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1.
National Journal of Physiology, Pharmacy and Pharmacology ; 12(8):1233-1240, 2022.
Article in English | EMBASE | ID: covidwho-1988325

ABSTRACT

Background: Due to the unprecedented magnitude of the current Coronavirus disease 2019 (COVID-19) pandemic, vaccine development was fast-tracked;yet, there were barriers to vaccination uptake. Aim and Objectives: The objectives of this study were to understand the factors promoting vaccination and the barriers to vaccination, to explore the infection prevention and control practices followed after vaccination. Materials and Methods: A qualitative study using in depth interviews, both face to face and telephonic;among beneficiaries willing to participate and given at least one dose of COVID-19 vaccine in the institutions’ vaccination center, stratified sampling technique was used. Informed consent was obtained. Absolute confidentiality was ensured. The interviews were recorded and transcribed verbatim and validated by back translation into vernacular. The results obtained were analyzed using framework approach and categorized into themes and subthemes and valid conclusions drawn. Results: Various factors promoting willingness for vaccination and barriers perceived by the participants in their community, social, and occupational setting have been revealed in the present study. Availability of vaccine along with clear and accurate information can go a long way in overcoming vaccine hesitancy and promoting vaccine literacy. Conclusion: Clear and accurate information should be disseminated. The role of social media, mass media, and dissemination of information by word of mouth cannot be undermined. It is hoped that results of the present study will aid in formulating future vaccination programs.

2.
British Journal of Haematology ; 197(SUPPL 1):206, 2022.
Article in English | EMBASE | ID: covidwho-1861254

ABSTRACT

Those affected by sickle cell disease have an increased susceptibility to infection by encapsulated bacteria and hepatitis B virus due to reduced splenic function and increased likelihood of receiving blood transfusions. Sickle cell disease patients are also more likely to suffer from complications, such as vaso-occlusive crises or acute chest syndrome, following infection with influenza or COVID-19. Standards for Clinical Care of Adults with Sickle Cell Disease in the UK (2018) outline that that those with sickle cell disease are recommended to be vaccinated against invasive pneumococcal disease, Haemophilus influenza type B, Neisseria meningitis types ACWY and type B, hepatitis B, and influenza . These patients are also recommended to have their hepatitis B immunity reviewed annually and to receive a hepatitis B vaccination booster if hepatitis B surface antibody (HBsAb) levels are less than 100 mIU/ml. According to the Standards , hospital staff is advised to remind and check with the patients' primary care teams whether these vaccinations have been administered. In this audit, we examined the records of 64 patients with sickle cell disease who receive regular care at the Cambridge University Hospitals NHS Foundation Trust. We collected data on the uptake of the pneumococcal conjugate vaccine (PCV13), pneumococcal polysaccharide vaccine (PPV23 or Pneumovax) within 5 years, two doses of Meningitis B vaccine, Meningitis ACWY vaccine (MenACWY), Haemophilus influenzae type b vaccine (Hib/MenC), influenza vaccine within 1 year, hepatitis B vaccine (HepB), whether HBsAb levels have been reviewed within 1 year, HepB booster if HBsAb levels were less than 100 mIU/ml, and two doses of COVID-19 vaccine. These records were obtained from electrical medical records provided by patients' general practitioners. Data collection took place from 23 September to 4 November 2021. The uptake of vaccinations was 67.4% for PCV13, 61.0% for PPV23 or Pneumovax within 5 years, 75.0% for Hib/MenC, 45.3% for MenACWY, 42.2% for the first dose of MenB and 29.3% for the second dose of MenB, 54.7% for influenza within 1 year, 75.0% for HepB, 71.9% for the first dose of the COVID-19 vaccine, and 68.3% for the second dose of the COVID-19 vaccine. 43.8% had their HbsAB reviewed and 20.0% received a HepB booster following HBsAb levels of less than 100mIU/ml. The uptake levels for the recommended vaccinations are lower than expected in our hospital trust. The COVID-19 pandemic has highlighted the effect of health inequalities and the uptake of the vaccination programme by patients of different ethnicities. During our patient support group, patients identified the Tuskegee syphilis experiment as one of the reasons why there is still distrust of the medical profession by those with Afro-Caribbean heritage. Beyond directed patient education, more communication is needed with the primary care teams to raise awareness of which vaccinations are required for sickle cell patients. Certain vaccinations, such as MenACWY and MenB were only introduced in 2015, meaning that some general practitioners may be still unaware of their necessity in adults with sickle cell disease..

