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1.
J Pharm Drug Res ; 3(2): 341-361, 2020.
Article in English | MEDLINE | ID: covidwho-1989782

ABSTRACT

A novel coronavirus designated as SARS-CoV-2 in February 2020 by World Health organization (WHO) was identified as main cause of SARS like pneumonia cases in Wuhan city in Hubei Province of China at the end of 2019. This been recently declared as Global Pandemic by WHO. There is a global emergency to identify potential drugs to treat the SARS-CoV-2. Currently, there is no specific treatment against the new virus. There is a urgency to identifying potential antiviral agents to combat the disease is urgently needed. An effective and quick approach is to test existing antiviral drugs against. Whole genome analysis and alignment carried out using BLASTn, SMART BLAST and WebDSV 2.0 had shown more than 238 ORF's coding for proteins mostly origin from Bat SARS coronavirus and root genomic origin from Archaea. Molecular docking results against protein targets Furin, papain like proteases, RdRp and Spike glycoprotein had shown paritaprevir, ritonavir, entecavir and chloroquine derivatives are the best drugs to inhibit multi targets of coronavirus infection including natural compounds corosolic acid, baicalin and glycyrrhizic acid with minimal inhibitory concentrations. Thus we propose use of paritaprevir, entecavir, ritonavir and chloroquine derivatives as best drug combination along with niacinamide, folic acid and zinc supplements to treat novel coronavirus infection. We also propose use of plant protease inhibitors (PI's) and Anti-IL8, IL-6, IL-2 as future drug models against coronavirus.

2.
Clin Exp Rheumatol ; 39(3): 676-687, 2021.
Article in English | MEDLINE | ID: covidwho-1970080

ABSTRACT

Systemic autoimmune diseases (SAD) are a heterogeneous group of diseases with a common aetiopathogenic basis affecting all ages characterised by a systemic phenotypic expression with a wide range of severity and outcomes that often require immunosuppressive therapies, leaving patients at high risk of infection. Knowledge of the impact of COVID-19 in patients with SAD is limited because most are included in studies carried out in patients with autoimmune and rheumatic diseases (mainly inflammatory arthritis). Most studies supported an increased risk of SARS-Cov-2 infection in patients with AD and SAD. Although case-control studies reported no significant differences in the rate of poor outcomes between patients with and without AD, large population-based studies analysing baseline risk factors reported a 2-3 times higher rate of poor outcomes in patients with AD, especially in those with SAD. Individual risk factors associated with poor outcomes included gender male, older age, and underlying comorbidities and therapies (glucocorticoids, sulfasalazine, immunosuppressants and rituximab). Patients with SAD had less favourable COVID-19 outcomes than those with inflammatory arthritis, possibly due to a differentiated underlying therapeutic approach (glucocorticoids, immunosuppressants and B-cell depleting agents for most SAD, anti-cytokine therapies and JAK inhibitors for inflammatory arthritis). Despite the limited evidence, most studies suggest that patients with SAD have an increased risk of a worse evolution of SARS-CoV-2 infection, including a greater risk of hospitalisation/ICU admission and worse survival rates and, therefore, should be considered a high-risk group for COVID-19.


Subject(s)
Autoimmune Diseases , COVID-19 , Rheumatic Diseases , Aged , Autoimmune Diseases/diagnosis , Autoimmune Diseases/drug therapy , Autoimmune Diseases/epidemiology , Glucocorticoids/therapeutic use , Humans , Male , SARS-CoV-2
3.
Hepatol Commun ; 4(9): 1242-1256, 2020 Sep.
Article in English | MEDLINE | ID: covidwho-1898760

ABSTRACT

The recent outbreak of the novel virus severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which causes the corona virus disease of 2019 (COVID19), has spread globally and affects millions of people. This pandemic has taxed our health care system and disrupted normal operations, even life-saving procedures, such as liver transplants. During these unprecedented times, providers and patients are imperiled and resources for diagnosis and care may be limited. Continuing to perform resource-intense advanced procedures is challenging, as is caring for patients with end-stage liver disease or patients with urgent needs for liver tumor control. Liver transplantation, in particular, requires critical resources, like blood products and critical care beds, which are fairly limited in the COVID19 pandemic. The potential of COVID19 infections in posttransplant recipients on immunosuppression and staff contacts further adds to the complexity. Therefore, transplant programs must reevaluate the ethicality, feasibility, and safety of performing liver transplants during this pandemic. Herein, we discuss the clinical and ethical challenges posed by performing liver transplants and offer guidance for managing patients with end-stage liver disease during the COVID19 pandemic.

