Enhancing understanding of SARS-CoV-2 infection among individuals with Down syndrome: An integrative review

ABSTRACT BACKGROUND: Down syndrome (DS) is a non-rare genetic condition that affects approximately 1 in every 800 live births worldwide. Further, it is associated with comorbidities, anatomical alterations of the respiratory tract, and immunological dysfunctions that make individuals more susceptible to respiratory infections. OBJECTIVE: To systematize the current scientific knowledge about the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection among individuals with DS. DESIGN AND SETTING: This integrative review was conducted at the Universidade Federal de São Carlos, São Paulo, Brazil. METHODS: This review was conducted in the following databases: the Virtual Health Library (Biblioteca Virtual em Saúde, BVS), PubMed, and Web of Science, using MeSH descriptors. The search included English or Portuguese studies published between January 1, 2020, and October 14, 2022. RESULTS: A total of 55 articles from 24 countries were selected, comprising 21 case-control or cohort studies, 23 case reports or series, and 11 narrative reviews or opinion studies. The articles were grouped into five categories: previous comorbidities, coronavirus disease 2019 (COVID-19) clinical features and evolution, cytokine storm and interleukins, living in institutions as a risk factor, and behavioral actions as a protective factor against SARS-CoV-2 infection. CONCLUSION: Individuals with DS are more susceptible to COVID-19 infection due to variables such as previous comorbidities, immunological factors, and their habitable environments. These aspects confer a higher risk of infection and an unfavorable clinical course. The precise pathways involved in the pathophysiology of COVID-19 in individuals with DS are not clear, thus requiring further studies. SYSTEMATIC REVIEW REGISTRATION: The Open Science Framework registered the research protocol (https://osf.io/jyb97/).

Multisystem inflammatory syndrome in children in the context of coronavirus disease 2019 pandemic / 中国当代儿科杂志

Multisystem inflammatory syndrome in children (MIS-C) is a complex syndrome characterized by multi-organ involvement that has emerged in the context of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak. The clinical presentation of MIS-C is similar to Kawasaki disease but predominantly presents with fever and gastrointestinal symptoms, and severe cases can involve toxic shock and cardiac dysfunction. Epidemiological findings indicate that the majority of MIS-C patients test positive for SARS-CoV-2 antibodies. The pathogenesis and pathophysiology of MIS-C remain unclear, though immune dysregulation following SARS-CoV-2 infection is considered a major contributing factor. Current treatment approaches for MIS-C primarily involve intravenous immunoglobulin therapy and symptomatic supportive care. This review article provides a comprehensive overview of the definition, epidemiology, pathogenesis, clinical presentation, diagnosis, treatment, and prognosis of MIS-C.

COVID-19 in Children with West Syndrome: An Ambispective Study

Objectives To study the course of West syndrome (WS) and coronavirus disease-19 (COVID-19) in children with WS who contracted SARS-CoV-2 infection. Methods This ambispective study was conducted at a tertiary-care center in North India between December 2020 and August 2021 after approval from the Institute Ethics Committee. Five children with WS, positive for COVID-19 based on RT-PCR, fulflled the inclusion criteria. Results One child with COVID-19 during the frst wave was retrospectively included while four children (of the 70 children screened) were prospectively enrolled. The median age at onset of epileptic spasms was 7 mo (2 boys), and that at presentation with COVID-19 was 18.5 mo. Three had underlying acquired structural etiology. Three were in remission following standard therapy, while two had ongoing spasms at the time of COVID-19 illness. During the illness, two of those in remission continued to be in remission while one child had a relapse. The children with ongoing epileptic spasms had variable course [one had persistent spasms and other had transient cessation lasting 3 wk from day 2 of COVID-19 illness, but electroencephalography (on day 8 of COVID-19 illness) continued to show hypsarrhythmia]. Fever was the most typical symptom (and sometimes the only symptom) of COVID-19, with a duration ranging from 1–8 d. Two children had moderate COVID-19 illness requiring hospitalization, while the rest had a mild illness. All the afected children had complete recovery from COVID-19. Conclusion The severity of COVID-19 illness in children with WS is often mild, while the subsequent course of WS is variable.

