How asthmatic children dealt with the coronavirus pandemia? Adherence to Controller Medications and Level of Control among Children with Asthma Registered in Mashhad University of Medical Sciences

Background: Coronavirus disease 2019 pandemic had a great effect on the lives of asthmatic children. In this study we assessed changes in medication adherence and asthma control rate among our registered children with pediatric asthma.Methods: This cross-sectional study was conducted on 113 patients registered in our asthma and allergy clinic in Mashhad, Iran. We called them via phone and completed a questionnaire on the level of asthma medication adherence and the asthma control test (ACT) before and in the 6 months after COVID-19 emergence. We investigated the changes in medication adherence and asthma control due to COVID-19 pandemic.Results: A total of 113 asthmatic children in the age range of 1 to 15 (mean, 7.02 +/- 3.24 years) were included in the study. There were zero confirmed positive cases among them since COVID-19 introduction. The minority of patients (8.8%) had weak adherence, most of the children (35.4%) completed one course of prescribed medications, 33% had longer adherence, and only 25 patients (22.1%) had full adherence during the pandemic. Overall, our patients experienced better asthma control with a 1.51 rise in ACT score to arrive in 23.64 points out of 25. They had no asthma exacerbation and emergency visit. Over half of the families compiled the national preventive measures;as 85% of children had followed the stay-at-home order during the first peak of the pandemic.Conclusion: Our patients managed to come to a higher asthma control level despite their generally decreased adherence to medications during the pandemic. COVID-19 not only could not worsen asthma status in our children but surprisingly improved it. This shows that the preventive measures should be strongly applied for the asthmatic population.

Molecular mechanisms and signaling pathways involved in immunopathological events of covid-19

Introduction: COVID-19, a novel coronavirus that causes severe acute respiratory syndrome (SARS-CoV-2), is currently regarded as the most serious viral disease. During corona infection, viruses bind to host proteins and employ a variety of cellular pathways for their own purposes. Cell signaling is important for the regulation of cellular function. SARS-CoV-2 infection alters multiple signal transduction pathways that are critical for cell survival. The virus causes a severe and prolonged period of hypercytokinemia with misusing of these signaling cascades. Hyperactivation of the host immune system after infection with SARS-CoV-2 is the main cause of death in COVID-19 patients. Thus, to develop effective therapeutic approaches, it is necessary to first understand the problem and the underlying molecular pathways implicated in host immunological function/dysfunction. A number of intracellular signaling cascades have been implicated in infected cell pathways, including MAPK pathway, NF-κB pathway, JAK–STAT signaling pathway, PI3K/AKT/mTOR pathway and TLRI signaling cascades. Here, we have presented the molecular insights on the potential mechanisms involved in immunopathological events of COVID-19.