4.
Rev Panam Salud Publica ; 44: e154, 2020.
Article in English | MEDLINE | ID: covidwho-1893627

ABSTRACT

OBJECTIVE: To identify emerging mental health problems, strategies to address them, and opportunities to reform mental health systems during the COVID-19 pandemic in South America. METHODS: An online questionnaire was sent to mental health decision-makers of ministries of health in 10 South American countries in mid-April 2020. The semi-structured questionnaire had 12 questions clustered into three main sections: emerging challenges in mental health, current and potential strategies to face the pandemic, and key elements for mental health reform. We identified keywords and themes for each section through summative content analysis. RESULTS: Increasing mental health burden and needs were reported as direct and indirect consequences of the COVID-19 pandemic. National lockdowns challenge the delivery and access to mental health treatment and care. Strategies to meet mental health needs rely heavily on timely and adequate responses by strengthened mental health governance and systems, availability of services, virtual platforms, and appropriate capacity-building for service providers. Short- and medium-term strategies focused on bolstering community-based mental health networks and telemedicine for high-risk populations. Opportunities for long-term mental health reform entail strengthening legal frameworks, redistribution of financial resources, and collaboration with local and international partners. CONCLUSIONS: Mental health and psychosocial support have been identified as a priority area by South American countries in the COVID-19 response. The pandemic has generated specific needs that require appropriate actions, including implementing virtual interventions, orienting capacity-building toward protecting users and health providers, strengthening evidence-driven decision-making, and integrating mental health and psychosocial support in high-level mechanisms guiding the response to COVID-19.

5.
J Clin Neurophysiol ; 39(2): 159-165, 2022 Feb 01.
Article in English | MEDLINE | ID: covidwho-1868451

ABSTRACT

PURPOSE: Neurologic manifestations of coronavirus disease (COVID-19) such as encephalopathy and seizures have been described. To our knowledge, detailed EEG findings in COVID-19 have not yet been reported. This report adds to the scarce body of evidence. METHODS: We identified eight COVID-19 positive patients who underwent EEG monitoring in our hospital system. RESULTS: EEGs were most commonly ordered for an altered level of consciousness, a nonspecific neurologic manifestation. We observed generalized background slowing in all patients and generalized epileptiform discharges with triphasic morphology in three patients. Focal electrographic seizures were observed in one patient with a history of focal epilepsy and in another patient with no such history. Five of eight patients had a previous diagnosis of epilepsy, suggesting that pre-existing epilepsy can be a potential risk factor for COVID-19-associated neurological manifestations. Five of eight patients who underwent EEG experienced a fatal outcome of infection. CONCLUSIONS: Our findings underscore previous observations that neurologic manifestations are common in severe cases. COVID-19 patients with epilepsy may have an increased risk of neurological manifestations and abnormal EEG.


Subject(s)
COVID-19 , Epilepsies, Partial , Electroencephalography , Humans , SARS-CoV-2 , Seizures/diagnosis , Seizures/etiology
6.
J Ayurveda Integr Med ; 13(1): 100424, 2022.
Article in English | MEDLINE | ID: covidwho-1838955

ABSTRACT

For centuries, traditional medicines of Ayurveda have been in use to manage infectious and non-infectious diseases. The key embodiment of traditional medicines is the holistic system of approach in the management of human diseases. SARS-CoV-2 (COVID-19) infection is an ongoing pandemic, which has emerged as the major health threat worldwide and is causing significant stress, morbidity and mortality. Studies from the individuals with SARS-CoV-2 infection have shown significant immune dysregulation and cytokine overproduction. Neutrophilia and neutrophil to lymphocyte ratio has been correlated to poor outcome due to the disease. Neutrophils, component of innate immune system, upon stimulation expel DNA along with histones and granular proteins to form extracellular traps (NETs). Although, these DNA lattices possess beneficial activity in trapping and eliminating pathogens, NETs may also cause adverse effects by inducing immunothrombosis and tissue damage in diseases including Type 2 Diabetes and atherosclerosis. Tissues of SARS-CoV-2 infected subjects showed microthrombi with neutrophil-platelet infiltration and serum showed elevated NETs components, suggesting large involvement and uncontrolled activation of neutrophils leading to pathogenesis and associated organ damage. Hence, traditional Ayurvedic herbs exhibiting anti-inflammatory and antioxidant properties may act in a manner that might prove beneficial in targeting over-functioning of neutrophils and there by promoting normal immune homeostasis. In the present manuscript, we have reviewed and discussed pathological importance of NETs formation in SARS-CoV-2 infections and discuss how various Ayurvedic herbs can be explored to modulate neutrophil function and inhibit NETs formation in the context of a) anti-microbial activity to enhance neutrophil function, b) immunomodulatory effects to maintain neutrophil mediated immune homeostasis and c) to inhibit NETs mediated thrombosis.

