Host-pathogen protein-protein interactions and interactomics in COVID-19

The current pandemic is already a third coronavirus spillover in the span of 20years. This recurrency meant that there was some information available about person-to-person transmission, cell entry, and host-pathogen interactions. The choice to target the Spike viral structural protein was easy, given its importance and specificity, together with a relatively low mutational rate. However, early in the pandemic, before any vaccines were ready, the scientific community was concerned with a lack of effective treatments against COVID-19. As soon as the viral genome was posted online, the race to identify potential host and viral targets gained pace, especially in the form of in silico "multi-omics.” Protein-protein interaction networks help identify key hub genes and proteins, as well as existing approved drugs whose mechanisms of action might be useful against this novel threat. To this end, several approaches have been devised: using influenza virus as a proxy;comparing SARS, MERS, and a common cold coronavirus to SARS-CoV-2;gene ontology matching;and the search for vulnerable proteins (VPs) and their perturbators. The algorithms deployed to perform the task have included a random walk with restart (RWR), degree of centrality, enrichment analysis, and weighted networks, backed up by experimental methods: cloning, tagging, and expressing viral proteins, affinity purification mass spectrometry, biotin labeling, and time-based transcriptomics, among others. Some of the proposed proteins and their genes reveal important pathways. Existing drugs available for repurposing encompass some interesting mechanisms of action: mRNA inhibitors, regulators of sigma receptors, and protease inhibitors. Candidate meds need to be further evaluated in clinical trials. Interestingly, most approaches give different results, and some of the insights and drugs do not make much sense. These studies, however, already make for a wealth of data to be revisited during gene discovery and drug repurposing. © 2023 Elsevier Inc. All rights reserved.

COVID-19 in the context of inborn errors of immunity, autoimmune diseases, and immune suppression

The COVID-19 pandemic reached five waves in three years, with over 6.5 million deaths across the globe. Knowing the differential susceptibility to the novel betacoronavirus has allowed us to better understand the pathophysiology and inflammatory complications and dissect the response against the virus. As in other viral infections, CD8+ T lymphocytes and NK cells stand out as key players, together with viral sensors, type 1 interferons, an exaggerated inflammatory response by NLRP3, and a storm that includes cytokines IL-6 and IL-8. Whole-exome sequencing has identified several genes with pathogenic germline variants in patients with severe COVID-19;said genes would account for around 5% of all severe cases. In addition, up to 20% of hospitalized adults harbor autoantibodies against type-I and III interferons. These findings translate into novel genetic etiologies, whereas autoantibodies explain the worse prognosis of the elderly, linked to the inflammaging phenomenon. In general, patients with known primary immune deficiencies who acquired COVID-19 fared well, with global survival rates over 80% and a predominance of mild courses. The exceptions were patients with severe-combined immune deficiency, and with the autoimmune polyglandular syndrome 1, the latter because they develop autoantibodies against interferon. Neither have there been reports of greater severity in patients with autoimmune or autoinflammatory disorders. However, those receiving immunosuppressant treatments usually have a more protracted course. Patients with NLRP3 or STAT1 gain of function might be especially susceptible to systemic inflammatory complications. In this review, we summarize the global experience in the caretaking of patients with immune alterations who were infected by SARS-CoV-2. © 2022 Instituto Nacional de Pediatria. All rights reserved.

Psychological impact of COVID-19 containment on CADASIL patients.

INTRODUCTION: COVID-19 restrictive containment was responsible for major psychological distress and alteration of quality of life (QoL) in the general population. Their impact in a group of patients having cerebral small vessel disease (SVD) and at high risk of stroke and disability was unknown. OBJECTIVE: We aimed to determine the potential psychological impact of strict containment during the COVID-19 pandemic in a sample of CADASIL patients, a rare SVD caused by NOTCH3 gene mutations. METHODS: Interviews of 135 CADASIL patients were obtained just after the end of the strict containment in France. Depression, QoL and negative subjective experience of the containment were analysed, as well as predictors of posttraumatic and stressor-related manifestations, defined as an Impact Event Scale-Revised score ≥ 24, using multivariable logistic analysis. RESULTS: Only 9% of patients showed a depressive episode. A similar proportion had significant posttraumatic and stressor-related disorder manifestations independently associated only with socio-environment factors, rather than clinical ones: living alone outside a couple (OR 7.86 (1.87-38.32), unemployment (OR 4.73 (1.17-18.70)) and the presence of 2 or more children at home (OR 6.34 (1.35-38.34). CONCLUSION: Psychological impact of the containment was limited in CADASIL patients and did not appear related to the disease status. About 9% of patients presented with significant posttraumatic and stressor-related disorder manifestations which were predicted by living alone, unemployment, or exhaustion related to parental burden.

