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1.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-335446

ABSTRACT

Pathogenic infections cause thymic atrophy, perturb thymic-T cell development and alter immunological response. Previous studies reported dysregulated T cell function and lymphopenia in coronavirus disease-19 (COVID-19) patients. However, immune-pathological changes, in the thymus, post severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection have not been elucidated. Here, we report SARS-CoV-2 infects thymocytes, depletes CD4 + CD8+ (double positive;DP) T cell population associated with an increased apoptosis of thymocytes, which leads to severe thymic atrophy in K18-hACE2-Tg mice. CD44 + CD25- T cells were found to be enriched in infected thymus, indicating an early arrest in the T cell developmental pathway. Further, Interferon gamma (IFN-γ) was crucial for thymic atrophy, as anti-IFN-g antibody neutralization rescued the loss of thymic involution. Therapeutic use of remdesivir (prototype anti-viral drug) was also able to rescue thymic atrophy. While Omicron variant of SARS-CoV2 caused marginal thymic atrophy, delta variant of SARS-CoV-2 exhibited most profound thymic atrophy characterized by severely depleted DP T cells. Recently characterized broadly SARS-CoV-2 neutralizing monoclonal antibody P4A2 was able to rescue thymic atrophy and restore thymic developmental pathway of T cells. Together, we provide the first report of SARS-CoV-2 associated thymic atrophy resulting from impaired T cell developmental pathway and also explains dysregulated T cell function in COVID-19.

2.
3.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-333046

ABSTRACT

Pathogenic infections cause thymic atrophy, perturb thymic-T cell development and alter immunological response. Previous studies reported dysregulated T cell function and lymphopenia in coronavirus disease-19 (COVID-19) patients. However, immune-pathological changes, in the thymus, post severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection have not been elucidated. Here, we report SARS-CoV-2 infects thymocytes, depletes CD4+CD8+ (double positive;DP) T cell population associated with an increased apoptosis of thymocytes, which leads to severe thymic atrophy in K18-hACE2-Tg mice. CD44+CD25-T cells were found to be enriched in infected thymus, indicating an early arrest in the T cell developmental pathway. Further, Interferon gamma (IFN-γ) was crucial for thymic atrophy, as anti-IFN-γ antibody neutralization rescued the loss of thymic involution. Therapeutic use of remdesivir (prototype anti-viral drug) was also able to rescue thymic atrophy. While Omicron variant of SARS-CoV2 caused marginal thymic atrophy, delta variant of SARS-CoV-2 exhibited most profound thymic atrophy characterized by severely depleted DP T cells. Recently characterized broadly SARS-CoV-2 neutralizing monoclonal antibody P4A2 was able to rescue thymic atrophy and restore thymic developmental pathway of T cells. Together, we provide the first report of SARS-CoV-2 associated thymic atrophy resulting from impaired T cell developmental pathway and also explains dysregulated T cell function in COVID-19.

4.
Proc Natl Acad Sci U S A ; 119(13): e2115276119, 2022 Mar 29.
Article in English | MEDLINE | ID: covidwho-1774039

ABSTRACT

SignificanceThe treatment of hypoxemia that is refractory to the current standard of care is time-sensitive and requires skilled caregivers and use of specialized equipment (e.g., extracorporeal membrane oxygenation). Most patients experiencing refractory hypoxemia will suffer organ dysfunction, and death is common in this cohort. Here, we describe a new strategy to stabilize and support patients using a microfluidic device that administers oxygen gas directly to the bloodstream in real time and on demand using a process that we call sequential shear-induced bubble breakup. If successful, the described technology may help to avoid or decrease the incidence of ventilator-related lung injury from refractory hypoxemia.

