Résumé
The current monkeypox outbreak is a public health emergency of international concern and is coming in the wake of the SARS-CoV-2 pandemic. Human monkeypox is a viral zoonotic infection caused by monkeypox virus, an enveloped double-stranded DNA virus of the genus Orthopoxvirus and family Poxviridae that also contain smallpox, cowpox, Orf, and vaccinia viruses. Online databases including PubMed, Google Scholar and Web of Science were searched to obtain relevant publications on the epidemiology, treatment, vaccines and the economic impacts of the current monkeypox (Mpox) outbreak.
Résumé
Background: COVID-19 is a major global health challenge that has affected all age groups and gender, with over 5 million deaths reported worldwide to date. The objective of this study is to assess available information on COVID-19 in children and adolescents with respect to clinical characteristics, co-morbidities, and outcomes, and identify gaps in the literatures for appropriate actions. Methodology: Electronic databases including Web of Science, PubMed, Scopus, and Google Scholar were searched for observational studies such as case series, cross-sectional and cohort studies published from December 2019 to September 2021, using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guide. Data extracted included (i) patient demography (age and gender), (ii) clinical characteristics including vaccination status and presence of co-morbidities, (iii) clinical management including the use of sequential organ failure assessment (SOFA) scores, oxygen requirement, use of mechanical ventilation, and (iv) disease outcomes including length of hospital and intensive care unit (ICU) admission, recovery, complications with sequelae, or death. Data were analyzed using descriptive statistics. Result(s): A total of 11 eligible studies were included with a total of 266 children and adolescents;137 (51.5%) females and 129 (48.5%) males. The mean age of the children was 9.8 years (range of 0 - 19 years), and children >= 6 years were more affected (40.7%) than age groups 1 - 5 years (31.9%) and < 1 year (27.4%). The major co-morbidities were respiratory diseases including pre-existing asthma (3.4%), neurologic conditions (3.4%) and cardiac pathology (2.3%). Majority (74.8%, 199/266) of the patients were discharged without sequelae, 0.8% (2/266) were discharged with sequalae from one study, and mortality of 1.9% (5/266) was reported, also from one study. SOFA scores of patients at admission were not stated in any of the study, while only one study reported patient vaccination status. Conclusion(s): It is recommended that safe vaccines for children < 1 year of age should be developed in addition to other preventive measures currently in place. SOFA scores should be used to assess risk of COVID-19 severity and monitor prognosis of the disease, and vaccination status of children should be documented as this may impact the management and prognosis of the disease. Copyright AJCEM 2022.
Résumé
SARS-CoV-2 has evolved over time with several mutations, especially on the spike protein, which has led to emergence of various variants. With the evolution of SARS-CoV-2 come new challenges in surveillance, effectiveness of preventive and treatment strategies, and outcome of the disease. Despite the lockdowns, mask mandates and other preventive measures put in place, in addition to over 10 million vaccine doses that have been administered globally as of February 2022, COVID-19 cases have risen to over 435 million and resulted in over 5.9 million deaths, largely as a result of the evolution of SARS-CoV-2 variants. To review the evolution of these variants, we searched different online database sources using keywords such as “source of SARS-CoV-2”, “SARS-CoV-2 origin”, “evolution of SARS-CoV-2”, “SARS-CoV-2 variants”, “variants of concern”, “variants of interest”, and “variants of high consequence”. This was to enable us give a good report about the various variants of SARS-CoV-2 that have emerged so far, and the public health challenges posed by them.
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Invasive fungal diseases (IFDs) are major causes of morbidity and mortality among hospitalized patients all over the world with a global prevalence of 15%. Since the first case of COVID-19 was reported on February 27, 2020, in Nigeria, it had been discovered across all geopolitical zones in Nigeria. As the medical community confronts the ongoing COVID-19 pandemic, determining whether patients infected with SARS-CoV-2 develop fungal complications, especially invasive aspergillosis, is crucial. This review aimed to highlight the fungal co-infections that might be associated with SARS-CoV-2 infection, and modalities for their diagnosis, prevention, and management, with the view to reducing the high mortality associated with these infections.
