COVID-19 during the Third Semester of Pregnancy: Maternal Characteristic, Possibility of Intrauterine Transmission and Neonatal Outcome in Aceh, Indonesia

BACKGROUND: Pregnant women are vulnerable against COVID-19 infection due to physiological and immunological changes. COVID-19 in pregnancy affects fetal well-being with a potential for vertical infection. AIM: This study aims to determine the incidence of vertical infection and anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies in infants born to mothers with positive COVID-19 infection. MATERIALS AND METHODS: Amniotic fluid, swabs of the newborn's nasopharynx and oropharynx, and swabs of the placenta were examined using reverse transcription polymerase chain reaction (RT-PCR) for SARS-CoV-2. Serological examination was performed by Electro-Chemiluminescence Immunoassay on infant's blood. RESULT(S): Four of 33 pregnant women gave birth to infants positive SARS-CoV-2 infection. RT-PCR examination of all amniotic fluid and placental swabs was negative for SARS-CoV-2. Four of 33 infants (12.1%) showed negative polymerase chain reaction (PCR) results but positive SARS-CoV-2 antibodies, another 4 newborns (12.1%) showed positive PCR results, but no SARS-CoV-2 antibodies detected. The remaining 25 babies (75.8%) showed both negative PCR and serologic results. CONCLUSION(S): No evidence of vertical transmission found in this study.Copyright © 2023 Cut Meurah Yeni, Zinatul Hayati, Sarjani M. Ali, Hasanuddin Hasanuddin, Rusnaidi Rusnaidi, Cut Rika Maharani.

Evaluation and Management of Dysphagia During the COVID-19 Pandemic

Dysphagia is a common symptom which requires a multidisciplinary approach to its assessment and management. Currently, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for the novel coronavirus disease 2019 (COVID-19) pandemic. Reports of SARS-CoV-2 dissemination via droplet and aerosol production imply risks of virus transmission by both. The risk of transmission of SARS-CoV-2 during nasal endoscopic procedures has elicited concern from clinicians and other healthcare workers regarding the level of personal protective equipment required during any transnasal procedure. SARS-CoV-2 infection has a variety of clinical manifestations of which pneumonia is the most devastating and which may potentially be fatal. Complications after prolonged endotracheal intubation or tracheostomy are common and include dysphagia. Poor lung function following recovery from pneumonia is an underrated precipitating factor for dysphagia. Multiple cranial nerve neuropathies are a more common direct cause of dysphagia that require urgent evaluation and treatment to avoid the complications of aspiration pneumonia that may compound the existing pneumonia caused by SARS-CoV-2. A videofluoroscopic study of a patient with dysphagia after recovering from COVID-19 will likely demonstrate significant impairment of their oral and pharyngeal phase of swallowing. A practical workflow for assessing and managing dysphagia during the COVID-19 pandemic is crucial to ensure the safety of both patients and healthcare workers. Critical considerations include the reservation of instrumental assessments for urgent cases only, the optimization of the non-instrumental swallowing evaluation, the appropriate use of personal protective equipment (PPE), and the use of telemedicine when appropriate. Despite significant limitations in the clinical service provision during the current COVID-19 pandemic, a safe and reasonable dysphagia care pathway can still be implemented with an understanding of safety precautions, modifications of the investigation setup and with the application of newer technologies. © The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2022.

Pericarditis related to post-acute COVID infection: A case report and review of the literature.

Cardiovascular involvement has been described in acute and recovered COVID-19 patients. Here, we present a case of symptomatic pericarditis with persistent symptoms for at least six months after the acute infection and report 66 published cases of pericarditis in discharged COVID patients. Patient mean age ± SD was 49.7 ± 13.3 years, ranging from 15 to 75 years and 57.6% were female. A proportion of 89.4% patients reported at least one comorbidity, with autoimmune and allergic disorders, hypertension and dyslipidaemia, as the most frequent. Only 8.3% of patients experienced severe symptoms of acute COVID-19. The time between acute COVID and pericarditis symptoms varied from 14 to 255 days. Chest pain (90.9%), tachycardia (60.0%) and dyspnoea (38.2%) were the most frequent symptoms in post-acute pericarditis. A proportion of 45.5% and 87% of patients had an abnormal electrocardiogram and abnormal transthoracic ultrasound, respectively. Colchicine combined with non-steroidal anti-inflammatory drug (NSAID) or acetylsalicylic acid (aspirin) were prescribed to 39/54 (72%) patients. Of them, 12 were switched to corticosteroid therapy due to non-response to the first-line treatment. Only 6 patients had persisting symptoms and were considered as non-respondent to therapy.Our report highlights that pericarditis should be suspected in COVID-19 patients with persistent chest pain and dyspnoea when pulmonary function is normal. Treatment with non-steroidal anti-inflammatory and colchicine is usually effective but corticosteroids are sometimes required.