5.
Lancet Infect Dis ; 22(4): 473-482, 2022 04.
Article in English | MEDLINE | ID: covidwho-1757985

ABSTRACT

BACKGROUND: SARS-CoV-2 variants of concern (VOCs) have threatened COVID-19 vaccine effectiveness. We aimed to assess the effectiveness of the ChAdOx1 nCoV-19 vaccine, predominantly against the delta (B.1.617.2) variant, in addition to the cellular immune response to vaccination. METHODS: We did a test-negative, case-control study at two medical research centres in Faridabad, India. All individuals who had a positive RT-PCR test for SARS-CoV-2 infection between April 1, 2021, and May 31, 2021, were included as cases and individuals who had a negative RT-PCR test were included as controls after matching with cases on calendar week of RT-PCR test. The primary outcome was effectiveness of complete vaccination with the ChAdOx1 nCoV-19 vaccine against laboratory-confirmed SARS-CoV-2 infection. The secondary outcomes were effectiveness of a single dose against SARS-CoV-2 infection and effectiveness of a single dose and complete vaccination against moderate-to-severe disease among infected individuals. Additionally, we tested in-vitro live-virus neutralisation and T-cell immune responses to the spike protein of the wild-type SARS-CoV-2 and VOCs among healthy (anti-nucleocapsid antibody negative) recipients of the ChAdOx1 nCoV-19 vaccine. FINDINGS: Of 2379 cases of confirmed SARS-CoV-2 infection, 85 (3·6%) were fully vaccinated compared with 168 (8·5%) of 1981 controls (adjusted OR [aOR] 0·37 [95% CI 0·28-0·48]), giving a vaccine effectiveness against SARS-CoV-2 infection of 63·1% (95% CI 51·5-72·1). 157 (6·4%) of 2451 of cases and 181 (9·1%) of 1994) controls had received a single dose of the ChAdOx1 nCoV-19 vaccine (aOR 0·54 [95% CI 0·42-0·68]), thus vaccine effectiveness of a single dose against SARS-CoV-2 infection was 46·2% (95% CI 31·6-57·7). One of 84 cases with moderate-to-severe COVID-19 was fully vaccinated compared with 84 of 2295 cases with mild COVID-19 (aOR 0·19 [95% CI 0·01-0·90]), giving a vaccine effectiveness of complete vaccination against moderate-to-severe disease of 81·5% (95% CI 9·9-99·0). The effectiveness of a single dose against moderate-to-severe disease was 79·2% (95% CI 46·1-94·0); four of 87 individuals with moderate-to-severe COVID-19 had received a single dose compared with 153 of 2364 participants with mild disease (aOR 0·20 [95% CI 0·06-0·54]). Among 49 healthy, fully vaccinated individuals, neutralising antibody responses were lower against the alpha (B.1.1.7; geometric mean titre 244·7 [95% CI 151·8-394·4]), beta (B.1.351; 97·6 [61·2-155·8]), kappa (B.1.617.1; 112·8 [72·7-175·0]), and delta (88·4 [61·2-127·8]) variants than against wild-type SARS-CoV-2 (599·4 [376·9-953·2]). However, the antigen-specific CD4 and CD8 T-cell responses were conserved against both the delta variant and wild-type SARS-CoV-2. INTERPRETATION: The ChAdOx1 nCoV-19 vaccine remained effective against moderate-to-severe COVID-19, even during a surge that was dominated by the highly transmissible delta variant of SARS-CoV-2. Spike-specific T-cell responses were maintained against the delta variant. Such cellular immune protection might compensate for waning humoral immunity. FUNDING: Department of Biotechnology India, Council of Scientific and Industrial Research India, and Fondation Botnar.