3.
Annals of Indian Psychiatry ; 6(1):86-94, 2022.
Article in English | Web of Science | ID: covidwho-1855973

ABSTRACT

Background: The health-care workers (HCWs) who are overburdened during the COVID-19 pandemic are at increased risk of developing psychological disorders. Aim: The aim of this study was to assess the magnitude of psychological problems such as depression, anxiety, and fear of COVID-19 among the HCWs and to study their correlates. Material and Methods: The study is an online multicentric cross-sectional survey of mental health problems in the HCWs of three tertiary level COVID care centers in Central India. HCWs were assessed using the Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder Scale-7 (GAD-7), and Fear of COVID-19 Scale. Results: Out of 467 HCWs assessed, 25.5% of the participants had depression (defined by PHQ-9 score of more than 5), whereas anxiety was present in 24.4% of the study subjects (defined by GAD-7 score of more than 5). Forty-six percent of the participants had medium-to-high levels of fear of COVID-19. Female gender, working in the nonclinical department, direct involvement in care of COVID-19 patients, perceived worsening of physical health status following the pandemic outbreak, and past history of psychiatric problem were the factors significantly associated with presence of depression as well as anxiety. Age of the participant had a positive correlation with fear of COVID-19 and a negative correlation with depression and anxiety levels. Conclusion: HCWs serving in COVID hospitals are vulnerable to develop mental health problems and appropriate screening measures and interventions should be designed so as to preserve mental health of this vital task force.

4.
9th International Conference on Frontiers in Intelligent Computing: Theory and Applications, FICTA 2021 ; 267:511-520, 2022.
Article in English | Scopus | ID: covidwho-1844316

ABSTRACT

The pandemic from COVID-19 impinged our day-to-day lives and wreaked havoc upon many sectors in our society. This worldwide pandemic, which had its onset in January 2020, has forced us to reconsider our perception of what “normal” should be. While there’s no official cure yet, various vaccines have been rolled out and are expected to take effect soon. However, the efficacy of vaccines has been a debatable issue. Thus, the most effective way to battle this situation would be to strictly follow the precautionary measures advised by the governing authorities. Wearing mask and following the social distancing norms are considered as one of the most effective ways to control the spread of infection [1]. However, this new normal becomes difficult to implement as many people tend not to follow social distancing. While it is difficult to check whether people are following social distancing, we propose a solution which would come in handy in such circumstances and would hasten the process of contact tracing in comparison to manual inspection. In this study, we strive to present a video surveillance model, which would allow the detection of social distancing between people based on object detection and tracking algorithms. The specific algorithm used in our study for object detection is the YOLO algorithm and monitoring the distance between any two persons is done using a technique called Perspective Transformation. The proposed method shows promising results which could be implemented as a surveillance system for monitoring social distancing. © 2022, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

5.
Biomedical and Biotechnology Research Journal ; 6(1):50-53, 2022.
Article in English | Scopus | ID: covidwho-1780160

ABSTRACT

The year 2019 witnessed a pandemic named COVID-19 caused by infection severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). It emerged in Wuhan, China, in December 2019 and has affected millions since then. It led to a global cry for vaccine development. Scientists arrayed the SARS-CoV-2 genome within a month of the outbreak. They used the parallels between SARS-CoV-1 and SARS-CoV-2 to speed up the vaccine preparation. As of now, different types of COVID-19 vaccines are prevailing. © 2022 Biomedical and Biotechnology Research Journal (BBRJ).

