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1.
Iranian Journal of Allergy, Asthma & Immunology ; 21(2):219-227, 2022.
Article in English | Academic Search Complete | ID: covidwho-1818866

ABSTRACT

LPS-responsive beige-like anchor protein (LRBA) deficiency is a primary immunodeficiency caused by a mutation in the LRBA gene. Affected individuals present with a variety of clinical symptoms including hypogammaglobulinemia, recurrent infections, splenomegaly, hepatomegaly, and autoimmune cytopenias. Except for hypogammaglobulinemia, the remaining features resemble autoimmune lymphoproliferative syndrome (ALPS). Here, we report the case of a 14-year-old boy with the ALPS phenotype, eventually diagnosed with LRBA deficiency. He presented with lymphadenopathy and hepatosplenomegaly, along with autoimmune cytopenia. Due to recurrent infections and worsening gastrointestinal symptoms, whole-exome sequencing was conducted and revealed a novel homozygous pathogenic variant in the LRBA gene (c.534del;p.9Asp179IIef*16). The patient recently suffered from clinical deterioration due to SARS-COV-2 which appears to have triggered an acute worsening of his existing Cytomegalovirus colitis leading to an eventual demise. A literature search for reported LRBA deficient patients with ALPS-like phenotype revealed 11 patients. The most common clinical presentations in LRBA patients with ALPS-like phenotype included autoimmunity (100%), splenomegaly (91%), lymphadenopathy (36.4%), and respiratory tract infections (63.6%). LRBA deficiency is unique in the fact that it encompasses immune deficiency, autoimmunity, and lymphoproliferation. In children with multiple symptoms related to these domains, a genetic diagnosis is necessary to ensure tailored and precise medical therapy. [ FROM AUTHOR] Copyright of Iranian Journal of Allergy, Asthma & Immunology is the property of Tehran University of Medical Sciences 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.)

2.
Transplantology ; 3(1):83, 2022.
Article in English | ProQuest Central | ID: covidwho-1818208

ABSTRACT

Immunocompromised patients with respiratory viral infections are at increased risk of fungal superinfections, including Pneumocystosis. Within the scope of the COVID-19 pandemic, Pneumocystis jirovecii co-infections are being increasingly reported. Differential diagnosis often creates a dilemma, due to multiple overlapping clinical and radiographic features. Awareness of fungal co-infections in the context of the COVID-19 pandemic is crucial to initiate prophylactic measures, especially in high-risk individuals. We report the second case of Pneumocystis jirovecii pneumonia and COVID-19 co-infection in a renal transplant recipient in Poland.

3.
Hemato ; 3(1):111, 2022.
Article in English | ProQuest Central | ID: covidwho-1818069

ABSTRACT

Background. Hypercoagulable state and endothelial cell activation are common alterations in patients with COVID-19. Nevertheless, the hypothesis of persistent hypercoagulability and endothelial cell activation following recovery from COVID-19 remains an unresolved issue. Objectives. To investigate the persistence of endothelial cell activation and hypercoagulability after recovery from COVID-19. Patients/Methods. COVID-19 survivors (n = 208) and 30 healthy individuals were enrolled in this study. The following biomarkers were measured: procoagulant phospholipid-dependent clotting time (PPL-ct), D-Dimer, fibrin monomers (FM), free Tissue factor pathway inhibitor (free-TFP)I, heparinase, and soluble thrombomodulin (sTM). Antibodies against SARS-CoV-2 (IgG and IgA) were also measured. Results. The median interval between symptom onset and screening for SARS-CoV-2 antibodies was 62 days (IQR = 22 days). Survivors showed significantly higher levels of D-Dimers, FM, TFPI, and heparanase as compared to that of the control group. Survivors had significantly shorter PPL-ct. Elevated D-dimer was associated with older age. Elevated FM was associated with female gender. Elevated heparanase was independently associated with male gender. Decreased Procoag-PPL clotting time was associated with female gender. One out of four of COVID-19 survivors showed increase at least one biomarker of endothelial cell activation or hypercoagulability. Conclusions. Two months after onset of COVID-19, a significant activation of endothelial cells and in vivo thrombin generation persists in at least one out of four survivors of COVID-19. The clinical relevance of these biomarkers in the diagnosis and follow-up of patients with long COVID-19 merits to be evaluated in a prospective clinical study.