7.
J Ayurveda Integr Med ; 13(1): 100397, 2022.
Article in English | MEDLINE | ID: covidwho-1838952

ABSTRACT

BACKGROUND: The corona virus disease 2019 (COVID-19), an acute respiratory disease, caused by a novel corona virus (SARS-CoV-2, previously known as 2019-nCoV), obtained worldwide attention. In this review, we explored the potential siddha strategies for COVID -19 infections. OBJECTIVES: To evaluate the additional benefits of siddha drugs Vasantha kusumakaram mathirai, Thippili rasayanam, Adathodai manapagu and Kabasura kudineer compared to the allopathic standard treatment of care alone in COVID-19 asymptomatic, mild - moderate cases. MATERIALS AND METHODS: The present study was an open label Two arm - randomized controlled interventional clinical study. The Group I patients were assigned to Siddha add on treatment whereas Group II subjects were assigned with standard treatment alone. The sample size was 100 for each group. RESULT: The average number of days taken for reduction of symptoms showed significant results (P < 0.001) in Siddha add on compared with standard treatment. The real - time polymerase chain reaction (RT-PCR) investigation turned negative for 78.33% in Siddha add on and 33.33% in standard treatment after 11-14 days. Similarly, CT chest, covid pattern lung involvement percentage showed highly significant reduction (P < 0.0001) in Siddha add on treatment. In addition, Neutrophil Lymphocyte Ratio (NLR) ratio, showed significant reduction (P < 0.01) when analyzed by Wilcoxon signed rank test, and Renal, Liver parameters were within the normal limits in Siddha add on Group for 25 samples in post treatment. CONCLUSION: Finally, it was concluded that Siddha add on Group showed accelerated recovery for COVID - 19 patients compared to standard Group. The synergistic effect of Siddha add on with standard treatment gave more promising results in the current study of COVID -19.

8.
Curr Opin Neurol ; 34(4): 589-597, 2021 08 01.
Article in English | MEDLINE | ID: covidwho-1816369

ABSTRACT

PURPOSE OF REVIEW: The COVID-pandemic has facilitated the implementation of telemedicine in both clinical practice and research. We highlight recent developments in three promising areas of telemedicine: teleconsultation, telemonitoring, and teletreatment. We illustrate this using Parkinson's disease as a model for other chronic neurological disorders. RECENT FINDINGS: Teleconsultations can reliably administer parts of the neurological examination remotely, but are typically not useful for establishing a reliable diagnosis. For follow-ups, teleconsultations can provide enhanced comfort and convenience to patients, and provide opportunities for blended and proactive care models. Barriers include technological challenges, limited clinician confidence, and a suboptimal clinician-patient relationship. Telemonitoring using wearable sensors and smartphone-based apps can support clinical decision-making, but we lack large-scale randomized controlled trials to prove effectiveness on clinical outcomes. Increasingly many trials are now incorporating telemonitoring as an exploratory outcome, but more work remains needed to demonstrate its clinical meaningfulness. Finding a balance between benefits and burdens for individual patients remains vital. Recent work emphasised the promise of various teletreatment solutions, such as remotely adjustable deep brain stimulation parameters, virtual reality enhanced exercise programs, and telephone-based cognitive behavioural therapy. Personal contact remains essential to ascertain adherence to teletreatment. SUMMARY: The availability of different telemedicine tools for remote consultation, monitoring, and treatment is increasing. Future research should establish whether telemedicine improves outcomes in routine clinical care, and further underpin its merits both as intervention and outcome in research settings.