CORRELATION OF SARS-COV-2 EXPRESSION IN THE PLACENTA AND THE INCIDENCE OF PREECLAMPSIA.

Background: The pandemic caused by SARS-CoV-2 also caused infection in some pregnant women. Some reports say this viral infection can show symptoms of preeclampsia. Material and Methods: We analyzed 25 pregnant women with SARS-CoV-2 infection with 4 patients presenting with symptoms of preeclampsia. we performed routine blood analysis, renal function, liver function, and IHC examination to see the expression of viral proteins in the placenta. Results: we obtained 4 patients with confirmed SARS-CoV-2 infection by RT-PCR. In these 4 cases, none of the cases showed expression of the SARS-CoV-2 viral protein in the placenta, and all 4 mothers were declared dead after treatment, and 2 babies delivered out of these 4 cases died. In one case we had fetal death in pregnancy while in one case prematurity. 2 babies born to mothers with SARS-CoV-2 infection with preeclampsia were born in good condition. There were no babies infected with SARS-CoV-2. Conclusion: We conclude that SAR-CoV-2 infection in pregnant women with comorbidities can lead to a poor prognosis for both mother and baby. We cannot yet conclude whether SARS-CoV-2 infection can cause preeclampsia, but SARS-CoV-2 infection can exacerbate preeclampsia symptoms.

Detection of Sars-Cov-2 from human chest CT images in Multi-Convolutional Neural Network's environment

This article focuses on the detection of the Sars-Cov2 virus from a large-scale public human chest Computed Tomography (CT) scan image dataset using a customized convolutional neural network model and other convolutional neural network models such as VGG-16, VGG-19, ResNet 50, Inception v3, DenseNet, XceptionNet, and MobileNet v2. The proposed customized convolutional neural network architecture contains two convolutional layers, one max pooling layer, two convolutional layers, one max pooling layer, one flatten layer, two dense layers, and an activation layer. All the models are applied on a large-scale public human chest Computed Tomography (CT) scan image dataset. To measure the performance of the various convolutional neural network models, different parameters are used such as Accuracy, Error Rate, Precision, Recall, and F1 score. The proposed customized convolutional neural network architecture's Accuracy, Error Rate, Precision Rate, Recall, and F1 Score are 0.924, 0.076, 0.937, 0.921, and 0.926 respectively. In comparison with other existing convolutional neural network strategies, the performance of the proposed model is superior as far as comparative tables and graphs are concerned. The proposed customized convolutional neural network model may help researchers and medical professionals to create a full-fledged computer-based Sars-Cov-2 virus detection system in the near future. © 2023 IEEE.

COVID-19 and pulmonary Tubercuiosis coinfection: three case reports from Iran

Tubercuiosis is still a significant problem worldwide. Until the COVID-19 pandemic, tuberculosis was the leading cause of mortality from a single infectious agent. Pulmonary Tubercuiosis patients are more tending to be co-infected with COVID-19 notably when they have a history of exposure. There are some case reports relating to pulmonary TB and COVID-19 coinfection but the information about TB and COVID-19 was still little. We report three coinfected patients. Case one and two were both middle-aged Iranian mans with history of opium addiction, case one presented with dyspnea and weakness and case two presented with progressive weakness. Case three was a healthy young man with history of progressive dyspnea, productive cough and hemoptysis. Case one and case three were improved. In conclusion, COVID-19 is still an important issue and can coexist with other lung infections such as Pulmonary Tubercuiosis, so we should be aware of the advancement of the Tubercuiosis epidemic after the COVID-19 pandemic.Copyright © 2023 Tuberculosis Association of India

The effects of exogenous estrogen in women with SAR-CoV-2 infection: a systematic review and meta-analysis.