Pleural empyema after COVID-19: A delayed presentation

Globally, the number of coronavirus disease-2019 (COVID-19) cases and deaths shows a declining trend since a peak in January 2022. For now, the pandemic phase looks to be ended, until a severe new variant may trigger another wave. At present, in India, small pockets of COVID-19 cases and post-COVID complications are still being reported. Therefore, physicians should remain vigilant about the atypical presentations and potential delayed or long-term complications of SARS-CoV-2 infection, even in individuals who had a mild COVID-19 infection. Here, we present the case of a 52-year-old male patient with a history of hypertension, who is a non-smoker and developed culture-negative pleural empyema 7 months after a mild COVID-19 infection. The patient was successfully treated with antibiotics and early video-assisted thoracoscopic surgery

Awareness, perceptions, and attitude towards Coronavirus disease 2019 vaccine among pregnant women in India: A cross-sectional study

Introduction: The present study was conducted to explore the awareness and perception of the coronavirus disease 2019 (COVID-19) vaccine among pregnant women. Material and Methods: A descriptive cross-sectional study was conducted from September 01, 2021, to September 28, 2021, among 301 pregnant women aged 18–35 years at antenatal care outpatient department in a tertiary care hospital of Western Maharashtra. Results: On assessing the knowledge and awareness score, the mean score (± standard deviation) was 7.83 ± 1.2 out of 16. A total of 176 (58.5%) had good scores(?8). There was no statistically significant association between knowledge and awareness scores and the level of education, type of residence, and age or with weeks of gestation. Although the overall awareness of study participants was satisfactory, 177 (58.8%) felt that COVID-19 vaccines should be avoided during the first trimester. Interestingly, 45 (15.3%) felt that vaccines should not be given during menstruation. There were misconceptions about perceived contraindication, with 81(26.9%), 50(16.6%) and 43(14.4%) responding that diabetes, hypertension and heart disease are contradicts respectively. Interestingly, a total of 52 (17.3%) responded as likely when enquired whether the present vaccine can cause infertility. Similarly, about 62% of study participants felt that the vaccine might alter the DNA. Conclusion: The present study revealed good overall knowledge and awareness about the COVID-19 vaccine among pregnant with certain misconceptions. The findings suggest that immediate health education programs, risk communication, and correct information should be disseminated by respective health authorities.

A review of venous thromboembolism in India

Venous thromboembolism (VTE), which entails the formation of a thrombus (blood clot) in a vein, has a significant disease burden worldwide. While VTE has traditionally been considered to predominantly affect Caucasian populations, recent studies have indicated a gradual shift in the disease burden towards Asian populations, with added significance of it being a key driver of post-operative mortality. It is imperative to develop a sound understanding of the various factors that affect VTE in stratified local populations. However, there is a glaring paucity of quality data on VTE and its ramifications among Indians - both in terms of quality of life and cost of healthcare. This review aims to throw light on the disease burden, epidemiology, risk factors, environmental factors, food and nutrition that plays a key role in VTE. We also explored the association of VTE with coronavirus disease 2019 to grasp the interplay between the two most significant public health crises of our time. It is vital to place a special emphasis on future research on VTE in India to plug the gaps, which exist in our current knowledge of the disease, particularly with respect to Indian population

Comparative study of the clinicoepidemiological profile of COVID-19 patients of first wave and second wave admitted in a tertiary care teaching hospital in Nadiad, Gujarat, India

Background: According to other studies, second wave was different as compared to the first wave in clinical outcomes and laboratory parameters. Aims and Objectives: We aimed to compare the clinicoepidemiological features and their effect on mortality in coronavirus disease-2019 (COVID-19) patients of first wave versus second wave. Materials and Methods: We carried out cross-sectional, observational, and retrospective study among two groups of COVID-19 patients of first and second wave. Each group contains a 135 patients of COVID-19 admitted at our hospital. We analyzed the demographic profile, clinical features, comorbidities, and inflammatory markers. Results: In our study, majority patients were male (67%). Majority number of the patients were between 18 and 60 years of age in both the groups. Presenting complaint of shortness of breath was significantly higher in second wave and sore throat was significantly higher in first wave. SpO2 on admission was significantly lower in second wave (93% vs. 98%). Median value of C-reactive protein (6.865 vs. 2.805), neutrophil-leucocyte ratio (4.647 vs. 2.917), and D-dimer (679.5 vs. 450) were significantly higher in second wave. Second wave had significantly higher mortality as compared to first wave (18.5% vs. 4.4%). However, level of D-dimer was found significantly higher in patients who died during first wave (6820 vs. 848). Higher mortality was seen in male patients of second wave. Conclusion: Overall higher mortality was seen during the second wave which was supported by increased in the inflammatory markers. Delta variant, late admission, increased demand of oxygen support, and intensive care unit beds may have led to higher mortality.

