ABSTRACT
The COVID-19 pandemic has had a devastating economic impact globally and Nepal is no exception. Tourism and migration abroad to work— two of the important sectors that have significantly contributed to the Nepali economy — have suffered tremendously in the face of lockdown and other restrictions related to the COVID-19 pandemic. In this context, this paper aims to understand how COVID-19 impacted Nepalis while focusing on Nepal's tourism and migration sector. The paper is based on the review of secondary resources, including newspaper articles available in the public sphere. Data in this paper comes from the period prior to February 2021. The COVID-19 pandemic has exacerbated the situation of Nepalis who were recovering from social and economic destruction caused by the global earthquake of 2015. The resulting lockdowns, the closing of land ports and airports, and the limitation of people's mobility have significantly affected Nepal's tourism sector. In addition, thousands of Nepali migrants lost their jobs and incomes in Gulf Cooperation Council (GCC) nations, Malaysia, India, and other destination countries as the pandemic struck the global economy. However, Nepali people appear to remain resilient in the face of yet another disaster. © 2022 Pulla et al. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
ABSTRACT
BACKGROUND: The SAR-CoV-2 pandemic continues to negatively impact the healthcare system globally with over 800,000 deaths in the United States and millions more worldwide. The cases are rising despite availability of vaccines. For most immunocompetent patients these vaccines will generate a humoral response and also a memory T-cell response. Few if any studies have reported data that measure anti-spike IgG titers and also correlate those titers with clinical outcomes in the instance of breakthrough infection. METHODS: We conducted a pilot prospective observational clinical study enrolling 30 immunocompetent patients who were admitted with a positive SARS-CoV-2 PCR. Leftover blood from admission was used to obtain antispike and anti-nucleocapsid antibody levels. Baseline characteristics were collected and patients were divided into two categories based on anti-spike antibody level and vaccination status. Clinical outcomes including mortality, major adverse cardiac events (MACE), overall length of stay (LOS), ICU LOS, maximum oxygen support needs, and mechanical ventilation needs were analyzed on day 28 in both categories. RESULTS: On analyzing the patients enrolled, the median age was 59 years, 56.67% were female and 73.3% were Caucasian. 6 patients (20%) were asymptomatic, and 63.3% patients had hypertension. Among all patients, the median duration of symptoms was 7 days, and the median LOS was 7 days as well.Anti-spike antibody was detected in 22 patients (73.33%), and the median value was 956. Anti-nucleocapsid antibody was positive only in 9 patients (30%). Three patients (10%) were admitted to ICU, and all 3 were mechanically ventilated. Four patients (13.33%) had a MACE event in those 28 days, and 5 patients (16.67%) died. Comparing vaccinated vs unvaccinated: 3/5 deceased patients were unvaccinated, and 2/3 mechanically ventilated were unvaccinated as well but these were not statistically significant. 0.6% patients were asymptomatic in unvaccinated group versus 33% in the vaccinated group. Among the 7 patients with high oxygen needs (fio2 100%), 5 had undetectable anti-spike antibodies, and one had low value (89.6). 2 out of 3 mechanically ventilated and 3 out of 5 deceased patients had undetectable anti-spike antibodies. CONCLUSIONS: Our pilot study did not show significance in outcomes between vaccinated and unvaccinated patients, but this relation has been verified in multiple larger studies. We also noted patients with undetectable/ low anti- spike antibody levels had increased fio2 needs, ICU admission, and mortality.However, it was not feasible to compare both these findings between groups due to less number of patients. This demands a larger study to better describe these relations.
ABSTRACT
INTRODUCTION: A wide range of complications from COVID-19 are being reported, including cardiac complications. CASE PRESENTATION: A 71-year-old woman with systemic lupus erythematosus complicated by focal segmental glomerular sclerosis status post kidney transplant presented with worsening left-sided chest pain after receiving treatment for COVID-19 pneumonia at an outside hospital. She was subsequently diagnosed with acute pericarditis, likely secondary to viral infection with COVID-19, and was successfully treated with aspirin and colchicine for 90 days without complications. DISCUSSION: NSAIDs and colchicine are mainstays in acute pericarditis treatment. Though treatment presented a potential challenge given this patient's prior kidney transplant, aspirin and colchicine proved to be effective in treating her case of COVID-19-associated pericarditis. CONCLUSION: This report has implications for future treatment of renal transplant patients with COVID-19-related pericarditis and emphasizes the need for research into the pathophysiology of pericarditis in the context of COVID-19, including risk factors and treatment.
ABSTRACT
Introduction: Coronavirus disease 2019 (COVID-19) adversely affects patients with cancer, underscoring the critical need for vaccination. However, the safety of COVID-19 vaccines in patients with solid tumors receiving systemic therapy is inadequately studied. Research Question or Hypothesis: Are COVID-19 vaccines safe in patients with solid tumors receiving systemic therapy? Study Design: Retrospective review of electronic medical records. Methods: Recipients of COVID-19 vaccines between January 1, 2021 and April 30, 2021, while on systemic therapy for solid tumors, were identified. Data were collected from the electronic clinic notes, and adverse events (AEs) were graded according to Common Terminology Criteria for Adverse Events, version 5.0. Results: The analysis included 185 patients;the median age was 71 years, and 55% were female. The most common chemotherapy, immunotherapy, and targeted therapy administered were Oxaliplatin (9%) and taxane-based (13.5%) regimens, anti-programmed death 1 agents (17%), and Osimertinib (3%), respectively. Patients received the following vaccines: BNT162b2 from Pfizer (96/185, 52%), mRNA-1273 from Moderna (79/185, 43%), and JNJ-78436735 from Johnson & Johnson (10/185, 5%). At least one AE was observed in 35 patients (19%);the total number of AEs was 56: 48 grade 1 (86%) and 8 grade 2 (14%). Most adverse events occurred after the second dose (33, 59%). The most frequent grade 1 AEs included injection site pain (7,14.6%), fever (7,14.6%), fatigue (7,14.6%), chills (5,10.4%). The most frequent grade 2 AE was fatigue (3, 37.5%). Therapy was delayed because of AEs in 3 patients (1.6%). The following table summarizes the data: Conclusion: COVID-19 vaccines caused infrequent and mild AEs in patients with solid tumors receiving systemic therapies.
ABSTRACT
SARS-CoV-2 virus is the serious health concern throughout the world. A comprehensive investigation of binding of SARS-CoV-2 active site with host receptor protein hACE2 is important in designing effective drugs. In the present work, the major amino acid binding partners between the virus CTD and host receptor have been studied and are compared with SARS-CoV RBD binding with hACE2. Our investigation show that some unique hydrogen bond pairs which were not reported in previous work. Along with hydrogen bonding, salt-bridges, hydrophobic interactions and contributions of electrostatic and van der Waals contacts play significant role in binding mechanism. The binding affinity of SARS-CoV-2 CTD/hACE2 is greater than SARS-CoV RBD/hACE2. This outcome is also verified from the free energy estimation by using umbrella sampling.