Causes Coronavirus Disease 2019 Research Articles

Polysaccharides and Lectins: A Natural Complementary Approach against the SARS-CoV-2 Pandemic

Infection with the novel coronavirus SARS-CoV-2, the cause of coronavirus disease (COVID-19), has emerged as a global pandemic, with a high toll on casualties, economic impact, and human lifestyle. Despite the recent approval of various vaccines against the virus, challenges remain, including the limited availability of these vaccines, the prevalent rejection of vaccination by a large proportion of the population, and the recurrent appearance of new variants of the virus due to mutations. This context raises the alarm for scientists and clinicians to seek alternative and complementary therapies. In this context, natural products and their derivatives serve as reservoirs for potential therapeutic compounds that can be exploited in the research and production of antiviral drugs against COVID-19. Among these substances, lectin and polysaccharides isolated from fauna and flora emerge as complementary strategies for treating coronavirus infection. The review objective is to cover and analyze the specific role of polysaccharides and lectins and their synergy in the fight against this deadly SARS-CoV-2 virus. For this purpose, a primary literature search was conducted on Google Scholar, PubMed, and Web of Sciences using relevant keywords like “SARS-CoV-2 Variants”; “Antiviral Strategies”; “Antiviral Polysaccharides”; “Antiviral Lectins”; and “Synergistic effect”. The results demonstrate that lectins and polysaccharides exhibit antiviral activities against SARS-CoV-2 via mechanisms related to binding and steric blocking, the binding of glycan-based decoys, chemical reactions, virus particle disruption strategies, and steric blocking for competitive inhibition to block SARS-CoV-2 and its variants’ entry. In addition, this review analyzes the rationale behind combining polysaccharides and lectins, emphasizing complementary mechanisms of action. By simultaneously targeting multiple stages of the viral life cycle, this dual strategy aims to comprehensively inhibit viral propagation and enhance the durability of antiviral strategies over time.

SARS-CoV-2 causes dysfunction in human iPSC-derived brainmicrovascular endothelial cells potentially by modulating the Wnt signaling pathway.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), which is associated with various neurological symptoms, including nausea, dizziness, headache, encephalitis, and epileptic seizures. SARS-CoV-2 is considered to affect the central nervous system (CNS) by interacting with the blood-brain barrier (BBB), which is defined by tight junctions that seal paracellular gaps between brain microvascular endothelial cells (BMECs). Although SARS-CoV-2 infection of BMECs has been reported, the detailed mechanism has not been fully elucidated. Using the original strain of SARS-CoV-2, the infection in BMECs was confirmed by a detection of intracellular RNA copy number and localization of viral particles. BMEC functions were evaluated by measuring transendothelial electrical resistance (TEER), which evaluates the integrity of tight junction dynamics, and expression levels of proinflammatory genes. BMEC signaling pathway was examined by comprehensive RNA-seq analysis. We observed that iPSC derived brain microvascular endothelial like cells (iPSC-BMELCs) were infected with SARS-CoV-2. SARS-CoV-2 infection resulted in decreased TEER. In addition, SARS-CoV-2 infection decreased expression levels of tight junction markers CLDN3 and CLDN11. SARS-CoV-2 infection also increased expression levels of proinflammatory genes, which are known to be elevated in patients with COVID-19. Furthermore, RNA-seq analysis revealed that SARS-CoV-2 dysregulated the canonical Wnt signaling pathway in iPSC-BMELCs. Modulation of the Wnt signaling by CHIR99021 partially inhibited the infection and the subsequent inflammatory responses. These findings suggest that SARS-CoV-2 infection causes BBB dysfunction via Wnt signaling. Thus, iPSC-BMELCs are a useful in vitro model for elucidating COVID-19 neuropathology and drug development.