4.
Allergy, Asthma and Clinical Immunology ; 18(SUPPL 1), 2022.
Article in English | EMBASE | ID: covidwho-1817253

ABSTRACT

Background: Ocrelizumab is a form of anti-CD20 therapy with B cell depleting effects used in patients with multiple sclerosis (MS). This medication has been associated with an impaired antibody response to mRNA COVID-19 vaccinations. Amongst MS patients, receiving B cell depleting therapy has been identified as a risk factor for severe COVID-19 infection. Case Presentation: A 56-year-old physician with a history of MS and resolved chronic spontaneous urticaria was incidentally found to have hypogammaglobulinemia, with IgG levels ranging from 4.0 to 4.8 (normal range: 7.0-16.0). He had normal IgA and IgM levels. There was no history of recurrent sinopulmonary infections. Medications included aspirin and glatiramer initially, but he was later switched to ocrelizumab due to progression of his MS. He had protective measles, rubella, and varicella antibody titres. Initially, he had inadequate titres to mumps but after vaccination, he achieved protective levels. However, response to pneumococcal vaccination administered while on ocrelizumab was inadequate. His last dose of ocrelizumab was in October of 2020. He received his first dose of the Pfizer COVID-19 mRNA in January of 2021 and his second dose 41 days later. At 55 days post-vaccination, he had no evidence of COVID-19 antibody titres, measured by two different assays. In light of his hypogammaglobulinemia and poor vaccine responses, genetic analysis was performed. A pathogenic heterozygous variant in TNFRSF13B was identified, which is associated with autosomal recessive common variable immunodeficiency. Possession of a single allele may have contributed to the patient's presentation. Conclusions: Clinicians should be aware that patients on ocrelizumab may have an inadequate response to COVID-19 vaccinations and that these patients are also at a higher risk of severe COVID-19 infection. Consideration should be given to attempting vaccination prior to initiating therapy if possible, or otherwise vaccinating near the end of dose cycles.

5.
Journal of the International Association of Providers of AIDS Care ; 21:16, 2022.
Article in English | EMBASE | ID: covidwho-1817142

ABSTRACT

Background: In sub-Saharan Africa, people living with HIV (PLHIV) face challenges accessing quality health care services, including barriers to care associated with widespread stigma and discrimination in health settings. Here, we present the results and lessons from a training program on stigma elimination rolled out in the city of Yaoundé, Cameroon within the framework of the joint IAPAC-UNAIDS Fast-Track Cities initiative. Method: Trainings were conducted as hybrid on-line and in-person for health workers and paraprofessional navigators employing self-narrated audio-visual training modules approved by the Cameroon National Aids Control Committee (NACC). Pre- and post-training questionnaires were administered to assess knowledge change across two modules: Human Rights and Integrating Stigma Elimination into Daily Practice. Results: A total of 417 health workers across 70 health facilities enrolled for the onsite training, while 671 across 37 health facilities registered for online training. For the onsite training sessions, average pre- and post-test scores for the module covering basics on human rights were 56% and 73%, respectively. Baseline score average for self-administered online trainings on human rights was 83% and 85% for post-training assessments. For the module covering integration of stigma elimination into daily practice, health worker overall knowledge gain in the pre- and post-test assessments was 49% to 69% for onsite trainees, and 85% to 87% for health workers enrolled online. Conclusion: Despite the COVID-19 pandemic, a blend of onsite and online training contributed to knowledge gains, especially among onsite trainees. Gauging the degree of knowledge improvement among self-administered online trainees was limited as health workers could repeat trainings over an extended period when compared to their onsite counterparts. Although the training of health workers is an entry point for stigma elimination, ongoing capacitation and follow up with the facility managers is critical for the attainment of stigma free health facilities.