Assessing School-Based COVID-19 Transmission in Middle and High Schools in an Underserved Population through Qualitative Interviews

Background. Case and contact investigation is a mitigation strategy to understand transmission of diseases. The goal of this study is to assess COVID-19 transmission in schools that employ contact tracing. Methods. Five middle and high schools provided a list of ongoing student and staff cases and their school contacts for the 2021-22 school year. Cases were eligible for interview if they had a known positive test or were a 'presumed positive' by a practitioner. Contacts were eligible if they were identified as a close contact to a case within their school. Contacts who later became a case were eligible for a separate case interview. Trained interviewers contacted eligible individuals to offer COVID-19 resources and determine interests in participating in the study. Interested cases and contacts underwent a semi-structured interview with standardized questions. Results. From 5/2021-4/2022, 360 cases (45% during Omicron surge) and their 412 contacts were identified (Fig 1).Among the 111 cases interviewed, 75% were students, half were in grades 6-8 (Fig 2). 61% of the cases were vaccinated with their primary series. 92% were symptomatic and fatigue, cough, and headaches were the most common symptoms. Transmission from school occurred in 29% (Fig 3) and most commonly occurred in the classroom. Among the 68 contacts interviewed, 96% were students. The two most reported activities contacts participated in were band (n=9) and sports (n=22), 10 from playing basketball. Three contacts reported exposure to COVID-19 within the household and five contacts reported exposure outside the home or school. Conclusion. Case and contact investigation can be a valuable tool to assess COVID-19 transmission in schools. Almost one-third of cases reported school exposures, a greater school transmission rate than previous reported likely do to the increased transmissibility of Omicron. Assessing transmission events with this strategy alone may be limited by its reliance on self-reports. Case investigations can help schools identify potential areas to improve in limiting school-based COVID-19 transmission.

Perceptions of change in the environment caused by the COVID-19 pandemic: Implications for environmental policy.

COVID-19 lockdown measures have impacted the environment with both positive and negative effects. However, how human populations have perceived such changes in the natural environment and how they may have changed their daily habits have not been yet thoroughly evaluated. The objectives of this work were to investigate (1) the social perception of the environmental changes produced by the COVID-19 pandemic lockdown and the derived change in habits in relation to i) waste management, energy saving, and sustainable consumption, ii) mobility, iii) social inequalities, iv) generation of noise, v) utilization of natural spaces, and, vi) human population perception towards the future, and (2) the associations of these potential new habits with various socio-demographic variables. First, a SWOT analysis identified strengths (S), weaknesses (W), opportunities (O), and threats (T) generated by the pandemic lockdown measures. Second, a survey based on the aspects of the SWOT was administered among 2370 adults from 37 countries during the period from February to September 2021. We found that the short-term positive impacts on the natural environment were generally well recognized. In contrast, longer-term negative effects arise, but they were often not reported by the survey participants, such as greater production of plastic waste derived from health safety measures, and the increase in e-commerce use, which can displace small storefront businesses. We were able to capture a mismatch between perceptions and the reported data related to visits to natural areas, and generation of waste. We found that age and country of residence were major contributors in shaping the survey participants ´answers, which highlights the importance of government management strategies to address current and future environmental problems. Enhanced positive perceptions of the environment and ecosystems, combined with the understanding that livelihood sustainability, needs to be prioritized and would reinforce environmental protection policies to create greener cities. Moreover, new sustainable jobs in combination with more sustainable human habits represent an opportunity to reinforce environmental policy.

SAFETY AND EFFICACY OF THYMIC PEPTIDES IN THE TREATMENT OF HOSPITALIZED COVID-19 PATIENTS IN HONDURAS.