Does COVID-19 cause or worsen LUT dysfunction, what are the mechanisms and possible treatments? ICI-RS 2023.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19) and produced a worldwide pandemic in 2020. There have been 770,875,433 confirmed cases and 6,959,316 attributed deaths worldwide until September 19, 2023. The virus can also affect the lower urinary tract (LUT) leading to bladder inflammation and producing lower urinary tract symptoms (LUTS) in both the acute and chronic phases of disease. At the 2023 meeting of the International Consultation on Incontinence-Research Society (ICI-RS), the literature relating to COVID-19 and bladder dysfunction was reviewed. The LUTSreported, as well as the pathophysiology of these bladder symptoms, were the subject of considerable discussion. A number of different topics were discussed including lower LUTS reported in COVID-19, how SARS-CoV-2 may infect and affect the urinary tract, and proposed mechanisms for how viral infection result in new, worsened, and in some persisting LUTS. The workshop discussed the interaction between the virus and the immune system, covering current evidence supporting theories underlying the causes of acute and chronic LUTS related to COVID-19 infection. Research questions for further investigation were suggested and identified.

Analysis of neuropsychological and laboratory parameters in patients with cerebrovascular disease and SARS-CoV-2 compared to those without SARS-CoV-2

Background. Severe acute respiratory syndrome сoronavіrus 2 (SARS-CoV-2, formerly known as 2019-nCoV) is the cause of coronavirus disease 2019 (COVID-19), and was first reported in Wuhan, China. However, it is also contagious to humans and spreads rapidly around the world through close contact between infected people or through a relatively simple transmission mechanism (airborne transmission). COVID-19 is known to affect almost all systems of the human body. Initial reports suggest that hypertension may be a risk factor for susceptibility to SARS-CoV-2 infection, a more severe course of COVID-19, and increased mortality associated with COVID-19. It is estimated that 1–3 % of COVID-19 patients experience transient ischemic attacks with a frequency similar to other coronavirus infections (SARS-CoV-1 and MERS-CoV). The cause of ischemic stroke associated with COVID-19 is unknown, but previous studies have suggested that an inflammatory cytokine storm may cause hypercoagulation and endothelial damage. We see that COVID-19 is closely related to neurological complications because there are potential factors that can cause them. Materials and methods. Cerebrovascular diseases were analyzed in 111 patients infected with SARS-CoV-2 (n = 71) and those without a history of SARS-CoV-2 (n = 40). The subject of the study was neuropsychological and laboratory indicators. The following methods were used: psychometric — Beck Anxiety Inventory, Hamilton Depression Rating Scale, Fatigue Assessment Scale; neuropsychological — Mini-Mental State Examination, Montreal Cognitive Assessment, Frontal Assessment Battery; clinical — neurological status; polymerase chain reaction to detect COVID-19 RNA; statistical methods. Results. In patients who suffered transient ischemic attack and ischemic stroke with a minimal neurological deficit and COVID-19, there were elevations in the erythrocyte sedimentation rate, leukocytes, segmented neutrophils, while an increase in C-reactive protein was noted in all participants with cerebrovascular disease and COVID-19, with more significant levels among those with ischemic stroke. All subgroups with COVID-19 showed an increase in D-dimer and fibrinogen with higher content in patients after ischemic stroke. Also in this subgroup, the procalcitonin index exceeded the norm, which indicates the severity of the course of COVID-19 with the addition of co-infection. Data of neuropsychological tests in patients with ischemic stroke with a minimal neurological deficit with SARS-CoV-2 revealed a decrease in the Montreal Cognitive Assessment score, indicating mild cognitive changes in these patients. The level of anxiety in patients with hypertension with frequent crises and ischemic stroke with a minimal neurological deficit was above the reference values, with a slight predominance in patients who did not have COVID-19. It follows that both laboratory and neuropsychological parameters differed in three subgroups depending on cerebrovascular disease, as well as the presence and absence of SARS-CoV-2, which makes it possible to develop more appropriate diagnostic methods in order to predict the course and outcome of COVID-19.