6.
Journal of the International Association of Providers of AIDS Care ; 21:15, 2022.
Article in English | EMBASE | ID: covidwho-1817140

ABSTRACT

Background: The goal of HIV treatment is sustained viral load suppression. Early initiation of ART and access to clientcentered, differentiated, high-quality, stigma-free care is a prerequisite of long-term retention and viral load suppression. Method: 2,374 PLHIV from 5 cities (Lagos, Kinshasa, Yaoundé, Lusaka, and Kigali) were surveyed about their perceptions of the quality of care they receive across the eight domains of HIV understanding, linkage to HIV care, engagement in HIV care, ART adherence, HIV counseling, secondary HIV prevention, whole person care, and interpersonal communication. Implementation took place between January-April 2020. Results: Among 2,374 respondents, there was a similar gender distribution across both regions with women comprising 47-70%. InWCA, 37-50% reported initiated ART on the same day as HIV diagnosis, with 63-73% reporting initiation within the WHO-recommended seven days. Lagos, Kinshasa, and Yaoundé reported same-day and within seven days of ART initiation ranging from 51% and 68%. In terms of differentiated service delivery, in WCA, 37%- 50% reported having initiated ART on the same day, with 63-73% reporting it same day or within less than seven days. In Lusaka and Kigali, respondents reported same-day ART initiation at 34-56%, with 47-65% having received ART on same day or in less than seven days from HIV diagnosis. 37%-53% of respondents reported they were either not virally suppressed or they did not know if that had an undetectable viral load. Conclusion: A third to a half of respondents reported not initiating ART within the WHO-recommended seven days of HIV diagnosis. In two cities, respondents reported continuation of 1-2 monthly clinic visits despite the WHO recommendation of 3-6 monthly visits. A third to a half reported not being undetectable or not knowing their viral load status. A follow-up survey looking closely at the impact of COVID-19 on HIV services and perceived QoC is recommended to clearly assess impact on WHO recommendations for ART initiation.

7.
Journal of the International Association of Providers of AIDS Care ; 21:10-11, 2022.
Article in English | EMBASE | ID: covidwho-1817139

ABSTRACT

Background: Men have been left behind in the HIV response in sub-SaharanAfrica. Health4Men is a comprehensive HIV prevention and treatment programme, integrated into City of Johannesburg public-sector primary health facilities. Services include demand creation, outreach, PrEP, PEP, condom, and lubricant provision, HIV testing and treatment services, and sexual and reproductive health services. PrEP has the potential to impact on incident infections but has not been implemented at scale in South Africa. Method: We used routine data at five Health4Men sites in Johannesburg to examine trends in number of men testing HIV negative, offered PrEP, started on PrEP and number of men receiving PrEP per quarter, from October 2019 to March 2021. October 2019 toMarch 2020 is considered pre-COVID, April to June 2020 the lockdown period, July to December 2020 post-COVID, and January to March 2021 a recovery period. Results: At all sites, for the complete 18-month period, 34% of men who tested HIV negative were assessed to be high risk and offered PrEP (5832 men). 26% of those men accepted and initiated PrEP (1545 men). Although the offer rate decreased from 43% of HIV negative men pre-COVID (1365 men offered PrEP per quarter) to 31% post-COVID (860 men offered PrEP per quarter), uptake increased from 20% of men offered PrEP to 33%. The number of men remaining on PrEP decreased from 1234 pre-COVID, to 967 during lockdown, and 1070 for the post-COVID period (13% decrease). This recovered to 1305 in March 2021. Conclusion: These findings have implications for scaling up and integrating PrEP services during COVID-19 and beyond. Percentage uptake increased with decreased number of men offered PrEP, likely due to greater time spent counselling each client. Retention on PrEP was affected more than new initiations, and innovative methods of supporting adherence during COVID-19 waves are needed, e.g., enhanced virtual communication.

