Etiology of Pancreatitis in Patients at a Tertiary Care Center

Objective: To compare etiological frequencies in patients of acute pancreatitis presenting to our setup with international data. Study Design: Cross-sectional study Place and Duration of Study: Department of Gastroenterology, Pakistan Emirates Military Hospital & Combined Military Hospital, Rawalpindi Pakistan, from Aug 2020 to Jan 2022. Methodology: Patients over 12 years suffering from pancreatitis were recruited using a convenience sampling technique based upon predefined criteria for diagnosis of pancreatitis on a questionnaire. Relevant basic lab tests, including chemistries and imaging, including Ultrasound abdomen and CECT abdomen, were analyzed to establish aetiology. Data were continuously uploaded into an electronic data sheet. International Consensus Diagnostic Criteria (ICDC) algorithms were applied to diagnose autoimmune pancreatitis. Results: Out of 120 patients, 74(61.7%) were males, and 46(38.3%) were females. Biliary pancreatitis was the most common aetiology 50(41.7%), followed in descending order by idiopathic 36(30%), drug-induced pancreatitis (DIP) 9(7.5%), Post ERCP Pancreatitis (PEP) 8(6.7%), tumours 5(4%), Autoimmune pancreatitis (AIP), Hypertriglyceridemia and alcohol-induced pancreatitis each 2(1.7%). Conclusion: Biliary pancreatitis has the highest frequency, followed by idiopathic and drug-induced pancreatitis. © 2023, Army Medical College. All rights reserved.

Cannabinoids receptors in Covid-19: Perpetrators and victims.

COVID-19 is caused by SARS-CoV-2 and leads to acute lung injury (ALI), acute respiratory distress syndrome (ARDS), and extrapulmonary manifestations in severely affected cases. However, most of the affected cases are mild or asymptomatic. Cannabinoids (CBs) such as tetrahydrocannabinol (THC) and cannabidiol (CBD), which act on G-protein-coupled receptors called CB1 and CB2, have anti-inflammatory effects. Many published studies show that CBs are effective in various inflammatory disorders, viral infections, and attenuation of ALI and ARDS. Therefore, the aim of the present narrative review was to summarize the possible immunological role of CBs in COVID-19. The effects of CBs are controversial, although they have beneficial effects via CB2 receptors and adverse effects via CB1 receptors against ALI, ARDS, and hyperinflammation, which are hallmarks of COVID-19. The present narrative review has shown that CBs effectively manage ALI and ARDS by suppressing pro-inflammatory cytokines, which are common in COVID-19. Therefore, CBs may be used to manage COVID-19 because of their potent anti-inflammatory effects with suppression of pro-inflammatory cytokines and inhibition of inflammatory signaling pathways.

SARS‐CoV‐2 induced HDL dysfunction may affect the host's response to and recovery from COVID‐19

Introduction Covid‐19 is linked with the development of cardio‐metabolic disorders, including dyslipidemia, dysregulation of high‐density lipoprotein (HDL), and low‐density lipoprotein (LDL). Furthermore, SARS‐Co‐2 infection is associated with noteworthy changes in lipid profile, which is suggested as a possible biomarker to support the diagnosis and management of Covid‐19. Methods This paper adopts the literature review method to obtain information about how Covid‐19 affects high‐risk group patients and may cause severe and critical effects due to the development of acute lung injury and acute respiratory distress syndrome. A narrative and comprehensive review is presented. Results Reducing HDL in Covid‐19 is connected to the disease severity and poor clinical outcomes, suggesting that high HDL serum levels could benefit Covid‐19. SARS‐CoV‐2 binds HDL, and this complex is attached to the co‐localized receptors, facilitating viral entry. Therefore, SARS‐CoV‐2 infection may induce the development of dysfunctional HDL through different mechanisms, including induction of inflammatory and oxidative stress with activation of inflammatory signaling pathways. In turn, the induction of dysfunctional HDL induces the activation of inflammatory signaling pathways and oxidative stress, increasing Covid‐19 severity. Conclusions Covid‐19 is linked with the development of cardio‐metabolic disorders, including dyslipidemia in general and dysregulation of high‐density lipoprotein and low‐density lipoprotein. Therefore, the present study aimed to overview the causal relationship between dysfunctional high‐density lipoprotein and Covid‐19. While Covid‐19 is linked with the development of cardio‐metabolic disorders, including dyslipidemia and dysregulation of high‐density lipoprotein and low‐density lipoprotein, this study aimed to overview the causal relationship between dysfunctional high‐density lipoprotein and Covid‐19.

