Synthesis of molnupiravir (MK-4482, EIDD-2801): a promising oral drug for the treatment of COVID-19 starting from cytidine.

The present work describes the synthesis of molnupiravir by employing commercially available inexpensive materials in two steps with an overall yield of 85.7%. The synthetic methodology starts with an eco-friendly starting material, that is, cytidine and establishes an alternative way to avoid costly enzyme mediated reactions. This synthetic strategy involves a selective acylation of cytidine as the first key step followed by the second step, that is, hydroxamination reaction. The major advantage of this protocol is that it is completely free of protection and deprotection reactions. Chemoselective acylation of cytidine's primary alcohol was achieved using isobutyryl chloride, Et3N, and DMF solvent (89.3% yield). The aqueous phase transformation was achieved for the hydroxamination reaction with a 96% yield.

Hierarchical Modelling of COVID-19 Death Risk in India in the Early Phase of the Pandemic.

We improve upon the modelling of India's pandemic vulnerability. Our model is multidisciplinary and recognises the nested levels of the epidemic. We create a model of the risk of severe COVID-19 and death, instead of a model of transmission. Our model allows for socio-demographic-group differentials in risk, obesity and underweight people, morbidity status and other conditioning regional and lifestyle factors. We build a hierarchical multilevel model of severe COVID-19 cases, using three different data sources: the National Family Health Survey for 2015/16, Census data for 2011 and data for COVID-19 deaths obtained cumulatively until June 2020. We provide results for 11 states of India, enabling best-yet targeting of policy actions. COVID-19 deaths in north and central India were higher in areas with older and overweight populations, and were more common among people with pre-existing health conditions, or who smoke, or who live in urban areas. Policy experts may both want to 'follow World Health Organisation advice' and yet also use disaggregated and spatially specific data to improve wellbeing outcomes during the pandemic. The future uses of our innovative data-combining model are numerous.

Dans le contexte du développement international, on peut améliorer la modélisation de la vulnérabilité à une pandémie en combinant différentes disciplines, en combinant des données et en reconnaissant les nombreux niveaux imbriqués de l'épidémie. Des modèles de transmission ont été élaborés à l'échelle nationale ou pour plusieurs pays. A l'inverse, nous construisons un modèle permettant de prendre en compte les différents niveaux de risque selon les groupes sociaux, ainsi que le conditionnement des facteurs régionaux et des facteurs liés au mode de vie. La forme grave de la COVID-19 est notre résultat clé innovant. Nous utilisons trois sources de données simultanément: l'enquête nationale sur la santé des familles en Inde, le recensement de la population indienne de 2011 et les décès liés à l'épidémie de COVID-19. Nous fournissons des résultats pour 11 États en Inde, ce qui permet un meilleur ciblage des actions politiques. Les utilisations futures de ces modèles sont nombreuses. Dans le nord et le centre de l'Inde, les décès liés à la COVID-19 étaient plus nombreux dans les régions avec populations âgées et populations en surpoids. Ces décès étaient plus fréquents chez les personnes ayant déjà des problèmes de santé, ou chez celles qui fument ou qui vivent dans les zones urbaines. Les experts en politiques publiques pourront souhaiter à la fois « suivre les conseils de l'Organisation mondiale de la santé ¼ tout en utilisant des données désagrégées et spatiales pour améliorer les résultats en matière de bien-être pendant la pandémie.

Conjunctivitis can be the only presenting sign and symptom of COVID-19.

Five cases of non-remitting conjunctivitis turned out to be the sole presenting sign and symptom of COVID-19. These patients tested positive on RT-PCR of naso-pharyngeal swabs and developed no fever, malaise, or respiratory symptoms throughout the course of their illness. They all fully recovered. In the current efforts to fight the spread of this virus, authors want to emphasize that atypical clinical presentations of COVID-19 can occur and a high level of suspicion should be maintained. Ocular involvement and transmission of SARS-CoV-2 should never be overlooked. In fact, conjunctival mucosae are susceptible to respiratory viruses and remain an important point of entry. For this reason, eye protection in the form of goggles or a face shield should be considered essential for all healthcare providers, even when taking care of patients who are not showing typical symptoms of COVID-19.