8.
Journal of the International Association of Providers of AIDS Care ; 21:3, 2022.
Article in English | EMBASE | ID: covidwho-1817138

ABSTRACT

Introduction: After the first diagnosis of COVID-19 on March 9, 2020, New Orleans, Louisiana had an early, rapid increase in cases, distinguished as the fastest-growing COVID outbreak worldwide. The University Medical Center-New Orleans (UMCNO), a safety net hospital in New Orleans, provided 24-hour access to routine HIV screening throughout the pandemic when many organizations halted screening services. Description: UMCNO implemented the Frontlines of Communities in the U.S. (FOCUS) grant funded HIV testing program in 2013, which integrated automated electronic medical record (EMR) driven routine HIV testing into normal hospital workflow, with system-wide policy changes to support sustainability. Two full-time navigator positions facilitate linkage to care for patients living with HIV identified through testing. Lessons Learned: Over 100,000 HIV tests were conducted at UMCNO between 2013 and 2020, with a HIV-seropositivity rate of approximately 0.9%. With implementation of stay-at-home orders, monthly average Emergency Department (ED) visits from April to June 2020 decreased to 65% of the November 2019 - January 2020 pre-pandemic levels, with monthly averages for HIV tests decreasing to 57% compared to the same pre-COVID quarter. Average monthly ED visits later increased, but remained lower than pre-pandemic levels (e.g., 7539 in the November 2019-January 2020 pre-COVID quarter compared to 6264 in the July - September 2020 quarter). Linkage to care rates remained consistently high (Table 1), proportional to identified positive diagnoses throughout 2020. Recommendations: UMCNO's FOCUS program integrated HIV screening into hospital workflow. As such, our hospitalmaintained testing, albeit at a reduced rate, during the months the stay-at-home orders were in place in New Orleans. The program maintained routine HIV testing and linkage services through EMR automation (best practice advisories) to ensure all eligible patients are offered testing when appropriate.

9.
Journal of the International Association of Providers of AIDS Care ; 21:4, 2022.
Article in English | EMBASE | ID: covidwho-1817137

ABSTRACT

Background: The HIV epidemic is a major public health problem in Mozambique. HIV patients retention in care and treatment is still among the most disturbing challenges. The National Health Service has adopted the differentiated models of service delivery for antiretroviral therapy to adapt the response to the needs of users. Thus, the Ministry of Health in collaboration with its partners established a partnership with public pharmacies outside the health facilities (FARMAC) to dispense antiretroviral drugs to patients in treatment. Method: Four FARMAC pharmacies in Maputo City were included in the strategy between September 2019 and August 2020. Eleven pharmacists from FARMAC were trained to dispense antiretroviral drugs and in counselling to enforce adherence to antiretroviral treatment. Education sessions and pamphlets were used to disseminate the strategy at health facilities. Patients older than 10, in the first line drugs, with good adherence, undetectable viral load, and without the need to take prophylaxis therapy were invited to participate. Those who consented were referred to the pharmacy of their choice. Patients received monitoring calls to collect their medication and attend clinical consultations timely. Results: About 2745 patients used FARMAC pharmacies through the intervention. Of those, 99% remained in HIV care and treatment. Adherence to the strategy was higher when associated to three months drugs collection. Only 26 patients interrupted their participation mainly (18 patients) due to repeated absences. Conclusion: Public pharmacies outside the health facilities are potentially an additional model to differentiated models for HIV service delivery. The strategy reduced the number of visits to the health facilities, demonstrating an appealing option in COVID-19 restrictions context and alike. Moreover, it illustrates patients centered models efficacy in retention improvement.

10.
Journal of the International Association of Providers of AIDS Care ; 21:6-7, 2022.
Article in English | EMBASE | ID: covidwho-1817135

