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PLoS Pathog ; 18(7): e1010691, 2022 07.
Article in English | MEDLINE | ID: covidwho-1951570


Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) marks the third novel ß-coronavirus to cause significant human mortality in the last two decades. Although vaccines are available, too few have been administered worldwide to keep the virus in check and to prevent mutations leading to immune escape. To determine if antibodies could be identified with universal coronavirus activity, plasma from convalescent subjects was screened for IgG against a stabilized pre-fusion SARS-CoV-2 spike S2 domain, which is highly conserved between human ß-coronavirus. From these subjects, several S2-specific human monoclonal antibodies (hmAbs) were developed that neutralized SARS-CoV-2 with recognition of all variants of concern (VoC) tested (Beta, Gamma, Delta, Epsilon, and Omicron). The hmAb 1249A8 emerged as the most potent and broad hmAb, able to recognize all human ß-coronavirus and neutralize SARS-CoV and MERS-CoV. 1249A8 demonstrated significant prophylactic activity in K18 hACE2 mice infected with SARS-CoV-2 lineage A and lineage B Beta, and Omicron VoC. 1249A8 delivered as a single 4 mg/kg intranasal (i.n.) dose to hamsters 12 hours following infection with SARS-CoV-2 Delta protected them from weight loss, with therapeutic activity further enhanced when combined with 1213H7, an S1-specific neutralizing hmAb. As little as 2 mg/kg of 1249A8 i.n. dose 12 hours following infection with SARS-CoV Urbani strain, protected hamsters from weight loss and significantly reduced upper and lower respiratory viral burden. These results indicate in vivo cooperativity between S1 and S2 specific neutralizing hmAbs and that potent universal coronavirus neutralizing mAbs with therapeutic potential can be induced in humans and can guide universal coronavirus vaccine development.

COVID-19 , Spike Glycoprotein, Coronavirus , Animals , Antibodies, Monoclonal/pharmacology , Antibodies, Neutralizing/pharmacology , Antibodies, Viral , COVID-19/therapy , COVID-19 Vaccines , Humans , Mice , SARS-CoV-2 , Weight Loss
Gastrointestinal Nursing ; 20(5):36-40, 2022.
Article in English | CINAHL | ID: covidwho-1903911


Background: COVID-19-related workforce absences have led to shortages of frontline healthcare staff. The colorectal nursing unit at Lincoln County Hospital was short-staffed for a few months due to the pandemic. This led to a change in the system of flagging postoperative histology results to the colorectal cancer multidisciplinary team (MDT) meeting. Data for patients during this period were studied to assess if this led to delays in MDT discussion. Methods: Data were extracted from a prospectively maintained database for all colorectal cancer patients undergoing resection surgery from 1 April 2021 to 31 July 2021. Data collected included: date of surgery, operation notes, histology results and date of postoperative MDT discussion. The time interval between date of surgery and date of MDT discussion was tabulated from this data. Results: Out of 98 patients identified on the database, 76 were included in this study. Eight (11%) of these patients did not have their histology results discussed in a timely fashion in the colorectal MDT. Four out of these eight subsequently required adjuvant therapy (chemotherapy or radiotherapy). Conclusion: There was a delay in discussion of postoperative histology in the colorectal MDT due to the change of pathway. This highlights the important role of the colorectal nurse specialists (CNSs) in the overall management of colorectal cancer patients. This article highlights the need to avoid burdening the CNS with tasks that can easily be completed by implementing advanced electronic MDT reporting systems.

Cochrane Database Syst Rev ; 5: CD013639, 2022 05 16.
Article in English | MEDLINE | ID: covidwho-1843836


