ABSTRACT
Background: As of December 2022, SARS-CoV-2 coronavirus resulted in over 6 million deaths worldwide.[1] It was realized early into the pandemic, that COVID-19 significantly impacts the Cardiovascular system. [2] Patients with pre-existing cardiovascular comorbidities were particularly at higher risk of adverse outcomes during their hospitalizations. [3] Similarly, it can be safe to assume patients with adult congenital heart disease (ACHD) should considered a high-risk population for the development of severe COVID infection with increased rates of significant cardiovascular complications. Objective(s): Based on this reasoning and the paucity of data available on this topic using a large database, we sought to investigate the outcomes of patients with ACHD who were admitted to the hospital with COVID-19. Method(s): The National Inpatient Sample database for 2020 was queried to identify adult hospitalizations with a primary diagnosis of COVID-19 and a secondary diagnosis of ACHD using International Classification of Diseases - 10 Clinical Modification (ICD-10-CM) codes. The primary outcome studied was inpatient mortality, while secondary outcomes included inpatient complications, mean length of stay (LOS), and total hospital charge (THC). Multivariate logistic and linear regression analyses were used to adjust for possible confounders and analyze the variables. Result(s): Out of 1,050,045 COVID-19 hospitalizations registered, 2,425 (0.23%) had ACHD as a secondary diagnosis. Encounters with ACHD who were hospitalized with COVID-19 had significantly higher adjusted odds of inpatient mortality (Adjusted Odds Ratio [aOR]: 1.4, [95% CI: 1.05-1.88], p=0.022), Longer LOS (Mean 2.4 days, [95% CI: 1.35-3.40], p <0.001), and higher Total Hospital Charges (Mean $53,000, [95% CI: 20811-85190], p <0.001). A Forrest plot (Figure 1) demonstrates a graphical representation of the multivariate analysis of the significant in-hospital complications when adjusted for patient demographics, comorbidities, and hospital characteristics. Conclusion(s): Among COVID-19 hospitalizations, those with a history of congenital heart diseases had significantly worse outcomes in terms of in-hospital mortality, sepsis;the need for endotracheal intubation, mechanical ventilation, and vasopressors;developing acute kidney injury and pulmonary embolism, in addition to the longer length of stay, and higher total hospital charges. [Formula presented]Copyright © 2023
ABSTRACT
The emerging human pathogenic viruses, including the recently emerged severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2), have markedly affected the human health and have become a challenge for researchers worldwide. Antibiotic therapy and existing vaccines have reduced the pandemic burden to some extent. However, there is still need for efficient treatment, vaccination, and antiviral agents to control the pandemic. This chapter illustrates the role of bacteriophage in bacterial infections, SARS-COV-2 infected patients, biological activities of phages, phage display method, phages as potential inducers of antiviral immunity, phage-based vaccines, CRISPR and phage-based SARS-CoV-2 vaccines, and possible advantages of phage-based vaccines. It is concluded that phages have considerable breadth in the SARS-CoV-2 pandemic and offer many substantial advantages, such as clearing respiratory bacterial infections, which significantly reduce the burden of mortalities. Phage plays a vital role in triggering antiviral immunity by inducing cytokines such as IFN-α and IL-12. It suggests the role in driving antiviral immunity, triggering TLR3-dependent pattern recognition receptors, inhibiting TNF-driving type I IFN, inducing antiviral immunity through upregulation of the expression of defensin in IL-2, and encouraging a marked upregulation of gene hBD2 that induces virucidal effects, thus playing a key role in anti-SARS-COV-2 immunity. Moreover, phages have been presented as an alternative universal adjuvant-free nano-vaccine platform in which single-phage scaffolds are used to incorporate multiple targets. © 2023 Elsevier Inc. All rights reserved.
ABSTRACT
Natural products have been proven to be the source of many antiviral drugs in the past. History has a bunch of natural products used as traditional medicine, therapies, mixtures, and oils. However, there are many bioactive natural products that need to be evaluated against severe acute respiratory syndrome (SARS-CoV-2) to curb the ongoing pandemic. Several plants and fungal-derived natural products are extensively reported with antiviral activities against SARS-CoV-2. In vitro, preliminary study assays and computational studies revealed several antiviral drugs from natural fungal compounds, including cordycepin isolated from Cordyceps militaris fungi. Polyphenolic compounds isolated from the Broussonetia papyrifera plant showed promising antiviral activity against SARS CoV-2 in in silico studies. Two alkaloid compounds, 10-hydroxyusambarensine and cryptoquindoline isolated from African medicinal plants, inhibited the main protease (Mpro) of SARS CoV-2. At the start of the COVID-19 pandemic, FDA approved the emergency use of chloroquine against SARS CoV-2;chloroquine is a derivative of alkaloid. The development of modern technologies has streamlined the discovery of new drugs from natural products. Gas chromatography–mass spectrometry, infrared radiation, nuclear magnetic resonance, high-performance thin-layer chromatography, and high-performance liquid chromatography and other high output technologies should be available for the structural interpretation and distinguishability of prudent lead molecules © 2023 Elsevier Inc. All rights reserved.
