MEDICINAL PLANTS AND VACCINATIONS USED AGAINST COVID-19: A COMPREHENSIVE REVIEW

The newly emerged severe acute respiratory syndrome corona virus-2 (SARS-CoV-2), the causative agent of corona virus disease 2019 (COVID-19), has deteriorated the global order economically, socially and politically. As an emergency of global concern, the disease continuously spread havoc with its dreadful health manifestations with no regard for any race, religion and region. The mortality rates in different countries are surprisingly variable and there is debate about population-wise differential response to virus. Different countries have imposed lock-down to reduce the spread of virus;however, the positive outcomes of lock-down in terms of reducing mortality rate and transmission of virus are still questioned. Further, public accusations and debate of world powers regarding the origin of virus has created regional hate sentiments and political chaos which could result is serious repercussions following miscalculation of actual facts. Scientific communities are struggling to cope with the disease by developing potential vaccines against the S protein of SARS-CoV-2 and were testing the already marketed drugs against this coronavirus. Therefore, several medicinal plants and various vaccinations have been used against Covid-19. This review highlights the origin, virulence, vaccination but most importantly the plants extracts used against the causative agent of COVID-19.

Seroprevalence of SARS-CoV-2-specific anti-spike IgM, IgG, and anti-nucleocapsid IgG antibodies during the second wave of the pandemic: A population-based cross-sectional survey across Kashmir, India.

Background: Within Kashmir, which is one of the topographically distinct areas in the Himalayan belt of India, a total of 2,236 cumulative deaths occurred by the end of the second wave. We aimed to conduct this population-based study in the age group of 7 years and above to estimate the seropositivity and its attributes in Kashmir valley. Methods: We conducted a community-based household-level cross-sectional study, with a multistage, population-stratified, probability-proportionate-to-size, cluster sampling method to select 400 participants from each of the 10 districts of Kashmir. We also selected a quota of healthcare workers, police personnel, and antenatal women from each of the districts. Households were selected from each cluster and all family members with age 7 years or more were invited to participate. Information was collected through a standardized questionnaire and entered into Epicollect 5 software. Trained healthcare personnel were assigned for collecting venous blood samples from each of the participants which were transferred and processed for immunological testing. Testing was done for the presence of SARS-CoV-2-specific anti-spike IgM, IgG antibodies, and anti-nucleocapsid IgG antibodies. Weighted seropositivity was estimated along with the adjustment done for the sensitivity and specificity of the test used. Findings: The data were collected from a total of 4,229 participants from the general population within the 10 districts of Kashmir. Our results showed that 84.84% (95% CI 84.51-85.18%) of the participants were seropositive in the weighted imputed data among the general population. In multiple logistic regression, the variables significantly affecting the seroprevalence were the age group 45-59 years (odds ratio of 0.73; 95% CI 0.67-0.78), self-reported history of comorbidity (odds ratio of 1.47; 95% CI 1.33-1.61), and positive vaccination history (odds ratio of 0.85; 95% CI 0.79-0.90) for anti-nucleocapsid IgG antibodies. The entire assessed variables showed a significant role during multiple logistic regression analysis for affecting IgM anti-spike antibodies with an odds ratio of 1.45 (95% CI 1.32-1.57) for age more than 60 years, 1.21 (95% CI 1.15-1.27) for the female gender, 0.87 (95% CI 0.82-0.92) for urban residents, 0.86 (95% CI 0.76-0.92) for self-reported comorbidity, and an odds ratio of 1.16 (95% CI 1.08-1.24) for a positive history of vaccination. The estimated infection fatality ratio was 0.033% (95% CI: 0.034-0.032%) between 22 May and 31 July 2021 against the seropositivity for IgM antibodies. Interpretation: During the second wave of the SARS-CoV-2 pandemic, 84.84% (95% CI 84.51-85.18%) of participants from this population-based cross-sectional sample were seropositive against SARS-CoV-2. Despite a comparatively lower number of cases reported and lower vaccination coverage in the region, our study found such high seropositivity across all age groups, which indicates the higher number of subclinical and less severe unnoticed caseload in the community.

Seroprevalence of SARS-CoV-2-specific IgG antibodies in Kashmir, India, 7 months after the first reported local COVID-19 case: results of a population-based seroprevalence survey from October to November 2020.

