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Bajaj, Jasmohan S.; Choudhury, Ashok K.; Xie, Qing; Kamath, Patrick S.; Topazian, Mark; Hayes, Peter C.; Torre, Aldo; Desalegn, Hailemichael; Idilman, Ramazan; Cao, Zhujun; Alvares-da-Silva, Mario R.; George, Jacob; Bush, Brian J.; Thacker, Leroy R.; Wong, Florence; Sarin, Shiv K.; Kumar, Shiva; Marciano, Sebastián; Gadano, Adrián; Tudehope, Fiona; Gibson, Robert; Prudence, Alexander; Doyle, Adam; Si, Hooi Ling; Riordan, Stephen; Farias, Alberto; Zitelli, Patricia; Bera, Chinmay; Faisal, Nabiha; Tandon, Puneeta; Dahiya, Monica; Lohoues, Marie Jeanne; Lah, Ponan Claude Regis; Benítez, Carlos; Arrese, Marco; Xian, Yongchao; Guan, Jin; Zhu, Chuanwu; Wang, Yingling; Su, Minghua; Su, Man; Gao, Yanhang; Wang, Xinrui; Jiang, Yongfang; Peng, Feng; Zhao, Caiyan; Wang, Wei; Wang, Lei; Yin, Dedong; Lu, Mingqin; Cai, Yijing; Zhang, Ningping; Zhang, Wanqin; Li, Hai; Dong, Fuchen; Zheng, Xin; Liu, Jing; Tang, Hong; Yan, Libo; Xu, Bin; Wei, Linlin; Gao, Zhiliang; Xu, Zhen; Lin, Minghua; Gao, Haibin; Chen, Jinjun; Li, Beiling; Liu, Chenghai; Zhang, Yanyun; Hu, Peng; Deng, Huan; Belimi, Hibat Allah; Debzi, Nabil; Fisseha, Henok; Aravinthan, Aloysious D.; Venkatachalapathy, Suresh Vasan; Rajoriya, Neil; Faulkes, Rosemary; Leith, Damien; Forrest, Ewan; Adebayo, Danielle; Kennedy, James; Yung, Diana; Seto, Wai-Kay; Fung, James; Katchman, Helena; Rabinowich, Liane; Nagral, Aabha; Jhaveri, Ajay; Kulkarni, Anand; Sharma, Mithun; Eapen, C. E.; Goel, Ashish; Gandotra, Akash; Duseja, Ajay; Saraya, Anoop; Yegurla, Jatin; Rela, Mohamed; Jothimani, Dinesh; Arora, Anil; Kumar, Ashish; Dhiman, Radha Krishan; Roy, Akash; Anand, Anil C.; Praharaj, Dibyalochan; Hueso, Sarai Gonzalez; Cabrera, Araceli Bravo; Pérez Hérnandez, José Luis; Gutierrez, Oscar Morales; Miranda Zazueta, Godolfino; Ramos-Pineda, Abraham; Castillo Barradas, Mauricio; Velazquez, Rene Male; Made, Lilian Torres; Velarde-Ruiz Velasco, José Antonio; Félix-Tellez, Francisco; Cordova-Gallardo, Jacqueline; Rajaram, Ruveena; Nik Muhamad Afendi, Nik Arsyad; Okeke, Edith N.; Nyam, David P.; Allam, Dalia; Kumar Patwa, Yashwi Haresh; Tan, Hiang Keat; Liou, Wei Lun; Treeprasertsuk, Sombat; Wejnaruemarn, Salisa; Haktaniyan, Busra; Gunduz, Feyza; Aslan, Rahmi; Yildirim, Abdullah Emre; Barutcu, Sezgin; Karasu, Zeki; Uysal, Alper; Ucbilek, Enver; Kosay, Tolga; Adanir, Haydar; Dinçer, Dinç; Albhaisi, Somaya; Asrani, Sumeet; Fallahadeh, Mohammad Amin; Reddy, K. Rajender; Rahematpura, Suditi; Shaw, Jawaid; Vargas, Hugo E.; Bayne, David; Biggins, Scott W.; Filipek, Natalia; Thuluvath, Paul; Sheshadri, Somya; Keaveny, Andrew; Duarte Rojo, Andres; Cabello Negrillo, Ricardo.
The Lancet Gastroenterology & Hepatology ; 2023.
Article in English | ScienceDirect | ID: covidwho-2321822

