Traditional Chinese herbal medicine-potential therapeutic application for the treatment of COVID-19.

Traditional Chinese Medicine (TCM) is a complete medical system that has evolved over millennia to include practices and procedures such as acupuncture, herbal medicine, manual therapies, nutrition, and mind-body therapies such as qi gong. In modern-day China and other Asian countries, TCM is a medical subspecialty utilized alongside western biomedicine. During the current Coronavirus Disease 19 (COVID-19) pandemic, TCM and TCM herbal medicine is being used and a number of single herbs and combination formulas have significant bioactivity and therapeutic potential. The purpose of this paper is to highlight the use of TCM in the treatment of COVID-19. This commentary provides the reader with a concise background on COVID-19 and summarizes TCM concepts including identification, pattern diagnosis, and treatment principles commonly used for the treatment of viral influenza-like diseases. It also highlights some of the challenges and potential for using TCM in an integrated medical setting.

The Resilient Child: Sex-Steroid Hormones and COVID-19 Incidence in Pediatric Patients.

Coronavirus disease-2019 (COVID-19), a disease caused by Severe Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection, has become an unprecedented global health emergency, with fatal outcomes among adults of all ages in the United States, and the highest incidence and mortality in adult men. As the pandemic evolves there is limited understanding of a potential association between symptomatic viral infection and age. To date, there is no knowledge of the role children (prepubescent, ages 9-13 years) play as "silent" vectors of the virus, with themselves being asymptomatic. Throughout different time frames and geographic locations, the current evidence on COVID-19 suggests that children are becoming infected at a significantly lower rate than other age groups-as low as 1%. Androgens upregulate the protease TMPRSS2 (type II transmembrane serine protease-2), which facilitates efficient virus-host cell fusion with the epithelium of the lungs, thus increasing susceptibility to SARS-CoV-2 infection and development of severe COVID-19. Owing to low levels of steroid hormones, prepubertal children may have low expression of TMPRSS2, thereby limiting the viral entry into host cells. As the world anticipates a vaccine against SARS-CoV-2, the role of prepubescent children as vectors transmitting the virus must be interrogated to prepare for a potential resurgence of COVID-19. This review discusses the current evidence on the low incidence of COVID-19 in children and the effect of sex-steroid hormones on SARS-CoV-2 viral infection and clinical outcomes of pediatric patients. On reopening society at large, schools will need to implement heightened health protocols with the knowledge that children as the "silent" viral transmitters can significantly affect the adult populations.