Subject(s)
COVID-19 , Parkinson Disease , Telemedicine , Humans , Pandemics , Parkinson Disease/diagnosis , Parkinson Disease/therapy , SARS-CoV-2
9.
Nat Rev Cardiol ; 18(11): 785-802, 2021 11.
Article in English | MEDLINE | ID: covidwho-1815550

ABSTRACT

High blood pressure is one of the most important risk factors for ischaemic heart disease, stroke, other cardiovascular diseases, chronic kidney disease and dementia. Mean blood pressure and the prevalence of raised blood pressure have declined substantially in high-income regions since at least the 1970s. By contrast, blood pressure has risen in East, South and Southeast Asia, Oceania and sub-Saharan Africa. Given these trends, the prevalence of hypertension is now higher in low-income and middle-income countries than in high-income countries. In 2015, an estimated 8.5 million deaths were attributable to systolic blood pressure >115 mmHg, 88% of which were in low-income and middle-income countries. Measures such as increasing the availability and affordability of fresh fruits and vegetables, lowering the sodium content of packaged and prepared food and staples such as bread, and improving the availability of dietary salt substitutes can help lower blood pressure in the entire population. The use and effectiveness of hypertension treatment vary substantially across countries. Factors influencing this variation include a country's financial resources, the extent of health insurance and health facilities, how frequently people interact with physicians and non-physician health personnel, whether a clear and widely adopted clinical guideline exists and the availability of medicines. Scaling up treatment coverage and improving its community effectiveness can substantially reduce the health burden of hypertension.


Subject(s)
Global Health , Hypertension , Global Health/statistics & numerical data , Humans , Hypertension/epidemiology , Hypertension/therapy
10.
Health Promot Int ; 37(1)2022 Feb 17.
Article in English | MEDLINE | ID: covidwho-1806409

ABSTRACT

Social distancing is crucial in breaking the cycle of transmission of COVID-19. However, many religions require the faithful to congregate. In Malaysia, the number of COVID-19 cases spiked up from below 30 in February 2020 to more than a thousand a month later. The sudden increase was mostly linked to a large Islamic gathering attended by 16,000 near the capital, Kuala Lumpur. Another large COVID-19 cluster was from a church gathering in Kuching, Sarawak. Within a few weeks, Malaysia became the worst hit country by COVID-19 in Southeast Asia. While religious leaders have advised social distancing among their congregants, the belief that "God is our shield" is often cited for gathering. There is a need to promote sound decision-making among religious adherents so that they will not prioritize their loyalty to the subjective interpretation of religion over evidence-based medicine. Malaysia, a multi-cultural and multi-faith country, is an example of how religious beliefs could strongly influence health behaviours at individual and community levels. In this article, we detail the religious aspects of COVID-19 prevention and control in Malaysia and discuss the possible role of religious organizations in encouraging sound decision-making among religious adherents in mitigating this crisis. We make recommendations on how to promote a partnership between the healthcare system and religious organizations, and how religion and faith could be integrated into health promotion channels and resources in the response of COVID-19 and future communicable diseases.


Subject(s)
COVID-19 , Health Promotion , Humans , Islam , Pandemics , Religion , SARS-CoV-2
11.
Crit Care Explor ; 2(6): e0139, 2020 Jun.
Article in English | MEDLINE | ID: covidwho-1795099

ABSTRACT

OBJECTIVES: The severe acute respiratory syndrome coronavirus 2 pandemic has stretched ICU resources in an unprecedented fashion and outstripped personal protective equipment supplies. The combination of a novel disease, resource limitations, and risks to medical personnel health have created new barriers to implementing the ICU Liberation ("A" for Assessment, Prevention, and Manage pain; "B" for Both Spontaneous Awakening Trials and Spontaneous Breathing Trials; "C" for Choice of Analgesia and Sedation; "D" for Delirium Assess, Prevent, and Manage; "E" for Early Mobility and Exercise; and "F" for Family Engagement and Empowerment [ABCDEF]) Bundle, a proven ICU care approach that reduces delirium, shortens mechanical ventilation duration, prevents post-ICU syndrome, and reduces healthcare costs. This narrative review acknowledges barriers and offers strategies to optimize Bundle performance in coronavirus disease 2019 patients requiring mechanical ventilation. DATA SOURCES STUDY SELECTION AND DATA EXTRACTION: The most relevant literature, media reports, and author experiences were assessed for inclusion in this narrative review including PubMed, national newspapers, and critical care/pharmacology textbooks. DATA SYNTHESIS: Uncertainty regarding coronavirus disease 2019 clinical course, shifts in attitude, and changes in routine behavior have hindered Bundle use. A domino effect results from: 1) changes to critical care hierarchy, priorities, and ICU team composition; 2) significant personal protective equipment shortages cause; 3) reduced/restricted physical bedside presence favoring; 4) increased depth of sedation and use of neuromuscular blockade; 5) which exacerbate drug shortages; and 6) which require prolonged use of limited ventilator resources. Other identified barriers include manageable knowledge deficits among non-ICU clinicians unfamiliar with the Bundle or among PICU specialists deploying pediatric-based Bundle approaches who are unfamiliar with adult medicine. Both groups have been enlisted to augment the adult ICU work force to meet demand. Strategies were identified to facilitate Bundle performance to liberate patients from the ICU. CONCLUSIONS: We acknowledge current challenges that interfere with comprehensive management of critically ill patients during the coronavirus disease 2019 pandemic. Rapid response to new circumstances precisely requires established safety mechanisms and protocols like the ABCDEF Bundle to increase ICU and ventilator capacity and help survivors maximize recovery from coronavirus disease 2019 as early as possible.

