Impact of Early Termination of Lockdown and Maintaining Social Distancing: COVID-19

A novel corona-virus named COVID-19 has spread rapidly and has caused a global outbreak of respiratory illness. It has been confirmed that the bats are the source host of SARS, and camels act as a source for MERS. However, the source host of the COVID-19 remains unknown. All three kinds of pneumonia show human-to-human transmissions. Among which, COVID-19 shows a longer incubation period. The routes for the human to human transmission are common, respiratory droplets, contact, and aerosol. In which, the new form is Aerosol transmission. In which, integration of the air with droplets will occur during transmission that leads to the formation of Droplet Nucleus. It can lead to infection after inhalation. Because of this, the virus has already spread to South Korea, Japan, Iran, Italy, and other countries. The objective of this chapter is to address the impact and list the suggestion to handle COVID-19 safely. The methodology followed in drafting this chapter is to provide answers to the following questions: Q1: The clinical manifestation of COVID-19? Q2: How to prevent the transmission of this disease and protect themselves? Q3: The outcome of COVID-19 pneumonia. Q4: How to diagnose COVID-19? Q5: The effects of COVID-19 pneumonia on pregnancy: Q6: Coronavirus pneumonia in children. Q7: The response strategies against the COVID-19 in China. Q8: Therapeutic Strategy for COVID-19. Q9: Consequences of COVID-19 in Human Daily Life. Q10: How to deal with the novel Coronavirus disease calmly? Q11: The COVID-19 prevention among students. Q12: Plan to return to the campus. Q13: Home-based self-care in climacteric women Q14: Strategies to climacteric women's psychological problems during COVID-19 pandemic. The outcome of the present research is to provide suggestions to the humankind towards handling the epidemic safely. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Significance of nuts in strengthening immune system during COVID-19

Viral infections are contagious and deadly. Many viral attacks in the past decades including COVID-19 have turned into pandemics and cost millions of lives. Treatment to virus is difficult as they transform themselves into many variants. Thus, an intelligent way of keeping oneself out of the trouble is through better nutrition that enhance immune responses. Foods that provide high quantities of nutrients are vegetables, fruits and nuts. They are rich in fibres, fats, protein, vitamins, minerals and plant bioactive compounds like phytosterols, polyphenolics, flavonoids, etc. Many studies and randomised control trials have proven their therapeutic effects and health promoting capacities. These compounds interfere with the pathways of metabolic mechanisms in the human body and work by either providing a protective scope or by destroying any harmful incomings into the body;that would disrupt the homeostasis. In this article, nuts and their nutritive components that administer healthy benefits are discussed. Almonds, cashew nuts, pistachios, peanuts, chestnuts and Brazil nuts are examined and reviewed here. The nutritional composition of these nuts and their mechanism to offer medicinal properties are explained in detail. Apart from nutritional values, these nuts are rich source of antioxidants that confer anti-inflammatory and immunomodulatory features. These activities enhance the immune responses by activating the defense mechanisms. Apart from the intake of highly nutritious diet, practising social distancing, isolation and better sanitation procedures are highly beneficial to avoid the severity of the viral attacks.

Key Elements and Mechanisms of a Peer-Support Intervention to Reduce Loneliness and Isolation among Low-Income Older Adults: A Qualitative Implementation Science Study.

This paper describes the evaluation of a longitudinal peer-support program developed to address loneliness and isolation among low-income, urban community-dwelling older adults in San Francisco. Our objective was to determine barriers, challenges, and successful strategies in implementation of the program. In-depth qualitative interviews with clients (n = 15) and peers (n = 6) were conducted and analyzed thematically by program component. We identified barriers and challenges to engagement and outlined strategies used to identify clients, match them with peers, and provide support to both peers and clients. We found that peers played a flexible, non-clinical role and were perceived as friends. Connections to community resources helped when clients needed additional support. We also documented creative strategies used to maintain inter-personal connections during the COVID-19 pandemic. This study fills a gap in understanding how a peer-support program can be designed to address loneliness and social isolation, particularly in low-income, urban settings.

