An approach to cellular tropism of SARS-CoV-2 through protein-protein interaction and enrichment analysis.

COVID-19, caused by SARS-CoV-2, is a primarily pulmonary disease that can affect several organs, directly or indirectly. To date, there are many questions about the different pathological mechanisms. Here, we generate an approach to identify the cellular-level tropism of SARS-CoV-2 using human proteomics, virus-host interactions, and enrichment analysis. Through a network-based approach, the molecular context was visualized and analyzed. This procedure was also performed for SARS-CoV-1. We obtained proteomes and interactomes from 145 different cells corresponding to 57 different tissues. We discarded the cells without the proteins known for interacting with the virus, such as ACE2 or TMPRSS2. Of the remaining cells, a gradient of susceptibility to infection was observed. In addition, we identified proteins associated with the coagulation cascade that can be directly or indirectly affected by viral proteins. As a whole we identified 55 cells that could be potentially controlled by the virus, with different susceptibilities, mainly being pneumocytes, heart, kidney, liver, or small intestine cells. These results help to explain the molecular context and provide elements for possible treatments in the current situation. This strategy may be useful for other viruses, especially those with limited reported PPI, such as a new virus.

Impact on the Nutritional and Functional Status of Older Mexican Adults in the Absence of Recreational Activities due to COVID-19: A Longitudinal Study From 2018 to 2021.

A longitudinal study, from 2018 to 2021, identified impacts on the nutritional and functional status of older adults when face-to-face activities at a social assistance center in Mexico were suspended due to the COVID-19 pandemic. A total of 71 older adults were evaluated at three different periods: 18 months prior, three months before the pandemic, and 12 months after the onset of the pandemic. Seventy-one older adults completed follow up. Anthropometric measurements, dietary intake, physical tests, and health screening for malnutrition, dependence, and physical frailty, were evaluated. There was a significant decrease in lean body mass and body water in the older adults assessed, in addition to a significant reduction in the frailty scale and gait speed. Finally, a significant reduction in ingested energy and several nutrients such as protein, and carbohydrates, was found, yet an increase in sugar and cholesterol intake was noted.

Risk Perception and Knowledge, Attitudes, and Practices Against COVID-19 in a Hypertensive Population From a Semi-Urban City of Ecuador.

Background: In an elderly population with hypertension, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is associated with a higher incidence of mortality and a protracted course of clinical symptoms. Objective: To assess the perceived risk of infection and complications due to COVID-19 in people with hypertension living in a semi-urban city of Ecuador. Methods: A cross-sectional telephone survey of adult outpatients with a previous diagnosis of hypertension in the semi-urban community of Conocoto in Quito, Ecuador was conducted from August to December 2020. Results: A total of 260 adult outpatients, aged 34-97 years, completed telephone surveys. Of total, 71.5% (n = 186) of respondents were women and 28.5% (n = 74) of respondents were men. Overall, 18.1% believe that their risk of infection is "very high," 55.4% believe that their risk of infection is "high," 21.5% believe that their risk of infection is "low," and 5% believe that their risk of infection is "very low." The perceived risk of complications, if infected by COVID-19, revealed that 21.9% believe that their risk of complication is "very high," 65.0% believe that their risk of complication is "high," 10.4% believe that their risk of complication is "low," and 2.7% believe that their risk of complication is "very low." Conclusion: Patients with hypertension are aware of the risks posed by COVID-19 infection and its impact on their health. However, the health system must educate the population on health practices and behaviors to avoid COVID-19 infection until the majority of the population of Ecuador can be vaccinated.

