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Background: SAMD9L is a tumor suppressor involved in regulating the proliferation and maturation of cells, particularly those derived from the bone marrow, and appears to play an important role in cerebellar function. It can be activated in hematopoietic stem cells by type I and type II interferons. It has been hypothesized to act as a critical antiviral gatekeeper regulating interferon dependent demand driven hematopoiesis. Gain of function mutations can present with an immunodeficiency due to transient severe cytopenias during viral infection. Case presentation: We report a 3-year-old boy born full term with a history of severe thrombocytopenia requiring transfusions, developmental delay, ataxia, seizure disorder, and recurrent severe respiratory viral infections. His infectious history was significant for respiratory syncytial virus with shock requiring extracorporeal membrane oxygenation complicated by cerebral infarction and a group A streptococcus empyema, osteomyelitis requiring a left below the knee amputation, and infections with rhinovirus, COVID-19, and parainfluenza requiring hospitalizations for respiratory support. Initial immunologic evaluation was done during his hospitalization for parainfluenza. His full T cell subsets was significant for lymphopenia across all cell lines with CD3 934/microL, CD4 653/microL, CD8 227/microL, CD19 76/microL, and CD1656 61/microL. His mitogen stimulation assay to phytohemagglutinin and pokeweed was normal. Immunoglobulin panel showed a mildly decreased IgM of 25 mg/dL, but normal IgA and IgG. Vaccine titers demonstrated protective titers to 12/22 pneumococcus serotypes, varicella, diphtheria, mumps, rubella, and rubeola. Repeat full T cell subsets 6 weeks later revealed marked improvement in lymphocyte counts with CD3 3083/microL, CD4 2101/microL, CD8 839/microL, CD19 225/microL, and CD1656/microL. A primary immunodeficiency genetic panel was ordered and positive for a heterozygous SAMD9L c.1549T>C (p.Trp517Arg) mutation classified as a variant of unknown significance. Discussion(s): This patient's history of severe viral infections, ataxia, thrombocytopenia, and severe transient lymphopenia during infection is suggestive of a SAM9DL gain of function mutation. Protein modeling done by the laboratory suggests this missense mutation would affect protein structure. The mutation found has been observed in individuals with thrombocytopenia. This case highlights the importance of immunophenotyping both during acute illness and once recovered.Copyright © 2023 Elsevier Inc.
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Background: Immune-mediated lung injury and complex changes of the immune system, such as lymphopenia and cytokine storm, that have been associated with adverse outcomes underlining a fundamental role of host response in severe acute respiratory syndrome coronavirus 2 infection and the pathogenesis of the disease. Thymosin alpha 1 (Ta1) is one of the molecules used in the management of COVID-19, because it is known to restore the homeostasis of the immune system during infections and cancer. Aim(s): To study the impact of thymosin alpha on the biochemical markers and mortality in covid 19 patients. Methodology: A retrospective, single-centred study including 127 patients with laboratory detected moderate to severe SARS-CoV-2 infection admitted to designated COVID-19 centre in a tertiary care hospital from September 2021 to March 2022 was done. 52 patients received thymosin alpha 1 and their results were compared with 75 patients who received standard care without thymosin alpha. Clinical records, laboratory data, and radiological findings were analysed of patients treated with thymosin alpha 1 to evaluate the role of treatment outcome. Result(s): hospital mortality was 7.6% (n = 4) in the thymosin group as compared to 9.3% (n = 7) in the non-thymosin group. 40 patients in the thymosin group had increased CRP levels on day 1 as compared to 61 in the non-thymosin group. On day 5, 11 patients in thymosin group had increased levels as compared to 47 patients in the nonthymosin group with a significant p-value of<0.001. Statistically significant results were obtained on day 10, only 7 patients in the thymosin group had increased levels as compared to 30 in the nonthymosin group. On day 1, 46 patients in the thymosin group had increased level of IL-6 as compared to 53 in the non-thymosin group. Serial monitoring on day 5 showed that in thymosin group, 18 patients had increased levels as compared to 44 patients in the non-thymosin group (with a significant of<0.05). Again, on day 1difference was statistically significant when in thymosin group only 5 patients had elevated levels as compared to 23 in non-thymosin group. Conclusion(s): Significant difference was seen in terms of biochemical parameters but that could not be translated in clinical improvement in terms of mortality rates.