Coronavirus disease 2019 (Covid-19) active cases continue to demand the development of safe and effective treatments. This is the first clinical trial to evaluate the safety and efficacy of oral thymic peptides. ; We conducted a nonrandomized phase 2 trial with a historic control group to evaluate the safety and efficacy of a daily 250-mg oral dose of thymic peptides in the treatment of hospitalized Covid-19 patients. Comparisons based on standard care from registry data were performed after propensity score matching. The primary outcomes were survival, time to recovery, and number of participants with treatment-related adverse events or side effects by day 20. ; A total of 44 patients were analyzed in this study: 22 in the thymic peptide group and 22 in the standard care group. There were no deaths in the intervention group compared to 24% mortality in standard care by day 20 (log-rank P=0.02). Kaplan-Meier analysis showed a significantly shorter time to recovery by day 20 in the thymic peptide group than in the standard care group (median, 6 days vs. 12 days; hazard ratio for recovery, 2.75 [95% confidence interval, 1.34 to 5.62]; log-rank P=0.002). No side effects or adverse events were reported. ; In patients hospitalized with Covid-19, the use of thymic peptides resulted in no side effects, adverse events, or deaths by day 20. Compared with the registry data, a significantly shorter time to recovery and mortality reduction were measured.

Evaluation of Variables to Determine Cycling Routes in Lima-Perú

The demand for transport without agglomerations in many cities has increased lately to avoid infections of COVID19. Therefore, this research is focused on a mathematical model for a cycling network minimizing the distances of cycle paths and maximizing the factors that are more important for citizens of Lima using linear programming and analytics. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Experience of chloroquine use in COVID-19 patients

Introduction: COVID-19 is a pandemic without specific treatment at the time of this study. Chloroquine has been one of the drugs applied due to its in vitro antiviral effects. Objective: To identify the effect of chloroquine on patients treated with COVID-19 in relation to humoral parameters, hospital stay, complications and mortality. Methods: Retrospective observational study, with 181 positive cases of SARS-CoV-2, divided into two study groups according to use. Group 1 (n = 154) those treated with chloroquine and group 2 (n = 27) those who did not receive it. Personal pathological history, antimicrobial treatment, humoral parameters were identified at admission and between the sixth and eighth day of admission, hospital stay, complications and death. The squared ji test, Mann-Whitney U test and Wilcoxon's sign rank test were used according to convenience. Results: Group 2 had a higher proportion of arrhythmia (n = 4;14.8%), dementia (n = 2;7.4%), other background (n = 12;44.4%) and higher values of leukocytes (m = 7.25 x 109/L;RIC: 4.55 – 9.55 vs. m = 4.8 x 109/L;RIC: 3.95 – 6.8) and alkaline phosphatase (m = 94 U/L;RIC: 84 – 125 vs. m = 83 U/L;RIC: 66 – 98) that group 1 upon admission. All humoral parameters on the sixth and eighth days, hospital stay, and proportions of complications and death in both groups were similar. Conclusions: No effect attributable to the use of chloroquine on patients with COVID-19 was identified in terms of humoral parameters, hospital stay, frequency of complications or mortality. © 2022, Editorial Ciencias Medicas. All rights reserved.

Clinical and Social Determinants of Change in Code Status among Patients Hospitalized with Covid-19

Background: Patients hospitalized with COVID-19 who develop cardiopulmonary arrest often have poor prognosis, prompting discussions with families about goals of care. The relationship between clinical and social determinants of code status change is poorly understood. Methods: This retrospective study included adult COVID-19 positive patients admitted to the intensive care unit with cardiac arrest in a multihospital center over the first 9 months of the pandemic (3/1/2020-12/1/2020). Data on medical and social factors was collected and adjudicated. Results: We identified 208 patients over the study timeline. The mean age was 63.7 ± 14.5 years and 54.3% (n=113) were male. The majority of patients with cardiopulmonary arrest had pulseless electrical activity (PEA) as their initial rhythm (91.3%, n=190). Code status was changed in 56.3% (n=117) of patients. The majority of COVID-19 patients with cardiac arrest were Hispanic (53.4%, n=111), followed by African American (27.9%, n=58), and White patients (13.5%, n=28). Race/ethnicity did not affect the rate of code status change. COVID-19 patients who had a code status change were statistically more likely to have a lower salary ($54,838 vs $62,374), have a history of stroke/transient ischemic attack (15.4 vs 4.4%, 18:4), or heart failure (28.2 vs 15.6%, 33:14), all with P<0.05. Patients with code status change had shorter courses of cardiopulmonary resuscitation (11.9 vs 16.9 minutes, P<0.05). Both groups had similar levels of aggressive care received including continuous renal replacement therapy, vasopressor and broad-spectrum antibiotics requirements. Insurance status, ethnicity, religion, and education did not lead to statistically significant changes in code status in COVID patients. Conclusion: Patients hospitalized with cardiopulmonary arrest and positive for COVID-19 are more likely to have a change in code status. This code status change is affected by cardiovascular comorbidities such as stroke and heart failure, along with lower income but not by insurance status, ethnicity, religion, and educational level.