Investigation of IL-6 serum level in COVID-19 patients with positive COVID-19 IgG/IgM antibody titers to check inflammation and disease progression

ObjectiveThe SARS-CoV-2, the cause of coronavirus disease 2019 (COVID-19), leads to severe pathogenicity and high mortality among different communities around the world. Therefore, it is important to understand the mechanisms of virus pathogenesis and the immune system's response to prevent the further spread of this virus. This study was aimed to evaluate the relationship between the serum level of interleukin 6 and positive IgG and IgM antibody levels in patients with COVID-19 to investigate inflammation and disease progression. Methods & MaterialsIn this study, 10 ml of EDTA blood samples were taken from 414 COVID-19 patients. Then, the plasma was separated and the levels of IgM and IgG antibodies and interleukin 6 cytokine were evaluated by ELISA and chemiluminescence methods, respectively. All data were analyzed by SPSS 22 and GraphPad prism 9 software at the significance level of P < 0.05. ResultsThe results of this study showed that there was no significant difference in the expression of IgM and IgG antibodies between men and women. Also, a significant increase in the mean expression of IL-6 was observed only in the high concentration range (100−〉1000 pg/ml) in men compared to women (P < 0.001). In addition, in the female population, all three concentration ranges (negative, medium, and high) of IL-6 have the highest correlation with high titers (>10 U/ml) of IgM and IgG antibodies. While, in men, all three concentration ranges of IL-6 had the highest correlation with > 10 U/ml IgM antibody titers, but in the case of IgG, the highest correlation between different concentrations of IL-6 was observed with the negative or moderate titers of this antibody and there was an inverse relationship with the high titers of IgG (>10 U/ml). ConclusionAs a result, the relationship between different serum levels of cytokine IL-6 with different titers of IgM and IgG antibodies was observed in both male and female populations. In general, it can be concluded that the correlation between different concentrations of IL-6 with different IgM titers was similar in both men and women, but in the case of different IgG titers, this correlation was higher in women than men.

QTc Prolongation to Predict Mortality in Patients Admitted with COVID-19 Infection: An Observational Study

Background: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causes Coronavirus disease 2019 (COVID-19), characterized by pulmonary infection ranging from asymptomatic forms to respiratory insufficiency and death. Evidence of cardiac involvement in COVID-19 is increasing, and systemic inflammation or direct heart damage by SARS-CoV-2 can prolong the corrected QT interval (QTc). Methods: In this observational study, a total of 333 consecutive patients admitted to the Covid Center of Verona University Hospital from November 2020 to April 2021 were included. Patients with bundle branch block, pacemaker-controlled heart rhythm and heart rate &gt;120 beats/min were excluded. A complete electrocardiogram (ECG) was performed at admission, and QTc values of ≥440 ms for males and ≥460 ms for females were considered prolonged. Results: Overall, 153 patients had prolonged QTc (45.5%). In multivariate logistic regression analysis, male sex (odds ratio (OR)=6.612, p=0.046), troponin (OR=1.04, p=0.015) and lymphocyte count (OR=3.047, p=0.019) were independently associated with QTc prolongation. Multivariate logistic regression showed that QTc was independently associated with mortality (OR=4.598, p=0.036). Age, sex, the ratio between the partial pressure of oxygen (PaO2) and the fraction of inspired oxygen (FiO2) (P/F), and fibrosis-4 index for liver fibrosis (FIB-4) were also independently associated with mortality. Conclusion: QTc interval prolongation appears to be a frequent finding in patients with COVID-19. Moreover, prolonged QTc may be predictive of more severe forms of COVID-19 and worse outcome.