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INTRODUCTION: The COVID-19 pandemic has become a threat to the public's health, especially to the elderly and those with chronic conditions. It is capable of spreading from carriers who are both asymptomatic and symptomatic. Associated factors such as age, sex, severe symptoms of COVID-19 disease, and chronic disease have a significant impact on the recovery time of patients. AIM: The study aimed to determine associated factors on recovery time in COVID-19 patients hospitalized at King Abdulaziz Medical city. METHODS: A single-center retrospective study was utilized to recruit 1776 confirmed COVID-19 patients from 13 September to 24 October 2020 at King Abdulaziz Medical City (KAMC) in Jeddah. RESULTS: The patients were categorized into three age groups: below 5 years, 5 to 65 years, and above 65 years. The number of male patients in each group was 49, 764, and 73, and the number of female patients in each group was 54, 754, and 82, respectively. Impact recovery time on female patients was 11.75 days; with male patients was 10.95 days. Symptoms such as sore throat, diarrhea, and fever in female patients declined the recovery time. On the other hand, symptoms such as runny nose, diarrhea, fever, and headache in male patients declined the recovery time. DISCUSSION AND CONCLUSION: It was revealed that older aged COVID-19 patients, male sex, and some symptoms decline recovery time. The study findings show an independent predictor of particular symptoms and sign which delay the time of recovery in the COVID-19 patients enrolled in the study differently, for male and female patients. Thus, patients who are infected with COVID-19 should be monitored keenly to prevent a prolonged rate of recovery and should be eligible for priority management to enhance a good clinical outcome.
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COVID-19 also called corona virus emerged in China in December 2019. This turned into a global pandemic in a short period of time. Covid-19 is a novel strain of corona virus that was not seen earlier in human beings. It is important to study the molecular structure of Covid-19 so as to aid in the development of therapeutic measures. Existing Covid-19 pandemic poses an extraordinary risk to health and healthcare systems worldwide. Corona viruses are made of single stranded RNA present within the coat proteins. The virus has a diameter of nearly 80–120nm. Usually, Covid-19 presents with the signs and symptoms of respiratory illness. Cough commonly dry cough, fever, associated with myalgias and sometimes breathing difficulties due to decrease in oxygen saturation rates are also present in these patients. Some people show fever with body aches, while some are relatively asymptomatic. Corona virus is primarily transmitted in humans through respiratory route and is highly contagious. Mostly old people and those having comorbid illnesses suffer most. After invading into the human body, the virus may lead to a sequence of processes such as viral invasion, replication, and programmed cell death, that is, apoptosis. To control and prevent this viral infection, we need to study the molecular aspects of Covid-19 in detail so as to design therapeutic agents as well as for vaccine formation. The micro-RNA is defined as the single-stranded noncoding RNA molecule. They have a length of about 22 nucleotides approximately and help in the post transcriptional regulation of gene expression. Micro RNAs regulate many types of cancers in addition to Covid-19 and other infections. Viral micro RNA is a newer type of mi-RNA and controls the host cell expression and viral target genes. This was completed by inducing micro-RNA cleavage, breakdown, translation, inhibition, or other mechanisms. The micro-RNAs of Covid-19 are explained to give an authoritative means to study this novel coronavirus. These control the host cell expression and also viral target genes by inducing micro-RNA cleavage, breakdown, translation, inhibition, and also other mechanisms. © 2022 Elsevier Inc. All rights reserved.