6.
American Journal of Kidney Diseases ; 77(4):625, 2021.
Article in English | EMBASE | ID: covidwho-1768912

ABSTRACT

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the 2019 novel coronavirus disease pandemic (COVID-19). Despite vast research about the adult population, there has been little data collected on acute kidney injury (AKI) epidemiology, associated risk factors, treatments, and mortality in pediatric COVID-19 patients admitted to the ICU. AKI is a severe complication of COVID-19 among children and adolescents. Therefore, understanding all aspects of the disease is crucial to further developing treatment and preventative care strategies to reduce morbidity and mortality. This study aims to assess AKI incidence among COVID-19 pediatric patients in the pediatric intensive care unit (ICU) within North America using the Virtual Pediatric Systems (VPS) database. Additionally, this study assesses AKI associated risk factors, treatments such as kidney replacement therapy (KRT) and associated mortality rates among COVID-19 pediatric patients within North America using VPS data. This is a retrospective study of COVID-19 pediatric patients (age < 24 years) in the pediatric ICU within North America using the VPS COVID-19 database between January 1, 2020 and June 30, 2020. Currently data regarding 1240 pediatric COVID-19 patients has been analyzed. 172 of these patients had renal/urinary system involvement. Of the 172 patients with renal involvement, there were 19 confirmed deaths. This means that 45% of all confirmed pediatric COVID-19 deaths were associated with renal involvement. 36 patients received KRT and there are 2 confirmed deaths in this group. Additionally, 264 (24.67%) patients were diagnosed with Multisystem Inflammatory Syndrome in Children (MIS-C). Although COVID-19 in the pediatric population tends to present more favorably, renal involvement among the pediatric COVID-19 patient population may be considered a negative prognostic factor with respect to patient outcomes.

7.
International Journal of Toxicological and Pharmacological Research ; 12(3):1-8, 2022.
Article in English | EMBASE | ID: covidwho-1766515

ABSTRACT

Introduction: The coronavirus pandemic had overwhelmed the healthcare sector and a need was felt to utilize the services of medical undergraduate students. For this, it was imperative that they have the right knowledge and perceptions about it. Therefore, a study was planned to assess the level of awareness and perception regarding the prevention and management of Covid-19 infection among medical undergraduates. Methods: A cross-sectional, questionnaire-based study was conducted over a period of two months in a tertiary care hospital of North India. A written and informed consent was taken. The google form-based questionnaire was distributed to MBBS students via online modes like email and WhatsApp for recording the responses. The categorical data were expressed as frequency, percentages, mean and standard deviation. Batchwise comparison was done using ANOVA. A p-value of <0.05 was considered statistically significant. Results: A total of 381 (76.2%) medical undergraduates participated in the study. They had an average knowledge score of 69.8%. The participants had a favorable attitude and majority of the students (96.2%) agreed that health education and campaigns have a pivotal role in preventing Covid-19. Two-third of students felt that the general public is not practicing Covid appropriate behavior adequately. On inter batch comparison, M.B.B.S second professional (2019 batch) students had significantly higher knowledge (p <0.001) and attitude (p <0.001) scores in comparison to the other batches. Conclusion: The undergraduate medical students were considerably aware of various aspects of Covid-19 infection and had a positive attitude towards the state of affairs as regards to the control and management of the pandemic in the country, with some scope for improvement.

