Your browser doesn't support javascript.
Show: 20 | 50 | 100
Results 1 - 20 de 93
Filter
1.
Structural Chemistry ; : 1-14, 2022.
Article in English | MEDLINE | ID: covidwho-2014354

ABSTRACT

The SARS-CoV-2 virus has been identified as a causative agent for COVID-19 pandemic. About more than 6.3 million fatalities have been attributed to COVID-19 worldwide to date. Finding a viable cure for the illness is urgently needed in light of the present pandemic. The prominence of main protease in the life cycle of virus shapes the main protease as a viable target for design and development of antiviral agents to combat COVID-19. The current study presents the fragment linking strategy to design the novel Mpro inhibitors for COVID-19. A total of 293,451 fragments from diversified libraries have been screened for their binding affinity towards Mpro enzyme. The best 1600 fragment hits were subjected to fragment joining to achieve 100 new molecules using Schrodinger software. The resulting molecules were further screened for their Mpro binding affinity, ADMET, and drug-likeness features. The best 13 molecules were selected, and the first 6 compounds were investigated for their ligand-receptor complex stability through a molecular dynamics study using GROMACS software. The resulting molecules have the potential to be further evaluated for COVID-19 drug discovery.

3.
Global health, science and practice ; 10(4), 2022.
Article in English | MEDLINE | ID: covidwho-2010495

ABSTRACT

Due to the coronavirus disease (COVID-19) pandemic and its associated response, TB deaths increased for the first time in a decade. In any potentially fatal illness, an assessment of severity is essential. This is not systematically done for adults with TB, mostly due to a lack of policy and/or limited availability of diagnostic and clinical capacity. We developed a screening tool using simple and easily measurable indicators that can be used by paramedical TB program staff to quickly identify people with severe illness. During October-November 2020 in Karnataka, India, the paramedical program staff from 16 districts screened people with TB (aged ≥15 years) notified by public facilities for "high risk of severe illness," which was defined as the presence of any of the following indicators: (1) body mass index (BMI) ≤14.0 kg/m2;(2) BMI ≤16.0 kg/m2 with bilateral leg swelling;(3) respiratory rate >24/minute;(4) oxygen saturation <94%;(5) inability to stand without support. In this cohort study, we determined the incidence of program-recorded early deaths (within 2 months) and its association with high risk of severe illness. Of 3,010 people with TB, 1,529 (50.8%) were screened at diagnosis/notification, of whom 537 (35.1%) had a high risk of severe illness. There were 195 (6.5%, 95% CI=5.7, 7.4) early deaths: 59 (30.2%) within a week and 100 (51.3%) within 2 weeks of treatment initiation. The incidence of early deaths was significantly higher among those with high risk of severe illness (8.9%) at diagnosis compared to those without (3.8%) [adjusted relative risk: 2.36 (95% confidence interval=1.57, 3.55)]. To conclude, early deaths were especially high during the first 2 weeks and strongly associated with a high risk of severe illness at diagnosis/notification. Screening for severe illness should be explored as a potential strategy to end TB deaths.

4.
Clin Endocrinol (Oxf) ; 2022.
Article in English | PubMed | ID: covidwho-2001621

ABSTRACT

It is widely recognised that the effects of COVID-19 extend beyond the respiratory system. Moreover, there are an estimated 1.3 million people living with Long COVID (symptoms persisting beyond 12 weeks after infection) in the UK alone. This article is protected by copyright. All rights reserved.

5.
Journal of General Internal Medicine ; 37:S267, 2022.
Article in English | EMBASE | ID: covidwho-1995599

ABSTRACT

BACKGROUND: Traditionally, randomized clinical trials have relied on physical research centers to support subject recruitment and participation. The COVID-19 pandemic has highlighted the need to interact with subjects who are unable to physically visit research centers. By leveraging remote technology, such clinical trials may reach subjects in isolation and broaden geographical reach. We describe a fully remote, multisite randomized controlled clinical trial of outpatient COVID-19 treatments using a technologyenabled, decentralized approach. METHODS: We conducted a remote double-blind, randomized placebocontrolled trial (COVID-OUT). We identified subjects through medical records, patient advocacy groups, testing facilities, and multiformat advertising. They were recruited via brochure, electronic message, telephone outreach, and self-referral. Research staff across sites used the Research Electronic Data Capture (REDCap) system to manage local and central enrollment and were reallocated dynamically based on trial needs. Subjects were screened by phone, consented and randomized electronically and delivered study medication by courier or same-day mail. They were followed via their preferred communication method (phone, video, text, or email) to determine the study endpoints. RESULTS: 1195 non-hospitalized adults aged 30-85 years with laboratory confirmed infection with SARS-CoV-2 were enrolled into the COVID-OUT trial through January 6, 2022 over a span of 7 months. Initially starting as a 2- arm trial with 7 sites, the study expanded to a 6-arm trial with recruitment at 8 sites. To date, 9600 subjects have been screened with an enrollment rate of 12% from 822 zip codes. 25 research coordinators are involved across 8 sites, and the rate of study completion is 90%. CONCLUSIONS: Decentralized remote studies offer an efficient, low-touch way of performing research in the COVID-19 era. Our decentralized study design enables research with infectious, isolated subjects in widespread geographies, while maintaining safety of subjects, the research team, and public atlarge. Coordination across sites via RED Cap enabled programmatic efficiencies, including the ability to redistribute staffing support across enrollment sites for study drug distribution, follow-up calls, recruitment, and event reporting. We decreased overall costs by less need for physical research space. The decentralized infrastructure enabled nimble adaptations of the protocol, including increasing follow-up periods to assess long-COVID symptoms and adding study arms for additional outpatient treatments. Given the widespread availability of mobile phones and remote communication, decentralized trials show promise for improving reach and efficiency in both pandemic and nonpandemic times.