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Introduction: The COVID-19 pandemic has highlighted the importance of hand hygiene and led to the increased use of sanitizing gels and wipes. Here we describe a case of contact dermatitis due to sanitizing gels and wipes which was misdiagnosed as eczema for 3 years. Case Description: A 40-year-old Guyanese female presented for evaluation of pruritic rash. She has seen several dermatologists and diagnosed with eczematous dermatitis. She has been prescribed topical 0.1% triamcinolone and a course of oral steroids with temporary improvement in symptoms. She had tried oral antihistamines with no improvement. On interview, she reported a rash predominantly on her hands which began in early 2020 and had worsened in the past year. Social history is significant for working as a registered nurse and having a baby 9 months ago. She admitted to frequent use of Clorox wipes without gloves at home since her baby was born. On exam she had numerous small papules with flare on bilateral dorsal hand, forearm, right orbit, and upper back. Patch testing was done and positive for benzyl alcohol. We recommended she use soap and water to clean her hands, avoid alcohol gels, and use gloves when using antiseptic wipes. She had abrupt improvement in symptoms. Discussion: This case emphasizes the importance of cleaning gels and wipes as a cause of contact dermatitis. It particularly important to remember in the context of healthcare workers who frequently clean their hands, new parents who may using sanitizing wipes more often, and people with darker colored skin.
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CONTEXT: Early use of a high-flow nasal cannula (HFNC) provides positive outcomes for preventing the risk of intubation. However, the efficiency and usage of HFNC in the case of coronavirus disease 2019 (COVID-19) among adult patients with multiple risk factors remain debatable and require more investigation. AIMS: The aim of this study was to determine the efficiency of HFNC in preventing the possible risk of intubation. SETTINGS AND DESIGN: This study was an observational cross-sectional study that was conducted at a selected hospital in Jeddah, Saudi Arabia, from July 2020 to August 2021. METHODS: The data were collected from patients' medical records through the hospital health information system. Adult COVID-19 patients who used HFNC were included, while those who used bilevel positive airway pressure or continuous positive airway pressure without any trials of HFNC and neonatal or pediatric patients were excluded. The exposure of HFNC setting which included variables such as percentages of the fraction of inspired oxygen and the duration of using HFNC were measured to find the relation with respiratory rate oxygenation (ROX) index as a measurement of patient outcome. STATISTICAL ANALYSIS USED: The data were analyzed by using the online calculator socscistatistics. com for prevalence statistics, and correlation tests of significance. Prevalence statistics were presented in mean, median, frequencies, and percentages. Statistical tests were used to measure correlations of key variables. P < 0.05 of ANOVA and t-tests was considered statistically significant. RESULTS: A total of 159 adult COVID-19 patients using HFNC were included, and most of these patients were male. The median age was 64 years. Most of patients were reported to have hypertension and diabetes mellitus. The majority (94.34%) of patients were successfully weaned from HFNC and shows effective intervention with a mean of 7.53 of ROX score. Appropriate implementation of HFNC might be a successful intervention for preventing the risk of intubation. CONCLUSIONS: According to the success rate of HFNC, which was considered a positive outcome, there might be a promising intervention for HFNC to prevent the risk of intubation and decrease the mortality rate.