Subject(s)
COVID-19 , SARS-CoV-2 , Antibody Formation , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines , Case-Control Studies , Humans , Vaccination
6.
Spatial Information Research ; : 1-10, 2022.
Article in English | EuropePMC | ID: covidwho-1743628

ABSTRACT

The present study analysed the spatial distribution of Aerosol Optical Depth (AOD) over India during the COVID-19 lockdown phase -1 (March 25 to April 15, 2020) using MODIS Terra (MOD04) AOD data (550 nm) during 2001–2020. Air temperature, rainfall, forest fire incidents, and wind patterns were analysed to understand their effect on the distribution of aerosols over India during the lockdown phase-1. Moderate absorption fine aerosol type is predominant but sparsely distributed over India during the study period compared to the reference period indicating the positive influence of the lockdown. Mean AOD has reduced by 9% over India during the lockdown phase-1 compared to the corresponding mean of the past 19 years (2001–2019). About 70% of the states/UTs of India showed a reduction in mean AOD due to restrictions on non-essential economic activities and rainfall occurrence. However, some states showed an increase in aerosol loading over specific pockets despite the restrictions on economic activities (Arunachal Pradesh, Assam, Gujarat, Orissa, Andhra Pradesh, Madhya Pradesh, Chhattisgarh, Maharashtra, Assam, Nagaland, Manipur and Karnataka) because of active forest fire cases. This study would be helpful for planners and policymakers to adopt suitable measures to control the rising concentrations of aerosols over hotspot regions of India.

7.
EuropePMC; 2022.
Preprint in English | EuropePMC | ID: ppcovidwho-330210

ABSTRACT

The emergence of new variants of SARS-CoV-2 necessitates unremitting efforts to discover novel therapeutic mAbs. Here, we report an extremely potent mAb named P4A2 that can neutralize all the circulating variants of concerns (VOCs) with high efficiency, including the highly transmissible Omicron. The crystal structure of the P4A2 Fab:RBD complex revealed that the residues of the RBD that interact with P4A2 are part of the ACE2-receptor-binding motif and are not mutated in any of the VOCs. The pan coronavirus pseudotyped neutralization assay confirmed that the P4A2 mAb is specific for SARS-CoV-2 and its VOCs. Passive administration of P4A2 to K18-hACE2 transgenic mice conferred protection, both prophylactically and therapeutically, against challenge with VOCs. Overall, our data shows that, the P4A2 mAb has immense therapeutic potential to neutralize the current circulating VOCs and will be highly effective against future variants as well due to its unique mode of binding.

8.
Thromb J ; 20(1): 11, 2022 Mar 04.
Article in English | MEDLINE | ID: covidwho-1717969

ABSTRACT

BACKGROUND: Vaccine-induced thrombotic thrombocytopenia (VITT) is a rare but devastating adverse event following adenoviral vector-based vaccinations for COVID-19, resulting in thrombosis, especially of the cerebral and splanchnic vasculature. Despite the progress in laboratory techniques for early diagnosis, VITT remains a clinical diagnosis supplemented by coagulation studies. We report on VITT for the first time from India. CASE: We describe cortical venous sinus thrombosis and intracerebral bleed associated with severe thrombocytopenia in two young men who had no other contributory cause besides a recent ChAdOx1 nCoV-19 vaccination. The diagnosis was supported with PF-4 antibodies in one patient. The second patient's test could not be processed to technical limitations. Both patients were treated with IVIG at 1 g/kg for 2 days and anticoagulation (Apixaban). One patient fully recovered with no residual deficits, and the other is under treatment and recovering. CONCLUSION: VITT can cause devastating fatality and morbidity in otherwise healthy patients via potential immune-mediated effects. Clinicians should have a high suspicion index and treat VITT in the appropriate setting even if the PF-4 antibody testing by ELISA is unavailable or delayed. Though counterintuitive, clinicians must not delay the administration of non-heparin anticoagulation, IVIG and restrict platelet transfusion even in the presence of intracerebral haemorrhage.