Lipschütz acute vulvar ulcer related to COVID-19 vaccination: First case report in South America / Úlcera vulvar aguda de Lipschütz relacionada con la vacunación por COVID-19: primer caso notificado en Sudamérica

Lipschütz ulcer is a non-sexually transmitted genital lesion of unknown etiology, which presents as a painful vulvar ulcer. Lipschütz ulcers have been described in most continents. This is the first case reported in Peru and South America. We present the case of a 33-year-old female patient with a Lipschütz ulcer after being vaccinated with the second dose of the AstraZeneca COVID-19 vaccine. She reported having had only one sexual partner in her lifetime. Laboratory results were negative for herpes simplex 2, Cytomegalovirus, Toxoplasma gondii, Epstein-Barr virus, and syphilis. The patient received symptomatic treatment. Ten days after the onset, the patient was significantly better during follow-up. This case report displays a potential adverse effect of the AstraZeneca COVID-19 vaccine as a Lipschütz ulcer triggered by the host humoral immune response. However, further research is needed to establish the causal relationship between these two.

La úlcera de Lipschütz es una lesión genital no transmitidas por vía sexual de etiología desconocida, se presenta como una úlcera vulvar muy dolorosa. Las úlceras de Lipschütz se han descrito en la mayoría de los continentes. Este es el primer caso que se reporta en Perú y Sudamérica. En este reporte de caso se presentauna paciente de 33 años con una úlcera de Lipschütz luego de haber sido vacunada con la segunda dosis de la vacuna AstraZeneca COVID-19. Refirió haber tenido una sola pareja sexual a lo largo de su vida. Los resultados de laboratorio fueron negativos para herpes simplex 2, Citomegalovirus, Toxoplasma gondii, virus de Epstein-Barr y sífilis. La paciente recibió tratamiento sintomático. Diez días después, durante el seguimiento, la paciente estaba significativamente mejor. Este reporte de caso expone un potencial efecto adverso de la vacuna AstraZeneca COVID-19, en forma de úlcera de Lipschütz, desencadenado por la respuesta inmune humoral del huésped. Sin embargo, es necesario realizar más investigación para establecer la relación causal entre ambos.

Bilateral acute depigmentation of the iris determined in two cases after COVID-19 infection

Bilateral acute depigmentation of the iris (BADI) is a rare disease characterized by iris atrophy. Although it can be self-limiting, it is sometimes progressive and can lead to glaucoma and severe vision loss. Two female patients were admitted to our clinic because of a change in iris color following coronavirus disease 2019 (COVID-19) infection. After the exclusion of other etiologies in the eye examination, BADI was diagnosed in both cases. Thus, it was shown that COVID-19 may also be involved in the etiology of BADI.

Pulmonary embolism in an adolescent with COVID-19 pneumonia / Tromboembolismo pulmonar en un adolescente con neumonía COVID-19

Abstract Background: Pulmonary embolism (PE) is a complication reported in the adult population with coronavirus disease 2019 (COVID-19); however, its documentation in the pediatric population is limiteda. Case report: We report the case of a 15-year-old male with obesity and Down syndrome who was admitted for severe COVID-19 pneumonia. On day 7 of admission, he presented with chest pain, hemoptysis, respiratory distress, and marked elevation of D-dimer. Pulmonary CT angiography found an extensive thrombus in the right lower lobar artery. He received treatment with enoxaparin and rivaroxaban and had a favorable clinical outcome. In the tomographic control 1 month after treatment, thrombus was not evidenced and was successfully resolved. Conclusions: There are few reports of PE in children with COVID-19. Prompt diagnosis and early anticoagulant treatment are important to avoid life-threatening complications.

Resumen Introducción: El tromboembolismo pulmonar es una complicación reportada en la población adulta con COVID-19; sin embargo, en la población pediátrica, su descripción es limitada. Caso clínico: Se reporta el caso de un varón de 15 años con antecedente de obesidad y síndrome de Down que fue hospitalizado por neumonía COVID-19 severa. En el séptimo día de hospitalización presentó dolor torácico, hemoptisis, dificultad respiratoria y elevación del dímero D. En la angiotomografía pulmonar se encontró un extenso trombo en la arteria lobar inferior derecha. Recibió tratamiento con enoxaparina y rivaroxabán evolucionando favorablemente. La resolución al mes de tratamiento fue existosa, ya que el control tomográfico no evidenció más el trombo. Conclusiones: El tromboembolismo pulmonar es una complicación poco reportada en niños con neumonía COVID-19. El diagnóstico oportuno y tratamiento anticoagulante es importante para evitar complicaciones mortales.

