COVID-19 outcomes in patients with Dermatomyositis: A registry-based cohort analysis.

BACKGROUND: Patients with rheumatic diseases (RDs) like DM are known to be vulnerable towards various types of infections due to aggressive disease activity mandating high dose immunosuppressive therapy. The severity of COVID-19 in RDs is limited in literature due to the heterogeneous nature of the condition. Therefore, specific details on mortality is essential to navigate any precautions required in the treatment. OBJECTIVES: To determine outcomes of COVID-19 in DM as compared to controls, and identify the risk association of gender, race, interstitial lung disease, neoplasms, and use of immunosuppressant. METHODS: Retrospective data of individuals with DM and COVID-19 and the general population with COVID-19 between January 2020 to August 2021 was retrieved from the TriNetX database. 1:1 Propensity Score matching was used to adjust for confounders. We assessed COVID-19 outcomes such as mortality, hospitalisation, ICU admission, severe COVID-19, mechanical ventilation (MV), acute kidney injury (AKI), venous thromboembolism (VTE), ischemic stroke, acute respiratory distress syndrome (ARDS), renal replacement therapy (RRT) and sepsis. Subgroup analyses included gender, race, ILD, cancer patients, disease-modifying rheumatic drugs (DMARDs) use, and glucocorticoids (GC) use. RESULTS: We identified 5,574 DM patients with COVID-19, and 5,574 general population with COVID-19 (controls). DM with COVID-19 had a lower risk of mortality in comparison to controls [RR 0.76], hospitalisation [RR 0.8], severe COVID-19 [RR 0.76], AKI [RR 0.83], and sepsis [RR 0.73]. Males and African Americans were more likely to develop AKI [RR 1.35, 1.65], while African Americans had higher odds for severe COVID-19 [RR 1.62] and VTE [RR 1.54]. DM with ILD group also experienced higher odds for severe COVID-19 infection [RR 1.64], and VTE [RR 2.06]. DM patients receiving DMARDs and glucocorticoids had higher odds for hospitalisation [RR 1.46, 2.12], and sepsis [RR 3.25, 2.4] Subgroup analysis of 5-year neoplasm history amongst DM patients with COVID-19 was inadequate for meaningful comparison. CONCLUSION: Dermatomyositis patients without comorbities have reasonable COVID-19 outcomes including mortality and hospitalisation. Black race, male gender, ILD, DMARDS and glucocorticoid users, are associated with poor outcomes.

An In-silico Screening Strategy to the Prediction of New Inhibitors of COVID-19 Mpro Protein.

The coronavirus disease-2019 (COVID-19) was first recognized in Wuhan, China, and quickly spread worldwide. Between all proposed research guidelines, inhibition of the main protease (Mpro) protein of the virus will be one of the main strategies for COVID-19 treatment. The present work was aimed to perform a computational study on FDA-approved drugs, similar to piperine scaffold, to find possible Mpro inhibitors. Firstly, virtual screening studies were performed on a library of FDA-approved drugs (43 medicinal compounds, similar to piperine scaffold). Among imported 43 drugs to virtual screening, 34 compounds were extracted. Four top-ranked drugs in terms of the highest interactions and the lowest binding energy were selected for the IFD study. Among these selections, lasofoxifene showed the lowest IFD score (-691.743 kcal mol-1). The stability of lasofoxifene in the COVID-19 Mpro protein active site was confirmed with 100 ns MD simulation. Lasofoxifene binding free energy was obtained -107.09 and -173.97 kcal mol-1, using Prime MM-GBSA and g_mmpbsa methods, respectively. The identified lasofoxifene by the presented computational approaches could be a suitable lead for inhibiting Mpro protein and COVID-19 treatment.

An In-silico Screening Strategy to the Prediction of New Inhibitors of COVID-19 Mpro Protein

The coronavirus disease-2019 (COVID-19) was first recognized in Wuhan, China, and quickly spread worldwide. Between all proposed research guidelines, inhibition of the main protease (Mpro) protein of the virus will be one of the main strategies for COVID-19 treatment. The present work was aimed to perform a computational study on FDA-approved drugs, similar to piperine scaffold, to find possible Mpro inhibitors. Firstly, virtual screening studies were performed on a library of FDA-approved drugs (43 medicinal compounds, similar to piperine scaffold). Among imported 43 drugs to virtual screening, 34 compounds were extracted. Four top-ranked drugs in terms of the highest interactions and the lowest binding energy were selected for the IFD study. Among these selections, lasofoxifene showed the lowest IFD score (-691.743 kcal mol-1). The stability of lasofoxifene in the COVID-19 Mpro protein active site was confirmed with 100 ns MD simulation. Lasofoxifene binding free energy was obtained -107.09 and -173.97 kcal mol-1, using Prime MM-GBSA and g_mmpbsa methods, respectively. The identified lasofoxifene by the presented computational approaches could be a suitable lead for inhibiting Mpro protein and COVID-19 treatment.

Specific Regulatory Motifs Network in SARS-CoV-2-Infected Caco-2 Cell Line, as a Model of Gastrointestinal Infections.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was primarily noted as a respiratory pathogen, but later clinical reports highlighted its extrapulmonary effects particularly on the gastrointestinal (GI) tract. The aim of the current study was the prediction of crucial genes associated with the regulatory network motifs, probably responsible for the SARS-CoV-2 effects on the GI tract. The data were obtained from a published study on the effect of SARS-CoV-2 on the Caco-2 (colon carcinoma) cell line. We used transcription factors-microRNA-gene interaction databases to find the key regulatory molecules, then analyzed the data using the FANMOD software for detection of the crucial regulatory motifs. Cytoscape software was then used to construct and analyze the regulatory network of these motifs and identify their crucial genes. Finally, GEPIA2 (Gene Expression Profiling Interactive Analysis 2) and UALCAN datasets were used to evaluate the possible relationship between crucial genes and colon cancer development. Using bioinformatics tools, we demonstrated one 3edge feed-forward loop motifs and recognized 10 crucial genes in relationship with Caco-2 cell infected by SARS-CoV-2, including SP1, TSC22D2, POU2F1, REST, NFIC, CHD7, E2F1, CEBPA, TCF7L2, and TSC22D1. The box plot analysis indicated the significant overexpression of CEBPA in colon cancer compared to normal colon tissues, while it was in contrast with the results of stage plot. However, the overall survival analysis indicated that high expression of CEBPA has positive effect on colon cancer patient survivability, verifying the results of CEBPA stage plot. We predict that the SARS-CoV-2 GI infections may cause a serious risk in colon cancer patients. However, further experimental studies are required.

Design and synthesis of novel phe-phe hydroxyethylene derivatives as potential coronavirus main protease inhibitors.

In response to the current pandemic caused by the novel SARS-CoV-2, we design new compounds based on Lopinavir structure as an FDA-approved antiviral agent which is currently under more evaluation in clinical trials for COVID-19 patients. This is the first example of the preparation of Lopinavir isosteres from the main core of Lopinavir conducted to various heterocyclic fragments. It is proposed that main protease inhibitors play an important role in the cycle life of coronavirus. Thus, the protease inhibition effect of synthesized compounds was studied by molecular docking method. All of these 10 molecules, showing a good docking score compared. Molecular dynamics (MD) simulations also confirmed the stability of the best-designed compound in Mpro active site.Communicated by Ramaswamy H. Sarma.