The protective effect of xanthenone against LPS-induced COVID-19 acute respiratory distress syndrome (ARDS) by modulating the ACE2/Ang-1-7 signaling pathway.

OBJECTIVE: Acute respiratory distress syndrome (ARDS) is an inflammatory lung disease that has a high rate of morbidity and mortality. It's an acute diffusive lung injury caused by the release of pro-inflammatory cytokines into the lungs. Specific microRNAs have been identified to play a crucial role in the renin-angiotensin system signaling pathways the main pathophysiological pathway responsible for ARDS. Since the ARDS life-threatening complication associated with COVID-19 is an ongoing challenge, this current study aimed to investigate the potential efficacy of xanthenone in the treatment of ARDS induced with LPS in mice through ACE2 activation and modulation of miR-200 and ACE2/Ang 1-7 pathways. MATERIALS AND METHODS: Mice were categorized into three groups randomly. The first set of mice served as the normal control group. The ARDS group was injected with LPS (15 mg/kg; i.p.). The last group was treated with xanthenone (2 mg/kg/day; p.o.) for one week before the LPS injection. RESULTS: Xanthenone treatment resulted in a significant down-regulation of miRNA-200 expression, leading to the activation of ACE2 accompanied with marked inhibition of Angiotensin II as well as increases the levels of Ang 1-7 and SP-A. CONCLUSIONS: Xanthenone has the potential to be a promising therapeutic drug for the treatment of ARDS COVID-19 complication through activation of ACE2/Ang 1-7 pathways.https://www.europeanreview.org/wp/wp-content/uploads/Graphical_abstract.tif.

Inflammatory Arthritis Post Covid-19 Infection

Presentation A 63-year-old man developed polyarthritis two months post recovery from COVID-19 infection. Diagnosis We concluded that the diagnosis was rheumatoid arthritis based upon raised inflammatory markers, positive rheumatoid factor and anti-cyclic citrullinated peptide antibodies. Treatment His symptoms improved with naproxen, corticosteroids, and methotrexate. Discussion We describe a patient with late onset rheumatoid arthritis possibly triggered or unmasked by COVID-19.

Qatar Biobank in the COVID-19 era and beyond

Background: During the COVID-19 outbreak, Qatar Biobank (QBB) adapted its services to collect, process, and store high-quality data and specimens. This transformation period brought opportunities, risks, and challenges. Methods: QBB holds College of American Pathologists (CAP) accreditation and International Organization for Standardization (ISO) certification for Quality Management (9001:2105) and Information Security Management Systems (27001: 2013)1. These standards helped to effectively convert its operations to facilitate the COVID-19 national project2. The COVID-19 Biorepository is a National Disease-based study aiming to collect adequate health information and biological samples from Qatar residents infected by SARS-CoV-2 virus to enable evidence-based research towards the discovery and development of novel healthcare interventions and to facilitate research projects related to the COVID-19 pandemic. QBB IT Department used open-source Onyx (ObiBa) software to newly develop a COVID-19 electronic system and interface for various clinical devices and Laboratory Information Management System. QBB operational services were adapted to accommodate the COVID-19 project by providing training to the personnel (n=20;i.e. nurses, research assistants etc.) and developing work instructions (n>5) for the participants' recruitment process, data and specimen collection in the different hospitals. A COVID-19 portal was also developed by QBB to facilitate data access for researchers from Qatar and worldwide4. Results: Within 5 weeks QBB transformed to accommodate a disease/virus-based biorepository. At an operational level, multi-adjustments were implemented. QBB IT department developed an electronic system for the data collection and specimen traceability3. Clinically trained staff were transferred to different healthcare facilities to recruit COVID-19 positive patients. QBB laboratory designed special collection kits. QBB Medical Review Office and Scientific and Education departments managed the recruitment process, set up of the study and provided training to the staff. The Communications and Participants Recruitment Department transformed its operations to fit the needs of the COVID-19 initiative. The Research Access Office designed the COVID-19 access portal and supported the project through purchasing of personal protective equipment and other administrative tasks. Conclusion: It is now time to consider lessons learned, as many countries have been affected by this pandemic, and to understand that biobanks are an asset for a country and there is a need to integrate them into a new standard with their sustainability in mind. Qatar Biobank is a good showcase of how a biobank can successfully assist in the collection of important data related to different health crises such as the COVID-19 pandemic.

