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3.
Am J Trop Med Hyg ; 106(2): 566-570, 2021 12 13.
Article in English | MEDLINE | ID: covidwho-1726466

ABSTRACT

There has been a surge of rhino-orbital mucormycosis cases in India in the wake of the second wave of the COVID-19 pandemic. It has been widely suggested that dysglycemia resulting from diabetes which is a common comorbidity in COVID-19 patients, and indiscriminate steroid use has resulted in this surge. We report a series of 13 cases of rhino-orbital mucormycosis in COVID-19 patients admitted to our center between mid-April and early June 2021. The cases showed a male preponderance, two patients had loss of vision, and four of them showed intracranial extension of disease. Twelve patients had received steroids and 12 had preexisting or newly diagnosed diabetes, both steroid use and diabetes being the most common identified risk factors. Considering other possible risk factors, immunosuppressed state, antiviral or ayurvedic (Indian traditional) medications, and oxygen therapy were not associated with a definite risk of mucormycosis, because they were not present uniformly in the patients. We propose that COVID-19 itself, through molecular mechanisms, predisposes to mucormycosis, with other factors such as dysglycemia or steroid use increasing the risk.


Subject(s)
COVID-19/complications , Eye Diseases/diagnosis , Eye Infections, Fungal/virology , Mucormycosis/diagnosis , Mucormycosis/virology , Adult , Antifungal Agents/therapeutic use , COVID-19/drug therapy , COVID-19/epidemiology , Case-Control Studies , Comorbidity , Diabetes Mellitus/epidemiology , Eye Diseases/drug therapy , Eye Diseases/epidemiology , Eye Diseases/virology , Eye Infections, Fungal/drug therapy , Eye Infections, Fungal/epidemiology , Female , Humans , India , Male , Middle Aged , Mucormycosis/drug therapy , Mucormycosis/mortality , Risk Factors , Steroids/therapeutic use
5.
J Ocul Pharmacol Ther ; 37(6): 319-320, 2021.
Article in English | MEDLINE | ID: covidwho-1541499
7.
J Am Chem Soc ; 143(43): 17891-17909, 2021 11 03.
Article in English | MEDLINE | ID: covidwho-1483091

ABSTRACT

The emergence of multi-drug-resistant pathogens threatens the healthcare systems world-wide. Recent advances in phototherapy (PT) approaches mediated by photo-antimicrobials (PAMs) provide new opportunities for the current serious antibiotic resistance. During the PT treatment, reactive oxygen species or heat produced by PAMs would react with the cell membrane, consequently leaking cytoplasm components and effectively eradicating different pathogens like bacteria, fungi, viruses, and even parasites. This Perspective will concentrate on the development of different organic photo-antimicrobials (OPAMs) and their application as practical therapeutic agents into therapy for local infections, wound dressings, and removal of biofilms from medical devices. We also discuss how to design highly efficient OPAMs by modifying the chemical structure or conjugating with a targeting component. Moreover, this Perspective provides a discussion of the general challenges and direction for OPAMs and what further needs to be done. It is hoped that through this overview, OPAMs can prosper and will be more widely used for microbial infections in the future, especially at a time when the global COVID-19 epidemic is getting more serious.


Subject(s)
Anti-Infective Agents/chemistry , Drug Design , Phototherapy/methods , Animals , Anti-Infective Agents/pharmacology , Anti-Infective Agents/therapeutic use , Bacteria/drug effects , Biofilms/drug effects , Biofilms/radiation effects , Coloring Agents/chemistry , Coloring Agents/pharmacology , Equipment and Supplies/microbiology , Equipment and Supplies/virology , Escherichia coli/drug effects , Escherichia coli/physiology , Eye Diseases/drug therapy , Eye Diseases/pathology , Fungi/drug effects , Graphite/chemistry , Light , Nanoparticles/chemistry , Nanoparticles/toxicity , Photosensitizing Agents/chemistry , Photosensitizing Agents/pharmacology , Photosensitizing Agents/therapeutic use , Quantum Theory , Reactive Oxygen Species/metabolism , Viruses/drug effects
8.
Signal Transduct Target Ther ; 6(1): 183, 2021 05 17.
Article in English | MEDLINE | ID: covidwho-1230872

ABSTRACT

CK2 is a constitutively active Ser/Thr protein kinase, which phosphorylates hundreds of substrates, controls several signaling pathways, and is implicated in a plethora of human diseases. Its best documented role is in cancer, where it regulates practically all malignant hallmarks. Other well-known functions of CK2 are in human infections; in particular, several viruses exploit host cell CK2 for their life cycle. Very recently, also SARS-CoV-2, the virus responsible for the COVID-19 pandemic, has been found to enhance CK2 activity and to induce the phosphorylation of several CK2 substrates (either viral and host proteins). CK2 is also considered an emerging target for neurological diseases, inflammation and autoimmune disorders, diverse ophthalmic pathologies, diabetes, and obesity. In addition, CK2 activity has been associated with cardiovascular diseases, as cardiac ischemia-reperfusion injury, atherosclerosis, and cardiac hypertrophy. The hypothesis of considering CK2 inhibition for cystic fibrosis therapies has been also entertained for many years. Moreover, psychiatric disorders and syndromes due to CK2 mutations have been recently identified. On these bases, CK2 is emerging as an increasingly attractive target in various fields of human medicine, with the advantage that several very specific and effective inhibitors are already available. Here, we review the literature on CK2 implication in different human pathologies and evaluate its potential as a pharmacological target in the light of the most recent findings.