9.
Circulation ; 144(SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1634326

ABSTRACT

Introduction: Myocardial injury during active coronavirus disease-2019 (COVID-19) infection is well described however, its persistence during recovery is unclear. We assessed left ventricle (LV) global longitudinal strain (GLS) using speckle tracking echocardiography (STE) in COVID-19 recovered patients and studied its correlation with various parameters. Methods: A total of 134 subjects within 30-45 days post recovery from COVID-19 infection and normal LV ejection fraction were enrolled. Routine blood investigations, inflammatory markers (on admission) and comprehensive echocardiography including STE were done for all subjects. Results: Of the 134 subjects, 121 (90.3%) were symptomatic during COVID-19 illness and were categorized into mild: 61 (45.5%), moderate: 50 (37.3%) and severe: 10 (7.5%) COVID-19 illness groups. Asymptomatic COVID-19 infection was reported in 13 (9.7%) patients. Subclinical LV and right ventricle (RV) dysfunction were seen in 40 (29.9%) and 14 (10.5%) patients respectively. Impaired LVGLS was reported in 1 (7.7%), 8 (13.1%), 22 (44%) and 9 (90%) subjects with asymptomatic, mild, moderate and severe disease respectively. LVGLS was significantly lower in patients recovered from severe illness (mild:-21 ± 3.4%;moderate:-18.1 ± 6.9%;severe:-15.5 ± 3.1%;P < 0.0001). Subjects with reduced LVGLS had significantly high interleukin-6 (P < 0.0001), C-reactive protein (P = 0.001), lactate dehydrogenase (P = 0.009) and serum ferritin (P = 0.03) levels during index admission. Conclusions: Subclinical LV dysfunction was seen in nearly a third of recovered COVID-19 patients while 10.5% had RV dysfunction. Our study suggests a need of close follow-up among COVID-19 recovered subjects to elucidate long-term cardiovascular outcomes.

10.
Concurrency and Computation-Practice & Experience ; : 12, 2021.
Article in English | Web of Science | ID: covidwho-1589149

ABSTRACT

The novel-corona-virus is presently accountable for 547,782 deaths worldwide. It was first observed in China in late 2019 and, the increase in number of its affected cases seriously disturbed almost every nation in terms of its economical, structural, educational growth. Furthermore, with the advancement of data-analytics and machine learning towards enhanced diagnostic tools for the infection, the growth rate in the affected patients has reduced considerably, thereby making it critical for AI researchers and experts from medical radiology to put more efforts in this side. In this regard, we present a controlled study which provides analysis of various potential possibilities in terms of detection models/algorithms for COVID-19 detection from radiology-based images like chest x-rays. We provide a rigorous comparison between the VGG16, VGG19, Residual Network, Dark-Net as the foundational network with the Single Shot MultiBox Detector (SSD) for predictions. With some preprocessing techniques specific to the task like CLAHE, this study shows the potential of the methodology relative to the existing techniques. The highest of all precision and recall were achieved with DenseNet201 + SSD512 as 93.01 and 94.98 respectively.

11.
National Journal of Physiology, Pharmacy and Pharmacology ; 11(12):1322-1326, 2021.
Article in English | EMBASE | ID: covidwho-1572878

ABSTRACT

Background: The recent new coronavirus disease or COVID-19 pandemic has affected the health services, particularly the essential services too. One of the consequences of the COVID-19 pandemic is that vaccination efforts that help control other diseases may be put on hold. This may lead to increased strain on health systems, and increase in morbidity and mortality due to vaccine-preventable disease in the coming years in future generation. Aims and Objectives: This study aim to study the impact of lockdown and reasons for this impact on vaccination. Materials and Methods: The proposed study is a cross-sectional type of study conducted among people accompanying the children to the UTHC, Amritsar, for vaccination. They were interviewed in a pre-designed and pre-tested questionnaire. Results: Most of the children were accompanied by their mothers (70.61%). Majority of the children had a delay of 1 week–1 month (32.62%) followed by 1–3 months gap (23.66%) in the first scheduled vaccination post-lockdown. Majority (50.44%) of them said that because of fear of COVID, they did not come for vaccination on due date. In the 2nd scheduled dose following first schedule dose post-lockdown was <1 month delay (94.74%) and the reason for delay was family problems (43.75%). Majority of the children delay in the 3rd scheduled dose following the first and second schedule doses, post-lockdown was <1 week (89.29%) and only 10.71% had a delay of 1 week–1 month. Conclusion: Many parents were not able to vaccinate their children because of fear of COVID and lockdown restrictions. There is an urgent need to address these issues.