STUDY QUESTION: Does exogenous estrogen use affect COVID-19-related mortality in women? SUMMARY ANSWER: Menopausal hormone therapy (MHT) was associated with a lower likelihood of all-cause fatality related to COVID-19 in postmenopausal women (odds ratio (OR) 0.28, 95% CI 0.18, 0.44; 4 studies, 21 517 women) but the combined oral contraceptive pill in premenopausal women did not have a significant effect (OR 1.00, 95% CI 0.42-2.41; 2 studies, 5099 women). WHAT IS KNOWN ALREADY: Men are much more likely to die from COVID-19 than women. STUDY DESIGN, SIZE, DURATION: In this systematic meta-analysis, a literature search was conducted using the following search terms related toCOVID-19 and estrogen, sex hormones, hormonal replacement, menopause, or contraception. The PubMed, Scopus, Cochrane Library, and EMBASE databases were searched to identify relevant studies published between December 2019 and December 2021. We also searched MedRxiv as a preprint database and reviewed the reference lists of all included studies and clinical trial registries for ongoing clinical studies until December 2021. PARTICIPANTS/MATERIALS, SETTING, METHODS: All comparative studies that compared the rates mortality and morbidity (hospitalization, intensive care unit (ICU) admission, and ventilation support) due to COVID-19 in women using exogenous estrogen to a control group of women (nonusers) were included. A review of the studies for inclusion, extraction of data, and assessment of the risk of bias was performed independently by two reviewers. The ROBINS-I tool and the RoB 2 tool were used for bias assessment of the included studies. Pooled odds ratios (ORs) with 95% CIs were calculated using Review Manager V5.4.1. The I2 statistic was used to quantify heterogeneity. The quality of the evidence was assessed using GRADE criteria. MAIN RESULTS AND THE ROLE OF CHANCE: After searching the databases, we identified a total of 5310 studies. After removing duplicate records, ineligible studies, and ongoing studies, a total of four cohort studies and one randomized controlled trial comprising 177 809 participants were included in this review. There was a moderate certainty of evidence that MHT was associated with a lower likelihood of all-cause fatality related to COVID-19 (OR 0.28, 95% CI 0.18, 0.44; I2 = 0%; 4 studies, 21 517 women). The review indicated a low certainty of evidence for other outcomes. The mortality rate of premenopausal women in the combined oral contraceptive pill group did not differ significantly from the control group (OR 1.00, 95% CI 0.42-2.41; 2 studies, 5099 women). MHT marginally increased the rate of hospitalization and ICU admission (OR 1.37, 95% CI 1.18-1.61; 3 studies, 151 485 women), but there was no significant difference in the need for respiratory support between MHT users and nonusers (OR 0.91, 95% CI 0.52-1.59; 3 studies, 151 485 women). Overall, the tendency and magnitude of the effects of MHT in postmenopausal women with COVID-19 were consistent across the included studies. LIMITATIONS, REASONS FOR CAUTION: The certainty of the evidence for other outcomes of this review may be limited, as all included studies were cohort studies. In addition, the dosages and durations of exogenous estrogen used by postmenopausal women varied from study to study, and combined progestogen administration may have had some effect on the outcomes. WIDER IMPLICATIONS OF THE FINDINGS: The findings of this study can aid in counseling postmenopausal women taking MHT when they are diagnosed with COVID, as they have a lower chance of death than those not taking MHT. STUDY FUNDING/COMPETING INTEREST(S): Khon Kaen University provided financial support for this review and had no involvement at any stage of the study. The authors have no conflicts of interest to declare. REGISTRATION NUMBER: PROSPERO, CRD42021271882.

Exploring polyamine interactions and binding pockets in SARS-CoV-2 ORF3a.

Ongoing global pandemic caused by coronavirus (COVID-19) requires urgent development of vaccines, treatments, and diagnostic tools. Open reading frame 3a (ORF3a) from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is considered to be a potential drug target for COVID-19 treatment. ORF3a is an accessory protein that plays a significant role in virus-host interactions and in facilitating host immune responses. Using putrescine, spermidine and spermine, an aliphatic polyamine for the activity suppression of ORF3a appears to be a promising approach in finding new targets for drug design. In this study, we explored the possible binding poses of polyamines to the ORF3a protein using a combination of various computational approaches i.e. pocket prediction, blind and site-specific molecular docking, molecular dynamics and ligand flooding simulations. The results showed that the tip of cytoplasmic domain and the upper tunnel of transmembrane domain of ORF3a provide a suitable binding site specific for the polyamines. MD simulations revealed the stability of spermidine binding in the upper tunnel pocket of ORF3a through salt bridge and hydrogen bond interactions between the amine groups of the ligand and negatively charged residues of ORF3a. These findings can be helpful in designing new therapeutic drugs.