Toward a big picture of COVID-19.

The paper aims to illustrate and explain the problems and opportunities for improvement in Covid management that become evident when taking a systems perspective. Critical time delays occurred in the regulation of the pandemic that the management cycle of political cybernetics makes explicit. In general, the executive management of the pandemic in global, regional, and national organizations was unprepared in detecting and responding to the onset of the waves and making appropriate decisions towards differential instead of general lockdowns based on available data. This was further complicated by the mutants of SARS-CoV2 that perpetuated the high dynamics of the pandemic. In addition, the diversity of medical specialisms, without appropriate big picture thinking, led to an imbalanced response that failed to appreciate the role of virology and epidemiology compared to clinical and public health-related issues. In consequence, laboratory experts suggested everyday regulations for the citizens without taking into account wider considerations for empirical research. There was an insufficient effort made for proposed treatment studies using existing agents based on the established understanding of essential physiology and the role of local and systemic chronic inflammation. In contrast, driven by media popularization, drugs that later proved beneficial were put in doubt and other drugs that lacked benefit and potentially caused harm were driven to clinical trials and utilization. Person-centered systems view backed by scientific knowledge and established data would have set better priorities. Finally, we need to take a step back and consider the Corona crisis pandemic in the context of the unidimensional utility-driven handling of natural ecosystems by the culture of industrialized countries. This ever-accelerating destruction of life spaces for species drives adaptations are the basis of zoonoses. There is strong evidence that future pandemics should be faced with a more systemic socio-ecological conceptual framework that also reflects the fatal impact of human civilization on natural ecosystems, no matter if SARS CoV2 is a zoonosis or a laboratory accident. It is critical for the future of our species that we collectively learn from this experience, address limitations in our perspectives, enhance our system-based science and bolster global, regional, and national crisis management. The impact of climate change and biodiversity loss has crossed the horizon and is now clearly in full sight.

Exploring the Shift From HIV Pre-exposure Prophylaxis Awareness to Uptake Among Young Gay and Bisexual Men.

Introduction: HIV pre-exposure prophylaxis (PrEP) in the form of a daily oral medication is highly effective at preventing HIV. In the United States, awareness about PrEP has steadily increased over time among individuals vulnerable to HIV, however awareness has not translated into widescale uptake. Estimates are that fewer than 20% of 1.2 million Americans for whom PrEP is indicated are utilizing it. We sought to understand how individuals moved from PrEP awareness to PrEP utilization. Methods: We conducted a series (n = 31) of in-depth interviews with young people, predominantly gay and bisexual men, ages 18-29 years old between February 2015 and January 2016, as part of the evaluation of a multi-year demonstration project funded to test innovative approaches to improve sexual health outcomes and curb the HIV epidemic in California. Interviews were audio-recorded and transcribed verbatim. We conducted a thematic analysis. Results: We present a continuum of PrEP awareness that spans three phases-basic, moderate and advanced. Participants rarely reported becoming well-informed about PrEP over the course of an initial exposure to PrEP information. Learning occurred after multiple exposures to PrEP information through numerous intersecting forms, messengers and formal and informal communication channels. Positively framed messages delivered by formal messengers emphasizing PrEP as a sensible HIV prevention strategy and explicitly communicating a regard for sexual wellness were overwhelmingly persuasive and facilitated movement to the advanced awareness phase. Once participants reached the advanced phase of PrEP awareness, uptake was possible. Conclusions: Our analysis provides insights into how PrEP awareness led to PrEP uptake among young gay and bi-sexual men. Building demand among those in the basic awareness phase took longer than those in the moderate phase. Individuals involved in formal and informal PrEP education can set reasonable expectations about whether, when and how eventual uptake may occur when keeping the continuum of PrEP awareness framework in mind. Many young, gay and bi-sexual male prospective PrEP users will benefit from positively framed messages that emphasize personal well-being, including social, sexual and emotional benefits of PrEP use.