6.
American Journal of Respiratory and Critical Care Medicine ; 205(1), 2022.
Article in English | EMBASE | ID: covidwho-1927908

ABSTRACT

Rationale Multiple anecdotal reports describe patients with COVID-19 presenting with what is referred to as silent hypoxemia (without dyspnea, tachypnea, or respiratory distress). However, there is a paucity of literature on this problem. We conducted a study to determine the prevalence of silent hypoxemia in patients with COVID-19 infection at presentation in the emergency department (ED) or on admission, and compared it with that of patients with pneumonia by any other etiology at Memorial Hermann Health System. In addition, we analyzed the differences between clinical, laboratory, hospital utilization, and mortality. Methods From electronic medical records, we identified pneumonia patients with a positive result for coronavirus on reverse transcriptasepolymerase chain reaction (RT-PCR) nasopharyngeal swab test, or diagnosis of pneumonia by influenza or any other etiology for one year, presenting to the ED or admitted to any MHHS hospital. We extracted age, sex, race/ethnicity, vital signs, oxygen saturation, intensive care unit (ICU) admission, and hospital stay for all patients. Results A total of 17,475 COVID-19 patients were compared with 2,343 patients with influenza/pneumonia of any etiology. The two groups were similar with respect to age, sex, and ethnicity. The frequency of silent hypoxemia was greater in the COVID-19 (n=232, 1.3%) group compared to influenza/pneumonia (n= 3, 0.13%) patients (p<0.001). For patients with an oxygen saturation < 90, the proportion who had silent hypoxemia was 11.7% (232/1981) in the COVID-19 patients and 2.6% (3/117) in the influenza and other viral pneumonia patients. Between COVID-19 patients admitted to the hospital, patients with symptomatic hypoxemia had a longer hospital stays (median: 11 days, IQR: 6-22) compared to those with silent hypoxemia (median: 8 days, IQR: 4-18) (p=0.001). The symptomatic hypoxemia group was more likely to be admitted to the ICU (n=457, 26.1%) compared to the silent hypoxemic patients (n=33, 15.5%) (p<0.001) and the mortality rate was higher (n=454, 26.0%) vs (36, 15.5%) (p=0.001). Conclusion The prevalence of silent hypoxemia for adults with viral pneumonia who were seen in the ED or hospitalized in a 17- hospital system in Houston, was higher in the COVID-19 infection patient group compared to patients with other pneumonias or any other etiology. Among the COVID-19 subjects, those with symptomatic hypoxemia had worse outcomes compared to those with silent hypoxemia. More studies are needed to confirm these findings.

7.
American Journal of Respiratory and Critical Care Medicine ; 205(1), 2022.
Article in English | EMBASE | ID: covidwho-1927823