BACKGROUND: Our March 2021 edition of this review showed thoracic imaging computed tomography (CT) to be sensitive and moderately specific in diagnosing COVID-19 pneumonia. This new edition is an update of the review. OBJECTIVES: Our objectives were to evaluate the diagnostic accuracy of thoracic imaging in people with suspected COVID-19; assess the rate of positive imaging in people who had an initial reverse transcriptase polymerase chain reaction (RT-PCR) negative result and a positive RT-PCR result on follow-up; and evaluate the accuracy of thoracic imaging for screening COVID-19 in asymptomatic individuals. The secondary objective was to assess threshold effects of index test positivity on accuracy. SEARCH METHODS: We searched the COVID-19 Living Evidence Database from the University of Bern, the Cochrane COVID-19 Study Register, The Stephen B. Thacker CDC Library, and repositories of COVID-19 publications through to 17 February 2021. We did not apply any language restrictions. SELECTION CRITERIA: We included diagnostic accuracy studies of all designs, except for case-control, that recruited participants of any age group suspected to have COVID-19. Studies had to assess chest CT, chest X-ray, or ultrasound of the lungs for the diagnosis of COVID-19, use a reference standard that included RT-PCR, and report estimates of test accuracy or provide data from which we could compute estimates. We excluded studies that used imaging as part of the reference standard and studies that excluded participants with normal index test results. DATA COLLECTION AND ANALYSIS: The review authors independently and in duplicate screened articles, extracted data and assessed risk of bias and applicability concerns using QUADAS-2. We presented sensitivity and specificity per study on paired forest plots, and summarized pooled estimates in tables. We used a bivariate meta-analysis model where appropriate. MAIN RESULTS: We included 98 studies in this review. Of these, 94 were included for evaluating the diagnostic accuracy of thoracic imaging in the evaluation of people with suspected COVID-19. Eight studies were included for assessing the rate of positive imaging in individuals with initial RT-PCR negative results and positive RT-PCR results on follow-up, and 10 studies were included for evaluating the accuracy of thoracic imaging for imagining asymptomatic individuals. For all 98 included studies, risk of bias was high or unclear in 52 (53%) studies with respect to participant selection, in 64 (65%) studies with respect to reference standard, in 46 (47%) studies with respect to index test, and in 48 (49%) studies with respect to flow and timing. Concerns about the applicability of the evidence to: participants were high or unclear in eight (8%) studies; index test were high or unclear in seven (7%) studies; and reference standard were high or unclear in seven (7%) studies. Imaging in people with suspected COVID-19 We included 94 studies. Eighty-seven studies evaluated one imaging modality, and seven studies evaluated two imaging modalities. All studies used RT-PCR alone or in combination with other criteria (for example, clinical signs and symptoms, positive contacts) as the reference standard for the diagnosis of COVID-19. For chest CT (69 studies, 28285 participants, 14,342 (51%) cases), sensitivities ranged from 45% to 100%, and specificities from 10% to 99%. The pooled sensitivity of chest CT was 86.9% (95% confidence interval (CI) 83.6 to 89.6), and pooled specificity was 78.3% (95% CI 73.7 to 82.3). Definition for index test positivity was a source of heterogeneity for sensitivity, but not specificity. Reference standard was not a source of heterogeneity. For chest X-ray (17 studies, 8529 participants, 5303 (62%) cases), the sensitivity ranged from 44% to 94% and specificity from 24 to 93%. The pooled sensitivity of chest X-ray was 73.1% (95% CI 64. to -80.5), and pooled specificity was 73.3% (95% CI 61.9 to 82.2). Definition for index test positivity was not found to be a source of heterogeneity. Definition for index test positivity and reference standard were not found to be sources of heterogeneity. For ultrasound of the lungs (15 studies, 2410 participants, 1158 (48%) cases), the sensitivity ranged from 73% to 94% and the specificity ranged from 21% to 98%. The pooled sensitivity of ultrasound was 88.9% (95% CI 84.9 to 92.0), and the pooled specificity was 72.2% (95% CI 58.8 to 82.5). Definition for index test positivity and reference standard were not found to be sources of heterogeneity. Indirect comparisons of modalities evaluated across all 94 studies indicated that chest CT and ultrasound gave higher sensitivity estimates than X-ray (P = 0.0003 and P = 0.001, respectively). Chest CT and ultrasound gave similar sensitivities (P=0.42). All modalities had similar specificities (CT versus X-ray P = 0.36; CT versus ultrasound P = 0.32; X-ray versus ultrasound P = 0.89). Imaging in PCR-negative people who subsequently became positive For rate of positive imaging in individuals with initial RT-PCR negative results, we included 8 studies (7 CT, 1 ultrasound) with a total of 198 participants suspected of having COVID-19, all of whom had a final diagnosis of COVID-19. Most studies (7/8) evaluated CT. Of 177 participants with initially negative RT-PCR who had positive RT-PCR results on follow-up testing, 75.8% (95% CI 45.3 to 92.2) had positive CT findings. Imaging in asymptomatic PCR-positive people For imaging asymptomatic individuals, we included 10 studies (7 CT, 1 X-ray, 2 ultrasound) with a total of 3548 asymptomatic participants, of whom 364 (10%) had a final diagnosis of COVID-19. For chest CT (7 studies, 3134 participants, 315 (10%) cases), the pooled sensitivity was 55.7% (95% CI 35.4 to 74.3) and the pooled specificity was 91.1% (95% CI 82.6 to 95.7). AUTHORS' CONCLUSIONS: Chest CT and ultrasound of the lungs are sensitive and moderately specific in diagnosing COVID-19. Chest X-ray is moderately sensitive and moderately specific in diagnosing COVID-19. Thus, chest CT and ultrasound may have more utility for ruling out COVID-19 than for differentiating SARS-CoV-2 infection from other causes of respiratory illness. The uncertainty resulting from high or unclear risk of bias and the heterogeneity of included studies limit our ability to confidently draw conclusions based on our results.

