Acute Respiratory Syndrome Coronavirus Research Articles

In silico identification of approved drugs for potential prophylactic uses against SARS-CoV-2 infection

The outbreak of Severe Acute Respiratory Syndrome Corona Virus (SARS-CoV-2) responsible for Coronavirus disease 2019 (COVID-19) constitute a major public health threat and economic burden. Despite the multifold research all over the world. COVID-19 has remained without a treatment. Hence, the urgent need to repurpose the FDA-approved drugs through in silico computational technique to identify inhibitors of SARS-CoV-2. Bioinformatics techniques were used to screen 2015 FDA- approved drugs against SARS-CoV-2 proteins and associated human protein, angiotensin-converting enzyme 2 (ACE2) to identify drug for new indication. The ligands were downloaded from Selleckchem drug data bank in SDF format. Open Babel was used to separate the ligands into their compounds and prepared for docking simulation using shell script and saved as PDBQT. Experimental crystal structures of the receptors (ACE2 and Spike proteins) were retrieved from Protein Data Bank (PDB), Autodock tools was used to prepare the proteins and saved as PDBQT files. Docking protocols were validated, molecular docking simulations were performed on a Linux platform using AutoDock Vina in quadruplicate. The binding energies (BEs) kcal/mol were calculated and expressed as mean ± standard deviation. Discovery studio was used for visualization. Density Functional Theory (DFT) was used to determine the predictive maximal inhibitory concentration (pIC50) of best hits. Ninety-one (91) new hits were identified for prophylaxis. Four (4) compounds were subjected to DFT based IC50 calculation with molnupiravir as a reference compound. Significantly, calculated IC50 of molnupiravir in Vero cells and Calu-3 were 0.299 and 0.008µM respectively while the experimental IC50 in Vero cells and Calu-3 as reported in literature were 0.3 and 0.08 µM respectively. The newly identified hits are promising therapeutic agents and there is no significant difference between the experimental IC50 of molnupiravir and the calculated IC50.

Spark Discharge Aerosol-generated copper-based nanoparticles: Structural & optical properties; application on the antiviral (SARS-CoV-2) and antibacterial improvement of face masks.

Nanoparticle formation by Spark Discharge Aerosol Generation offers low-cost fabrication of nanoparticles, without the use of chemicals or vacuum. It produces aerosol particles of a few nanometers in size with high purity. In this work, copper-based - CuO (tenorite) and Cu- nanoparticles are produced, characterized and used to modify face mask air filters, achieving the introduction of antibacterial and antiviral properties. A range of characterization techniques have been employed, down to the atomic level. The majority of the particles are CuO (of a few nanometers in size that agglomerate to form aggregates), the remainder being a small number of larger Cu particles. The particles were deposited on various substrates, mainly fiber filters in order to study them and use them as biocidal agents. On face masks, their antibacterial activity against Escherichia coli (E.coli) results in a 100% decrease in bacteria cell viability. Their antiviral activity on face masks results in a 90% reduction of the Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2) viability, 15 minutes post the application of the virus stock solution. This highlights the effectiveness of this approach, its simplicity, its low cost and its excellent environmental credentials.

The Main Mechanisms of Mesenchymal Stem Cell-Based Treatments against COVID-19.

Coronavirus disease 2019 (COVID-19) has a clinical manifestation of hypoxic respiratory failure and acute respiratory distress syndrome. However, COVID-19 still lacks of effective clinical treatments so far. As a promising potential treatment against COVID-19, stem cell therapy raised recently and had attracted much attention. Here we review the mechanisms of mesenchymal stem cell-based treatments against COVID-19, and provide potential cues for the effective control of COVID-19 in the future. Literature is obtained from databases PubMed and Web of Science. Key words were chosen for COVID- 19, acute respiratory syndrome coronavirus 2, mesenchymal stem cells, stem cell therapy, and therapeutic mechanism. Then we summarize and critically analyze the relevant articles retrieved. Mesenchymal stem cell therapy is a potential effective treatment against COVID-19. Its therapeutic efficacy is mainly reflected in reducing severe pulmonary inflammation, reducing lung injury, improving pulmonary function, protecting and repairing lung tissue of the patients. Possible therapeutic mechanisms might include immunoregulation, anti-inflammatory effect, tissue regeneration, anti-apoptosis effect, antiviral, and antibacterial effect, MSC - EVs, and so on. Mesenchymal stem cells can effectively treat COVID-19 through immunoregulation, anti-inflammatory, tissue regeneration, anti-apoptosis, anti-virus and antibacterial, MSC - EVs, and other ways. Systematically elucidating the mechanisms of mesenchymal stem cell-based treatments for COVID-19 will provide novel insights into the follow-up research and development of new therapeutic strategies in next step.