12.
Psychol Res Behav Manag ; 13: 705-711, 2020.
Article in English | MEDLINE | ID: covidwho-1793276

ABSTRACT

PURPOSE: Orphaned children carry many psychological and emotional issues with them throughout their lives, which influence every decision they make, including investment decisions. A lack of self-determination and low confidence may make orphans make more risky decisions than their nonorphan counterparts. In this study, we aimed to see how this risky behavior was reflected in investment choices during the COVID-19 pandemic. METHODS: A well-structured questionnaire was distributed to 230 adult investors (130 orphans and 100 nonorphans) between January 22 and March 13, 2020. RESULTS: Orphans were found to be risk-takers during the COVID-19 pandemic, as hypothesized from their childhood history. Moreover, female investors showed more sensible (less risky) behavior than male investors when investing in fixed-income securities. Income and age showed significant inverse relationships with risk tolerance, while education showed a positive but insignificant effect. CONCLUSION: This study indicates that orphan investors enjoy taking risks and their behavior toward risk remains consistent, even in abnormal conditions, such as a global pandemic. It also suggests that their risk-taking behavior remains stable from orphanhood through to adulthood, contradicting many reports that orphans make reasonable decisions in adulthood.

13.
Can J Anaesth ; 67(10): 1424-1430, 2020 Oct.
Article in English | MEDLINE | ID: covidwho-1777852

ABSTRACT

PURPOSE: Risk to healthcare workers treating asymptomatic patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the operating room depends on multiple factors. This review examines the evidence for asymptomatic or pre-symptomatic carriage of SARS-CoV-2, the risk of transmission from asymptomatic patients, and the specific risks associated with aerosol-generating procedures. Protective measures, such as minimization of aerosols and use of personal protective equipment in the setting of treating asymptomatic patients, are also reviewed. SOURCE: We examined the published literature as well as Societal guidelines. PRINCIPAL FINDINGS: There is evidence that a proportion of those infected with SARS-CoV-2 have detectable viral loads prior to exhibiting symptoms, or without ever developing symptoms. The degree of risk of transmission from asymptomatic patients to healthcare providers will depend on the prevalence of disease in the population, which is difficult to assess without widespread population screening. Aerosol-generating procedures increase the odds of viral transmission from infected symptomatic patients to healthcare providers, but transmission from asymptomatic patients has not been reported. Techniques to minimize aerosolization and appropriate personal protective equipment may help reduce the risk to healthcare workers in the operating room. Some societal guidelines recommend the use of airborne precautions during aerosol-generating procedures on asymptomatic patients during the coronavirus disease pandemic, although evidence supporting this practice is limited. CONCLUSION: Viral transmission from patients exhibiting no symptoms in the operating room is plausible and efforts to reduce risk to healthcare providers include reducing aerosolization and wearing appropriate personal protective equipment, the feasibility of which will vary based on geographic risk and equipment availability.


