Characteristics and outcomes of multisystem inflammatory syndrome in children: A multicenter, retrospective, observational cohort study in Mexico.

Introduction: Multisystem inflammatory syndrome in children associated with coronavirus disease 2019 (MIS-C), a novel hyperinflammatory condition secondary to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, is associated with severe outcomes such as coronary artery aneurysm and death. Methods: This multicenter, retrospective, observational cohort study including eight centers in Mexico, aimed to describe the clinical characteristics and outcomes of patients with MIS-C. Patient data were evaluated using latent class analysis (LCA) to categorize patients into three phenotypes: toxic shock syndrome-like (TSSL)-MIS-C, Kawasaki disease-like (KDL)-MIS-C, and nonspecific MIS-C (NS-MIS-C). Risk factors for adverse outcomes were estimated using multilevel mixed-effects logistic regression. Results: The study included 239 patients with MIS-C, including 61 (26%), 70 (29%), and 108 (45%) patients in the TSSL-MIS-C, KDL-MIS-C, and NS-MIS-C groups, respectively. Fifty-four percent of the patients were admitted to the intensive care unit, and 42%, 78%, and 41% received intravenous immunoglobulin, systemic glucocorticoids, and anticoagulants, respectively. Coronary artery dilatation and aneurysms were found in 5.7% and 13.2% of the patients in whom coronary artery diameter was measured, respectively. Any cause in-hospital mortality was 5.4%. Hospitalization after ten days of symptoms was associated with coronary artery abnormalities (odds ratio [OR] 1.6, 95% confidence interval [CI] 1.2-2.0). Age ≥10 years (OR: 5.6, 95% CI: 1.4-2.04), severe underlying condition (OR: 9.3, 95% CI: 2.8-31.0), platelet count <150,000 /mm3 (OR: 4.2, 95% CI: 1.2-14.7), international normalized ratio >1.2 (OR: 3.8, 95% CI: 1.05-13.9), and serum ferritin concentration >1,500 mg/dl at admission (OR: 52, 95% CI: 5.9-463) were risk factors for death. Discussion: Mortality in patients with MIS-C was higher than reported in other series, probably because of a high rate of cases with serious underlying diseases.

Higher Rates of Complicated Appendicitis During the COVID-19 Pandemic: A Year-to-Year Analysis.

INTRODUCTION: The COVID-19 pandemic impacted presentation, management strategies, and patient outcomes of numerous medical conditions. The aim of this study is to perform a year-to-year comparison of clinical outcomes of patients with acute appendicitis (AA) before and during the pandemic. METHODS: Patients treated for AA during the initial 12-mo period of the pandemic at our institute were compared to those treated for AA during the 12-mo period before. Clinical and laboratory parameters, treatment strategies, intraoperative findings, pathology reports, and postoperative outcomes were compared. RESULTS: During the study period, 541 patients presented with AA. The median (interquartile range) age was 28 (21-40) y and 292 (54%) were males. 262 (48%) patients presented during the pre-COVID-19 period, while 279 patients (52%) presented during the COVID 19 pandemic. The groups were comparable for baseline clinical data and imaging results upon index admission. There was no significant difference in rate of nonoperative treatment between the Pre-COVID-19 and During-COVID-19 eras (51% versus 53%, P = 0.6) as well as the success rate of such treatment (95.4% versus 96.4%, P = 0.3). Significantly more patients presented with a periappendicular abscess during COVID-19 (4.6% versus 1.1%, P = 0.01) and median (interquartile range) operative time was significantly longer (78 (61-90) versus 32.5 (27-45) min, P < 0.001). Pathology reports revealed a higher rate of perforated appendicitis during COVID-19 (27.4% versus 10.2%, P < 0.001). CONCLUSIONS: Patients with AA present with higher rates of perforated and complicated appendicitis during the COVID-19 pandemic. The success rates of nonoperative management in selected patients with noncomplicated AA did not change during the pandemic and is a safe, feasible, option.