Potential role of tirzepatide towards Covid-19 infection in diabetic patients: a perspective approach.

In Covid-19, variations in fasting blood glucose are considered a distinct risk element for a bad prognosis and outcome in Covid-19 patients. Tirazepatide (TZT), a dual glucagon-like peptide-1 (GLP-1)and glucose-dependent insulinotropic polypeptide (GIP) receptor agonist may be effective in managing Covid-19-induced hyperglycemia in diabetic and non-diabetic patients. The beneficial effect of TZT in T2DM and obesity is related to direct activation of GIP and GLP-1 receptors with subsequent improvement of insulin sensitivity and reduction of body weight. TZT improves endothelial dysfunction (ED) and associated inflammatory changes through modulation of glucose homeostasis, insulin sensitivity, and pro-inflammatory biomarkers release. TZT, through activation of the GLP-1 receptor, may produce beneficial effects against Covid-19 severity since GLP-1 receptor agonists (GLP-1RAs) have anti-inflammatory and pulmoprotective implications in Covid-19. Therefore, GLP-1RAs could effectively treat severely affected Covid-19 diabetic and non-diabetic patients. Notably, using GLP-1RAs in T2DM patients prevents glucose variability, a common finding in Covid-19 patients. Therefore, GLP-1RAs like TZT could be a therapeutic strategy in T2DM patients with Covid-19 to prevent glucose variability-induced complications. In Covid-19, the inflammatory signaling pathways are highly activated, resulting in hyperinflammation. GLP-1RAs reduce inflammatory biomarkers like IL-6, CRP, and ferritin in Covid-19 patients. Therefore, GLP-1RAs like TZ may be effective in Covid-19 patients by reducing the inflammatory burden. The anti-obesogenic effect of TZT may reduce Covid-19 severity by ameliorating body weight and adiposity. Furthermore, Covid-19 may induce substantial alterations in gut microbiota. GLP-1RA preserves gut microbiota and prevents intestinal dysbiosis. Herein, TZT, like other GLP-1RA, may attenuate Covid-19-induced gut microbiota alterations and, by this mechanism, may mitigate intestinal inflammation and systemic complications in Covid-19 patients with either T2DM or obesity. As opposed to that, glucose-dependent insulinotropic polypeptide (GIP) was reduced in obese and T2DM patients. However, activation of GIP-1R by TZT in T2DM patients improves glucose homeostasis. Thus, TZT, through activation of both GIP and GLP-1, may reduce obesity-mediated inflammation. In Covid-19, GIP response to the meal is impaired, leading to postprandial hyperglycemia and abnormal glucose homeostasis. Therefore, using TZT in severely affected Covid-19 patients may prevent the development of glucose variability and hyperglycemia-induced oxidative stress. Moreover, exaggerated inflammatory disorders in Covid-19 due to the release of pro-inflammatory cytokines like IL-1ß, IL-6, and TNF-α may lead to systemic inflammation and cytokine storm development. Besides, GIP-1 inhibits expression of IL-1ß, IL-6, MCP-1, chemokines and TNF-α. Therefore, using GIP-1RA like TZT may inhibit the onset of inflammatory disorders in severely affected Covid-19 patients. In conclusion, TZT, through activation of GLP-1 and GIP receptors, may prevent SARS-CoV-2-induced hyperinflammation and glucose variability in diabetic and non-diabetic patients.