SARS-CoV-2 inactivation by supercritical carbon dioxide coupled with hydrogen peroxide

The recent COVID-19 pandemic has underscored the need for innovative decontamination techniques capable of treating sensitive materials potentially contaminated. Combining supercritical carbon dioxide (scCO2) with sterilant agents has shown promise in this regard. This study aimed at testing scCO2 as a virus inactivation method for biomedical materials contaminated with the Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2). The virus was inoculated on a stainless-steel carrier and treated at 45°C and 8MPa. No inactivation was detected when only scCO2 was used, even after long treatment times (60min). The addition of 50 ppm of H2O2 to the process allowed the inactivation of more than 5 Log PFU (Plaque Forming Unit) of the virus by only pressurising and depressurising the vessel, while a 20-min process is needed by only using H2O2. Overall, the study demonstrates a synergistic effect when H2O2 is added to the scCO2 process for the inactivation of SARS-CoV-2.

Clinical characteristics and effects of inhaled corticosteroid in patients with post-COVID-19 chronic cough during the Omicron variant outbreak

BackgroundChronic cough is a common symptom in patients post the coronavirus disease 2019 (COVID-19). In this study, we aimed to investigate the efficacy of inhaled corticosteroids (ICS) and the clinical characteristics of patients with post-COVID-19 chronic cough during the Omicron era.MethodsAn ambispective, longitudinal cohort study was conducted that included patients with post-COVID-19 who attended the respiratory clinic at our hospital between January 1, 2023, and March 31, 2023 with a complaint of persistent cough lasting more than 8 weeks. At 30 and 60 days after the first clinic visit for post-COVID-19 chronic cough, enrolled patients were prospectively followed up. We compared the changes in symptoms and pulmonary function between patients receiving ICS treatment (ICS group) and those not receiving ICS treatment (NICS group) at the two visits.ResultsA total of 104 patients with post-COVID-19 chronic cough were enrolled in this study (ICS group, n = 51; NICS group, n = 53). The most common symptoms accompanying post-COVID-19 chronic cough were sputum (58.7%, 61/104) and dyspnea (48.1%, 50/104). Seventy-one (82.6%, 71/86) patients had airway hyperresponsiveness, and 49 patients (47.1%, 49/104) were newly diagnosed with asthma. Most patients (95.2%, 99/104) exhibited improvement at 60 days after the first visit. The pulmonary function parameters of the patients in the ICS group were significantly improved compared to the baseline values (P < 0.05), and the improvement in the FEV1/FVC was significantly greater than that in the NICS group (P = 0.003) after 60 days.ConclusionsSevere acute respiratory syndrome coronavirus-2 (SARS-CoV-2) may contribute to the pathogenesis of asthma, which could be the underlying cause of persistent cough post-COVID-19 infection. Post-COVID-19 chronic cough during the Omicron era was often accompanied by sputum, dyspnea, and airway hyperresponsiveness. ICS treatment did not have a significant impact on symptom management of post-COVID-19 chronic cough; however, it can improve impaired lung function in in these individuals.

Spectroscopic Analysis of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2)

Abstract: When light shines on an object, it sheds focus on the intrinsic characteristics of that material. Transmission of light or an electromagnetic (em) wave through a matter undergoes various physiochemical processes, like emission, absorption, and splitting of light into its constituent wavelengths. This interaction of em radiation with matter is widely used for the investigation of unknown and new target analytes in a sample, and the technique is known as spectroscopy. In the early 2000s, energy excitation of the virus was demonstrated in influenza. The research first demonstrated the use of Surface-enhanced Raman Scattering (SERS), whose biomedical application became a potential diagnostic tool. The LASERs also attracted attention and were incorporated with the optical and spectroscopy instruments that significantly enhanced the application, reach, and detection limit of air and waterborne elements. Surface plasmon resonance and SERS are the most applied spectroscopic techniques with high accuracy and speed. A combination of these techniques with other advanced microscopy techniques, such as atomic force microscopy, scanning electron microscopy, and tunnelling electron microscopy, may ease and boost biomedical applications. This review is focused on the application of spectroscopy and laser-based techniques in the detection of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2).