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Background: Tissue damage caused by COVID-19 could be detected by several clinical indicators including hematological, immunological, biochemical, and inflammatory markers. This study was to detect these clinical parameters to reveal the correlation between the factors and their roles in the development of COVID-19, to explore the hazard factors in severe cases. Materials and Methods: A total of 200 participants of both sexes were included in the study, with an age range of (25-72) years, categorized into three main groups: 50 healthy individuals, 62 mild infected patients, and 88 severe infected patients with pneumonia. Different hematological and clinical parameters were included in the analysis (Basrah city, Iraq). Serum levels of interleukin-6 (IL-6), ferritin, and high-sensitivity C-reactive protein (hs-CRP) were assessed for all participants using an enzyme-linked immunosorbent assay (ELISA). The liver, renal, and cardiac functions were assessed by clinical chemistry testing. Results: COVID-19 patients had leukocytosis, with an increased number of neutrophils and a decreased lymphocyte count, according to our findings. In regard to inflammatory parameters, both ESR and hs-CRP showed significant differences between the two groups, whereas IL-6 was significantly higher in the total severe group compared to the other two groups. Biochemical results revealed that each lactate dehydrogenase (LDH), ferritin, alanine aminotransferase (ALT), and aspartate aminotransferase (AST) had significant changes in the total severe group. Among pneumonic with an O2 requirement and pneumonic without an O2 requirement, there were significant differences in immunological and inflammatory markers (p > 0.05). The neutrophils-lymphocytes ratio (NLR) was highly elevated in severe who required O2. Moreover, IL-6, lymphocytes, and neutrophils were possible risk factors for COVID-19 infection, with the strongest influence of IL-6 with a high odds ratio (OR: 24.138, 95% CI: 8.437-30.65, p < 0.01). Furthermore, there were significant correlations among the indicators. Conclusion: Each of IL-6, lymphocytes, and neutrophils might represent major factors in the severity of COVID-19 and IL-6 plays the main role in inducing the inflammatory and pathophysiology process that is known as the cytokine storm.
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BACKGROUND: The coronavirus disease (COVID-19), due to the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), causes chemosensory dysfunction. AIMS/OBJECTIVES: To determine the characteristics of chemosensory dysfunction and to identify factors associated with chemosensory complete recovery and time to recovery. MATERIALS AND METHODS: This cross-sectional study included all patients presenting with chemosensory dysfunction and confirmed SARS-CoV-2 infection from May to August 2020 who underwent telemedicine follow-up after 1 year to assess their chemosensory recovery. RESULTS: A total of 372 patients were included, of which 53.8% were male. The mean age ± SD was 37.45 ± 13.44. The majority experienced combined (olfactory and gustatory) dysfunction (85.7%), and 315 patients (84.7%) had complete loss of chemosensory function. The independent predictors associated with a low likelihood of complete recovery were parosmia (aOR 0.16, p < .001), upper respiratory tract symptoms (aOR 0.28, p = .001), and dyspnoea (aOR 0.21, p < .001), whereas the factors associated with a long recovery period were parosmia (aOR 12.04, p = .002), headache (aOR 7.19, p = .007), and hypertension (aOR 7.76, p = .039). CONCLUSIONS: A full recovery outcome was predominant. The presence of parosmia was linked to both an incomplete recovery and a long time to recovery. SIGNIFICANCE: Parosmia and respiratory symptoms are implicated in the incomplete recuperation of chemosensory function.
Subject(s)
COVID-19 , Olfaction Disorders , COVID-19/complications , COVID-19/epidemiology , Cross-Sectional Studies , Female , Humans , Male , Olfaction Disorders/epidemiology , Olfaction Disorders/etiology , Pandemics , SARS-CoV-2 , Self ReportABSTRACT
In the prevailing apocalyptic times of coronavirus disease (COVID-19), the whole scientific community is busy in designing anticovid drug or vaccine. Under such a fascination, Schiff bases or azomethine compounds are continuously interrogated for antimicrobial properties. These compounds represent interesting molecular scaffolds of huge medicinal and industrial relevance. In order to update the current literature support of such facts this article introduces the synthetic chemistry, mechanism of formation of a Schiff base, followed by biological efficacy and finally a suitable discussion on the mechanism of respective bioactivity. In most of the studies revealing the biological evaluation of azomethine functionalized frameworks, fascinated results have been recorded in case of azomethine-metal complexes as compared with the free ligands. Also, the CH=N or C=N form of organic ligands have indicated marvellous results. Therefore, in connection with the biological relevance and microbicidal implications of such metallic compounds, this works reviews the current update of microorganism fighting efficacy of azomethine metal complexes along with the introduction of some metallodrugs as excellent candidates having COVID-19 defending potentiality. © 2021 Walter de Gruyter GmbH, Berlin/Boston 2021.