Evaluating COVID-19 vaccination intentions and vaccine hesitancy among parents of children with autism spectrum disorder.

As the global vaccination mass campaign against COVID-19 extended to children aged 5 to 11 years, some parents remained hesitant about their children being administered the vaccine despite data supporting its safety. Parent vaccine hesitancy (PVH) may have predisposed certain groups of children, particularly those with autism spectrum disorder (ASD), to COVID-19 when other neurotypical children would have been vaccinated. We investigated the current PVH in 243 parents of children with ASD and 245 controls using the Parent Attitudes about Childhood Vaccines (PACV) scale. The study was conducted in Qatar from May to October 2022. Overall, 15.0% [95% CI 11.7%; 18.3%] of parents were vaccine-hesitant, with no difference (p = 0.054) between groups (ASD children [18.2%] vs. controls [11.7%]). The only sociodemographic factor associated with higher vaccine hesitancy was being a mother (as compared to being a father). The COVID-19 vaccine receipt rate at the time of the study did not differ between ASD (24.3%) and non-ASD groups (27.8%). Around two-thirds of parents of children with ASD refused or were unsure about vaccinating their children against COVID-19. We found that the intent to vaccinate against COVID-19 was higher in parents who were married and in those with a lower PACV total score. Continued public health efforts are needed to address vaccine hesitancy among parents.

Multinational perspectives on changes to psychiatric care during the COVID-19 pandemic: a survey of practicing psychiatrists.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has resulted in significant upheaval in psychiatric care. Despite survey data collected from psychiatric patients and broad samples of individuals in single countries, there is little quantitative or qualitative data on changes to psychiatric care from the perspective of mental health providers themselves across developing countries. METHODS: To address this gap, we surveyed 27 practicing psychiatrists from Central and Eastern Europe, as well as Africa, the Middle East, and Latin America. RESULTS: Respondents observed a marked increase in anxiety in their patients, with increased (though less prominent) symptoms of depression, somatization, and addiction. They reported largescale changes in the structure of psychiatric treatment, chiefly a decline in psychiatric admissions and closing/repurposing of psychiatric beds. Results supported strong "buy in" from clinicians regarding the use of telehealth, though some clinicians perceived a reduction in the ability to connect with, and build alliances with, their patients. Finally, clinicians described an improvement in the image and meaning of psychiatry in society, increased awareness of mental illness, and greater value placed on mental health in the general population. CONCLUSIONS: These changes warrant further empirical study as to their potential long-term ramifications, particularly as the COVID-19 pandemic persists and new waves of infection occur periodically throughout the world. The increased psychiatric burden on the population coupled with the apparent salience of mental health and well-being in the public consciousness represents a global opportunity for psychiatry to advocate for further treatment, research, and education.

Multinational perspectives on changes to psychiatric care during the COVID-19 pandemic: a survey of practicing psychiatrists Multinationale Perspektiven zu Veränderungen in der psychiatrischen Versorgung während der COVID-19-Pandemie: eine Umfrage unter praktizierenden Psychiatern

Background The coronavirus disease 2019 (COVID-19) pandemic has resulted in significant upheaval in psychiatric care. Despite survey data collected from psychiatric patients and broad samples of individuals in single countries, there is little quantitative or qualitative data on changes to psychiatric care from the perspective of mental health providers themselves across developing countries. Methods To address this gap, we surveyed 27 practicing psychiatrists from Central and Eastern Europe, as well as Africa, the Middle East, and Latin America. Results Respondents observed a marked increase in anxiety in their patients, with increased (though less prominent) symptoms of depression, somatization, and addiction. They reported largescale changes in the structure of psychiatric treatment, chiefly a decline in psychiatric admissions and closing/repurposing of psychiatric beds. Results supported strong "buy in” from clinicians regarding the use of telehealth, though some clinicians perceived a reduction in the ability to connect with, and build alliances with, their patients. Finally, clinicians described an improvement in the image and meaning of psychiatry in society, increased awareness of mental illness, and greater value placed on mental health in the general population. Conclusions These changes warrant further empirical study as to their potential long-term ramifications, particularly as the COVID-19 pandemic persists and new waves of infection occur periodically throughout the world. The increased psychiatric burden on the population coupled with the apparent salience of mental health and well-being in the public consciousness represents a global opportunity for psychiatry to advocate for further treatment, research, and education.

