blood/complications/epidemiology/virology ; Cardiovascular Diseases/blood/complications/diagnosis ; Humans ; Pandemics ; SARS-CoV-2/isolation & purification ; Sensitivity and Specificity ; Troponin/*blood ; }, abstract = {BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that emerged late in 2019 causing COVID-19 (coronavirus disease-2019) may adversely affect the cardiovascular system. Publications from Asia, Europe, and North America have identified cardiac troponin as an important prognostic indicator for patients hospitalized with COVID-19. We recognized from publications within the first 6 months of the pandemic that there has been much uncertainty on the reporting, interpretation, and pathophysiology of an increased cardiac troponin concentration in this setting.

CONTENT: The purpose of this mini-review is: a) to review the pathophysiology of SARS-CoV-2 and the cardiovascular system, b) to overview the strengths and weaknesses of selected studies evaluating cardiac troponin in patients with COVID-19, and c) to recommend testing strategies in the acute period, in the convalescence period and in long-term care for patients who have become ill with COVID-19.

SUMMARY: This review provides important educational information and identifies gaps in understanding the role of cardiac troponin and COVID-19. Future, properly designed studies will hopefully provide the much-needed evidence on the path forward in testing cardiac troponin in patients with COVID-19.}, } @article {pmid33016788, year = {2020}, author = {Wong, PTP}, title = {Existential positive psychology and integrative meaning therapy.}, journal = {International review of psychiatry (Abingdon, England)}, volume = {32}, number = {7-8}, pages = {565-578}, doi = {10.1080/09540261.2020.1814703}, pmid = {33016788}, issn = {1369-1627}, mesh = {*COVID-19 ; *Existentialism ; Humans ; *Mental Health/trends ; *Psychology, Clinical ; *Psychology, Positive ; *Psychotherapy/trends ; }, abstract = {The unprecedented changes in our society because of COVID-19 and the fourth industrial revolution (4IR) shows that our healthcare system and the medical approach to psychotherapy can no longer meet the mental health needs of society. This paper first described the negative impact of COVID-19 and 4IR on our mental health. Then, following a brief critique of the medical model, this paper proposes that the future of psychotherapy needs to be based on the more inclusive and integrative framework of existential positive psychology (PP 2.0), which emphasizes flourishing through suffering. Finally, the paper emphasizes Viktor Frankl's cure and Wong's integrative meaning therapy. It concludes that integrative meaning therapy represents the future of psychotherapy, because it is situated in the area of interactions of at least three traditions: Clinical psychology, existential psychology, and positive psychology. This integrative model is holistic, recognising humans as bio-psycho-social-spiritual beings and considers several theoretical perspectives in both diagnosis and treatment.}, } @article {pmid33010461, year = {2021}, author = {Musa, HH and Musa, TH and Musa, IH and Musa, IH and Ranciaro, A and Campbell, MC}, title = {Addressing Africa's pandemic puzzle: Perspectives on COVID-19 transmission and mortality in sub-Saharan Africa.}, journal = {International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases}, volume = {102}, number = {}, pages = {483-488}, doi = {10.1016/j.ijid.2020.09.1456}, pmid = {33010461}, issn = {1878-3511}, mesh = {Africa South of the Sahara/epidemiology ; COVID-19/epidemiology/*mortality/*transmission/virology ; Humans ; Pandemics/statistics & numerical data ; SARS-CoV-2/genetics/physiology ; }, abstract = {To date, SARS-CoV-2 (the virus that causes COVID-19) has spread to almost every region of the world, infecting millions and resulting in the deaths of hundreds of thousands of people. Although it was predicted that Africa would suffer a massive loss of life due to this pandemic, the number of COVID-19 cases has been relatively low across the continent. Researchers have speculated that several factors may be responsible for this outcome in Africa, including the extensive experience that countries have with infectious diseases and the young median age of their populations. However, it is still important for African countries to adopt aggressive and bold approaches against COVID-19, in case the nature of the pandemic changes. This short review will summarize the status of the outbreak in Africa and propose possible reasons for current trends, as well as discuss interventions aimed at preventing a rapid increase in the number of COVID-19 cases in the future.}, } @article {pmid32974640, year = {2021}, author = {Lankes, HA and Makhlouf, H}, title = {Biospecimen Collection During the COVID-19 Pandemic.}, journal = {American journal of clinical pathology}, volume = {155}, number = {1}, pages = {55-63}, pmid = {32974640}, issn = {1943-7722}, mesh = {*Biological Specimen Banks/standards ; COVID-19/epidemiology/*prevention & control/transmission ; *Clinical Laboratory Services/standards ; Global Health ; Humans ; Infection Control/*methods/standards ; Occupational Diseases/*prevention & control ; Pandemics ; Practice Guidelines as Topic ; Specimen Handling/*methods/standards ; Viral Load ; }, abstract = {OBJECTIVES: Millions of biospecimens will be collected during the coronavirus disease 2019 (COVID-19) pandemic. As learned from severe acute respiratory syndrome (SARS), proper biospecimen handling is necessary to prevent laboratory-related infections.

METHODS: Centers for Disease Control and Prevention and World Health Organization severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) interim biosafety guidelines continue to be updated. Presented here are additional considerations intended to complement the interim guidance. These considerations draw on prior SARS recommendations and recent COVID-19 reports.

RESULTS: SARS-CoV-2 viral RNA has been detected in various biospecimen types; however, studies are needed to determine whether viral load indicates viable virus. Throughout the pandemic, biospecimens will be collected for various purposes from COVID-19 known and suspected cases, as well as presymptomatic and asymptomatic individuals. Current data suggest the pandemic start may be as early as October 2019; thus, all biospecimens collected since could be considered potentially infectious.

CONCLUSIONS: All entities handling these biospecimens should do risk assessments in accordance with institutional policies and adhere to any guidance provided. The scientific community has a responsibility to safely handle and maintain all biospecimens collected during the COVID-19 pandemic. Soon, it will be imperative to convene expert working groups to address the current and long-term storage and use of these biospecimens. Ideally, worldwide guidelines will be established to protect the personnel handling these biospecimens and communities at large.}, } @article {pmid32960100, year = {2021}, author = {Doyno, C and Sobieraj, DM and Baker, WL}, title = {Toxicity of chloroquine and hydroxychloroquine following therapeutic use or overdose.}, journal = {Clinical toxicology (Philadelphia, Pa.)}, volume = {59}, number = {1}, pages = {12-23}, doi = {10.1080/15563650.2020.1817479}, pmid = {32960100}, issn = {1556-9519}, mesh = {Blood Glucose/analysis ; COVID-19/*drug therapy ; Cardiotoxicity ; Chloroquine/*toxicity ; Drug Overdose/*etiology ; Gastrointestinal Diseases/chemically induced ; Humans ; Hydroxychloroquine/*toxicity ; Psychoses, Substance-Induced/etiology ; Retinal Diseases/chemically induced ; *SARS-CoV-2 ; Skin Diseases/chemically induced ; }, abstract = {INTRODUCTION: While chloroquine, a derivative of quinine, has been used as an antimalarial for 70 years, hydroxychloroquine is now used to treat conditions such as rheumatoid arthritis and systemic lupus erythematosus. In 2020, hydroxychloroquine (and to a lesser extent chloroquine) also received attention as a possible treatment for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). During investigation for treating coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2, concerns for serious adverse events arose.

OBJECTIVE: We review the toxicity associated with hydroxychloroquine and chloroquine use both short-term and long-term and in overdose.

METHODS: Medline (via OVID) was searched from its inception through June 7 2020 using the following as either MeSH or keyword terms: ("Chloroquine/" or "Hydroxychloroquine/") AND ("Adverse Drug Event/" or "Toxicities, Drug/" or "Toxic.mp." or "Toxicity.mp." or "Overdose.mp."). We limited resultant articles to those published in English and reporting on Human subjects. This search yielded 330 articles, of which 57 were included. Articles were excluded due to lack of relevance, not reporting desired outcomes, or being duplicative in their content. Twenty-five additional articles were identified through screening references of included articles. To identify toxicities in individuals treated with hydroxychloroquine or chloroquine with COVID-19, we searched PubMed on June 10th, 2020: ("Chloroquine" or "Hydroxychloroquine") AND ("Coronavirus" or "COVID-19" or "SARS-CoV-2"). This search resulted in 638 articles. We reviewed articles for reporting of adverse events or toxicities. Most citations were excluded because they did not include original investigations or extrapolated data from subjects that did not have COVID-19; 34 citations were relevant. For the drug-interactions section, relevant classes and agents were identified through a screen of the https://www.covid19-druginteractions.org/ website. We then conducted targeted searches of PubMed up to June 7th 2020 combining "chloroquine" and "hydroxychloroquine" with terms for specific drug classes and drugs identified from the drug-interaction site as potentially relevant. We found 29 relevant articles.

TOXICITY WITH SHORT-TERM USE: Gastrointestinal: Gastrointestinal toxicities are the most common to occur following initiation of chloroquine or hydroxychloroquine. Nausea, vomiting, and diarrhea account for most reported intolerances. Glucose abnormalities: Alterations in blood glucose concentrations may occur with hydroxychloroquine but are rare with standard therapeutic use. Cardiotoxicity: Short-term use can produce conduction abnormalities. Evidence from COVID-19 treatment suggests QT/QTc prolongation is of concern, particularly when used in combination with azithromycin, although disagreement exists across studies. Dermatologic: Drug eruptions or rashes, followed by cutaneous hyperpigmentation, pruritis, Stevens-Johnson syndrome, and toxic epidermal necrolysis, may occur within days to weeks of exposure but usually resolve with the discontinuation of therapy. Neuropsychiatric: Reported symptoms include confusion, disorientation, and hallucination within 24-48 h of drug initiation. Other toxicities: Hemolysis and anemia may occur in patients with glucose-6-phosphate dehydrogenase. Chloroquine treatment of COVID-19 was associated with elevation in creatine kinase and creatine kinase-MB activities with more events in the higher-dose group.

TOXICITY WITH LONG-TERM USE: Retinopathy: Retinopathy is the major dose-limiting toxicity associated with long-term use; the risk is higher with increasing age, dose, and duration of usage. Cardiotoxicity: Long-term use has been associated with conduction abnormalities, cardiomyopathy, and valvular disorders. Neurotoxicity: Rarely myositis and muscle weakness, extremity weakness, and pseudoparkinsonism have been reported.

TOXICITY IN OVERDOSE: Symptoms in overdose manifest rapidly (minutes to hours) and cardiotoxicity such as cardiovascular shock and collapse are most prominent. Neurotoxic effects such as psychosis and seizure may also occur.

CONCLUSIONS: Hydroxychloroquine is a generally well-tolerated medication. Short-term (days to weeks) toxicity includes gastrointestinal effects and rarely glucose abnormalities, dermatologic reactions, and neuropsychiatric events. Cardiotoxicity became of increased concern with its use in COVID-19 patients. Long-term (years) toxicities include retinopathy, neuromyotoxicity, and cardiotoxicity (conduction abnormalities, cardiomyopathy). Deaths from overdoses most often result from cardiovascular collapse.}, } @article {pmid32955375, year = {2021}, author = {Deidda, S and Tora, L and Firinu, D and Del Giacco, S and Campagna, M and Meloni, F and Orrù, G and Chessa, L and Carta, MG and Melis, A and Spolverato, G and Littera, R and Perra, A and Onali, S and Zorcolo, L and Restivo, A}, title = {Gastrointestinal coronavirus disease 2019: epidemiology, clinical features, pathogenesis, prevention, and management.}, journal = {Expert review of gastroenterology & hepatology}, volume = {15}, number = {1}, pages = {41-50}, doi = {10.1080/17474124.2020.1821653}, pmid = {32955375}, issn = {1747-4132}, mesh = {Abdominal Pain/epidemiology ; Angiotensin-Converting Enzyme 2/metabolism ; COVID-19/*complications/transmission ; Diarrhea/epidemiology ; Epithelial Cells/metabolism ; Feces/chemistry ; Gastrointestinal Diseases/*epidemiology/*virology ; Gastrointestinal Tract/cytology ; Humans ; Incidence ; Nausea/epidemiology ; Prevalence ; RNA, Viral/*analysis ; SARS-CoV-2/isolation & purification/*physiology ; Spike Glycoprotein, Coronavirus/metabolism ; Virus Attachment ; Vomiting/epidemiology ; }, abstract = {INTRODUCTION: The new Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is the etiologic agent of coronavirus disease 2019. Some authors reported pieces of evidence that patients with SARS-CoV-2 infection could have direct involvement of the gastrointestinal tract, and in symptomatic cases, gastrointestinal symptoms (diarrhea, nausea/vomiting, abdominal pain) could be very common.

AREA COVERED: In this article, we reviewed current-published data of the gastrointestinal aspects involved in SARS-CoV-2 infection, including prevalence and incidence of specific symptoms, the presumptive biological mechanism of GI infection, prognosis, clinical management, and public health-related concerns on the possible risk of oral-fecal transmission.

