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1.
Journal of Clinical and Scientific Research ; 9(1):37-41, 2020.
Article in English | CAB Abstracts | ID: covidwho-2201879

ABSTRACT

Many countries in the world are affected by severe acute respiratory syndrome (SARS) coronavirus-2 (SARS-CoV-2) disease-2019 (COVID-19) pandemic. Approximately 80% of the cases are mild symptomatic, 15% are severe and approximately 5% are critically ill. The mortality among severe and critically ill patients ranges from 17% to 78%. Elderly and patients with comorbidities have higher chances of progression to severe disease and subsequent mortality. There are no proven antiviral agents available for the management of COVID-19. Besides the viral cytopathic effects, dysregulation in immunity also contributes substantially to the pathogenesis. Treatment with immunomodulatory agents such as interleukin-6 blockers, glucocorticoids and mesenchymal stem cell therapy has been observed to be potentially beneficial. In this review, the immune response in SARS-CoV-2, the mechanism of immune dysregulation as well as potential therapeutic targets for immunomodulatory therapies are discussed.

2.
Chest ; 162(4):A2300, 2022.
Article in English | EMBASE | ID: covidwho-2060934

ABSTRACT

SESSION TITLE: Rare Cases of Nervous System and Thrombotic Complication Posters SESSION TYPE: Case Report Posters PRESENTED ON: 10/17/2022 12:15 pm - 01:15 pm INTRODUCTION: Covid 19 virus has impacted nearly 450 million people across the globe;ranging from an asymptomatic carrier state to respiratory symptoms, cardiovascular symptoms, hematologic manifestations and multiorgan failure to death. Thrombotic events are one of its devastating complications. CASE PRESENTATION: A 66 year old man with a history of diabetes mellitus, hypertension and 30 pack years smoking history presented to the emergency room with hypoxia and altered mental status. On exam, his GCS was 8/15 and oxygen saturation was 85% on room air. He was subsequently intubated. CTA chest demonstrated bilateral diffuse ground glass opacities and left pulmonary embolism (PE). CT abdomen and pelvis showed multifocal infarcts in the right kidney with findings suggestive of renal artery thrombosis. Initial platelet count was 80,000/ul with creatinine of 3.9 mg/dl and creatine kinase (CK) of 3977 u/l. His INR was 1.4. Patient was not a candidate for thrombolysis given his thrombocytopenia. He was started on intravenous (IV) heparin and given IV hydration. On day 3 of his admission, he developed dry gangrene of the toes. Ankle brachial index of the right lower extremity (LE) was 1.16 and left LE was 0. Duplex ultrasonography of left LE showed mid to distal popliteal artery thrombus occluding below knee popliteal and tibial arteries. Echocardiogram showed ejection fraction of 55% and bubble study was negative for any intra atrial or pulmonary shunting. On day 4 of his admission, he developed oliguria and his gangrene got worse. His platelet counts decreased to 36,000/ul. Other pertinent labs showed INR 1.2, PT 15.3, PTT 34, D dimer 14.82, fibrinogen 498, CK 6434 mg/dl, hemoglobin 13.2 g/dl, haptoglobin 243 mg/dl and LDH 1041 U/l. Given his poor prognosis in the setting of ventilator dependent respiratory failure, multiple thrombosis and kidney failure requiring hemodialysis, the family decided to withdraw care. DISCUSSION: There are multiple hypotheses of thrombus formation in Covid 19 infection such as interleukin 6 and other cytokines induced endothelial injury, angiogenesis and elevated prothrombotic factors such as factor VIII and fibrinogen. Our patient had PE, renal artery thrombosis and popliteal artery thrombosis. Despite being on full dose anticoagulation, he developed gangrene of the toes. His lab results were not consistent with disseminated intravascular coagulation, thrombotic thrombocytopenic purpura and he was not known to have any baseline hypercoagulable disorder. He did not have any intra cardiac shunts. Hence, it is most likely Covid 19 induced multiple arterial and venous thrombosis. CONCLUSIONS: The treatment of Covid 19 related thrombosis has become very challenging especially in the setting of multiple clots. It is crucial to have large multicenter studies to investigate vascular complications of Covid-19 and to formulate management strategies to ensure good patient outcomes. Reference #1: https://www.nejm.org/doi/full/10.1056/nejmoa2015432 Reference #2: https://journal.chestnet.org/article/S0012-3692(21)01126-0/fulltext DISCLOSURES: No relevant relationships by Devashish Desai No relevant relationships by Swe Swe Hlaing no disclosure on file for Jean Marie Koka;No relevant relationships by Hui Chong Lau No relevant relationships by Subha Saeed No relevant relationships by Anupam Sharma No relevant relationships by Muhammad Moiz Tahir

3.
Bioprospecting of Microbial Diversity: Challenges and Applications in Biochemical Industry, Agriculture and Environment Protection ; : 455-469, 2022.
Article in English | Scopus | ID: covidwho-1872879