Polymorphism of genes in patients with new coronavirus infection COVID-19

The incidence of new coronavirus infection (COVID-19) varies significantly between countries and continents. Until now, there has been no clear explanation for this observation. Epidemiological studies have demonstrated a large difference in infection and mortality rates between men and women. This may be due to the gender difference in the polymorphism of genes linked to the X chromosome, which play an important role in the immune response. In addition, there is a different degree of severity of the disease: from an asymptomatic course and mild symptoms to a life-threatening condition requiring hospitalization in the intensive care unit and artificial lung ventilation. Several factors are associated with the severity of COVID-19, such as elderly age, multiple comorbid diseases, smoking, hypercholesterolemia, etc. However, we observe that severe disease is also observed in patients who do not have the above risk factors. In recent months, severe forms of COVID-19 have been reported in children, including early infancy. In this connection, it is relevant, in our opinion, to focus the problem on genetic factors, such as the carriage of single-nucleotide polymorphisms, which can affect susceptibility to infection and variability in the severity of the disease.Copyright © 2022 Sorbtsionnye i Khromatograficheskie Protsessy. All rights reserved.

Preliminary analysis of the epidemiological effectiveness of COVID-19 vaccination in the Saratov Region

The new coronavirus infection (COVID-19) caused by the SARS-CoV-2 virus continues to spread rapidly worldwide, despite the increased prevention and treatment measures being taken. Vaccination is one of the most cost-effective and effective methods of preventing infectious diseases in the modern world, including one of the most effective methods of combating COVID-19. Over several centuries of history, vaccination has proven its effectiveness in saving people's lives, reducing the spread of infectious diseases among the population, as well as reducing mortality. The effectiveness of immunization against COVID-19 is an urgent problem at the moment, especially when it comes to vaccination. The aim of the work is to study the effect of vaccination on the incidence of a new coronavirus infection among residents of the Saratov Region. Material and methods. Methods of retrospective epidemiological analysis of trends in the epidemic process COVID-19 were used. The obtained materials were processed using methods of variational statistics (Excel program). The analysis was based on data from daily monitoring of laboratory diagnostic results (more than 1780 thousand PCR diagnostic studies were conducted during the epidemic), COVID-19 cases and deaths, taking into account the coverage of the population with preventive vaccinations. The statistical significance of the differences was assessed according to the Student's criterion. The differences were considered significant at t<=2. Results and discussion. As of June 30, 2021, more than 267 thousand people or 11% of the population of the Saratov region were fully vaccinated against COVID-19. There were no complications after the introduction of vaccines. In the structure of all medical immunobiological preparations that were immunized, the proportion of the vaccine "Gam-COVID-Vac" was 97.88%, "Epivaccorona" - 1.69% and "Covivac" - 0.43%. According to preliminary data, 361 of the vaccinated people were infected with SARS-CoV-2, of which: 255 (70.6%) had a mild course of the disease with manifestations of catarrhal syndrome, 84 (23.3%) had community-acquired pneumonia, 22 (6%) had no symptoms of the disease. No deaths have been registered among the vaccinated. The overall incidence of COVID-19 among vaccinated was 0.06%. The incidence rate of COVID-19 among the vaccinated population is 6.025+/-0.15 per 10 thousand people, which is significantly lower (t>2) than among the unvaccinated (103.8+/-0.63 per 10 thousand people), efficiency index - 17.23, epidemiological efficiency coefficient - 94.20% Conclusion. Insufficient coverage of the population of the Saratov Region with vaccination (as of June 30, 2021, 11% were fully vaccinated) does not allow to influence the reduction of the incidence of COVID-19. The high epidemiological effectiveness of COVID-19 vaccination of the adult population with domestic vaccines, including people over 65 years of age, has been revealed.Copyright © 2022 Geotar Media Publishing Group

COVID-19 complicating pregnancy: A retrospective study of nine intensive care unit patients

Background: With the emergence of the coronavirus 2019 (COVID-19) pandemic, it was essential to determine the impact of this disease on pregnant women and neonatal outcomes. In this study, we present a series of nine cases of pregnant women with COVID-19 disease requiring intensive care unit (ICU) admission. Method(s): We retrospectively collected clinical data of pregnant women with COVID-19 disease admitted to ICU between September 2020 and September 2021. Result(s): Most common presenting symptom was cough. Two patients had no respiratory symptoms at presentation. Five of the nine patients required invasive mechanical ventilation. Seven patients required caesarean section, four of whom delivered preterm. There were no maternal or neonatal deaths. Conclusion(s): Although maternal and neonatal outcomes reported in our study are encouraging, it is imperative to emphasize the importance of an individualized, multidisciplinary approach, and good healthcare infrastructure for optimal management of this group of patients.Copyright © The Author(s) 2023.