9.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-321231

ABSTRACT

This paper presents a block-chain enabled inkjet-printed ultrahigh frequency radiofrequency identification (UHF RFID) system for the supply chain management, traceability and authentication of hard to tag bottled consumer products containing fluids such as water, oil, juice, and wine. In this context, we propose a novel low-cost, compact inkjet-printed UHF RFID tag antenna design for liquid bottles, with 2.5 m read range improvement over existing designs along with robust performance on different liquid bottle products. The tag antenna is based on a nested slot-based configuration that achieves good impedance matching around high permittivity surfaces. The tag was designed and optimized using the characteristic mode analysis. Moreover, the proposed RFID tag was commercially tested for tagging and billing of liquid bottle products in a conveyer belt and smart refrigerator for automatic billing applications. With the help of block-chain based product tracking and a mobile application, we demonstrate a real-time, secure and smart supply chain process in which items can be monitored using the proposed RFID technology. We believe the standalone system presented in this paper can be deployed to create smart contracts that benefit both the suppliers and consumers through the development of trust. Furthermore, the proposed system will paves the way towards authentic and contact-less delivery of food, drinks and medicine in recent Corona virus pandemic.

10.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-313481

ABSTRACT

Vaccine induced thrombotic thrombocytopenia (VITT) is a rare but devastating adverse event following adenoviral vector based vaccinations for COVID-19. Guidance statements and available reports lack clarity on the choice of imaging modalities and emphasize on the need for specialized tests as a requisite criterion. Such tests have practical limitations of availability likely to restrict the treatment and reporting of such catastrophic events and need reconsideration. We describe two young men with VITT who had no other contributory cause besides a recent ChAdOx1 nCoV-19 vaccination. They were treated with IVIG and full dose anticoagulation. In both our cases the primary neuroimaging was normal and the recommended PF-4 testing was not reported due to technical limitations. Diagnosis was based on a 4T inspired score. Clinicians should report and though counter intuitive;not delay the institution of full dose anticoagulation, IVIG and limit platelet transfusion in the appropriate setting.

11.
EuropePMC; 2021.
Preprint in English | EuropePMC | ID: ppcovidwho-314677

ABSTRACT

Medical health care centers are envisioned as a promising paradigm to handle the massive volume of data of COVID-19 patients using artificial intelligence (AI). Traditionally, AI techniques often require centralized data collection and training the model in a single organization, which is most common weakness due to the privacy and security of raw data communication. To solve this challenging task, we propose a blockchain-based federated learning framework that provides collaborative data training solutions by coordinating multiple hospitals to train and share encrypted federated models without leakage of data privacy. The blockchain ledger technology provides the decentralization of federated learning model without any central server. The proposed homomorphic encryption scheme encrypts and decrypts the gradients of model to preserve the privacy. More precisely, the proposed framework: i) train the local model by a novel capsule network to segmentation and classify COVID-19 images, ii) then use the homomorphic encryption scheme to secure the local model that encrypts and decrypts the gradients, and finally the model is shared over a decentralized platform through proposed blockchain-based federated learning algorithm. The integration of blockchain and federated learning leads to a new paradigm for medical image data sharing in the decentralized network. The conducted experimental resultsdemonstrate the performance of the proposed scheme.

12.
EuropePMC; 2020.
Preprint in English | EuropePMC | ID: ppcovidwho-314675

ABSTRACT

With the increase of COVID-19 cases worldwide, an effective way is required to diagnose COVID-19 patients. The primary problem in diagnosing COVID-19 patients is the shortage and reliability of testing kits, due to the quick spread of the virus, medical practitioners are facing difficulty identifying the positive cases. The second real-world problem is to share the data among the hospitals globally while keeping in view the privacy concerns of the organizations. Building a collaborative model and preserving privacy are major concerns for training a global deep learning model. This paper proposes a framework that collects a small amount of data from different sources (various hospitals) and trains a global deep learning model using blockchain based federated learning. Blockchain technology authenticates the data and federated learning trains the model globally while preserving the privacy of the organization. First, we propose a data normalization technique that deals with the heterogeneity of data as the data is gathered from different hospitals having different kinds of CT scanners. Secondly, we use Capsule Network-based segmentation and classification to detect COVID-19 patients. Thirdly, we design a method that can collaboratively train a global model using blockchain technology with federated learning while preserving privacy. Additionally, we collected real-life COVID-19 patients data, which is, open to the research community. The proposed framework can utilize up-to-date data which improves the recognition of computed tomography (CT) images. Finally, our results demonstrate a better performance to detect COVID-19 patients.