#NeuroTwitterNetwork #HowToNeuroTwitter Guide 2020-2021: Increasing Accessto Resources For #FutureNeurologists

Objective: To describe the growth of #HowToNeuroTwitter, a collaborative social media initiative orienting neurology residency applicants to Twitter as an educational and networking platform. Background: During the initial 6 months of the COVID-19 pandemic and the virtual residency interview season in 2020, a group of medical students, neurology residents, and fellows came together to create a #HowToNeuroTwitter guide and the #NeuroTwitterNetwork. With a continued virtual recruitment in 2021, the guide was expanded to provide more comprehensive and inclusive resources for all types of neurology applicants. Design/Methods: A group of 48 medical students, residents, fellows, and attendings created and promoted the updated guide between May 2021 - August 2021. Twitter was the primary method of promotion and recruitment. Based on feedback from the initial guide, we created new resources to include DO, IMG, and fellowship applicants in addition to residency resources. This was accomplished with the creation of topical subsections. Results: The comprehensive #HowToNeuroTwitter (bit.ly/NeuroTwitterNetwork2) guide was released on August 22nd, 2021 on Twitter, with a tweet that generated 91,082 impressions, 2,739 engagements, 1,137 link clicks to the guide, 180 likes, and 151 retweets as of October 4th, 2021. The guide was broken down into 12 sections including applying to residency, residency program twitter accounts, #MedEd resources, organizations to follow, the #NeuroTwitterNetwork database, child neurology resources, and more. Thirty organizations were catalogued, including subspecialty specific accounts, research journals, and national organizations. There were 111 adult neurology and 18 child neurology residency Twitter accounts included. Conclusions: The #HowToNeuroTwitter Guide 2.0 increased access to high yield information for medical students and residents applying to neurology by developing a centralized resource for trainees at all levels along with a diverse database of neurologists on Twitter.

Dentistry 2020, a congress in the time of COVID-19

Introduction: Due to the COVID-19 pandemic, the International Congress programmed to mark the 120th anniversary of the Dental School of Havana had to change its format and was held virtually in November 2020. Objective: Characterize the virtual International Congress Dentistry 2020, held in the time of COVID-19. Methods: A descriptive study was conducted based on the final statistical reports provided by the Congress website and applying historical-logical and document review methods. Results: A total 970 users were registered in the Congress page. Of these, 899 were Cuban and 71 were foreign. All the provinces were represented. 81% of the users were professionals and 16.8% were students. 391 papers were accepted and published, for 82.8%;373 papers were written by Cuban authors and 18 by foreign authors. 18% of the papers dealt with general comprehensive dentistry in primary health care, followed by orthodontics (14.3%). 2 405 comments were made, with 92.3% of the published papers receiving comments. 354 papers were recorded in the Congress Proceedings. Conclusions: Most of the users registered were Cuban, female and professionals. All the provinces were represented. Most of the papers received met the publication requirements and almost one fifth dealt with general comprehensive dentistry in primary health care. Students had an outstanding participation. © 2021, Editorial Ciencias Medicas. All rights reserved.