Resilient Hospital Design: From Crimean War to COVID-19.

OBJECTIVES: Serious COVID-19 nosocomial infection has demonstrated a need to design our health services in a different manner. Triggered by the current crisis and the interest in rapid deployable hospital, this article discusses how hospital building layouts can be improved to streamline the patient pathways and thus to reduce the risk of hospital-related infections. Another objective of this work is to explore the possibility to develop flexible and scalable hospital building layouts through modular construction. This enables hospitals to better cope with different future demands and thereby enhance the resilience of the healthcare facilities. BACKGROUND: During the first wave of COVID-19, approximate one-seventh to one-fifth COVID-19 patients and majority of infected healthcare workers acquired the disease in NHS hospitals. Similar issues emerged during the Crimean War (1853-1856) when more soldiers died from infectious diseases rather than of battlefield casualties in Scutari Hospital. This led to an important collaborative work between Florence Nightingale, who looked into this problem statistically, and Isambard Kingdom Brunel, who designed the rapid deployment Renkioi Hospital which yielded a death rate 90% lower than that in Scutari Hospital. While contemporary medical research and practice have moved beyond Nightingale's concept of contagion, challenges of optimizing hospital building layouts to support healing and effectively combat nosocomial infections still pose elusive problems that require further investigation. METHODS: Through case study investigations, this article evaluates the risk of nosocomial infections of airborne transmissions under different building layouts, and this provides essential data for infection control in the new-build or refurbished healthcare projects. RESULTS: Improved hospital layout can be achieved through reconfiguration of rooms and concourse. Design interventions through evidence-based infection risk analysis can reduce congestion and provide extra separation and compartmentalization which will contribute the reduced nosocomial infection rate. CONCLUSIONS: A resilient hospital shall be able to cope with unexpected circumstances and be flexible to change when new challenges arise, without compromising the safety and well-being of frontline medical staff and other patients. Such an organizational resilience depends on not only flexible clinical protocols but also flexible hospital building layouts. The latter allows hospitals to get better prepared for rapidly changing patient expectations, medical advances, and extreme weather events. The reconfigurability of an existing healthcare facility can be further enhanced through modular construction, standardization of building components, and additional space considered.

Modelling spatial variations of novel coronavirus disease (COVID-19): evidence from a global perspective.

In late December 2019, strange pneumonia was detected in a seafood market in Wuhan, China which was later termed COVID-19 by the World Health Organization. At present, the virus has spread across 232 countries worldwide killing 2,409,011 as of 17 February 2021 (9:37 CET). Motivated by a recent dataset, knowledge gaps, surge in global cases, and the need to combat the virus spread, this study examined the relationship between COVID-19 confirmed cases and attributable deaths at the global and regional levels. We used a panel of 232 countries (further disaggregated into Africa-49, Americas-54, Eastern Mediterranean-23, Europe-61, Southeast Asia-10, and Western Pacific-35) from 03 January 2020 to 28 November 2020, and the instrumental variable generalized method of moment's model (IV-GMM) for analysing the datasets. The results showed that COVID-19 confirmed cases at both the global and regional levels have a strong positive effect on deaths. Thus, the confirmed cases significantly increase attributable deaths at the global and regional levels. At the global level, a 1% increase in confirmed cases increases attributable deaths by 0.78%. Regionally, a 1% increase in confirmed cases increases attributable deaths by 0.65% in Africa, 0.90% in the Americas, 0.67% in the Eastern Mediterranean, 0.72% in Europe, 0.88% in Southeast Asia, and 0.52% in the Western Pacific. This study expands the understanding of the relationship between COVID-19 cases and deaths by using a global dataset and the instrumental variable generalized method of moment's model (IV-GMM) for the analysis that addresses endogeneity and omitted variable issues.

Monoclonal antibody designed for SARS-nCoV-2 spike protein of receptor binding domain on antigenic targeted epitopes for inhibition to prevent viral entry.