Knowledge, attitude, and practice related to COVID-19: A comparison between patients with mental illness and the general population in Qatar.

Background: In 2020, the World Health Organization (WHO) declared COVID-19 a global health pandemic. The rapid spread and high fatalities associated with COVID-19 have increased interest in assessing Knowledge, Attitude, and Practice (KAP) toward this illness among the general population in comparison to specific subgroups. Most publications to date have explored KAP among the general public, healthcare providers, and people with chronic conditions, but not amongst those with mental illness. Yet, research has shown patients with mental illness are at higher risk of poor outcomes related to infectious diseases such as COVID-19. The objective of this study is to compare KAP toward COVID-19 between people with mental illness and the general public. Materials and methods: This is a cross-sectional study, done over 3°months in 2020, to compare KAP during the COVID-19 pandemic in three groups: outpatients from outpatient Psychiatry clinics (N = 165), inpatients admitted to a Psychiatry ward (N = 100), and the general public (N = 345). KAP parameters were assessed through online surveys. Results: The proportion of subjects in the public group (84.8%) giving the correct responses to most Knowledge questions was significantly higher than those in the inpatient and outpatient groups. Compared to the public and inpatient groups, subjects in the outpatient group (92.7%) were significantly more optimistic and confident that COVID-19 would be brought under control. A higher proportion of subjects from the general public (82.9%) indicated that they attended crowded places and were more compliant in wearing masks. Multiple linear regression analyses showed that poorer COVID-19 knowledge was associated with being single and having a young age (18-29), with both inpatients and outpatients and with primary-or secondary-level education. Conclusion: Patient populations, both inpatients and outpatients, had inadequate Knowledge, more positive attitudes and confidence regarding the outcome of COVID-19, and less safe practices than the public. This highlights the need for targeted approaches around COVID-19 and pandemics in general in this vulnerable population.

Anxiety symptoms among children visiting a pediatric emergency center in Qatar during the COVID-19 pandemic: A cross-sectional study.

Although the evidence base regarding the impact of the COVID-19 pandemic on children has been growing, descriptions of their experiences remain scarce. In this cross-sectional study, the authors used the Child-Reported Spence Children's Anxiety Scale to collect data from 91 children visiting a pediatric emergency center in Qatar during the pandemic. Around 25% of the children reported elevated levels of overall anxiety. Obsessive-compulsive symptoms were the most common, with 59.3% of children reporting elevated symptoms. The mean score of physical injury fears was significantly affected by gender, with females having higher scores. Overall rates for elevated anxiety symptoms were similar in natives and expatriate children. The findings suggest that the effects of the pandemic on children may depend on several vulnerability factors, including developmental age and gender. This study highlights the need to plan multidisciplinary strategies to enhance children's access to mental health services during and after the current health crisis.

Knowledge, attitude, and practice related to COVID-19: A comparison between patients with mental illness and the general population in Qatar