Prophylactic effect of ensitrelvir in mice infected with SARS-CoV-2

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the etiological cause of coronavirus disease 2019 (COVID-19) and continues to be a major health concern worldwide. Strategies to protect individuals at high risk of COVID-19 are critical but are currently a largely unmet need. We evaluated the oral antiviral drug ensitrelvir, which specifically targets the SARS-CoV-2 3CL protease, for its efficacy as a pre-exposure prophylactic treatment. Aged BALB/c mice were subcutaneously treated with various doses of ensitrelvir 24 h prior to a lethal SARS-CoV-2 challenge infection. Mouse body weight changes, survival rates, and viral titers in the lungs were evaluated, and plasma concentrations of ensitrelvir were determined. A single subcutaneous administration of ensitrelvir at 64 mg/kg or greater 24 h prior to SARS-CoV-2 challenge infection significantly protected aged mice against lethality and inhibited body weight loss. Pharmacokinetic analysis of ensitrelvir in the aged mice suggested that plasma concentrations ≥2.99 μg/mL resulted in a significant prophylactic effect against SARS-CoV-2 infection. In the aged mouse prophylaxis model, SARS-CoV-2 titers were suppressed in the lungs of mice treated with ensitrelvir 24 h prior to challenge infection, suggesting that the prophylactic administration of ensitrelvir exerted its prophylactic effect by suppressing viral proliferation. These findings suggest that ensitrelvir is a candidate drug for pre-exposure prophylactic treatment of individuals at high risk of COVID-19.

Immunogenicity and protective efficacy of a co-formulated two-in-one inactivated whole virus particle COVID-19/influenza vaccine

Due to the synchronous circulation of seasonal influenza viruses and severe acute respiratory coronavirus 2 (SARS-CoV-2) which causes coronavirus disease 2019 (COVID-19), there is need for routine vaccination for both COVID-19 and influenza to reduce disease severity. Here, we prepared individual WPVs composed of formalin-inactivated SARS-CoV-2 WK 521 (Ancestral strain; Co WPV) or influenza virus [A/California/07/2009 (X-179A) (H1N1) pdm; Flu WPV] to produce a two-in-one Co/Flu WPV. Serum analysis from vaccinated mice revealed that a single dose of Co/Flu WPV induced antigen-specific neutralizing antibodies against both viruses, similar to those induced by either type of WPV alone. Following infection with either virus, mice vaccinated with Co/Flu WPV showed no weight loss, reduced pneumonia and viral titers in the lung, and lower gene expression of proinflammatory cytokines, as observed with individual WPV-vaccinated. Furthermore, a pentavalent vaccine (Co/qFlu WPV) comprising of Co WPV and quadrivalent influenza vaccine (qFlu WPV) was immunogenic and protected animals from severe COVID-19. These results suggest that a single dose of the two-in-one WPV provides efficient protection against SARS-CoV-2 and influenza virus infections with no evidence of vaccine interference in mice. We propose that concomitant vaccination with the two-in-one WPV can be useful for controlling both diseases.

Gender differences in mental health outcomes amid the COVID-19 pandemic and a collapsing economy: A Lebanese cross-sectional study

Response plans to control the transmission of the severe acute respiratory syndrome coronavirus 2 that causes coronavirus disease 2019 (COVID-19) overlooked the repercussions of the combined economic and public health crisis among the most vulnerable populations, including women and people who have experienced abuse. This paper primarily aimed to assess the effects of the COVID-19 pandemic and economy-related variables on Lebanese adults&amp;rsquo; mental health, focusing on gender differences. A cross-sectional study was conducted in May 2020 using an online survey with validated scales created on Google Forms. A total of 502 adults living in Lebanon with access to the internet were enrolled in the study, irrespective of age, socioeconomic status, race, ethnicity, nationality, sex, gender identity, religion, location, education, and culture (n = 502). The multivariate analysis, adjusted on sociodemographic characteristics, economic, and coronavirus-related variables, showed that women exhibited higher distress, anxiety, and post-traumatic stress symptoms (PTSSs) levels than men. Moreover, violence at home was associated with more distress and insomnia, with borderline results for anxiety and well-being. No significant difference was found for PTSSs. In the context of combined health and economic crises, mental health outcomes are not equally felt across genders. Additional studies in a few months would help better understand the long-term impact, especially on PTSS and quality of life, which might not be perceptible during the crisis. Focused public health strategies are warranted to support and protect the most vulnerable populations.