COVID-19 , COVID-19/diagnostic imaging , Humans , SARS-CoV-2 , Sensitivity and Specificity , Tomography, X-Ray Computed , Ultrasonography
Sustainable Energy Technologies and Assessments ; 52:102082, 2022.
Article in English | ScienceDirect | ID: covidwho-1740177


The requirement for passive cooling strategies in buildings has great attention in almost all countries, where hot temperatures are predominant throughout the year. The ventilation process is a crucial necessity for a healthy lifestyle and its significance is additionally highlighted through the contemporary universal outbreak of Covid-19. One of the promising applications for cooling residential buildings is the solar chimney (SC) that is particularly convenient for hot and humid climates. The solar chimney is a natural draught passive method that utilizes available solar energy to build up the stack pressure. The solar chimney participates in elevating the cooling and heating efficiency of residential/non-residential spaces. The present article introduces an overview of the operation and performance of the SC. Studying the potential design and operating parameters influencing the SC performance for natural ventilation (NV) compared to the electrical high-energy technologies to sustain the acceptable indoor climatic conditions is important. As well, the natural ventilation for harsh climate conditions using SC only is not applicable so the enhanced solar ventilation systems are studied. Combined enhanced cooling/heating energy systems based on the solar chimney are considered as an effective strategy towards low-energy consuming buildings.

Acta Biomed ; 92(6): e2021543, 2022 01 19.
Article in English | MEDLINE | ID: covidwho-1649966


INTRODUCTION: World Health Organization (WHO) is encouraging reporting of children with Multisystem Inflammatory Syndrome (MIS-C) associated with SARS-CoV-2 infection for better understanding and management of the disease. METHODOLOGY: This retrospective study included the first 15 pediatrics patient with a confirmed diagnosis of MIS-C associated with SARS-CoV-2 infection in the state of Qatar. We studied and analyzed their demographic data, clinical manifestations, laboratory tests, treatment, and outcome. RESULTS: A total of 15 children were studied (mean age 3.5 ± 2.7year). Recent severe acute respiratory syndrome coronavirus 2 infection was identified in all of them (100%). The majority of these patients had 4 or more systems involvement. Nine of the 15 presented with Kawasaki disease - picture and all had gastrointestinal symptoms (vomiting and diarrhea). Five required Pediatrics Intensive Care Unit (PICU) admission. Lab investigations revealed high D-Dimer, hyponatremia, and hypoalbuminemia in all. Low hemoglobin (Hb) , thrombocytopenia, and sterile pyuria occurred in 86.6%, 60% and 75% of them, respectively. Treatment with combined anti-inflammatory medications (intravenous immunoglobulin, corticosteroids) was used in along with immunomodulatory agents (Anakinra) in a selected group of refractory patients. No mortality happened. CONCLUSION: Our young children who presented with MIS-C related to SARS-CoV-2 infection had significantly higher Kawasaki-disease picture compared to other reports. One third of them required PICU admission but no mortality occurred.

COVID-19 , COVID-19/complications , Child , Child, Preschool , Humans , Infant , Qatar/epidemiology , Retrospective Studies , SARS-CoV-2 , Systemic Inflammatory Response Syndrome
researchsquare; 2021.