COVID-19 vaccine causes of acceptance and rejection among university students in Baghdad

Despite numerous recommendations concerning individual and social preventive measures, including quarantine, wearing a mask, physical distancing, and handwashing, vaccination with effective and safe vaccines is still the most effective measure to break the chain of coronavirus SARS-Co2 transmission;still, vaccine hesitancy is a significant barrier to achieve high vaccination coverage against infectious diseases. An observational cross-sectional study was conducted among students of different universities (medical and non-medical) in Baghdad city Iraq using an online structured google form questionnaire from October 20 to November 20, 2021, and a final number of 658 students were included in the study. Causes of acceptance and rejection of the coronavirus vaccine were tested through the questionnaire. Of the total 658 participants, 557(84.7%) had received the vaccine before the start of the study and only 101 (15.3%) were not vaccinated;of them, more than half, 58(57.4%) were willing to, and the remaining 43(42.6%) refused to receive COVID-19 vaccination. Accordingly, the acceptance rate of the vaccine among the total participants was 93.5%, and the rejection rate was only 6.5%. The most chosen cause of vaccine acceptance was that they believed the vaccine protected them, their families and the community against COVID-19 infection and its complications with 63.5%. The most chosen rejection cause was fear of side effects of the vaccine, with 62% of the rejecting participants, followed by 28% having doubts about the vaccine's efficiency in protecting against COVID-19 infection. In this study, although the majority of the participants were willing to be vaccinated, still around one-third of them were under pressure from the government obligations and did not accept the vaccine due to their own convictions;education programs should be designed and directed to remove barriers to negative vaccine beliefs and perception to increase the vaccine coverage in the community. © 2022 by the authors.

SARS-COV-2 infection and Parkinson's disease: Possible links and perspectives.

Parkinson's disease (PD) is a neurodegenerative disorder characterized by the progressive loss of dopaminergic neurons in the substantia nigra. The hallmarks are the presence of Lewy bodies composed mainly of aggregated α-synuclein and immune activation and inflammation in the brain. The neurotropism of SARS-CoV-2 with induction of cytokine storm and neuroinflammation can contribute to the development of PD. Interestingly, overexpression of α-synuclein in PD patients may limit SARS-CoV-2 neuroinvasion and degeneration of dopaminergic neurons; however, on the other hand, this virus can speed up the α-synuclein aggregation. The review aims to discuss the potential link between COVID-19 and the risk of PD, highlighting the need for further studies to authenticate the potential association. We have also overviewed the influence of SARS-CoV-2 infection on the PD course and management. In this context, we presented the prospects for controlling the COVID-19 pandemic and related PD cases that, beyond global vaccination and novel anti-SARS-CoV-2 agents, may include the development of graphene-based nanoscale platforms offering antiviral and anti-amyloid strategies against PD.

Mechanistic insight and possible mechanism of seizure in Covid-19: The nuances and focal points.

Coronavirus disease 2019 (COVID-19) is a primary respiratory disease with an alarming impact worldwide. COVID-19 is caused by severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) and presents various neurological symptoms, including seizures. SARS-CoV-2 shows neuroinvasive and neurotropic capabilities through a neuronal angiotensin-converting enzyme 2 (ACE2), which is also highly expressed in both neuronal and glial cells. Therefore, SARS-CoV-2 can trigger neuroinflammation and neuronal hyperexcitability, increasing the risk of seizures'. Olfactory neurons could be an exceptional neuronal pathway for the neuroinvasion of respiratory viruses to access the central nervous system (CNS) from the nasal cavity, leading to neuronal injury and neuroinflammation. Although neuronal ACE2 has been widely studied, other receptors for SARS-CoV-2 in the brain have been proposed to mediate viral-neuronal interactions with subsequent neurological squeals. Thus, the objective of the present critical review was to find the association and mechanistic insight between COVID-19 and the risk of seizures.