Evaluation of the Progress of Coronavirus Disease-19 Pneumonia using the British Society of Thoracic Imaging Reporting Model: A Validation Study

Abstract: Background: SARS-COV-2 (also known as severe acute respiratory syndrome corona virus-2), emerged as a pandemic and became an overwhelming global concern, causing substantial morbidity and mortality worldwide. Reverse transcription polymerase chain reaction (RT-PCR) is considered a gold standard in detecting clinically symptomatic patients but can have false negative and false positive results. As chest X-Ray (CXR) is considered as a baseline investigation in many hospitals, BSTI reporting model during COVID-19 pandemic has been a useful tool in diagnosis of COVID-19 pneumonia. Objective: To validate the British Society Thoracic Imaging (BSTI) coding system in the evaluation of the progress of the disease severity in patients with coronavirus disease-2019 (COVID-19) pneumonia. Materials and Methods: This is a cross sectional observational study. Total 450 CXRs (which included both the baseline and serial CXRs) of 225 COVID positive patients (RT-PCR positive for COVID-19 on nasal swabs) were included. These were retrospectively reviewed and reported by two Radiologists (having experience of at least 5 years in Radiology Reporting) in Corona Ward in Dr. Ruth K M Pfau Civil Hospital Karachi, Pakistan, for the duration of 10 months from 1st March 2020 till 31st December 2020. BSTI coding system was used to classify and interpret the CXR imaging findings as normal, definitive, indeterminate and non-COVID for baseline (CXR on 1st day of admission) and follow up CXRs (done in between 3rd and 7th day of admission). Data was analyzed using SPSS version 25. Numeric data was assessed for distribution using Shapiro-Wilks test. Median and interquartile range (IQR) were reported for numeric variables. Frequencies and percentages were reported for categorical data. Kappa statistics was applied to assess the agreement between BSTI scoring at baseline and follow-up CXRs. A p-value ≤0.05 was considered as statistically significant. Result: CXRs (including 225 baseline and 225 follow up CXRs) of 225 RT-PCR COVID-19 positive patients were analyzed. Interval change in BSTI coding system was noted, increase in frequency of probable/definitive COVID-19 findings were diagnosed on serial CXRs. The BSTI scoring at baseline and follow-up showed moderate agreement with kappa statistics as 60.3% (p=0.001). Conclusion: BSTI coding system can be helpful to classify the COVID-19 disease on CXR and filter for the prognosis of disease severity in the serial radiographs. Utilization of BSTI reporting model for reporting CXRs, even before RT-PCR, in future COVID pandemic can be considered as a useful tool.

Exploring the Correlation Between Splenomegaly and Lung Involvement in COVID-19: A Retrospective Study.

Background Coronavirus disease 2019 (COVID-19), resulting from the severe acute respiratory syndrome corona virus 2 (SARS-CoV-2), has not only shown substantial effects on the respiratory system but also on extrapulmonary systems, including cardiovascular, gastrointestinal, hematological, and immune responses, notably spleen enlargement. The connection between the enlargement of the spleen and pulmonary complications in individuals with COVID-19 is still not well elucidated, with current studies offering divergent conclusions. Objective This study aims to elucidate the correlation between splenomegaly, as assessed by computed tomography (CT) imaging, and the extent of lung involvement (LI) in COVID-19 patients, thereby offering insights into potential prognostic indicators. Methodology A hospital-based, cross-sectional, retrospective study was conductedinvolving 1058 symptomatic COVID-19 patients confirmed by reverse transcriptase-polymerase chain reaction (RT-PCR), aged 18 years and above. CT imaging was utilized to evaluate spleen size and LI. Statistical analyses, including Pearson correlation and simple linear regression, were performed to explore the relationship between spleen size and LI. Results The study cohort exhibited a mean spleen size of 9.49 cm and a mean LI score of 0.272. The Pearson correlation coefficient was calculated at 0.0495, indicating a marginal positive correlation between spleen size and LI. Regression analysis demonstrated a minimal impact of spleen size on LI, with spleen size accounting for only 0.2% of the variance in LI scores. Conclusions The study found a slight, statistically non-significant correlation between splenomegaly and LI in COVID-19 patients, suggesting that while splenic enlargement may reflect systemic disease involvement, it is not a strong independent predictor of lung damage extent. The findings highlight the complexity ofextrapulmonary manifestations and highlight the need for additional research to fully understand the implications of splenic involvement in COVID-19.