EXPERT OPINION: Different clues point to direct virus infection and replication in mucosal cells of the gastrointestinal tract. In vitro studies showed that SARS-CoV-2 could enter into the gastrointestinal epithelial cells by the Angiotensin-Converting enzyme two membrane receptor. These findings, coupled with the identification of viral RNA found in stools of patients, clearly suggest that direct involvement of the gastrointestinal tract is very likely. This can justify most of the gastrointestinal symptoms but also suggest a risk for an oral-fecal route for transmission, additionally or alternatively to the main respiratory route.}, } @article {pmid32952005, year = {2021}, author = {Mafra, D and Cardozo, LFMF and Moraes, C and Moreira, LSG and Teixeira, KTR and Reis, DCMV and Fanton, S and Salarolli, R and Kalantar-Zadeh, K and Burrowe, JD}, title = {Coronavirus Disease 2019: Quick Diet and Nutrition Guide for Patients With Chronic Kidney Disease.}, journal = {Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation}, volume = {31}, number = {1}, pages = {39-42}, doi = {10.1053/j.jrn.2020.08.008}, pmid = {32952005}, issn = {1532-8503}, mesh = {COVID-19/*complications ; Diet/*methods ; Humans ; Renal Insufficiency, Chronic/*complications/*diet therapy ; }, abstract = {Considering the Covid-19 pandemic and that patients with CKD are included in a high-risk group, a quick nutrition guide for patients with CKD in all stages was developed, and it is available in Portuguese at https://bit.ly/2zfSjl0, in English at https://bit.ly/covid19ckd, in Spanish at https://bit.ly/guia enfermedad renal and in French at https://bit.ly/covid19maladierenale.}, } @article {pmid32951499, year = {2021}, author = {Lesley, M}, title = {Psychoanalytic Perspectives on Moral Injury in Nurses on the Frontlines of the COVID-19 Pandemic.}, journal = {Journal of the American Psychiatric Nurses Association}, volume = {27}, number = {1}, pages = {72-76}, doi = {10.1177/1078390320960535}, pmid = {32951499}, issn = {1532-5725}, mesh = {*Attitude of Health Personnel ; COVID-19/*nursing/*psychology ; Humans ; *Morals ; Nursing Staff, Hospital/*psychology ; Pandemics ; Stress, Psychological/*psychology ; }, abstract = {OBJECTIVE: To raise awareness of the potential for moral injury in nurses working on the frontlines of COVID-19 patient care and to present aspects of mental functioning that may increase the likelihood of psychological distress. Approaches that draw on psychoanalytic thinking to support frontline nurses' mental health are explained. METHOD: This article draws on recent work that is available from multiple sources, including published journal articles on moral injury, recent reports from news services highlighting the crisis state of the pandemic and effects on nurses, established literature on the structural model of the mind, and recent webinars and online lectures addressing mental health crisis interventions. The author draws on expertise from years of training in the Adult Psychoanalytic Training Program at the Michigan Psychoanalytic Institute and graduation as an academic analyst. RESULTS: How nurses navigate moral hazards inherent in the current state of frontline health care may depend on their existing ego strengths and levels of self-blame and guilt from a harsh superego. CONCLUSIONS: Mental health professionals need to be aware of the mental minefields that frontline nurses must navigate when providing care that, due to circumstances beyond their control, may be morally ambiguous. Educating nurses about the meaning of their own emotional and psychic responses amid the realities in the field may help to decrease the damaging effects of moral injury.}, } @article {pmid32921198, year = {2021}, author = {White-Dzuro, G and Gibson, LE and Zazzeron, L and White-Dzuro, C and Sullivan, Z and Diiorio, DA and Low, SA and Chang, MG and Bittner, EA}, title = {Multisystem effects of COVID-19: a concise review for practitioners.}, journal = {Postgraduate medicine}, volume = {133}, number = {1}, pages = {20-27}, doi = {10.1080/00325481.2020.1823094}, pmid = {32921198}, issn = {1941-9260}, mesh = {COVID-19/mortality/*physiopathology ; Cardiovascular Diseases/physiopathology ; Critical Illness ; Cytokines/biosynthesis ; Endocrine System Diseases/physiopathology ; Gastrointestinal Diseases/physiopathology ; Hematologic Diseases/physiopathology ; Humans ; Kidney Diseases/physiopathology ; Musculoskeletal Diseases/physiopathology ; Nervous System Diseases/physiopathology ; Obesity/physiopathology ; Organ Dysfunction Scores ; Respiratory Tract Diseases/physiopathology ; Risk Factors ; SARS-CoV-2 ; Skin Diseases/physiopathology ; Systemic Inflammatory Response Syndrome/physiopathology ; }, abstract = {While COVID-19 has primarily been characterized by the respiratory impact of viral pneumonia, it affects every organ system and carries a high consequent risk of death in critically ill patients. Higher sequential organ failure assessment (SOFA) scores have been associated with increased mortality in patients critically ill patients with COVID-19. It is important that clinicians managing critically ill COVID-19 patients be aware of the multisystem impact of the disease so that care can be focused on the prevention of end-organ injuries to potentially improve clinical outcomes. We review the multisystem complications of COVID-19 and associated treatment strategies to improve the care of critically ill COVID-19 patients.}, } @article {pmid32881628, year = {2020}, author = {Rizwan, K and Rasheed, T and Khan, SA and Bilal, M and Mahmood, T}, title = {Current perspective on diagnosis, epidemiological assessment, prevention strategies, and potential therapeutic interventions for severe acute respiratory infections caused by 2019 novel coronavirus (SARS-CoV-2).}, journal = {Human vaccines & immunotherapeutics}, volume = {16}, number = {12}, pages = {3001-3010}, doi = {10.1080/21645515.2020.1794684}, pmid = {32881628}, issn = {2164-554X}, mesh = {Animals ; Antiviral Agents/administration & dosage/*immunology ; COVID-19/genetics/*immunology/*prevention & control ; Coronavirus/drug effects/genetics/immunology ; Disease Outbreaks/prevention & control ; Humans ; Immunity, Herd/drug effects/immunology ; Immunotherapy/*methods/trends ; Quarantine/methods/trends ; Respiratory Tract Infections ; SARS-CoV-2/drug effects/genetics/*immunology ; }, abstract = {Coronaviruses are single-stranded RNA viruses that cause severe respiratory, enteric, and systemic infections in a vast range of hosts, including man, fish, mammals, and avian. Scientific interest has heightened on coronaviruses after the emergence of the 2019 novel Coronavirus (SARS-CoV-2). This review provides current perspectives on morphology, genetic diversity, transmission characteristics, replication cycle, diagnostic approaches, epidemiological assessment, and prevention strategies against the SARS-CoV-2. Moreover, different potential biotherapeutics such as small drug molecules, different vaccines, and immunotherapies to control severe acute respiratory infections caused by 2019 novel coronavirus (SARS-CoV-2) are repurposed and discussed with different mechanistic approaches. The current growth trends of the SARS-CoV-2/COVID-19 outbreak globally and preventive measures are briefly discussed. Furthermore, the lessons learned from the COVID-19 outbreak, so far, concluding remarks and future directions for controlling for COVID-19, are also recommended for a safer tomorrow.}, } @article {pmid32878546, year = {2020}, author = {O'Connell, P and Aldhamen, YA}, title = {Systemic innate and adaptive immune responses to SARS-CoV-2 as it relates to other coronaviruses.}, journal = {Human vaccines & immunotherapeutics}, volume = {16}, number = {12}, pages = {2980-2991}, doi = {10.1080/21645515.2020.1802974}, pmid = {32878546}, issn = {2164-554X}, mesh = {Adaptive Immunity/drug effects/*immunology ; Animals ; COVID-19/epidemiology/immunology/*therapy ; Coronavirus/drug effects/immunology ; Coronavirus Infections/epidemiology/*immunology/therapy ; Humans ; Immunity, Innate/drug effects/*immunology ; Immunotherapy/*methods/trends ; SARS-CoV-2/drug effects/*immunology ; Severe Acute Respiratory Syndrome/epidemiology/*immunology/therapy ; }, abstract = {The deadly pandemic caused by the novel coronavirus, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) represents one of the greatest threats humanity has faced in the last century. Infection with this easily transmissible virus can run the gamut from asymptomatic to fatal, and the disease caused by SARS-CoV-2 has been termed Coronavirus Disease 2019 (COVID-19). What little research that has already been conducted implicates pathological responses by the immune system as the leading culprit responsible for much of the morbidity and mortality caused by COVID-19. In this review we will summarize what is currently known about the systemic immune response to SARS-CoV-2 and potential immunotherapeutic approaches.}, } @article {pmid32862099, year = {2020}, author = {Singhai, K and Swami, MK and Nebhinani, N and Rastogi, A and Jude, E}, title = {Psychological adaptive difficulties and their management during COVID-19 pandemic in people with diabetes mellitus.}, journal = {Diabetes & metabolic syndrome}, volume = {14}, number = {6}, pages = {1603-1605}, pmid = {32862099}, issn = {1878-0334}, mesh = {Adaptation, Psychological/*physiology ; COVID-19/*epidemiology/*psychology ; Diabetes Mellitus/*epidemiology/*psychology/therapy ; Humans ; Pandemics ; Self-Management/*psychology/trends ; }, abstract = {BACKGROUND AND AIMS: People with diabetes have multiple psychosocial issues related to diabetes and its complications and this may be exacerbated during the COVID-19 pandemic.

METHODS: We reviewed the psychological adaptative difficulties in people with diabetes especially during natural disasters including the prevailing COVID-19 pandemic.

RESULTS: There are significant concerns regarding worsening of glycemic control, unavailability of appropriate medicines, inaccessibility to health care or acquiring SARS- CoV-2 infection and subsequent poorer outcomes during the COVID-19 pandemic. Although there are some guidance documents for managing diabetes and associated complications during COVID-19 pandemic but very few address the psychological issues in people with diabetes. We discuss the psychological adaptive difficulties and an approach to address the psychosocial concerns in people with diabetes during the COVID-19 pandemic.

CONCLUSIONS: People with diabetes have significant diabetes distress and psychological adaptive difficulties that is aggravated by the COVID-19 pandemic. An integrated multidisciplinary approach is needed to manage the prevailing psychological issues amongst people with diabetes during the COVID-19 pandemic.}, } @article {pmid32857671, year = {2021}, author = {Dzobo, K and Chiririwa, H and Dandara, C and Dzobo, W}, title = {Coronavirus Disease-2019 Treatment Strategies Targeting Interleukin-6 Signaling and Herbal Medicine.}, journal = {Omics : a journal of integrative biology}, volume = {25}, number = {1}, pages = {13-22}, doi = {10.1089/omi.2020.0122}, pmid = {32857671}, issn = {1557-8100}, mesh = {Antiviral Agents/pharmacology/*therapeutic use ; Biological Products/pharmacology/*therapeutic use ; COVID-19/complications/*drug therapy/*metabolism/virology ; Clinical Trials as Topic ; Cytokine Release Syndrome/drug therapy/etiology ; Cytokines/metabolism ; Drug Repositioning ; *Herbal Medicine/methods ; Humans ; Interleukin-6/*metabolism ; SARS-CoV-2/*drug effects ; Signal Transduction/*drug effects ; }, abstract = {Coronavirus disease-2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is evolving across the world and new treatments are urgently needed as with vaccines to prevent the illness and stem the contagion. The virus affects not only the lungs but also other tissues, thus lending support to the idea that COVID-19 is a systemic disease. The current vaccine and treatment development strategies ought to consider such systems medicine perspectives rather than a narrower focus on the lung infection only. COVID-19 is associated with elevated levels of the inflammatory cytokines such as interleukin-6 (IL-6), IL-10, and interferon-gamma (IFN-γ). Elevated levels of cytokines and the cytokine storm have been linked to fatal disease. This suggests new therapeutic strategies through blocking the cytokine storm. IL-6 is one of the major cytokines associated with the cytokine storm. IL-6 is also known to display pleiotropic/diverse pathophysiological effects. We suggest the blockage of IL-6 signaling and its downstream mediators such as Janus kinases (JAKs), and signal transducer and activators of transcription (STATs) offer potential hope for the treatment of severe cases of COVID-19. Thus, repurposing of already approved IL-6-JAK-STAT signaling inhibitors as well as other anti-inflammatory drugs, including dexamethasone, is under development for severe COVID-19 cases. We conclude this expert review by highlighting the potential role of precision herbal medicines, for example, the Cannabis sativa, provided that omics technologies can be utilized to build a robust scientific evidence base on their clinical safety and efficacy. Precision herbal medicine buttressed by omics systems science would also help identify new molecular targets for drug discovery against COVID-19.}, } @article {pmid32854169, year = {2021}, author = {Hopkins, C and Alanin, M and Philpott, C and Harries, P and Whitcroft, K and Qureishi, A and Anari, S and Ramakrishnan, Y and Sama, A and Davies, E and Stew, B and Gane, S and Carrie, S and Hathorn, I and Bhalla, R and Kelly, C and Hill, N and Boak, D and Nirmal Kumar, B}, title = {Management of new onset loss of sense of smell during the COVID-19 pandemic - BRS Consensus Guidelines.}, journal = {Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery}, volume = {46}, number = {1}, pages = {16-22}, doi = {10.1111/coa.13636}, pmid = {32854169}, issn = {1749-4486}, mesh = {COVID-19/*complications/epidemiology ; *Consensus ; *Disease Management ; Humans ; Olfaction Disorders/etiology/physiopathology/*therapy ; *Pandemics ; SARS-CoV-2 ; Smell/*physiology ; }, abstract = {OBJECTIVES: The primary aim of the study is to provide recommendations for the investigation and management of patients with new onset loss of sense of smell during the COVID-19 pandemic.

DESIGN: After undertaking a literature review, we used the RAND/UCLA methodology with a multi-step process to reach consensus about treatment options, onward referral, and imaging.

SETTING AND PARTICIPANTS: An expert panel consisting of 15 members was assembled. A literature review was undertaken prior to the study and evidence was summarised for the panellists.

MAIN OUTCOME MEASURES: The panel undertook a process of ranking and classifying appropriateness of different investigations and treatment options for new onset loss of sense of smell during the COVID-19 pandemic. Using a 9-point Likert scale, panellists scored whether a treatment was: Not recommended, optional, or recommended. Consensus was achieved when more than 70% of responses fell into the category defined by the mean.

RESULTS: Consensus was reached on the majority of statements after 2 rounds of ranking. Disagreement meant no recommendation was made regarding one treatment, using Vitamin A drops. Alpha-lipoic acid was not recommended, olfactory training was recommended for all patients with persistent loss of sense of smell of more than 2 weeks duration, and oral steroids, steroid rinses, and omega 3 supplements may be considered on an individual basis. Recommendations regarding the need for referral and investigation have been made.