ABSTRACT

Rhinoviridae are the most common cause of upper respiratory tract infections, especially in children, and often referred to as “the common cold”. Symptoms are usually mild, nasopharyngeal in nature;they have, however, been implicated in cases of infantile viral pericarditis. Its role in the presentation of adult viral pericarditis remains unclear. We present the case of a 45-year-old male with a past medical history of pre-diabetes, hyperlipidemia and hypertension with complaints of severe left-sided chest pain that worsened with movement and coughing but improved when lying supine. Two weeks prior to presentation, he had developed an intermittent cough, treated with antibiotics and steroids. On presentation to the ED, the patient was afebrile but hypotensive to 80/52 mmHg, tachycardic to 116 BPM, hypoxic to 88% on room air, improving to 91% with 3L nasal cannula. Physical examination was notable for wheezing and egophony. Laboratory findings were concerning for WBC 19.97x10-3/uL, Hgb 13.4 g/dL, CRP 176 mg/L, Ferritin 772 ug/L, D-dimer 3.70 ug/mL FEU;procalcitonin 0.2 ng/mL and troponin <0.015 ng/mL. Respiratory viral panel revealed negative COVID-19 test but positive for rhinovirus/enterovirus. Electrocardiogram showed sinus tachycardia. Chest computed tomography demonstrated moderate pericardial effusion, ground glass attenuation of the lungs bilaterally with moderate left pleural effusion and reflux of contrast into the hepatic veins, suggestive of right heart failure. Echocardiogram demonstrated small to moderate pericardial effusion. The patient was admitted with the diagnosis of acute rhino/enteroviral-associated pleuropericarditis. Broad-spectrum antibiotics, prednisone, colchicine and indomethacin were commenced. Upon clinical stabilization of his condition, steroids were discontinued and he was discharged home with close follow-up. While rhinovirus has been associated with infantile viral pericarditis, it is implicated in pneumonia and COPD exacerbations in adults but rarely reported as a cause of adult pericarditis. A case-control study of adults diagnosed with acute idiopathic pericarditis had an independent association with an upper respiratory tract infection or gastroenteritis in the month preceding pericarditis diagnosis but did not delineate causative viruses. Therefore in cases of unknown causes of viral pericarditis, thorough history is vital. Steroids as part of the treatment algorithm for pleuropericarditis management has long been debated. Older literature has not favored the use of steroids due to high recurrence rate. However, Perrone et al refuted this point, noting that low-dose steroids with gradual tapers have equal efficacy and recurrence rates as compared with NSAIDs/colchicine. Therefore, steroids may be a reasonable option for patients with contraindications to NSAIDs/colchicine.

8.
International Journal of Pharmaceutical and Clinical Research ; 14(6):176-181, 2022.
Article in English | EMBASE | ID: covidwho-1912995

ABSTRACT

Objective: Covid-19 has impacted the health of the people and 20% of the patients were critical and hospitalized with the need for ventilation and intensive care unit (ICU) support. This study aimed to study the association of inflammatory biomarkers with severity of COVID-19 infection. Material & Method: For this study, 545 Covid-19 infected patients admitted in New Civil hospital, Bharuch were selected. The infection related to Covid-19 was confirmed using the Real-Time Reverse Transcription Polymerase Chain Reaction (RT-PCR) test. Pearson correlation was used to assess the correlation between inflammatory markers and laboratory indicators. A p-value of <0.05 was used as a cut-off value for significance. Results: The inflammatory markers and WBC count was significantly elevated in the critical COVID-19 patients. Moreover, patients with lower absolute lymphocyte count (ALC) were significantly associated with severe to critical COVID-19 infection compared to the mild to moderate form that showed higher lymphocyte count (P<0.0001). Moreover, patients with evidence of acute cardiac injury showed a significantly lower ALC (1.08±0.628× 103 cells/μL) compared to (1.38±0.72× 103 cells/μL) (P<0.0001). Conclusion: From the study, it can be concluded that there is a significant association between different inflammatory markers, clinical as well as the laboratory profile of the Covid-19 patients affecting the recovery.

11.
Lung India ; 39(SUPPL 1):S243, 2022.
Article in English | EMBASE | ID: covidwho-1857119

ABSTRACT

Introduction: Mucormycosis is an emerging angioinvasive infection caused by the ubiquitous filamentous fungi of the mucorales order of the class of zygomycetes. It has emerged as one of the most common invasive mycosis in patient with hematological and allogeneic stem cell transplantation. It also remains threat in diabetic and also recently in post covid patients. Case Report: A 62 year old male farmer patient came with complaints of cough with expectoration, fever, moderate hemoptysis and headache. Patient is having uncontrolled diabetes mellitus. All routine blood investigations and coagulation profile was normal. CECT Thorax suggestive of ring like opacities with areas of ground glass opacities surrounded by ring of consolidation suggestive of fungal pneumonia. Simultaneously patient is having severe throbbing headache. So MRI brain with orbit and paranasal sinus done, which suggestive of ethamoidal sinusitis ,osteomyelitis of clivus. Hence IV antifungal amphotericin b started as immediate measure in a view of disseminated fungal infection with strict glycemic control. Sputum smear, microscopy, bacterial culture, gene xpert are negative. Lung biopsy done which suggestive of branching ribbon like hyphae. Hence patient posted for right upper lobectomy. Patient discharged on Tab. Posaconazole. Patient came follow up after 3 months , symptomatically improved and radiological resolution of lesions of chest xray. Conclusion: Mucormycosis is a life threatening infection, and usually the diagnosis late because of nonspecific clinical ,radiological features and need biopsy for confirmation of the organism. The cornerstone for the management and increase the survival rate remain on rapid diagnosis ,treatment of the underlying predisposing condition and urgent surgical debridement.