Endothelin-1 is increased in the plasma of patients hospitalised with Covid-19.

Virus induced endothelial dysregulation is a well-recognised feature of severe Covid-19 infection. Endothelin-1 (ET-1) is the most highly expressed peptide in endothelial cells and a potent vasoconstrictor, thus representing a potential therapeutic target. ET-1 plasma levels were measured in a cohort of 194 Covid-19 patients stratified according to the clinical severity of their illness. Hospitalised patients, including those who died and those developing acute myocardial or kidney injury, had significantly elevated ET-1 plasma levels during the acute phase of infection. The results support the hypothesis that endothelin receptor antagonists may provide clinical benefit for certain Covid-19 patients.

Differential expression in humans of the viral entry receptor ACE2 compared with the short deltaACE2 isoform lacking SARS-CoV-2 binding sites.

ACE2 is a membrane protein that regulates the cardiovascular system. Additionally, ACE2 acts as a receptor for host cell infection by human coronaviruses, including SARS-CoV-2 that emerged as the cause of the on-going COVID-19 pandemic and has brought unprecedented burden to economy and health. ACE2 binds the spike protein of SARS-CoV-2 with high affinity and shows little variation in amino acid sequence meaning natural resistance is rare. The discovery of a novel short ACE2 isoform (deltaACE2) provides evidence for inter-individual differences in SARS-CoV-2 susceptibility and severity, and likelihood of developing subsequent 'Long COVID'. Critically, deltaACE2 loses SARS-CoV-2 spike protein binding sites in the extracellular domain, and is predicted to confer reduced susceptibility to viral infection. We aimed to assess the differential expression of full-length ACE2 versus deltaACE2 in a panel of human tissues (kidney, heart, lung, and liver) that are implicated in COVID-19, and confirm ACE2 protein in these tissues. Using dual antibody staining, we show that deltaACE2 localises, and is enriched, in lung airway epithelia and bile duct epithelia in the liver. Finally, we also confirm that a fluorescently tagged SARS-CoV-2 spike protein monomer shows low binding at lung and bile duct epithelia where dACE2 is enriched.

Differential expression in humans of the viral entry receptor ACE2 compared with the short deltaACE2 isoform lacking SARS-CoV-2 binding sites (preprint)

ACE2 is a membrane protein that regulates the cardiovascular system. Additionally, ACE2 acts as a receptor for host cell infection by human coronaviruses, including SARS-CoV-2 that emerged as the cause of the on-going COVID-19 pandemic and has brought unprecedented burden to economy and health. ACE2 binds the spike protein of SARS-CoV-2 with high affinity and shows little variation in amino acid sequence meaning natural resistance is rare. The discovery of a novel short ACE2 isoform (deltaACE2) provides evidence for inter-individual differences in SARS-CoV-2 susceptibility and severity, and likelihood of developing subsequent ‘Long COVID’. Critically, deltaACE2 loses SARS-CoV-2 spike protein binding sites in the extracellular domain, and is predicted to confer reduced susceptibility to viral infection. We aimed to assess the differential expression of full-length ACE2 versus deltaACE2 in a panel of human tissues (kidney, heart, lung, and liver) that are implicated in COVID-19, and confirm ACE2 protein in these tissues. Using dual antibody staining, we show that deltaACE2 localises, and is enriched, in lung airway epithelia and bile duct epithelia in the liver. Finally, we also confirm that a fluorescently tagged SARS-CoV-2 spike protein monomer shows low binding at lung and bile duct epithelia where dACE2 is enriched.

Human embryonic stem cell-derived cardiomyocyte platform screens inhibitors of SARS-CoV-2 infection.