Prices of essential drugs for management and treatment of COVID-19 in public and private Peruvian pharmacies

RESUMEN Objetivo: comparar los precios de venta de medicamentos esenciales para el manejo y tratamiento de la COVID-19 en establecimientos farmacéuticos peruanos públicos y privados. Además, estimar el costo por persona del tratamiento farmacológico para casos leves y severos. Materiales y métodos: estudio transversal con información reportada por establecimientos farmacéuticos públicos y privados. El precio de los medicamentos se presenta en medianas y se compararon usando la prueba no paramétrica de Kruskal-Wallis. Además, se estimó el costo por persona y asequibilidad para el tratamiento de casos leves y severos. Resultados: medicamentos para casos leves como azitromicina, hidroxicloquina, ivermectina y paracetamol tienen medianas de precios entre S/ 0,04 (US$ 0,011) y S/ 23,81 (US$ 6,71) en establecimientos públicos, mientras que los mismos medicamentos en establecimientos privados fluctúan entre S/ 1,00 y S/ 36,00. En promedio, los precios de los medicamentos en el sector privado son 11 veces los precios en el sector público. Los costos de tratamiento por persona en establecimientos públicos son más asequibles que en los privados, especialmente para los medicamentos para casos más severos. Los esquemas de tratamiento para casos leves requieren la inversión de entre uno a cuatro días de salario mínimo. Mientras que los tratamientos de casos severos pueden requerir, hasta 64 días de salario mínimo en establecimientos privados. Conclusiones: el tratamiento farmacológico para COVID-19 supone un gasto importante para el sistema de salud público y para las familias a través de gastos de bolsillo. Urge diseñar e implementar medidas regulatorias para mejorar el acceso a medicamentos a precios asequibles. ABSTRACT Objective: to compare the sale price of essential drugs used in the management and therapy of COVID-19 in public and private pharmacies in Peru. Also, to assess the cost per person of drug therapy for both mild and severe cases. Materials and methods: this is a cross-sectional study using data reported by public and private pharmacies in Peru. Drug prices are presented as median values and they were compared using the non-parametric Kruskal-Wallis test. Also, costs per person and drug accessibility for treating mild and moderate cases were estimated. Results: drugs used when treating mild cases of COVID-19, such as azythromycin, hydroxichloroquine, ivermectin, and paracetamol had median prices between S/ 0.04 (US$ 0.011) and S/ 23.81 (US$ 6.71) in public pharmacies, while the same compounds cost between S/ 1.00 (US$ 0.28) and S/ 36.00 (US$ 10.15) in private pharmacies. On average, drug prices in private pharmacies are 11 times higher compared to those in public pharmacies. Costs for (COVID-19) therapy in public pharmacies are more accessible compared to those found in private pharmacies, particularly for drugs used for more severely affected patients. Therapy regimens for mild cases require spending 1 to 4 days of the minimum daily wages, while therapy for severe cases (of COVID-19) may require up to 64 days of the minimum daily wages in private pharmacies. Conclusions: pharmacological treatment for COVID-19 represents an important expense for the public health system and for families through out-of-pocket expenses. It is urgent to design and implement regulatory measures aiming to improve the access to drug therapy (for Covid-19) in order to have drugs sold at accessible prices.

Healthcare challenges for people with diabetes during the national state of emergency due to COVID-19 in Lima, Peru: primary healthcare recommendations

RESUMEN Las personas con diabetes mellitus tipo 2 infectadas por SARS-CoV-2 tienen mayores riesgos de desarrollar COVID-19 con complicaciones y de morir como consecuencia de ella. La diabetes es una condición crónica en la que se requiere continuidad de cuidados que implican un contacto con los establecimientos de salud, pues deben tener acceso regular a medicamentos, exámenes y citas con personal de salud. Esta continuidad de cuidados se ha visto afectada en el Perú a raíz de la declaratoria del estado de emergencia nacional, producto de la pandemia por la COVID-19 pues muchos establecimientos de salud han suspendido las consultas externas. Este artículo describe algunas estrategias que han desarrollado los diferentes proveedores de salud peruanos en el marco de la pandemia para proveer continuidad del cuidado a las personas con diabetes y finalmente brinda recomendaciones para que reciban los cuidados que necesitan a través del fortalecimiento del primer nivel de atención, como el punto de contacto más cercano con las personas con diabetes. ABSTRACT Patients diagnosed with type 2 diabetes mellitus, who then become infected with SARS-CoV-2, are at greater risk of developing complications from COVID-19, which may even lead to death. Diabetes is a chronic condition that requires continuous contact with healthcare facilities;therefore, this type of patients should have regular access to medicines, tests and appointments with healthcare personnel. In Peru, care and treatment continuity have been affected since the national state of emergency due to COVID-19 began;because many healthcare facilities suspended outpatient consultations. The strategies presented in this study were developed by different Peruvian health providers in the pandemic context to ensure care continuity for people with diabetes. This article provides recommendations to strengthen primary healthcare, because it is the first level of healthcare contact for patients with diabetes.