RéSUMé: OBJECTIF: Le risque encouru par les travailleurs de la santé traitant des patients asymptomatiques infectés par le syndrome respiratoire aigu sévère du coronavirus 2 (SARS-CoV-2) en salle d'opération dépend de plusieurs facteurs. Ce compte rendu examine les données probantes concernant la présence asymptomatique ou pré-symptomatique du SARS-CoV-2, le risque de transmission des patients asymptomatiques, et les risques spécifiques associés aux interventions générant des aérosols. Nous passons également en revue différentes mesures de protection, telles que la minimisation des aérosols et l'utilisation d'équipements de protection individuelle, dans un contexte de traitement de patients asymptomatiques. SOURCE: Nous avons examiné la littérature publiée ainsi que les directives sociétales. CONSTATATIONS PRINCIPALES: Selon certaines données probantes, une proportion des personnes infectées par le SARS-CoV-2 possèdent des charges virales détectables avant la présence de symptômes, voire même sans manifestation de symptômes. Le degré de risque de transmission des patients asymptomatiques aux travailleurs de la santé dépendra de la prévalence de la maladie dans la population, une donnée difficile à évaluer sans dépistage généralisé. Les interventions générant des aérosols augmentent le risque de transmission virale des patients symptomatiques infectés aux travailleurs de la santé, mais la transmission de patients asymptomatiques n'a pas été rapportée. Les techniques visant à minimiser l'aérosolisation et les équipements de protection individuelle adaptés pourraient être utiles pour réduire le risque des travailleurs de la santé en salle d'opération. Certaines directives régionales et nationales recommandent le recours à des précautions contre la transmission par voie aérienne durant les interventions générant des aérosols pratiquées sur des patients asymptomatiques pendant la pandémie de coronavirus, bien que les données probantes appuyant cette pratique soient limitées. CONCLUSION: La transmission virale des patients asymptomatiques en salle d'opération est plausible et les efforts visant à réduire le risque pour les travailleurs de la santé comprennent la réduction de l'aérosolisation et le port d'équipements de protection individuelle adaptés, deux mesures dont la faisabilité variera en fonction du risque géographique et de la disponibilité des équipements.


Subject(s)
Asymptomatic Infections/epidemiology , Coronavirus Infections/transmission , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Pneumonia, Viral/transmission , Aerosols , Betacoronavirus/isolation & purification , COVID-19 , Carrier State/epidemiology , Carrier State/virology , Coronavirus Infections/epidemiology , Health Personnel , Humans , Pandemics , Personal Protective Equipment , Pneumonia, Viral/epidemiology , SARS-CoV-2
14.
Chin Med J (Engl) ; 134(13): 1602-1609, 2021 Jun 16.
Article in English | MEDLINE | ID: covidwho-1769421

ABSTRACT

BACKGROUND: Hypertension is considered an important risk factor for the coronavirus disease 2019 (COVID-19). The commonly anti-hypertensive drugs are the renin-angiotensin-aldosterone system (RAAS) inhibitors, calcium channel blockers (CCBs), and beta-blockers. The association between commonly used anti-hypertensive medications and the clinical outcome of COVID-19 patients with hypertension has not been well studied. METHODS: We conducted a retrospective cohort study that included all patients admitted with COVID-19 to Huo Shen Shan Hospital and Guanggu District of the Maternal and Child Health Hospital of Hubei Province, Wuhan, China. Clinical and laboratory characteristics were extracted from electronic medical records. Hypertension and anti-hypertensive treatment were confirmed by medical history and clinical records. The primary clinical endpoint was all-cause mortality. Secondary endpoints included the rates of patients in common wards transferred to the intensive care unit and hospital stay duration. Logistic regression was used to explore the risk factors associated with mortality and prognosis. Propensity score matching was used to balance the confounders between different anti-hypertensive treatments. Kaplan-Meier curves were used to compare the cumulative recovery rate. Log-rank tests were performed to test for differences in Kaplan-Meier curves between different groups. RESULTS: Among 4569 hospitalized patients with COVID-19, 31.7% (1449/4569) had a history of hypertension. There were significant differences in mortality rates between hypertensive patients with CCBs (7/359) and those without (21/359) (1.95% vs. 5.85%, risk ratio [RR]: 0.32, 95% confidence interval [CI]: 0.13-0.76, χ2 = 7.61, P = 0.0058). After matching for confounders, the mortality rates were similar between the RAAS inhibitor (4/236) and non-RAAS inhibitor (9/236) cohorts (1.69% vs. 3.81%, RR: 0.43, 95% CI: 0.13-1.43, χ2 = 1.98, P = 0.1596). Hypertensive patients with beta-blockers (13/340) showed no statistical difference in mortality compared with those without (11/340) (3.82% vs. 3.24%, RR: 1.19, 95% CI: 0.53-2.69, χ2 = 0.17, P = 0.6777). CONCLUSIONS: In our study, we did not find any positive or negative effects of RAAS inhibitors or beta-blockers in COVID-19 patients with hypertension, while CCBs could improve prognosis.