SARS, or severe acute respiratory syndrome, is caused by a novel coronavirus (COVID-19). This situation has compelled many pharmaceutical R&D companies and public health research sectors to focus their efforts on developing effective therapeutics. SARS-nCoV-2 was chosen as a protein spike to targeted monoclonal antibodies and therapeutics for prevention and treatment. Deep mutational scanning created a monoclonal antibody to characterize the effects of mutations in a variable antibody fragment based on its expression levels, specificity, stability, and affinity for specific antigenic conserved epitopes to the Spike-S-Receptor Binding Domain (RBD). Improved contacts between Fv light and heavy chains and the targeted antigens of RBD could result in a highly potent neutralizing antibody (NAbs) response as well as cross-protection against other SARS-nCoV-2 strains. It undergoes multipoint core mutations that combine enhancing mutations, resulting in increased binding affinity and significantly increased stability between RBD and antibody. In addition, we improved. Structures of variable fragment (Fv) complexed with the RBD of Spike protein were subjected to our established in-silico antibody-engineering platform to obtain enhanced binding affinity to SARS-nCoV-2 and develop ability profiling. We found that the size and three-dimensional shape of epitopes significantly impacted the activity of antibodies produced against the RBD of Spike protein. Overall, because of the conformational changes between RBD and hACE2, it prevents viral entry. As a result of this in-silico study, the designed antibody can be used as a promising therapeutic strategy to treat COVID-19.

Comparison of Atmospheric Environment in China during Sars and Covid-19 Pandemics

Satellite remote sensing has advantages in monitoring environmental changes during the global pandemics such as the Severe Acute Respiratory Syndrome Coronavirus (SARS) and the Corona Virus Disease 2019 (COVID-19). In this paper, the variations of atmospheric environment during SARS and COVID-19 pandemics were calculated and analyzed based on the Moderate Resolution Imaging Spectroradiometer (MODIS) Atmosphere Monthly Global Product. Preliminary results show that: (1) aerosol optical depth is most affected by the pandemics, especially the duration and prevention and control measures;(2) the correlations between the variables of aerosol optical depth, cloud fraction, total column ozone and precipitable water vapor were not very strong during the two pandemics.

Possibilities of simulation of coronavirus SARS-CoV-2 by using light scattering approach.

Issues related to human coronavirus (SARS CoV-2) are a burning topic of research in present times. Due to its easily contagious nature, real experimentation under laboratory conditions requires a high level of biosafety. A powerful algorithm serves as a potential tool for the analysis of these particles. We attempted to simulate the light scattering from coronavirus (SARS CoV-2) model. Different images were modelled using a modified version of a Monte Carlo code. The results indicate that spikes on the viruses exhibit a significant scattering profile and that the presence of spikes during modelling contributes to the distinctiveness of the scattering profiles.

Therapeutic Options for the Treatment of 2019-Novel Coronavirus in India: A Review

Purpose: As of, from 30th Jan to 31st May, 2020, more than 182,143 confirmed cases were reported in India along with 86,984 recovered cases and 5164 deceased cases of COVID-19. More than 53 countries are also affected with this pandemic virus. However, the lack of specific drugs to prevent/treat this pandemic disease is a major problem in this current scenario. In this re-gard, this systemic review was conducted to identify the therapeutic approaches and researches, which are ongoing in India against COVID-19. Method(s): We had screened Google Scholar database with the keywords nCoV, corona virus in In-dia, effect of SARS-CoV-2 in India, 2019-nCoV, treatment pattern in India for nCoV and therapy used to treat nCoV in India. In the final review, we had included a total of 49 articles. Result(s): As a result we had found that the Indian Council of Medical Research and NIH have giv-en a standard guideline of Hydroxychloroquine and other antiviral drugs for nCoV, and also there are various researches going on related to nCoV treatment like, chemicals from natural products, herbs and spices commonly used in India, combination therapy of lopinavir and ritonavir, ultra-vio-let radiation therapy, molecular dynamic (MD) simulations of molecules for vaccine preparation, Convalescent plasma transfusion (CPT) therapy and many more. Conclusion(s): New drugs and therapy are in the premature stage for this hazardous pandemic. We need more time to gain the detailed knowledge of the life cycle of the nCoV, which can speed up the drug/vaccine development process against nCoV.Copyright © 2022 Bentham Science Publishers.

