ABSTRACT
Background and aim: Patients with underlying cardiovascular disorders such as coronary artery disease (CAD) are more prone to severe forms and multiple complications of COVID-19. The present systematic review and meta-analysis aimed to investigate the impact of CAD on patients with COVID-19. Methods: Main electronic databases, including Medline (via PubMed), EMBASE, and Web of Science, were carefully searched and reviewed for original research articles published between 2019 and 2021. One hundred nine studies that address CAD in patients with COVID-19 were selected and analyzed. Results: Following search and screening processes, 109 relevant publications were selected for analysis. The meta-analysis of prevalence studies indicated that the frequency of CAD among patients with COVID-19 was reported in 10 countries with an overall frequency of 12.4% [(95% CI) 11.1-13.8] among 20079 COVID-19 patients. According to case reports/case series studies, 50.9% of COVID-19 patients suffered from CAD. Fever was the most common symptom in these patients (47%); 36.5% also had hypertension. Conclusion: The results obtained during the present study show that the simultaneous presence of COVID-19 and CAD, especially in men and elderly patients, can increase the risks and complications of both diseases. Therefore, careful examination of the condition of this group of patients for timely diagnosis and treatment is strongly recommended.
ABSTRACT
Background and aim: Coronavirus disease 2019 (COVID-19) coinfection with other respiratory pathogens poses a serious concern that can complicate diagnosis, treatment, and prognosis. Since COVID-19 and tuberculosis are both severe respiratory infections, their symptoms may overlap and even increase mortality in case of coinfection. The current study aimed to investigate the coinfection of tuberculosis and COVID-19 worldwide through a systematic review and meta-analysis. Methods: A systematic literature search based on the Systematic Reviews and Meta-Analyses" (PRISMA) was performed on September 28, 2021, for original research articles published in PubMed, Web of Science, and Embase databases from December 2019 to September 2021 using relevant keywords. Data analysis was performed using Stata 14 software. Results: The final evaluation included 18 prevalence studies with 5843 patients with COVID-19 and 101 patients with COVID-19 and Mycobacterium tuberculosis (M. tuberculosis). The prevalence of tuberculosis infection was 1.1% in patients with confirmed COVID-19. This coinfection among patients with COVID-19 was 3.6% in Africa, 1.5% in Asia, and 1.1% in America. Eighteen case reports and 57 case series were also selected. Eighty-nine adults (67 men and 22 women) with a mean age of 45.14 years had concurrent infections with tuberculosis. The most common clinical manifestations were fever, cough, and weight loss. A total of 20.83% of evaluated patients died, whereas 65.62% recovered. Lopinavir/ritonavir was the most widely used antiviral drug for 10.41% of patients. Conclusion: COVID-19 has a low prevalence of tuberculosis coinfection, but it remains a critical issue, especially for high-risk individuals. The exact rate of simultaneous tuberculosis in COVID-19 patients could not be reported since we didn't have access to all data worldwide. Therefore, further studies in this field are strongly recommended.
ABSTRACT
Among the vaccines have been developed thus far against SARS-CoV-2, the mRNA-based ones have demonstrated more promising results regarding both safety and efficacy. Two remarkable features of the mRNA vaccines introduced by the Pfizer/BioNTech and Moderna companies are the use of (N1-methyl-pseudouridine-) modified mRNA and the microfluidics-based production of lipid nanoparticles (LNPs) as the carrier. In the present study, except Anti-Reverse Cap Analog (ARCA), no other nucleoside analogs were employed to synthesize Spike-encoding mRNA using the in vitro transcription (IVT) method. Furthermore, LNPs were prepared via the ethanol injection method commonly used for liposome formation as an alternative for microfluidics-based approaches. The produced mRNA-LNP vaccine was evaluated for nanoparticles characteristics, encapsulation and transfection efficiencies, in vitro cytotoxicity as well as stability and storability. The safety of vaccine was assessed in Balb/c mice injected with mRNA-LNPs containing 10 µg of spike-encoding mRNA. Eventually, the vaccine efficacy in inducing an immune response against SARS-CoV-2 was studied in Balb/c and C57BL/6 mice (received either 1 or 10 µg of mRNA) as well as in rhesus macaque monkeys (infused with mRNA-LNPs containing 100 µg of mRNA). The ELISA and virus neutralizing test (VNT) results showed a significant augmentation in the level of neutralizing antibodies against SARS-CoV-2. Moreover, the ELISA assay showed virus-specific IFN-γ secretion in immunized mice as a marker of TH1 cell-based immune response, whereas favorably no change in the production of IL-4 was detected.