ABSTRACT

Background: SARS-CoV-2 pandemic had a negative impact not only on diagnostic and therapeutic services but also on prevention, including HIV screening. In this study we evaluated and compared the impact of the pandemic on HIV testing in healthcare and community settings in Milan. Method: We considered the HIV screening tests performed between 01/01/2019 and 10/06/2021 in two local hospitalbased STIs outpatient clinics and in a community-based HIV testing facility. We then compared the two settings in pre COVID (before Mar2020) and post COVID (Mar2020-Jun2021) period in terms of number of tests performed, test results and age, sex and nationality of the subjects tested. Results: 4106 HIV screening tests have been performed (30.8% healthcare setting, 69.2% community setting). Globally, the community setting tested younger subjects, more females, and fewer foreigners, with a lower HIV prevalence (Tab1). In the healthcare setting, in the post COVID period there has been a decrease in the number of tests performed (Tab4), with older subjects and fewer females tested (Tab2). HIV prevalence remained quite high (Tab3). In the community setting, in the post COVID period there has been also a decrease in the number of tests performed, mostly due to lockdown (Mar - Jun 2020, Fig1). Indeed, after restricting to the period of Jul 2020 - Jun 2021, the average number of HIV-test/month was similar to pre COVID era. Younger subjects, fewer females and a lower HIV prevalence have been found in post COVID period. Conclusion: Both settings have reduced their activity due to the pandemic. The prevalence of HIV was high in the healthcare setting, possibly because of subjects attending the service while symptomatic or at higher risk. The differences between the subjects tested in the two settings demonstrate the importance of an integrated approach to ensure greater coverage of HIV screening campaigns.

11.
Journal of the International Association of Providers of AIDS Care ; 21:11, 2022.
Article in English | EMBASE | ID: covidwho-1817134

ABSTRACT

Introduction: State-wide lockdowns for COVID-19 pandemic caused major disruptions for People Living with HIV (PLHIV) registered for treatment with Public Antiretroviral Treatment (ART) Centres in Mumbai. They faced enormous difficulties in reaching their treatment centres while many PLHIVs, being migrants in the city, travelled back to their native districts. These situations posed serious challenges for HIV program implementation to ensure UNAIDS treatment goals of retention in care. It was also compounded due to 53% of PLHIV, being unreachable by phone among those who missed their appointments at ART Centres, with resultant treatment interruptions. Description: Mumbai Districts AIDS Control Society (MDACS) launched ARTMitr (Mitr meaning friend), the strategy to guide PLHIV for services based on their geo-location during the lockdown. PLHIV who missed appointments received a short SMS vernacular text message from ARTmitr with a helpline number. The patients who responded to SMS and successful SMS beneficiaries received personalized tele-guidance based on their current location and their ability to reach the nearest ART centre. The ARV refills through community refill sites were initiated through training of outreach staff. The mobile web form captured refill data from community sites for real- time updates at ART centre. Lessons Learned: During April-June 2021, SMS notifications were sent to 9524 PLHIV and were successfully received by 5958 (62%). Tele-guidance was provided to 3242 (54%) patients. ARV medicines in transit were facilitated from nearby treatment centers for 1982 patients and 475 were advised to reach local ART centre. The patient centric services of Community ARV refills and courier services were arranged for continuum of care. Innovative services of e-transfer and e-consultation were launched for PLHIVs using digital technology. Recommendations: ARTmitr facilitated to reach PLHIVs for accessible ARV services during COVID lockdown through the community ARV refills and e-consultation services.

12.
J Int Assoc Provid AIDS Care ; 21:23259582221075431, 2022.
Article in English | EMBASE | ID: covidwho-1817133

ABSTRACT

The proceedings contain 36 papers. The topics discussed include: Austin/Travis County fast-track cities: developing a local action plan through stakeholder engagement;impact of community pharmacies on access to point-of-care tests for HIV and hepatitis C and B infections: an observational, cross-sectional study;routine HIV screening in the era of COVID-19;modelling the interaction between depression and HIV incidence in Manicaland, East Zimbabwe;TB treatment initiation time in HIV positive patients: implications for TB treatment outcomes;the effect of using FARMAC pharmacies in strengthening the differentiated models of service delivery for antiretroviral therapy;and associations of income and demographics with care continuum outcomes: a zip code level analysis in 36 US cities.