SARS-CoV-2, which causes COVID-19, is a new virus that has spread fast over the world. The severity of COVID-19 at different ages has been a notable and constant observation: severity, the requirement for hospitalization, and mortality all grow sharply with age, although severe disease and death are uncommon in children and young adults.. The majority of children infected with SARS-CoV-2 are asymptomatic or have moderate symptoms, which include fever, cough, pharyngitis, gastrointestinal symptoms, and changes in taste and smell. The question of whether children are less likely to be infected with SARS-CoV-2 is still being debated. Children make up only 1 to 2% of all SARS-CoV-2 cases, according to large epidemiological research. these numbers are heavily, depend on testing criteria, and in many reports, testing was limited to those who were symptomatic or required hospitalization, which is less common in children.. According to certain research, children are just as likely as adults to contract SARS-CoV-2.9. Recent research suggests that children are less likely to become infected after coming into touch with a SARS-CoV-2-positive person.According to some reports, children and adolescents have similar virus loads and are hence just as likely to transmit SARS-CoV-2 as adults. Furthermore, the viral load in asymptomatic and symptomatic people may be identical. Reassuringly, transmission of the virus from children to other children or adults in schools has been infrequent.Children are less likely to be infected with SARS-CoV-2 and have less severe symptoms, which is similar to what has been observed with SARS-CoV-1 and Middle East respiratory disease (MERS)-CoV. Infection with most other respiratory viruses (e.g., respiratory syncytial virus (RSV), metapneumovirus, parainfluenza, or influenza viruses), on the other hand, has a far higher prevalence and severity in youngsters. Dr. Mahmoud Elkazzaz and Dr Amr kamel khalil Ahmed, the lead investigators of this observational study, recently published a preprint that demonstrated Docosahexaenoic acid (DHA) had a high binding affinity and greatest interactions with ACE2 active sites, as well as a moderate binding affinity and moderate interactions with the active sites of IL-6. The Docosahexaenoic acid (DHA) interacts with different active sites of IL6 and ACE2 which are involved in direct or indirect contacts with the ACE2 and IL-6 receptors which might act as potential blockers of functional ACE2 and IL-6 receptor complex.. A study proposed, a clinical benefit of targeting IL-17A signaling and the synergic inflammatory cytokine IL-6 to manage COVID-19 patients, particularly those presenting with cytokine storm syndrome.Hypercytokinemia, caused by notably high pro-inflammatory cytokines such as interleukin (IL)-1B, IL-6, IL-8, and IL-17, is mostly linked to the worsened clinical presentation of COVID-19 patients(14). In PBMCs from individuals with relapsing-remitting multiple sclerosis, a combination of docosahexaenoic acid (DHA) and all-trans-retinoic acid (ATRA) inhibits IL-17 gene expression. Conclusions: Docosahexaenoic acid (DHA) was detected in abundance in breast milk and other algal sources milk supplement used for newborns and children's feeding. As a result, we believe that docosahexaenoic acid (DHA) may protect children and newborns thorough competing with COVID-19 for ACE2 receptors and inhibiting IL-6 activity and may possibly help them avoid a cytokine storm and save their lives through inhibiting IL-6 and preventing SARS- CoV-2 RBD attachment to ACE2. In addition to IL-17 was fond to increase COVID-19 inflammatory complication in this case DHA combined with retinoic acid is expected to be effective in inhibiting IL-6 and IL-17.

Thyroid Crisis , Respiratory Syncytial Virus Infections , Multiple Sclerosis , Theileriasis , Fever , Gastrointestinal Diseases , Pharyngitis
researchsquare; 2021.