CFD STUDY OF THE INFLUENCE OF SARS-COV-2 DEPOSITION ON HUMAN LUNG DYNAMIC: A COMPARISON BETWEEN HEALTHY AND DISEASED CONDITION

This paper presents a numerical approach to analyze the influence of SARS-CoV-2 deposition on human lung dynamics under real conditions. A comparison is made between a healthy and a diseased lung. A multiphase three-dimensional computational fluid dynamics (CFD) study is performed for the dispersion of covid-19 virus particles throughout the alveolar tree. Then, fully coupled fluid-structure interaction (FSI) is used to evaluate the expansion properties of the alveolar wall. The mesh morphing technique with solid displacement characteristics is used to obtain a realistic wall displacement during the inspiratory and expiratory phases corresponding to the expansion and retraction of the alveolar sac, respectively. These phases are studied under steady-state conditions. The main objective of this study is to evaluate how particle deposition alters the displacement of alveoli exposed to a Sars-Cov-2 and to compare the obtained simulation results with the healthy case. The novelty of this analysis is that it examines where the virus is most deposited and how the presence of Sars-Cov-2 can affect the mechanical properties of the alveolar sac and worsen the respiratory capacity of a sick person at an advanced stage of infection. Copyright © 2022 by ASME.

Impact of age dominating over the pre-existing comorbidities influencing the D-Dimer levels in SARS-COV-2 infection

COVID-19-related disease severity is more commonly seen in elderly patients with comorbidities, and hypercoagulability has been demonstrated to be involved in the disease progression. This study aimed to evaluate the level of D-Dimer in hospitalized SARS-COV-2 infected patients and to determine the influence of age, gender, Body Mass Index (BMI), and comorbidities on Ddimer value and correlate it with disease severity. This case-control retrospective study retrieved patient data on demographic characteristics, vital functions, comorbidities, disease severity [National Institutes of Health (NIH) classification], and D-dimer from medical records of Thumbay University Hospital, Ajman, United Arab Emirates. SPSS-Version-28 was used for data analysis;a Chi-Square test was done to compare the distribution of comorbidities and disease severity between demographic categories. An independent sample t-test and one-way ANOVA were done to compare mean levels of D-Dimer between two or more categories, respectively. The majority of patients were males, >40 years of age, overweight/obese, with 30% having one comorbidity and 20% having ≥2 comorbidities. Among the total, three-quarters had moderate, and one-quarter had severe disease conditions, irrespective of gender or BMI, with an increasing trend of severe cases in the older age group and with comorbidities. Increased D-dimer levels were seen in the majority of SARS-COV-2-infected hospitalized patients, with age as the primary determinant, irrespective of absence or presence of comorbidity, though the trend of higher prevalence of elevated D-dimer value in the multiple comorbid groups and more severe condition was observed. Supporting SAR-COV-2 as a coagulopathic condition, D-dimer concentrations can be a helpful marker of disease progression and can be considered to guide the clinical treatment. [ FROM AUTHOR] Copyright of Journal of Applied & Natural Science is the property of Applied & Natural Science Foundation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Transient Leukopenia Induced by Combination Therapy for Severe SARS-CoV-2 Pneumonia.

Treatment strategies for patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continue to be heavily researched and ever-changing. Recent data has suggested that combination therapy with dexamethasone, remdesivir and baricitinib could decrease the severity and length of illness in patients with severe SARS-CoV-2. However; the data regarding the safety and side effects related to this combination therapy are limited to case reports. The purpose of this case report is to highlight a potentially life-threatening side effect of one or all medications mentioned above. LEARNING POINTS: Current National Institutes of Health treatment guidelines recommend remdesivir for patients with a high risk of progression. In patients requiring minimal supplemental oxygen, remdesivir or dexamethasone monotherapy is recommended, while in patients requiring high-flow oxygen or non-invasive ventilation, dexamethasone monotherapy or dexamethasone plus remdesivir is recommended. Baricitinib or tocilizumab can be added in patients requiring oxygen supplementation.Clinicians should be aware of transient leukocytopenia that can be induced with combination therapy of dexamethasone, remdesivir and baricitinib during the early phase of treatment of SARS-CoV-2 patients.The evaluation approach for leukopenia should consider autoimmune disorders, inflammatory diseases, infections, malignancy, and medication and toxin exposure.