Background In 2020, the World Health Organization (WHO) declared COVID-19 a global health pandemic. The rapid spread and high fatalities associated with COVID-19 have increased interest in assessing Knowledge, Attitude, and Practice (KAP) toward this illness among the general population in comparison to specific subgroups. Most publications to date have explored KAP among the general public, healthcare providers, and people with chronic conditions, but not amongst those with mental illness. Yet, research has shown patients with mental illness are at higher risk of poor outcomes related to infectious diseases such as COVID-19. The objective of this study is to compare KAP toward COVID-19 between people with mental illness and the general public. Materials and methods This is a cross-sectional study, done over 3°months in 2020, to compare KAP during the COVID-19 pandemic in three groups: outpatients from outpatient Psychiatry clinics (N = 165), inpatients admitted to a Psychiatry ward (N = 100), and the general public (N = 345). KAP parameters were assessed through online surveys. Results The proportion of subjects in the public group (84.8%) giving the correct responses to most Knowledge questions was significantly higher than those in the inpatient and outpatient groups. Compared to the public and inpatient groups, subjects in the outpatient group (92.7%) were significantly more optimistic and confident that COVID-19 would be brought under control. A higher proportion of subjects from the general public (82.9%) indicated that they attended crowded places and were more compliant in wearing masks. Multiple linear regression analyses showed that poorer COVID-19 knowledge was associated with being single and having a young age (18–29), with both inpatients and outpatients and with primary-or secondary-level education. Conclusion Patient populations, both inpatients and outpatients, had inadequate Knowledge, more positive attitudes and confidence regarding the outcome of COVID-19, and less safe practices than the public. This highlights the need for targeted approaches around COVID-19 and pandemics in general in this vulnerable population.

SARS-CoV-2 Diverges from Other Betacoronaviruses in Only Partially Activating the IRE1α/XBP1 Endoplasmic Reticulum Stress Pathway in Human Lung-Derived Cells.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has killed over 6 million individuals worldwide and continues to spread in countries where vaccines are not yet widely available or its citizens are hesitant to become vaccinated. Therefore, it is critical to unravel the molecular mechanisms that allow SARS-CoV-2 and other coronaviruses to infect and overtake the host machinery of human cells. Coronavirus replication triggers endoplasmic reticulum (ER) stress and activation of the unfolded protein response (UPR), a key host cell pathway widely believed to be essential for viral replication. We examined the master UPR sensor IRE1α kinase/RNase and its downstream transcription factor effector XBP1s, which is processed through an IRE1α-mediated mRNA splicing event, in human lung-derived cells infected with betacoronaviruses. We found that human respiratory coronavirus OC43 (HCoV-OC43), Middle East respiratory syndrome coronavirus (MERS-CoV), and murine coronavirus (MHV) all induce ER stress and strongly trigger the kinase and RNase activities of IRE1α as well as XBP1 splicing. In contrast, SARS-CoV-2 only partially activates IRE1α through autophosphorylation, but its RNase activity fails to splice XBP1. Moreover, while IRE1α was dispensable for replication in human cells for all coronaviruses tested, it was required for maximal expression of genes associated with several key cellular functions, including the interferon signaling pathway, during SARS-CoV-2 infection. Our data suggest that SARS-CoV-2 actively inhibits the RNase of autophosphorylated IRE1α, perhaps as a strategy to eliminate detection by the host immune system. IMPORTANCE SARS-CoV-2 is the third lethal respiratory coronavirus, after MERS-CoV and SARS-CoV, to emerge this century, causing millions of deaths worldwide. Other common coronaviruses such as HCoV-OC43 cause less severe respiratory disease. Thus, it is imperative to understand the similarities and differences among these viruses in how each interacts with host cells. We focused here on the inositol-requiring enzyme 1α (IRE1α) pathway, part of the host unfolded protein response to virus-induced stress. We found that while MERS-CoV and HCoV-OC43 fully activate the IRE1α kinase and RNase activities, SARS-CoV-2 only partially activates IRE1α, promoting its kinase activity but not RNase activity. Based on IRE1α-dependent gene expression changes during infection, we propose that SARS-CoV-2 prevents IRE1α RNase activation as a strategy to limit detection by the host immune system.

Cannabidiol inhibits SARS-CoV-2 replication through induction of the host ER stress and innate immune responses.