ABSTRACT

Summary Background Cirrhosis, the end result of liver injury, has high mortality globally. The effect of country-level income on mortality from cirrhosis is unclear. We aimed to assess predictors of death in inpatients with cirrhosis using a global consortium focusing on cirrhosis-related and access-related variables. Methods In this prospective observational cohort study, the CLEARED Consortium followed up inpatients with cirrhosis at 90 tertiary care hospitals in 25 countries across six continents. Consecutive patients older than 18 years who were admitted non-electively, without COVID-19 or advanced hepatocellular carcinoma, were enrolled. We ensured equitable participation by limiting enrolment to a maximum of 50 patients per site. Data were collected from patients and their medical records, and included demographic characteristics;country;disease severity (MELD-Na score);cirrhosis cause;medications used;reasons for admission;transplantation listing;cirrhosis-related history in the past 6 months;and clinical course and management while hospitalised and for 30 days post discharge. Primary outcomes were death and receipt of liver transplant during index hospitalisation or within 30 days post discharge. Sites were surveyed regarding availability of and access to diagnostic and treatment services. Outcomes were compared by country income level of participating sites, defined according to World Bank income classifications (high-income countries [HICs], upper-middle-income countries [UMICs], and low-income or lower-middle-income countries [LICs or LMICs]). Multivariable models controlling for demographic variables, disease cause, and disease severity were used to analyse the odds of each outcome associated with variables of interest. Findings Patients were recruited between Nov 5, 2021, and Aug 31, 2022. Complete inpatient data were obtained for 3884 patients (mean age 55·9 years [SD 13·3];2493 (64·2%) men and 1391 (35·8%) women;1413 [36·4%] from HICs, 1757 [45·2%] from UMICs, and 714 [18·4%] from LICs or LMICs), with 410 lost to follow-up within 30 days after hospital discharge. The number of patients who died while hospitalised was 110 (7·8%) of 1413 in HICs, 182 (10·4%) of 1757 in UMICs, and 158 (22·1%) of 714 in LICs and LMICs (p<0·0001), and within 30 days post discharge these values were 179 (14·4%) of 1244 in HICs, 267 (17·2%) of 1556 in UMICs, and 204 (30·3%) of 674 in LICs and LMICs (p<0·0001). Compared with patients from HICs, increased risk of death during hospitalisation was found for patients from UMICs (adjusted odds ratio [aOR] 2·14 [95% CI 1·61–2·84]) and from LICs or LMICs (2·54 [1·82–3·54]), in addition to increased risk of death within 30 days post discharge (1·95 [1·44–2·65] in UMICs and 1·84 [1·24–2·72] in LICs or LMICs). Receipt of a liver transplant was recorded in 59 (4·2%) of 1413 patients from HICs, 28 (1·6%) of 1757 from UMICs (aOR 0·41 [95% CI 0·24–0·69] vs HICs), and 14 (2·0%) of 714 from LICs and LMICs (0·21 [0·10–0·41] vs HICs) during index hospitalisation (p<0·0001), and in 105 (9·2%) of 1137 patients from HICs, 55 (4·0%) of 1372 from UMICs (0·58 [0·39–0·85] vs HICs), and 16 (3·1%) of 509 from LICs or LMICs (0·21 [0·11–0·40] vs HICs) by 30 days post discharge (p<0·0001). Site survey results showed that access to important medications (rifaximin, albumin, and terlipressin) and interventions (emergency endoscopy, liver transplantation, intensive care, and palliative care) varied geographically. Interpretation Inpatients with cirrhosis in LICs, LMICs, or UMICs have significantly higher mortality than inpatients in HICs independent of medical risk factors, and this might be due to disparities in access to essential diagnostic and treatment services. These results should encourage researchers and policy makers to consider access to services and medications when evaluating cirrhosis-related outcomes. Funding National Institutes of Health and US Department of Veterans Affairs.

