ABSTRACT
In 2020, there were reports of people with albinism being branded as 'Corona' and 'COVID-19', using individuals as scapegoats and further ostracizing them from communities. People with albinism are vulnerable to human rights' violations and suffer with skin and eye health. Albinism is increasingly recognized in the Pacific Region, particularly in the Polynesian community in Fiji, Samoa, Vanuatu and Tuvalu. A register has been created for Fijians with albinism, with the objective of understanding the scale and health needs of the population. In 2014, The Fiji Albinism Project was established through charity funding in partnership with the Fiji Ministry of Health. The aim is to improve the quality of life of people living with albinism in Fiji. Proformas are completed by Fijians with albinism and their details are collated into an Excel spreadsheet, including name, gender, date of birth, ethnicity, contact details, address, nearest health centre, school, date of entry and additional comments. The database currently holds the details of 172 people with albinism (aged 9 months-77 years), with 161 self-reporting as iTaukei. There are 88 females and 82 males registered (two do not have gender documented). Sixty-four participants are < 18 years of age. Basal and squamous cell carcinomas have been seen among adults, with one incidence of clinical Bowen disease in a child. Similar numbers of people attended the national skin clinic in 2020 vs. nonpandemic times. However, uptake of outreach clinics was reduced and fewer people with albinism are collecting free sunscreen. Owing to the COVID-19 pandemic, the first virtual International Albinism Awareness Day was held in 2020, with participants from Fiji. In 2020, a 5-year National Strategic Plan for Dermatology, Leprosy and Albinism was submitted and reviewed by the Minister of Health and Permanent Secretary of Health in Fiji. The plan includes proposals for continued free sunscreen and formalizing of referral pathways to Tamavua Twomey Hospital and The Pacific Eye Institute. This incorporation of albinism care within the Ministry of Health and Ministry of Education provides a model for other pacific islands and developing countries to follow.
ABSTRACT
Background. Patient and treatment-related factors have been used to stratify COVID-19 outcomes;however, studies in the general population and specifically veterans have yielded variable results. This study was designed to assess how baseline characteristics and interventions correlate with clinical outcomes in patients admitted with COVID-19 at a large academic Veterans Affairs hospital. Methods. Retrospective chart review was conducted on veterans admitted to the hospital with COVID-19 between March 1 to December 31, 2020. Veterans without respiratory symptoms attributed to COVID-19 or enrolled in a COVID-19 clinical trial were excluded. Primary outcome was in-hospital mortality up to 28 days. Secondary outcomes were 90-day mortality, discharge to higher level of care or remained in the hospital within 28 days, and discharge with new oxygen requirement within 28 days. Patient characteristics and therapeutic interventions were assessed for correlation with primary and secondary outcomes. Results. Of 497 hospitalized patients reviewed, 293 were included for analysis;94% were male;average age was 68 years with 64.9% of veterans greater than 65 years of age;43.7% were Black;17.4% were Hispanic. In-hospital mortality at 28-days and 90-day mortality were 18.1% and 21.5%, respectively. At discharge, 34.1% had a new oxygen requirement and 17.5% went to a higher level of care. Patients that died in-hospital were more likely to be greater than 65 years of age (p< 0.001), Hispanic (p=0.007), have chronic kidney disease (CKD) (p=0.005), be admitted to ICU (p< 0.001);receive dexamethasone (p< 0.001), convalescent plasma (p< 0.001), or antibiotics (p< 0.001);require mechanical ventilation (p< 0.001);or have new onset atrial fibrillation (p< 0.001). Veterans also had higher levels of inflammatory markers within 48 hours of hospital admission (see Table 2) and longer length of hospital stay (< 0.001). There was a trend for patients that died in the hospital within 28-days to be less likely to be Black (p=0.06). Conclusion. Patients were more likely to die in-hospital within 28-days if they were greater than 65 years of age, Hispanic and had CKD. Veterans that died in-hospital within 28-days had higher inflammatory marker levels and were more likely to receive COVID-19 treatments.
ABSTRACT
The coronavirus disease 2019 (COVID-19) pandemic has created an urgent need for therapeutics that inhibit the SARS-COV-2 virus and suppress the fulminant inflammation characteristic of advanced illness. Here, we describe the anti-COVID-19 potential of PTC299, an orally bioavailable compound that is a potent inhibitor of dihydroorotate dehydrogenase (DHODH), the rate-limiting enzyme of the de novo pyrimidine nucleotide biosynthesis pathway. In tissue culture, PTC299 manifests robust, dose-dependent, and DHODH-dependent inhibition of SARS-COV-2 replication (EC50 range, 2.0-31.6 nM) with a selectivity index >3,800. PTC299 also blocked replication of other RNA viruses, including Ebola virus. Consistent with known DHODH requirements for immunomodulatory cytokine production, PTC299 inhibited the production of interleukin (IL)-6, IL-17A (also called IL-17), IL-17 F, and vascular endothelial growth factor (VEGF) in tissue culture models. The combination of anti-SARS-CoV-2 activity, cytokine inhibitory activity, and previously established favorable pharmacokinetic and human safety profiles render PTC299 a promising therapeutic for COVID-19.