Cytokine storm syndrome (CSS) is a life-threatening consequence of inflammatory immunological illnesses; it can also occur with COVID-19 infection. CSS is characterized by a disruption in cytokine synthesis, including regulatory, pro-inflammatory and anti-inflammatory cytokines, resulting in pathologic stimulation of innate in addition to adaptive (Th17 and Th1 mediated) response. In the pathophysiology of CSS, interleukin-6 could play a key role. The significant role of IL-6 in COVID-19 pathogenesis was established in a wide variety of researches, which reported that the plasma concentration of IL-6 was raised in COVID-19 patients with severe symptoms. COVID-19 spike protein binding to angiotensin-converting enzyme 2 (ACE2), the virus's cellular receptor, causes a cascade of molecular processes that could result in hyperinflammation which may lead to cytokine storm. Therefore, the development of new natural therapies and repurposing some drugs such as Phenformin and Docosahexaenoic acid that could compete with COVID-19 for ACE2 binding or inhibit IL-6 activity may possibly help COVID-19 patients avoid a cytokine storm and save their lives through inhibiting IL-6 and preventing SARS-CoV-2 RBD attachment to ACE2. Herein we made a docking based screening for some natural phytochemicals and drugs that could be repurposed according to our findings to counter COVID-19 cell entry and inhibit the hyper activation of IL-6. Our results revealed that a five phytochemicals including Epigallocatechin gallate (EGCG), bromelain, luteolin, vitexin and isovitexin) showed a high binding affinities with best interactions with the active sites of IL-6. The binding affinities of these phytochemicals including, EGCG, bromelain, luteolin, vitexin and isovitexin with IL-6 were (-7.7, -6.7, -7.4, -7.2 and − 7.3 ), respectively. In addition to, phenformin showed a high binding affinity with best interactions with the active sites of IL-6 and ACE2. The binding affinity of phenformin with IL-6 was (-7.4) and with ACE 2 ( -7.2). Docosahexaenoic acid (DHA) had a moderate binding affinity and moderate interactions with the active sites of IL-6 and had a high binding affinity with best interactions with ACE2 active sites. The binding affinity of Docosahexaenoic acid(DHA) with IL-6 was (-5.3) and with AC2 (-6.3).ConclusionProposing possible IL-6 inhibitors with less adverse effects has been suggested as a way to aid COVID-19 patients who are suffering from severe cytokine storms. This study has been designed to elucidate the potential of potent antiviral phytocompounds as well as phenformin and Docosahexaenoic acid (DHA) as a potent ACE2 and IL-6 inhibitors. The compounds interact with different active sites of IL6 and ACE2 which are involved in direct or indirect contacts with the ACE2 and IL-6 receptors which might act as potential blockers of functional ACE2 and IL-6 receptor complex. It worth mentioning that phenformin which showed high binding affinity with both ACE2 and IL-6 is currently under investigation for treating COVID-19 Identifier: NCT05003492

Thyroid Crisis , Reactive Attachment Disorder
9.; 10/08/2021; TrialID: NCT05003492
Clinical Trial Register | ICTRP | ID: ictrp-NCT05003492





Combination Product: Combination therapy plus Standard therapy;Radiation: Photodynamic therapy;Drug: Standard therapy

Primary outcome:

lung injury score


Inclusion Criteria:

Adult SARI patients with 2019-ncov infection confirmed by PCR; Absolute value of
lymphocytes < 0. 6x 109/L; Severe respiratory failure within 48 hours and requires
admission to ICU. (severe respiratory failure was defined as PaO2/FiO2 < 200 mmHg and was
supported by positive pressure mechanical ventilation (including non-invasive and invasive
mechanical ventilation, PEEP>=5cmH2O))

Exclusion Criteria:

- Age < 18

- A history of renal failure (unless recovered for at least 6 months), lactic acidosis,
recurrent or severe hypoglycemia.

- A history of known glucose-6-phosphate dehydrogenase (G6PD) deficiency.

- Other uncontrolled intercurrent illness including, but not limited to, ongoing or
active infection, symptomatic congestive heart failure, unstable angina pectoris,
cardiac arrhythmia, or psychiatric illness/social situations that would limit
compliance with study requirements

- Allergic to experimental drugs and patients have the following conditions:

- Medical records of cirrhosis

- Myocardial infarction, developed after the patient was included in the study, but
before the intervention

- bleeding, developed after the patient was included in the study, but before the

- connection to artificial lung ventilation developed after the patient was included in
the study, but before the intervention

- Active infection, or chronic or persistent infection that might worsen with
immunosuppressive treatment (e.g., HIV, hepatitis B virus, hepatitis C virus,
tuberculosis [TB])

- Liver disease

- Renal disease

- Pregnancy

- Lactation

- Depressive disorder

- Body mass index less than 18 points or higher than 25 points

- Contraindications for hormonal contraception or intrauterine device.

- Autoimmune diseases

- A history of organ, bone marrow or hematopoietic stem cell transplantation

- Patients receiving anti-hcv treatment

- The competent physician considered it inappropriate to participate in the study

Eur J Clin Invest ; 51(9): e13645, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1286673