ABSTRACT

The scientific community is still in search of compounds that can be most effective to fight against COVID-19. A thorough evaluation of natural therapeutic compounds in relation to combat COVID-19 disease is the call of the hour. Out of many resources, seaweeds, available in the marine environment, offer immense potential, containing various therapeutic molecules and possess antimicrobial, anti-inflammatory, and antioxidant properties. Seaweeds contain various polysaccharides including sulfated galactan, sulfated rhamnans or mannans, carrageenans, and agars, etc. These compounds are known to inhibit the growth, transformation, and settlement of many viruses. Various seaweed species are sources for steroids, flavonoids, glycosides, alkaloids, and other related bioactive compounds with great medicinal values. Seaweeds and their products can be used to aid in the treatment of many diseases without any side effects. This review summarizes the medicinal use of seaweeds with special reference to the COVID-19 situation and human health. © 2022 Elsevier Inc.

4.
Pediatric Transplantation ; 26:2, 2022.
Article in English | Web of Science | ID: covidwho-1801429
5.
Open Forum Infectious Diseases ; 8(SUPPL 1):S558, 2021.
Article in English | EMBASE | ID: covidwho-1746349

ABSTRACT

Background. The impact of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection among pediatric solid organ transplant (SOT) recipients remains unclear. We sought to characterize the clinical epidemiology and outcomes following SARS-CoV-2 infection among pediatric SOT recipients in Dallas, TX. Methods. Retrospective review of all SOT recipients with laboratory confirmed COVID-19 infection from March 1, 2020 -March 31, 2021. Demographic, clinical, and outcome data were stratified by transplant type and disease severity. Fischer's exact test and Kruskall-Wallis test were used to evaluate risk factors for more severe disease among hospitalized children. Results. Twenty-six SOT recipients with a median age of 14 years were included in the study. Fifteen (58%) were female, eighteen (69%) were Hispanic and thirteen (50%) were overweight/obese. Median time post-transplant was 3.6 years (1311 days, interquartile range (IQR) 394-2881). Fourteen patients were liver recipients, seven kidney, three heart, and two multiorgan. The majority of patients (65%) had a known community exposure and presented with fever (50%), cough (38%) and GI symptoms (19%). Half of all cases were hospitalized (n=13), with 2 requiring intensive care unit (ICU) admission, but no patients required positive pressure ventilation. Median hospital stay was 3 days. Five of the thirteen hospitalized patients were categorized as having moderate disease. No patients developed severe disease and there were no deaths. Older children, as well as children with multiple co-morbidities were noted on univariate analysis to be at higher risk for moderate, as compared to mild, disease. Conclusion. SARS-CoV-2 infection among pediatric SOT recipients are at increased risk for hospital admission but demonstrate an overall mild /moderate disease course. Larger studies are required to elucidate the risk of morbidity between pediatric SOT recipients and immunocompetent children with SARS-CoV-2.

6.
American Journal of Transplantation ; 21(SUPPL 4):438, 2021.
Article in English | EMBASE | ID: covidwho-1494451

ABSTRACT

Purpose: The COVID-19 pandemic led to a decrease in transplantation throughout the United States. We examined the impact of the pandemic in regards to the volume of pediatric donors from which livers were successfully transplanted and donor characteristics during this time. Methods: The UNOS database was examined between 3/1/2019-8/1/2019 (non-COVID era) and 3/1/2020-8/1/2020 (COVID era). The numbers of potential pediatric donors and those who donated livers were determined. Donor demographic data was obtained. STATA software was used to perform statistical analysis. A p-value of <0.05 was considered to be significant. Results: There was a 12% decrease in referral numbers of pediatric liver donors between the non-COVID period (n=440) and the COVID period (n=389). Additionally, overall (25% vs. 27% ) and intraoperative (10% vs. 11%) discard rates were higher resulting in a 14% reduction in livers for transplant between non-COVID and COVID periods. Patterns were not uniform across the country. Region 5 had an increase in donors from the non-COVID to COVID era (6.25%), while region 10 had the greatest decrease in donors (15%). Analysis of donor data did not show differences in age (10.9 vs. 11.1 y), BMI (21.7 vs. 21.2 kg/m2), AST (94 vs. 101 U/L), ALT (107 vs. 84 U/L), whole organ use (94.7% vs. 96.7%), DCD status (7.8% vs. 7.3%), or IRD status (14.8% vs. 13.0%) between COVID and non-COVID periods. Macrosteatosis (3.7% vs. 12.6%) was lower in the COVID period although few livers underwent biopsy. Interestingly, the DRI was significantly higher in the COVID period (1.77 vs. 1.60, p = 0.001) with a greater proportion of higher risk donors (DRI>2) used during COVID (24%) compared to non-COVID (20%). Conclusions: During the COVID period there was a large decrease in pediatric donor referral. It appears that this promoted utilization of livers with higher overall donor risk by liver transplant centers.

7.
Int. Conf. Inf. Syst., ICIS - Mak. Digit. Incl.: Blending Local Glob. ; 2021.
Article in English | Scopus | ID: covidwho-1172198
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