COVID-19 vaccination in peritoneal dialysis patients.

BACKGROUND: COVID-19 vaccine is recommended in Peritoneal dialysis (PD) patients, but a paucity of data is available regarding vaccine-related adverse effects among PD patients. METHOD: A cross-sectional study was conducted in a single center between October and November 2021. PD patients were provided with the online survey link to participate in the study. RESULTS: A total of 107 PD patients responded to the survey (55%: male, 79%: Chinese, 40%: > 65 years old). Of these, 95% received the COVID-19 vaccine (77% received two doses and 22% received three doses). Most participants (91%) received Pfizer vaccine. The main source of vaccine information was from the government (48%). The most common reason to receive and refuse vaccines were the perception of the seriousness of COVID-19 infection (63%) and concern about vaccine safety (60%), respectively. After the first dose, 25% of patients developed one or more vaccine-related adverse effects. Common local adverse effect was pain at the injection site (21%), and systemic adverse effects were muscle pain (15%), fatigue (13%). Similar adverse effects were observed with subsequent doses. None of them required hospitalization for vaccine-related adverse effects. Female patients had a higher risk of developing adverse effects than male patients after the first dose (odds ratio: 3.37; 95% confidence interval: 1.25 - 9.08). No such difference was observed in the subsequent dose. Age, race, employment status and history of drug allergy were not associated with the risk of adverse effects. CONCLUSIONS: The COVID-19 vaccine was well-tolerated by most PD patients, but few experienced non-severe adverse effects. All PD patients should be vaccinated against SAR-COV-2 infection.

Prolonged Viral Shedding in Three Young Adult Cases of COVID-19

Severe acute respiratory syndrome coronavirus-2 infection is usually self-limited, with a short duration for viral shedding within several weeks. However, prolonged viral shedding has been observed in severe or immune-compromised coronavirus disease 2019 (COVID-19) cases. Here, we reported that three young adult cases of COVID-19 patients, who were either immunosuppressed nor severe, showed prolonged viral RNA shedding from the upper respiratory tract for 58, 81, and 137 days since initial diagnosis. To our knowledge, this is the longest duration of viral shedding reported to date in young adult patients. Further studies on factors relevant to prolonged viral positivity, as well as the correlation between viral positivity and transmission risk are needed for the optimal management of COVID-19 patients with prolonged nucleic acid positive. © Copyright 2022 The Chinese Medical Association, published by Wolters Kluwer Health, Inc.

Molnupiravir is effective in patients with haematological malignancies.

Patients with hematologic malignancies are particularly vulnerable to severe infectious complications. SARS-CoV-2 infection is associated with a high risk of severe course and death in this patient population. In addition, immune deficits associated with both the blood cancer and the treatment used make vaccination against SARS-CoV-2 less effective than in immunocompetent individuals. Molnupiravir is one of the first oral antiviral drugs to demonstrate a significant benefit in reducing hospitalisation and death in COVID-19 in the general population. In this context, 175 haematology patients with diagnosed COVID-19, and treated with MOL between January and April 2022, came under our scrutiny with a view to defining their clinical characteristics and outcomes. The most common underlying conditions were lymphomas (45%), multiple myelomas (21%) and acute leukaemias or myelodysplastic syndrome (35%). Of all, 77% of the patients were vaccinated, and half of them received a booster. At 28 days after the breakthrough COVID-19 diagnosis, 35 (20%) subjects required hospital admission. Out of those patients, seven (4%) died during the follow-up due to the progression of COVID. Our results corroborate what has been established to date with regard to the positive clinical and safety outcomes of MOL in haematology patients with mild or moderate COVID-19.