CONCLUSION: This study identified the appropriateness of olfactory training, different medical treatment options, referral guidelines and imaging for patients with COVID-19-related loss of sense of smell. The guideline may evolve as our experience of COVID-19 develops.}, } @article {pmid33453351, year = {2021}, author = {Tang, JW and Bahnfleth, WP and Bluyssen, PM and Buonanno, G and Jimenez, JL and Kurnitski, J and Li, Y and Miller, S and Sekhar, C and Morawska, L and Marr, LC and Melikov, AK and Nazaroff, WW and Nielsen, PV and Tellier, R and Wargocki, P and Dancer, SJ}, title = {Dismantling myths on the airborne transmission of severe acute respiratory syndrome coronavirus (SARS-CoV-2).}, journal = {The Journal of hospital infection}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.jhin.2020.12.022}, pmid = {33453351}, issn = {1532-2939}, abstract = {The Covid-19 pandemic has caused untold disruption and enhanced mortality rates around the world. Understanding the mechanisms for transmission of SARS-CoV-2 is key to preventing further spread but there is confusion over the meaning of "airborne" whenever transmission is discussed. Scientific ambivalence originates from evidence published many years ago, which has generated mythological beliefs that obscure current thinking. This article gathers together and explores some of the most commonly held dogmas on airborne transmission in order to stimulate revision of the science in the light of current evidence. Six 'myths' are presented, explained, and ultimately refuted on the basis of recently published papers and expert opinion from previous work related to similar viruses. There is little doubt that SARS-CoV-2 is transmitted via a range of airborne particle sizes subject to all the usual ventilation parameters and human behaviour. Experts from specialties encompassing aerosol studies, ventilation, engineering, physics, virology and clinical medicine have joined together to present this review, in order to consolidate the evidence for airborne transmission mechanisms and offer justification for modern strategies for prevention and control of Covid-19 in healthcare and community.}, } @article {pmid33453285, year = {2021}, author = {Hwang, CL and Chen, SH and Chou, CH and Grigoriadis, G and Liao, TC and Fancher, IS and Arena, R and Phillips, SA}, title = {The physiological benefits of sitting less and moving more: Opportunities for future research.}, journal = {Progress in cardiovascular diseases}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.pcad.2020.12.010}, pmid = {33453285}, issn = {1873-1740}, abstract = {Sedentary behavior (SB) and physical activity (PA) are important risk factors of cardiovascular disease morbidity and mortality. In addition to increasing the amount of moderate-to-vigorous PA; MVPA, the current PA guidelines recommend that adults should reduce SB, or any waking activity performed while sitting, reclining, or lying, with low energy expenditure. While mounting evidence has emphasized the benefits of increasing MVPA, little is focused on the effect of SB on health. Therefore, this review discusses the pathophysiological effects of SB and the potential physiological benefits of reducing/breaking up SB at the levels below the current guidelines for PA. Such knowledge is important, given the majority of the United States population performs insufficient or no MVPA and are at high risk of being negatively impacted by SB. Interventions targeting sedentary time, such as breaking up SB by standing and moving, may be safe, feasible, and applicable to execute daily for a wider range of the population. This review also discusses the importance of monitoring SB in the era of the coronavirus disease 2019 (COVID-19) pandemic and the clinical implications of sitting less and moving more.}, } @article {pmid33453010, year = {2021}, author = {Krishnan, A and Hamilton, JP and Alqahtani, SA and A Woreta, T}, title = {A narrative review of coronavirus disease 2019 (COVID-19): clinical, epidemiological characteristics, and systemic manifestations.}, journal = {Internal and emergency medicine}, volume = {}, number = {}, pages = {}, pmid = {33453010}, issn = {1970-9366}, abstract = {Coronavirus disease 2019 (COVID-19) is an emerging infectious disease which has had a rapid surge in cases and deaths since it is first documented in Wuhan, China, in December 2019. COVID-19 is caused by the Betacoronavirus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 uses angiotensin-converting enzyme 2, which is highly expressed in the human lower respiratory tract but also in other tissues, as the cellular entry receptor. Thus, COVID-19 mainly affects the respiratory system but can cause damage to other body systems, including the cardiovascular, gastrointestinal, hepatobiliary, renal, and central nervous systems. We review the pathogenesis and clinical manifestations of the infection, focusing on our current understanding of the disease mechanisms and their translation to clinical outcomes, as well as adverse effects on different body systems. We also discuss the epidemiology pathogenesis, clinical, and multi-organ consequences, and highlight some of the research gaps regarding COVID-19.}, } @article {pmid33452660, year = {2021}, author = {Pothen, L and Yildiz, H and Samnick, MM and Yombi, JC}, title = {Hydroxychloroquine in the post-COVID-19 era: will this pandemic upset decades of clinical practice?.}, journal = {Clinical rheumatology}, volume = {}, number = {}, pages = {}, pmid = {33452660}, issn = {1434-9949}, abstract = {In the early stage of the COVID-19 pandemic, Belgian health authorities endorsed the interim guidelines for the treatment of COVID-19 pneumonia: hydroxychloroquine (HCQ) recommended for treatment of hospitalized patients with moderate to severe disease. As a growing number of patients were admitted, inevitably, our internal medicine team questioned the efficacy and safety of HCQ, especially with regard to cardiac side effects. In parallel with our concerns, data regarding the safety and efficacy of HCQ were published, with discordant results and debate in the medical community. Media coverage of the possible risks and benefits of HCQ use in COVID-19 also caused confusion amongst the public. In this Perspectives in Rheumatology article, we review the use and safety of HCQ in autoimmune disease and its putative efficacy and toxicity in COVID-19. Finally, we share our concern about the future of this widely used and inexpensive drug after the COVID-19 pandemic has passed.}, } @article {pmid33452375, year = {2021}, author = {Shrivastav, AM and Cvelbar, U and Abdulhalim, I}, title = {A comprehensive review on plasmonic-based biosensors used in viral diagnostics.}, journal = {Communications biology}, volume = {4}, number = {1}, pages = {70}, pmid = {33452375}, issn = {2399-3642}, abstract = {The proliferation and transmission of viruses has become a threat to worldwide biosecurity, as exemplified by the current COVID-19 pandemic. Early diagnosis of viral infection and disease control have always been critical. Virus detection can be achieved based on various plasmonic phenomena, including propagating surface plasmon resonance (SPR), localized SPR, surface-enhanced Raman scattering, surface-enhanced fluorescence and surface-enhanced infrared absorption spectroscopy. The present review covers all available information on plasmonic-based virus detection, and collected data on these sensors based on several parameters. These data will assist the audience in advancing research and development of a new generation of versatile virus biosensors.}, } @article {pmid33452116, year = {2021}, author = {Naylor-Wardle, J and Rowland, B and Kunadian, V}, title = {Socioeconomic status and cardiovascular health in the COVID-19 pandemic.}, journal = {Heart (British Cardiac Society)}, volume = {}, number = {}, pages = {}, doi = {10.1136/heartjnl-2020-318425}, pmid = {33452116}, issn = {1468-201X}, abstract = {The goals of this review are to evaluate the impact of socioeconomic (SE) status on the general health and cardiovascular health of individuals during the COVID-19 pandemic and also discuss the measures to address disparity. SE status is a strong predictor of premature morbidity and mortality within general health. A lower SE status also has implications of increased cardiovascular disease (CVD) mortality and poorer CVD risk factor profiles. CVD comorbidity is associated with a higher case severity and mortality rate from COVID-19, with both CVD and COVID-19 sharing important risk factors. The COVID-19 pandemic has adversely affected people of a lower SE status and of ethnic minority group, who in the most deprived regions are suffering double the mortality rate of the least deprived. The acute stress, economic recession and quarantine restrictions in the wake of COVID-19 are also predicted to cause a decline in mental health. This could pose substantial increase to CVD incidence, particularly with acute pathologies such as stroke, acute coronary syndrome and cardiogenic shock among lower SE status individuals and vulnerable elderly populations. Efforts to tackle SE status and CVD may aid in reducing avoidable deaths. The implementation of 'upstream' interventions and policies demonstrates promise in achieving the greatest population impact, aiming to protect and empower individuals. Specific measures may involve risk factor targeting restrictions on the availability and advertisement of tobacco, alcohol and high-fat and salt content food, and targeting SE disparity with healthy and secure workplaces.}, } @article {pmid33452061, year = {2021}, author = {Horner, D and O'Rourke, J and Collins, J and Darbyshire, D and Lecky, F}, title = {Emergency Medicine Journal COVID-19 monthly top five.}, journal = {Emergency medicine journal : EMJ}, volume = {}, number = {}, pages = {}, doi = {10.1136/emermed-2020-211110}, pmid = {33452061}, issn = {1472-0213}, } @article {pmid33451934, year = {2020}, author = {Gulati, S and Muddasani, R and Gustavo Bergerot, P and Pal, SK}, title = {Systemic therapy and COVID19: Immunotherapy and chemotherapy.}, journal = {Urologic oncology}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.urolonc.2020.12.022}, pmid = {33451934}, issn = {1873-2496}, abstract = {As the novel severe acute respiratory syndrome coronavirus-2 related pandemic - Corona Virus Disease 2019 (COVID-19) has emerged, decision making in the context of cancer treatment has become more complex. The apprehension of using drugs that could adversely affect infected patients, the risk of not using life-saving treatments and the complexities related to the type of cancer itself, all must be taken into consideration before proceeding with treatment. Data from large registries such as COVID-19 and Cancer Consortium, Thoracic Cancers International COVID-19 Collaboration (TERAVOLT) and NCI COVID-19 in Cancer Patients Study will hopefully provide granularity on the outcomes of patients with cancer who are infected with COVID-19. As these efforts are underway, this review aims to shed light on the management of patients with genitourinary malignancies being treated with systemic therapies while infected with COVID-19.}, } @article {pmid33451855, year = {2020}, author = {Suryawanshi, RK and Koganti, R and Agelidis, A and Patil, CD and Shukla, D}, title = {Dysregulation of Cell Signaling by SARS-CoV-2.}, journal = {Trends in microbiology}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.tim.2020.12.007}, pmid = {33451855}, issn = {1878-4380}, abstract = {Pathogens usurp host pathways to generate a permissive environment for their propagation. The current spread of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection presents the urgent need to understand the complex pathogen-host interplay for effective control of the virus. SARS-CoV-2 reorganizes the host cytoskeleton for efficient cell entry and controls host transcriptional processes to support viral protein translation. The virus also dysregulates innate cellular defenses using various structural and nonstructural proteins. This results in substantial but delayed hyperinflammation alongside a weakened interferon (IFN) response. We provide an overview of SARS-CoV-2 and its uniquely aggressive life cycle and discuss the interactions of various viral proteins with host signaling pathways. We also address the functional changes in SARS-CoV-2 proteins, relative to SARS-CoV. Our comprehensive assessment of host signaling in SARS-CoV-2 pathogenesis provides some complex yet important strategic clues for the development of novel therapeutics against this rapidly emerging worldwide crisis.}, } @article {pmid33451069, year = {2021}, author = {Fouladirad, S and Bach, H}, title = {Development of Coronavirus Treatments Using Neutralizing Antibodies.}, journal = {Microorganisms}, volume = {9}, number = {1}, pages = {}, doi = {10.3390/microorganisms9010165}, pmid = {33451069}, issn = {2076-2607}, support = {OV3-170627/CAPMC/CIHR/Canada ; }, abstract = {The Coronavirus disease 2019 (COVID-19), caused by the novel coronavirus SARS-CoV-2, was first reported in December 2019 in Wuhan, Hubei province, China. This virus has led to 61.8 million cases worldwide being reported as of December 1st, 2020. Currently, there are no definite approved therapies endorsed by the World Health Organization for COVID-19, focusing only on supportive care. Treatment centers around symptom management, including oxygen therapy or invasive mechanical ventilation. Immunotherapy has the potential to play a role in the treatment of SARS-CoV-2. Monoclonal antibodies (mAbs), in particular, is a relatively new approach in the world of infectious diseases and has the benefit of overcoming challenges with serum therapy and intravenous immunoglobulins preparations. Here, we reviewed the articles published in PubMed with the purpose of summarizing the currently available evidence for the use of neutralizing antibodies as a potential treatment for coronaviruses. Studies reporting in vivo results were summarized and analyzed. Despite promising data from some studies, none of them progressed to clinical trials. It is expected that neutralizing antibodies might offer an alternative for COVID-19 treatment. Thus, there is a need for randomized trials to understand the potential use of this treatment.}, } @article {pmid33451039, year = {2021}, author = {Andryukov, BG and Besednova, NN and Kuznetsova, TA and Fedyanina, LN}, title = {Laboratory-Based Resources for COVID-19 Diagnostics: Traditional Tools and Novel Technologies. A Perspective of Personalized Medicine.}, journal = {Journal of personalized medicine}, volume = {11}, number = {1}, pages = {}, doi = {10.3390/jpm11010042}, pmid = {33451039}, issn = {2075-4426}, abstract = {The coronavirus infection 2019 (COVID-19) pandemic, caused by the highly contagious SARS-CoV-2 virus, has provoked a global healthcare and economic crisis. The control over the spread of the disease requires an efficient and scalable laboratory-based strategy for testing the population based on multiple platforms to provide rapid and accurate diagnosis. With the onset of the pandemic, the reverse transcription polymerase chain reaction (RT-PCR) method has become a standard diagnostic tool, which has received wide clinical use. In large-scale and repeated examinations, these tests can identify infected patients with COVID-19, with their accuracy, however, dependent on many factors, while the entire process takes up to 6-8 h. Here we also describe a number of serological systems for detecting antibodies against SARS-CoV-2. These are used to assess the level of population immunity in various categories of people, as well as for retrospective diagnosis of asymptomatic and mild COVID-19 in patients. However, the widespread use of traditional diagnostic tools in the context of the rapid spread of COVID-19 is hampered by a number of limitations. Therefore, the sharp increase in the number of patients with COVID-19 necessitates creation of new rapid, inexpensive, sensitive, and specific tests. In this regard, we focus on new laboratory technologies such as loop mediated isothermal amplification (LAMP) and lateral flow immunoassay (LFIA), which have proven to work well in the COVID-19 diagnostics and can become a worthy alternative to traditional laboratory-based diagnostics resources. To cope with the COVID-19 pandemic, the healthcare system requires a combination of various types of laboratory diagnostic testing techniques, whodse sensitivity and specificity increases with the progress in the SARS-CoV-2 research. The testing strategy should be designed in such a way to provide, depending on the timing of examination and the severity of the infection in patients, large-scale and repeated examinations based on the principle: screening-monitoring-control. The search and development of new methods for rapid diagnostics of COVID-19 in laboratory, based on new analytical platforms, is still a highly important and urgent healthcare issue. In the final part of the review, special emphasis is made on the relevance of the concept of personalized medicine to combat the COVID-19 pandemic in the light of the recent studies carried out to identify the causes of variation in individual susceptibility to SARS-CoV-2 and increase the efficiency and cost-effectiveness of treatment.}, } @article {pmid33451007, year = {2021}, author = {Łagocka, R and Dziedziejko, V and Kłos, P and Pawlik, A}, title = {Favipiravir in Therapy of Viral Infections.}, journal = {Journal of clinical medicine}, volume = {10}, number = {2}, pages = {}, doi = {10.3390/jcm10020273}, pmid = {33451007}, issn = {2077-0383}, abstract = {Favipiravir (FPV) is a novel antiviral drug acting as a competitive inhibitor of RNA-dependent RNA polymerase (RdRp), preventing viral transcription and replication. FPV was approved in Japan in 2014 for therapy of influenza unresponsive to standard antiviral therapies. FPV was also used in the therapy of Ebola virus disease (EVD) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In this review, we discuss the mechanisms of action, pharmacokinetic parameters, toxicity, and adverse effects of FPV, as well as clinical studies evaluating the use of FPV in the therapy of influenza virus (IV) infection, EVD, and SARS-CoV-2 infection, along with its effectiveness in treating other human RNA infections.}, } @article {pmid33450689, year = {2020}, author = {Paraskevis, D and Kostaki, EG and Alygizakis, N and Thomaidis, NS and Cartalis, C and Tsiodras, S and Dimopoulos, MA}, title = {A review of the impact of weather and climate variables to COVID-19: In the absence of public health measures high temperatures cannot probably mitigate outbreaks.}, journal = {The Science of the total environment}, volume = {768}, number = {}, pages = {144578}, doi = {10.1016/j.scitotenv.2020.144578}, pmid = {33450689}, issn = {1879-1026}, abstract = {The new severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) pandemic was first recognized at the end of 2019 and has caused one of the most serious global public health crises in the last years. In this paper, we review current literature on the effect of weather (temperature, humidity, precipitation, wind, etc.) and climate (temperature as an essential climate variable, solar radiation in the ultraviolet, sunshine duration) variables on SARS-CoV-2 and discuss their impact to the COVID-19 pandemic; the review also refers to respective effect of urban parameters and air pollution. Most studies suggest that a negative correlation exists between ambient temperature and humidity on the one hand and the number of COVID-19 cases on the other, while there have been studies which support the absence of any correlation or even a positive one. The urban environment and specifically the air ventilation rate, as well as air pollution, can probably affect, also, the transmission dynamics and the case fatality rate of COVID-19. Due to the inherent limitations in previously published studies, it remains unclear if the magnitude of the effect of temperature or humidity on COVID-19 is confounded by the public health measures implemented widely during the first pandemic wave. The effect of weather and climate variables, as suggested previously for other viruses, cannot be excluded, however, under the conditions of the first pandemic wave, it might be difficult to be uncovered. The increase in the number of cases observed during summertime in the Northern hemisphere, and especially in countries with high average ambient temperatures, demonstrates that weather and climate variables, in the absence of public health interventions, cannot mitigate the resurgence of COVID-19 outbreaks.}, } @article {pmid33450678, year = {2020}, author = {Keflie, TS and Biesalski, HK}, title = {Micronutrients and bioactive substances: Their potential roles in combating COVID-19.}, journal = {Nutrition (Burbank, Los Angeles County, Calif.)}, volume = {84}, number = {}, pages = {111103}, doi = {10.1016/j.nut.2020.111103}, pmid = {33450678}, issn = {1873-1244}, abstract = {OBJECTIVES: The coronavirus disease 2019 (COVID-19) pandemic is seriously threatening public health and setting off huge economic crises across the world. In the absence of specific drugs for COVID-19, there is an urgent need to look for alternative approaches. Therefore, the aim of this paper was to review the roles of micronutrients and bioactive substances as potential alternative approaches in combating COVID-19.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