Mixed storm in SARS‐CoV‐2 infection: A narrative review and new term in the Covid‐19 era

Coronavirus disease 2019 (Covid‐19) is caused by a novel severe acute respiratory syndrome coronavirus virus type 2 (SARS‐CoV‐2) leading to the global pandemic worldwide. Systemic complications in Covid‐19 are mainly related to the direct SARS‐CoV‐2 cytopathic effects, associated hyperinflammation, hypercytokinemia, and the development of cytokine storm (CS). As well, Covid‐19 complications are developed due to the propagation of oxidative and thrombotic events which may progress to a severe state called oxidative storm and thrombotic storm (TS), respectively. In addition, inflammatory and lipid storms are also developed in Covid‐19 due to the activation of inflammatory cells and the release of bioactive lipids correspondingly. Therefore, the present narrative review aimed to elucidate the interrelated relationship between different storm types in Covid‐19 and the development of the mixed storm (MS). In conclusion, SARS‐CoV‐2 infection induces various storm types including CS, inflammatory storm, lipid storm, TS and oxidative storm. These storms are not developing alone since there is a close relationship between them. Therefore, the MS seems to be more appropriate to be related to severe Covid‐19 than CS, since it develops in Covid‐19 due to the intricate interface between reactive oxygen species, proinflammatory cytokines, complement activation, coagulation disorders, and activated inflammatory signaling pathway. SARS‐CoV‐2 infection induces various storm types including cytokine storm (CS), inflammatory storm, lipid storm, thrombotic storm (TS), and oxidative storm. These storms are not developing alone since there is a close relationship between them. Therefore, the mixed storm seems to be more appropriate to be related to severe Covid‐19 than CS, since it develops in Covid‐19 due to the intricate interface between reactive oxygen species, proinflammatory cytokines, complement activation, coagulation disorders, and activated inflammatory signaling pathway

The potential role of scavenger receptor B type I (SR‐BI) in SARS‐CoV‐2 infection

Scavenger receptor type B I (SR‐BI), the major receptor for high‐density lipoprotein (HDL) mediates the delivery of cholesterol ester and cholesterol from HDL to the cell membrane. SR‐BI is implicated as a receptor for entry of severe acute respiratory syndrome coronavirus type 2 (SARS‐CoV‐2). SR‐BI is colocalized with the angiotensin‐converting enzyme 2 (ACE2) increasing the binding and affinity of SARS‐CoV‐2 to ACE2 with subsequent viral internalization. SR‐BI regulates lymphocyte proliferation and the release of pro‐inflammatory cytokines from activated macrophages and lymphocytes. SR‐BI is reduced during COVID‐19 due to consumption by SARS‐CoV‐2 infection. COVID‐19‐associated inflammatory changes and high angiotensin II (AngII) might be possible causes of repression of SR‐BI in SARS‐CoV‐2 infection. In conclusion, the downregulation of SR‐BI in COVID‐19 could be due to direct invasion by SARS‐CoV‐2 or through upregulation of pro‐inflammatory cytokines, inflammatory signaling pathways, and high circulating AngII. Reduction of SR‐BI in COVID‐19 look like ACE2 may provoke COVID‐19 severity through exaggeration of the immune response. Further studies are invoked to clarify the potential role of SR‐BI in the pathogenesis of COVID‐19 that could be protective rather than detrimental. We illustrate that Scavenger receptor type B I (SR‐BI), the major receptor for high‐density lipoprotein (HDL) mediates delivery of cholesterol ester and cholesterol from HDL to the cell membrane. SR‐BI is implicated as a receptor for entry of severe acute respiratory syndrome coronavirus type 2 (SARS‐CoV‐2). Downregulation of SR‐BI in COVID‐19 could be due to direct invasion by SARS‐CoV‐2 or through upregulation of pro‐inflammatory cytokines, inflammatory signaling pathways and high circulating AngII.

Recent applications of microfluidic immunosensors

[Display omitted] • Materials have an important effect on the reliability of microfluidic systems. • Magnetic particles are widely used in the fabrication of microfluidics immunosensors. • Near field communication-integrated microfluidics will more use in the future studies. The fast diagnosis of diseases is vital in the early stages of the cure of illnesses. Although conventional procedures have been broadly employed in clinics, newly presented microfluidic microchips are becoming more attractive. The benefits of the new microfluidic system involve more fast diagnosis, the need for low patient samples and reagents, user-friendly application, and high repeatability in the quantification of biomolecules. The primary aim of this review is to offer a summary of the effect of the applied nanomaterials in the fabrication of novel immunosensor-based microfluidic sticks and to carefully explore different applications of microfluidic systems in the determination of bioagents. New kinds of immunosensor-based microfluidic systems for coronavirus disease and HIV are also explored. The next types of biomedical diagnosis will mainly rely on point-of-care (POC) methods, which propose rapid and sensitive detections. However, microfluidic systems propose a high potential to fabricate reliable POC devices. [ FROM AUTHOR] Copyright of Microchemical Journal is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Detection Covid-19 Infection of Lung CT Scan Slices Images Based on a Transfer Learning and GRAD-CAM