12.
Journal of Pharmaceutical Research International ; 33(46B):148-153, 2021.
Article in English | Web of Science | ID: covidwho-1513168

ABSTRACT

With the rapid spread of severe acute respiratory syndrome SARS-CoV2, the incidence of the disease is increasing each day with a higher infectivity rate and unpredictable morbidity and mortality. The second wave in India has higher morbidity and mortality compared to the previous wave of SARS-Cov2. With the increasing trend of screening hypoxic patients with high resolution computed tomography (HRCT) of thorax, treatment modalities, and investigational approaches have changed drastically. Here we report a case of a 31-year-old female who presented to a tertiary care centre in the rural area with a history of fever five days back and a history of breathlessness of 3 days duration and dry cough of 3 days duration. She was hypoxic on admission and later on diagnosed with SARS-Cov2 infection. HRCT thorax revealed a CT severity score of 25/25. She was treated according to standard treatment protocols. The patient was discharged after 46 days with normal oxygen saturation on room air. The aim of this case study is to emphasize the wholesome approach in the management of COVID-19.

13.
PLoS ONE ; 16(2), 2021.
Article in English | CAB Abstracts | ID: covidwho-1410681

ABSTRACT

There is growing evidence that thrombotic and inflammatory pathways contribute to the severity of COVID-19. Common medications such as aspirin, that mitigate these pathways, may decrease COVID-19 mortality. This retrospective assessment was designed to quantify the correlation between pre-diagnosis aspirin and mortality for COVID-19 positive patients in our care. Data from the Veterans Health Administration national electronic health record database was utilized for the evaluation. Veterans from across the country with a first positive COVID-19 polymerase chain reaction lab result were included in the evaluation which comprised 35,370 patients from March 2, 2020 to September 13, 2020 for the 14-day mortality cohort and 32,836 patients from March 2, 2020 to August 28, 2020 for the 30-day mortality cohort. Patients were matched via propensity scores and the odds of mortality were then compared. Among COVID-19 positive Veterans, preexisting aspirin prescription was associated with a statistically and clinically significant decrease in overall mortality at 14-days (OR 0.38, 95% CI 0.32-0.46) and at 30-days (OR 0.38, 95% CI 0.33-0.45), cutting the odds of mortality by more than half. Findings demonstrated that pre-diagnosis aspirin prescription was strongly associated with decreased mortality rates for Veterans diagnosed with COVID-19. Prospective evaluation is required to more completely assess this correlation and its implications for patient care.

14.
Computers, Materials and Continua ; 70(1):1541-1556, 2021.
Article in English | Scopus | ID: covidwho-1405632

ABSTRACT

Like the Covid-19 pandemic, smallpox virus infection broke out in the last century, wherein 500 million deaths were reported along with enormous economic loss. But unlike smallpox, the Covid-19 recorded a low exponential infection rate and mortality rate due to advancement in medical aid and diagnostics. Data analytics, machine learning, and automation techniques can help in early diagnostics and supporting treatments of many reported patients. This paper proposes a robust and efficient methodology for the early detection of COVID-19 from Chest X-Ray scans utilizing enhanced deep learning techniques. Our study suggests that using the Prediction and Deconvolutional Modules in combination with the SSD architecture can improve the performance of the model trained at this task. We used a publicly open CXR image dataset and implemented the detection model with task-specific pre-processing and near 80:20 split. This achieved a competitive specificity of 0.9474 and a sensibility/accuracy of 0.9597, which shall help better decision-making for various aspects of identification and treat the infection. © 2021 Tech Science Press. All rights reserved.