Qatar Biobank: COVID-19 biorepository project

Background: The rapid spread of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and its resulting disease (COVID-19) is one of the greatest global public health crisis of the recent decades1. The COVID-19 Biorepository is a national project aimed to support the high demand of biomedical research by multiple groups and the need to have access to high quality, curated clinical data, and specimens contributing to the understanding of, and response to, the COVID-19 pandemic and its impacts in Qatar2, 3. Methods/Case presentation: Patients with a laboratory diagnosis of COVID-19, who were Qatar residents that could communicate in Arabic, English, Hindi, and Urdu were eligible to participate in the study. COVID-19 diagnosed patients were recruited at the time of their disease period from the main three public hospitals (Communicable Disease Center, Cuban, and Hazm Mebaireek Hospitals) serving as isolation facilities of symptomatic patients in Qatar, during a 7-month period from March 2020 until September 2020. Consented participants were followed up on a weekly basis until recovery, and then monthly for a year. Sociodemographic and clinical data were collected in electronic questionnaires via a face-to-face interview by trained Qatar Biobank (QBB) staff. Results: A total of 2097 consented participants were recruited up to September 2020, males (N=1050) and females (N=1047), with a mean age of 41 years (SD: 15.5). 61.0% of the participants had at least one follow up while 27% adhered to monthly follow up visits. Data was collected for 99.7% of the participants, while the follow up process is still ongoing. In total there are 107,171 high quality specimens in the biorepository including plasma, erythrocytes, buffy coat, serum, PAXgene whole blood, nasopharyngeal secretions, and DNA. Conclusion: The COVID-19 Biorepository is a national asset to illuminate the pathophysiological and identify markers of disease prognosis as well as to describe the clinical features and epidemiology of COVID-19 in Qatar and worldwide.

QBB rapid transformation into COVID-19 Biorepository: A showcase

Background: The SARS-CoV-2 virus and the outbreak of COVID-19 disease has been one of the most important global crises on public health. Qatar Biobank (QBB) had to convert and respond to this crisis by providing its services for the collection, processing and storage of high-quality data and specimens for the better understanding and the response to the therapy and survival of COVID-19 disease. In this study we will highlight the challenges, risks and opportunities of QBB during this transformation period. Methods: QBB is CAP accredited and holds ISO certification for Quality Management Systems 9001:2105 and Information Security Management Systems 27001: 2013. These standards helped QBB management to rabidly adapt by following rigorous processes to effectively convert its operations and facilitate the COVID-19 National project. Results: Within 5 weeks QBB transformed to accommodate a disease/virus-based biorepository. Multi-adjustments had to be implemented at operational level such as: i) QBB IT department developed a highly secured electronic system for the data collection and specimen traceability ii) Clinically trained staff (n = 17) were transferred to different healthcare facilities in order to recruit COVID-19 positive patients;iii) QBB Laboratory designed special collection kit, iv) QBB Medical Review Office (n = 4) and Scientific and Education (n = 2) departments managed the recruitment process, set up the study and provided training to the staff;v) the Communications and Participants Recruitment Department (n = 7) transformed its operations to fit the needs of the COVID-19 initiative. The Research Access Office (n = 6) designed the COVID-19 access portal and supported the project from the purchasing of PPE and other administrative works needed. Conclusion: It is now time to consider lessons learned, as many countries have been affected by COVID-19 outbreak, and to understand that biobanks are an asset for a country and integrate them into a new standard with their sustainability in mind. Qatar Biobank and its network with academic, research and governmental entities is a good showcase.

COVID-19 biorepository-Qatar

Background: The unpresented global spread of the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and its resulting disease (COVID-19) is characterized as one of the greatest global public health crises of the recent decades. The COVID-19 Biorepository is Qatar's National project aiming to support the extraordinary demand on high-quality, curated clinical data and biological samples contributing to research related to the understanding of, and response to, the COVID-19 pandemic and its impacts in Qatar and worldwide. Methods: COVID-19 diagnosed patients, who were Qatar residents and they could communicate in Arabic, English, Hindi and Urdu, were eligible to participate in the study. Participants were recruited from the main three COVID-19 public hospitals and isolation facilities in Doha, Qatar for a 7-month period (March-September 2020). Consented participants were followed up on a weekly basis until recovery, and then monthly for a year. Sociodemographic and clinical data were collected in electronic questionnaires via a face-to-face interview by trained QBB staff together with biological samples. COVID-19 Rapid Antibodies tests together with Anti- SARS-COV-2- seroprevalence tests are in place to investigate the development and durability of antibodies against SARS-CoV-2 infection. Results: A total of 2097 consented participants were recruited up to September 2020. The population is multinational (n = 45 different nationalities)withmales (N = 1050;50.07%) and females (N = 1047;49.93%) and a mean age of 41 years (SD, 15.5). 61.0% of the participants had at least one follow up while 27%adhered to monthly follow up visits. Data have been collected for 99.7% of the participants, while the follow up process is ongoing. In total there are 107,171 high quality specimens in the biorepository including plasma, erythrocytes, buffy coat, serum, PAXgene Whole Blood, Nasopharyngeal secretions and DNA. 61.6% of the participants were asymptomatic or with mild symptoms, 12.4% developed moderate symptoms, 15.1% developed severe symptoms and 11.0% were reported as critical. The 5.7% (n = 121) of the participants were deceased after hospitalization. Conclusion: COVID-19 biorepository is a National asset for Qatar. It is expected to provide high quality data and biological samples to the scientific community that can be used to illuminate the pathophysiology of and to identify markers of disease prognosis of COVID-19 in Qatar and worldwide.