RESUMEN
Coronavirus disease 2019 (COVID-19) can be life threating if untreated. Early diagnosis and effective nutritional management can save life. To assess the nutritional status and predict possible outcomes of critical patients Sequential Organ Failure Assessment (SOFA), nutrition risk in critically ill patients (NUTRIC), and acute physiology and chronic health evaluation (APACHE) score has been used. This retrospective observational study was conducted on confirmed COVID-19 cases in Intensive Care Unit (ICU) of Shifa hospital between November 24, 2020 to May 31, 2021. The demographic, clinical and laboratory information was obtained from hospital records. Risk factors for COVID-19 were identified and compared using multivariate logistic regression analysis. The nutritional risk for each patient was assessed. In this study 162 COVID-19 patients with median age of 64 years (IQR: 56-74) were included. Hypertension (59.2%) was found to be the most common comorbidity and the most prevalent symptoms upon admission were fever (54.9%). The patients in critical condition were supplied nutrients through nasogastric route (61.7%) while 37.7% and 0.6 % were assisted through oral and total parenteral nutrition (TPN) route. The Glasgow comma score was found to be mild (72.2%) (GCS>12) with increased creatinine, white blood cell count, C-reactive protein (CRP C), and glycosylated haemoglobin HbA1c level were present. Interestingly based on SOFA, APACHE and NUTRIC score low insignificant malnutrition risk was observed. Our study found different demographic factors and comorbidities have a substantial impact on COVID19 patients, as evidenced by demographic, laboratory, clinical, and nutritional risk factors.
RESUMEN
Novel coronavirus (2019-nCoV), since its emergence from Wuhan China in December 31, 2019 is still uncontrolled and has raised attention around the globe. According to World health organization, up to March 20, 2020, globally 209,839 confirmed cases of COVID-19 have been reported along with 8778 deaths. 2019-nCoV is likely to be a recombinant of different coronaviruses such as SARS CoV and MERS CoV. Recent developments revealed that glycosylated spike (S) protein of 2019-nCov is contributing significantly in facilitating 2019- nCov infection in human body. The subunit (S1) of spike protein facilitates 2019-nCov binding with host cells’ receptors, while S2 subunit (post fusion core of 2019-nCov) is a key factor in fusion of 2019-nCov with host cell membrane and subsequent inoculation of its DNA in to the host cell. Therefore, in coronavirus infection, membrane fusion and receptor binding are critical. And if active sites of 2019-nCov spike protein S2 (post fusion core of 2019-nCov) are blocked, this may reduce COVID-19 infections in human. We use clustering based drug-drug interaction (DDI) networks and drug repositioning approach based on modularity to inhibit the membrane fusion and receptor binding capacity of 2019-nCov. About 150 drug compounds effective against SARS-CoV and MERS-CoV were retrieved, and screened on the basis of Lipinski rule of five. Clusters and strongly interacted DDI networks were generated in accordance to their modularity class, average path length and density. Promising drug candidates were then filtered by toxicity indicator and molecular docking. Our finding reveals that ZINC000029038525 and ZINC000029129064 drug compounds have significant binding potential with active sites of post fusion core of 2019-nCov ‘S2’ subunit and may inhibit membrane fusion and receptor binding capacity of 2019-nCov. Therefore, these drug compounds alone or in amalgamation could be strong and more effective therapeutic candidates against 2019-nCov infections.