Signs and symptoms commonly seen in COVID-19 in newborns, children, and adolescents and pediatric subjects

The recent findings reported that the most frequent coronavirus disease 2019 (COVID-19) clinical course in pediatric subjects ranged from mild to moderate form in with nonspecific symptoms such as fever, cough, dyspnea, fatigue, muscle pain, headache, and nasal congestion. On the contrary, a lower frequency of severe COVID-19 forms was reported, including refractory metabolic acidosis, coagulation disorders, tachypnea, severe pneumonia, and septic shock. Recent literature is associated with the COVID-19 pediatric subject to the acute multisystem inflammatory syndrome (MIS-C) with abdominal symptoms and left ventricular systolic dysfunction. The recent findings seem to support that the unvaccinated and comorbid children could present more severe clinical forms. Few data of COVID-19 hospitalization in pediatric intensive care unit (PICU) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) transmission in schools were reported during the first wave. The main reasons could be correlated to the early school's closure, while the swabs were destined more frequently to adult symptomatic subjects. The pandemic state generated rise in psychological disorders, anxiety, and depression more frequently during the first year of the disease spread, with a higher prevalence in older adolescents. © 2023 Elsevier Inc. All rights reserved.

Navigation systems in maxillofacial surgery and neurosurgery and their potential advantages

Operating microscopes, navigation systems and intraoperative neurophysiological monitoring are essential in modern neurosurgical and maxillofacial procedures. Advances in surgical planning in neurosurgery and maxillofacial surgery led to the more common navigation system that helps surgeons know more information and ultimately do more for their patients. The benefits of a contemporary navigation system in the complicated brain, skull-base, maxillofacial and spine surgery are undeniable. Workflow analyses and cost-benefit evaluations must be carried out to increase the efficiency of neuronavigation systems in the next future.

Augmented and virtual reality as training tool for maxillofacial surgeons and neurosurgeons: is it the future?

Recent biotechnological advances, including three-dimensional microscopy and endoscopy, virtual reality, surgical simulation, surgical robotics, and advanced neuroimaging, have moulded the surgeon-computer relationship. For developing neurosurgeons and maxillofacial surgeons, such tools can reduce the learning curve, improve conceptual understanding of complex anatomy, and enhance visuospatial skills. However, current clinical trials in dental virtual reality must still be experimental.

Surgical multidisciplinarity for precision medicine: the challenge for the future

Multidisciplinary care has been shown to improve patient outcomes, and interprofessional collaboration has been shown to improve one's medical knowledge. Multidisciplinary interventions in the field of surgery are designed to address a specific problem occurring in a particular patient population and/or within the context of an individual hospital system. The importance of multidisciplinarity and interdisciplinarity at all levels, including clinical oncology, craniofacial trauma, and brain abscess caused by dental peri-implantitis, is well established. The challenge for future research is to further develop and validate medical team performance assessment instruments;this will help improve medical and surgical team training efforts and aid the design of clinical work systems supporting effective teamwork and safe patient care.

Neurosurgical and craniofacial surgery during the Covid-19 pandemic

The pandemic of coronavirus disease (COVID-19) resulted in an unprecedented global public health crisis and impacted all spheres of life, including all economic activity, travel, governance, education, surgery and, of course, healthcare. Neurosurgery, dentistry, and maxillofacial surgery are also not spared. Surgeons operating near the aerodigestive tract are at particularly high risk of being infected, and consequently, they shifted their practices toward more protective personal protective equipment. In the present digital era, surgeons use more and more web, teleconsulting, and virtual reality to effectively communicate with patients and their relatives on treatment strategies and appointments for surgical works. The COVID-19 situation also provides a novel opportunity to learn, update our knowledge, and update ourselves such that we continue to save lives. In conclusion, it seems appropriate to request that every healthcare institution receives well-researched and documented protocols for dealing with future inevitable global pandemics. © by BIOLIFE, s.a.s.

Periodontal disease and clinical association with COVID-19 infection

SARS-CoV-2 infection can cause long-standing damage to the immune system characterized by increased inflammatory cytokine activation. Maintaining periodontal health may reduce host susceptibility to COVID-19 and prevent COVID-19 aggravation in infected patients. There is sufficient evidence in the literature to warrant an association between the presence of PDs and the development and course of respiratory illnesses. Optimum oral health, maintaining good systemic health, and elimination of smoking habits may be beneficial for the prevention and management of COVID-19 infections. Future studies on the periodontal status of patients with COVID-19, including from mild to severe forms, could allow the opportune identification of people at risk of severe illness and generate relevant recommendations. The connection, if any, between the oral microbiome and COVID-19 complications is urgently required to establish the importance of oral hygiene and pre-existing oral disease in the severity and mortality risk of COVID-19.