PRIMERS DESIGN for GENE-N AMPLIFICATION of SARS-COV-2 USING the VIRUS GENOMES of ARGENTINE PATIENTS

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was associated with pandemic disease in 2019 (COVID-19). The high diagnostic demand has affected the supply of reagents used in the molecular detection workflow for COVID-19. Knowing the nucleotide sequences of genes in SARS-CoV-2, allows us to improve, increase and readjust the diagnostic detection system, i.e. sensitivity and specificity for assays. For this purpose, bioinformatics analysis are crucial for the development of new primer and probe systems that amplify molecular markers in viruses and bacteria. The aim of this work was to design specific primers in order to amplify the complete nucleocapsid gene (gen-N) of SARS-CoV-2 to analyze its sequences and detect possible variations in the strains that circulates in Salta-Argentina. Nucleotide sequences of gen-N of Argentina and Wuhan were downloaded from the Global Initiative on Sharing All Influenza Data (GISAID) database. A multiple sequence alignment was carried out with DNA-Man software to identify the consensus regions using default settings. Different primer sets were designed using Primer Express® v.3.0.1 software. The primer sets obtained were tested in silico with a Basic local Alignment Search Tool (primer-BLAST) of public databases. Inactivated clinical samples from COVID-19 positive patients in Salta city were used to obtain RNA viral using commercial kits. Retro-transcription (RT), conventional PCR and electrophoresis were performed using primes design to gen-N amplification. The results obtained with primer-BLAST software show an in silico amplification of 1468 bp of gene-N in SARS-CoV-2 strains for the database of NCBI. High specificity was observed with primer designed for the virus target demonstrated by NCBI database analysis. Positive results for RT-qPCR reactions were obtained to amplify N and RNaseP genes from all samples. These results show a correct sample processing, RNA extraction and amplification of SARS-CoV-2 genes by RT-qPCR. Nevertheless, in some positive samples the amplification of the complete gen-N by RT followed by conventional PCR failed. This could be a consequence of the RNA poor integrity or variations in gene-N sequence in the region primers annealing. In this work we show a specific design of primers that amplify the complete gene that encodes the nucleocapsid of SARS-CoV-2, which will be sequenced to carry out a more specific design of the marker of the virus under study in the future. MICROBIOLOGY - FOOD MICROBIOLOGY.

Covid-19 rapid test validation. Isla de la juventud, Cuba

Having diagnostic methods that meet certain attributes is vital to guide health decisions, the current context warrants it. In order to validate the capacity of two rapid tests to detect antibodies due to SARS-CoV-2 infection in Isla de la Juventud, Cuba, from April to May 2020, a descriptive cross-sectional evaluation study was carried out. Rapid tests: Wondfo (SARS-CoV-2 antibody test) and Lungene covid-19 IgG/IgM, were compared to the real-time polymerase chain reaction test. Two homogeneous samples of 250 each were constructed, determining validation indicators. Sensitivity values of 6.6% and 8.3% respectively were obtained for each test, while the specificity was higher for Wondfo (95%). The positive predictive values were very low, the negative ones were adequate, higher in Lungene with 94.8%. Likelihood ratio values were classified as useless. In different scenarios in terms of symptomatic cases, sensitivity of 50% was reached in an interval of 1 to 7 days for Wondfo. The area under the ROC curve for Wondfo was 0.50 (95% CI = 0.46-0.55) and 0.46 for Lungene (95%CI = 0.38-0.55). The kappa index for Wondfo was 0.025 and 0.010 for Lungene. The rapid tests explored showed very low sensitivity, positive predictive value, and inadequate likelihood ratio. The global validity of the tests did not demonstrate a good diagnostic performance, marked by the value of the area under the ROC curve. The degree of agreement was poor. © 2021, Finlay Ediciones. All rights reserved.

#How to NeuroTwitter: Evaluating the Impact of a Comprehensive #NeuroTwitter Network Guide for the 2020-2021 Neurology Residency Application Cycle

Objective: To understand the impact of a novel social media guide, #HowToNeuroTwitter, on how neurology applicants and residency programs utilize Twitter throughout the 2020-2021 neurology residency application process. Background: Due to COVID-19 and the unprecedented changes to neurology residency interview season, a team of neurology trainees initiated a grassroots effort to highlight #NeuroTwitterNetwork through the creation of a comprehensive guide: #HowToNeuroTwitter. Design/Methods: Participants self-enrolled through a publicly available virtual form, recruited through Twitter, alternative social media platforms, and online forums. The first edition of the #HowToNeuroTwitter guide was published in August 2020. Results: The first edition of the #HowToNeuroTwitter Guide featured 462 registered users, composed of 122 medical students, 158 neurology residents/fellows, and 182 attending physicians. The guide launched on August 9th, 2020 in a Twitter post generating 29,874 impressions, 4,443 engagements, 1,242 link clicks, 207 likes, and 160 retweets. A unique hyperlink, "bit.ly/NeuroTwitterNetwork" allowing for monitoring of guide utilization, is currently at >1800 interactions. Following inaugural release, a utilization survey was completed by 31 individuals with 30 of 31 rating the guide >/= 8 out of 10. Respondents stated primary uses of the guide included identifying other neurologists, medical education leaders, and neurological organization Twitter accounts with which to interact. A noted correlation following the release of the #HowToNeuroTwitter guide and amplification of the "#NeuroTwitterNetwork" hashtag was the increase by 204% of neurology residency programs (n=24 to n=73) and 142% of 4th year US medical students self-identifying as neurology applicants (n=29 to n=70) on Twitter. Conclusions: A trainee driven initiative to increase Twitter utilization as a networking, recruitment, and educational tool has led to the creation of a novel social media guide, spurring the utilization of Twitter by neurologists. Given our demonstration of feasibility and reach, national organizations in neurology should consider adopting this activity to advocate for medical students considering neurology training.