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Because of high mortality and long-term hospital stay among patients with SARS-CoV-2 infections, it is important to search for biochemical changes in different organs and systems that could be useful in diagnosis and prognosis of COVID-19. We conducted a literature search of online databases including PubMed, Web of Science, Scopus and Google scholar for relevant materials on biochemical changes in SARS-COV-2 infections published between December 2019 and March 2021. The review shows that SARS-COV-2 uses the angiotensin converting enzyme 2 (ACE2) for attachment and entry into host cells. These ACE2 are abundantly expressed by the epithelial cells of the respiratory tract and moderately expressed by the epithelial cells of the esophagus, stomach, duodenum, ileum, rectum, cholangiocytes, liver hepatocytes, pancreatic beta cells, and kidney tubular cells. This explains the systemic nature of SARS-COV-2 infection, and the high morbidity and mortality associated with COVID-19. Although, tests to assess biochemical changes are not specific enough for the diagnosis of SARS-CoV-2 infection, they may be useful for predicting outcome of COVID-19. This review highlights biochemical parameters that are significantly elevated or reduced in SARS-COV-2 infections, and which can be used as predictive factors of the severity and prognosis in COVID-19 patients.
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Severe acute respiratory syndrome–coronavirus-2 (SARS-CoV-2) enters cells using the angiotensin converting enzyme 2 (ACE2), which are expressed by the respiratory tract endothelium, epithelial cells of the stomach, duodenum, ileum, rectum, cholangiocytes, and hepatocytes. Pathological examinations of these organs are not feasible method of diagnosis but can explain pathological changes, pathogenesis of the disease, and the cause of death in COVID-19 cases. In this review, we performed a literature search for COVID-19-related pathological changes seen during post-mortem examinations in different organs of the body including the lungs, gastrointestinal tract, liver, kidney, skin, heart and blood. Our findings showed that SARS-CoV-2 has damaging effects on many organs, probably due to the host immune responses to the presence of the virus. It is recommended that both antiviral and immunomodulatory agents should be considered in the management of COVID-19 patients for better prognosis, and clinical outcome.
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Ivermectin is an avermectin which is a group of pentacyclic sixteen-membered lactone (macrocyclic lactone disaccharide) derived from the soil bacterium Streptomyces avermitilis. It is a semi-synthetic broad-spectrum anti-helminthic, anti-viral and anti-cancer agent. It has a wide safety margin with low adverse effects when it is used orally. It has, however, so far only been approved by the Food and Drug Administration (FDA) as a broad spectrum anti-parasitic agent. Because ivermectin also has broad activities as an anti-viral agent, we herein review its pharmacokinetic and pharmacodynamic activities, as well as the in vitro and in vivo studies conducted on the drug. It is hoped that this work will pave way for ivermectin being seriously considered as an addition to the drugs available for the management of patients with COVID-19.
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Dexamethasone is a potent synthetic member of the glucocorticoid class of corticosteroid drugs that has been useful for the management of some pathological disorders because it affects a protean number of signaling pathways. It is used as adjunct therapy in the management of sepsis, arthritis, cardiac transplant, blood, hormone/immune system disorders, allergic reaction, skin, eye conditions, cancer and other pathologic disorders and as a mainstay of therapy in autoimmune hepatitis. With the advent of COVID-19, there have been investigations of its use as anti-inflammatory agent in severely ill patients. This present review elucidates the various studies on the use of dexamethasone in the management of severe respiratory tract infections, with the ultimate aim of reducing mortality amongst severely ill patients, including COVID-19.
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Objectives: A mysterious respiratory disease named Severe Acute Respiratory Syndrome Coronavirus -2 (SARS CoV-2) broke out in Wuhan, China in December 2019, and has stimulated a rapid and intense public health response. As at 7th of July, 2020, about 11,516,782 confirmed cases and about 535,453 deaths have been reported across over 187 countries/regions of the world as reported by Johns Hopkins University, Maryland USA. We need to understand the immunologic responses to this infection, so as to be able to properly manage patients, and also hopefully to be able to produce effective vaccines against SARS CoV-2. Data sources and synthesis: SARS-CoV-2 via virus Spike (S)-protein primarily attaches to the epithelium of the respiratory tract because of its high affinity for the ACE 2 receptor on the epithelium. It gets into the respiratory tract endothelium by means of endocytosis. The mast cells in the sub-mucosa of the respiratory tract form a barrier of protection against the virus. Mast cells get primed when they make contact with the virus, and cytokines are then released. The cytokines, however, play an important role both in its virulence and in the outcome of the viral infection.