Immunogenetic studies on SARS-CoV-2: Our experience at SKIMS

Background: The pathophysiology of viral-infections is highly complex and involves host immunocompetence, host genetics, and gene-environment interactions. We hypothesized that polymorphic variants in host genes, blood group and previous vaccination status against H1N1 may affect the clinical course of covid-19 infection. Method(s): A total of 202 subjects who were RT-PCR negative after Covid-19 infection were recruited. We investigated association between Covid-19 infection (Severity and recovery period) and multiple factors including ABO and Rh blood groups, H1N1 vaccination, polymorphism in Viral susceptibility genes (ACE2 G8790A), and polymorphism in host response genes (ACE I/D rs4646994, IL6- 174G/C, GSTT1/GSTM1 I/D and GSTP1 Ile 105 Val). Result(s): B-ve and O-ve ABO and Rh blood groups had significantly higher Covid-19 recovery period applied on one-vs.-all in a nonparametric t-test (p<0.05). Subjects who had vaccinated themselves against H1N1 presented with a lower recovery-period (p<0.05). Both variables (blood group and H1N1 vaccination) were not however associated with Covid-19 severity. Out of the studied polymorphisms, ACE2 G8790A and GSTT1/GSTM1 were significantly associated with covid-19 infection. Our results indicated that G/G genotype of ACE2 G8790A (OR 3.52, P 0.007) and GSTT1/ GSTM1 null (M1 - / - OR = 3.98, P = 0.0004;T1 - / - OR 3.84, P = 0.004) and double null (M1 - / - /T1 - / - OR = 9.66, P = 0.001) are likely to be associated with an increased risk for severe-critical outcomes in individuals with COVID-19. Other polymorphisms analyzed in this study were found to have no significant association with Covid-19 outcome. Conclusion(s): This study suggests that outcome of Covid-19 infection is affected by both clinical and genetic factors. Thus it seems plausible to utilize these factors as prediction and susceptibility markers in the prognosis of COVID-19, which may help to personalize the treatment.

Rash with Atypical Pneumonia: Varicella Pneumonia in a Young Immunocompetent Male

Varicella pneumonia is a serious complication of varicella infection. It occurs more often in adults than in children, although it is now infrequently seen since the introduction of the chickenpox vaccines. In immunocompetent adults, varicella pneumonia has a reported incidence of about 1 in 400 cases of varicella infection and it also carries significant mortality. Here, we report a case of varicella pneumonia in a young male who was immunocompetent and had no comorbidities. This case teaches us to be always careful and thorough with our clinical assessment and to think about the alternative etiologies for the cause of atypical pneumonia even during the times of the COVID-19 pandemic and not get swayed by the sheer numbers of coronavirus infections.

Advances on concrete strength properties after adding polypropylene fibers from health personal protective equipment (PPE) of COVID-19: Implication on waste management and sustainable environment.

Using Health personal protective equipment (PPE) such as face masks, safety foot shoes and protective suits has expanded dramatically due to COVID-19 pandemic leading to a widespread distribution of the PPE, particularly the face masks, in the environments including streets, dump sites, seashores and other risky locations. The environmental degradation of polypropylene, the essential plastic component in single-use face masks (SUM), takes between 20 and 30 years and thus it is essential to develop experimental approaches to recycle the polypropylene or to reuse it in different ways. This paper explores the integration of SUM into concrete structures to improve its mechanical properties. We first to cut the inner nose wire and ear loops, then distribute the PPE material among five different mixed styles. The PPE were applied by volume at 0%, 1%, 1.5%, 2.0%, and 2.5%, with tests focusing on UCS, STS, FS, and PV to determine the concrete's overall consistency and assess the improvement in its mechanical properties. The results showed that adding PPE improves the strength properties and general performance of the concrete specimens. The pattern of rising intensity started to fade after 2%. The findings demonstrated that adding PPE fibers enhanced the UCS by 9.4% at the optimum 2% PPE. The PPE fibers, on the other side, are crucial in calculating the STS and FS of the reinforcement concrete.

Risk Factors and a Novel Score (CARI-65) Predicting Mortality in COVID-19 Patients

Purpose: The rapid spread of severe acute respiratory syndrome coronavirus-2 infection resulted in an exponential increase in hospitalizations and mortality. We aimed to explore the determinants of mortality and formulate a score that can predict mortality in patients hospitalized due to coronavirus disease 2019 (COVID-19). Materials and Methods: In this retrospective study, 1024 COVID-19 patients hospitalized between March 2020 and October 2020 were included. Patient demographics, underlying comorbid illnesses, clinical features, vital signs at admission, disease severity, and laboratory parameters, were collected from hospital medical records and analyzed to derive risk factors for in-hospital mortality and formulate a mortality prediction score. Results: The median age of the study population was 56 years (interquartile range [IQR], 45-65) and was significantly higher in nonsurvivors than in survivors (62 [IQR 55-70] vs. 52 [IQR 40-65];P = 0.001). Hypertension and diabetes were the most common associated comorbid illnesses seen in 50.5% (n = 518) and 29.1% (n = 299) of patients, respectively. The presence of altered level of consciousness (C), azotemia with serum creatinine >1.5 mg/dl (A), respiratory rate >25/min (R), interleukin-6 >25 pg/ml (I), and age >= 65 years were independent predictors of mortality. A six-point COVID-19 mortality prediction score, "CARI-65," was developed using variables predicting mortality in multivariate regression analysis. The CARI-65 score >= 3 had a sensitivity and specificity of 87.1% and 57.3%, respectively, and positive and negative predictive values of 42.52% and 92.45%, respectively, in predicting mortality. Conclusion: This study demonstrated various demographic, clinical, and laboratory parameters that predict mortality in hospitalized COVID-19 patients. We also proposed a simple risk stratification score to predict mortality in hospitalized COVID-19 patients, so that effective triaging of patients can be done to utilize health-care resources efficiently.