OBJECTIVES: We designed a population-based survey in Kashmir to estimate the seroprevalence of SARS-CoV-2-specific IgG antibodies in the general population aged 18 years and above. SETTING: The survey was conducted among 110 villages and urban wards across 10 districts in Kashmir from 17 October 2020 to 4 November 2020. PARTICIPANTS: Individuals aged 18 years and above were eligible to be included in the survey. Serum samples were tested for the presence of SARS-CoV-2-specific IgG antibodies using the Abbott SARS-CoV-2 IgG assay. PRIMARY AND SECONDARY OUTCOME MEASURES: We labelled assay results equal to or above the cut-off index value of 1.4 as positive for SARS-CoV-2-specific IgG antibodies. Seroprevalence estimates were adjusted for the sampling design and assay characteristics. RESULTS: Out of 6397 eligible individuals enumerated, 6315 (98.7%) agreed to participate. The final analysis was done on 6230 participants. Seroprevalence adjusted for the sampling design and assay characteristics was 36.7% (95% CI 34.3% to 39.2%). Seroprevalence was higher among the older population. Among seropositive individuals, 10.2% (247/2415) reported a history of COVID-19-like symptoms. Out of 474 symptomatic individuals, 233 (49.2%) reported having been tested. We estimated an infection fatality rate of 0.034%. CONCLUSIONS: During the first 7 months of the COVID-19 epidemic in Kashmir Valley, approximately 37% of individuals were infected. The reported number of COVID-19 cases was only a small fraction of the estimated number of infections. A more efficient surveillance system with strengthened reporting of COVID-19 cases and deaths is warranted.

Study the Effects of COVID-19 in Punjab, Pakistan using Space-time Scan Statistic for Policy Measures in Regional Agriculture and Food Supply Chain (preprint)

Food service and retailing sectors play a vital role in economics of Punjab, Pakistan. Pakistan is included in top 50 countries which are estimated to face serious agriculture and food deficiency related challenges due to the world-wide pandemic coronavirus 2019 (COVID-19). The aim of this study was to study the effects of COVID-19 on food security and agriculture in Punjab, Pakistan using space-time scan statistic (STSS). A survey was conducted at 720 points in different districts of the province. The STSS detected “active” and emerging clusters that are current at the end of our study aera – particularly 17 clusters were formed while adding the updated case data. ArcGIS 10.3 software was used to find relative risk (RR) values; the maximum RR value was found to be 42.19 and maximum observed cases 53265 during June 15th – July 1st. Due to the highest number of cases of COVID-19 and RR vales during July, mostly farmers faced many difficulties during the cultivation of cotton and rice. Mostly farmers (72%) observed increase in prices of inputs (fertilizers and pesticides) during lockdown. The timely results (attained through STSS and RR) can inform decision makers and public health officials about where to improve the allocation of resources (including those for farming community), also, where to apply stricter quarantines and travel bans. If the supply chain of agriculture related inputs is disturbed, farmers may find it quite difficult to access markets, which could result in a decline in production and sales of crops and livestock in study area. It is suggested that to protection of food security and to decrease the effect of the lockdown, Punjab government needs to review food policy as well as analyze how market forces will respond to the imbalanced storage facilities and capacity, supply and demand, and price control of products. The findings of this study can also help policy-makers to formulate an effective food security and agriculture adaptation strategy.

SARS-CoV-2 Infection in the Heart Transplant Recipient.

Review of the literature and reported case series has not reported an increased risk of SARS-CoV-2 infection in heart transplant recipients. However, this population is at increased risk of a more severe infection with increased mortality because of age and the presence of multiple comorbid conditions There is no significant difference in presenting symptoms in transplant recipients as compared to nontransplant patients, although diarrhea has been reported to be more frequent in transplant patients, a common side effect of immunosuppressive medications. Standard preventive measures have been shown to be equally protective in heart transplant recipients. Risk factors for severe disease and mortality are similar in both transplant recipients and nontransplant patients and include older age and the presence of comorbidities hypertension being the most common. The SARS-CoV-2 infection did not increase the risk of transplant allograft rejection. Currently, there are no specific treatment recommendations for SARS-CoV-2 infection in transplant recipients. However, the International Society of Heart and Lung and Transplant has issued guidance on how to modulate immunosuppressive therapy during SARS-CoV-2 infection.

COVID-19 and Heart Failure: The Big Challenge.

Patients with chronic heart failure (HF) are among the most vulnerable populations in the COVID era. HF patients infected with COVID-19 are at a significant risk of severe illness and death. They usually present with shortness of breath and radiologic signs of an acute decompensation, which can mask the manifestations of COVID-19. Delay in the diagnosis increases the risk of individual poor outcomes and jeopardizes healthcare workers if protective and isolation measures are not established promptly. Furthermore, the COVID-19 pandemic is forcing health-care systems to modify the delivery of care to patients. Outpatient services are being done virtually, and elective procedures postponed. These may have an impact on the quality of life and survival of chronic HF patients. We present two cases of patients with the previous history of HF who developed an acute exacerbation secondary to COVID-19 infection. In this review, we focused on the main challenges physicians face when dealing with COVID-19 in chronic HF patients at the individual and system levels.

Myocarditis and Pericarditis in Patients with COVID-19.