13.
Clinical Cancer Research ; 27(6 SUPPL 1), 2021.
Article in English | EMBASE | ID: covidwho-1816891

ABSTRACT

Background: Serology tests for detecting the antibodies to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can identify previous infection and help to confirm the presence of current infection. Objective: The aim of this study was to evaluate the performances of a newly developed high throughput immunoassay for anti-SARS-CoV-2 IgG antibody detection. Results: Clinical agreement studies were performed in 77 COVID-19 patient serum samples and 226 negative donor serum/plasma samples. Positive percent agreement (PPA) was 46.15% (95% CI: 19.22% ∼74.87%), 61.54% (95% CI: 31.58% ∼86.14%), and 97.53% (95% CI: 91.36% ∼99.70%) for samples collected on 0-7 days, 8-14 days, and ≥15 days from symptom onset, respectively. Negative Percent Agreement (NPA) was 98.23% (95% CI: 95.53% ∼99.52%). No cross-reactivity was observed to patient samples positive for IgG antibodies against the following pathogens: HIV, HAV, HBV, RSV, CMV, EBV, Rubella, Influenza A, and Influenza B. Hemoglobin (200 mg/dL), bilirubin (2 mg/dL) and EDTA (10 mM) showed no significant interfering effect on this assay. Conclusion: An anti-SARS-CoV-2 IgG antibody assay with high sensitivity and specificity has been developed. With the high throughput, this assay will speed up the anti-SARS-CoV-2 IgG testing.

14.
Journal of Acquired Immune Deficiency Syndromes ; 89(5):511-518, 2022.
Article in English | ProQuest Central | ID: covidwho-1816363

ABSTRACT

Background:We aim to investigate the infection rate, the clinical characteristics and outcomes of COVID-19-disease in a cohort of people living with HIV in Madrid (Spain), during the first year of pandemics.Setting:Observational single-center study, in which we included all HIV-infected patients (aged ≥ 18 years) with laboratory-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection as of February 28, 2021, at the Hospital Universitario 12 de Octubre.Methods:Confirmed disease was defined as any patient with a positive antigen test, reverse transcriptase polymerase chain reaction, or serology for SARS-CoV-2. We compared the characteristics of patients with mild disease (asymptomatic included) with those with moderate or severe disease (requiring admission).Results:Of 2344 HIV-infected patients, 158 (82.9% male;median age, 46.5 years) were diagnosed with SARS-CoV-2 (infection rate, 6.74%;95% confidence interval, 5.79 to 7.83). Thirty-nine individuals (24.7%) had moderate or severe disease, 43.7% had mild disease, and 31.6% were asymptomatic. Hypertension (23.4%) and obesity (15.8%) were the most prevalent comorbidities;12.7% had at least 2 comorbidities. One hundred forty-five patients (97.3%) had RNA-HIV viral load of <50 copies per milliliter, and only 3 had CD4 cell count of <200 cells per cubic millimeter before infection. Of those admitted to hospital, 59% required oxygen support and 15.4%, invasive mechanical ventilation. Five patients died. None of the patient taking tenofovir-disoproxil-fumarate required admission. In the multivariate analysis, age remained as the only independent factor for moderate-severe disease (odds ratio, 1.09;95% confidence interval 1.04 to 1.14;P < 0.001).Conclusions:People living with HIV are at risk of severe SARS-CoV-2 infection. Age was the only variable with an independent association with moderate-severe disease, after adjusting by comorbidities and other factors.

15.
The Lancet ; 399(10336):1686-1687, 2022.
Article in English | ProQuest Central | ID: covidwho-1815320

ABSTRACT

Only one staff member in full personal protective equipment sat at the front, screening patients individually and escorting them into examination rooms. An intern at the hospital made sure that he was linked to our clinic. Because of his compromised immune system, he told me that simply coming to the clinic felt like a huge risk. Black patients in the USA have worse outcomes at each step along the HIV care continuum due to the same daunting structural and social factors Ray faced—the housing instability, the poverty and unemployment, the food insecurity, the structural racism. In his case, acknowledging the trauma and excavating the pain were part of his journey to achieving and maintaining an undetectable viral load and establishing a foundation for human flourishing.

