Assessment of Serum Zinc and Selenium Levels in Children with COVID-19

Objective Zinc and selenium levels are being investigated with increasing frequency in adult patients with coronavirus disease 2019 (COVID-19). However, levels of zinc and selenium in children with COVID-19 have not been adequately studied to date. Methods This prospective, observational study was conducted on 146 pediatric patients diagnosed with COVID-19 and 49 healthy controls between 2020 and 2021. Normal serum zinc reference values were 0.60 to 1.20 mu g/ml for children 0 to 10 years old and 0.66 to 1.10 mu g/mL for children >= 11 years old. The normal range for serum selenium concentration was considered between 70 and 150 mu g/L. Deficiencies were defined for values below the reference range. Results Zinc and selenium levels were significantly lower in the COVID-19 (+/-) group compared with the controls (zinc: 0.7 +/- 0.2 vs 0.9 = 0.2 mu g/mL, p < 0.001;selenium: 57.1 +/- 9.1 vs 66.5 +/- 11.4 mu g/L, p < 0.01, respectively). Also, zinc and selenium levels were found to be statistically significantly lower in the hospitalized group compared with the outpatient group (zinc: 0.6 +/- 0.2 vs 0.8 +/- 0.2 mu g/mL, p < 0.001;selenium: 52.1 +/- 9.6 vs 58.8 +/- 8.3 mu g/L, p < 0.001). In the receiver operating characteristic curve analysis, selenium levels with a cutoff value of 55.50 mu g/L, with 75% sensitivity and 70% specificity, and zinc levels with a cutoff value of 0.7 mu g/mL, with 56% sensitivity and 53% specificity, predicted hospitalization. Conclusion Our data showed that serum zinc and selenium levels were significantly lower in patients with COVID-19 compared with healthy control group. Also, zinc and selenium levels were found to be lower in the hospitalized group compared with the outpatient COVID-19 group.

Evaluation of the Relationship Between Clinical Findings and Neutrophil-Lymphocyte Ratio and Mean Platelet Volume in COVID-19 PCR-Positive Children

Objective: In this study, we aimed to evaluate the importance of predicting the severity of the disease by measuring the hematological parameters such as the neutrophil-lymphocyte ratio and mean platelet volume, are positively correlated or not. We used COVID-19 PCR positive children who applied to the pediatrics outpatient clinic of our hospital for measurement. Material and Methods: Our study was designed retrospectively and included 136 children aged 6-18 years who applied to the pediatrics outpatient clinic of our hospital between 29 March 2020 and 31 November 2020. Sixty-eight of these children were found to be healthy and COVID-19 negative, while the other 68 were positive. COVID-19 PCR-positive patients were divided into four groups, each consisting of 17 patients, as asymptomatic infection, acute upper respiratory tract infection, mild pneumonia and severe pneumonia. Results: The three most common clinical findings in COVID-19 PCR positive patients are;cough was present in 44 (64.7%), fever in 37 (54.4%), and tachypnea in 17 (25%). Neutrophil count, neutrophil-lymphocyte ratio and mean platelet volume were found to be statistically significantly higher in COVID-19 PCR positive children compared to negative ones (p< 0.05). The lymphocyte count was found to be significantly lower in COVID-19 PCR positive children (p< 0.05). When the subgroups of COVID-19 PCR positive patients are evaluated;as the clinical severity increased between the groups, a significant increase was found in neutrophil count and neutrophil-lymphocyte ratio (p< 0.05). A significant decrease was observed in the lymphocyte count with the increase in clinical severity (p< 0.05). There was no significant difference between subgroups in the mean platelet volume of COVID-19 patients, consistent with clinical severity (p> 0.05). Conclusion: In our study, increased neutrophil count and neutrophil-lymphocyte ratio and decreased lymphocyte count were found to be associated with the clinical severity of COVID-19 disease. It is thought that these parameters can be used as good markers to predict the severity of COVID-19 disease. Although mean platelet volume was found to be significantly higher in COVID-19 PCR positive cases, it was not significantly associated with the clinical severity of the disease. Therefore, it was concluded that mean platelet volume is not a good prognostic predictor of the clinical course of the disease.