15.
Medical Journal of Dr. D.Y. Patil Vidyapeeth ; 14(5):481-485, 2021.
Article in English | Scopus | ID: covidwho-1403953

ABSTRACT

Introduction: Risk communication is a vital component of the management of health-care crisis including the present pandemic. The health-care professionals play an important role in risk communication;however, health-care professionals have been found wanting when it comes to risk communication during any health-care crisis. The doctors/health-care professionals, being the technical personnel, are required to provide the technical information in a nontechnical or laymen language to the relevant authorities, which in turn are expected to share this knowledge to the people at risk. This study attempts to unravel the perceptions of health-care professionals on this important topic concerning public health. Methodology: A cross-sectional descriptive study was designed for the study question. An online survey was conducted based on Google Forms using snowball sampling technique. The data, collected using a pilot-tested questionnaire, were compiled in MS Excel and analyzed using SPSS software version 23. Requisite permission was taken from the institutional ethic committee. All participants were informed of the voluntary nature of the study, and the data collection was done in an anonymous manner. Results: A majority of participants (61.5%) answered in affirmative when asked if they know what risk communication is and 13 (7.7%) were not aware of it. A majority of the participants (60.9%) perceived risk communication as an exchange of information between health experts and general public, whereas 23 (13.6%) participants felt that risk communication is exchange of information between health experts and other health-care workers. Rumor management was not considered an essential part of risk communication by about half (48.5%) of the participants. Conclusion: We found significant gaps in the knowledge and perception of risk communication in the health-care professionals, which can be attributed to lack of training. Risk communication needs to be incorporated as a part of formal medical education to plug this gap. © 2021 Medical Journal of Dr. D.Y. Patil Vidyapeeth.

16.
Transbound Emerg Dis ; 2021 Aug 17.
Article in English | MEDLINE | ID: covidwho-1360535

ABSTRACT

The current pandemic caused by a novel coronavirus (SARS-CoV-2) has underlined the importance of emerging diseases of zoonotic importance. Along with human beings, several species of wild and pet animals have been demonstrated to be infected by SARS-CoV-2, both naturally and experimentally. In addition, with constant emergence of new variants, the species susceptibility might further change which warrants intensified screening efforts. India is a vast and second most populated country, with a habitat of a very diverse range of animal species. In this study we place on record of SARS-CoV-2 infections in three captive Asiatic lions. Detailed genomic characterization revealed involvement of Delta mutant (Pango lineage B.1.617.2) of SARS-CoV-2 at two different locations. Interestingly, no other feline species enclosed in the zoo/park were found infected. The epidemiological and molecular analysis will contribute to the understanding of the emerging mutants of SARS-CoV-2 in wild and domestic animals.

17.
International Conference on Intelligent Computing and Advances in Communication, ICAC 2020 ; 202 LNNS:7-16, 2021.
Article in English | Scopus | ID: covidwho-1340419

ABSTRACT

In the recent history of human civilization, a pandemic affecting such an enormous population like COVID-19 was about 140 years ago-The Smallpox Worldwide Epidemic (1877–1977, Deaths-500 M). It can be easily inferred that the health management system over the globe in the nineteenth century was too underdeveloped than that of today, which also refers to the fact that the present epidemic must not be allowed to last much longer as the number of deaths is increasing nonlinearly (506 K, with 10.3 M affected). While the medical community around the globe is striving to find a permanent cure, it becomes evident responsibility of all professionals who can contribute in stabilizing the medical management systems of countries particularly underdeveloped/developing countries or those with highest rate of increase in COVID-19 cases like USA, Brazil. In this regard, this study introduces a fast, robust and practically effective method for detection of COVID-19 from chest x-ray images utilizing enhanced deep learning techniques. An object detection network is proposed to be trained with publicly existing datasets. In this model, SSD is used with ResNet101 as a base layer and some pre-processing, achieving a sensitivity of 0.9495 and a specificity of 0.9247. If practically implemented, this can prove very beneficial in aiding economies and health systems of the above-mentioned countries. © 2021, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