2.
Clin Infect Dis ; 2022 Aug 20.
Article in English | MEDLINE | ID: covidwho-2259967

ABSTRACT

BACKGROUND: Treatment of coronavirus disease-2019 (Covid-19) with nirmatrelvir plus ritonavir (NMV-r) in high-risk non-hospitalized unvaccinated patients reduced the risk of progression to severe disease. However, the potential benefits of NMV-r among vaccinated patients are unclear. METHODS: We conducted a comparative retrospective cohort study using the TriNetX research network. Patients ≥18 years of age who were vaccinated and subsequently developed Covid-19 between December 1, 2021, and April 18, 2022, were included. Cohorts were developed based on the use of NMV-r within five days of diagnosis. The primary composite outcome was all-cause emergency room (ER) visit, hospitalization, or death at a 30-days follow-up. Secondary outcomes included individual components of primary outcomes, multisystem symptoms, Covid-19 associated complications, and diagnostic test utilization. RESULTS: After propensity score matching, 1,130 patients remained in each cohort. A primary composite outcome of all-cause ER visits, hospitalization, or death in 30 days occurred in 89 (7.87%) patients in the NMV-r cohort as compared to 163 (14.4%) patients in the non-NMV-r cohort (OR 0.5, CI 0.39-0.67; p<0.005) consistent with 45% relative risk reduction. A significant reduction in multisystem symptom burden and subsequent complications such as lower respiratory tract infection, cardiac arrhythmia, and diagnostic radiology testing were noted in NMV-r treated patients. There was no apparent increase serious complications between days 10 to 30. CONCLUSION: Treatment with NMV-r in non-hospitalized vaccinated patients with Covid-19 was associated with a reduced likelihood of emergency room visits, hospitalization, or death. Complications and overall resource utilization were also decreased.

3.
Biochim Biophys Acta Mol Basis Dis ; 1869(3): 166634, 2023 03.
Article in English | MEDLINE | ID: covidwho-2228036

ABSTRACT

Coronavirus disease 19 (COVID-19) is caused by a highly contagious RNA virus Severe Acute Respiratory Syndrome coronavirus-2 (SARS-CoV-2), originated in December 2019 in Wuhan, China. Since then, it has become a global public health concern and leads the disease table with the highest mortality rate, highlighting the necessity for a thorough understanding of its biological properties. The intricate interaction between the virus and the host immune system gives rise to diverse implications of COVID-19. RNA viruses are known to hijack the host epigenetic mechanisms of immune cells to regulate antiviral defence. Epigenetics involves processes that alter gene expression without changing the DNA sequence, leading to heritable phenotypic changes. The epigenetic landscape consists of reversible modifications like chromatin remodelling, DNA/RNA methylation, and histone methylation/acetylation that regulates gene expression. The epigenetic machinery contributes to many aspects of SARS-CoV-2 pathogenesis, like global DNA methylation and receptor angiotensin-converting enzyme 2 (ACE2) methylation determines the viral entry inside the host, viral replication, and infection efficiency. Further, it is also reported to epigenetically regulate the expression of different host cytokines affecting antiviral response. The viral proteins of SARS-CoV-2 interact with various host epigenetic enzymes like histone deacetylases (HDACs) and bromodomain-containing proteins to antagonize cellular signalling. The central role of epigenetic factors in SARS-CoV-2 pathogenesis is now exploited as promising biomarkers and therapeutic targets against COVID-19. This review article highlights the ability of SARS-CoV-2 in regulating the host epigenetic landscape during infection leading to immune evasion. It also discusses the ongoing therapeutic approaches to curtail and control the viral outbreak.


