Proof-of-concept trial of an amniotic fluid-derived extracellular vesicle biologic for treating high risk patients with mild-to-moderate acute COVID-19 infection.

A pandemic brought on by COVID-19 has created a scalable health crisis. The search to help alleviate COVID-19-related complications through therapeutics has become a necessity. Zofin is an investigational, acellular biologic derived from full-term perinatal amniotic fluid that contains extracellular vesicles. Extracellular nanoparticles as such have been studied for their immunomodulatory benefits via cellular therapeutics and, if applied to COVID-19-related inflammation, could benefit patient outcome. Subjects (n = 8) experiencing mild-to-moderate COVID-19 symptoms were treated with the experimental intervention. Complete blood count, complete metabolic panel, inflammatory biomarkers, and absolute lymphocyte counts were recorded prior to and on days 4, 8, 14, 21, and 30 as markers of disease progression. Additionally, chest x-rays were taken of the patients prior to and on days 8 and 30. Patients experienced no serious adverse events. All COVID-19-associated symptoms resolved or became stable with no indication of disease worsening as found by patient and chest x-ray reports. Inflammatory biomarkers (CRP, IL-6, TNF- α ) and absolute lymphocyte counts improved throughout the study period. Findings from a proof-of-concept, expanded access trial for COVID-19 patients prove the acellular biologic is safe and potentially effective to prevent disease progression in a high-risk COVID-19 population with mild-to-moderate symptoms.

ABO blood group association and COVID-19. COVID-19 susceptibility and severity: a review.

INTRODUCTION: The SARS-CoV-2 pandemic has been affecting the health and economic, as well as social, life of the entire globe since the end of 2019. The virus causes COVID-19, with a wide range of symptoms among the infected individuals, from asymptomatic infection to mortality. This, along with a high infection rate, prompted efforts to investigate the potential mechanisms of the different clinical manifestations caused by SARS-CoV-2 among the infected populations. HYPOTHESIS: One of the possible mechanisms that has been reported is the ABO blood system polymorphism. Indeed, one of the major proposed mechanisms is the presence of naturally occurring anti-A antibodies in individuals of groups O and B, which could be partially protective against SARS-CoV-2 virions. OBJECTIVE AND METHOD: This article aimed to review the published data on the potential effect of the ABO blood group system on the susceptibility to COVID-19 and the disease progression and outcomes. RESULTS: The reviewed data suggest that individuals of blood group A are at a higher risk of infection with SARS-CoV-2 and may develop severe COVID-19 outcomes, whereas blood group O is considered protective against the infection, to some extent. However, some of the available studies seem to have been influenced by unaccounted confounders and biases. CONCLUSION: Therefore, further appropriately controlled studies are warranted to fully investigate the possible association between the ABO blood groups and COVID-19 susceptibility and severity.

Treatment of a COVID-19 long hauler with an amniotic fluid-derived extracellular vesicle biologic.

Post-COVID-19 infection symptoms such as mental fog, tachycardia, and extreme fatigue are just a few of the symptoms wreaking havoc on patients' lives. Patients with long-term symptoms following COVID-19 are being called long haulers. To date, long haulers are receiving little to no guidance from physicians on their lingering COVID-19 symptoms with limited treatment options available. Zofin is an acellular biologic that contains the extracellular vesicle (EV) fraction of human amniotic fluid and is under investigation for use as a COVID-19 therapeutic. We obtained FDA and IRB approval to investigate the therapeutic use of Zofin in a single long hauler patient case experiencing prolonged shortness of breath and respiratory impairment. Administration of the EV product was shown to be safe. Furthermore, demonstrated respiratory improvements through chest X ray images and oxygen saturation measurement. The single patient IND studies were completed without any reported adverse events or safety concerns. Furthermore, these completed studies demonstrate the feasibility and a therapeutic potential of amniotic fluid-derived EVs for COVID-19 long hauler intervention.

Follow-up study of clinical and chest CT scans in confirmed COVID-19 patients.