The spread of SARS-CoV-2 and ongoing COVID-19 pandemic underscores the need for new treatments. Here we report that cannabidiol (CBD) inhibits infection of SARS-CoV-2 in cells and mice. CBD and its metabolite 7-OH-CBD, but not THC or other congeneric cannabinoids tested, potently block SARS-CoV-2 replication in lung epithelial cells. CBD acts after viral entry, inhibiting viral gene expression and reversing many effects of SARS-CoV-2 on host gene transcription. CBD inhibits SARS-CoV-2 replication in part by up-regulating the host IRE1α RNase endoplasmic reticulum (ER) stress response and interferon signaling pathways. In matched groups of human patients from the National COVID Cohort Collaborative, CBD (100 mg/ml oral solution per medical records) had a significant negative association with positive SARS-CoV-2 tests. This study highlights CBD as a potential preventative agent for early-stage SARS-CoV-2 infection and merits future clinical trials. We caution against use of non-medical formulations including edibles, inhalants or topicals as a preventative or treatment therapy at the present time.

Factors associated with mental health outcomes among medical residents exposed to COVID-19

Aims The aims of our study were to assess and to examine i. the psychological impact of the COVID-19 pandemic on medical residents working on the front and second line, ii. the association between coping strategies, resilience and optimism and different mental health outcomes like stress, anxiety, and depression among the medical residents’ workers during the COVID-19 pandemic, and iii. the coping strategies used on the same sample with consideration of different factors like seniority, frontliner, gender and coping style. Method An electronic survey was sent to all medical residents in Qatar. Depression, anxiety and stress were assessed by the Depression, Anxiety and Stress Scale – 21 Items. Professional quality of life was measured by the Professional Quality of Life measure. The coping mechanisms were assessed with the Brief-COPE, resilience by the Brief Resilience Scale, and optimism by the Revised Life Orientation Test (LOT-R). Result Of the 640 medical residents contacted, 127 (20%) responded. A considerable proportion of residents reported symptoms of depression (42.5%), anxiety (41.7%) and stress (30.7%). Multivariate analysis of variance showed significant effects of seniority in residency, with junior residents having poorer outcomes. In addition, there was a statistically significant interaction effect with moderate effect sizes between gender and working on the front line, as well as gender, working on the front line and seniority, on mental health outcomes. The most commonly used coping strategies were acceptance, religion, and active coping. The least reported coping strategies were substance use and denial. Avoidant coping style scores were higher among junior residents (p = .032) and non-COVID-19 frontliners (p = .039). Optimism LOT-R score was higher in senior than in junior residents (p < .001). Another important finding is that optimism and resilience were associated with better mental health outcomes. In addition, we find that avoidant coping style is highly associated with depression. Conclusion The COVID-19 pandemic may have a negative impact on junior residents’ mental health. Preventive measures to reduce stress levels and easy access to professional mental health services are crucial. This study also raises awareness among residency programs on the psychological and coping responses and strategies of medical residents.

Coping strategies, optimism, and resilience factors associated with mental health outcomes among medical residents exposed to coronavirus disease 2019 in Qatar.

OBJECTIVE: The aim of this study is to examine the association between coping strategies, resilience, optimism and different mental health outcomes like stress, anxiety, and depression among the medical residents' during the COVID-19 pandemic, with consideration of different factors like seniority, frontliner, gender, and coping style. METHODS: An electronic survey was sent to all medical residents in Qatar. Depression, anxiety, and stress were assessed by the DASS-21. Professional quality of life was measured by the ProQOL scale. The coping mechanisms were assessed with the Brief-COPE, and resilience was measured by the Brief Resilience Scale. RESULTS: The most commonly used coping strategies were acceptance, religion, and active coping. The avoidant coping style scores were higher among junior residents (p = .032) and non-COVID-19 frontliners (p = .039). Optimism LOT-R score was higher in senior than in junior residents (p < .001). Lower avoidant coping scores, higher optimism, and higher resilience were associated with lower stress, anxiety, and depressive symptoms. CONCLUSION: It seems that avoidant coping styles can exacerbate depressive, anxiety, and stress symptoms in medical residents amidst the COVID-19 pandemic. Strategies promoting optimism, resilience, and approach coping styles can decrease the mental health burden of the pandemic on medical residents.