Ayush [Indian System of Medicines] Prophylaxis Against COVID-19: A Living Systematic Review and Meta-Analysis (Second Update).

Background: Ayush (Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy) system of medicine has been extensively used in India for the prevention and management of coronavirus disease 2019 (COVID-19). The present report is the second update of a living systematic review and meta-analysis and has been intended to assess the preventive potential and safety of Ayush drugs against COVID-19. Methods: A search of databases such as PubMed, the Cochrane central register of controlled trials, the World Health Organization (WHO) COVID-19 database, the clinical trial registry-India, the AYUSH research portal, and preprint repositories was performed till March 1, 2023. Randomized controlled trials or analytical observational studies were included. Incidences of COVID-19 infections and mortality were taken as primary outcome measures; and symptomatic severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) infection, incidences of hospital admissions, and adverse events were taken as secondary outcomes. The risk of bias was evaluated by version 2 of the Cochrane risk-of-bias tool for randomized trials (RoB-2) and the Risk of Bias in Non-Randomized Studies-of Interventions (ROBINS-I) tool. Data were synthesized through the RevMan 5.4 tool, and the certainty of the evidence was ranked through the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) approach. Results: Out of 2350 articles, 15 studies were included in the review. The pooled estimate of Guduchi [Tinospora cordifolia (Thunb.) Miers], Chyawanprasha, and Ayuraksha kit was obtained. Meta-analysis of the data suggested that Guduchi may reduce the incidences of COVID-19 infections (risk ratio [RR]: 0.67 [95% confidence interval, CI: 0.48-0.95]) and the symptom development among the infected (RR: 0.88 [95% CI: 0.73-1.08]), however, no change was observed in hospital admissions (RR: 0.96 [95% CI: 0.20-4.53]). It is uncertain that Chyawanprasha reduces the incidence of COVID-19 infection (RR: 0.28; [95% CI: 0.07-1.08]). Ayuraksha kit as chemoprophylaxis may reduce the incidences of COVID-19 infections (RR: 0.49; [95% CI: 0.32-0.77]). The certainty of the evidence was low to moderate mainly due to the serious risk of bias. Conclusion: Prophylactic use of Ayush medicines for populations at risk may help to prevent COVID-19 infection by reducing incidence and severity. However, considering the certainty and fewer studies, high-quality studies are still desired to confirm the efficacy and safety of Ayush chemoprophylaxis for COVID-19. Nevertheless, this update will serve as a torchbearer for policymakers, physicians, and other stakeholders for their decision-making through evidence-based medicine.

Updates in the pathophysiology of COVID-19 infection in male reproductive and sexual health: a literature review.

This extensive comprehensive review explores the impact of the Coronavirus disease 2019 (COVID-19) pandemic on men's sexual and reproductive health. We conducted a literature review focusing on the possible pathophysiology by which severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) affects men's sexual and reproductive systems. We reviewed most of the studies that reported the impact of SARS-CoV-2 infection on the Testicular, Epididymal, Prostatic, and Penile tissue. Also, we focused on evaluating the SARS-CoV-2 infection on semen parameters and male reproductive hormones. Finally, we reviewed the COVID-19 vaccine's effect on male reproductive and sexual health. Findings revealed the adverse consequences of SARS-CoV-2 at cellular and organ levels on the male genital tract. However, the reported data are still controversial. The initial data regarding COVID-19 vaccination was promising promoted safety for men's reproductive and sexual health. We conclude this paper by offering recommendations to address these adverse consequences and potentially improve sexual and reproductive health among men in the post-COVID-19 pandemic era.