Subject(s)
COVID-19 , Humans , COVID-19/genetics , SARS-CoV-2 , Antiviral Agents/therapeutic use , Cytokines , Epigenesis, Genetic
4.
Journal of International Financial Markets, Institutions and Money ; 77:101523-101523, 2022.
Article in English | EuropePMC | ID: covidwho-2168806
5.
International Journal of Hospitality & Tourism Systems ; 15(COVID-19 Issue):31-39, 2022.
Article in English | CAB Abstracts | ID: covidwho-2167572
6.
J Electrocardiol ; 75: 1-9, 2022.
Article in English | MEDLINE | ID: covidwho-2150049

ABSTRACT

BACKGROUND: The electrocardiography (ECG) has short-term prognostic value in coronavirus disease 2019 (COVID-19), yet its ability to predict long-term mortality is unknown. This study aimed to elucidate the predictive role of initial ECG on long-term all-cause mortality in patients diagnosed with COVID-19. METHODS: In this prospective cohort study, adults with COVID-19 who underwent ECG testing within a 17-hospital health system in Northeast Ohio and Florida between 03/2020-06/2020 were identified. An expert ECG reader analyzed all studies blinded to patient status. The associations of ECG characteristics with long-term all-cause mortality and intensive care unit (ICU) admission were assessed using Cox proportional hazards regression model and multivariable logistic regression models, respectively. Status of long-term mortality was adjudicated on 01/07/2022. RESULTS: Of 837 patients (median age 65 years, 51% female, 44% Black), 683 (81.6%) were hospitalized, 281 (33.6%) required ICU admission, 67 (8.0%) died in-hospital, and 206 (24.6%) died at final follow-up after a median (IQR) of 21 (9-103) days after ECG. Overall, 179 (20.7%) patients presented with sinus tachycardia, 12 (1.4%) with atrial flutter, and 45 (5.4%) with atrial fibrillation (AF). After multivariable adjustment, sinus tachycardia (E-value for HR=3.09, lower CI=2.2) and AF (E-value for HR=3.13, lower CI=2.03) each independently predicted all-cause mortality. At final follow-up, patients with AF had 64.5% probability of death compared with 20.5% for those with normal sinus rhythm (P<.0001). CONCLUSIONS: Sinus tachycardia and AF on initial ECG strongly predict long-term all-cause mortality in COVID-19. The ECG can serve as a powerful long-term prognostic tool in COVID-19.


Subject(s)
Atrial Fibrillation , COVID-19 , Adult , Humans , Female , Aged , Male , Electrocardiography , Prognosis , Prospective Studies , Tachycardia, Sinus , Atrial Fibrillation/diagnosis
7.
Front Med (Lausanne) ; 9: 955930, 2022.
Article in English | MEDLINE | ID: covidwho-2123424

ABSTRACT

Background: Recent studies on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reveal that Omicron variant BA.1 and sub-lineages have revived the concern over resistance to antiviral drugs and vaccine-induced immunity. The present study aims to analyze the clinical profile and genome characterization of the SARS-CoV-2 variant in eastern Uttar Pradesh (UP), North India. Methods: Whole-genome sequencing (WGS) was conducted for 146 SARS-CoV-2 samples obtained from individuals who tested coronavirus disease 2019 (COVID-19) positive between the period of 1 January 2022 and 24 February 2022, from three districts of eastern UP. The details regarding clinical and hospitalized status were captured through telephonic interviews after obtaining verbal informed consent. A maximum-likelihood phylogenetic tree was created for evolutionary analysis using MEGA7. Results: The mean age of study participants was 33.9 ± 13.1 years, with 73.5% accounting for male patients. Of the 98 cases contacted by telephone, 30 (30.6%) had a travel history (domestic/international), 16 (16.3%) reported having been infected with COVID-19 in past, 79 (80.6%) had symptoms, and seven had at least one comorbidity. Most of the sequences belonged to the Omicron variant, with BA.1 (6.2%), BA.1.1 (2.7%), BA.1.1.1 (0.7%), BA.1.1.7 (5.5%), BA.1.17.2 (0.7%), BA.1.18 (0.7%), BA.2 (30.8%), BA.2.10 (50.7%), BA.2.12 (0.7%), and B.1.617.2 (1.3%) lineages. BA.1 and BA.1.1 strains possess signature spike mutations S:A67V, S:T95I, S:R346K, S:S371L, S:G446S, S:G496S, S:T547K, S:N856K, and S:L981F, and BA.2 contains S:V213G, S:T376A, and S:D405N. Notably, ins214EPE (S1- N-Terminal domain) mutation was found in a significant number of Omicron BA.1 and sub-lineages. The overall Omicron BA.2 lineage was observed in 79.5% of women and 83.2% of men. Conclusion: The current study showed a predominance of the Omicron BA.2 variant outcompeting the BA.1 over a period in eastern UP. Most of the cases had a breakthrough infection following the recommended two doses of vaccine with four in five cases being symptomatic. There is a need to further explore the immune evasion properties of the Omicron variant.