Review on COVID-19 Vaccines

Coronavirus disease 2019 (COVID-19) outbreak started in Wuhan, China when people started with the symptoms of respiratory disorder. The onset of this disease have symptoms like fever, dry cough, fatigue, and difficulty in breathing. The nature of SARS-CoV-2 seems highly contagious as it also can be spread with asymptomatically infected individuals. It has been more than a year which this outbreak have been announced as a pandemic by World Health Organization (WHO) due to major public health crisis and uncontrollable around the globe. Some countries have taken initiatives in inventing vaccines and step up in the clinical trial process since a vaccine is an all-powerful tool which it always been a saviour in fighting infectious disease. In searching for the vaccine, researchers had studied the previously published article of SARS-CoV or MERS as in the beginning, in light, there will be a suitable vaccine to fight this pandemic situation. Recent research on the vaccine has been tested to seek the right vaccine for COVID-19. This study is to focus on the current vaccine development against COVID-19 and to explore the potential vaccines' characteristics that have been studied by the previous proven research findings. This review was done based on the research articles and reviews published until the end of April 2021 through established scientific search engines and related scientific platforms based on the inclusion criteria with its related keywords like coronavirus, SARS-CoV-2, COVID-19 Vaccine, clinical trials, and COVID-19 vaccine development. This review summarized a few vaccine candidates that have entered clinical trials and some supported evidence from Phase I until Phase III clinical trial studies that have been published and reported. In this review, 12 vaccine candidates have the potential to against SARS-CoV-2. Thus, their vaccine platform, characteristic as well as its efficacy studies have been discussed.Copyright © RJPT All right reserved.

Research and application progress of COVID-19 vaccine.

The coronavirus disease 2019 (COVID-19) pandemic is a serious threat to human life, health and social development. In response to this public health event, various COVID-19 vaccines have been rapidly developed around the world. To date, 41 vaccines have been approved for emergency use, and the use of vaccines has significantly reduced the morbidity and mortality of COVID-19. However, with the continuous mutants, especially the emergence of the Omicron variant, challenges to vaccine-induced immune protection are appearing, there is still a long way to go for the continued development of COVID-19 vaccines. This article briefly reviews the research progress of COVID-19 vaccine and its effect on mutant virus strains.Copyright © 2022 Authors. All rights reserved.

Anticipating a Post COVID-19 World and the Pivotal Role of Science and Technology

Currently, the Coronavirus disease (COVID-19) has transformed into a severe public health crisis and wreaking havoc worldwide. The ongoing pandemic has exposed the public healthcare system's weaknesses, and highlighted the urgent need for investments in scientific programs and policies. A com-prehensive program utilizing the science and technology-driven strategies combined with well-resourced healthcare organizations appears to be essential for current and future outbreak management.Copyright © 2021 Bentham Science Publishers.

Critical Insight into the Attributes of Emerging Novel Coronavirus (COVID-19) in India and Across the World

The World Health Organization (WHO) has recently announced the spread of novel coronavi-rus (nCoV) globally and has declared it a pandemic. The probable source of transmission of the virus, which is from animal to human and human to human contact, has been established. As per the statistics reported by the WHO on 11th April 2020, data has shown that more than sixteen lakh confirmed cases have been identified globally. The reported cases related to nCoV in India have been rising substantially. The review article discusses the characteristics of nCoV in detail with the probability of potentially effective old drugs that may inhibit the virus. The research may further emphasize and draw the attention of the world towards the development of an effective vaccine as well as alternative therapies. Moreover, the article will help to bridge the gap between the new researchers since it's the current thrust area of research.Copyright © 2020 Bentham Science Publishers.