The neutralizing antibody, LY-CoV555, protects against SARS-CoV-2 infection in nonhuman primates.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) poses a public health threat for which preventive and therapeutic agents are urgently needed. Neutralizing antibodies are a key class of therapeutics that may bridge widespread vaccination campaigns and offer a treatment solution in populations less responsive to vaccination. Here, we report that high-throughput microfluidic screening of antigen-specific B cells led to the identification of LY-CoV555 (also known as bamlanivimab), a potent anti-spike neutralizing antibody from a hospitalized, convalescent patient with coronavirus disease 2019 (COVID-19). Biochemical, structural, and functional characterization of LY-CoV555 revealed high-affinity binding to the receptor-binding domain, angiotensin-converting enzyme 2 binding inhibition, and potent neutralizing activity. A pharmacokinetic study of LY-CoV555 conducted in cynomolgus monkeys demonstrated a mean half-life of 13 days and a clearance of 0.22 ml hour-1 kg-1, consistent with a typical human therapeutic antibody. In a rhesus macaque challenge model, prophylactic doses as low as 2.5 mg/kg reduced viral replication in the upper and lower respiratory tract in samples collected through study day 6 after viral inoculation. This antibody has entered clinical testing and is being evaluated across a spectrum of COVID-19 indications, including prevention and treatment.

Mental Health, resilience, and religiosity in the elderly under COVID-19 quarantine in Qatar.

INTRODUCTION: Corona Virus Disease 2019 (COVID-19) quarantine has been associated with depression, anxiety, and stress symptoms. We hypothesize these symptoms might even be more pronounced in the elderly, who may be particularly sensitive to social isolation. However, certain individuals might be more resilient than others due to their coping mechanisms, including religious coping. OBJECTIVES: We aimed to examine the levels of perceived stress, depressive, and anxiety symptoms in older adults under COVID-19 quarantine in Qatar; and to identify the sociodemographic, psychological, and clinical factors associated with mental health outcomes, with a focus on the role of resilience, and religiosity. METHODS: A cross-sectional study assessing depressive, anxiety, and stress symptoms as well as resilience, and religiosity through a phone survey in adults aged 60 years or more under COVID-19 quarantine in the State of Qatar, in comparison to age and gender-matched controls. RESULTS: The prevalence of depressive, anxiety, and stress symptoms in elderly subjects under COVID-19 quarantine in Qatar was not significantly different from the prevalence in gender and age-matched controls. In the quarantined group, higher depressive, anxiety, and stress scores were associated with the female gender and with lower resilience scores but were not linked to age, psychiatric history, medical history, duration of quarantine, or religiosity. CONCLUSION: The elderly population does not seem to develop significant COVID-19 quarantine-related psychological distress, possibly thanks to high resilience and effective coping strategies developed through the years.

A comparative analysis of SARS-CoV-2 antivirals characterizes 3CLpro inhibitor PF-00835231 as a potential new treatment for COVID-19.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the etiological agent of Coronavirus Disease 2019 (COVID-19). There is a dire need for novel effective antivirals to treat COVID-19, as the only approved direct-acting antiviral to date is remdesivir, targeting the viral polymerase complex. A potential alternate target in the viral life cycle is the main SARS-CoV-2 protease 3CLpro (Mpro). The drug candidate PF-00835231 is the active compound of the first anti-3CLpro regimen in clinical trials. Here, we perform a comparative analysis of PF-00835231, the pre-clinical 3CLpro inhibitor GC-376, and the polymerase inhibitor remdesivir, in alveolar basal epithelial cells modified to express ACE2 (A549+ACE2 cells). We find PF-00835231 with at least similar or higher potency than remdesivir or GC-376. A time-of-drug-addition approach delineates the timing of early SARS-CoV-2 life cycle steps in A549+ACE2 cells and validates PF-00835231's early time of action. In a model of the human polarized airway epithelium, both PF-00835231 and remdesivir potently inhibit SARS-CoV-2 at low micromolar concentrations. Finally, we show that the efflux transporter P-glycoprotein, which was previously suggested to diminish PF-00835231's efficacy based on experiments in monkey kidney Vero E6 cells, does not negatively impact PF-00835231 efficacy in either A549+ACE2 cells or human polarized airway epithelial cultures. Thus, our study provides in vitro evidence for the potential of PF-00835231 as an effective SARS-CoV-2 antiviral and addresses concerns that emerged based on prior studies in non-human in vitro models.Importance:The arsenal of SARS-CoV-2 specific antiviral drugs is extremely limited. Only one direct-acting antiviral drug is currently approved, the viral polymerase inhibitor remdesivir, and it has limited efficacy. Thus, there is a substantial need to develop additional antiviral compounds with minimal side effects and alternate viral targets. One such alternate target is its main protease, 3CLpro (Mpro), an essential component of the SARS-CoV-2 life cycle processing the viral polyprotein into the components of the viral polymerase complex. In this study, we characterize a novel antiviral drug, PF-00835231, which is the active component of the first-in-class 3CLpro-targeting regimen in clinical trials. Using 3D in vitro models of the human airway epithelium, we demonstrate the antiviral potential of PF-00835231 for inhibition of SARS-CoV-2.