13.
Urban Clim ; 41: 101059, 2022 Jan.
Article in English | MEDLINE | ID: covidwho-1671254

ABSTRACT

To curb the 2nd wave of COVID-19 disease in April-May 2021, a night curfew followed by full lockdown was imposed over the National Capital Territory, Delhi. We have analyzed the observed variation in pollutants and meteorology, and role of local and transboundary emission sources during night-curfew and lockdown, as compared to pre-lockdown period and identical periods of 2020 lockdown as well as of 2018 and 2019. In 2021, concentration of pollutants (except O3, SO2, and toluene) declined by 4-16% during night-curfew as compared to the pre-lockdown period but these changes are not statistically significant. During lockdown in 2021, various pollutants decreased by 1-28% as compared to the night-curfew (except O3 and PM2.5), but increased by 31-129% compared to the identical period of 2020 lockdown except O3. Advection of pollutants from the region of moderate lockdown restrictions and an abrupt increase in crop-residue burning activity (120-587%) over Haryana and Punjab increased the air pollution levels over NCT during the lockdown period of 2021 as compared to 2020 in addition to a significant contribution of long-range transport. The increase in PM2.5 during the lockdown period of 2021 compared to 2020 might led to 5-29 additional premature mortalities.

14.
Indian J Nephrol ; 31(6): 544-549, 2021.
Article in English | MEDLINE | ID: covidwho-1573870

ABSTRACT

Introduction: There are several studies of symptomatic hemodialysis patients with proven COVID-19 infection. However, there is paucity of data on asymptomatic COVID-19 infection in the outpatient hemodialysis population. The true prevalence and transmission of this infection in hemodialysis centres is unknown. This study was conducted across hemodialysis centers by testing all patients and staff for COVID-19 PCR and later for IgG antibody, irrespective of their symptoms. Methods: All 705 hemodialysis patients and 103 dialysis staff across nine centres, were tested for COVID-19 over a period of 54 days of the pandemic, and for COVID IgG antibody of available enrolled staff and patients, after 8 weeks of study termination. Results: The period prevalence of infection in patients and staff was 7.1% and 14.6% respectively. Mortality in patients was 18%, and all staff recovered. Clustering of patients and staff occurred at 3 of 9 centers. Of 26 HIV positive patients, only one contracted the COVID-19 infection and has recovered. Of those infected, seroconversion occurred in 80% of patients and 83% of staff. Seroconversion also occurred in 16% of patients and 37% of staff, who were asymptomatic and COVID PCR negative during the study period. Conclusions: Testing a patient only when symptomatic, identified only 26% (13/50) of infected patients. For every single symptomatic patient who tested positive, there were 3 other asymptomatic infected ones. There was a high seroconversion rates in infected subjects. But antibodies also developed in asymptomatic subjects, indicating silent transmission and antibody generation in this population.