Diabetes, hyperglycemia and evolution of patients with covid-19

Introduction: Diabetes mellitus and hyperglycemia, in patients with COVID-19, predispose to greater severity of the disease and worse short-term outcomes. Objective: To identify clinical differences, of humoral parameters, evolution and in the use of medications in patients infected with SARS-CoV-2;in relation to glycemic status, during the COVID-19 pandemic. Methods: Retrospective study of all patients infected with SARS-CoV-2, treated at the Hospital Militar Dr. Mario Muñoz Monroy _until June/2020. Demographic variables, evolution of symptoms, hospital stay, personal pathological history, humoral parameters on admission, complications and use of medications were collected. Three groups were created: diabetic (n = 16), hyperglycemic (fasting blood glucose ≥ 7.8 mmol/L;n = 10) and normo glycemic (n = 219). Chi-square and Kruskal-Wallis H test were used for comparisons between groups. A 95% confidence interval was used. Results: Diabetic and hyperglycemic patients had a higher proportion of symptoms on admission, arterial hypertension, ischemic heart disease, chronic renal insufficiency, other antecedents, complications, mortality, and use of steroids and Jusvinza. In addition, they had lower values of hematocrit and lymphocytes, and higher values of neutrophils, platelets, creatinine, aspartate amino transferase, glutamyl transpeptidase, alkaline phosphatase and lactic dehydrogenase. Conclusions: Both diabetes and hyperglycemia predisposed to more severe clinical forms of COVID-19, with worse humoral parameters, evolution and higher mortality. Steroids and Jusvinza were used more frequently in these patients. © 2021, Editorial Ciencias Medicas. All rights reserved.

A brief overview of hospitalized COVID-19 patients from an inner-city, residents-run clinic

Rationale: Background: On December 29, 2019, the first 4 cases of the novel coronavirus (COVID-19) were identified in Wuhan, China. The northeastern United Sates experienced the first wave between March 1 and June 30, 2020. Poor, inner-city patients experienced the highest hospitalization and mortality rates. Many were elderly and had underlying medical conditions, including chronic kidney disease, morbid obesity and diabetes. The full impact of COVID-19 on the inner city patients has not been fully studied. The goal of this study is to describe the clinical characteristics and outcomes of patients from an inner-city residents run clinic hospitalized with COVID- 19 during the first wave of COVID-19 pandemic in Northeastern USA from March 1 through June 30, 2020. Methods: We identified hospitalized patients with COVID-19 from an inner-city, residents run primary care clinic by reviewing daily COVID-19 admissions and matching the list with the clinic database of the patients. Identified patients were prospectively followed during and after their hospital stay. Data abstracted included demographic characteristics, co-morbid conditions, intubations, durations of ICU and hospital stay and in-hospital mortality. Results: A total of 40 patients from the Bridgeport Hospital Primary Care Center were admitted to Bridgeport Hospital, Yale New Haven Health, between March 1 and June 30, 2020. They were 26 men and 14 women, between 21 and 88 years (Median 54 years). Most (60%) were Hispanics. About 32.5% were African-Americans and 7.5% were Caucasians. About 32.5% (13 out of 40) were aged 60 years or over. The predominant comorbid conditions were hypertension (45%), diabetes mellitus (35%), ischemic heart disease (22.5%), chronic kidney disease (11.6%), and lung diseases (9.3%). 25% (10/40) had BMI of 35 or over. About 31% (12 out of 40) were intubated for acute hypoxemic respiratory failure. The median duration of hospital stay was 9 days (range from 1 to 47 days). The in-hospital mortality rate was 22.5%. Age 60 years or older was the single best predictor for in-hospital mortality after adjusting for BMI and other co-morbid conditions (adjusted OR 35.6, 95% CI: 2.1, 605.7, p=0.01). Conclusion: The in-hospital mortality rate for the hospitalized inner-city clinic patients was 22.5%. Many of the patients had significant co-morbid conditions. Age 60 or more was the best predictor of mortality. The very high mortality rate among hospitalized inner city patients mandates that aggressive preventive strategies are implemented to slow the spread of COVID-19 in this patient population group.