9.
Contrast Media Mol Imaging ; 2022: 1306664, 2022.
Article in English | MEDLINE | ID: covidwho-2088963

ABSTRACT

Artificial Intelligence (AI) has been applied successfully in many real-life domains for solving complex problems. With the invention of Machine Learning (ML) paradigms, it becomes convenient for researchers to predict the outcome based on past data. Nowadays, ML is acting as the biggest weapon against the COVID-19 pandemic by detecting symptomatic cases at an early stage and warning people about its futuristic effects. It is observed that COVID-19 has blown out globally so much in a short period because of the shortage of testing facilities and delays in test reports. To address this challenge, AI can be effectively applied to produce fast as well as cost-effective solutions. Plenty of researchers come up with AI-based solutions for preliminary diagnosis using chest CT Images, respiratory sound analysis, voice analysis of symptomatic persons with asymptomatic ones, and so forth. Some AI-based applications claim good accuracy in predicting the chances of being COVID-19-positive. Within a short period, plenty of research work is published regarding the identification of COVID-19. This paper has carefully examined and presented a comprehensive survey of more than 110 papers that came from various reputed sources, that is, Springer, IEEE, Elsevier, MDPI, arXiv, and medRxiv. Most of the papers selected for this survey presented candid work to detect and classify COVID-19, using deep-learning-based models from chest X-Rays and CT scan images. We hope that this survey covers most of the work and provides insights to the research community in proposing efficient as well as accurate solutions for fighting the pandemic.


Subject(s)
COVID-19 , Deep Learning , Humans , COVID-19/diagnostic imaging , Pandemics , Artificial Intelligence , SARS-CoV-2
11.
Curr Cardiol Rep ; 24(9): 1117-1127, 2022 09.
Article in English | MEDLINE | ID: covidwho-2003760

ABSTRACT

PURPOSE OF REVIEW: The purpose of this article is to provide a comprehensive review of available data on health disparities and the interconnected social determinants of health (SDOH) in cardio-oncology. We identify the gaps in the literature and suggest areas for future research. In addition, we propose strategies to address these disparities at various levels. RECENT FINDINGS: There has been increasing recognition of health disparities and the role of SODH on an individual's access to health care, quality of care, and outcomes of the illness. There is growing evidence of sex and race-based differences in cancer therapy-related cardiotoxicity. Recent studies have shown how access and quality of health care are affected by financial stability and rurality. Our recent study utilizing the social vulnerability index (SVI) and county-level patient data found graded increase in county-level cardio-oncology mortality with greater social vulnerability. The incremental impact of social vulnerability was higher for cardio-oncology mortality than for mortality related to either cancer or CVD alone. The mortality rates in these patients were higher in rural areas compared to urban areas regardless of social vulnerability. Additionally, for those within the counties within highest social vulnerability, Black individuals had significantly higher cardio-oncology mortality compared with White individuals. Disparities in the cardio-oncology population are deep-rooted and widespread, leading to poor quality of life and increased mortality. It is crucial to integrate SDOH, not only in clinical care delivery but also in future research, and registry data to improve our understanding and the outcomes in our unique subset of cardio-oncology patients.


