ABSTRACT
With the Corona Virus Disease 2019 (COVID-19) outbreak, vaccination is an urgent need worldwide. Internet of Things (IoT) has a vital role in the smart city for vaccine manufacturing with wearable sensors. According to the advanced services in intelligent manufacturing, the fourth resolution is also changing in Industry 5.0 and utilizes high-definition connectivity sensors. Traditional manufacturing companies rely on trusted third parties, which may act as a single point of failure. Access control, big data, and scalability are also challenging issues in existing systems because of the demand response data (DRD) in advanced manufacturing. To mitigate these challenges, CoVAC: A P2P Smart Contract-based Intelligent Smart City Architecture for Vaccine Manufacturing is proposed with three layers, including connection, conversion, and intelligent cloud layer. Smart contract-based blockchain is utilized at the conversion layer for resolving access control, security, and privacy issues. Deep learning is adopted in the intelligent cloud layer for big data analysis and increasing production for vaccine manufacturing in smart city environments. A case study is carried out wherein access data are collected from the various smart plants for vaccines using smart manufacturing to validate the effectiveness of the proposed architecture. Simulation of the proposed architecture is performed on the collected advanced sensor IoT plants data to address the challenges above, offering scalable production in the vaccine manufacturing for the smart city.
ABSTRACT
BACKGROUND: The association of ACE inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) with disease severity of patients with COVID-19 is still unclear. We conducted a systematic review and meta-analysis to investigate if ACEI/ARB use is associated with the risk of mortality and severe disease in patients with COVID-19. METHODS: We searched all available clinical studies that included patients with confirmed COVID-19 who could be classified into an ACEI/ARB group and a non-ACEI/ARB group up until 4 May 2020. A meta-analysis was performed, and primary outcomes were all-cause mortality and severe disease. RESULTS: ACEI/ARB use did not increase the risk of all-cause mortality both in meta-analysis for 11 studies with 12 601 patients reporting ORs (OR=0.52 (95% CI=0.37 to 0.72), moderate certainty of evidence) and in 2 studies with 8577 patients presenting HRs. For 12 848 patients in 13 studies, ACEI/ARB use was not related to an increased risk of severe disease in COVID-19 (OR=0.68 (95% CI=0.44 to 1.07); I2=95%, low certainty of evidence). CONCLUSIONS: ACEI/ARB therapy was not associated with increased risk of all-cause mortality or severe manifestations in patients with COVID-19. ACEI/ARB therapy can be continued without concern of drug-related worsening in patients with COVID-19.