Nanosponges: Advancement in Nanotherapeutics

The emergence of nanotechnology paves the way for improving disease therapy strategies. An investigation into the progression of the release of the medication targeting the specified predetermined location is a significant factor to consider. Due to the ability to advance existing products and to develop new products in a variety of applications, the nanotechnology industry is considered an evolving technology. Cyclodextrin-based porous nanoparticles or unique nano-sponges (NSs) which have recently been used in the pharmaceutical, biomedical, and cosmetic industries are the main elements of this growth. This superior technology can circumvent the defects of current techniques by its ability to attack and visualize tumour sites. A biodegradable and biocompatible feature along with a built-in high surface area resulting in enormous amounts of drug loading and biomimetic design, and the ability to control nanoparticles size are just a handful of good attractive attributes that find this technique as an overwhelming advantage in the field of nanomedicine. This review article is organized such that we first explored the unique features of these nanosponges and the diverse methods for synthesizing, followed by the drug loading and release principle and application based on drug delivery, targeting, boosting solubility of BCS Class II and IV drugs, others in biomedicine and more. Finally, the recent progress on the use of biomimetic nanosponge as a pandemic tool due to the SARS-CoV-2 virus briefly comes into line. Copyright © RJPT All right reserved.

Mortality and Clinical Characteristics of Multisystemic Inflammatory Syndrome in Children (Mis-C) Associated with Covid-19 in Critically Ill Patients in a Middleincome Country: Observational Multicenter Study

BACKGROUND AND AIM: The clinical presentation and severity of (MIS-C) presents a very low mortality in high-income countries. This research describes clinical characteristics of MIS-C in critically ill children in middleincome countries and factors associated with mortality and critical outcomes. METHOD(S): Observational cohort study in 14 (PICUs) in Colombia between April 2020 -January 2021. Patient age from one month to18 years, that met WHO requirements for MIS-C. RESULT(S): There were 78 children in this study. The median age was seven years (IQR 1-11), 18 % (14/78) were under one year old. 35 % of patients (29/78) were obese or overweight. 100 % had fever upon arrival to the clinic lasting at least five days (IQR 3.7-6). 70 % (55/78) of patients had diarrhea, and 87% (68/78) shock or systolic myocardial dysfunction (78 %), 35% (27/78) coronary aneurysms, and pericardial effusion in 36 %.There was a higher mortality rate compared to high in-come countries (9 % vs. 1.8 %;p=0.001). When assessing the group of patients who died, ferritin levels was above 500 ngr/mL (100 % vs. 45 %;p=0.012), as well as more cardiovascular complications (100 % vs. 54 %;p = 0.019). CONCLUSION(S): MIS-C in critically ill children living in a middle-income country has some clinical, laboratory, and echocardiographic characteristics, similar to high-income countries. Inflammatory response and cardiovascular involvement added to the difficulties in accessing the healthcare system in limited resources countries, could explain the greater mortality seen. Prospective studies are needed to compare the differences found in MIS-C outcomes between countries with different income.

Cross-sectional study to determine the prevalence of telogen effluvium among patients experiencing COVID-19 infection or vaccination in Saudi Arabia and Arabic countries

Background: Telogen effluvium (TE) after COVID-19 infection or vaccination is a common sequelae in dermatology clinics. Objective(s): to study the prevalence of telogen effluvium in COVID-19 patients and its association with COVID vaccine. Method(s): Cross-sectional study via online questionnaire in Saudi Arabia and other Arabic countries. Result(s): Prevalence of hair loss among COVID-19 patients is ~85% with 45.9% meeting the criteria of TE. Majority of those with high fever associated with COVID-19 developed TE (87.5%). 100% of hospitalized patients exhibited TE with 58% having diffuse hair loss for less than 6 months (acute TE) and 32% for more than 6 months (chronic TE). 63.2% of our participants had hair loss after COVID vaccination regardless of vaccine type with the majority experiencing it after the first dose (55.8%). Limitation(s): The majority of the participants were female. Other factors associated with hair loss were taken into consideration. Conclusion(s): COVID-19 infection and its vaccines carry a high risk for development of telogen effluvium. Copyright © 2022 Ubiquity Press. All rights reserved.

Mortality rate in patients with SAR-COV-2 infection treated with extracorporeal membrane oxygenator: A systematic review and meta-analysis.