A critical review of personal protective equipments in relation to pandemics

PurposePersonal Protective Equipment plays an inevitable part in the current scenario of pandemics in the world. A novel coronavirus, Severe Acute Respiratory Syndrome-Corona Virus-2 (SARS-Cov 2), began as an outbreak of pneumonia in Wuhan, China, in late December 2019, and quickly spread worldwide. It quickly escalated into an international public health crisis. This opened up the high demand for the innovation and research of new materials in the Personal Protective Equipment industry.Design/methodology/approachPubMed, Embase and Google Scholar were searched for relevant literature regarding personal protective equipment and the information was organized in a systematic way.FindingsThere are no adequate number of studies taken up in the field of use of textiles in medical applications especially with PPEs.Research limitations/implicationsThis structured review will generate a sense of the significance of using PPE for controlling pandemics and also awaken need for additional research and innovations in this area.Practical implicationsThe authorities of the management should take timely intervention in choosing the right material for their PPE in their hospitals. Hence health care professionals teams have an inevitable role in preventing the adverse environmental impact due to the inadvertent disposal of PPEs.Social implicationsThere is a lack of systematic way of disposing contaminated single-use face masks in a safe, environmentally acceptable manner. The dumping of single-use PPE in domestic garbage has had an adverse effect on the environment. Mismanaged plastic waste endangers the health of ecosystems by polluting marine and terrestrial environments, posing a significant risk of ingestion or injury to animals and contaminating habitats.Originality/valueThis review article provides an in-depth review of the use of different materials in PPE and challenges regarding its long-term use and implications on the environment.

Effects of a randomized-controlled and online-supported physical activity intervention on exercise capacity, fatigue and health related quality of life in patients with post-COVID-19 syndrome

BackgroundThe Post-COVID-19 syndrome (PCS), which can occur after acute respiratory syndrome coronavirus 2 infection, leads to restrictions in everyday activity. Our study assessed the impact of an online-guided intervention which intended to facilitate physical activity on the mental and physical capability of PCS patients.MethodsWe randomized 62 patients with PCS (20 male/ 42 female; age: 46 ± 12 years; body mass index: 28.7 ± 6.7 kg/m2) with a score ≥ 22 in the fatigue assessment scale (FAS) to a 3-month exercise-focused intervention (IG n = 30) or control period (CG n = 32). We assessed changes in exercise capacity (bicycle exercise test with measurements of gas exchange), fatigue, markers of health-related quality of life (HrQoL) and mental health.ResultsThe FAS score decreased significantly in both study groups (IG: 35.1 ± 7.4 to 31.8 ± 8.5 points; CG: 35.6 ± 7.4 to 32.6 ± 7.5 points, both p < 0.01). Exercise capacity did not increase in the CG or IG (within-group changes for IG: peak oxygen uptake: 0.9 ± 2.6 ml/min/kg, p = 0.098; peak power output: 6.1 ± 17.8 W, p = 0.076) with no significant changes in HrQoL and work ability. Patients with a FAS score at baseline ≥ 35 (severe fatigue) showed no change in exercise capacity with the 3-month intervention whereas the sub-group of patients with FAS < 35 points (moderate fatigue) showed improvements, independent of the study group.ConclusionsOur 3-month intervention seems appropriate for patients with moderate fatigue, whereas those with more severe fatigue appear to be too restricted with respect to their mental or physical health status to perform exercise at a level which is sufficient to improve markers of physical performance.Trial registrationGerman Clinical Trials Register (registration trial number: DRKS00026245) on September 2 2021.