In vitro and clinical studies on the efficacy of alpha-cyclodextrin and hydroxytyrosol against SARS-CoV-2 infection

OBJECTIVE: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new coronavirus responsible for the current pandemic of coronavirus disease 2019 (COVID-19). This virus attacks cells of the airway epithelium by binding transmembrane angiotensin-converting enzyme 2 (ACE2). Hydroxytyrosol has anti-viral properties. Alpha-cyclodextrin can deplete sphingolipids and phospholipids from cell membranes. The aim of the present experimental study was to evaluate the efficacy of alpha-cyclodextrin and hydroxytyrosol in improving defenses against SARS-CoV-2 infection in in vitro cell models and humans. PATIENTS AND METHODS: For in vitro experiments on Vero E6 cells, RNA for RT-qPCR analysis was extracted from Caco2 and human fibroblast cell lines. For study in humans, the treatment group consisted of 149 healthy volunteers in Northern Cyprus, considered at higher risk of SARS-CoV-2 infection than the general population. The volunteers used nasal spray containing alpha-cyclodextrin and hydroxytyrosol for 4 weeks. The control group consisted of 76 healthy volunteers who did not use the spray. RESULTS: RT-qPCR experiments on targeted genes involved in endocytosis showed a reduction in gene expression, whereas cytotoxicity and cytoprotective tests showed that the compounds exerted a protective effect against SARS-CoV-2 infection at non-cytotoxic concentrations. None of the volunteers became positive to SARS-CoV-2 RT-qPCR assay during the 30 days of treatment. CONCLUSIONS: Treatment with alpha-cyclodextrin and hydroxytyrosol nasal spray improved defenses against SARS-CoV-2 infection and reduced synthesis of viral particles.

Scoping review on the role and interactions of hydroxytyrosol and alpha-cyclodextrin in lipid-raft-mediated endocytosis of SARS-CoV-2 and bioinformatic molecular docking studies.

OBJECTIVE: The aim of the study was to show the effect that two naturally occurring compounds, a cyclodextrin and hydroxytyrosol, can have on the entry of SARS-CoV-2 into human cells. MATERIALS AND METHODS: The PubMed database was searched to retrieve studies published from 2000 to 2020, satisfying the inclusion criteria. The search keywords were: SARS-CoV, SARS-CoV-2, coronavirus, lipid raft, endocytosis, hydroxytyrosol, cyclodextrin. Modeling of alpha-cyclodextrin and hydroxytyrosol were done using UCSF Chimera 1.14. RESULTS: The search results indicated that cyclodextrins can reduce the efficiency of viral endocytosis and that hydroxytyrosol has antiviral properties. Bioinformatic docking studies showed that alpha-cyclodextrin and hydroxytyrosol, alone or in combination, interact with the viral spike protein and its host cell receptor ACE2, thereby potentially influencing the endocytosis process. CONCLUSIONS: Hydroxytyrosol and alpha-cyclodextrin can be useful against the spread of SARS-CoV-2.

In vitro and clinical studies on the efficacy of α-cyclodextrin and hydroxytyrosol against SARS-CoV-2 infection.

OBJECTIVE: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new coronavirus responsible for the current pandemic of coronavirus disease 2019 (COVID-19). This virus attacks cells of the airway epithelium by binding transmembrane angiotensin-converting enzyme 2 (ACE2). Hydroxytyrosol has anti-viral properties. Alpha-cyclodextrin can deplete sphingolipids and phospholipids from cell membranes. The aim of the present experimental study was to evaluate the efficacy of α-cyclodextrin and hydroxytyrosol in improving defenses against SARS-CoV-2 infection in in vitro cell models and humans. PATIENTS AND METHODS: For in vitro experiments on Vero E6 cells, RNA for RT-qPCR analysis was extracted from Caco2 and human fibroblast cell lines. For study in humans, the treatment group consisted of 149 healthy volunteers in Northern Cyprus, considered at higher risk of SARS-CoV-2 infection than the general population. The volunteers used nasal spray containing α-cyclodextrin and hydroxytyrosol for 4 weeks. The control group consisted of 76 healthy volunteers who did not use the spray. RESULTS: RT-qPCR experiments on targeted genes involved in endocytosis showed a reduction in gene expression, whereas cytotoxicity and cytoprotective tests showed that the compounds exerted a protective effect against SARS-CoV-2 infection at non-cytotoxic concentrations. None of the volunteers became positive to SARS-CoV-2 RT-qPCR assay during the 30 days of treatment. CONCLUSIONS: Treatment with α-cyclodextrin and hydroxytyrosol nasal spray improved defenses against SARS-CoV-2 infection and reduced synthesis of viral particles.

SARS-CoV-2 Disease through Viral Genomic and Receptor Implications: An Overview of Diagnostic and Immunology Breakthroughs

The SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), which is believed to have originated in China towards the end of November 2019, has now spread across the globe, causing a pandemic in 192 countries. The World Health Organization has called it the SARS-CoV-2 pandemic. Rapid dissemination of the virus occurs mainly through the saliva (Flugge's droplets) and aerosol, together with nasal and lachrymal passages. The literature associated with the recent advancement in terms of rapid diagnostics and SARS-CoV-2 vaccines has thoroughly studied the role of ACE2 receptors and Furin, as well as viral agent access into the host cell and its significant persistence at the level of the oral mucosa, which represents the main access to the virus. The purpose of this review was to underline the processes of SARS-CoV-2 infection mechanisms and novel breakthroughs in diagnostics and vaccines. Different technologies, such as the RT-PCR molecular test and the antigenic test, have been developed to identify subjects affected by the SARS-CoV-2 in order to improve the tracking of infection geographical diffusion. Novel rapid and highly sensitive diagnostic tests has been proposed for the detection of SARS-CoV-2 to improve the screening capability of suspected contagions. The strengthening of the vaccination campaign represents the most effective means to combat the SARS-CoV-2 infection and prevent severe manifestations of the virus-different classes of vaccines have been developed for this purpose. Further attention on the novel SARS-CoV-2 variant is necessary in order to verify the protection efficacy and virulence reduction of the infective agent in the recent vaccine campaign.