Factors associated with mental health outcomes among medical residents exposed to COVID-19.

BACKGROUND: The COVID-19 outbreak has caused challenges for healthcare systems worldwide. Recent data indicates that the psychological impact has differed with respect to occupation. In many countries, medical residents have been on the front line of this pandemic. However, data on the psychological impact of infectious disease outbreaks, and COVID-19 in particular, on medical residents are relatively lacking. AIMS: The aim of our study was to assess the psychological impact of the COVID-19 pandemic on medical residents working on the front and second line. METHOD: An electronic survey was sent to all medical residents in Qatar. Depression, anxiety and stress were assessed by the Depression, Anxiety and Stress Scale - 21 Items. Professional quality of life was measured by the Professional Quality of Life measure. RESULTS: Of the 640 medical residents contacted, 127 (20%) responded. A considerable proportion of residents reported symptoms of depression (42.5%), anxiety (41.7%) and stress (30.7%). Multivariate analysis of variance showed significant effects of seniority in residency, with junior residents having poorer outcomes. In addition, there was a statistically significant interaction effect with moderate effect sizes between gender and working on the front line, as well as gender, working on the front line and seniority, on mental health outcomes. CONCLUSIONS: The COVID-19 pandemic may have a negative impact on junior residents' mental health. Preventive measures to reduce stress levels and easy access to professional mental health services are crucial.

Psychological impact of the COVID-19 pandemic within institutional quarantine and isolation centres and its sociodemographic correlates in Qatar: a cross-sectional study.

SETTING: The State of Qatar has had one of the highest COVID-19 infection rates globally and has used state-managed quarantine and isolation centres to limit the spread of infection. Quarantine and isolation have been shown to negatively affect the mental health of individuals. Qatar has a unique population, with around 90% of the population being economic migrants and a majority being blue-collar workers and labourers. OBJECTIVES: This study was carried out to evaluate the psychological impact of institutional isolation and quarantine during the COVID-19 pandemic outbreak in Qatar. The study also explored the sociodemographic correlates of this psychological impact. DESIGN, PARTICIPANTS AND INTERVENTION: A cross-sectional study involving 748 consenting individuals in institutional quarantine and isolation in Qatar during the months of June and July 2020 was carried out. Relevant sociodemographic data along with depressive and anxiety symptomatology scores were collected from consenting adults at these facilities. RESULTS: 37.4% (n=270) of respondents reported depressive symptoms and 25.9% (n=189) reported anxiety symptoms. The scores were higher for individuals in isolation facilities and higher for migrants from poor socioeconomic group (p<0.001 for both). Within this group, although worries about infection were widely reported, lack of contact with the family was cited as one of the most important sources of distress. Respondents reported that contact with the family and reliable information were important factors that helped during the duration of isolation and quarantine. CONCLUSIONS: Our study reported significantly elevated scores for depression and anxiety during institutional quarantine, which is in keeping with emerging evidence. However, in contrast to other studies reporting mostly from native populations, this study of a population with an overwhelming majority of immigrants highlights the special mental health needs of this specific group and can inform future healthcare policies.