Computational Study Reveals the Inhibitory Effects of Chemical Constituents from Azadirachta indica (Indian Neem) Against Delta and Omicron Variants of SARS-CoV-2

Background: The newly emerged delta and omicron variants of severe acute respiratory syn-drome coronavirus (SARS-CoV-2) have affected millions of individuals globally with increased transmis-sible and infectivity rates. Although, numerous vaccines are available or under clinical trials to combat the SARS-CoV-2 and its variant, still, a therapeutic agent is awaited. Objective(s): The present work is focused on rigorous screening of chemical constituents of Azadirachta indica (A. indica) against delta and omicron variants of SARS-CoV-2 via inhibition of S-glycoprotein. Method(s): Total, 10 compounds of A. indica were subjected to molecular docking and pharmacophore modeling studies against the S-glycoprotein of delta and omicron variants of SARS-CoV-2. Furthermore, homology modeling was performed for omicron S-glycoprotein with the help of SWISS-MODEL and aligned by PyMOL software. Later on, the residues of protein were verified in the allowed region via Ramachandran plot. In addition, our docking results have also been validated by MMGBSA binding free energy calculations. Result(s): Our computed study demonstrated that nimbolinin B12-methyl ether and nimbidinin showed promising docking scores (>-6.0) as compared to docking scores (< 6.0) of reference drug 'camostat' against S-glycoproteins of both delta and omicron variants. Redocking by using MMGBSA calculation also reveals that both these compounds can effectively bind within the pockets of said protein receptors Conclusion(s): Nimbolinin B12-methyl ether and nimbidinin have potent anti-SARS-CoV activity against delta and omicron variants and thus, A. indica might be a useful source for developing novel anti-SARS-CoV-2 therapeutic agents.Copyright © 2022 Bentham Science Publishers.

Applications of alignment-free sequence descriptors in the characterization of sequences in the age of big data: a case study with Zika virus, SARS, MERS, and COVID-19

This chapter gives a detailed presentation of the theoretical background and computational approaches to the utility of alignment-free sequence descriptors and multidimensional variable reduction methods in the characterization and visualization of biological sequence data. The utility of such novel methods developed by the authors of this chapter is shown using data on case studies of severe acute respiratory syndrome, Middle East respiratory syndrome, Coronavirus disease-2019, and Zika viruses. © 2023 Elsevier Inc. All rights reserved.

Genetic Association of Angiotensin-converting enzyme 2 ACE-2 (rs2285666) Polymorphism with the Susceptibility of COVID-19 Disease in Iraqi Patients

Significant risks to human health are posed by the 2019 coronavirus illness (COVID-19). SARS coronavirus type 2 receptor, also known as the major enzyme in the renin-angiotensin system (RAS), angiotensin-converting enzyme 2 (ACE-2), connects COVID-19 and RAS. This study was conducted with the intention of determining whether or not RAS gene polymorphisms and ACE-2 (G8790A) play a part in the process of predicting susceptibility to infection with COVID-19. In this study 127 participants, 67 of whom were deemed by a physician to be in a severe state of illness, and 60 of whom were categorized as "healthy controls".The genetic study included an extraction of genomic DNA from blood samples of each covid 19 patients and healthy controls, then amplification the site of SNP (rs2285666) Within the ACE2 gene by using specific primers, sequencing PCR products, and genotyping to detect the role of the ACE-2 gene (rs2285666) in the incidence of COVID-19. ACE-2 (rs2285666) is statistically associated to COVID-19. The COVID-19 group had 65.67 %of individuals with the wild-type homozygous genotype (GG) and 20% in the control group, while the control group had 63.33% of individuals with the mutant genotype (AA). Consequently, the wild-type homozygous (GG) and allele (G) may be considered a risk factor (etiological fraction E. F) for COVID-19 in Iraqi patients, whereas the mutant homozygous (AA) and allele (A) may be considered a protective factor (preventive fraction). The findings of the present study reveal that carriers of the GG genotype of ACE2 (rs2285666) are substantially more susceptible to COVID-19.Copyright © 2023 Allami et al.