A Comprehensive Review on Potentially Therapeutic Agents against COVID-19 from Natural Sources

Abstract: Acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused the recent pandemic and worldwide outbreak of respiratory disease. Since there are no known specific drugs for fighting this virus and the process for new drug development is lengthy, scientists have been trying to develop drugs against this viral infection. The potent antiviral activity of natural products has been confirmed in several previous studies. Viral and host proteins contributing to COVID-19 infections can be targeted by natural compounds derived from plants, marine organisms, and microorganisms. The most important of these compounds are polyphenols (e.g., anthraquinone polyphenol, hinokinin, curcumin, and epigallocatechin gallate), alkaloids (e.g., isoquinoline, 10- hydroxyusambarensine, anisotine, and adhatodine), and terpenoids (salvinorin A, thymoquinone, bilobalide, ginkgolide A, and celastrol) from plants, sulphated polysaccharides (carrageenans, chondroitin sulfate C, and fucoidan) from marine organisms, and glycocin F and lactococcin G phycocyanin, and lipopeptide from microorganisms. This study reviews these compounds and their mechanism of action for treating COVID-19 infection and guides researchers in developing effective and safe therapeutic agents against this disease from naturally derived compounds.

Hierarchical Virtual Screening of SARS-CoV-2 Main Protease Potential Inhibitors: Similarity Search, Pharmacophore Modeling, and Molecular Docking Study

Background: The outbreak of COVID-19 caused by severe acute respiratory syndrome coronavirus2 (SARS-CoV-2) resulted in a widespread pandemic. Various approaches involved the repositioning of antiviral remedies and other medications. Several therapies, including oral antiviral treatments, represent some approaches to adapting to the long existence of the COVID-19 pandemic. In silico studies provide valuable insights throughout drug discovery and development in compliance with global efforts to overcome the pandemic. The main protease is an essential target in the viral cycle. Computer-aided drug design accelerates the identification of potential treatments, including oral therapy. Aim: This work aims to identify potential SARS-CoV-2 main protease inhibitors using different aspects of in silico approaches. Method: In this work, we conducted a hierarchical virtual screening of SARS-CoV-2 main protease inhibitors. A similarity search was conducted to screen molecules similar to the inhibitor PF-07321332. Concurrently, structure-based pharmacophores, besides ligand-based pharmacophores, were derived. A drug-likeness filter filtered the compounds retrieved from similarity search and pharmacophore modeling before being subjected to molecular docking. The candidate molecules that showed higher affinity to the main protease than the reference inhibitor were further filtered by absorption, distribution, metabolism, and excretion (ADME) parameters. Result: According to binding affinity and ADME analysis, four molecules (CHEMBL218022, PubChem163362029, PubChem166149100, and PubChem 162396459) were prioritized as promising hits. The compounds above were not reported before; no previous experimental studies and bioactive assays are available. Conclusion: Our time-saving approach represents a strategy for discovering novel SARS-CoV- 2 main protease inhibitors. The ultimate hits may be nominated as leads in discovering novel SARS-CoV-2 main protease inhibitors.

The Role of Saliva in Examining for SARS-CoV-2

SARS-CoV-2 causes COVID-19 (Corona Virus Infection Disease-19), an infectious disease (Severe Acute Respiratory Syndrome Corona Virus-2)virus which was first confirmed on December 2, Wuhan, China, in 2019 and very quickly world-wide. World Health Organization (WHO) declared it on March 11th, 2020,fever, cough, and breathing difficulties are all common symptoms. The gold standard for diagnosing SARS-CoV-2 infection is the real-time reverse transcription polymerase chain reaction (rRT-PCR)by detecting viral RNA using nasopharyngeal swabs and other respiratory specimens. However, this process necessitates the use of specialist medical staff, centralized laboratory facilities, and a lengthy period of time for results to be obtained. Besides that, the possibility of virus transmission is not negligiblefor procedure's operator. Due to this reason, several investigations have shown that other bodily fluids, like as saliva, could be used to identify SARS-CoV-2. Saliva is used as a diagnostic sample has many advantages: it is easy to collect samples by the patient themselves with a fairly comfortable procedure, does not require health personnel with special expertise to manage it, and reduces the risk of transmitting the virus to the operator. Currently, there are several alternative tests for SARS-CoV-2 which have simpler and more efficient procedures, such as antigen based rapid diagnostic tests, antibody based rapid diagnostics, and RT LAMP tests. This examination is suitable for screening and mass examination, but cannot be used as a primary diagnostic tool because the sensitivity and specificity are not as high as rRT-PCR.