Food and nutrition security in the Philippines during the COVID-19 pandemic / Journal of Rural Medicine

Objective: The COVID-19 pandemic placed the Philippines’ food and nutrition issues front and center. In this paper, we discuss the response of its government in addressing food and nutrition security at the beginning of the COVID-19 pandemic and describe its implications on nutritional status. We also cite initiatives that address food accessibility and availability in the communities. Lastly, we explore the importance of nutrition security dimension in food security.Methods: We analyze food and nutrition security issues in the Philippines during the COVID-19 pandemic through online reports and news articles.Results: The distribution of food and financial assistance in the country was extensive, albeit insufficient, considering the prolonged lockdown restrictions. Constantly changing community quarantine guidelines have affected the movement of food supply, delivery of health services, and household economic security. Nutrition programs, such as vitamin A supplementation, feeding for children, and micronutrient supplementation for pregnant women, had lower coverage rates, and by the latter half of 2020, the country had reached its highest recorded hunger rate. Cases of both undernutrition and overnutrition are predicted to rise because of dietary imbalances and a variety of factors. Conversely, community members and some local government units took it upon themselves to improve the food situation in their areas. The provision of food packs containing fresh fruits and vegetables was lauded, as it exemplified a conscious effort to deal with nutrition security.Conclusion: Efforts to address food security have always focused on increasing accessibility, availability, and affordability, often neglecting the nutritional components of foods. Strategies that incorporate nutrition security into food security are much needed in the country, especially during emergencies like the COVID-19 pandemic.

Evolution of the newest diagnostic methods for COVID-19: a Chinese perspective / 浙江大学学报（英文版）（B辑：生物医学和生物技术）

Coronavirus disease 2019 (COVID-19) has continued to spread globally since late 2019, representing a formidable challenge to the world's healthcare systems, wreaking havoc, and spreading rapidly through human contact. With fever, fatigue, and a persistent dry cough being the hallmark symptoms, this disease threatened to destabilize the delicate balance of our global community. Rapid and accurate diagnosis of COVID-19 is a prerequisite for understanding the number of confirmed cases in the world or a region, and an important factor in epidemic assessment and the development of control measures. It also plays a crucial role in ensuring that patients receive the appropriate medical treatment, leading to optimal patient care. Reverse transcription-polymerase chain reaction (RT-PCR) technology is currently the most mature method for detecting viral nucleic acids, but it has many drawbacks. Meanwhile, a variety of COVID-19 detection methods, including molecular biological diagnostic, immunodiagnostic, imaging, and artificial intelligence methods have been developed and applied in clinical practice to meet diverse scenarios and needs. These methods can help clinicians diagnose and treat COVID-19 patients. This review describes the variety of such methods used in China, providing an important reference in the field of the clinical diagnosis of COVID-19.

Integrated Chinese and Western Medicine for Tuberculosis and Severe Malnutrition with Coronavirus Disease 2019（Critical Type）： A Case Report / 中医杂志

We reported a case of a patient dignosed as tuberculosis and severe malnutrition with coronavirus disease 2019 （critical type） treated with a combination of Chinese medicine and Western medicine. Through the retrospective analysis of the diagnosis and treatment process of this patient， on the basis of Chinese medicine's understanding of the etiology and pathogenesis of “old state” and “deficient state”， the critical coronavirus pneumonia combined with pulmonary tuberculosis and severe malnutrition was mostly due to the physical condition and the invasion of epidemic toxin， resulting in dysfunctions of the internal organs such as the lungs， spleens， kidneys and other organs. Based on the understanding of the cause and mechanism of the coronavirus disease， the treatment combined Chinese and Western medical therapies was given. The western medicine was used with the main treatments of oxygen therapy， anti-viral， intestinal nutritional support， and anti-coagulation， while the Chinese medicine was used by tonifying qi， blood， yin， and yang， warming yang and dissipating cold， and clearing heat and dampness， then tonifying qi， nourishing yin and eliminating heat， in which tonifying middle and replenishing qi ran through the whole process. The integrated treatment eventually improved the patient's symptoms and accelerated the negative conversion of nucleic acid of the coronavirus.