Subject(s)
COVID-19 , Cardiovascular Diseases , Casein Kinase II , Cystic Fibrosis , Eye Diseases , Mental Disorders , Protein Kinase Inhibitors/therapeutic use , SARS-CoV-2 , COVID-19/drug therapy , COVID-19/enzymology , COVID-19/genetics , Cardiovascular Diseases/drug therapy , Cardiovascular Diseases/enzymology , Cardiovascular Diseases/genetics , Casein Kinase II/antagonists & inhibitors , Casein Kinase II/genetics , Casein Kinase II/metabolism , Cystic Fibrosis/drug therapy , Cystic Fibrosis/enzymology , Cystic Fibrosis/genetics , Eye Diseases/drug therapy , Eye Diseases/enzymology , Eye Diseases/genetics , Humans , Mental Disorders/drug therapy , Mental Disorders/enzymology , Mental Disorders/genetics , Mutation , Phosphorylation , Signal Transduction/drug effects , Signal Transduction/genetics
10.
Arch Soc Esp Oftalmol (Engl Ed) ; 95(12): 586-590, 2020 Dec.
Article in English, Spanish | MEDLINE | ID: covidwho-915625

ABSTRACT

BACKGROUND: To report a pilot experience of telemedicine in ophthalmology in open-care modality (i.e. direct video call), in a confinement period due to the COVID-19 pandemic. METHODS: Descriptive study of the demographic and clinical characteristics of patients attended in a 10-week confinement period. Reported satisfaction of the participating patients and doctors was evaluated through an online survey. RESULTS: In the 10-week period, 291 ophthalmologic telemedicine consultations were performed. The main reasons for consultation were inflammatory conditions of the ocular surface and eyelids (79.4%), followed by administrative requirements (6.5%), non-inflammatory conditions of the ocular surface (5.2%), strabismus suspicion (3.4%) and vitreo-retinal symptoms (3.1%). According to previously defined criteria, 22 patients (7.5%) were referred to immediate face-to-face consultation. The level of satisfaction was high, both in doctors (100%) and in patients (93.4%). CONCLUSIONS: Open-care modality of telemedicine in ophthalmology during the pandemic period is a useful instrument to filter potential face-to-face consultations, either elective or emergency, and potentially reduce the risk of COVID-19 infection.


Subject(s)
COVID-19/epidemiology , Ophthalmology/statistics & numerical data , Pandemics , Quarantine , SARS-CoV-2 , Telemedicine/statistics & numerical data , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Eye Diseases/diagnosis , Eye Diseases/drug therapy , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Ophthalmology/standards , Ophthalmology/trends , Patient Satisfaction , Pilot Projects , Practice Guidelines as Topic , Referral and Consultation/statistics & numerical data , Surveys and Questionnaires , Telemedicine/standards , Telemedicine/trends , Time Factors , Young Adult
11.
J Neuroophthalmol ; 40(3): 305-314, 2020 09.
Article in English | MEDLINE | ID: covidwho-682845

ABSTRACT

The initiation and continuation of immune-based therapies to treat and prevent complications of inflammatory neuro-ophthalmologic disorders during the 2019 novel coronavirus (COVID-19) pandemic is the subject of considerable debate. In each case, a treatment decision must be reached based on best clinical practices for the disorder, patient comorbidities, the current state of knowledge about the pathogenesis and infectivity of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the utilization of hospital and community resources. Unfortunately, the evidence needed to standardize the decision-making process for each neuro-ophthalmologic disorder is currently absent and is likely to require months or years to develop based on the accrual of robust international data sets. In this article, we review the current understanding of SARS-CoV-2 and COVID-19 complications to provide a framework for approaching the treatment of inflammatory neuro-ophthalmic disorders during the COVID-19 viral pandemic.


Subject(s)
Betacoronavirus , Coronavirus Infections/epidemiology , Eye Diseases/drug therapy , Inflammation/drug therapy , Nervous System Diseases/drug therapy , Pandemics , Pneumonia, Viral/epidemiology , COVID-19 , Coronavirus Infections/immunology , Giant Cell Arteritis/drug therapy , Humans , Immunomodulation , Immunosuppressive Agents/therapeutic use , Myasthenia Gravis/drug therapy , Optic Neuritis/drug therapy , Pneumonia, Viral/immunology , SARS-CoV-2
12.
Br J Ophthalmol ; 105(3): 306-310, 2021 03.
Article in English | MEDLINE | ID: covidwho-597786

ABSTRACT

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in December 2019 in Wuhan city, Hubei province, China. This is the third and largest coronavirus outbreak since the new millennium after SARS in 2002 and Middle East respiratory syndrome (MERS) in 2012. Over 3 million people have been infected and the COVID-19 has caused more than 217 000 deaths. A concern exists regarding the vulnerability of patients who have been treated with immunosuppressive drugs prior or during this pandemic. Would they be more susceptible to infection by the SARS-CoV-2 and how would their clinical course be altered by their immunosuppressed state? This is a question the wider medical fraternity-including ophthalmologists, rheumatologists, gastroenterologist and transplant physicians among others-must answer. The evidence from the SARS and MERS outbreak offer some degree of confidence that immunosuppression is largely safe in the current COVID-19 pandemic. Preliminary clinical experiences based on case reports, small series and observational studies show the morbidity and mortality rates in immunosuppressed patients may not differ largely from the general population. Overwhelmingly, current best practice guidelines worldwide recommended the continuation of immunosuppression treatment in patients who require them except for perhaps high-dose corticosteroid therapy and in patients with associated risk factors for severe COVID-19 disease.


Subject(s)
COVID-19/immunology , Eye Diseases/drug therapy , Immunosuppressive Agents/therapeutic use , SARS-CoV-2/immunology , Humans , Ophthalmology , Pharmaceutical Preparations , Practice Guidelines as Topic
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