DATA SOURCES: The PubMed database was searched.

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

DATA EXTRACTION: Of 240 studies, 4 were included.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

CONCLUSION: Here we discuss SARS-CoV-2 life cycle and a number of approaches aiming to suppress viral infection rates or propagation; increase virus antigen presentation in order to activate a robust and durable adaptive immune response from the host, and/or mitigate the ARDS-related "cytokine storm" and collateral tissue damage that triggers the severe life-threatening complications of COVID-19.}, } @article {pmid33435548, year = {2021}, author = {Yan, P and Daliri, EB and Oh, DH}, title = {New Clinical Applications of Electrolyzed Water: A Review.}, journal = {Microorganisms}, volume = {9}, number = {1}, pages = {}, doi = {10.3390/microorganisms9010136}, pmid = {33435548}, issn = {2076-2607}, abstract = {As the situation of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) is still deteriorating, there has been a huge increase in the demand and use of disinfectants. Electrolyzed water (EW), as a novel broad-spectrum disinfectant and cleaner, has been widely used for several years. EW can be produced in an electrolysis chamber which contains dilute salt and tap water. It is an effective antimicrobial and antibiofilm agent, with several advantages such as on-the-spot, cheap, environmentally friendly and safe for human beings. Therefore, EW holds potential significance for high-risk settings in hospitals and other clinical facilities. EW can also be applied for wound healing, advanced tissue care, and dental clinics. The present review article highlights the latest developments and new perspectives of EW, especially in clinical fields. Furthermore, the main action modes of antibiofilm and antimicrobial will be summarized.}, } @article {pmid33435547, year = {2021}, author = {Wong, YP and Khong, TY and Tan, GC}, title = {The Effects of COVID-19 on Placenta and Pregnancy: What Do We Know So Far?.}, journal = {Diagnostics (Basel, Switzerland)}, volume = {11}, number = {1}, pages = {}, doi = {10.3390/diagnostics11010094}, pmid = {33435547}, issn = {2075-4418}, support = {FRGS/1/2019/SKK13/UKM/02/1//Ministry of Higher Education, Malaysia/ ; }, abstract = {The current coronavirus disease 2019 (COVID-19) pandemic, caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has inflicted a serious health crisis globally. This virus is associated with a spectrum of respiratory illness ranging from asymptomatic, mild to severe pneumonia, and acute respiratory distress syndrome. Accumulating evidence supports that COVID-19 is not merely a respiratory illness per se, but potentially affects other organ systems including the placenta. SARS-CoV-2 gains access to human cells via angiotensin-converting enzyme 2 (ACE-2). The abundance of ACE-2 on the placental cell surface, especially the syncytiotrophoblasts, could potentially contribute to vertical transplacental transmission to the fetus following maternal COVID-19 infection. Intriguingly, despite the placentas being tested positive for SARS-CoV-2, there are very few newborns that manifest virus-induced diseases. The protective effects of the placental barrier to viral infection, limiting the spread of the virus to newborn infants, remain a mystery. The detrimental role of COVID-19 in pregnancies is largely debatable, although COVID-19 maternal infection has been implicated in unfavorable pregnancy outcomes. In this review, we summarize the pathological features manifested in placenta due to COVID-19 maternal infection that have been previously reported, and relate them to the possible disease manifestation. The potential mechanistic pathways associated with transplacental viral transmission and adverse pregnancy outcomes are also discussed.}, } @article {pmid33435521, year = {2021}, author = {Dominguez, LJ and Veronese, N and Guerrero-Romero, F and Barbagallo, M}, title = {Magnesium in Infectious Diseases in Older People.}, journal = {Nutrients}, volume = {13}, number = {1}, pages = {}, doi = {10.3390/nu13010180}, pmid = {33435521}, issn = {2072-6643}, abstract = {Reduced magnesium (Mg) intake is a frequent cause of deficiency with age together with reduced absorption, renal wasting, and polypharmacotherapy. Chronic Mg deficiency may result in increased oxidative stress and low-grade inflammation, which may be linked to several age-related diseases, including higher predisposition to infectious diseases. Mg might play a role in the immune response being a cofactor for immunoglobulin synthesis and other processes strictly associated with the function of T and B cells. Mg is necessary for the biosynthesis, transport, and activation of vitamin D, another key factor in the pathogenesis of infectious diseases. The regulation of cytosolic free Mg in immune cells involves Mg transport systems, such as the melastatin-like transient receptor potential 7 channel, the solute carrier family, and the magnesium transporter 1 (MAGT1). The functional importance of Mg transport in immunity was unknown until the description of the primary immunodeficiency XMEN (X-linked immunodeficiency with Mg defect, Epstein-Barr virus infection, and neoplasia) due to a genetic deficiency of MAGT1 characterized by chronic Epstein-Barr virus infection. This and other research reporting associations of Mg deficit with viral and bacterial infections indicate a possible role of Mg deficit in the recent coronavirus disease 2019 (COVID-19) and its complications. In this review, we will discuss the importance of Mg for the immune system and for infectious diseases, including the recent pandemic of COVID-19.}, } @article {pmid33435454, year = {2021}, author = {Zmievskaya, E and Valiullina, A and Ganeeva, I and Petukhov, A and Rizvanov, A and Bulatov, E}, title = {Application of CAR-T Cell Therapy beyond Oncology: Autoimmune Diseases and Viral Infections.}, journal = {Biomedicines}, volume = {9}, number = {1}, pages = {}, doi = {10.3390/biomedicines9010059}, pmid = {33435454}, issn = {2227-9059}, support = {19-74-20026//Russian Science Foundation/ ; CΠ-227.2019.4//Stipend of the President of Russian Federation/ ; }, abstract = {Adoptive cell transfer (ACT) has long been at the forefront of the battle with cancer that began last century with the therapeutic application of tumor-infiltrating lymphocytes (TILs) against melanoma. The development of novel ACT approaches led researchers and clinicians to highly efficient technologies based on genetically engineered T lymphocytes, with chimeric antigen receptor (CAR)-T cells as the most prominent example. CARs consist of an extracellular domain that represents the single-chain variable fragment (scFv) of a monoclonal antibody (mAb) responsible for target recognition and the intracellular domain, which was built from up to several signaling motifs that mediated T cell activation. The number of potential targets amenable for CAR-T cell therapy is expanding rapidly, which means that the tremendous success of this approach in oncology could be further translated to treating other diseases. In this review, we outlined modern trends and recent developments in CAR-T cell therapy from an unusual point of view by focusing on diseases beyond cancer, such as autoimmune disorders and viral infections, including SARS-CoV-2.}, } @article {pmid33435405, year = {2021}, author = {Gheorghe, G and Ilie, M and Bungau, S and Stoian, AMP and Bacalbasa, N and Diaconu, CC}, title = {Is There a Relationship between COVID-19 and Hyponatremia?.}, journal = {Medicina (Kaunas, Lithuania)}, volume = {57}, number = {1}, pages = {}, doi = {10.3390/medicina57010055}, pmid = {33435405}, issn = {1648-9144}, abstract = {Nowadays, humanity faces one of the most serious health crises, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. The severity of coronavirus disease 2019 (COVID-19) pandemic is related to the high rate of interhuman transmission of the virus, variability of clinical presentation, and the absence of specific therapeutic methods. COVID-19 can manifest with non-specific symptoms and signs, especially among the elderly. In some cases, the clinical manifestations of hyponatremia may be the first to appear. The pathophysiological mechanisms of hyponatremia among patients with COVID-19 are diverse, including syndrome of inappropriate antidiuretic hormone secretion (SIADH), digestive loss of sodium ions, reduced sodium ion intake or use of diuretic therapy. Hyponatremia may also be considered a negative prognostic factor in patients diagnosed with COVID-19. We need further studies to evaluate the etiology and therapeutic management of hyponatremia in patients with COVID-19.}, } @article {pmid33435337, year = {2021}, author = {Yu, YJ and Park, YS and Keller, A and Noh, JW and Cha, J}, title = {A Mixed-Methods Systematic Review of the Impacts of Coronavirus on Society and Culture.}, journal = {International journal of environmental research and public health}, volume = {18}, number = {2}, pages = {}, doi = {10.3390/ijerph18020491}, pmid = {33435337}, issn = {1660-4601}, support = {202013C11//Korea Medical Device Development Fund/ ; }, abstract = {Little is understood of the social and cultural effects of coronaviruses such as coronavirus disease 2019 (COVID-19), severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS-CoV). This systematic review aims to synthesize existing findings (both qualitative and quantitative) that focus on the social and cultural impacts of coronaviruses in order to gain a better understanding of the COVID-19 pandemic. Utilizing a predetermined search strategy, we searched CINAHL, PsycINFO, PubMed, and Web of Science to identify existing (qualitative, quantitative, and mixed-methods) studies pertaining to the coronavirus infections and their intersection with societies and cultures. A narrative synthesis approach was applied to summarize and interpret findings of the study. Stemming from SARS outbreak in 2003, qualitative and quantitative findings (twelve adopted quantitative methods and eight exclusively used qualitative methods) were organized under five topical domains: governance, crisis communication and public knowledge, stigma and discrimination, social compliance of preventive measures, and the social experience of health workers. The selected studies suggest that current societies are not equipped for effective coronavirus response and control. This mixed-methods systematic review demonstrates that the effects of coronaviruses on a society can be debilitating.}, } @article {pmid33434886, year = {2021}, author = {Tian, Y and Zhou, LQ}, title = {Evaluating the impact of COVID-19 on male reproduction.}, journal = {Reproduction (Cambridge, England)}, volume = {161}, number = {2}, pages = {R37-R44}, doi = {10.1530/REP-20-0523}, pmid = {33434886}, issn = {1741-7899}, abstract = {Invasion or damage of the male reproductive system is one of the reported outcomes of viral infection. Current studies have documented that SARS-CoV-2, which causes COVID-19, can damage the male reproductive system in large part by inflammatory damage caused by a cytokine storm. However, whether SARS-CoV-2 can infect the human testis directly and enter semen is controversial. Other adverse effects of SARS-CoV-2 on male reproduction are also of concern and require comprehensive evaluation. Here, we analyze the invasiveness of SARS-CoV-2 in the testis and examine reported mechanisms by which SARS-CoV-2 interferes with male reproduction. Long-term implications of SARS-CoV-2 infection on male reproduction are also discussed. It should be emphasized that although COVID-19 may induce testicular damage, a substantial decrease in male reproductive capacity awaits clinical evidence. We propose that there is an urgent need to track male COVID-19 patients during their recovery. The development of suitable experimental models, including human reproductive organoids, will be valuable to further investigate the viral impact on reproduction for current and future pandemics.}, } @article {pmid33434780, year = {2021}, author = {Ghodake, GS and Shinde, SK and Kadam, AA and Saratale, RG and Saratale, GD and Syed, A and Elgorban, AM and Marraiki, N and Kim, DY}, title = {Biological characteristics and biomarkers of novel SARS-CoV-2 facilitated rapid development and implementation of diagnostic tools and surveillance measures.}, journal = {Biosensors & bioelectronics}, volume = {177}, number = {}, pages = {112969}, doi = {10.1016/j.bios.2021.112969}, pmid = {33434780}, issn = {1873-4235}, abstract = {Existing coronavirus named as a severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has speeded its spread across the globe immediately after emergence in China, Wuhan region, at the end of the year 2019. Different techniques, including genome sequencing, structural feature classification by electron microscopy, and chest imaging using computed tomography, are primarily used to diagnose and screen SARS-CoV-2 suspected individuals. Determination of the viral structure, surface proteins, and genome sequence has provided a design blueprint for the diagnostic investigations of novel SARS-CoV-2 virus and rapidly emerging diagnostic technologies, vaccine trials, and cell-entry-inhibiting drugs. Here, we describe recent understandings on the spike glycoprotein (S protein), receptor-binding domain (RBD), and angiotensin-converting enzyme 2 (ACE2) and their receptor complex. This report also aims to review recently established diagnostic technologies and developments in surveillance measures for SARS-CoV-2 as well as the characteristics and performance of emerging techniques. Smartphone apps for contact tracing can help nations to conduct surveillance measures before a vaccine and effective medicines become available. We also describe promising point-of-care (POC) diagnostic technologies that are under consideration by researchers for advancement beyond the proof-of-concept stage. Developing novel diagnostic techniques needs to be facilitated to establish automatic systems, without any personal involvement or arrangement to curb an existing SARS-CoV-2 epidemic crisis, and could also be appropriate for avoiding the emergence of a future epidemic crisis.}, } @article {pmid33434768, year = {2021}, author = {Sterley, TL and Bains, JS}, title = {Social communication of affective states.}, journal = {Current opinion in neurobiology}, volume = {68}, number = {}, pages = {44-51}, doi = {10.1016/j.conb.2020.12.007}, pmid = {33434768}, issn = {1873-6882}, abstract = {Social interactions promote the communication of explicit and implicit information between individuals. Implicit or subconscious sharing of cues can be useful in conveying affective states. Knowing the affective state of others can guide future interactions, while an inability to decipher another's affective state is a core feature of autism spectrum disorder. The precise neural circuitry and mechanisms involved in communicating affective states are not well understood. Over the past few years, a number of important observations in rodent models have increased our knowledge of the neural processes for social communication of affective state. Here we highlight these contributions by first describing the rodent models used to investigate social communication of affect and then summarising the neural circuitry and processes implicated by these rodent models. We relate these findings to humans as well as to the current global context where social interactions have been modified by the Covid-19 pandemic.}, } @article {pmid33434662, year = {2021}, author = {Tandon, M and Kataria, S and Patel, J and Mehta, TR and Daimee, M and Patel, V and Prasad, A and Chowdhary, AA and Jaiswal, S and Sriwastava, S}, title = {A Comprehensive Systematic Review of CSF analysis that defines Neurological Manifestations of COVID-19.}, journal = {International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.ijid.2021.01.002}, pmid = {33434662}, issn = {1878-3511}, abstract = {BACKGROUND: Limited literature exists on CSF findings in COVID-19 patients with neurological symptoms. In this review, we conducted a descriptive analysis of CSF findings in patients with COVID-19 to understand prognosis and explore therapeutic options.