Subject(s)
COVID-19 , Hypertension , Angiotensin Receptor Antagonists/therapeutic use , Angiotensin-Converting Enzyme Inhibitors/therapeutic use , Antihypertensive Agents/therapeutic use , Calcium Channel Blockers/therapeutic use , Child , China , Humans , Hypertension/drug therapy , Prognosis , Retrospective Studies , SARS-CoV-2
15.
J Clin Med ; 10(4)2021 Feb 11.
Article in English | MEDLINE | ID: covidwho-1753571

ABSTRACT

The perioperative use of regional anesthesia and local anesthetics is part of almost every anesthesiologist's daily clinical practice. Retrospective analyses and results from experimental studies pointed towards a potential beneficial effect of the local anesthetics regarding outcome-i.e., overall and/or recurrence-free survival-in patients undergoing cancer surgery. The perioperative period, where the anesthesiologist is responsible for the patients, might be crucial for the further course of the disease, as circulating tumor cells (shed from the primary tumor into the patient's bloodstream) might form new micro-metastases independent of complete tumor removal. Due to their strong anti-inflammatory properties, local anesthetics might have a certain impact on these circulating tumor cells, either via direct or indirect measures, for example via blunting the inflammatory stress response as induced by the surgical stimulus. This narrative review highlights the foundation of these principles, features recent experimental and clinical data and provides an outlook regarding current and potential future research activities.

16.
J Clin Med ; 10(1)2020 Dec 30.
Article in English | MEDLINE | ID: covidwho-1753519

ABSTRACT

Candida species are common global opportunistic pathogens that could repeatedly and chronically cause oral mucosa infection and create an inflammatory environment, leading to organ dysfunction. Oral Candida infections may cause temporary or permanent damage to salivary glands, resulting in the destruction of acinar cells and the formation of scar tissue. Restricted function of the salivary glands leads to discomfort and diseases of the oral mucosa, such as dry mouth and associated infection. This narrative review attempts to summarize the anatomy and function of salivary glands, the associations between Candida and saliva, the effects of Candida infection on salivary glands, and the treatment strategies. Overall, clinicians should proactively manage Candida infections by educating patients on oral hygiene management for vulnerable populations, conducting frequent checks for a timely diagnosis, and providing an effective treatment plan.

17.
Curr Psychol ; 41(2): 1057-1064, 2022.
Article in English | MEDLINE | ID: covidwho-1748411

ABSTRACT

As in the whole world, the Novel Coronavirus (COVID-19) pandemic poses many threats to healthcare workers in our country too, which leads to anxiety in healthcare workers. This study was conducted to explore the anxiety levels of healthcare workers during the COVID-19 pandemic. The study is a cross-sectional study. The population consisted of health care workers employed in hospitals in seven regions in Turkey. All volunteer healthcare workers were included in the study, and 356 healthcare workers responded to the questionnaire. The data were collected using the State Anxiety Inventory and a questionnaire created by the researchers using an online questionnaire between 10 May 2020 and 15 May 2020. In the evaluation of the data, mean, standard deviation, percentages, t-test, one-way ANOVA, Pearson correlation, and multiple regression analysis were used. 33% of healthcare workers did not have anxiety, 50% had mild, and 17% had severe anxiety. The anxiety scores of those who were nurses (p < 0.001), who were working in the emergency room (p < 0.001), who were involved in treatment for COVID-19 patients (p = 0.040), who left their homes to prevent transmission to their families and relatives during the pandemic (p = 0.038), and whose working hours had changed (p = 0.036) were found to be significantly higher. It was observed that there was a positive and significant relationship between the fear of death and disease transmission, uncertainty, loneliness, anger, and hopelessness, and anxiety levels in healthcare workers. The main factors that significantly affected the anxiety levels of healthcare workers were male gender, weekly working hours, the presence of chronic diseases, and feelings of anger and uncertainty. In conclusion, during the COVID-19 pandemic, healthcare workers experienced some negative emotions, their anxiety levels increased, and they were psychologically affected. Planning psychosocial interventions for healthcare workers in the high-risk group will make significant contributions to the health system.

18.
J Matern Fetal Neonatal Med ; 35(8): 1610-1618, 2022 Apr.
Article in English | MEDLINE | ID: covidwho-1747012

ABSTRACT

Corona virus disease 2019 started in December 2019 as an outbreak of unexplained pneumonias in Wuhan, a city in Hubei province of China. This illness emerged as an epidemic in China and later spread to almost all countries over the globe except Antarctica. This is caused by a beta Corona virus, which is genetically similar to SARS virus. The predominant mode of transmission is via droplet spread, when the infected person coughs, sneezes or talks the virus is released in the respiratory secretions. As there are only a few cases of COVID 19 in neonates, there is no convincing evidence to support the possibility of vertical transmission. Clinical presentation in neonates is nonspecific, commonly observed are temperature instability, respiratory distress, poor feeding, lethargy, vomiting and diarrhea. Laboratory examinations may be nonspecific. Definitive test for 2019-nCoV is the detection of viral nucleic acid by real-time fluorescence polymerase chain reaction (RT-PCR). Suspected and confirmed COVID positive mothers should be delivered in separate delivery rooms and operation theaters. Since there is no approved treatment or drug for this disease, prevention of infection and breaking the chain of transmission plays a crucial role.