Prices of essential drugs for management and treatment of COVID-19 in public and private Peruvian pharmacies

RESUMEN Objetivo: comparar los precios de venta de medicamentos esenciales para el manejo y tratamiento de la COVID-19 en establecimientos farmacéuticos peruanos públicos y privados. Además, estimar el costo por persona del tratamiento farmacológico para casos leves y severos. Materiales y métodos: estudio transversal con información reportada por establecimientos farmacéuticos públicos y privados. El precio de los medicamentos se presenta en medianas y se compararon usando la prueba no paramétrica de Kruskal-Wallis. Además, se estimó el costo por persona y asequibilidad para el tratamiento de casos leves y severos. Resultados: medicamentos para casos leves como azitromicina, hidroxicloquina, ivermectina y paracetamol tienen medianas de precios entre S/ 0,04 (US$ 0,011) y S/ 23,81 (US$ 6,71) en establecimientos públicos, mientras que los mismos medicamentos en establecimientos privados fluctúan entre S/ 1,00 y S/ 36,00. En promedio, los precios de los medicamentos en el sector privado son 11 veces los precios en el sector público. Los costos de tratamiento por persona en establecimientos públicos son más asequibles que en los privados, especialmente para los medicamentos para casos más severos. Los esquemas de tratamiento para casos leves requieren la inversión de entre uno a cuatro días de salario mínimo. Mientras que los tratamientos de casos severos pueden requerir, hasta 64 días de salario mínimo en establecimientos privados. Conclusiones: el tratamiento farmacológico para COVID-19 supone un gasto importante para el sistema de salud público y para las familias a través de gastos de bolsillo. Urge diseñar e implementar medidas regulatorias para mejorar el acceso a medicamentos a precios asequibles. ABSTRACT Objective: to compare the sale price of essential drugs used in the management and therapy of COVID-19 in public and private pharmacies in Peru. Also, to assess the cost per person of drug therapy for both mild and severe cases. Materials and methods: this is a cross-sectional study using data reported by public and private pharmacies in Peru. Drug prices are presented as median values and they were compared using the non-parametric Kruskal-Wallis test. Also, costs per person and drug accessibility for treating mild and moderate cases were estimated. Results: drugs used when treating mild cases of COVID-19, such as azythromycin, hydroxichloroquine, ivermectin, and paracetamol had median prices between S/ 0.04 (US$ 0.011) and S/ 23.81 (US$ 6.71) in public pharmacies, while the same compounds cost between S/ 1.00 (US$ 0.28) and S/ 36.00 (US$ 10.15) in private pharmacies. On average, drug prices in private pharmacies are 11 times higher compared to those in public pharmacies. Costs for (COVID-19) therapy in public pharmacies are more accessible compared to those found in private pharmacies, particularly for drugs used for more severely affected patients. Therapy regimens for mild cases require spending 1 to 4 days of the minimum daily wages, while therapy for severe cases (of COVID-19) may require up to 64 days of the minimum daily wages in private pharmacies. Conclusions: pharmacological treatment for COVID-19 represents an important expense for the public health system and for families through out-of-pocket expenses. It is urgent to design and implement regulatory measures aiming to improve the access to drug therapy (for Covid-19) in order to have drugs sold at accessible prices.

Healthcare challenges for people with diabetes during the national state of emergency due to COVID-19 in Lima, Peru: primary healthcare recommendations