Patients with cardiovascular comorbidities are more susceptible to severe infection with SARS-CoV-2, known to directly cause pathological damage to cardiovascular tissue. We outline a screening platform using human embryonic stem cell-derived cardiomyocytes, confirmed to express the protein machinery critical for SARS-CoV-2 infection, and a SARS-CoV-2 spike-pseudotyped virus system. The method has allowed us to identify benztropine and DX600 as novel inhibitors of SARS-CoV-2 infection in a clinically relevant stem cell-derived cardiomyocyte line. Discovery of new medicines will be critical for protecting the heart in patients with SARS-CoV-2, and for individuals where vaccination is contraindicated.

Role and significance of fruits in boosting immunity against COVID-19 infections

Novel coronavirus disease-19 (COVID-19) has been declared as a world pandemic which is responsible for high mortality rate. Finding a clinical cure for the same is difficult due to its variable characteristics. Thus, prevention is the most adaptive way to improve the current pandemic situation. Various studies suggest that patients with compromised immune health are the most susceptible host for this virus. This can be overcome by consumption of functional foods rich in nutritional components that boosts the human immune health. Recommended diet to improve the functioning of immune system includes vegetables, fruits, legumes, etc. They contain high quantities of protein, vitamins, minerals and phytochemicals that enhance the antioxidant and anti-inflammatory capabilities. Nutraceutical rich fruits like apples, papayas, citrus, berries and pineapples are under consideration to boost the immunity and keep the infections at bay. Apart from dietary supplementation, a good sleep combined with exercise routine can enhance the functioning of immune system and decrease the viral impact to a greater extent.

Importance of vegetables as healthier diet in the management of COVID-19 pandemic

COVID-19, a viral outbreak has taken toll on millions of lives in a very short span of time. This spread can be mainly due to ease of travel. Remedy for viral infections is extremely difficult as they keep changing their characteristics often. Though, vaccines have been under study for coronavirus, none has been approved yet. Till then, nutritional supplement is the only way to protect the human body against such lethality. As per World Health reports, every year about 2.7 million deaths occur due to poor diet lacking in enough and essential dietary fibres, vitamins and minerals received from vegetables and fruits. Immune system must be improved and developed through proper dietary management. Recommended diet includes green, low fat, vegetarian foods to boost immunity. They contain variety of nutrients including vitamins, minerals, fibre and many phytochemicals. These secondary metabolites and phytochemicals constitute a major part in developing immunity. Phytochemicals are the most important element in the pharmaceutical and medical industry too. Intake of water, vitamins like A, C, B complex, minerals like zinc and magnesium and other micronutrients keep the infections at bay. Thus, including foods rich in these substances help to fight diseases including cancer, diabetes, cardiovascular disorders, etc. The nutrients from vegetables like tomato, onions, bell peppers, crucifiers, etc., and medicinal crops like turmeric, ginger and garlic combat against these viral infections.

Human embryonic stem cell-derived cardiomyocytes express SARS-CoV-2 host entry proteins: screen to identify inhibitors of infection (preprint)

Patients with cardiovascular comorbidities are more susceptible to severe infection with SARS-CoV-2, known to directly cause pathological damage to cardiovascular tissue. We outline a screening platform using human embryonic stem cell-derived cardiomyocytes, confirmed to express the protein machinery critical for SARS-CoV-2 infection, and a pseudotyped virus system. The method has allowed us to identify benztropine and DX600 as novel inhibitors of SARS-CoV-2 infection.

Bispecific antibody prevents SARS-CoV-2 escape and protects mice from disease (preprint)

Neutralizing antibodies targeting the receptor binding domain (RBD) of the SARS-CoV-2 Spike (S) are among the most promising approaches against coronavirus disease 2019 (COVID-19). We developed a bispecific, IgG1-like molecule based on two antibodies derived from COVID-19 convalescent donors, C121 and C135. CoV-X2 simultaneously binds two independent sites on the RBD and, unlike its parental antibodies, completely prevents S binding to Angiotensin-Converting Enzyme 2 (ACE2), the virus cellular receptor. Furthermore, CoV-X2 recognizes a broad panel of RBD variants and neutralizes SARS-CoV-2 and the escape mutants generated by the single monoclonals at sub-nanomolar concentrations. In a novel model of SARS-CoV-2 infection with lung inflammation, CoV-X2 protects mice from disease and suppresses viral escape. Thus, simultaneous targeting of non-overlapping RBD epitopes by IgG-like bispecific antibodies is feasible and effective, combining into a single molecule the advantages of antibody cocktails.