Baseline Characteristics And Outcome Of Covid-19 Patients In Bangladesh

Background: Coronavirus disease-2019 (COVID-19) is the disease caused by Severe Acute Respiratory Syndrome Corona virus 2 (SARS-CoV-2). The disease was declared as a pandemic by WHO in a press release on 11 February 2020. The virus was confirmed to have spread to Bangladesh in March 2020. To combat this pandemic disease, baseline characteristics of the COVID-19 patients are essential to be identified in the context of Bangladesh.&#x0D; Methods: The cross-sectional study was conducted among 1016 COVID-19 patients diagnosed by Reversed Transcriptase-Polymerase Chain Reaction (RT-PCR) assay at the National Institute of Preventive and Social Medicine (NIPSOM) laboratory. The study was conducted during the period from March to June 2020, Data were collected form the participants, who were selected conveniently and were interviewed by using a pre-tested semi-structured questionnaire over telephone.&#x0D; Results: The study revealed that among 1016 respondents, 64.1% were male and the rest 35.9% were female. Almost half of the respondents (46.5%) were aged 19-39 years. Among the respondents, 72.6% were married and 39.6% were graduated and above. More than two-thirds (69.3%) of the respondents lived in urban area and 72.7% were from nuclear family. On the fourteenth (14th) day or onwards of being positive, RT–PCR Test-1 found 12.5% positive and on twenty-eighth (28th) day or onwards RT–PCR Test-2 found positive only 3.3%. On the other hand, RT–PCR Test-1 was not done by 11.6% and RT–PCR Test-2 by 41.8%. While on the fourteenth (14th) day or onwards of being positive, 62.1% patients were continuing treatment and on the twenty-eighth (28th) day or onwards only 3.5% patients were continuing treatment due to covid related complications.&#x0D; Conclusion: Baseline characteristics, severity and outcomes of sequentially tested patients with confirmed COVID-19 positive cases in Bangladesh. Such information should be disseminated across the country to raise awareness and initiate necessary measures by the policy makers to prevent spread of corona virus in Bangladesh.&#x0D; JOPSOM 2021; 41(2):36-42

In-silico evaluation of natural alkaloids against the main protease and spike glycoprotein as potential therapeutic agents for SARS-CoV-2.

Severe Acute Respiratory Syndrome Corona Virus (SARS-CoV-2) is the causative agent of COVID-19 pandemic, which has resulted in global fatalities since late December 2019. Alkaloids play a significant role in drug design for various antiviral diseases, which makes them viable candidates for treating COVID-19. To identify potential antiviral agents, 102 known alkaloids were subjected to docking studies against the two key targets of SARS-CoV-2, namely the spike glycoprotein and main protease. The spike glycoprotein is vital for mediating viral entry into host cells, and main protease plays a crucial role in viral replication; therefore, they serve as compelling targets for therapeutic intervention in combating the disease. From the selection of alkaloids, the top 6 dual inhibitory compounds, namely liensinine, neferine, isoliensinine, fangchinoline, emetine, and acrimarine F, emerged as lead compounds with favorable docked scores. Interestingly, most of them shared the bisbenzylisoquinoline alkaloid framework and belong to Nelumbo nucifera, commonly known as the lotus plant. Docking analysis was conducted by considering the key active site residues of the selected proteins. The stability of the top three ligands with the receptor proteins was further validated through dynamic simulation analysis. The leads underwent ADMET profiling, bioactivity score analysis, and evaluation of drug-likeness and physicochemical properties. Neferine demonstrated a particularly strong affinity for binding, with a docking score of -7.5025 kcal/mol for main protease and -10.0245 kcal/mol for spike glycoprotein, and therefore a strong interaction with both target proteins. Of the lead alkaloids, emetine and fangchinoline demonstrated the lowest toxicity and high LD50 values. These top alkaloids, may support the body's defense and reduce the symptoms by their numerous biological potentials, even though some properties naturally point to their direct antiviral nature. These findings demonstrate the promising anti-COVID-19 properties of the six selected alkaloids, making them potential candidates for drug design. This study will be beneficial in effective drug discovery and design against COVID-19 with negligible side effects.

Development and External Validation of Clinical Features-based Machine Learning Models for Predicting COVID-19 in the Emergency Department.