The long timeline of polymerase chain reaction (PCR) tests and the lack of test tool kits in many hospitals lead to fast infection according to the slow diagnosis. The Various experiences of radiologists cause deferent in accurately detection lessons. This research suggested and designed a model based on utilizing the deep learning (DL) algorithms to detect and visualize the infection of covid-19 patients. This work shows how various convolution layers of convolution neural networks (CNN) extract different types of features, which helps us understand how CNN steadily gains spatial information in each layer. As a result, every transition focuses on the region of interest. Understanding how CNN identifies and locates distinct infection areas in an image is easier with a heat map of activation. A gradient class activation map (Grad-CAM) was used to visualize the infected area in the lungs. Transfer learning such as Resnet50, VGG16, and inception V3 have been applied to the dataset to detect the infection area. The result of these models reached an accuracy of 71.01%, 83.51%, and 94.93%, respectively. The VGG16 has been manipulated because the model consumes less training time than the other models to solve the problem. Manipulating on VGG16 has been accomplished to achieve acceptable accuracy. The tuning on the last three layers of VGG16 architecture (dense layers) replaces them with two layers (global average layer and dense layer). The dense layer that is added deals with binary classification problems depending on the sigmoid function. This tuning serves the current study by speeding up the model's prediction and increasing the accuracy. The result of the testing reached 0.9683% of accuracy and 0.0931 loss function without augmentation. This work depends on the current dataset because it contains the mask of lung and infection, which was obtained to localize the infection area. The obtained result proved that the system could help the radiologist accommodate the pandemic. © 2022 IEEE.

Occupational Health of Frontline Workers during the COVID-19 Pandemic: Is Health and Well-Being an Issue in Bangladesh?

The coronavirus outbreak has significantly affected the health and well-being of several people around the world. In a similar vein, Bangladeshi medical professionals have also been affected by several severe physical and mental health complications resulting from their frequent contact with COVID-19 patients. This exposes them to a greater risk of infection with the lethal virus, which can substantially impact their job performance. Therefore, this research aims to investigate the manner in which the COVID-19 pandemic affects the occupational health and safety of medical employees. The researchers deployed a descriptive qualitative technique to investigate the complexities of the COVID-19 crisis amongst medical practitioners. Employing purposeful sampling and in-depth interview techniques, the researchers collected data from a total of 32 healthcare professionals and investigated their state of occupational health, their exposure to stress and trauma, and the effects of stress and trauma on their livelihood, health and well-being. The data revealed the occupational health of healthcare workers as being fragile, resulting to stress and trauma, and eventually, a depressed state of mind. To address this issue, relevant government and non-governmental organizations should concentrate on reducing COVID-19-related risks and repercussions in hospital settings. In addition, policymakers, social workers, public health practitioners and psychologists must work together to ensure that healthcare workers are healthy and safe at work. © 2023, Editura Lumen. All rights reserved.

Immunological interactions in helminths-SARS CoV-2 coinfection: Could old enemy be a friend today?