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

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

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

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

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

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

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

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

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

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

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

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

Conclusion: Based on the review, it can be inferred that it is important to boost one's immune system and to stay healthy by developing healthy habits of food intake, sleep, exercise, personal hygiene and so on. Practicing social distancing with a self-motivated attitude will help to control the virus to a large extent. The current situation also demands a great sense of responsibility of people towards society by protecting oneself from the virus in order to protect the society one lives in.}, } @article {pmid33432272, year = {2020}, author = {Ehsanian, R and Workman, J and Jones, D and Selvage, D and Rivers, WE and Manole, AK and Sloan, JH}, title = {Free-standing acute inpatient rehabilitation hospital enhanced practices and policies in response to the COVID-19 outbreak.}, journal = {Future science OA}, volume = {7}, number = {2}, pages = {FSO667}, pmid = {33432272}, issn = {2056-5623}, abstract = {This special report was developed to communicate policy and procedures for free-standing acute inpatient rehabilitation hospitals (AIRHs) to protect patients and healthcare personnel and to prevent further spread of severe acute respiratory syndrome coronavirus 2. The recommended policies were developed in conjunction with the New Mexico Department of Health and hospital leadership. As we attain additional knowledge and experience during this pandemic, suggestions of best practice will continue to evolve for AIRHs. The authors encourage readers to work with local regulatory officials to ensure regulatory compliance as well as respect of the availability of local resources.}, } @article {pmid33431425, year = {2021}, author = {Mohebali, D and Kittleson, MM}, title = {Remote monitoring in heart failure: current and emerging technologies in the context of the pandemic.}, journal = {Heart (British Cardiac Society)}, volume = {}, number = {}, pages = {}, doi = {10.1136/heartjnl-2020-318062}, pmid = {33431425}, issn = {1468-201X}, abstract = {The incidence of heart failure (HF) remains high and patients with HF are at risk for frequent hospitalisations. Remote monitoring technologies may provide early indications of HF decompensation and potentially allow for optimisation of therapy to prevent HF hospitalisations. The need for reliable remote monitoring technology has never been greater as the COVID-19 pandemic has led to the rapid expansion of a new mode of healthcare delivery: the virtual visit. With the convergence of remote monitoring technologies and reliable method of remote healthcare delivery, an understanding of the role of both in the management of patients with HF is critical. In this review, we outline the evidence on current remote monitoring technologies in patients with HF and highlight how these advances may benefit patients in the context of the current pandemic.}, } @article {pmid33430467, year = {2021}, author = {Dąbrowska, J and Sobota, M and Świąder, M and Borowski, P and Moryl, A and Stodolak, R and Kucharczak, E and Zięba, Z and Kazak, JK}, title = {Marine Waste-Sources, Fate, Risks, Challenges and Research Needs.}, journal = {International journal of environmental research and public health}, volume = {18}, number = {2}, pages = {}, doi = {10.3390/ijerph18020433}, pmid = {33430467}, issn = {1660-4601}, abstract = {The article presents a comprehensive and cross-cutting review of key marine waste issues, taking into account: sources, fate, risks, transport pathways, threats, legislation, current challenges, and knowledge gaps. The growing amount of both human-created waste in seas and oceans and waste reaching marine ecosystems from land is one of today's challenges for the global economy and the European Union. It is predicted that if no decisive steps are taken to limit the amount of this type of waste, there may be more plastic waste than fish in the oceans after 2050. The influence of microplastics and nanoplastics on living organisms remains undiagnosed. Within the international and EU law, solutions are being developed to properly manage waste on board ships and to reduce the impact of processes related to the recycling of the vessels on the environment. Currently, over 80% of ships are dismantled in the countries of South Asia, in conditions that threaten the environment and the safety of workers. After World War 2, large quantities of chemical weapons were deposited in the seas. Steel containers with dangerous substances residing in the sea for over 70 years have begun leaking, thus polluting water. For many years, radioactive waste had also been dumped into marine ecosystems, although since 1993 there has been a total ban on such disposal of radionuclides. The impact of the COVID-19 pandemic on marine waste generation has also been presented as a significant factor influencing marine waste generation and management.}, } @article {pmid33430431, year = {2021}, author = {Iba, T and Warkentin, TE and Thachil, J and Levi, M and Levy, JH}, title = {Proposal of the Definition for COVID-19-Associated Coagulopathy.}, journal = {Journal of clinical medicine}, volume = {10}, number = {2}, pages = {}, doi = {10.3390/jcm10020191}, pmid = {33430431}, issn = {2077-0383}, support = {11596632//Promotion and Mutual Aid Corporation for Private Schools of Japan/ ; }, abstract = {Thrombotic events are common complications in COVID-19 patients that include both thrombus formation in large vessels and the microvasculature of the lung and other organs. COVID-19-associated coagulopathy (CAC) and disseminated intravascular coagulation (DIC) have similarities and differences, and whether CAC is a form of DIC is the subject of debate. Reported mechanisms of CAC include activated coagulation, endotheliopathy, up-regulated innate and adaptive immunity, and activated complement system. Although the clinical features and laboratory findings of CAC and DIC seem different, there are fundamental similarities that should be considered. Basically, the pathological findings of COVID-19 fall within the scope of the definition of DIC, i.e., systemic activation of coagulation caused by or resulting from the microvascular damage. Therefore, we suggest that although CAC differs from usual infection-associated DIC, its various features indicate that it can be considered a thrombotic phenotype DIC. This review summarizes the current knowledge about CAC including differences and similarities with sepsis-associated DIC.}, } @article {pmid33430424, year = {2021}, author = {Chugh, RM and Bhanja, P and Norris, A and Saha, S}, title = {Experimental Models to Study COVID-19 Effect in Stem Cells.}, journal = {Cells}, volume = {10}, number = {1}, pages = {}, doi = {10.3390/cells10010091}, pmid = {33430424}, issn = {2073-4409}, support = {P20//The University of Kansas Cancer Center/International ; }, abstract = {The new strain of coronavirus (severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2)) emerged in 2019 and hence is often referred to as coronavirus disease 2019 (COVID-19). This disease causes hypoxic respiratory failure and acute respiratory distress syndrome (ARDS), and is considered as the cause of a global pandemic. Very limited reports in addition to ex vivo model systems are available to understand the mechanism of action of this virus, which can be used for testing of any drug efficacy against virus infectivity. COVID-19 induces tissue stem cell loss, resulting inhibition of epithelial repair followed by inflammatory fibrotic consequences. Development of clinically relevant models is important to examine the impact of the COVID-19 virus in tissue stem cells among different organs. In this review, we discuss ex vivo experimental models available to study the effect of COVID-19 on tissue stem cells.}, } @article {pmid33430309, year = {2021}, author = {Terracciano, R and Preianò, M and Fregola, A and Pelaia, C and Montalcini, T and Savino, R}, title = {Mapping the SARS-CoV-2-Host Protein-Protein Interactome by Affinity Purification Mass Spectrometry and Proximity-Dependent Biotin Labeling: A Rational and Straightforward Route to Discover Host-Directed Anti-SARS-CoV-2 Therapeutics.}, journal = {International journal of molecular sciences}, volume = {22}, number = {2}, pages = {}, doi = {10.3390/ijms22020532}, pmid = {33430309}, issn = {1422-0067}, abstract = {Protein-protein interactions (PPIs) are the vital engine of cellular machinery. After virus entry in host cells the global organization of the viral life cycle is strongly regulated by the formation of virus-host protein interactions. With the advent of high-throughput -omics platforms, the mirage to obtain a "high resolution" view of virus-host interactions has come true. In fact, the rapidly expanding approaches of mass spectrometry (MS)-based proteomics in the study of PPIs provide efficient tools to identify a significant number of potential drug targets. Generation of PPIs maps by affinity purification-MS and by the more recent proximity labeling-MS may help to uncover cellular processes hijacked and/or altered by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), providing promising therapeutic targets. The possibility to further validate putative key targets from high-confidence interactions between viral bait and host protein through follow-up MS-based multi-omics experiments offers an unprecedented opportunity in the drug discovery pipeline. In particular, drug repurposing, making use of already existing approved drugs directly targeting these identified and validated host interactors, might shorten the time and reduce the costs in comparison to the traditional drug discovery process. This route might be promising for finding effective antiviral therapeutic options providing a turning point in the fight against the coronavirus disease-2019 (COVID-19) outbreak.}, } @article {pmid33430234, year = {2021}, author = {Kervevan, J and Chakrabarti, LA}, title = {Role of CD4+ T Cells in the Control of Viral Infections: Recent Advances and Open Questions.}, journal = {International journal of molecular sciences}, volume = {22}, number = {2}, pages = {}, doi = {10.3390/ijms22020523}, pmid = {33430234}, issn = {1422-0067}, support = {18096 and ECTZ88800//Agence Nationale de Recherches sur le Sida et les Hépatites Virales/ ; AI25-1-02343/2344/2345//Sidaction/ ; SARS-CoV-2 CP 2017-266//DIM ELICIT Région Ile-de-France/ ; Task Force SARS-CoV-2 TROPICORO//Institut Pasteur/ ; }, abstract = {CD4+ T cells orchestrate adaptive immune responses through their capacity to recruit and provide help to multiple immune effectors, in addition to exerting direct effector functions. CD4+ T cells are increasingly recognized as playing an essential role in the control of chronic viral infections. In this review, we present recent advances in understanding the nature of CD4+ T cell help provided to antiviral effectors. Drawing from our studies of natural human immunodeficiency virus (HIV) control, we then focus on the role of high-affinity T cell receptor (TCR) clonotypes in mediating antiviral CD4+ T cell responses. Last, we discuss the role of TCR affinity in determining CD4+ T cell differentiation, reviewing the at times divergent studies associating TCR signal strength to the choice of a T helper 1 (Th1) or a T follicular helper (Tfh) cell fate.}, } @article {pmid33430200, year = {2021}, author = {Perricone, C and Triggianese, P and Bursi, R and Cafaro, G and Bartoloni, E and Chimenti, MS and Gerli, R and Perricone, R}, title = {Intravenous Immunoglobulins at the Crossroad of Autoimmunity and Viral Infections.}, journal = {Microorganisms}, volume = {9}, number = {1}, pages = {}, doi = {10.3390/microorganisms9010121}, pmid = {33430200}, issn = {2076-2607}, abstract = {Intravenous immunoglobulins (IVIG) are blood preparations pooled from the plasma of donors that have been first employed as replacement therapy in immunodeficiency. IVIG interact at multiple levels with the different components of the immune system and exert their activity against infections. Passive immunotherapy includes convalescent plasma from subjects who have recovered from infection, hyperimmune globulin formulations with a high titer of neutralizing antibodies, and monoclonal antibodies (mAbs). IVIG are used for the prevention and treatment of several infections, especially in immunocompromised patients, or in case of a poorly responsive immune system. The evolution of IVIG from a source of passive immunity to a powerful immunomodulatory/anti-inflammatory agent results in extensive applications in autoimmune diseases. IVIG composition depends on the antibodies of the donor population and the alterations of protein structure due to the processing of plasma. The anti-viral and anti-inflammatory activity of IVIG has led us to think that they may represent a useful therapeutic tool even in COVID-19. The human origin of IVIG carries specific criticalities including risks of blood products, supply, and elevated costs. IVIG can be useful in critically ill patients, as well as early empirical treatment. To date, the need for further well-designed studies stating protocols and the efficacy/tolerability profile of IVIG and convalescent plasma in selected situations are awaited.}, } @article {pmid33429973, year = {2021}, author = {Schipilliti, FM and Garajová, I and Rovesti, G and Balsano, R and Piacentini, F and Dominici, M and Gelsomino, F}, title = {The Growing Skyline of Advanced Hepatocellular Carcinoma Treatment: A Review.}, journal = {Pharmaceuticals (Basel, Switzerland)}, volume = {14}, number = {1}, pages = {}, doi = {10.3390/ph14010043}, pmid = {33429973}, issn = {1424-8247}, abstract = {Hepatocellular carcinoma (HCC) is the main type of liver cancer. In the majority of cases, HCC is diagnosed at the advanced stage, leading to poor prognosis. In recent years, many efforts have been devoted to investigating potential new and more effective drugs and, indeed, the treatment armamentarium for advanced HCC has broadened tremendously, with targeted- and immune-therapies, and probably the combination of both, playing pivotal roles. Together with new established knowledge, many issues are emerging, with the role of neoadjuvant/adjuvant settings, the definition of the best transitioning time from loco-regional treatments to systemic therapy, the identification of potential predictive biomarkers, and radiomics being just some of the topics that will have to be further explored in the next future. Clearly, the current COVID-19 pandemic has influenced the management of HCC patients and some considerations about this topic will be elucidated.}, } @article {pmid33429925, year = {2021}, author = {Klopf, J and Brostjan, C and Eilenberg, W and Neumayer, C}, title = {Neutrophil Extracellular Traps and Their Implications in Cardiovascular and Inflammatory Disease.}, journal = {International journal of molecular sciences}, volume = {22}, number = {2}, pages = {}, doi = {10.3390/ijms22020559}, pmid = {33429925}, issn = {1422-0067}, abstract = {Neutrophils are primary effector cells of innate immunity and fight infection by phagocytosis and degranulation. Activated neutrophils also release neutrophil extracellular traps (NETs) in response to a variety of stimuli. These NETs are net-like complexes composed of cell-free DNA, histones and neutrophil granule proteins. Besides the evolutionarily conserved mechanism to capture and eliminate pathogens, NETs are also associated with pathophysiological processes of various diseases. Here, we elucidate the mechanisms of NET formation and their different implications in disease. We focused on autoinflammatory and cardiovascular disorders as the leading cause of death. Neutrophil extracellular traps are not only present in various cardiovascular diseases but play an essential role in atherosclerotic plaque formation, arterial and venous thrombosis, as well as in the development and progression of abdominal aortic aneurysms. Furthermore, NETosis can be considered as a source of autoantigens and maintains an inflammatory milieu promoting autoimmune diseases. Indeed, there is further need for research into the balance between NET induction, inhibition, and degradation in order to pharmacologically target NETs and their compounds without impairing the patient's immune defense. This review may be of interest to both basic scientists and clinicians to stimulate translational research and innovative clinical approaches.}, } @article {pmid33429880, year = {2021}, author = {Prüβ, BM}, title = {Current State of the First COVID-19 Vaccines.}, journal = {Vaccines}, volume = {9}, number = {1}, pages = {}, doi = {10.3390/vaccines9010030}, pmid = {33429880}, issn = {2076-393X}, support = {ND02438//U.S. Department of Agriculture/ ; }, abstract = {SARS CoV-2 and its associated disease COVID-19 has devastated the world during 2020. Masks and social distancing could be efficient if done by large proportions of the population, but pandemic fatigue has decreased their efficacy. Economic shut downs come with large price tags and cannot be a long term solution either. The announcements by three vaccine manufacturers in November that their vaccines are 90% or more effective has given hope to at least those in the population who plan to get vaccinated as soon as a scientifically and medically sound vaccine becomes available. This review summarizes the underlying design strategies and current status of development of the nine vaccines that were in phase III trial on 8 November 2020. Contracts between vaccine manufacturing companies and governments aim at distributing the vaccine to a large part of the world population. Questions remain how the temperature sensitive mRNA vaccines will be transported and/or stored and how vaccination will be prioritized within each country. Additionally, current contracts do not cover all countries, with a serious gap in Africa and South America. The second part of this review will detail current distribution plans and remaining challenges with vaccine accessibility and acceptance.}, } @article {pmid33422039, year = {2021}, author = {De Kock, JH and Latham, HA and Leslie, SJ and Grindle, M and Munoz, SA and Ellis, L and Polson, R and O'Malley, CM}, title = {A rapid review of the impact of COVID-19 on the mental health of healthcare workers: implications for supporting psychological well-being.}, journal = {BMC public health}, volume = {21}, number = {1}, pages = {104}, pmid = {33422039}, issn = {1471-2458}, support = {Rapid COVID-19 response: UHI/Portfolio//Chief Scientist Office, Scottish Government Health and Social Care Directorate/International ; }, mesh = {COVID-19/epidemiology/*psychology/*therapy ; Health Personnel/*psychology ; Humans ; Mental Disorders/*epidemiology ; Risk Factors ; }, abstract = {BACKGROUND: Health and social care workers (HSCWs) have carried a heavy burden during the COVID-19 crisis and, in the challenge to control the virus, have directly faced its consequences. Supporting their psychological wellbeing continues, therefore, to be a priority. This rapid review was carried out to establish whether there are any identifiable risk factors for adverse mental health outcomes amongst HSCWs during the COVID-19 crisis.