Clinical characteristics and risk factors associated with severe disease and outcome of patients with COVID-19

Introduction: Since the beginning of the pandemic, factors associated with mortality in patients with corona virus infection disease 2019 (COVID-19) have been investigated. Comorbidities and increased age have been frequently reported to be associated with mortality. We aimed to evaluate the factors associated with unfavorable outcome of patients with COVID-19 at an early period of the pandemic. Methodology: This single center, retrospective, observational study was conducted among laboratory confirmed COVID-19 patients hospitalized between March 11 and May 5, 2020, at Umraniye Training and Research Hospital, Istanbul, Turkey. The effects of the severity of illness, comorbidities, symptoms, and laboratory findings on the clinical outcome were evaluated. Factors associated with unfavorable outcome (necessity of mechanical ventilation or death) were examined using Cox proportional hazards models. Results: Out of a total of 728 patients, 53.8% were men and median age 54 years. The 30-day mortality rate was 4.9% among all hospitalized patients. A logistic regression model identified six predictors of unfavorable clinical outcome: age, severity of illness, the numbers of comorbidities, lymphopenia, high levels of C-reactive protein, and procalcitonin. Conclusions: The mortality rate was lower among the patients with COVID-19, hospitalized during the early period of the pandemic. Older age, higher severity score on admission, the numbers of comorbidities, higher levels of C-reactive protein, procalcitonin, and lymphopenia were identified to be associated with unfavorable outcome of the hospitalized patients with COVID-19. Copyright © 2022 Ozel et al.

Vibrational spectroscopic characterization and structural investigations of Cepharanthine, a natural alkaloid

Cepharanthine, a natural alkaloid obtained from the Stephania cepharantha Hayata plant, that has antitumor, anti-inflammatory, antioxidative, antiparasitic, and antiviral properties, has been widely used for many years to treat a wide variety of diseases in Japan. However, to elucidate its mechanism of action needs further study. This study aimed to enlighten the molecular structure, and the anticancer and antiviral action mechanisms of Cepharanthine. To evaluate the molecular structure of Cepharanthine, conformational analysis was performed using the DFT/B3LYP with 6-31G(d,p) basis set. The obtained most stable molecular geometry was then optimized at the DFT/B3LYP/6-311++G(d,p) level of theory. The observed IR and Raman bands were compared with harmonic vibrational frequencies of the optimized structure of cepharanthine, calculated using the same level of theory, and assigned on the base of potential energy distribution (PED). The experimental UV-Vis absorption spectrum was recorded and compared with the simulated Time Dependent (TD-DFT/B3LYP/6-311++G(d,p)) method. Moreover, 1H and 13C NMR spectra has been calculated and compared by the experimental spectra. To reveal pharmacological importance of Cepharanthine, a molecular docking study was performed with NF-κB (nuclear factor kappa-light-chain-enhancer of activated B cells) receptor which controls transcription of DNA, cytokine production and cell survival. Molecular docking simulations revealed that Cepharanthine showed strong binding affinity to NF-κB receptor (ΔG = - 8.9 kcal/mol). In addition, to enlight the antiviral properties of cepharantine and to explore the possibility of its use in the treatment of COVID-19, the interactions of cepharanthine with ACE2, apo and holo forms of COVID-19 main protease enzyme (Mpro) and spike glycoprotein of SARSCoV-2 receptors were investigated. © 2022 Elsevier B.V.