Helminths are metazoan parasites affecting about one third of the worldwide population. Chronic helminth infections (CHIs) confer immunological tolerance to harmless and self-antigens mediated by regulatory T cells (Treg) that are up-regulated. In coronavirus disease 2019 (COVID-19), abnormal adaptive immune response and unrestrained innate immune response could result in local and systemic immune-mediated tissue damage. COVID-19 and CHIs establish complicated immune interactions due to SARS-CoV-2-induced immunological stimulation and CHIs-induced immunological tolerance. However, COVID-19 severity in patients with CHIs is mild, as immuno-suppressive anti-inflammatory cytokines counterbalance the risk of cytokine storm. Here, an overview of the interplay between helminths and COVID-19 severity is given. CHIs through helminth-derived molecules may suppress SARS-CoV-2 entry and associated hyperinflammation through attenuation of the TLR4/NF-kB signalling pathway. In addition, CHIs may reduce the COVID-19 severity by reducing the SARS-CoV-2 entry points at ACE2/DPP4/CD147 axis in the initial phase and immunomodulation in the late phase of the disease by suppressing TLR4/NF-kB signalling pathway.

Mixed storm in SARS-CoV-2 infection: A narrative review and new term in the Covid-19 era.

Coronavirus disease 2019 (Covid-19) is caused by a novel severe acute respiratory syndrome coronavirus virus type 2 (SARS-CoV-2) leading to the global pandemic worldwide. Systemic complications in Covid-19 are mainly related to the direct SARS-CoV-2 cytopathic effects, associated hyperinflammation, hypercytokinemia, and the development of cytokine storm (CS). As well, Covid-19 complications are developed due to the propagation of oxidative and thrombotic events which may progress to a severe state called oxidative storm and thrombotic storm (TS), respectively. In addition, inflammatory and lipid storms are also developed in Covid-19 due to the activation of inflammatory cells and the release of bioactive lipids correspondingly. Therefore, the present narrative review aimed to elucidate the interrelated relationship between different storm types in Covid-19 and the development of the mixed storm (MS). In conclusion, SARS-CoV-2 infection induces various storm types including CS, inflammatory storm, lipid storm, TS and oxidative storm. These storms are not developing alone since there is a close relationship between them. Therefore, the MS seems to be more appropriate to be related to severe Covid-19 than CS, since it develops in Covid-19 due to the intricate interface between reactive oxygen species, proinflammatory cytokines, complement activation, coagulation disorders, and activated inflammatory signaling pathway.

The potential role of scavenger receptor B type I (SR-BI) in SARS-CoV-2 infection.

Scavenger receptor type B I (SR-BI), the major receptor for high-density lipoprotein (HDL) mediates the delivery of cholesterol ester and cholesterol from HDL to the cell membrane. SR-BI is implicated as a receptor for entry of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2). SR-BI is colocalized with the angiotensin-converting enzyme 2 (ACE2) increasing the binding and affinity of SARS-CoV-2 to ACE2 with subsequent viral internalization. SR-BI regulates lymphocyte proliferation and the release of pro-inflammatory cytokines from activated macrophages and lymphocytes. SR-BI is reduced during COVID-19 due to consumption by SARS-CoV-2 infection. COVID-19-associated inflammatory changes and high angiotensin II (AngII) might be possible causes of repression of SR-BI in SARS-CoV-2 infection. In conclusion, the downregulation of SR-BI in COVID-19 could be due to direct invasion by SARS-CoV-2 or through upregulation of pro-inflammatory cytokines, inflammatory signaling pathways, and high circulating AngII. Reduction of SR-BI in COVID-19 look like ACE2 may provoke COVID-19 severity through exaggeration of the immune response. Further studies are invoked to clarify the potential role of SR-BI in the pathogenesis of COVID-19 that could be protective rather than detrimental.

Long COVID and risk of erectile dysfunction in recovered patients from mild to moderate COVID-19.