Subject(s)
Neoplasms , Quality of Life , Humans , Medical Oncology , Neoplasms/drug therapy , Rural Population , White People
13.
Cell Death Dis ; 13(6): 520, 2022 Jun 02.
Article in English | MEDLINE | ID: covidwho-1921605

ABSTRACT

Intracellular and cell surface pattern-recognition receptors (PRRs) are an essential part of innate immune recognition and host defense. Here, we have compared the innate immune responses between humans and bats to identify a novel membrane-associated protein, Rnd1, which defends against viral and bacterial infection in an interferon-independent manner. Rnd1 belongs to the Rho GTPase family, but unlike other small GTPase members, it is constitutively active. We show that Rnd1 is induced by pro-inflammatory cytokines during viral and bacterial infections and provides protection against these pathogens through two distinct mechanisms. Rnd1 counteracts intracellular calcium fluctuations by inhibiting RhoA activation, thereby inhibiting virus internalisation. On the other hand, Rnd1 also facilitates pro-inflammatory cytokines IL-6 and TNF-α through Plxnb1, which are highly effective against intracellular bacterial infections. These data provide a novel Rnd1-mediated innate defense against viral and bacterial infections.


Subject(s)
Bacterial Infections , Immunity, Innate , Cytokines , Humans , Interferons , Receptors, Pattern Recognition , rho GTP-Binding Proteins/genetics
14.
Journal of Physics: Conference Series ; 2267(1):012125, 2022.
Article in English | ProQuest Central | ID: covidwho-1877006
15.
Journal of the American College of Cardiology (JACC) ; 79(9):2088-2088, 2022.
Article in English | Academic Search Complete | ID: covidwho-1751319
16.
MEDLINE; 2020.
Non-conventional in English | MEDLINE | ID: grc-750606

ABSTRACT

BACKGROUND: COVID-19 is a new disease which has become a global pandemic, and is caused by a novel coronavirus, SARS-CoV-2. The disease is still not very well characterized, and factors associated with severe clinical course are not well known. METHODS: The main objectives were to determine the demographic, clinical and laboratory manifestations of COVID-19 and to identify the factors associated with severe clinical course. We searched the PubMed for studies published between Jan 1, 2020 and Mar 17, 2020, and included them if they were in English language, published in full, were retrospective or prospective observational or case control study with data on clinical, laboratory and imaging features of adult patients with COVID-19 disease from single or multiple centers. Studies that included exclusively pediatric patients were excluded. The demographic, clinical and laboratory data was displayed as n (%) or mean (SD). The meta-analysis on factors associated with severe clinical course was performed using the random effects model, and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated as the effect sizes. FINDINGS: We included 58 studies (6892 patients) for the systematic review on clinical manifestations and 21 studies (3496 patients) for meta-analysis on factors associated with severe clinical course. The mean age of patients with COVID-19 is 49.7±16.3 years with a male to female ratio of 1.2:1. Common symptoms and their frequency are: fever (83.4%), cough (60.5%), fatigue (33.8%), sputum (28.9%), dyspnea (22.1%), myalgia (20.6%), chest tightness / pain (16.3%), sore throat (13.5%), headache (11.2%), diarhhea (7.5%), nasal congestion / rhinorrhea (6.7%), nausea / vomiting (5.6%), pain abdomen (4.6%), and hemoptysis (1.7%). The comorbidities associated with COVID-19 are: hypertension (18.4%), diabetes mellitus (9.8%), cardiovascular diseases (8.8%), endocrine diseases (5.8%), gastrointestinal diseases (5%), CLD (3%), and COPD (2.8%). Among the laboratory parameters WBC was low in 27%, high in 9%, platelets were low in 22.9%, creatinine was high in 6.5%, AST was high in 25.3%, ALT was high in 22.7%, bilirubin was high in 8.8%, albumin was low 60.1%, CT chest was abnormal in 89%, CRP was high in 67.5%, LDH was high in 52%, D-dimer was high in 34.8%, CK was high in 14.4%, and procalcitonin was high in 15.4%. Factors significantly associated severe clinical course (with their ORs) are as follows: High CRP (5.78), high procalcitonin (5.45), age >60 (4.82), dyspnea (4.66), high LDH (4.59), COPD (4.37), low albumin (4.34), high D-dimer (4.03), cardiac disease (3.88), low lymphocyte count (3.22), any associated comorbidity (3.16), diabetes mellitus (3.11), high WBC count (2.67), high bilirubin level (2.55), high creatinine (2.34), high AST (2.31), hypertension (2.30), low platelets (1.78), High ALT (1.69), high CK (1.66), fever spikes ≥39°C (1.59), diarrhea (1.55), male gender (1.47), and sputum (1.35). INTERPRETATION: Identification of these factors associated with severe COVID-19 will help the physicians working at all levels of healthcare (primary, secondary, tertiary and ICU) in determining which patients need home care, hospital care, HDU care, and ICU admission;and thus, prioritize the scarce healthcare resource use more judiciously. Many of these identified factors can also help the public at large in the current COVID-19 epidemic setting, to judge when they should seek immediate medical care. Funding Statement: None. Declaration of Interests: The authors declare no competing interests.