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

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

CONCLUSIONS: The evidence to date suggests that female nurses with close contact with COVID-19 patients may have the most to gain from efforts aimed at supporting psychological well-being. However, inconsistencies in findings and a lack of data collected outside of hospital settings, suggest that we should not exclude any groups when addressing psychological well-being in health and social care workers. Whilst psychological interventions aimed at enhancing resilience in the individual may be of benefit, it is evident that to build a resilient workforce, occupational and environmental factors must be addressed. Further research including social care workers and analysis of wider societal structural factors is recommended.}, } @article {pmid33417755, year = {2020}, author = {Sommer-Larraza, G and Mallen-Trejo, A and Tomás-Reyna, C and Rodríguez-Reséndiz, F}, title = {[Guidelines for restarting elective orthopaedic surgery post Covid-19 in Mexico].}, journal = {Acta ortopedica mexicana}, volume = {34}, number = {3}, pages = {176-182}, pmid = {33417755}, issn = {2306-4102}, mesh = {*COVID-19 ; Elective Surgical Procedures ; Humans ; Mexico ; *Orthopedic Procedures ; Pandemics ; SARS-CoV-2 ; }, abstract = {BACKGROUND: Elaborate an updated guideline of recommendations for the safe return to elective orthopedic surgery post COVID-19 pandemic.

METHODS: Bibliographic review of relevant global literature.

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

CONCLUSIONS: The safe restart of orthopedic elective surgery is possible as long as we take into consideration the appropriate recommendations, which we have summarized in this review.}, } @article {pmid33411674, year = {2021}, author = {Graf, J and Mares, J and Barnett, M and Aktas, O and Albrecht, P and Zamvil, SS and Hartung, HP}, title = {Targeting B cells to modify MS, NMOSD, and MOGAD: Part 2.}, journal = {Neurology(R) neuroimmunology & neuroinflammation}, volume = {8}, number = {1}, pages = {}, doi = {10.1212/NXI.0000000000000919}, pmid = {33411674}, issn = {2332-7812}, mesh = {Aquaporin 4 ; B-Lymphocytes ; *COVID-19 ; Humans ; *Neuromyelitis Optica/drug therapy ; SARS-CoV-2 ; }, abstract = {Ocrelizumab, rituximab, ofatumumab, ublituximab, inebilizumab, and evobrutinib are immunotherapies that target various B cell-related proteins. Most of these treatments have proven efficacy in relapsing and progressive forms of MS and neuromyelitis optica spectrum disease (NMOSD) or are in advanced stages of clinical development. Currently, ocrelizumab and inebilizumab are licensed for treatment of MS and NMOSD, respectively. This part of the review focuses on monoclonal antibody B cell-depleting strategies in NMOSD and the emerging related myelin oligodendrocyte glycoprotein (MOG) immunoglobulin G-associated disease (MOGAD). Case series and phase 2/3 studies in these inflammatory disorders are assessed. The safety profile of long-term B-cell depletion in MS, NMOSD, and MOGAD will be highlighted. Finally implications of the current coronavirus disease 2019 pandemic on the management of patients with these disorders and the use of B cell-depleting agents will be discussed.}, } @article {pmid33408715, year = {2020}, author = {Leonardi, AJ and Proenca, RB}, title = {Akt-Fas to Quell Aberrant T Cell Differentiation and Apoptosis in Covid-19.}, journal = {Frontiers in immunology}, volume = {11}, number = {}, pages = {600405}, pmid = {33408715}, issn = {1664-3224}, mesh = {Apoptosis/*immunology ; CD4-Positive T-Lymphocytes/*immunology/pathology ; CD8-Positive T-Lymphocytes/*immunology/pathology ; COVID-19/*immunology/pathology ; Cell Differentiation/*immunology ; Humans ; Proto-Oncogene Proteins c-akt/*immunology ; SARS-CoV-2/*immunology ; fas Receptor/*immunology ; }, abstract = {Aberrant T cell differentiation and lymphopenia are hallmarks of severe COVID-19 disease. Since T cells must race to cull infected cells, they are quick to differentiate and achieve cytotoxic function. With this responsiveness, comes hastened apoptosis, due to a coupled mechanism of death and differentiation in both CD4+ and CD8+ lymphocytes via CD95 (Fas) and serine-threonine kinase (Akt). T cell lymphopenia in severe cases may represent cell death or peripheral migration. These facets depict SARS-Cov-2 as a lympho-manipulative pathogen; it distorts T cell function, numbers, and death, and creates a dysfunctional immune response. Whether preservation of T cells, prevention of their aberrant differentiation, and expansion of their population may alter disease course is unknown. Its investigation requires experimental interrogation of the linked differentiation and death pathway by agents known to uncouple T cell proliferation and differentiation in both CD4+ and CD8+ T cells.}, } @article {pmid33408212, year = {2021}, author = {Rieckert, A and Schuit, E and Bleijenberg, N and Ten Cate, D and de Lange, W and de Man-van Ginkel, JM and Mathijssen, E and Smit, LC and Stalpers, D and Schoonhoven, L and Veldhuizen, JD and Trappenburg, JC}, title = {How can we build and maintain the resilience of our health care professionals during COVID-19? Recommendations based on a scoping review.}, journal = {BMJ open}, volume = {11}, number = {1}, pages = {e043718}, pmid = {33408212}, issn = {2044-6055}, mesh = {COVID-19/*epidemiology/psychology ; Employment/*psychology ; Health Personnel/*psychology ; Humans ; *Mental Health ; *Pandemics ; SARS-CoV-2 ; }, abstract = {OBJECTIVE: To explore how to build and maintain the resilience of frontline healthcare professionals exposed to COVID-19 outbreak working conditions.

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

SETTING: Hospitals.

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

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

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

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

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

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

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

CONCLUSION: High index of suspicion for ASS is mandated in patients with unexplained ILD. A comprehensive autoimmune work-up is important as an early treatment with corticosteroids with or without immunomodulators improves patient outcomes and survival in an otherwise poor prognostic disease.}, } @article {pmid33407008, year = {2021}, author = {Bredan, A and Bakoush, O}, title = {COVID-19 epidemic in Libya.}, journal = {The Libyan journal of medicine}, volume = {16}, number = {1}, pages = {1871798}, doi = {10.1080/19932820.2021.1871798}, pmid = {33407008}, issn = {1819-6357}, mesh = {COVID-19/*epidemiology ; Humans ; Libya/epidemiology ; *Pandemics ; Risk Factors ; *SARS-CoV-2 ; }, abstract = {The first case of COVID-19 was identified in Libya on 24/3/2020, and about 2 months later, the number of reported COVID-19 cases started to increase notably. The outbreak was first prominent in the southern region (Sabha) and then spread to the western and eastern parts of Libya. By 24/12/2020, the reported total number of deaths from COVID-19 reached 1415. There seems to be no published data on the size of the epidemic in Libya. Here, we estimated the number of Libyans exposed to COVID-19 by using a COVID-19 mortality adjusted mathematical model for the spread of infectious diseases. We estimated that 14-20% of the Libyan population have been exposed to the COVID-19 pandemic. Thus, the risk of spread of COVID-19 infections during the coming months is high, and a considerable number of Libyans, particularly the elderly and people with chronic diseases, should be protected against COVID-19 infection. This is particularly urgent in the light of unofficial reports that the relevant healthcare facilities are under extreme stress.}, } @article {pmid33399851, year = {2021}, author = {Sharma, RK and Li, J and Krishnan, S and Richards, EM and Raizada, MK and Mohandas, R}, title = {Angiotensin-converting enzyme 2 and COVID-19 in cardiorenal diseases.}, journal = {Clinical science (London, England : 1979)}, volume = {135}, number = {1}, pages = {1-17}, doi = {10.1042/CS20200482}, pmid = {33399851}, issn = {1470-8736}, support = {R01 HL102033/HL/NHLBI NIH HHS/United States ; K08 HL130945/HL/NHLBI NIH HHS/United States ; }, mesh = {Angiotensin II/metabolism ; Angiotensin-Converting Enzyme 2/genetics/*metabolism ; Animals ; COVID-19/*enzymology/genetics/metabolism/virology ; Heart Diseases/*enzymology/genetics/metabolism/virology ; Humans ; Kidney Diseases/*enzymology/genetics/metabolism/virology ; Receptors, Virus/genetics/metabolism ; Renin-Angiotensin System ; SARS-CoV-2/physiology ; }, abstract = {The rapid spread of the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has brought into focus the key role of angiotensin-converting enzyme 2 (ACE2), which serves as a cell surface receptor required for the virus to enter cells. SARS-CoV-2 can decrease cell surface ACE2 directly by internalization of ACE2 bound to the virus and indirectly by increased ADAM17 (a disintegrin and metalloproteinase 17)-mediated shedding of ACE2. ACE2 is widely expressed in the heart, lungs, vasculature, kidney and the gastrointestinal (GI) tract, where it counteracts the deleterious effects of angiotensin II (AngII) by catalyzing the conversion of AngII into the vasodilator peptide angiotensin-(1-7) (Ang-(1-7)). The down-regulation of ACE2 by SARS-CoV-2 can be detrimental to the cardiovascular system and kidneys. Further, decreased ACE2 can cause gut dysbiosis, inflammation and potentially worsen the systemic inflammatory response and coagulopathy associated with SARS-CoV-2. This review aims to elucidate the crucial role of ACE2 both as a regulator of the renin-angiotensin system and a receptor for SARS-CoV-2 as well as the implications for Coronavirus disease 19 and its associated cardiovascular and renal complications.}, } @article {pmid33398362, year = {2021}, author = {Albashir, AAD}, title = {Renin-Angiotensin-Aldosterone System (RAAS) Inhibitors and Coronavirus Disease 2019 (COVID-19).}, journal = {Southern medical journal}, volume = {114}, number = {1}, pages = {51-56}, pmid = {33398362}, issn = {1541-8243}, mesh = {Angiotensin Receptor Antagonists/*therapeutic use ; Angiotensin-Converting Enzyme Inhibitors/*therapeutic use ; Animals ; COVID-19/*drug therapy/epidemiology/metabolism ; Humans ; *Pandemics ; Renin-Angiotensin System/drug effects/*physiology ; SARS-CoV-2 ; }, abstract = {Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the virus responsible for the coronavirus disease 2019 (COVID-19) pandemic. The angiotensin-converting enzyme 2 (ACE2) has been proven to be used by SARS-CoV-2 for host cell entry. Considering that angiotensin receptor blockers and ACE inhibitors (ACEIs) upregulate the expression of ACE2 in animal studies, there may be a concern about whether these drugs may increase COVID-19 susceptibility and severity. Recently, there has been a debate among clinicians about whether to continue or to stop ACEIs and angiotensin receptor blockers in the context of COVID-19. Also, some media outlets and health systems have called for the discontinuation of these drugs in the context of suspected COVID-19. This has necessitated an urgent release of guidance on the use of such medications in COVID-19 patients. To date, multiple theories relating to the pure effects of renin-angiotensin-aldosterone system (RAAS) inhibitors on COVID-19 infections have been postulated. Favorable effects include blocking the ACE2 receptors, preventing viral entry into the heart and lungs, and protecting against lung injury in COVID-19. Adverse effects include a possible retrograde feedback mechanism that upregulates ACE2 receptors. This review provides greater insight into the role of the RAAS axis in acute lung injury and the effects of RAAS inhibitors on SARS-CoVs. The hypothesis that RAAS inhibitors facilitate viral insertion and the alternative hypothesis of the beneficial role of these drugs are discussed. Up-to-date published data concerning the RAAS inhibitors and COVID-19 are summarized.}, } @article {pmid33394906, year = {2020}, author = {Khan, AR and Farooqui, MO and Jatoi, NN and Jawaid, S and Mahdi, D and Khosa, F}, title = {Neurological Manifestations of SARS-CoV-2: A Narrative Review.}, journal = {The neurologist}, volume = {26}, number = {1}, pages = {15-19}, pmid = {33394906}, issn = {2331-2637}, mesh = {COVID-19/*complications ; Central Nervous System Diseases/diagnostic imaging/*etiology/physiopathology ; Humans ; Musculoskeletal Diseases/diagnostic imaging/*etiology/physiopathology ; Peripheral Nervous System Diseases/diagnostic imaging/*etiology/physiopathology ; }, abstract = {BACKGROUND: Coronavirus disease 2019 (COVID-19) pandemic started as an outbreak in China and soon crossed borders to affect the populations in all countries of the world. During the initial course of the disease, COVID-19 was perceived as a pneumonia-like illness. However, recent findings of COVID-19 patients suggest that the virus has the potential to disseminate to different tissues and organs, and cause significant complications.