15.
Korean J Fam Med ; 42(6): 445-452, 2021 Nov.
Article in English | MEDLINE | ID: covidwho-1551698

ABSTRACT

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has caused a large number of deaths along with severe socio-economic effects. The vaccine is considered to be the last hope to control viral transmission. This study aimed to explore the determinants of health care workers' (HCWs) willingness to take the COVID-19 vaccination. METHODS: A structured, pre-validated, and pre-tested questionnaire was administered online to 599 HCWs including physicians, residents, and nurses from different types of healthcare set-ups across India. Information was collected regarding vaccine acceptability, attitude toward vaccination, and reasons for hesitancy. The chi-square test, followed by multinomial regression analysis, was applied to determine the factors associated with HCWs' vaccination willingness. RESULTS: It was found that 73 % (n=437) of HCWs were willing to accept the vaccines, while 10.85% (n=65) refused and 16.2% (n=96) needed more time to decide. Gender (P<0.001), occupation (P=0.040), working as front-line workers (P=0.008), vaccine manufacturing country preferences (P<0.001), and perceived risk of catching COVID-19 in the next 6 months (P=0.005) had a significant association with intent to receive vaccination (the response were "yes" vs. "no" and "not sure"). The reasons for vaccine hesitancy were vaccine safety and efficacy concerns, antivaccine attitude and beliefs, personal choice, and not wanting to take a vaccine before others. CONCLUSION: The majority of HCWs agreed to take COVID-19 vaccines once available. Nevertheless, providing support to manage evolving vaccine environments will help change the perception of HCWs who refuse or are reluctant to take the vaccines.

16.
J Educ Health Promot ; 10: 392, 2021.
Article in English | MEDLINE | ID: covidwho-1526907

ABSTRACT

BACKGROUND: Coronavirus disease rapidly spreads across the entire world in < 2 months and gravely jeopardizes the regular human routine. The medical fraternity recommends a vaccine as one of the best solutions to save the universe. However, to be effective, the population should reflect an encouraging attitude to accept it. The study aimed to measure vaccine acceptability and reason for hesitancy among the public. MATERIALS AND METHODS: Eight hundred and forty one adults visiting a tertiary care hospital responded to a pretested validated questionnaire on vaccine acceptability and hesitancy. The Chi-square test and independent t-test, followed by multinomial logistic regression, were used to analyze the findings. RESULTS: Overall, 53.4% (n = 445) of participants interested to take vaccine, 27.2% (n = 229) were not sure, and the remaining 19.4% (n = 163) did not intent to vaccinate. Gender (P = 0.013), information on the vaccine (P = 0.022), chances to get coronavirus disease in the next 6 months (P < 0.001), awareness on India COVID-19 vaccine (P < 0.001), Indian manufacturing company of vaccine (P < 0.001), family history of the laboratory-confirmed case (P < 0.001), and health status (P = 0.011) found a significant association with intention to vaccination (a response "yes" vs. "no" and "not sure"). Reasons for vaccine hesitancy included specific antivaccine attitudes and beliefs, a concern of fear and phobia, lack of information, and safety issues on the vaccine. CONCLUSIONS: This institute-specific survey revealed that approximately every 4 in 8 people were not sure to take the vaccine, and one in five people refused to be vaccinated. The study recommends using target-based health education to understand and address vaccine-specific concerns to enhance vaccine coverage, and boost confidence among the population.

18.
Cureus ; 13(10): e19070, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1513115

ABSTRACT

Introduction This study aimed to determine the breakthrough infection rate of coronavirus disease 2019 (COVID-19) (severe acute respiratory syndrome coronavirus 2 {SARS-CoV-2}) infection in healthcare workers (HCWs) vaccinated with either BBV152 or AZD1222 (ChAdOx1-S) vaccine. Methods A cross-sectional analysis was conducted at a medical college and hospital complex in Delhi, India, through telephonic interviews among HCWs who had received at least one dose of a COVID-19 vaccine during January-March 2021. Breakthrough infections were operationally defined as the occurrence of COVID-19 infection ≥14 days after administration of two doses of either COVID-19 vaccine. Data were entered in Epidata 3.1 (Odense, Denmark: EpiData Association) (single entered) and analyzed with IBM SPSS version 25 (Armonk, NY: IBM Corp.). A p-value < 0.05 was considered statistically significant. Results We enrolled 325 HCWs with a mean (SD) age of 29.1 (9.9) years including 211 (64.9%) males and 114 (35.1%) females. A total of 37 (13.3%, 95% CI 9.8, 17.7) COVID-19 breakthrough infections were observed in the HCWs. Additionally, 20 (6.1%) non-breakthrough infections were reported in the HCWs who were vaccinated with at least a single dose of a COVID-19 vaccine, or both doses, but prior to 14 days since the administration of the second dose. Most breakthrough infections were mild without needing supplemental oxygen for recovery. Conclusion Nearly one in seven HCWs experienced a COVID-19 breakthrough infection in the present study. A history of SARS-CoV-2 natural infection followed by at least one dose of COVID-19 vaccination was associated with significant protection against breakthrough infections.