Transmission and clinical characteristic of covid-19 in healthcare workers: Cross-sectional study

Objective: Frontline healthcare workers (HCW) exposed to coronavirus disease-2019 (COVID-19) patients at their work environment are at a higher risk of acquiring the disease. The aim of this study was to research the COVID-19 risks due to the occupational exposure of HCW and the clinical characteristics of the affected. Material and Methods: In this retrospective study, HCW, employed by The Ümraniye Research and Training Hospital, who were diagnosed with COVID-19 between 20th March 2020 to 20th May 2020 were analysed. Results: A total of 128 (3.8%) HCW were diagnosed with COVID-19. Most of the infected HCW were medical staff (34%), nurses (24%), physicians (22%) and staff with no patient contact (20%). Fifty-six percent of the infected HCW were working in COVID-19 wards and out-patient clinics. Twenty-nine percent acquired the infection in hospital from an index patient and 32% of them from an infected HCW. The highest transmission was during the sharing of the same environment (53%) like offices. Thirteen per cent of the HCW took the virus during examination or treatment, 31% of the individuals were unaware of the transmission. The number of the infected HCW was higher during the beginning of the outbreak in Turkey. The symptomatic cases were more (88%) than the asymptomatic cases (12%). A total of 28 (22%) HCW were hospitalised and only 4% of the cases were severe. Conclusion: The asymptomatic COVID-19 carrying HCW are to be considered as the source of the spread of the disease among their colleagues. Stricter measures should be implemented to prevent in-hospital transmission. © 2021 by Türkiye Klinikleri.

Interactions mechanism of commonly used drugs for the treatment of COVID-19

In this study conformation analysis of seven drugs commonly used in the treatment of COVID-19 was performed. The most stable conformers of the drug molecules were used as initial data for docking analysis. Using the Cavityplus program, the probable most active binding sites of both apo and holo forms of COVID-19 main protease enzyme (M^pro) and spike glycoprotein of SARSCoV-2 receptors were determined. The interaction mechanisms of the 7 FDA approved drugs (arbidol, colchicine, dexamethasone, favipiravir, galidesivir, hydroxychloroquine, remdesivir) were examined using the AutoDock Vina program. The six of the seven drugs were found to be more stable in binding to apo form of COVID-19 M^pro and spike glycoprotein. Moreover, a set of molecular mechanics (MM) Poisson-Boltzmann (PB) surface area (SA) calculations on the investigated drugs-protein systems were performed and the estimated binding free energy of remdesivir and the apo form of M^pro system was found to be the best. The interaction results of FDA drugs with the apo form of COVID-19 M^pro and spike glycoprotein can play an important role for the treatment of COVID-19.

The origin of SARS-CoV-2 in Istanbul: Sequencing findings from the epicenter of the pandemic in Turkey.

OBJECTIVE: Turkey is one of the latest countries that COVID-19 disease was reported, with the first case on March 11, 2020, and since then, Istanbul became the epicenter of the pandemic in Turkey. Here, we reveal sequences of the virus isolated from three different patients with various clinical presentations. METHODS: Nasopharyngeal swab specimens of the patients were tested positive for the COVID-19 by qRT-PCR. Viral RNA extraction was performed from the same swab samples. Amplicon based libraries were prepared and sequenced using the Illumina NextSeq platform. Raw sequencing data were processed for variant calling and generating near-complete genome sequences. All three genomes were evaluated and compared with other worldwide isolates. RESULTS: The patients showed various clinics (an asymptomatic patient, patient with mild disease, and with severe pulmonary infiltration). Amplicon-based next-generation sequencing approach successfully applied to generate near-complete genomes with an average depth of 2.616. All three viral genomes carried the D614G variant (G clade according to GISAID classification) with implications for the origin of a spread first through China to Europe then to Istanbul. CONCLUSION: Here, we report the viral genomes circulating in Istanbul for the first time. Further sequencing of the virus isolates may enable us to understand variations in disease presentation and association with viral factors if there is any. In addition, the sequencing of more viral genomes will delineate the spread of disease and will guide and ease the necessary measures taken to stem the spread of the novel coronavirus.