Patients with coronavirus disease 2019 (COVID-19) were shown to have reduced serum testosterone levels compared to healthy individuals. Low testosterone levels are linked with the development of erectile dysfunction (ED). In this case-controlled study, 20 healthy controls and 39 patients with ED 3 months after recovering from mild-to-moderate COVID-19 pneumonia were studied. The patients ranged in age from 31 to 47 years. To identify early and late COVID-19 infections, real-time polymerase-chain reaction (RT-PCR) and COVID-19 antibody testing were done. The levels of luteinizing hormone (LH), follicular stimulating hormone (FSH), total testosterone (TT), free testosterone (FT), free androgenic index (FAI), and sex hormone-binding globulin (SHBG) were measured. The sexual health inventory for patients (SHIM) score was used to measure the erectile function of the patients and controls. When compared to the controls, the TT serum level in long COVID-19 (LC) patients with ED was low (p = 0.01). In contrast to controls, FT and FAI were both lower in LC patients with ED. (p = 0.001). FSH serum levels did not significantly differ (p = 0.07), but in ED patients, LH serum levels were elevated. SHIM scores were associated with low TT (p = 0.30), FT (p = 0.09), and high LH (p = 0.76) in LC patients with ED. Male patients with decreased serum levels of LH and testosterone may have hypothalamic-pituitary-gonadal axis dysfunction, which could lead to the development of LC-induced ED. Therefore, an in-depth research is necessary to confirm the causal link between COVID-19 and ED in LC patients.

The potential role of SARS‐CoV‐2 infection in acute coronary syndrome and type 2 myocardial infarction (T2MI): Intertwining spread

Coronavirus disease 2019 (COVID‐19) is a novel pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). It has been shown that SARS‐CoV‐2 infection‐induced inflammatory and oxidative stress and associated endothelial dysfunction may lead to the development of acute coronary syndrome (ACS). Therefore, this review aimed to ascertain the link between severe SARS‐CoV‐2 infection and ACS. ACS is a spectrum of acute myocardial ischemia due to a sudden decrease in coronary blood flow, ranging from unstable angina to myocardial infarction (MI). Primary or type 1 MI (T1MI) is mainly caused by coronary plaque rupture and/or erosion with subsequent occlusive thrombosis. Secondary or type 2 MI (T2MI) is due to cardiac and systemic disorders without acute coronary atherothrombotic disruption. Acute SARS‐CoV‐2 infection is linked with the development of nonobstructive coronary disorders such as coronary vasospasm, dilated cardiomyopathy, myocardial fibrosis, and myocarditis. Furthermore, SARS‐CoV‐2 infection is associated with systemic inflammation that might affect coronary atherosclerotic plaque stability through augmentation of cardiac preload and afterload. Nevertheless, major coronary vessels with atherosclerotic plaques develop minor inflammation during COVID‐19 since coronary arteries are not initially and primarily targeted by SARS‐CoV‐2 due to low expression of angiotensin‐converting enzyme 2 in coronary vessels. In conclusion, SARS‐CoV‐2 infection through hypercytokinemia, direct cardiomyocyte injury, and dysregulation of the renin‐angiotensin system may aggravate underlying ACS or cause new‐onset T2MI. As well, arrhythmias induced by anti‐COVID‐19 medications could worsen underlying ACS. SARS‐CoV‐2 infection through hypercytokinemia, direct cardiomyocyte injury, and dysregulation of the renin‐angiotensin system may aggravate acute coronary syndrome (ACS) or cause new‐onset type 2 myocardial infarction. As well, arrhythmias induced by anti‐COVID‐19 medications could worsen ACS.

SARS-CoV-2 vaccines from A to Z: A review of the current challenges

COVID-19 pandemic is a major worldwide health disaster firstly reported in December 2019. The Food and Drug Administration (FDA) has offered the public hope of halting it, authorizing vaccinations for emergency use with more than 85% efficacy against serious acute respiratory syndrome (SARS-CoV-2). Recent outbreaks of SARS-CoV-2 variations including spike-protein mutations, the key vaccines viral target for immune response, have prompted a thorough investigation into the vaccine's long-term effectiveness. Consequently, this review assayed the details on SARS-CoV-2 infection mechanism and how to control the infection by different types of SARS-CoV-2 vaccines, and their effectiveness against other mutant strains. Additionally, the review summarized the different complaints which have been recorded after vaccination. In conclusion, these negative effects must be constantly weighed against the predicted advantages in terms of disease prevention. Although COVID-19 vaccination is recommended for everyone aged 5 years and older, SARS-CoV-2 is high likely to continue to be a pandemic infectious as a result of the broadcasting of variants of the virus. Therefore, a booster vaccination, wearing a mask, and social distancing should be maintained. © 2023 Global NEST.