ABSTRACT
The COVID-19 pandemic has put millions of lives at risk. SARS-CoV-2, the causative agent of COVID-19, primarily targets the respiratory system. The subsequent immune reactions may cause severe inflammation. The severe infection, disease progression, and dysregulated immune response can affect various sites of the body. Moreover, angiotensin-converting enzyme-2, the cellular receptor for viral entry, is expressed by different organs of the body. This hints at the possibility of virus infection and manifestations at miscellaneous sites. Indeed, COVID-19 patients with comorbidities like cardiovascular diseases, hypertension, diabetes, chronic kidney diseases, obesity, and immunosuppressive conditions have shown either increased disease severity, delayed viral clearance, or higher mortality. COVID-19 treatment with steroids and associated comorbidities like diabetes have also been shown to make people susceptible to lethal secondary infections like mucormycosis. Therefore, COVID-19 patients should be vigilantly monitored for symptoms and underlying conditions. In this regard, we comprehensively explained the aspects of COVID-19-associated comorbidities. As dysregulated inflammation is a key factor in worsening the disease conditions, we have also summarized the important molecular pathways associated with SARS-CoV-2 associated inflammation. This could further help researchers find targets for reducing COVID-19 inflammation and achieve better outcomes in comorbidity associated patients. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.
ABSTRACT
Background: Plant natural products have a long history of usage as a source of therapeutic agents. Oroxylum indicum (L.) Kurz is a prominent therapeutic plant in South Asia, comprising several phytochemicals with substantial medical significance, including the treatment of COVID-19. Methods: Herein, we documented the medicinal importance of O. indicum throughout Nepal using a questionnaire-based survey and and validated the findings through biochemical analyses. Results: All fractions (water, hexane and dichloromethane) obtained from different extraction solvents revealed a high abundance of alkaloids, flavonoids, phenolic compounds, saponins, and carbohydrates that is consistent with its vast ethnomedicinal uses generated through the questionnaire survey. Conclusions: In a nutshell, O. indicum is a promising medicinal plant based on our current experiment, and more research on ethnomedicinal and plant biochemical capabilities might lead to new scientific avenues and novel drug discoveries. It further paves the scope of documentation of traditional knowledge for the benefit of local and national communities. © 2022, Ilia State University, Institute of Botany, Department of Ethnobotany. All rights reserved.
ABSTRACT
Mountains of Nepal are rich in natural resources as well as shelter for many ethnic group and indigenous community. Mountain people depend on natural resources and unique landscapes to survive, to preserve a unique sense of identity, and to provide livelihoods for centuries. The COVID-19 pandemic has brought unprecedented damage to the mountain economy given the immediate effect on ecotourism and remittance, which are the main source of income for communities in the mountains. People in mountains have been using indigenous and local knowledge for utilization of natural resources for their survival. Skilled manpower returning home from abroad can be beneficial and with the use of appropriate technology will be beneficial for those returning from the abroad due to various reasons. Sustainable harvesting of natural resources and various micro/small enterprises can be developed using the appropriate technology. These enterprises not only creates jobs but also can contribute to improve the local to national level economy. A new approach is required combining the science and engineering aspect with local communities contributing their local knowledge and practices, which can develop socio-environmental resilience-building and transformation in mountains of Nepal. © 2021 Elsevier Inc.
ABSTRACT
Background : Thromboprophylaxis is currently recommended for all COVID-19 patients requiring hospitalization. Whether therapeutic anticoagulation should be considered is highly debated. Aims : Compare mortality, thromboembolism, and bleeding rates between prophylactic and therapeutic anticoagulation. Methods : We performed a systematic search on PubMed and the Cochrane COVID-19 Study Register for studies comparing prophylactic and therapeutic anticoagulation, up to January 31, 2021. Search terms were: ('anticoagulant' OR 'anticoagulation' OR 'heparin' OR 'thromboprophylaxis') AND ('COVID-19' OR 'SARSCoV-2'). No language restriction was applied. Filters were applied to display comparative studies, clinical trials, and observational cohort studies. The Newcastle-Ottawa scale was used to assess the quality of included studies. Results : We identified 472 records and screened 412 for eligibility. Thirty-eight studies were found to be eligible, including thirty-four retrospective cohorts and four prospective studies. Twenty-three, twenty-two, and twenty-three studies were included in the metaanalysis of mortality, thromboembolism, and bleeding outcomes respectively. Patients receiving prophylactic anticoagulation had better survival compared to those treated with therapeutic anticoagulation (OR, 0.65, 95% CI, 0.46-0.91). Therapeutic anticoagulation did not decrease risk of thromboembolism and was associated with significantly higher risk of bleeding (Figures 1 and 2). Severe COVID-19 patients admitted to intensive care unit (ICU) showed a non-significant trend towards improved mortality (OR, 1.85, 95% CI 0.90-3.81), and lower rates of thromboembolism (OR, 1.46, 95% CI, 0.83-2.57) with therapeutic anticoagulation. Conclusions : To our knowledge, this is the first in-depth review of the outcomes of prophylactic versus therapeutic anticoagulation in COVID-19. Our findings argue against the empiric use of therapeutic anticoagulation in COVID-19 patients. Compared to prophylactic anticoagulation, therapeutic anticoagulation did not improve survival or reduce risk of thromboembolism, and was associated with significantly higher risk of bleeding. Prospective trials are encouraged to explore the benefit of therapeutic anticoagulation in critically ill COVID-19 patients admitted to ICU.