OBJECTIVE: To analyze the CT imaging results of patients with COVID-19 who previously received several follow-up visits and to explain the changes in pulmonary inflammation. METHODS: Cases of 15 patients with COVID-19 were retrospectively analyzed: their epidemiology, clinical history, laboratory tests, and multiple CT chest scans obtained during the disease period were studied. RESULTS: The CT scans of the 15 patients showed different results. Four patients had no abnormal findings in their chest CT scans. The first scan of 1 patient revealed right lower lobe inflammation, while the lesion had been completely absorbed in follow-up. Two patients showed bilateral pulmonary inflammation in the first scan which had been absorbed by follow-up but the last examination showed extensive fibrosis. Two patients had no abnormalities in their first CT scans, while pulmonary inflammation was found in the second scan and this had not been completely absorbed by the last follow-up. One patient had pulmonary interstitial lesions with no evidence of National Cochlear Implant Programme (NCIP) on the first and second CT scans. NCIP was found at the third scan, and pulmonary inflammation was not completely absorbed at the last follow-up. Three patients were in the early stage of inflammation at the first scan, and the lesions were absorbed and repaired at the last follow-up. However, the lesions were not completely absorbed. One patient was in the advanced stage at the first scan, and the last follow-up pulmonary lesions were not completely absorbed. The first CT scan of 1 patient revealed large ground-glass opacity in the lungs involving the inner and middle bands. After follow-up, the disease progressed, and this condition was consistent with severe manifestations. CONCLUSION: The follow-up of chest CT can reflect the change process of NCIP and the treatment effect. The first CT scan of lung lesions has a certain predictive effect on the outcome and prognosis of patients.

Community-Based Assessment of Knowledge, Attitude, Practices and Risk Factors Regarding COVID-19 Among Pakistanis Residents During a Recent Outbreak: A Cross-Sectional Survey.

Exceptional precautionary measures have been adopted to stop the transmission and control of COVID-19 through the world and Pakistan is facing lockdown in this scenario. Public loyalty to precautionary measures is affected by their knowledge, attitude, risk factors and practices (KAP) towards COVID-19. The present study was conducted among the Pakistani residents to observe the knowledge, attitude, practices and risk factors towards COVID-19 outbreak in Pakistan. A questionnaire was designed, and a cross-sectional survey was conducted among participants of the study area. Participants were asked the questions regarding knowledge, attitude, practices and risk factors towards COVID-19. Data were analyzed by SPSS and t/F test and correlation was applied among the knowledge, attitude, risk factors and practices. A total of 1060 questionnaires were received. 1004 were included while 56 were excluded. The highest representation was from Punjab province (65.6%), female (63%) and age group of 21-30 years (62.1%). Most participants were single (85%), Muslim (99.4%), Urdu speaking (45.6%) and were graduates (51.5%). Most of the participants were students (52.9%) and were from economically middle-class families (40.8%). The knowledge was positively correlated with attitude and practices whereas negatively correlated with risk factors (P < 0.05). The attitude was negatively correlated with risk factor and positively correlated with practices. The risk factors and practices were positively correlated with each other. Health education program to improve the COVID-19 knowledge, attitude, practices and risk factors should be initiated to combat current health challenge.

COVID-19 challenges to Pakistan: Is GIS analysis useful to draw solutions?

The outbreak of novel coronavirus (COVID-19) is a public health emergency that had caused disastrous results in more than 100 countries. The ability to detect disease outbreaks in the early stages is a key component of efficient disease control and prevention. With the increased availability of electronic health-care data and spatial analysis techniques, there is great potential to develop algorithms to enable more effective disease surveillance. The research focuses to develop a transparent user-friendly method to simulate the outbreak data. The paper describes the GIS tools to identify and define the field of investigation which requires consideration of the strengths and limitations of data collection instruments, facility of locational data collection, accuracy of locational data, and pertinent attributes for understanding disease risk. Using such information, it is quite easy for authorities to locate the highly effected area and take appropriate actions in that particular areas. However, GIS techniques, resources, and methods can be used in Pakistan for more effective investigation of vulnerable geographical locations.