Subject(s)
COVID-19 , SARS Virus , COVID-19/diagnosis , Disease Outbreaks , Humans , Infant, Newborn , Infectious Disease Transmission, Vertical , SARS-CoV-2
19.
Curr Med Chem ; 29(4): 635-665, 2022.
Article in English | MEDLINE | ID: covidwho-1742086

ABSTRACT

Due to its fast international spread and substantial mortality, the coronavirus disease COVID-19 evolved to a global threat. Since there is currently no causative drug against this viral infection available, science is striving for new drugs and other approaches to treat the new disease. Studies have shown that the cell entry of coronaviruses into host cells takes place through the binding of the viral spike (S) protein to cell receptors. Priming of the S protein occurs via hydrolysis by different host proteases. The inhibition of these proteases could impair the processing of the S protein, thereby affecting the interaction with the host-cell receptors and preventing virus cell entry. Hence, inhibition of these proteases could be a promising strategy for treatment against SARSCoV- 2. In this review, we discuss the current state of the art of developing inhibitors against the entry proteases furin, the transmembrane serine protease type-II (TMPRSS2), trypsin, and cathepsin L.


Subject(s)
COVID-19 , SARS-CoV-2 , COVID-19/drug therapy , Humans , Serine Proteases , Spike Glycoprotein, Coronavirus/metabolism , Virus Internalization
20.
J Virol ; 94(13)2020 06 16.
Article in English | MEDLINE | ID: covidwho-1723544

ABSTRACT

Genetic variability across the three major histocompatibility complex (MHC) class I genes (human leukocyte antigen A [HLA-A], -B, and -C genes) may affect susceptibility to and severity of the disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease 2019 (COVID-19). We performed a comprehensive in silico analysis of viral peptide-MHC class I binding affinity across 145 HLA-A, -B, and -C genotypes for all SARS-CoV-2 peptides. We further explored the potential for cross-protective immunity conferred by prior exposure to four common human coronaviruses. The SARS-CoV-2 proteome was successfully sampled and was represented by a diversity of HLA alleles. However, we found that HLA-B*46:01 had the fewest predicted binding peptides for SARS-CoV-2, suggesting that individuals with this allele may be particularly vulnerable to COVID-19, as they were previously shown to be for SARS (M. Lin, H.-T. Tseng, J. A. Trejaut, H.-L. Lee, et al., BMC Med Genet 4:9, 2003, https://bmcmedgenet.biomedcentral.com/articles/10.1186/1471-2350-4-9). Conversely, we found that HLA-B*15:03 showed the greatest capacity to present highly conserved SARS-CoV-2 peptides that are shared among common human coronaviruses, suggesting that it could enable cross-protective T-cell-based immunity. Finally, we reported global distributions of HLA types with potential epidemiological ramifications in the setting of the current pandemic.IMPORTANCE Individual genetic variation may help to explain different immune responses to a virus across a population. In particular, understanding how variation in HLA may affect the course of COVID-19 could help identify individuals at higher risk from the disease. HLA typing can be fast and inexpensive. Pairing HLA typing with COVID-19 testing where feasible could improve assessment of severity of viral disease in the population. Following the development of a vaccine against SARS-CoV-2, the virus that causes COVID-19, individuals with high-risk HLA types could be prioritized for vaccination.


Subject(s)
Betacoronavirus/immunology , Coronavirus Infections/virology , Histocompatibility Testing/methods , Pneumonia, Viral/virology , Amino Acid Sequence , COVID-19 , COVID-19 Testing , Clinical Laboratory Techniques , Coronavirus Infections/diagnosis , Coronavirus Infections/immunology , Epitopes, T-Lymphocyte/immunology , Genetic Variation , Genotype , Haplotypes , Histocompatibility Antigens Class I/genetics , Histocompatibility Antigens Class I/immunology , Humans , Immunity, Innate/immunology , Pandemics , Pneumonia, Viral/immunology , SARS-CoV-2 , T-Lymphocytes/immunology
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