BACKGROUND: Colchicine was recently repurposed for the management of coronavirus disease 2019 (COVID-19). This rapid review and meta-analysis aimed to assess colchicine's impact on mortality outcomes in COVID-19 patients. MATERIALS AND METHODS: We systematically searched PubMed, EMBASE, Google Scholar since their inception till 25/03/2021 for observational or controlled studies that reported mortality as an outcome. The mortality odd ratios were generated with their corresponding 95% confidence intervals utilizing the random-effects model. RESULTS: Nine studies comprising 5522 patients met our inclusion criteria. Our meta-analysis revealed significantly lower mortality in the colchicine group (OR 0.35, 95% CI 0.25-0.48, I2 0%) compared with controls. A subgroup analysis limited to hospitalized patients (OR 0.35, 95% CI 0.25-0.50, I2 0%) revealed similarly lower mortality in the colchicine group. CONCLUSIONS: This meta-analysis suggests a mortality benefit with colchicine when used in the treatment of COVID-19 patients. The majority of included studies were observational; thus, the findings of this review need to be further supported by the results of ongoing trials.

COVID-19/drug therapy , Colchicine/therapeutic use , Tubulin Modulators/therapeutic use , COVID-19/mortality , Humans , Odds Ratio , SARS-CoV-2
Front Pediatr ; 9: 634844, 2021.
Article in English | MEDLINE | ID: covidwho-1133941


Objective: We aimed to describe the presentations and biochemical characteristics of sepsis-like syndrome (SLS) in infants aged <2 months who tested positive for SARS-CoV-2-in comparison to those in the same age group who were SARS-CoV-2-negative. Background: COVID-19 presents with a spectrum of manifestations, and children seem to have a favorable clinical course compared to other age groups. Limited data are available for symptomatic infants. Design: This was a case-controlled single-institution retrospective study on infants aged <2 months admitted with SLS between 1 April 2020 and 1 July 2020. These infants were divided into 2 groups: Group 1 (n = 41), infants with positive nasal/oropharyngeal swab polymerase chain reaction (PCR) results for SARS-CoV-2; and Group 2 (n = 40), infants with negative PCR results for SARS-CoV-2 (control group). Details between both groups were reviewed and analyzed. Outcome: The clinical and laboratory data for SARS-CoV-2 -positive infants who presented with SLS may differ from those for infants with SLS who tested negative for SARS-CoV-2. Results: Overall, 105 infants were admitted with clinical sepsis: 41 were SARS-CoV-2-positive, and 64 were negative. Fever was present in 90% of SARS-CoV-2-positive infants vs. 80% of the negative group. SARS-CoV-2-positive infants had a higher incidence of nasal congestion and cough (39 and 29%, respectively) compared to the SARS-CoV-2-negative group (20 and 3%, respectively) (P < 0.05). Poor feeding and hypoactivity occurred more frequently in the SARS-CoV-2-negative group (58 and 45%, respectively) than in the SARS-CoV-2-positive group (22 and 12%, respectively, P < 0.004). Sepsis workup, including lumbar puncture, was performed in 67% and partial septic workup was performed in 23% of the SARS-CoV-2-positive infants. Full sepsis workup was performed in 92% of the SARS-CoV-2-negative group. Cerebrospinal fluid (CSF) cultures were negative in 26/27SARS-CoV-2-positive infants (an infant had Klebsiella meningitis). All the SARS-CoV-2-negative infants had negative CSF cultures. Blood culture was negative in both groups. Urine culture showed bacterial growth in 9 infants with SARS-CoV-2-negative sepsis. Conclusions: Our study showed that respiratory symptoms (cough and nasal congestion) were more prominent in the SARS-CoV-2-positive group, while poor feeding and hypoactivity were reported more frequently in the negative group. However, the clinical differentiation between COVID-19 disease and sepsis in such age groups is difficult. Therefore, screening young infants with SLS for SARS-CoV-2- is necessary during this pandemic.

researchsquare; 2020.


Background All over the world, severe Acute Respiratory Syndrome coronavirus-2 (SARS-CoV-2) has been the most important public health issue this year; recently this was re-named as corona virus disease 2019 (COVID-19) by the World Health Organization (WHO). Olfactory or gustatory dysfunction is often reported as a symptom.Aims Aim of the study is to evaluate the role and effectiveness of Doxycycline, Oral Methyl Prednisolone, and Topical Nasal Steroid (Mometasone) in the treatment of COVID-19 related anosmia/hyposmiaMaterial and Methods Total 64 patients were evaluated randomly who were COVID-19 positive and developed recent onset of anosmia/hyposmia. They were divided into two groups 32 each. First group was treated with Doxycycline, Oral Methyl Prednisolone, and Topical Nasal Steroid (Mometasone). Second group was the control group and was given placebo and Olfactory training.Results Out of 32 patients 27 patients completely recover after only 2 days of the administration of above treatment. Out of the remaining 5 patients 4 had partial resolution of the anosmia after 2 days and near complete resolution after 5-7 days, and 1 patient did not responded at all with the above treatment. Out of the control group 19 patient had near complete recovery after 7 days and rest 13 patient did not recover after 10 days.Conclusion The above study showed a very promising results but many more similar studies are needed following the similar treatment protocol on a larger group of patients suffering from olfactory dysfunction.