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

CONCLUSIONS: As subacute respiratory syndrome-coronavirus-2 may potentially have lethal implications on the nervous system, it is important that neurologists are better informed about the spectrum of clinical manifestations, radiologic findings, and likely mechanisms of injury. Understanding the symptoms and radiologic imaging allows clinicians to consider brain imaging in any patient with suspected COVID-19 and neurological symptoms.}, } @article {pmid33387996, year = {2020}, author = {Burlacu, A and Crisan-Dabija, R and Covic, A and Raiu, C and Mavrichi, I and Popa, IV and Lillo-Crespo, M}, title = {Pandemic lockdown, healthcare policies and human rights: integrating opposed views on COVID-19 public health mitigation measures.}, journal = {Reviews in cardiovascular medicine}, volume = {21}, number = {4}, pages = {509-516}, doi = {10.31083/j.rcm.2020.04.274}, pmid = {33387996}, issn = {1530-6550}, mesh = {COVID-19/*epidemiology/transmission ; Communicable Disease Control/*methods ; *Health Policy ; *Human Rights ; Humans ; Pandemics/legislation & jurisprudence/*prevention & control ; *Public Health ; *SARS-CoV-2 ; }, abstract = {The issue of the COVID-19 pandemic occupies the agenda of the whole world. The pivot of this pandemic is a crucial element that has become almost as important as the virus itself, namely the lockdown. Although, the rationale for lockdown is well-sustained by strong epidemiological arguments, exploring the 'other' unwanted consequences of the contemporary COVID-19 pandemic is mandatory for coagulating a robust agreed position against the numerous problems generated by the SARS-CoV-2 virus. Starting from the rationale of the lockdown, in this paper we explored and exposed the other consequences of the COVID-19 pandemic measures such as the use or abuse of human rights and freedom restrictions, economic issues, marginalized groups and eclipse of all other diseases. Our scientific attempt is to coagulate a stable position and integrate current opposing views by advancing the idea that rather than applying the uniform lockdown policy, one could recommend instead an improved model targeting more strict and more prolonged lockdowns to vulnerable risk/age groups while enabling less stringent measures for the lower-risk groups, minimizing both economic losses and deaths. Rigorous (and also governed by freedom) debating may be able to synchronize the opposed perspectives between those advocating an extreme lockdown (e.g., most of the epidemiologists and health experts), and those criticizing all restrictive measures (e.g., economists and human rights experts). Confronting the multiple facets of the public health mitigation measures is the only way to avoid contributing to history with yet another failure, as seen in other past epidemics.}, } @article {pmid33387993, year = {2020}, author = {Thamman, R and Janardhanan, R}, title = {Cardiac rehabilitation using telemedicine: the need for tele cardiac rehabilitation.}, journal = {Reviews in cardiovascular medicine}, volume = {21}, number = {4}, pages = {497-500}, doi = {10.31083/j.rcm.2020.04.201}, pmid = {33387993}, issn = {1530-6550}, mesh = {COVID-19/*epidemiology ; Cardiac Rehabilitation/*methods ; Comorbidity ; Heart Diseases/epidemiology/*rehabilitation ; Humans ; *Pandemics ; SARS-CoV-2 ; Telemedicine/*methods ; }, abstract = {Cardiac Rehabilitation programs have shown to improve outcomes. The COVID-19 pandemic has posed barriers to these programs. A virtual platform might be a good solution to these challenges. Tele Cardiac Rehabilitation and remote patient monitoring provide an excellent alternative practical solution.}, } @article {pmid33382966, year = {2020}, author = {Huang, C and Li, Q and Xu, W and Chen, L}, title = {Molecular and cellular mechanisms of liver dysfunction in COVID-19.}, journal = {Discovery medicine}, volume = {30}, number = {160}, pages = {107-112}, pmid = {33382966}, issn = {1944-7930}, mesh = {Antiviral Agents/therapeutic use ; COVID-19/complications/drug therapy/*metabolism/pathology ; Humans ; Hypoxia/drug therapy/*metabolism/pathology ; Inflammation/drug therapy/metabolism/pathology ; Liver/*blood supply/*metabolism/pathology ; Liver Diseases/drug therapy/etiology/*metabolism/pathology ; SARS-CoV-2/*metabolism ; }, abstract = {Liver injury has been reported as a common complication in Coronavirus disease 2019 (COVID-19). Recently, more and more studies reported that the degree of liver damages was associated with the severity of COVID-19. Although the exact mechanism of liver injury in COVID-19 patients is unknown, recent studies have made some explorations and investigations. In this review, we summarized the potential mechanisms of liver dysfunction in COVID-19 patients gleaned from recently published research reports, which suggested that the progression of pre-existing liver diseases, direct damage of liver by SARS-CoV-2, systemic inflammation caused by SARS-CoV-2 infection, anti-viral drug toxicity, and hypoxia-reperfusion may be associated with liver injury in patients with COVID-19. Hypoxic liver injury due to ischemia and shock, cholestasis-related liver injury due to altered bile metabolism, and hepatocellular injury due to drug toxicity or overwhelming inflammation might occur in severe COVID-19 patients with sepsis. To understand the pathogenesis of liver dysfunction in COVID-19 patients, further research is needed to focus on liver-related comorbidities, the evidence of viral replication in hepatocytes and bile duct cells, histological features of liver injury, and the influence of hepatotoxic antiviral drugs. We also suggested that special attention should be paid to monitoring inflammatory cytokines and hypoxia for the prevention and treatment of liver injury in severe COVID-19 patients. A deep understanding of the mechanism of liver injury is helpful for the management and treatment of COVID-19 patients.}, } @article {pmid33381955, year = {2020}, author = {Abdel-Rahman, N and Izbicki, G}, title = {To Fly Or Not To Fly? Aviation and Respiratory Diseases.}, journal = {The Israel Medical Association journal : IMAJ}, volume = {22}, number = {12}, pages = {794-799}, pmid = {33381955}, issn = {1565-1088}, mesh = {*Aircraft ; Asthenia/etiology ; Bronchiectasis/etiology ; COVID-19/etiology ; Humans ; Pulmonary Disease, Chronic Obstructive/etiology ; Respiratory Tract Diseases/*etiology ; Travel ; }, abstract = {BACKGROUND: For most passengers, even those with respiratory disease, air travel is safe and comfortable. Some travelers may experience hypoxia at sea level but may not need supplemental oxygen during air travel in a hypobaric hypoxic environment. For some individuals compensatory pulmonary mechanisms may be inadequate, causing profound hypoxia. In addition, venous thromboembolism/pulmonary emboli may occur, especially during long haul flights. With adequate screening, patients at risk can be identified, therapeutic solutions can be proposed for the flight, and most can travel can continue safely with supplemental oxygen and other preventive measures.}, } @article {pmid33377885, year = {2020}, author = {Ophinni, Y and Hasibuan, AS and Widhani, A and Maria, S and Koesnoe, S and Yunihastuti, E and Karjadi, TH and Rengganis, I and Djauzi, S}, title = {COVID-19 Vaccines: Current Status and Implication for Use in Indonesia.}, journal = {Acta medica Indonesiana}, volume = {52}, number = {4}, pages = {388-412}, pmid = {33377885}, issn = {0125-9326}, mesh = {COVID-19/immunology/prevention & control ; COVID-19 Vaccines/*pharmacology/supply & distribution ; Clinical Trials, Phase III as Topic ; Genetic Vectors ; Humans ; Immunity, Herd ; Indonesia ; Patient Selection ; RNA, Messenger/immunology ; SARS-CoV-2/genetics/immunology ; Vaccines, DNA ; Vaccines, Inactivated ; Vaccines, Synthetic ; }, abstract = {The coronavirus disease 2019 (COVID-19) has inflicted catastrophic damages in public health, economic and social stability-putting life globally on hold in 2020 and presumably a year more. Indonesia bears a heavy burden of the pandemic, counting the highest case prevalence and fatality rate in all of Southeast Asia. One hope remains in the groundbreaking universal effort in search of a vaccine against the causative virus SARS-CoV-2, which has shown success unparalleled in human vaccine development thus far. An array of modalities including novel techniques are being utilized as vaccine platforms, with the closest to phase III clinical trial completion being mRNA (manufactured by Moderna and BioNTech/Pfizer), inactivated virus (Sinovac, Sinopharm), viral vector (Oxford/AstraZeneca, Gamaleya, Janssen/Johnson&Johnson, CanSino), and protein subunit (Novavax). The vaccine produced by BioNTech/Pfizer has been deployed to the public as the first ever licensed COVID-19 vaccine. In this review, we will review all of these modalities on their safety and immunogenicity, phase II/III trial results of the nine vaccine candidates and current situation as of 29 December 2020, as well as the implication for use and distribution in Indonesia. COVID-19 vaccine progress, however, is moving exceedingly fast and new advances are unfolding on a daily basis, to which we hope an update to this review can be published in early 2021.}, } @article {pmid33361386, year = {2021}, author = {Manouchehri, N and Steinman, L and Stuve, O}, title = {Biological Significance of Anti-SARS-CoV-2 Antibodies: Lessons Learned From Progressive Multifocal Leukoencephalopathy.}, journal = {Neurology(R) neuroimmunology & neuroinflammation}, volume = {8}, number = {2}, pages = {}, pmid = {33361386}, issn = {2332-7812}, mesh = {Adaptive Immunity/*immunology ; Antibodies, Viral/*immunology ; Antibody Formation/*immunology ; Humans ; Immunity, Humoral/*immunology ; Leukoencephalopathy, Progressive Multifocal/drug therapy/*immunology ; SARS-CoV-2/*immunology ; T-Lymphocytes/*immunology ; }, abstract = {OBJECTIVE: To discuss the pathogenic and diagnostic relevance of cellular and humoral immune responses against severe acute respiratory syndrome novel coronavirus (SARS-COV-2) and pertinent observations made in progressive multifocal leukoencephalopathy (PML).

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

CONCLUSION: Based on pathogenic lessons learned from PML under natalizumab therapy, we suggest the incorporation of functional assays that determine neutralizing properties of SARS-CoV-2-specific antibodies. In addition, we outline the potential role of T-cell detection assays in determining herd immunity in a given population or in studying therapeutic responses to vaccines.}, } @article {pmid33353524, year = {2021}, author = {Al-Benna, S}, title = {Negative pressure rooms and COVID-19.}, journal = {Journal of perioperative practice}, volume = {31}, number = {1-2}, pages = {18-23}, doi = {10.1177/1750458920949453}, pmid = {33353524}, issn = {2515-7949}, mesh = {COVID-19 ; Coronavirus Infections/*prevention & control ; Humans ; Infection Control/*methods/*standards ; Operating Rooms/*standards ; Patient Isolators/*standards ; Perioperative Care/*standards ; Practice Guidelines as Topic ; Ventilation/*standards ; }, abstract = {The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes 2019 novel coronavirus disease (COVID-19), has rapidly developed into a global pandemic and public health emergency. The transmission and virulence of this new pathogen have raised concern for how best to protect healthcare professionals while effectively providing care to the infected patient requiring surgery. Although negative pressure rooms are ideal for aerosol-generating procedures, such as intubation and extubation, most operating theatres are generally maintained at a positive pressure when compared with the surrounding areas. This article compares negative and positive pressure rooms and the advantages of a negative pressure environment in optimising clinical care and minimising the exposure of patients and health care professionals to SARS-CoV-2.}, } @article {pmid33315752, year = {2021}, author = {Ogunbodede, OT and Zablotska-Manos, I and Lewis, DA}, title = {Potential and demonstrated impacts of the COVID-19 pandemic on sexually transmissible infections.}, journal = {Current opinion in infectious diseases}, volume = {34}, number = {1}, pages = {56-61}, pmid = {33315752}, issn = {1473-6527}, mesh = {COVID-19/*epidemiology ; HIV Infections/*epidemiology/transmission ; Humans ; Incidence ; *SARS-CoV-2 ; Sexual Behavior ; Sexual Health ; Sexual Partners ; Sexually Transmitted Diseases/*epidemiology/transmission ; }, abstract = {PURPOSE OF REVIEW: This review considers the potential and demonstrated impacts of SARS-CoV-2 on the sexually transmissible infection (STI)/HIV transmission.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

CONCLUSIONS: In this clinical guidance article, we review the current clinical knowledge of coronavirus disease 2019 disease in critically ill children and discuss some specific treatment concepts based mainly on expert opinion based on limited experience and the lack of any completed controlled trials in children at this time.}, } @article {pmid33002972, year = {2020}, author = {Ortiz, D}, title = {Assessment and management of agitation, sleep, and mental illness in the surgical ICU.}, journal = {Current opinion in critical care}, volume = {26}, number = {6}, pages = {634-639}, doi = {10.1097/MCC.0000000000000762}, pmid = {33002972}, issn = {1531-7072}, mesh = {*COVID-19 ; Critical Illness ; *Delirium/diagnosis/therapy ; Humans ; Intensive Care Units ; Pain Management ; Psychomotor Agitation/therapy ; SARS-CoV-2 ; Sleep ; }, abstract = {PURPOSE OF REVIEW: Increased focus on patient-centered outcomes, mental health, and delirium prevention makes this review timely and relevant for critical care.

