Comparing the severity of Outcomes of SARS-CoV-2 between RT-PCR-positive and RT-PCR-negative Individuals in Iran Comparing the severity of Outcomes of SARS-CoV-2 between RT-PCR-positive and RT-PCR-negative Individuals in Iran (preprint)

The aim of this study was to compare the outcomes of SARS-CoV-2 RT-PCR-positive and RT-PCR negative Patients in Iran. This cohort study performed on 81393 patients with COVID-19 in six provinces of Iran during 2020. The studied variables include demographic and clinical. To examine the associations between RT-PCR test and death or ICU admission as dependent variable the multiple Bayesian logistic regression model was used by R software. 81393 individual (44.9 % female) with a mean age of 52.98 ± 20.8 years were included to the analysis. At all, 25434 tests (31.2 %) were positive RT-PCR, including 10772 men (44.9%) and 14662 women (55.1%). The multiple Bayesian logistic regression model showed a significant positive association between RT-PCR test results and COVID-19 mortality rate (OR: 1.46; 95% Crl: 1.29- 1.64). Also, males, older age, individual with chronic disease have higher risk of COVID-19 death, however, negative association observed between history of contact and COVID-19 death. We observed a significant inverse association between RT-PCR test results and ICU admission, while, the risk of ICU admission increased significantly by 1.2 times (95% Crl for odds ratio: 1.09, 1.34) among patients with negative RT-PCR test compared to positive RT-PCR test. People with positive RT-PCR test, male gender, older age, having a history of underlying disease have a higher risk of death and hospitalization in the ICU. Therefore, paying attention to these factors will be effective in reducing the risk of death and hospitalization in ICU.

Inhibiting NF-κB During Cytokine Storm in COVID-19: Potential Role of Natural Products as a Promising Therapeutic Approach (preprint)

Many inflammatory mechanisms are involved in the pathophysiology of COVID-19 infection. COVID-19 inhibits IFN antiviral responses, so we should expect an out-of-control viral replication. “Cytokine storms” occur due to the over-production of pro-inflammatory cytokines after an influx of neutrophils and monocytes/macrophages and may be responsible for the immunopathology of the lung involvement. Several cascades have been reported in the activation process of NF-κB. In this paper, to find new therapeutic options for COVID-19 infection, we reviewed some natural products that could potentially inhibit the NF-κB pathway. We found that sevoflurane, quercetin, resveratrol, curcumin, KIOM-C, bergenin, garcinia kola, shenfu, piperlongumine, wogonin, oroxylin, plantamajoside, naringin, ginseng, kaempferol, allium sativum L, illicium henryi, isoliquiritigenin, lianhua qingwen, magnoflorine, and ma Huang Tang might be effective in inhibiting the NF-KB pathway. These natural products could be helpful in the control of COVID-19 infections. However, larger clinical trials are needed to ascertain the efficacy of these products fully.

Inhibiting IL-6 During Cytokine Storm in COVID-19: Potential Role of Natural Products (preprint)

Plant species with anti-inflammatory properties might play an essential role in combatting COVID-19 via reducing cytokine storms. We aimed to review the extant evidence of the potential therapeutic efficacy of natural products against cytokine storms by inhibiting interleukin-6 (IL-6) as a major pathological mediator. Data were collected following an electronic search in major databases (Pubmed, Scopus, Web of Science, Google Scholar) and also preprint articles on preprint and medRxiv servers by using a combination of relevant keywords. Seventeen active compounds and medicinal plants were found and reviewed in the present review. Results of both in-vivo and in-vitro experiments conducted on these compounds showed that Phillyrin, SMFM, Qiangzhi decoction, curcumin, Shen-Fu, Forsythia, and Alpha-Mangostin inhibit the production of IL-6. Andrographolide and Liu Shen Wan have an inhibitory effect on releasing this agent, while Ilex Asprella and Deoxy-11,12-didehydroandrographolide and naringin reduce the expression of IL-6. Theaflavin and Cholorogenic acid inhibit the secretion of IL-6, Xuebijing, and Chai-Hu-Gui-Zi-Gan-Jiang-Tang and Lipanpaidu prescription can reduce the serum level of IL-6. These agents also effectively improve infected lungs, increase survival rates, and minimize tissue damage. Medicinal plants and their phytochemical ingredients with down-regulatory effects on the expression of IL-6 have a potential influence on the inhibition of cytokine storms during viral infection caused by COVID-19. Therefore, phytochemicals could be regarded as promising candidates for managing cytokine storm inflammatory responses due to COVID-19 infection.