ABSTRACT
Background and aim: The Coronavirus 2019 (COVID-19) pandemic has affected the delivery of healthcare around the world. We assessed the impact of the COVID-19 pandemic on hospital presentations, reperfusion treatment and outcomes in a comprehensive stroke centre. Methods: In this observational study seven months of retrospective data from February 2020 at the beginning of the pandemic were compared to data collected for the same time frame in 2019. Results: There was a transient reduction in stroke presentation only at the beginning of the wave of COVID-19 community transmissions in Sydney. There were significantly more haemorrhagic strokes in the COVID- 19 period (n = 66, 15.4 % vs n = 95, 21.5 %, p = 0.02) and baseline stroke severity was higher (NIHSS median 3 vs 4, p = 0.049). Similar proportions of ischaemic stroke patients received reperfusion therapy in the two time periods (IV thrombolysis [n = 51, 17.3% vs n = 52, 17.9%, p = 0.838];and ECR [n = 38, 12.9% vs n = 46, 15.9%, p = 0.30]). The time from presentation to stroke bed admission was significantly shorter during the COVID-19 period (p = 0.031). Three-month follow-up Modified Rankin Score was 2 (median) in both periods (P = 0.92). Conclusion: There was no change in stroke presentations overall during the 2020 COVID 19 pandemic time period with the exception of the first phase of the pandemic. Baseline stroke severity scores were higher. There was no difference in the degree of disability at three-month follow-up.
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INTRODUCTION/AIMS: It is unknown if patients with neuromuscular diseases prefer in-person or virtual telemedicine visits. We studied patient opinions and preference on virtual versus in-person visits, and the factors influencing such preferences. METHODS: Telephone surveys, consisting of 11 questions, of patients from 10 neuromuscular centers were completed. RESULTS: Five hundred and twenty surveys were completed. Twenty-six percent of respondents preferred virtual visits, while 50% preferred in-person visits. Sixty-four percent reported physical interaction as "very important." For receiving a new diagnosis, 55% preferred in-person vs 35% reporting no preference. Forty percent were concerned about a lack of physical examination vs 20% who were concerned about evaluating vital signs. Eighty four percent reported virtual visits were sufficiently private. Sixty eight percent did not consider expenses a factor in their preference. Although 92% were comfortable with virtual communication technology, 55% preferred video communications, and 19% preferred phone calls. Visit preference was not significantly associated with gender, diagnosis, disease severity, or symptom management. Patients who were concerned about a lack of physical exam or assessment of vitals had significantly higher odds of selecting in-person visits than no preference. DISCUSSION: Although neither technology, privacy, nor finance burdened patients in our study, more patients preferred in-person visits than virtual visits and 40% were concerned about a lack of physical examination. Interactions that occur with in-person encounters had high importance for patients, reflecting differences in the perception of the patient-physician relationship between virtual and in-person visits.
Subject(s)
Patient Preference , Telemedicine , Communication , Humans , Surveys and QuestionnairesABSTRACT
Background: There was a difficult time of COVID-19 pandemic and lockdown. People around the country were forced to stay home. Hospitals were deeply concerned about managing the exposure to COVID-19 virus. Aim of the study: To evaluate the cellphone based remote consultation in reproductive endocrinology and infertility. Material & Methods: The observational cross sectional study was carried out in the Department of Reproductive Endocrinology & Infertility for about 6 months from July 2020 to December 2020. Following approval of Institutional Review Board of Bangabandhu Sheikh Mujib Medical University, we decided to call the patients who had attended our consultation from 1st January 2020. The Department of Reproductive Endocrinology & Infertility attends every working day approximately 50-60 new patients of infertility and related problems of reproductive endocrinology in outdoor. The COVID-19 pandemic halted the interaction of the patients with us for indefinite period. Remote consultation with cell phone was applied to maintain the continuity of care of the patients. Statistical Package of Social Sciences (SPSS) version 22 was used for quantitative analysis.
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Aims: To assess medical students' perception of online teaching to suggest transforming the future curriculum in low-economic countries. Study Design: Cross-sectional online interview study. Place and Duration of Study: A team of collaborators interviewed final year medical and dental students of Pakistan from 07/08/2020 till 17/09/2020. Methodology: A questionnaire was developed based on open and close-ended questions in Google forms;focusing on institutional preparedness, views on online education, the institute's closure and COVID-19, and long-term effects of closure of the institute. Independent fellow researchers systematically analyzed the unaltered transcripts of the responses, and themes were then identified and coded to conclude the results. SPSS version 23 used for analysis. As this study was based on final year students. Results: In response to an invitation email, 2442/2661 (91.77%) students voluntarily participate in this qualitative study. Most participants were females (1614, 66.10%). Closing down institutes was directly linked to a lack of motivation and feel of helplessness. As most showed dissatisfaction with online teaching compounded by psychological effects, students feared losing clinical skills and life during the pandemic. Conclusion: The psychological impact of the crisis led to resistance to accepting the change for a better outcome. Incorporating telemedicine, different interactive learning style to online teaching, and resilience training would result in fruitful outcomes. Developed countries may also guide build infrastructure in developing countries to develop a more robust online teaching methodology in the long-run.