The coronavirus conundrum Countries better prepared to face the pandemic The Omicron variant and mutations New vaccines? The pregnant woman, the placenta, the fetus and the neonate / El enigma del coronavirus - Países mejor preparados para enfrentar la pandemia La variante ómicron y mutaciones - ¿Nuevas vacunas? La gestante, la placenta, el feto y neonato

RESUMEN Varios países occidentales han iniciado la vuelta a la vida prepandemia al disminuir el número de infectados severos y muertes a pesar de la gran infectividad de la variante ómicron B2. Esto ocurre en medio de reclamos de la población cansada de las restricciones por el COVID-19, los problemas económicos y laborales consecuentes y con un sector antivacuna con importante presencia. El SARS-CoV-2 no desaparecerá, se presentarán nuevas variantes y se deberá estar alerta a sus amenazas y diseñar nuevas vacunas. Sin embargo, el ser humano está aprendiendo las medidas para no infectarse, la importancia de la autoprotección y de la familia, y la vigilancia del virus. Se ha logrado vacunas aún imperfectas que requieren refuerzos en intervalos relativamente cortos. Pero, muchos países no están aún preparados para enfrentar la pandemia -ahora endemia-, por demasiada confianza a una eventual desaparición del virus, la falta de recursos humanos y económicos para una mejor atención en salud, corrupción. La mujer es más sensible a la infección viral y se está haciendo vacunar para evitar la infección grave y muerte. La evidencia encuentra que la gestante con COVID-19 sufre más abortos, partos pretérmino y muerte intrauterina y perinatal. La placenta es la unidad más comprometida en su defensa al feto. La placentitis resultante causa insuficiencia placentaria y lesión hipóxico-isquémica fetal. Los recién nacidos tienen protección dada por el pasaje de anticuerpos maternos, con mayor duración los originados por las vacunas. Aún queda mucho por conocer sobre el futuro de la infección por SARS-CoV-2. Pero ya es realidad un problema complejo e impactante producto de la infección la prolongación de los daños multiorgánicos ocurridos, aún con enfermedad leve, principalmente en los sistemas cardiovascular, pulmonar y cerebral, así como la alteración de la salud mental y el acortamiento de la vida.

ABSTRACT Several western countries have initiated the return to pre-pandemic life with the reduction in the number of severe infections and deaths despite of the high infectivity of the Omicron B2 variant. This is occurring amid complaints from the population tired of the restrictions due to COVID-19, the consequent economic and labor problems and with an antivaccine sector with an important presence. SARSCoV-2 will not disappear, new variants will emerge, and it will be necessary to be alert to its threats and design new vaccines. However, human beings are learning the measures to prevent infection, the importance of self-protection and of the family, and the surveillance of the virus. Imperfect vaccines have been developed that require boosters at relatively short intervals. However, many countries are not yet prepared to face the pandemic now endemic due to overconfidence in the eventual disappearance of the virus, lack of human and economic resources for better health care, and corruption. Women are more sensitive to viral infection and is getting vaccinated to avoid serious infection and death. Evidence finds that pregnant women with COVID-19 suffer more miscarriages, preterm deliveries, and intrauterine and perinatal death. The placenta is the unit most compromised in its defense of the fetus. The resulting placentitis causes placental insufficiency and fetal hypoxic-ischemic injury. Newborns are protected by the passage of maternal antibodies, with a longer duration of those originated by vaccines. Much remains to be known about the future of SARS-CoV-2 infection. But a complex and shocking problem resulting from the infection is already a reality - the prolongation of multiorgan damage, even with mild disease, mainly in the cardiovascular, pulmonary, and cerebral systems, as well as the alteration of mental health and shortening of life.

Neuro-Behcet's disease in the setting of active COVID-19 infection

Background: Cases of SARS-COV-2 triggering or exacerbating autoimmune responses has been described in the literature, and it has shown that use of steroids in non-severe COVID-19 may potentially increase mortality. Case presentation: A 22 year-old African-American man presented with headache, weight, loss, and oral/scrotal ulcerations. Case report: Neurological exam revealed somnolence and right hemiplegia. MRI was remarkable multiple enhancing lesions involving the brainstem and left hemisphere. He was found to have a positive SARS-CoV-2 test. Work-up was unrevealing, and he was diagnosed with Neuro-Behcet's disease (NBD) based on the International Criteria for Behcet's Disease (ICBD)ackspaceD)BackspaceBackspacep. The patient was treated with systemic steroids, which resulted in both clinical and radiological improvement of his disease without exacerbation of his SAR-CoV-2 infection. Conclusion(s): This case presentation suggests that IV steroids may be safe in the treatment of NBD in adult patients presenting with SARS-CoV-2 infection.Copyright © 2021