Timely diagnosis of patients affected by an emerging infectious disease plays a crucial role in treating patients and avoiding disease spread. In prior research, we developed an approach by using machine learning (ML) algorithms to predict serious acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection based on clinical features of patients visiting an emergency department (ED) during the early coronavirus 2019 (COVID-19) pandemic. In this study, we aimed to externally validate this approach within a distinct ED population. To create our training/validation cohort (model development) we collected data retrospectively from suspected COVID-19 patients at a US ED from February 23-May 12, 2020. Another dataset was collected as an external validation (testing) cohort from an ED in another country from May 12-June 15, 2021. Clinical features including patient demographics and triage information were used to train and test the models. The primary outcome was the confirmed diagnosis of COVID-19, defined as a positive reverse transcription polymerase chain reaction test result for SARS-CoV-2. We employed three different ML algorithms, including gradient boosting, random forest, and extra trees classifiers, to construct the predictive model. The predictive performances were evaluated with the area under the receiver operating characteristic curve (AUC) in the testing cohort. In total, 580 and 946 ED patients were included in the training and testing cohorts, respectively. Of them, 98 (16.9%) and 180 (19.0%) were diagnosed with COVID-19. All the constructed ML models showed acceptable discrimination, as indicated by the AUC. Among them, random forest (0.785, 95% confidence interval [CI] 0.747-0.822) performed better than gradient boosting (0.774, 95% CI 0.739-0.811) and extra trees classifier (0.72, 95% CI 0.677-0.762). There was no significant difference between the constructed models. Our study validates the use of ML for predicting COVID-19 in the ED and demonstrates its potential for predicting emerging infectious diseases based on models built by clinical features with temporal and spatial heterogeneity. This approach holds promise for scenarios where effective diagnostic tools for an emerging infectious disease may be lacking in the future.

Cold Agglutinin Disease and COVID-19: A Scoping Review of Treatments and Outcomes.

Reports suggest that patients with both acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and cold agglutinin disease (CAD) may experience poorer survival when treated with rituximab. We conducted a scoping review to evaluate severe outcomes, including intensive care unit (ICU) admission and mortality, in coronavirus disease 2019 (COVID-19) patients with CAD on various treatments, including rituximab. This review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). Four literature databases were searched on December 19, 2023, for studies reporting lab-confirmed SARS-CoV-2 and CAD, excluding rheumatological conditions. Of the 741 screened articles, 19 were included. Studies, predominantly case reports (17/19) or case series (2/19), were mainly from the USA (8/19) and India (3/19), with others across Europe and Asia. Among 23 patients (61% female, median age 61 years), 21/23 had a new CAD diagnosis; only two had pre-existing CAD. Overall, 74% recovered, 21% died, and outcomes for one were unreported. Nine (39%) were ICU-admitted. Of rituximab-treated patients (n = 4), 25% were ICU-admitted, none died. Non-rituximab treatments (n = 19) saw 42% ICU admissions and 26% mortality. This review found no increased risk of severe outcomes in CAD and COVID-19 patients treated with rituximab.

Covid-19: Investigation of Important Mutations and their Effect on Vaccine Efficacy

Introduction: Unknown pneumonia caused by acute respiratory syndrome coronavirus-2 (nCoV/SARS-CoV-2 2019) started in Wuhan, China. Compared to other corona virus infections, this variant is more contagious and its genome encodes all the proteins necessary for infection and reproduction. The most important structural proteins of this virus are spike glycoprotein, envelope protein, membrane protein and nucleocapsid protein. Mutations accrued to these proteins, especially to the spike protein, played an important role in the creation of new variants. For example, E484K, L452R, S477N and F486V mutations are among the important mutations that can be considered when designing vaccines based on spike protein in the future. These mutations lead to the variants with new and different characteristics, and for this reason, the vaccine production process for this virus has faced many challenges. Various companies all over the world entered the competition to make vaccines, and finally, by producing different types of vaccines, this disease was controlled tolerably. But new mutations in the future could still lead to diverse variants with resistance to existing vaccines, and for this reason, societies and governments would face serious challenges.&#x0D; Conclusion: Based on these interpretations, possible emergence of new variants in the future could not be denied. However, prediction of the location of these mutations in not possible though. as a result, it is important to conduct research on the emerging variants, to be prepared for new possible challenges in the future.