COVID-19 has been associated with a variety of cardiac manifestations. Myocarditis and pericarditis have been reported as one of the many cardiac manifestations in association with COVID-19. We describe below three cases of myocarditis, pericarditis with associated pericardial effusion and myopericarditis, respectively, in the setting of COVID-19. Although these entities may occur in isolation, they often occur in association to varying degrees. It could either be the initial diagnosis at the time of presentation or it could occur later in the course of COVID-19 infection. Pericarditis may occasionally be associated with significant pericardial effusion and tamponade requiring therapeutic pericardiocentesis. The assessment of pericardial effusion has been found to be exudative and is usually negative for SARS-CoV-2. Treatment of pericarditis with nonsteroidal anti-inflammatory drugs, colchicine, and corticosteroids has proven to be safe in COVID-19. Myocarditis may present with severe left ventricular systolic dysfunction and cardiogenic shock requiring inotropes and mechanical circulatory support.

COVID-19 risk perception and coping mechanisms: Does gender make a difference?

The novel coronavirus disease (COVID-19) emerged as a real threat to humans, drastically disrupting everyday life in 2020-21. Although the pandemic affected people from all walks of life, irrespective of age or gender, the way the risk is perceived varies from one person to another. The pandemic risk reduction strategies can only be effective if individuals and communities respond positively to them, and for that, it is important to understand how the risk is perceived and responded to, differently by different groups of people. Gender plays a vital role in shaping risk perceptions and coping strategies, reflecting the predisposition of the public to accept health interventions and take precautionary measures. This study aims to understand the gender differences in COVID-19 risk perception and coping mechanisms - Pakistan is selected as a case study area. Following on from designing the questionnaire, which included 40 indicators grouped into domains (four risk perception and three coping mechanisms domains), an online survey was conducted, and a sample of 389 respondents was collected (248 male and 141 female). An index-based approach was used to quantify risk perception and its domains (fear, behaviour, awareness, and trust), and likewise coping mechanisms and their domains (problem, emotion, and action). Statistical tests were employed to ascertain the differences among both genders, whereas regression modelling was used to measure the effect of gender on overall risk perception and coping mechanisms. Results reveal that perceived fear and trust varied significantly between Pakistani men and women, while coping mechanisms were also notably different between the two genders. Females were found to perceive risks higher, complied more with the government's guidelines, and coped better than males in response to COVID-19. These findings imply that the gender aspect must be incorporated in designing effective communication and risk reduction strategies to efficiently address the current and potential future pandemic situations.

Evolutionary Frequency of the Available Human Coronavirus Genomes (preprint)

Background. A novel, human-infecting coronavirus causing CoVID-19 was first identified in Wuhan, China in late December, 2019. Within a short span of time more the virus has recorded more than 1 million deaths world-wide. This study is designed to address the overall evolutionary process of the novel Coronavirus complete genomes. Addressing the complexity and huge population size, network-based approaches are used in mapping samples to their reported locations. Results. Total of 473 complete human-coronavirus genomes representing 20 different countries are studied including 17 states from the United States and samples collected from the Cruise-diamond princess. The phylodynamic network of global-scale is classified into five clusters contained two clusters U1 and U2 of the USA samples. Cluster B is a shared cluster of China and the USA while A and C are of diverse nature. We found that Chinese samples aggregated in cluster A and B which aided in retaining the homogeneous viral genomic pool. In contrast, samples from the USA and Spain were split into distinct clusters indicating multiple port entries and a possibility in implying a delay in quarantine measures. Among the samples from the USA, we found that sequences reported from Washington and Virginia are scattered indicating evolutionary diversity.Conclusion. This report provides insight into the transmission pattern of CoV2 which is complicated to evaluate exclusively through conventional surveillance means. Our data not only identify the transmission network but also suggest that the severity of the disease is linked to the spatial diversity of infection. 

Analysis and Prediction of COVID-19 Pandemic in Pakistan using Time-dependent SIR Model (preprint)

The current outbreak is known as Coronavirus Disease or COVID-19 caused by the virus SAR-COV-2 which continues to wreak havoc across the globe. The World Health Organization (WHO) has declared the outbreak a Public Health Emergency of International Concern. In Pakistan, the spread of the virus is on the rise with the number of infected people and causalities rapidly increasing. In the absence of proper vaccination and treatment, to reduce the number of infections and casualties, the only option so far is to educate people regarding preventive measures and to enforce countrywide lock-down. Any strategy about the preventive measures needs to be based upon detailed analysis of the COVID-19 outbreak and accurate scientific predictions. In this paper, we conduct mathematical and numerical analysis to come up with reliable and accurate predictions of the outbreak in Pakistan. The time-dependent Susceptible-Infected-Recovered (SIR) model is used to fit the data and provide future predictions. The turning point of the peak of the pandemic is defined as the day when the transmission rate becomes less than the recovering rate. We have predicted that the outbreak will reach its maximum peak occurring from late May to 9 June with unrecovered number of Infectives in the range 20000-47000 and the cumulative number of infected cases in the range of 57500-153100. The number of Infectives will remain at the lower end in the lock-down scenario but can rapidly double or triple if the spread of the epidemic is not curtailed and localized. The uncertainty on single day projection in our analysis after April 15 is found to be within 5\%.