RESUMEN Las personas con diabetes mellitus tipo 2 infectadas por SARS-CoV-2 tienen mayores riesgos de desarrollar COVID-19 con complicaciones y de morir como consecuencia de ella. La diabetes es una condición crónica en la que se requiere continuidad de cuidados que implican un contacto con los establecimientos de salud, pues deben tener acceso regular a medicamentos, exámenes y citas con personal de salud. Esta continuidad de cuidados se ha visto afectada en el Perú a raíz de la declaratoria del estado de emergencia nacional, producto de la pandemia por la COVID-19 pues muchos establecimientos de salud han suspendido las consultas externas. Este artículo describe algunas estrategias que han desarrollado los diferentes proveedores de salud peruanos en el marco de la pandemia para proveer continuidad del cuidado a las personas con diabetes y finalmente brinda recomendaciones para que reciban los cuidados que necesitan a través del fortalecimiento del primer nivel de atención, como el punto de contacto más cercano con las personas con diabetes. ABSTRACT Patients diagnosed with type 2 diabetes mellitus, who then become infected with SARS-CoV-2, are at greater risk of developing complications from COVID-19, which may even lead to death. Diabetes is a chronic condition that requires continuous contact with healthcare facilities;therefore, this type of patients should have regular access to medicines, tests and appointments with healthcare personnel. In Peru, care and treatment continuity have been affected since the national state of emergency due to COVID-19 began;because many healthcare facilities suspended outpatient consultations. The strategies presented in this study were developed by different Peruvian health providers in the pandemic context to ensure care continuity for people with diabetes. This article provides recommendations to strengthen primary healthcare, because it is the first level of healthcare contact for patients with diabetes.

Haemophagocytic syndrome and COVID-19.

Primary and secondary haemophagocytic lymphohistiocytosis (HLH) are hyperferritinaemic hyperinflammatory syndromes with a common terminal pathway triggered by different etiopathogenetic factors. HLH is characterised by a decreased capacity of interferon gamma production with an activated NK phenotype profile similar to other hyperinflammatory syndromes. Viruses are closely linked to the development of HLH as infectious triggers, and the break of tolerance to self-antigens is considered a critical mechanism involved in the development of immune-mediated conditions triggered by viral infections. Emerging studies in patients with COVID-19 are suggesting a key role of monocytes/macrophages in the pathogenesis of this viral infection, and there is a significant overlap between several features reported in severe COVID-19 and the features included in the HLH-2004 diagnostic criteria. Therefore, SARS-Cov-2, as other respiratory viruses, may also be considered a potential etiological trigger of HLH. The frequency of HLH in adult patients with severe COVID-19 is lower than 5%, although this figure could be underestimated considering that most reported cases lacked information about some specific criteria (mainly the histopathological criteria and the measurement of NK cell function and sCD25 levels). Because HLH is a multi-organ syndrome, the diagnostic approach in a patient with severe COVID-19 in whom HLH is suspected must be carried out in a syndromic and holistic way, and not in the light of isolated clinical or laboratory features. In COVID-19 patients presenting with persistent high fever, progressive pancytopenia, and hepatosplenic involvement, together with the characteristic triad of laboratory abnormalities (hyperferritinaemia, hypertriglyceridaemia, and hypofibrinogenaemia), the suspicion of HLH is high, and the diagnostic workup must be completed with specific immunological and histopathological studies.

Characterising and managing paediatric SARSCoV-2 infection: Learning about the virus in a global classroom.

AIM: This study is a comprehensive review with the purpose of collecting the most relevant data in several sections including current treatment guidelines in the paediatric population. METHODS: Literature was systematically searched in different databases. Results were limited to 2019+ and English, French and Spanish language. RESULTS: Children can exhibit mild and less severe COVID-19 disease than adults and also have asymptomatic carriage of SARS-CoV-2, while severe disease is more frequently noted during infancy (<1 year). SARS-CoV-2 binds the angiotensin-converting enzyme 2 (ACE-2) receptor; age-, racial-, and gender-specific differences in ACE-2 expression need to be elucidated in order to explain the differential clinical profiles between children and adults. Multisystem inflammatory syndrome in children (MIS-C) is an important condition to recognise in children. The decision to use antiviral or immunomodulatory therapy in a child or adolescent should be individualised based on the clinical scenario. Remdesivir is the only FDA-approved therapy available for children older than 12 years old who require hospitalisation for COVID-19. CONCLUSION: Further studies are urgently required to address prevention and treatment in at-risk and infected children, especially with underlying comorbidities. The chapter on the overall impact of COVID-19 in children has not yet been written. Nevertheless, SARS-CoV-2 has now joined a long list of human pandemics, which may forever change the world's history.