16.
Computers in Biology and Medicine ; 145, 2022.
Article in English | EMBASE | ID: covidwho-1814279

ABSTRACT

Starting three decades ago and spreading rapidly around the world, acquired immunodeficiency syndrome (AIDS) is an infectious disease distinct from other contagious diseases by its unique ways of transmission. Over the past few decades, research into new drug compounds has been accompanied by extensive advances, and the design and manufacture of drugs that inhibit virus enzymes is one way to combat the AIDS virus. Since blocking enzyme activity can kill a pathogen or correct a metabolic imbalance, the design and use of enzyme inhibitors is a new approach against viruses. We carried out an in-depth analysis of the efficacy of atazanavir and its newly designed analogs as human immunodeficiency virus (HIV) protease inhibitors using molecular docking. The best-designed analogs were then compared with atazanavir by the molecular dynamics simulation. The most promising results were ultimately found based on the docking analysis for HIV protease. Several exhibited an estimated free binding energy lower than −9.45 kcal/mol, indicating better prediction results than the atazanavir. ATV7 inhibitor with antiviral action may be more beneficial for infected patients with HIV. Molecular dynamics analysis and binding energy also showed that the ATV7 drug had more inhibitory ability than the atazanavir drug.

17.
Clinical Case Reports ; 10(4), 2022.
Article in English | ProQuest Central | ID: covidwho-1813481

ABSTRACT

STAT 1 GOF mutations are a rare cause of childhood primary immunodeficiency. Recurrent mucocutaneous candidiasis, chest infections, and autoimmune disease are all classic phenotype presentations. Rapid identification and diagnosis of this debilitating disease using whole exon sequencing may improve outcomes and minimize long‐term sequelae.

18.
Natural Volatiles & Essential Oils ; 8(5):2689-2707, 2021.
Article in English | CAB Abstracts | ID: covidwho-1813080

ABSTRACT

The growth and development of children is very important, as this would form the foundation for the quality of future generations in the nation. The slightest developmental disorders in infancy, if not detected and not handled properly will lead to a bad impact. Various genetic and environmental factors influence Toddler growth and development. Purpose: To distinguish the description of the risk factors related to child growth and development. Method: This research uses quantitative method. The design of the research is based on a cross-sectional approach in the analysis survey design. In the study, all toddlers under 59 month old were collected using a total of 366 samples in 2020 at the Ngalang Village, Gedangsari public health center and Gunungkidul Regency. Data analysis used univariate analysis of frequency distribution.

19.
Natural Volatiles & Essential Oils ; 8(5):1240-1245, 2021.
Article in English | GIM | ID: covidwho-1812950

ABSTRACT

Since of July 2020, about 6 months keen on the epidemic of new corona virus illness 2019, the question of why persons infected with human immunodeficiency virus (HIV;PLWH) are negatively impacted remained unanswered (COVID-19). So far, COVID-19 vulnerability appears to be equivalent in persons with and without HIV, however findings may be contradictory. Some of the misunderstanding arises from COVID-19's newness and shortage of data;others stem from ambiguity regarding come again? it resources for HIV to be a "risk factor" for COVID-19.

20.
Primary Care Reports ; 28(5), 2022.
Article in English | ProQuest Central | ID: covidwho-1812717

ABSTRACT

* Pneumonia is an infection of the alveoli characterized by fever, cough, and pulmonary infiltrate. * Prior to COVID-19, the most common pathogens found in adults hospitalized with pneumonia were rhinovirus, influenza, and Streptococcus pneumoniae. * The identification of a pathogen is increased in severe cases of pneumonia and when multiple detection techniques are used. * Blood cultures are not recommended for routine cases of pneumonia. * SARS-CoV-2 and influenza testing is recommended when either is prevalent in the community. * Healthy patients with suspected bacterial community-acquired pneumonia and who are otherwise suitable for discharge can be treated with a course of oral antibiotics for five to seven days. * Patients with comorbidities who are appropriate for discharge should be treated with either an amoxicillin/clavulanic acid or a cephalosporin in addition to treatment with a macrolide or doxycycline for seven days. * The concept of healthcare-associated pneumonia is not useful to identify patients at increased risk for infection from drug-resistant organisms. * Scoring tools can be used to support clinical judgment in determining patients with a low mortality risk who may be appropriate for outpatient treatment. * The effectiveness of monoclonal antibodies and antivirals is subject to change because of the potential development of resistance to newer variants.

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