RESUMO
RationaleCOVID-19 is an acute infectious disease caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Human surfactant protein D (SP-D) is known to interact with spike protein of SARS-CoV, but its immune-surveillance against SARS-CoV-2 is not known. ObjectiveThis study aimed to examine the potential of a recombinant fragment of human SP-D (rfhSP-D) as an inhibitor of replication and infection of SARS-CoV-2. MethodsrfhSP-D interaction with spike protein of SARS-CoV-2 and hACE-2 receptor was predicted via docking analysis. The inhibition of interaction between spike protein and ACE-2 by rfhSP-D was confirmed using direct and indirect ELISA. The effect of rfhSP-D on replication and infectivity of SARS-CoV-2 from clinical samples was studied by measuring the expression of RdRp gene of the virus using qPCR. Measurements and Main ResultsIn-silico interaction studies indicated that three amino acid residues in the RBD of spike of SARS-CoV-2 were commonly involved in interacting with rfhSP-D and ACE-2. Studies using clinical samples of SARS-CoV-2 positive cases (asymptomatic, n=7 and symptomatic, n=8 and negative controls n=15) demonstrated that treatment with 5M rfhSP-D inhibited viral replication by ~5.5 fold and was more efficient than Remdesivir (100 M). Approximately, a 2-fold reduction in viral infectivity was also observed after treatment with 5M rfhSP-D. ConclusionsThese results conclusively demonstrate that the calcium independent rfhSP-D mediated inhibition of binding between the receptor binding domain of the S1 subunit of the SARS-CoV-2 spike protein and human ACE-2, its host cell receptor, and a significant reduction in SARS-CoV-2 infection and replication in-vitro.
RESUMO
BACKGROUND: Patient experience is considered an important tool to measure the quality of healthcare, which is a treatment efficiency and effectiveness outcome. This study aims to measure the level of quality provided by three hospitals in Alipurduar District, India with a focus on the patient satisfaction and to identify inequality of service received by patients from different backgrounds. METHODS: By using stratified random sampling technique and seven points Likert scale, the required primary data were collected from the patients of these hospitals with a selected sample size of 300 patients. Exploratory Factor Analysis (EFA) was used in grouping the items and Multiple Linear Regression, ANOVA, and T-test were used for analysing the data. RESULTS: The services delivered in these hospitals moderately (4.660 ± .787) satisfy the patients, showing an average quality of healthcare. Therefore, patients from better income groups tend to have paid caregivers to provide better care. Moreover, quality of healthcare has a significant impact (R2 = .770) on patient satisfaction which varied between respondent groups, indicating inequality in the services delivered. CONCLUSIONS: In these Govt. hospitals where every patient has an equal right to receive quality care, due to the inequality in the patients' socio-economic background, this is still not possible. Hospital authorities should improve the quality of healthcare by identifying deficiencies and by taking feedback from patients.