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

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

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

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

WHAT IS NEW AND CONCLUSION: The strategy to repurpose CQ/HCQ to combat COVID-19 infection is overshadowed by concerns about their QT liability, resulting in choice of potentially subtherapeutic doses. Although the risk of QT-related proarrhythmia is real, it is low and manageable by careful monitoring. Recent discontinuation of HCQ from at least four large studies effectively marks the end of efforts at repurposing of CQ or HCQ for COVID-19 infection. This episode leaves behind important questions on dose selection and risk/benefit balance in repurposing drugs generally.}, } @article {pmid32972205, year = {2021}, author = {Tukpah, AM and Moll, M and Gay, E}, title = {COVID-19 Racial and Ethnic Inequities in Acute Care and Critical Illness Survivorship.}, journal = {Annals of the American Thoracic Society}, volume = {18}, number = {1}, pages = {23-25}, pmid = {32972205}, issn = {2325-6621}, mesh = {COVID-19/*ethnology ; Critical Care/*methods ; Critical Illness/*epidemiology ; *Ethnic Groups ; Humans ; *Pandemics ; *SARS-CoV-2 ; *Survivorship ; }, } @article {pmid32970479, year = {2020}, author = {Berger, MM and Hackett, PH and Bärtsch, P}, title = {No Relevant Analogy Between COVID-19 and Acute Mountain Sickness.}, journal = {High altitude medicine & biology}, volume = {21}, number = {4}, pages = {315-318}, doi = {10.1089/ham.2020.0147}, pmid = {32970479}, issn = {1557-8682}, mesh = {Acute Disease ; *Altitude Sickness/complications/drug therapy ; Angiotensin-Converting Enzyme 2/metabolism ; *COVID-19/complications/drug therapy ; *Erythropoietin/therapeutic use ; Humans ; Hypoxia/complications ; Inflammation/complications ; SARS-CoV-2 ; Symptom Assessment ; }, abstract = {Berger, Marc Moritz, Peter H. Hackett, and Peter Bärtsch. No relevant analogy between COVID-19 and acute mountain sickness. High Alt Med Biol. 21:315-318, 2020.-Clinicians and scientists have suggested therapies for coronavirus disease-19 (COVID-19) that are known to be effective for other medical conditions. A recent publication suggests that pathophysiological mechanisms underlying acute mountain sickness (a syndrome of nonspecific neurological symptoms typically experienced by nonacclimatized individuals at altitudes >2500 m) may overlap with the mechanisms causing COVID-19. In this short review, we briefly evaluate this mistaken analogy and demonstrate that this concept is not supported by scientific evidence.}, } @article {pmid32961274, year = {2020}, author = {de Queiroz, NMGP and Marinho, FV and Chagas, MA and Leite, LCC and Homan, EJ and de Magalhães, MTQ and Oliveira, SC}, title = {Vaccines for COVID-19: perspectives from nucleic acid vaccines to BCG as delivery vector system.}, journal = {Microbes and infection}, volume = {22}, number = {10}, pages = {515-524}, pmid = {32961274}, issn = {1769-714X}, support = {R01 AI116453/AI/NIAID NIH HHS/United States ; }, mesh = {Angiotensin-Converting Enzyme 2/chemistry ; Antibodies, Viral/immunology ; BCG Vaccine/*administration & dosage ; COVID-19/*immunology/prevention & control ; COVID-19 Vaccines/*immunology ; Epitope Mapping ; Humans ; Middle East Respiratory Syndrome Coronavirus/chemistry ; Protein Binding ; SARS-CoV-2/*immunology ; Spike Glycoprotein, Coronavirus/chemistry/*immunology ; Vaccines, DNA/*immunology ; Viral Vaccines/*immunology ; }, abstract = {This article discusses standard and new disruptive strategies in the race to develop an anti-COVID-19 vaccine. We also included new bioinformatic data from our group mapping immunodominant epitopes and structural analysis of the spike protein. Another innovative approach reviewed here is the use of BCG vaccine as priming strategy and/or delivery system expressing SARS-CoV-2 antigens.}, } @article {pmid33429331, year = {2020}, author = {Molaei, S and Dadkhah, M and Asghariazar, V and Karami, C and Safarzadeh, E}, title = {The immune response and immune evasion characteristics in SARS-CoV, MERS-CoV, and SARS-CoV-2: Vaccine design strategies.}, journal = {International immunopharmacology}, volume = {92}, number = {}, pages = {107051}, doi = {10.1016/j.intimp.2020.107051}, pmid = {33429331}, issn = {1878-1705}, abstract = {The worldwide outbreak of SARS-CoV-2, severe acute respiratory syndrome coronavirus 2 as a novel human coronavirus, was the worrying news at the beginning of 2020. Since its emergence complicated more than 870,000 individuals and led to more than 43,000 deaths worldwide. Considering to the potential threat of a pandemic and transmission severity of it, there is an urgent need to evaluate and realize this new virus's structure and behavior and the immunopathology of this disease to find potential therapeutic protocols and to design and develop effective vaccines. This disease is able to agitate the response of the immune system in the infected patients, so ARDS, as a common consequence of immunopathological events for infections with Middle East respiratory syndrome coronavirus (MERS-CoV), SARS-CoV, and SARS-CoV-2, could be the main reason for death. Here, we summarized the immune response and immune evasion characteristics in SARS-CoV, MERS-CoV, and SARS-CoV-2 and therapeutic and prophylactic strategies with a focus on vaccine development and its challenges.}, } @article {pmid33428981, year = {2021}, author = {Safari, F and Afarid, M and Rastegari, B and Haghighi, AB and Barekati-Mowahed, M and Behbahani, AB}, title = {CRISPR systems: Novel approaches for detection and combating COVID-19.}, journal = {Virus research}, volume = {}, number = {}, pages = {198282}, doi = {10.1016/j.virusres.2020.198282}, pmid = {33428981}, issn = {1872-7492}, abstract = {Type V and VI CRISPR enzymes are RNA-guided, DNA and RNA-targeting effectors that allow specific gene knockdown. Cas12 and Cas13 are CRISPR proteins that are efficient agents for diagnosis and combating single-stranded RNA (ssRNA) viruses. The programmability of these proteins paves the way for the detection and degradation of RNA viruses by targeting RNAs complementary to its CRISPR RNA (crRNA). Approximately two-thirds of viruses causing diseases contain ssRNA genomes. The Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) has caused the outbreak of the coronavirus disease 2019 (COVID-19), which has infected more than fifty million people worldwide with near 1.3 million deaths since December 2019. Thus, accurate and rapid diagnostic and therapeutic tools are essential for early detection and treatment of this widespread infectious disease. For us, the CRISPR based platforms seem to be a plausible new approach for an accurate detection and treatment of SARS-CoV-2. In this review, we talk about Cas12 and Cas13 CRISPR systems and their applications in diagnosis and treatment of RNA virus mediated diseases. In continue, the SARS-CoV-2 pathogenicity, and its conventional diagnostics and antivirals will be discussed. Moreover, we highlight novel CRISPR based diagnostic platforms and therapies for COVID-19. We also discuss the challenges of diagnostic CRISPR based platforms as well as clarifying the proposed solution for high efficient selective in vivo delivery of CRISPR components into SARS-CoV-2-infected cells.}, } @article {pmid33428900, year = {2021}, author = {Palaz, F and Kerem Kalkan, A and Tozluyurt, A and Ozsoz, M}, title = {CRISPR-based tools: alternative methods for the diagnosis of COVID-19.}, journal = {Clinical biochemistry}, volume = {}, number = {}, pages = {}, doi = {10.1016/j.clinbiochem.2020.12.011}, pmid = {33428900}, issn = {1873-2933}, abstract = {The recently emerged severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) spread all over the world rapidly and caused a global pandemic. To prevent the virus from spreading to more individuals, it is of great importance to identify and isolate infected individuals through testing. Reverse transcription-quantitative polymerase chain reaction (RT-qPCR) is the gold standard method for the diagnosis of coronavirus disease (COVID-19) worldwide. However, performing RT-qPCR is limited to centralized laboratories because of the need for sophisticated laboratory equipment and skilled personnel. Further, it can sometimes give false negative or uncertain results. Recently, new methods have been developed for nucleic acid detection and pathogen diagnosis using CRISPR-Cas systems. These methods present rapid and cost-effective diagnostic platforms that provide high sensitivity and specificity without the need for complex instrumentation. Using the CRISPR-based SARS-CoV-2 detection methods, it is possible to increase the number of daily tests in existing laboratories, reduce false negative or uncertain result rates obtained with RT-qPCR, and perform testing in resource-limited settings or at points of need where performing RT-qPCR is not feasible. Here, we briefly describe the RT-qPCR method, and discuss its limitations in meeting the current diagnostic needs. We explain how the unique properties of various CRISPR-associated enzymes are utilized for nucleic acid detection and pathogen diagnosis. Then, we highlight the important features of CRISPR-based diagnostic methods developed for SARS-CoV-2 detection. Finally, we examine the advantages and limitations of these methods, and discuss how they can contribute to improving the efficiency of the current testing systems for combating SARS-CoV-2.}, } @article {pmid33428898, year = {2021}, author = {Noreen, S and Maqbool, I and Madni, A}, title = {Dexamethasone: Therapeutic potential, risks, and future projection during COVID-19 pandemic.}, journal = {European journal of pharmacology}, volume = {}, number = {}, pages = {173854}, doi = {10.1016/j.ejphar.2021.173854}, pmid = {33428898}, issn = {1879-0712}, abstract = {The current outbreak of novel COVID-19 challenges the development of an efficient treatment plan as soon as possible. Several promising treatment options stand out as potential therapy of COVID-19, including plasma-derived drugs, monoclonal antibodies, antivirals, antimalarial, cell therapy, and corticosteroids. Dexamethasone an approved corticosteroid medication, acting as an anti-inflammatory and immunosuppressant agent. In the current pandemic, dexamethasone is declared a "major development" in the fight against COVID-19. Steroidal dexamethasone was presented as the recent advancement that significantly reduces the mortality rate among severe COVID-19 cases. This review summarizes the preliminary opinion about the dexamethasone outbreak, therapeutic potential, risks, and strategies during the COVID-19 pandemic.}, } @article {pmid33428055, year = {2021}, author = {Desai, I and Manchanda, R and Kumar, N and Tiwari, A and Kumar, M}, title = {Neurological manifestations of coronavirus disease 2019: exploring past to understand present.}, journal = {Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology}, volume = {}, number = {}, pages = {}, pmid = {33428055}, issn = {1590-3478}, abstract = {SARS-CoV-2 infection, resulting in Coronavirus disease 2019 (COVID-19), has significantly affected the entire world. It was labelled a pandemic by World Health Organization. Although it commonly produces respiratory symptoms, neurological features have been described. Neurological manifestations may vary from non-specific symptoms such as headache, dizziness, myalgia and/or fatigue, olfactory or taste dysfunction to specific syndromes including meningitis, stroke, acute transverse myelitis and Guillain-Barre syndrome. This review describes potential pathogenetic mechanisms and neurological manifestations of COVID-19 along with its management. Considering structural and pathogenetic similarity of SARS-CoV-2 with SARS-CoV and MERS viruses, we compared their neurological manifestations and mentioned few features expected in COVID-19 in future. Interestingly, many COVID-19 cases may present with pure neurological manifestations at onset with non-neurological features manifesting few days later and we propose the term "Neuro-COVID syndrome" for such cases. Awareness of neurological manifestations may facilitate its management and improve outcome in such patients.}, } @article {pmid33428032, year = {2021}, author = {Li, D and Hu, J and Li, D and Yang, W and Yin, SF and Qiu, R}, title = {Reviews on Biological Activity, Clinical Trial and Synthesis Progress of Small Molecules for the Treatment of COVID-19.}, journal = {Topics in current chemistry (Cham)}, volume = {379}, number = {1}, pages = {4}, pmid = {33428032}, issn = {2364-8961}, support = {21676076//Natural Science Foundation of China/ ; 21878071//Natural Science Foundation of China/ ; 21971060//Natural Science Foundation of China/ ; 2018RS3042//Hu-Xiang High Talent in Hunan Province/ ; WQ20164300353//State Administration of Foreign Experts Affairs (CN)/ ; }, abstract = {COVID-19 has broken out rapidly in nearly all countries worldwide, and has blossomed into a pandemic. Since the beginning of the spread of COVID-19, many scientists have been cooperating to study a vast array of old drugs and new clinical trial drugs to discover potent drugs with anti-COVID-19 activity, including antiviral drugs, antimalarial drugs, immunosuppressants, Chinese medicines, Mpro inhibitors, JAK inhibitors, etc. The most commonly used drugs are antiviral compounds, antimalarial drugs and JAK inhibitors. In this review, we summarize mainly the antimalarial drugs chloroquine and hydroxychloroquine, the antiviral drugs Favipiravir and Remdesivir, and JAK inhibitor Ruxolitinib, discussing their biological activities, clinical trials and synthesis progress.}, } @article {pmid33427404, year = {2021}, author = {Yao, Y and Yuan, X and Wu, L and Guo, N and Yin, L and Li, Y}, title = {COVID-19 and male reproduction: current research and unknown factors.}, journal = {Andrology}, volume = {}, number = {}, pages = {}, doi = {10.1111/andr.12970}, pmid = {33427404}, issn = {2047-2927}, abstract = {BACKGROUND: The testes are suspected target organs of SARS-CoV-2. However, the results of studies on the effect of COVID-19 on male reproduction are controversial.

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

METHODS: Narrative literature review.

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

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

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

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

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

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