A rational roadmap for SARS-CoV-2/COVID-19 pharmacotherapeutic research and development: IUPHAR Review 29.

In this review, we identify opportunities for drug discovery in the treatment of COVID-19 and, in so doing, provide a rational roadmap whereby pharmacology and pharmacologists can mitigate against the global pandemic. We assess the scope for targeting key host and viral targets in the mid-term, by first screening these targets against drugs already licensed, an agenda for drug repurposing, which should allow rapid translation to clinical trials. A simultaneous, multi-pronged approach using conventional drug discovery methods aimed at discovering novel chemical and biological means of targeting a short list of host and viral entities which should extend the arsenal of anti-SARS-CoV-2 agents. This longer term strategy would provide a deeper pool of drug choices for future-proofing against acquired drug resistance. Second, there will be further viral threats, which will inevitably evade existing vaccines. This will require a coherent therapeutic strategy which pharmacology and pharmacologists are best placed to provide. LINKED ARTICLES: This article is part of a themed issue on The Pharmacology of COVID-19. To view the other articles in this section visit http://onlinelibrary.wiley.com/doi/10.1111/bph.v177.21/issuetoc.

Responding to the Pandemic: Challenges With Public Health Surveillance Systems and Development of a COVID-19 National Surveillance Case Definition to Support Case-Based Morbidity Surveillance During the Early Response.

Responding to introductions of diseases and conditions of unknown etiology is a critical public health function. In late December 2019, investigation of a cluster of pneumonia cases of unknown origin in Wuhan, China, resulted in the identification of a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Multiple public health surveillance actions were rapidly implemented to detect introduction of the virus into the United States and track its spread including establishment of a national surveillance case definition and addition of the disease, coronavirus disease 2019, to the list of nationally notifiable conditions. Challenges in conducting effective case-based surveillance and the public health data supply chain and infrastructure are discussed.

Genes Encoding ACE2, TMPRSS2 and Related Proteins Mediating SARS-CoV-2 Viral Entry are Upregulated with Age in Human Cardiomyocytes (preprint)

Age is an independent risk factor for adverse outcome in patients following COVID-19 infection. We hypothesised that differential expression of genes encoding proteins proposed to be required for entry of SARS-Cov-2 in aged compared to younger cardiomyocytes might contribute to the susceptibility of older individuals to COVID-19-associated cardiovascular complications.We generated strand-specific RNA-sequencing libraries from RNA isolated from flow-sorted cardiomyocyte nuclei from left ventricular tissue. RNASeq data were compared between five young (19-25yr) and five older (63-78yr) Caucasian males who had not been on medication or exhibited evidence of cardiovascular disease post-mortem.Expression of relevant genes encoding ACE2, TMPRSS2, TMPRS11D, TMPRS11E, FURIN, CTSL, CTSB and B0AT1/SLC6A19 were upregulated in aged cardiomyocytes and the combined relative cardiomyocyte expression of these genes correlated positively with age. Genes encoding proteins in the RAAS and interferon/interleukin pathways were also upregulated such as ACE, AGTR1, MAS1 and IL6R.Our results highlight SARS-CoV-2 related genes that have higher expression in aged compared with young adult cardiomyocytes. These data may inform studies using selective enzyme inhibitors/antagonists, available as experimental compounds or clinically approved drugs e.g. remdesivir that has recently been rapidly accepted for compassionate use, to further understand the contribution of these pathways in human cardiomyocytes to disease outcome in COVID-19 patients.Competing Interest StatementThe authors have declared no competing interest.View Full Text