The picture theory of seven pathways associated with COVID-19 in the real world (preprint)

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) induces immune-mediated diseases. Interactions between the host and virus govern induction, resulting in multiorgan impacts. In 2021, as normal life was challenging during the pandemic era, we analyzed SCI journals according to L. Wittgenstein's Tractatus Logi-co-Philosophicus. The pathophysiology of coronavirus disease 2019 (COVID-19) involves the following steps: 1) the angiotensin-converting enzyme (ACE2) and Toll-like receptor (TLR) pathways: 2) the neuropilin (NRP) pathway, with seven papers and continuing with twenty-four: 3) the sterile alpha motif (SAM) and histidine-aspartate domain (HD)-containing protein 1 (SAMHD1) tetramerization pathway, with two papers and continuing with twelve: 4) inflammasome activation pathways, with five papers and continuing with thirteen: 5) the cytosolic DNA sensor cyclic-GMP-AMP synthase (cGAS)/stimulator of interferon genes (STING) (cGAS–STING) signaling pathway, with six papers and successful with eleven: 6) the spike protein pathway, with fourteen and continuing with twenty-three: 7) the immunological memory engram pathway, with thirteen papers and successive with eighteen: 8) the excess acetylcholine pathway, with three papers and successful with nine. We reconfirmed that COVID-19 involves seven (1-7) pathways and a new pathway involving excess acetylcholine. Therefore, it is necessary to therapeutically alleviate and block the pathological course harmoniously with modulating innate lymphoid cells (ILCs) if diverse SARS-CoV-2 variants are subsequently encountered in the future.

The Impact of Face Shields on the Quality of Colonoscopy During the COVID-19 Pandemic (preprint)

Background: The coronavirus disease 2019 (COVID-19) has become a global pandemic. Healthcare workers are at a higher risk for exposure to COVID-19 infection than the general population. During the COVID-19 pandemic, endoscopists are recommended to wear personal protective equipment (PPE), including face shields, to prevent COVID-19 transmission. However, to the best of our knowledge, there are no reports on the impact of face shields on the quality of colonoscopy. This study aimed to determine whether the use of PPE, including face shields, affects the quality of colonoscopy during the COVID-19 pandemic. Methods: We retrospectively reviewed the medical records of patients who underwent screening or surveillance colonoscopy performed at Dong-A University Hospital between June 2020 and March 2021 during the COVID-19 pandemic. Endoscopists wore isolation gowns, disposable gloves, and KF94 masks from June 2020 to October 2020. From November 2020, endoscopists additionally wore face shields. Therefore, we compared the colonoscopy quality indicators during the 5 months without the use of face shields and the 5 months with the use of face shields. We calculated the overall adenoma detection rates (ADRs) of the group using face shields and the group not using face shields. Further, the polyp detection rate (PDR), sessile serrated lesion detection rate (SSLDR), advanced neoplasia detection rate (ANDR), polyp per colonoscopy, and adenoma per colonoscopy were calculated for each group. Results: : In total, 1,359 patients were included in the study; the face shield and non-face shield groups comprised 679 and 680 patients, respectively. We found no statistically significant differences in the PDR (49.04 vs. 52.50%, p =0.202), ADR (38.59 vs. 38.97%, p =0.884) SSPDR (1.91 vs. 1.32%, p =0.388), and ANDR (3.98 vs. 3.97%, p =0.991) between the groups. In both the experienced endoscopist group and trainee endoscopist group, there was no difference in the colonoscopy quality indicators between the groups of patients examined by endoscopists with and without face shields. Conclusions: : The quality indicators of colonoscopy were not affected by face shields during the COVID-19 pandemic.

Randomized Controlled Trial of DDS for Covid-19 ARDS (preprint)

Background Clinicians considered DDS administration to treat SARS-CoV-2 inflammasome. DDS is helpful in the molecular regulation of Nod-like receptor family pyrin domain-containing 3 (NLRP3).Objective To study the targeting of NLRP3 itself or up-/downstream factors of the NLRP3 inflammasome by DDS must be responsible for its observed preventive effects, functioning as a competitor.Methods This is a randomized controlled trial (RCT). We set out to use objective criteria of improvement. We treated the patients with standard Covid-19 acute respiratory distress syndrome (ARDS) treatment with DDS. The RCT results were analyzed.Results ARDS progression was blocked in 17 of 19 total patients at the first period. The 44 subjects were analyzed during the second period. It is significant at the ARDS onset stage. The mortality of ARDS-onset patients was 0% with DDS and 40% without DDS among the total of 65 cases. The t-value of RCT is -1.5, and the p-value is .075475. The result is significant at p < 0.10. ARDS onset with DDS prescribed group survived more 90% than ARDS onset without DDS group. The chi-square is 5.8108. The p-value is .015928. (Significant at p < .05) (RR 0.15, OR 0.09)Conclusion There was a significant difference in DDS treatment results in the ARDS-onset group. We confirmed that DDS clinically treated the onset of ARDS by targeting SARS-CoV-2-activated inflammasomes. Like chemically reacting substances, inflammasome and DDS compete, proving that it is effective in early ARDS.ClinicalTrials.gov Identifier: NCT04918914