19.
Annals of Indian Psychiatry ; 4(2):7, 2020.
Article in English | Web of Science | ID: covidwho-1285429

ABSTRACT

Background: COVID-19 pandemic has resulted in heightened stress, anxiety, and depression in doctors. This research was undertaken during the lockdown period in Mumbai to study the differences in perceptions of the various concerns related to the pandemic, viz., concerns related to area of residence, workplace, personal, and educational and stress faced by the 3 groups of health-care workers, medical interns, resident doctors, and medical teachers, during the pandemic. Materials and Methods: 1011 residents participated in this online cross-sectional survey after informed consent and ethics approval and 494 completed the survey via a Google Form sent on the WhatsApp groups. Results: Significant differences were noted with interns and residents staying in COVID hotspots, sealed homes, being ostracized, and having difficulty in procuring food as compared to the teachers. Workplace concerns significantly revealed that 90% interns and residents had training before duty, wore personal protective equipment, had difficulty in donning, doffing, were uncomfortable, anxious about being dehydrated, and used frequent sanitizer as compared to teachers. Interns and residents were also significantly anxious about not following social distancing, being preoccupied about the same, and having sleep problems as compared to teachers. They also were concerned about financial issues, travel plans, exams, and missing skill training as compared to teachers. Conclusion: It highlights the difficulties faced by the participants during the lockdown and its impact on their emotional well-being.

20.
Topics in Antiviral Medicine ; 29(1):120, 2021.
Article in English | EMBASE | ID: covidwho-1250034

ABSTRACT

Background: Autopsies of the COVID-19 patients, show presence of SARS-CoV-2 in the brain endothelium, cerebrospinal fluid, glial cells, and neuronal tissue and emerging clinical data from the current pandemic suggests that ∼40% of the patients with COVID-19 developed neurological symptoms. We examined the effect of SARS-COV2 RBD spike protein and heat inactivated SARS-COV2 on Blood barrier barrier (BBB) integrity using a well validated 2D in-vitro Blood brain barrier model, and on the expression levels of tight junction proteins (TJP) that are key to BBB permeability and function. Methods: Our experimental paradigm included treating primary human BMVEC (Cat# ACBRI-376) with recombinant SARS-COV2 Spike protein ( BEI Resources Inc) for 24-48 hrs, followed by examining ACE2 receptor expression by immunofluorescent staining, quantification of levels of pro-inflammatory cytokines in culture supertanants using BioLegend's LEGENDLplex™ bead-based immunoassay. Additionally, we examined the effects of SARS-COV2 on BBB integrity using a well validated 2D in-vitro BBB model and modulation of TJ protein gene expression levels using real time quantitative PCR. Results: Our data shows that primary human BMVEC expressed the ACE2 receptor and that treatment with SARS-COV2 spike protein resulted in a significant increase in ACE 2 receptor expression by BMVEC. We observed a significant increase in the levels of pro-inflammatory cytokines such as TNF-α (p<0.01), IL-6 (p<0.0001), IL-10 (p<0.05), IL-23 (p<0.05) and IL-33 (p<0.01) in BMVEC treated with SARS-COV2 spike protein compared to the untreated controls. BBB integrity which was measured using the transendothelial electrical resistance (TEER) across membrane showed an ∼ 30% (p<0.05) decrease in TEER in BBB treated with SARS-COV2 spike protein as compared to the untreated control, and the functional translational of this effects was evident by the SARS-COV2 induced decrease in TJP expression. Our data showed that SARS-CoV-2 treatment resulted in a decrease in the gene expression of TJPs-ZO-1 (52%;p<0.05), ZO-2 (92%;p<0.001), Claudin-5 (97%;p<0.001) and JAM-2 (45%;p<0.05) as compared to the untreated controls. Conclusion: BMVEC have a paracrine-autocrine role in maintaining CNS homeostasis and that the SARS-COV2 associated endothelial cell dysfunction preludes the neuropathology associated with SARS-COV2 that is observed in COVID-19 infected patients. Potentially, anti-cytokine based therapeutics may be effective in treating patients with COVID-19 associated neurological disease.

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