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Introduction Children with cancer are immunocompromised due to the disease per se or anticancer therapy. Children are believed to be at a lower risk of severe coronavirus disease 2019 (COVID-19) disease.Objective This study analyzed the outcome of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in children with cancer.Materials and Methods A retrospective analysis was performed on patients (<= 14 years) with cancer attending the pediatric oncology services of our institute who tested positive for the SARS-CoV-2 infection and those who had COVID-19 disease between August 2020 and May 2021. Real-time reverse transcriptase-polymerase chain reaction performed on the nasopharyngeal swab identified the SARS-CoV-2 infection. The primary endpoints were clinical recovery, interruption of cancer treatment, and associated morbidity and mortality.Results Sixty-six (5.7%) of 1,146 tests were positive for the SARS-CoV-2 infection. Fifty-two (79%) and 14 (21%) patients had hematolymphoid and solid malignancies. Thirty-two (48.5%) patients were asymptomatic. A mild-moderate, severe, or critical disease was observed in 75% (18/24), 12.5% (3/24), and 12.5% (3/24) of the symptomatic patients. The "all-cause" mortality was 7.6% (5/66), with only one (1.5%) death attributable to COVID-19. Two (3%) patients required ventilation. Two (3%) patients had a delay in cancer diagnosis secondary to COVID-19 infection. Thirty-eight (57.6%) had a disruption in anticancer treatment.Conclusion Children with cancer do not appear to be at an increased risk of severe illness due to SARS-CoV-2 infection. Our findings substantiate continuing the delivery of nonintensive anticancer treatment unless sick. However, SARS-CoV-2 infection interrupted anticancer therapy in a considerable proportion of children.
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Purpose: To determine if Apadenoson or Regadenoson has a therapeutic effect in attenuating hyper-inflammation and improving survival rate in K18-hACE2mice or Syrian hamsters infected with SARS-CoV-2. Method(s): 6-8 weeks old male K18-hACE2mice were divided into Control group that received vehicle;Test group 1 that received the drug (Apadenoson or Regadenoson) 24hrs prior to challenge with SARS-CoV-2;and Test Group 2 (Drug-delay), that received the drug with a 5 hr delay post-viral infection (n=6/grp). Viral dose was 1250 PfuHong Kong/VM20001061/2020 delivered via intranasal route. Drug was delivered subcutaneously using 1007D ALZET pumps. 6 weeks old Syrian hamsters were divided into Control group that received Vehicle and Virus (n=4) and 2 test groups (n=5/group) that received Apadenoson+Virus and Regadenoson+Virus. Drugs were delivered by 2ML2 ALZET pumps (4ug/kg/hr). Hamsters were inoculated intratracheally with 750PFU SARS-CoV-2 WA1 strain prior to treatment. Mice were weighed and clinical scores recorded daily. Bronchoalveolar lavage fluid (BALF) and serum were collected along with lungs. Plethysmography was done on days 0, 2, 4 and 7. Result(s): Apadenoson administered post-infection was efficacious in decreasing weight loss, improving clinical score, and increasing the survival rate in K18-hACE2 mice, i.e. 50% survival was observed at Day 5 and at Day 7 post-infection for drug given before or after infection respectively. Apadenoson given post-infection improved the histopathology that was observed in the vehicle control group, decreased pro-inflammatory IL-6, IFN-gamma, MCCP-1, MIP-1beta, IP-10, and Rantes in serum, increased anti-inflammatory Ang1-7 levels, and decreased monocytes in BALF. 42% of mice that received Regadenoson pre-challenge survived infection compared to 6.25% in the vehicle or Drug delay (drug given post-infection) groups. Viral titers in the lungs of Regadenoson-treated mice were found decreased. Treatment also significantly decreased CD4+, CD8+T cells, eosinophils, and neutrophils in BALF. Plethysmography, in hamsters, showed significant improvement of pulmonary function parameters, Rpef and PenH, following treatment with Apadenoson given post-infection. Apadenoson cleared the virus from BALF and maintained Ang1-7 levels. Both drugs decreased plasma IFN-gamma levels. Conclusion(s): Treatment with Apadenoson attenuated inflammation, improved pulmonary function, decreased weight loss, and enhanced survival rate following infection with SARS-CoV-2 virus. The results demonstrate the translational significance of Apadenoson in the treatment of COVID-19.
