Résumé
As of August 16,2021,there have been 207,173,086 confirmed cases and 4,361,996 deaths due to the coronavirus disease(COVID-19),and the pandemic remains a global challenge.To date,no effective and approved drugs are available for the treatment of COVID-19.Angiotensin-converting enzyme 2(ACE2)plays a crucial role in the invasion into host cells by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2),the etiological agent of COVID-19.Notably,ACE2 density is influenced by medical con-ditions,such as hypertension,or by drugs,including angiotensin-converting enzyme inhibitors(ACEIs)and angiotensin receptor blockers(ARBs),which can change the fate of SARS-CoV-2 infectivity.ACE2 is a target for these drugs and can be manipulated to limit the viral entry and replication within the cells.Different strategies aimed at blocking ACE2 with small molecules,peptides,and antibodies,or by neutralizing the virus through its competitive binding with human recombinant soluble ACE2(hrsACE2)are currently under investigation.In this article,we review the current state of knowledge that em-phasizes the need to find effective therapeutic agents against COVID-19 by exploiting ACE2 as a potential target.The increased soluble ACE2 levels and the application of hrsACE2 in patients with COVID-19 can be implemented to control the disease.It has not yet been established whether hypertension and other comorbidities,independent of age,have a direct role in COVID-19.Therefore,the use of renin-angiotensin system inhibitors,ACEls and ARBs,should not be discontinued during COVID-19 treatment.
Résumé
The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is an ongoing global pandemic that has devastated our globalized economic system. Apart from infecting 12,102,328 human beings and taking a toll of over 551,046 lives globally by the 11th of July 2020, it has fundamentally affected the way we live, work, travel, and relate to each other. Despite imposing early preventive measures, India has crossed a total caseload of 820,916 with a total death of 22,123 till-date, ranking third in the descending list of worst-affected nations. Although comparatively lower, the case fatality rate in India is 2.72% against the global fatality of 4.53%. It is an empirical fact that every process and institution must evolve to meet the needs of its time. A model for categorization of fatality among real-time reverse transcriptase-polymerase chain reaction (RT-PCR) positive COVID-19 patients has been developed at Uttar Pradesh University of Medical Sciences (UPUMS), to address the issue of patients being transferred very late in the course of the disease to level-3 facilities. The UPUMS model of categorization of fatalities of COVID-19 patients at level-3 center comprises of category-1 as ‘Institutional COVID-19 fatalities’, category-2 as ‘Imported COVID-19 fatalities’ and category-3 being ‘Imminent with Incidental COVID-19’ fatalities. This endeavor of categorizing COVID-19 fatalities is an opportunity to analyze facts and contemporary science to assess our response to this pandemic and thereby take lessons to prepare better for the future. Following proper analysis, we noted that most of these fatalities (64%) at the higher center are because of delayed referrals hence termed as imported fatalities, which need a modality of early attention and referral. However, there are fatalities which occur because of severe systemic illness like liver failure, cardiovascular accident (CVA), myocardial infarction (MI), etc. They need due treatment at a regional center. These constitute up to 18%. Authors found that actual COVID-19 deaths constitute only 18% of the total projected fatalities.
Résumé
Background: Objective of current study was to compare and evaluate different diagnostic tests to establish a reliable and less time consuming diagnostic test for prompt diagnosis of acute Japanese encephalitis cases mainly amongst children and young adults from North-Eastern part of Uttar Pradesh. Methods: A total of 100 subjects, including 50 suspected cases and 50 diseased controls were investigated to establish the diagnosis of JE in acute encephalitis patients. All CSF samples were subjected to MAC-ELISA, virus cultivation and RT-PCR. Results: Out of 50 cases, 6 showed negative results by all the three tests. 50% (22 out of 44), 47.5% (21 out of 44), and 66% (23 out of 44) were found positive by MAC-ELISA, Virus cultivation and RT-PCR respectively. The rate of detection by Virus cultivation and RT-PCR was higher in case of MAC-ELISA negative cases (57.1% and 78.5%) than that of MAC-ELISA positive cases (22.7% and 27.2%) respectively. Mean age of the patients was 12.5 years, which ranged from 1-24 years with male to female ratio of 3:1. Conclusions: The RT-PCR was found most reliable, sensitive and specific method amongst the three chosen methods for detection of JEV in suspected encephalitis patients.