TONG Xiaolin's Cold-Damp Epidemic Differentiation and Treatment Concepts and Diagnostic and Therapeutic Key Points / 中医杂志

Building on a clear understanding of the diagnosis and treatment patterns for cold-damp epidemics， and incorporating the insights of Academician TONG Xiaolin regarding the differentiation and treatment of such epidemics， this article have distilled the key diagnostic principles. These principles primarily entail observing color and pulse， initially distinguishing between yin and yang， with treatment focusing on dispelling cold and dampness. A comprehensive approach is adopted throughout treatment， with a combination of overall strategies and tailored treatments that evolve in line with the patient's condition. In critical and severe cases， particular attention is given to aspects such as sweating， pulse analysis， and consciousness， preventing the pathogen from penetrating deeply. Efforts are made to open and close organ networks， expelling external pathogens without fixating on resolving constipation. The dosage and efficacy of herbal remedies are adjusted based on individual circumstances and clinical symptoms. The objective is to eliminate pathogens comprehensively， while being vigilant against relapses， ultimately achieving a full recovery. This overview of the thought processes and clinical principles for diagnosing and treating cold-damp epidemics will guide precise clinical practices and provide a theoretical foundation for the involvement of traditional Chinese medicine in epidemic prevention and treatment.

Verification of detection method for multiple pathogens in plasma of convalescent patients with Coronavirus Disease 2019 / 中国生物制品学杂志

@#Objective To systematically verify the detection method for multiple pathogens in plasma of convalescent patients(CPs)with Coronavirus Disease 2019(COVID-19).Methods According to the actual situation of plasma samples and the requirements of kit,the molecular biological detection method for multiple pathogens in plasma of CPs with COVID-19 was systematically verified for specificity,reproducibility,intermediate precision and limit of detection(LOD),and confirmed for applicability by detecting 50 plasma samples of CPs with COVID-19.Results The results of interference test and cross test showed that the detection of positive samples and negative samples were not affected;The RSDs of melting temperature values(Tm)of the positive control four pathogens by the same or different test personnels at different time under the same test conditions were 0.07%,0.14%,0.07%,0.14% and 0.06%,0.23%,0.23%,0.20%,and those of internal control(IC)and amplification control(AC)1 and 2 were 0.07%,0.01%,0.07%,0.14% and 0.11%,0.10%,0.15%,0.22%,respectively.Meanwhile,the RSDs of reproducibility and intermediate precision were less than 15% and20% respectively,which met the requirements;The minimum LOD of 22 pathogens were determined;No pathogen was detected in 50 plasma samples of CPs with COVID-19.Conclusion The method for detecting pathogens in plasma of CPs with COVID-19 was specific,stable,reliable and reproducible,which was suitable for the detection of pathogens in plasma of CPs with COVID-19.

Enhancing the Effectiveness of Surveillance Systems in Pacific Island Countries as Early Warning Systems for Detecting and Responding to COVID-19 Outbreaks: Key Strategies and Recommendations

@#The coronavirus disease 2019 (COVID-19) pandemic has uncovered the need for health systems to be strengthened in order to be able to respond quickly to any potential future outbreaks. In response, the Pacific Syndromic Surveillance System (PSSS) is currently being used by many countries within the Pacific Islands for tracking and addressing infectious disease outbreaks, including COVID-19. To maximise its usefulness as an early warning system, investments must be made in strengthening data quality, data sharing, health facility capacity, technology, and ongoing evaluation of surveillance systems. Doing so will ensure that the PSSS and other surveillance systems can remain effective tools for monitoring and respond to infectious disease outbreaks in the Pacific Islands

Vascular endothelial growth factor gene insertion/deletion polymorphism is associated with Vitamin D level in Turkish patients with coronavirus disease 2019

SUMMARY OBJECTIVE: Coronavirus disease 2019 emerges as a disease caused by severe acute respiratory syndrome coronavirus 2. It is a systemic disease associated with vascular inflammation and endothelial damage. In this study, we aimed to investigate whether vascular endothelial growth factor gene insertion/deletion polymorphism is associated with coronavirus disease 2019 in the Turkish population. METHODS: The study included 179 participants (79 patients with coronavirus disease 2019 and 100 controls). DNA isolation was made from peripheral blood, and then the polymerase chain reaction analysis was performed. RESULTS: When we analyze vascular endothelial growth factor gene insertion/deletion polymorphism in the study group, we found that the DD genotype and D allele were found to be statistically significantly different when compared to coronavirus disease 2019 patients with high vitamin D value (p=0.005 for DD genotype and p=0.006 for D allele) in the control group. In this high-level control group, when we analyze II+ID genotype versus DD, a statistically significant difference was also detected (p=0.007). CONCLUSION: As a result of the study, we found that DD genotype and D allele were associated with vitamin D level in Turkish patients with coronavirus disease 2019.