BACKGROUND: Extracorporeal membrane oxygenator (ECMO) is one of the life-saving modalities for the treatment of multiple organs dysfunction, particularly the heart and the lungs. OBJECTIVE: To evaluate the benefit of ECMO for the treatment of SAR-COV-2 infection and its outcomes, complications, and mortality rate. METHODS: A comprehensive search for articles was performed using MEDLINE and SCOPUS from December 2019 to December 2020. Two independent reviewers selected eligible studies, extracted the data, assessed the quality of the studies, reviewed the full study protocols, and reported the findings according to the PRISMA protocol. The meta-analyses were performed using the Comprehensive Meta-Analysis software version 2.0. RESULTS: Pooled data from 57 studies was analyzed. There were 7,035 patients with SAR-COV-2 infection with event rate of ECMO treatment was 58.10% (95%CI: 43.70-71.20). The mortality rate was 16.66% (95%CI: 11.49-23.53). The mean mortality rate of ECMO supported patients was 35.60% (95%CI: 30.60 to 41.00). Thirty-one percent (95%CI: 24.50-38.40) of the patients had venous thromboembolic events, 30.90% (95%CI: 17.90-47.80) of the patients had ECMO circuit thrombosis, and 24.50% (95%CI: 12.50-42.40) of the patients had bleeding. In the subgroup analysis, the mortality rate was higher among patients who were treated with ECMO, the pooled odds ratio was 4.47 (95%CI: 2.39-8.35, p < 0.001), and was significantly higher in Asia with an odds ratio of 7.88 (95%CI: 2.40-25.85, p = 0.001). CONCLUSION: Mortality rate among patients who received ECMO therapy was high. A system of care, including patient selection, resource management and referral system, can impact the outcomes of ECMO therapy.

An overview of viral mutagenesis and the impact on pathogenesis of SARS-CoV-2 variants.

Viruses are submicroscopic, obligate intracellular parasites that carry either DNA or RNA as their genome, protected by a capsid. Viruses are genetic entities that propagate by using the metabolic and biosynthetic machinery of their hosts and many of them cause sickness in the host. The ability of viruses to adapt to different hosts and settings mainly relies on their ability to create de novo variety in a short interval of time. The size and chemical composition of the viral genome have been recognized as important factors affecting the rate of mutations. Coronavirus disease 2019 (Covid-19) is a novel viral disease that has quickly become one of the world's leading causes of mortality, making it one of the most serious public health problems in recent decades. The discovery of new medications to cope with Covid-19 is a difficult and time-consuming procedure, as new mutations represent a serious threat to the efficacy of recently developed vaccines. The current article discusses viral mutations and their impact on the pathogenicity of newly developed variants with a special emphasis on Covid-19. The biology of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), its mutations, pathogenesis, and treatment strategies are discussed in detail along with the statistical data.

In silico insight into the interaction of 4-aminoquinolines with selected SARS-CoV-2 structural and nonstructural proteins

The development of efficacious therapeutic agents with relatively low or no level of toxicity was necessitated due to the reemergence of coronavirus. The present study investigated the inhibitory potentials of 4-aminoquinolines (amopyroquine, mefloquine, amodiaquine, bispyroquine, quinine, chloroquine, hydroxychloroquine, chloroquine hydrochloride, chloroquine sulfate, cycloquine, and quinacrine) against selected structural and nonstructural proteins of SARS-CoV-2. The 4-aminoquinolines with higher binding affinities were selected for physicochemical properties, absorption, distribution, metabolism, and excretion (ADME) analysis. The binding energies were computed with Autodock vina screening software while physicochemical properties and ADME parameters were predicted through SwissADME server. Amopyroquine, mefloquine, bispyroquine, and quinine had the highest binding affinities with the amino acids in the pocket of the SARS-CoV-2 structural proteins (envelope, membrane, nucleocapsid, and spike) and nonstructural proteins (3-chymotrypsin-like protease, papain-like protease, and RNA-dependent RNA polymerase) compared with chloroquine and other 4-aminoquinolines used in this study. In addition, the pharmacokinetics and physicochemical parameters revealed that amopyroquine, mefloquine, bispyroquine, and quinine demonstrated good drug-like properties with relatively low toxic effects. The data from this study provide evidence that some of the 4-aminoquinolines can be repurposed and further developed as therapeutic agents with potentials to inhibit coronavirus cellular entry and replication. © 2022 Elsevier Inc. All rights reserved.