17.
Journal of Molecular Liquids ; : 117344, 2021.
Article in English | ScienceDirect | ID: covidwho-1370650
18.
Cureus ; 13(8): e16877, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1359406

ABSTRACT

Background and objective QT prolongation is associated with an increased risk of ventricular arrhythmias. Since some patients on contact or droplet precautions require QT-prolonging medications, monitoring the QT interval may become imperative to prevent fatal arrhythmias. To limit the exposure of staff to patients during and even after the coronavirus disease 2019 (COVID-19) pandemic and judiciously use personal protective equipment (PPE), it is important to find alternatives to frequent 12-lead electrocardiograms (ECG). The objective of this study was to compare QT intervals measured on telemetry to those measured on 12-lead ECG to determine whether telemetry QT interval measurements could be used in place of 12-lead measurements. Methods Simultaneous telemetry recordings via a Philips telemetry monitoring system (Philips Healthcare, Eindhoven, Netherlands) and 12-lead ECGs were obtained from 50 patients. Patients were from cardiac telemetry and cardiac intensive care units. QT interval from the telemetry system was compared to the QT interval on the 12-lead ECG. QT intervals on two telemetry strips were uninterpretable as the termination of the T-wave could not be defined appropriately; therefore, these patients were excluded. Results In 33 of 48 patients (69%), QT intervals from the telemetry studies matched the QT intervals measured by 12-lead ECG. The intraclass correlation coefficient (ICC) between telemetry QT and 12-lead ECG QT was 0.887 (95% CI: 0.809-0.934; p<0.001). In 15 of 48 patients (31%), the QT intervals measured from telemetry were different from those measured by 12-lead ECG. These patients either had an abnormal rhythm, conduction abnormalities, or repolarization abnormalities at baseline. Conclusion Telemetry is a suitable alternative for measuring QT intervals in the majority of patients. However, those with baseline ECG abnormalities should have serial 12-lead ECGs. This can reduce the risk of staff exposure to pathogens and prevent overuse of PPE during the COVID-19 pandemic and for other patients in isolation.

19.
J Mol Liq ; 342: 116942, 2021 Nov 15.
Article in English | MEDLINE | ID: covidwho-1324277

ABSTRACT

The scientific community is continuously working to discover drug candidates against potential targets of SARS-CoV-2, but effective treatment has not been discovered yet. The virus enters the host cell through molecular interaction with its enzymatic receptors i.e., ACE2 and TMPRSS2, which, if, synergistically blocked can lead to the development of novel drug candidates. In this study, 1503 natural bioactive compounds were screened by HTVS, followed by SP and XP docking using Schrodinger Maestro software. Bio-0357 (protozide) and Bio-597 (chrysin) were selected for dynamics simulation based on synergistic binding affinity on S1 (docking score -9.642 and -8.78 kcal/mol) and S2 domains (-5.83 and -5.3 kcal/mol), and the RMSD, RMSF and Rg analyses showed stable interaction. The DFT analysis showed that the adsorption of protozide/chrysin, the band gap of protozide/chrysin-F/G reduced significantly. From SERS, results, it can be concluded that QDs nanocluster will act as a sensor for the detection of drugs. The docking study showed Bio-0357 and Bio-0597 bind to both S1 and S2 domains through stable molecular interactions, which can lead to the discovery of new drug candidates to prevent the entry of SARS-CoV-2. This in-silico study may be helpful to researchers for further in vitro experimental validation and development of new therapy for COVID-19.

20.
Eur Heart J ; 41(39): 3782-3783, 2020 10 14.
Article in English | MEDLINE | ID: covidwho-1319164
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