19.
Maedica (Bucur) ; 16(2): 163-169, 2021 Jun.
Article in English | MEDLINE | ID: covidwho-1464179

ABSTRACT

Introduction: Concomitant atrial fibrillation (AF) in non-ST segment elevation acute coronary syndrome (NSTE-ACS) patients complicates the decision-making process regarding short- and long-term antithrombotic strategies. Patient profiles and usage rates of different antithrombotic combinations in this patient subgroup in Romania are poorly described. Introduction: Coronavirus disease 2019 (COVID-19) is an emerging viral infection without any approved treatment. Investigational therapies for COVID-19 may cause clinically important drug-drug interactions (DDIs). We aimed to study drug-drug interactions (DDIs) and their risk factors in hospitalised COVID-19 patients. Methods: We conducted a retrospective study in a tertiary care hospital dedicated to COVID-19 patients. The Lexi-Interact database was used to investigate clinically important DDIs. The database output, including interacting drug pairs, risk rating, reliability rating, mechanism, and management, was evaluated. Results: Medical records of 200 COVID-19 patients were analysed. All patients had at least one clinically important DDI. More than half of interactions were associated with hydroxychloroquine and azithromycin, the most commonly prescribed medications for the management of COVID-19. Concomitant drugs for comorbid conditions leading to polypharmacy were significantly associated with the occurrence of this. Conclusion: There is a higher chance of DDI, which necessitates ongoing care evaluation and therapy adjustment. Drugs used to treat COVID-19 should be carefully selected.

20.
Curr Top Med Chem ; 20(11): 915-962, 2020.
Article in English | MEDLINE | ID: covidwho-1453165

ABSTRACT

BACKGROUND: Emerging viral zoonotic diseases are one of the major obstacles to secure the "One Health" concept under the current scenario. Current prophylactic, diagnostic and therapeutic approaches often associated with certain limitations and thus proved to be insufficient for customizing rapid and efficient combating strategy against the highly transmissible pathogenic infectious agents leading to the disastrous socio-economic outcome. Moreover, most of the viral zoonoses originate from the wildlife and poor knowledge about the global virome database renders it difficult to predict future outbreaks. Thus, alternative management strategy in terms of improved prophylactic vaccines and their delivery systems; rapid and efficient diagnostics and effective targeted therapeutics are the need of the hour. METHODS: Structured literature search has been performed with specific keywords in bibliographic databases for the accumulation of information regarding current nanomedicine interventions along with standard books for basic virology inputs. RESULTS: Multi-arrayed applications of nanomedicine have proved to be an effective alternative in all the aspects regarding the prevention, diagnosis, and control of zoonotic viral diseases. The current review is focused to outline the applications of nanomaterials as anti-viral vaccines or vaccine/drug delivery systems, diagnostics and directly acting therapeutic agents in combating the important zoonotic viral diseases in the recent scenario along with their potential benefits, challenges and prospects to design successful control strategies. CONCLUSION: This review provides significant introspection towards the multi-arrayed applications of nanomedicine to combat several important zoonotic viral diseases.


Subject(s)
Drug Delivery Systems/methods , Viral Vaccines/chemistry , Viral Zoonoses/diagnosis , Viral Zoonoses/prevention & control , Viral Zoonoses/therapy , Viruses/drug effects , Animals , Animals, Wild , Biosensing Techniques , Drug Carriers/chemistry , Drug Compounding , Drug Liberation , Humans , Nanomedicine , Nanoparticles/chemistry , Polymers/chemistry , Polymers/metabolism , Transfection , Viruses/metabolism
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