After action review of the COVID-19 pandemic response in North West province, South Africa

Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) caused coronavirus disease 2019 (COVID-19) pandemic with major disruptions globally. Northwest Province Department of Health (NWDoH) in South Africa set up comprehensive epidemiological emergency response plans for preventing, finding, containing and stopping the spread of COVID-19 in accordance with the National Disaster Management Act. Objectives: This After-Action Report (AAR) describes the provincial response to the pandemic from September 2020 to October 2022. Method: The AAR was conducted using the World Health Organization AAR methodology. Focus groups discussed five items: coordination, leadership and governance; epidemiology, surveillance and laboratory; case management and continuity of essential services; risk communication and community engagement and COVID-19 vaccination. Results: The timely establishment and activation of provincial intergovernmental and intersectoral coordinating structures led to effective coordination, resource mobilisation, leadership, decision-making and intervention. The effective communication in the department and other stakeholders resulted in improved surveillance data quality, timelier response and increased ownership of data. Dissemination, training and implementation of case management protocols ensured standardised case management. The multi-channel information dissemination targeting different audiences empowered people with real-time knowledge on the infection and encouraged health-seeking behaviours. Conclusion: The AAR demonstrated the importance of coordinated epidemiological, laboratory and communication response that requires significant public health reserve capacity in peacetime for rapid expansion in an emergency. Contribution: This review contributes to the body of knowledge emerging from the COVID-19 pandemic and provides guidance on enhanced public health response to future emergencies.

Acute and subacute oral toxicity characterization and safety assessment of COVID organics® (Madagascar's Anti­COVID Herbal Tea) in animal models

Introduction: Coronavirus disease 2019 (COVID 19) is an infectious disease caused by severe acute respiratory syndrome coronavirus 2. No drug has been generally approved as safe and effective for the treatment of COVID 19. Several therapeutic agents such as COVID Organics® (CVO) have been explored as treatment options. CVO is an herbal tea composed of 62% of Artemisia annua and 38% of other plants. There is presently no existing scientific report and data on the safety and efficacy of CVO herbal drug. Thus, acute and subacute toxicity studies were undertaken to evaluate the safety and toxicity of CVO on short and long term usage in animal models. Materials and Methods: Phytochemical and nutritional compositions of CVO were determined using standard methods. Acute oral toxicity was investigated using female Swiss albino mice (three per group). While subacute oral toxicity was done using female and male Swiss albino rats (five per group). The animals were administered 2000 mg/kg, 5000 mg/kg, therapeutic dose; 5500 mg/kg and supratherapeutic dose; 11,000 mg/kg of CVO herbal product. The control group received water ad libitum. The oral toxicity studies were done in accordance with Organization for Economic Corporation and Development guidelines. The experimental protocol was approved by the Institutional Animal Care and Use Committee, Nigerian Institute of Medical Research (Ethics No. IRB/17/043). Results: CVO is rich in antioxidants: flavonoids(10.3%), tannins(29.1%), and phenolics(434.4 mg). It contains proteins (33.8%), carbohydrates (34.5%), fat (6.8%), and fiber (0.5%). In the acute toxicity study, no mortality was recorded in all the treated and untreated groups. The lethal dose of CVO is >5000 mg/kg body weight. The hematological, biochemical, lipid profile, and histologic parameters were all normal at therapeutic doses when compared to the control group. Conclusion: The acute and subacute oral toxicity studies revealed that CVO is not toxic. The specific organ toxicity evaluations also indicated that CVO has no toxic effects on blood parameters and vital organs structure and function at therapeutic dose. Thus, CVO is safe for short and long term usage. We recommend that CVO should be subjected to efficacy studies to investigate whether it is effective for COVID 19 treatment as claimed by the manufacturer.

A close contact of coronavirus disease 2019 with severe imported malaria: a case report / 中国血吸虫病防治杂志

This article presents a severe cerebral malaria patient in shock with a close contact of COVID-19 that was successfully cured in a negative pressure ward during the global pandemic of COVID-19. The patient experienced a sudden onset of high fever and coma in a designated isolation hotel after returning from Africa, and was transferred to a designated hospital. Following antimalarial therapy, blood pressure elevation, increase of blood volume, bedside hemodialysis, mechanical ventilation, plasma and platelet transfusions, the case gradual recovered.