Seizures , Olfaction Disorders , Coronavirus Infections
Monaldi Arch Chest Dis ; 90(4)2020 Sep 22.
Article in English | MEDLINE | ID: covidwho-789590


The National Health Service (NHS) has rapidly adopted telemedicine solutions as an alternative to face-to-face consultations during the COVID-19 pandemic. The majority of HCPs (Healthcare Professionals) were unfamiliar with Telemedicine prior to the current pandemic. Remote consultation is expected to continue for the foreseeable future, thus we designed this survey. A survey designed to evaluate the use of telephone consultation by HCPs, assessing its implementation, challenges and drawbacks. A web link survey conducted through SurveyMonkey was sent to HCPs across six UK Trusts the period of May 2020. The survey received 114 responses (84%) being doctors. 95% of respondents had not received training prior to engaging in telemedicine consultations. 64% were unaware of the updated General Medical Council guidance concerning remote consultations. The most common barrier in remote consultation was the inability to access patient records raised by 37% of respondents. However, 73% of respondents felt that patients understood their medical condition and the instructions given to them over the phone, and 70% agreed that videoconference consultations would add to patients care. Telemedicine can be used for selected groups of patients in the post COVID-19 era, and the HCPs carrying that should have the sufficient experience and knowledge expected to operate these clinics.

Attitude of Health Personnel , Coronavirus Infections/epidemiology , Pneumonia, Viral/epidemiology , Telemedicine , Betacoronavirus , COVID-19 , Gynecology , Humans , Nurse Clinicians , Obstetrics , Pandemics , Patient Satisfaction , Physicians , SARS-CoV-2 , Surgeons , Surveys and Questionnaires , United Kingdom/epidemiology
Medicine (Baltimore) ; 99(36): e21911, 2020 Sep 04.
Article in English | MEDLINE | ID: covidwho-752029


BACKGROUND: Severe acute respiratory syndrome coronavirus 2 (SARS-COV2) infection is a recently emerged viral infection causing predominantly mild upper respiratory symptoms. However, in some instances, it might result in acute respiratory distress syndrome (ARDS) that poses a significant mortality risk. ARDS is postulated to be mediated by a surge of pro-inflammatory cytokines and chemokines, leading to a dysregulated hyper inflammatory response. Colchicine being an anti-inflammatory agent, might mitigate this dysregulated response. Thus, in the absence of therapeutic options available to manage coronavirus disease 2019 (COVID-19), it is imperative to ascertain the effect of colchicine on improving outcomes in COVID-19 patients. METHOD: We will perform a systematic review including a search of the following databases: PubMed, EMBASE, MEDLINE,, Cochrane library, and google scholar since inception. We will include randomized controlled trials exploring the effect of colchicine on the efficacy and safety outcomes of COVID-19 patients. Subsequently, we will perform a meta-analysis utilizing the random-effects to ascertain the effect of colchicine on reducing COVID-19 related mortality (primary endpoint) and other efficacy and safety outcomes. RESULTS: Our review results are anticipated in early 2021 (based on the completion of several ongoing randomized controlled trial). Our review results will be published in a peer-reviewed journal. CONCLUSION: This systematic review and meta-analysis, is exploring the effect of colchicine on the efficacy and safety outcomes of COVID-19 patients. If colchicine proved to be effective, it would be a significant milestone in the management of COVID-19, a disease with limited available therapeutic options. PROSPERO REGISTRATION NUMBER: CRD42020191086.

Anti-Inflammatory Agents/therapeutic use , Colchicine/therapeutic use , Coronavirus Infections/drug therapy , Pneumonia, Viral/drug therapy , Anti-Inflammatory Agents/administration & dosage , Anti-Inflammatory Agents/adverse effects , Betacoronavirus , COVID-19 , Colchicine/administration & dosage , Colchicine/adverse effects , Humans , Pandemics , Randomized Controlled Trials as Topic , Research Design , SARS-CoV-2