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Purpose: To determine if IgM has a direct effect in preventing SARS-CoV-2 replication in Vero E6 cells, and delaying or preventing disease in infected K18- hACE2 mice. Method(s): 1) Vero E6 cells, grown to confluence in 12 well plates, were used to test the effect of IgM in reducing the number of plaque-forming units (PFU).There were 4 groups: a) 25PFU WA-1 SARS-CoV-2 was combined with 20, 5 or 0.8mug IgM in growth medium, and incubated for 1hr in a final volume of 500ul. 100mul was added to Vero E6 cells in replicate wells and incubated for 1hr;b) 100mul of 20, 5 or 0.8mug IgM was added to Vero E6 cells and incubated. Media was aspirated and the cells were then inoculated with 25PFU WA-1 and incubated for 1hr;c) Virus control - as above, but with no IgM;d) No virus or IgM. FBS growth medium containing Avicel was overlain in the wells and incubated for 48 hours. Virus replication was stopped by incubating with 10% buffered formalin. Following removal of formalin, plates were stained with Giemsa violet, dried, and photographed. 2) A COVID -19 Spike- ACE2 binding assay kit was used to determine if IgM (2ug, 4.5ug, 20ug, 45ug IgM) inhibits the interaction between the Spike-receptor binding domain (S-RBD) and Angiotensin I ConvertingEnzyme 2 (ACE2) receptor. 3) K18-hACE2 mice were divided into 3 groups based on treatment regimen;Group 1: with IgM, No virus;2: with Saline, with virus;3: with IgM, with virus. 35ug IgM was injected intraperitoneal in a single dose, 2 days prior to infection. Mice were innoculated intranasally with 1250 pfu of HK SARS-CoV-2. Result(s): 1) Exposure of 25PFU SARS-CoV-2 to IgM (at all concentrations) prior to incubation with Vero E6 cells, inhibited its replication in Vero E6 cells. When Vero E6 cells were incubated with IgM prior to infection, no plaques were seen in wells with 20ug and 5ug IgM but were observed in wells with 0.8ug IgM. Plaques were also observed in the Virus alone group, but none were seen in the 'No IgM-No virus' group. 2) 45ug IgM/100uls inhibited the binding of S-RBD to ACE2 by ~94-100%, 20ug IgM/100uls inhibited it by ~80%, and 2 or 4.5ug/100ul by ~70-75%. Control without IgM did not inhibit the S-RBD-ACE-2 binding. 3) Pretreatment with a single low dose IgM injection delayed weight loss and mortality. Conclusion(s): IgM inhibits the replication of SARS-CoV-2 in Vero cells in vitro. It also inhibits the interaction between S-RBD that is present on the viral surface and the ACE2 receptor, by binding to S-RBD. A single low dose of IgM given prechallenge delayed disease in infected mice. The discovery that IgM interferes with the formation of the S-RBD-ACE2 complex, and that a single low dose can delay disease, indicates its translational potential as a vaccine/therapeutic to prevent or treat COVID-19.
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BACKGROUND: Online teaching has been practiced after lockdown due to Coronavirus Disease 2019 (COVID-19) pandemic which has replaced conventional classroom teaching. The aim of the present study was to know the perceptions regarding online learning as perceived by both teachers and students during COVID-19 pandemic. MATERIALS AND METHODS: The present study was cross-sectional and questionnaire-based. Web-based respondent-driven sampling technique was used to recruit participants for the present study. Three hundred and thirty-two students and 130 teachers of varying ages and gender participated in the study. The link of web-based questionnaire was sent to respondents through WhatsApp/Facebook. Responses from all the participants were tabulated and analyzed using univariate analysis (Chi-square test). RESULTS: Prerecorded lectures (38.9%) and Webinar apps (35/8%) were the most common modules of online teaching by students. One-third (34.3%) had the convenience to attend lectures from home whereas 44.3% had difficulty in concentration. Commonly cited disadvantage by students was inability to do practical work (37.9%). Regarding teaching faculty, 43.8% had no prior knowledge of online teaching. Sixty percent of teachers had 4 h/week of online teaching. No face-to-face interaction (67.7%) and internet issues (26.9%) were commonly stated barriers by faculty. CONCLUSION: The pandemic has pushed the teachers and students toward newer teaching avenues. However, more needs to be done to supplement the existent teaching pattern and preparedness of teaching faculty by incorporating online assignments and assessment methods, strengthening digital infrastructure in medical schools, and training support for teachers. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
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Background: One severely impacted sector during a COVID-19 pandemic is the field of Medical Education. Initially, when the Medical students were sent home based on Government Lockdown orders, it was very hard to imagine that it would change the way of teaching especially in this field. After successfully adjusting to this new scenario the question of the hour is how many students and the teachers did adjust? What were their perceptions? And overall what was the effectiveness of this exercise? This study puts in a sincere effort to find the same. Methods: The student’s and the teacher’s perceptions were taken using Likert’s scale when the online sessions were going on. Another student’s perception was taken about a live lecture class in a classroom. The perception scores of the students were compared. An online test was taken after online sessions which were proctored by teachers and the marks attained by the students reflected the effectiveness of the programme. Results: The perception score of the students was better for live classes than that for the online session. There is no significant difference between the marks scored after the online session when compared to the marks scored when live lectures were being taken. Conclusion: The medical students have been benefitted by this exercise during the pandemic. Further, this mode of teaching should be implemented when regular classes will go on. © @IJCRR.
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Coronavirus (COVID-19) pandemic has been declared by the World Health Organization after it has gripped many countries of the world. The exponential increase in the number of cases has resulted in panic and confusion among healthcare workers and the vulnerable population. Pregnant and lactating mothers are a vulnerable group and need evidence-based advice to protect the health of the mother and the child. Healthcare workers can play an important role in dispelling the myths and misconceptions among pregnant and lactating mothers regarding COVID-19, if they are equipped with scientific information on antenatal care, care at birth, and breastfeeding. This review attempts to summarize the published evidence related to antenatal care, care at birth and breastfeeding during the COVID-19 pandemic. © 2020, Indian Association of Preventive and Social Medicine. All rights reserved.