Multi-omic Characterization of Human Tubular Epithelial Cell Response to Serum (preprint)

Proteinuria, the spillage of serum proteins into the urine, is a feature of glomerulonephritides, podocyte disorders and diabetic nephropathy. However, the response of tubular epithelial cells to serum protein exposure has not been systematically characterized. Using transcriptomic profiling we studied serum-induced changes in primary human tubular epithelial cells cultured in 3D microphysiological devices. Serum proteins induced cellular proliferation, cytokine secretion and activated a coordinated stress response. We orthogonally confirmed our findings by comparing the transcriptomic and epigenomic landscapes of intact human kidney cortex and isolated tubular epithelial cells cultured in fetal bovine serum. Importantly, key transcriptomic programs in response to either type of serum exposure remained consistent, including comparisons to an established mouse model of kidney injury. This serum-induced transcriptional response was dominated by switching off of nuclear receptor-driven programs and activation of AP-1 and NF-κB signatures in the tubular epigenomic landscape. These features of active regulation were seen at canonical kidney injury genes ( HAVCR1 ) and genes associated with COVID-19 ( ACE2 , IL6 ). Our data provide a reference map for dissecting the regulatory and transcriptional response of kidney tubular epithelial cells injury induced by serum.

Otolaryngologic Manifestation and Long-Term Outcome in Mild COVID-19: Experience from a Tertiary Care Centre in India.

This study endeavours to comprehensively the study the spectrum of ENT manifestations in mild and asymptomatic COVID-19 and observe the natural course of anosmia and dysgeusia consequent to SARS-Cov-2 infection. A prospective cohort study was undertaken at a tertiary care centre in India on admitted patients with RT-PCR proven COVID-19. Patients were included provided the baseline National Early Warning Score (NEWS) was less than 4. Patients were screened for ENT manifestations using a questionnaire at baseline, 7 days, 14 days and 28 days. 225 patients were included in the study. Of these complete data at 4 weeks was available for 210. Out of 145 patients with mild COVID-19 (asymptomatic = 80), ENT manifestations accounted for 66.2% of all symptoms. Smell and taste disturbance had an overall incidence of 20% and 45% of ENT manifestations. Temporal trends of the recovery rate of anosmia and dysgeusia were 53.6% and 66.7% at 2 weeks, respectively. Corresponding rates at 3 weeks were 89.29% and 86.7%, respectively. By the end of 4 weeks 96% of the patients had recovered completely. The incidence of anosmia and dysgeusia in this study parallels the rates reported from other Asian countries, albeit, lower than the rates quoted from the Western Hemisphere. We recommend structured reporting of all ENT manifestations especially smell and taste disturbances to accurately identify individuals infected with SARS-Cov-2.

LY-CoV555, a rapidly isolated potent neutralizing antibody, provides protection in a non-human primate model of SARS-CoV-2 infection.

SARS-CoV-2 poses a public health threat for which therapeutic agents are urgently needed. Herein, we report that high-throughput microfluidic screening of antigen-specific B-cells led to the identification of LY-CoV555, a potent anti-spike neutralizing antibody from a convalescent COVID-19 patient. Biochemical, structural, and functional characterization revealed high-affinity binding to the receptor-binding domain, ACE2 binding inhibition, and potent neutralizing activity. In a rhesus macaque challenge model, prophylaxis doses as low as 2.5 mg/kg reduced viral replication in the upper and lower respiratory tract. These data demonstrate that high-throughput screening can lead to the identification of a potent antiviral antibody that protects against SARS-CoV-2 infection. ONE SENTENCE SUMMARY: LY-CoV555, an anti-spike antibody derived from a convalescent COVID-19 patient, potently neutralizes SARS-CoV-2 and protects the upper and lower airways of non-human primates against SARS-CoV-2 infection.