12.
Journal of the American College of Cardiology ; 79(9):1950-1950, 2022.
Article in English | Web of Science | ID: covidwho-1849405
15.
Journal of the American College of Cardiology ; 79(9):2113-2113, 2022.
Article in English | Web of Science | ID: covidwho-1848842
16.
Journal of the American College of Cardiology ; 79(9):2128-2128, 2022.
Article in English | Web of Science | ID: covidwho-1848841
18.
Journal of Indian Academy of Forensic Medicine ; 43(2):168-172, 2021.
Article in English | Scopus | ID: covidwho-1744702

ABSTRACT

'PANDEMIC': A word which shook the whole world due to the fear of severe acute respiratory syndrome (SARS) - coronavirus-2 (CoV-2) outbreak in Wuhan, China which affected myriad lives worldwide till date. These numbers are increasing rapidly causing an inevitable rise in autopsy cases. Many reputed organizations stepped forward and released guidelines regarding the post-mortem examination in suspected COVID-19 cases. At present we are equipped with various such guidelines. Centre of Disease Control (CDC), Royal College of Pathologists (RCP) and WHO guidance are considered worldwide which elaborate the risks, precautions and safety measures for the Health care worker. In India, Ministry of Health & Family Welfare (MOHFW) has framed the guidelines on dead body management. The following article is a review of the guidelines given by various apex bodies with a pragmatic approach regarding applicability and feasibility in the Indian scenario with certain recommendations. © 2021. Journal of Indian Academy of Forensic Medicine. All rights reserved.

19.
Benchmarking ; 2022.
Article in English | Scopus | ID: covidwho-1741081

ABSTRACT

Purpose: The micro, small and medium scale enterprises (MSMEs) faced various challenges in the ongoing COVID-19 pandemic, making it challenging to remain competitive and survive in the market. This research develops a model for MSMEs to cope with the current pandemic's operational and supply chain disruptions and similar circumstances. Design/methodology/approach: The exhaustive literature review helped in identifying the constructs, their items and five hypotheses are developed. The responses were collected from the experts working in MSMEs. Total 311 valid responses were received, and the structural equation modeling (SEM) approach was used for testing and validating the proposed model. Findings: Critical constructs identified for the study are-flexibility (FLE), collaboration (COL), risk management culture (RMC) and digitalization (DIG). The statistical analysis indicated that the four latent variables, flexibility, digitalization, risk management culture and collaboration, contribute significantly to the firm performance of MSMEs. Organizational resilience (ORS) mediates the effects of all the four latent variables on firm performance (FP) of MSMEs. Practical implications: The current study's findings will be fruitful for the manufacturing MSMEs and other firms in developing countries. It will enable them to identify the practices that significantly help in achieving the firm performance. Originality/value: The previous researches have not considered the effect of “organizational resilience” on the “firm performance” of MSMEs. This study attempts to fill this gap. © 2022, Emerald Publishing Limited.

20.
MEDLINE; 2022.
Preprint in English | MEDLINE | ID: ppcovidwho-329793

ABSTRACT

The ongoing evolution of SARS-Co-V2 variants to omicron severely limits available effective monoclonal antibody therapies. Effective drugs are also supply limited. Covid-19 convalescent plasma (CCP) qualified for high antibody levels effectively reduces immunocompetent outpatient hospitalization. The FDA currently allows outpatient CCP for the immunosuppressed. Viral specific antibody levels in CCP can range ten-to hundred-fold between donors unlike the uniform viral specific monoclonal antibody dosing. Limited data are available on the efficacy of polyclonal CCP to neutralize variants. We examined 108 pre-delta/pre-omicron donor units obtained before March 2021, 20 post-delta COVID-19/post-vaccination units and one pre-delta/pre-omicron hyperimmunoglobulin preparation for variant specific virus (vaccine-related isolate (WA-1), delta and omicron) neutralization correlated to Euroimmun S1 IgG antibody levels. We observed a 2-to 4-fold and 20-to 40-fold drop in virus neutralization from SARS-CoV-2 WA-1 to delta or omicron, respectively. CCP antibody levels in the upper 10% of the 108 donations as well as 100% of the post-delta COVID-19/post-vaccination units and the hyperimmunoglobulin effectively neutralized all three variants. High-titer CCP neutralizes SARS-CoV-2 variants despite no previous donor exposure to the variants. Key points: All of the post-delta COVID-19/post vaccination convalescent plasma effectively neutralizes the omicron and delta variants.High-titer CCP and hyperimmunoglobulin neutralizes SARS-CoV-2 variants despite no previous donor exposure to the variants.

SELECTION OF CITATIONS
SEARCH DETAIL