SARS-CoV-2 spike-reactive naïve B cells and pre-existing memory B cells contribute to antibody responses in unexposed individuals after vaccination.

Since December 2019, the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) has presented considerable public health challenges. Multiple vaccines have been used to induce neutralizing antibodies (nAbs) and memory B-cell responses against the viral spike (S) glycoprotein, and many essential epitopes have been defined. Previous reports have identified severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike-reactive naïve B cells and preexisting memory B cells in unexposed individuals. However, the role of these spike-reactive B cells in vaccine-induced immunity remains unknown. To elucidate the characteristics of preexisting SARS-CoV-2 S-reactive B cells as well as their maturation after antigen encounter, we assessed the relationship of spike-reactive B cells before and after vaccination in unexposed human individuals. We further characterized the sequence identity, targeting domain, broad-spectrum binding activity and neutralizing activity of these SARS-CoV-2 S-reactive B cells by isolating monoclonal antibodies (mAbs) from these B cells. The frequencies of both spike-reactive naïve B cells and preexisting memory B cells before vaccination correlated with the frequencies of spike-reactive memory B cells after vaccination. Isolated mAbs from spike-reactive naïve B cells before vaccination had fewer somatic hypermutations (SHMs) than mAbs isolated from spike-reactive memory B cells before and after vaccination, but bound SARS-CoV-2 spike in vitro. Intriguingly, these germline-like mAbs possessed broad binding profiles for SARS-CoV-2 and its variants, although with low or no neutralizing capacity. According to tracking of the evolution of IGHV4-4/IGKV3-20 lineage antibodies from a single donor, the lineage underwent SHMs and developed increased binding activity after vaccination. Our findings suggest that spike-reactive naïve B cells can be expanded and matured by vaccination and cocontribute to vaccine-elicited antibody responses with preexisting memory B cells. Selectively and precisely targeting spike-reactive B cells by rational antigen design may provide a novel strategy for next-generation SARS-CoV-2 vaccine development.

Altered expression of serum lncRNA CASC2 and miRNA-21-5p in COVID-19 patients

Infection by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19) has a high incidence of spread. On January 30, 2020, the World Health Organization proclaimed a public health emergency of worldwide concern. More than 6.9 million deaths and more than 768 million confirmed cases had been reported worldwide as of June 18, 2023. This study included 51 patients and 50 age- and sex-matched healthy subjects. The present study aimed to identify the expression levels of lncRNA CASC2 and miRNA-21-5p (also known as miRNA-21) in COVID-19 patients and their relation to the clinicopathological characteristics of the disease. The expression levels of noncoding RNAs were measured by RT-PCR technique. Results detected that CASC2 was significantly downregulated while miRNA-21-5p was significantly upregulated in COVID-19 patients compared to healthy subjects. A significant negative correlation was found between CASC2 and miRNA-21-5p. ROC curve analysis used to distinguish COVID-19 patients from controls. MiRNA-21-p serum expression level had a significant positive association with temperature and PO2 (p = 0.04 for each). These findings indicate that CASC2 and miRNA-21-p might be used as potential diagnostic and therapeutic biomarkers in COVID-19.

The ELANE rs17223045C/T and rs3761007G/A variants are protective factors against COVID-19.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is responsible for causing coronavirus disease 2019 (COVID-19). The development and severity of this infectious disease is influenced by a combination of environmental and genetic factors. Angiotensin-converting enzyme 2 (ACE2) facilitates SARS-CoV-2 entry into human cells, with transmembrane serine protease 2 (TMPRSS2) playing a crucial role in S protein priming. Other proteases, such as cathepsin L and elastase, neutrophil-expressed (ELANE), have the capability to prime the S protein and contribute to SARS-CoV-2 infection. ELANE variants have not been previously examined in COVID-19 patients. We aimed to assess the association of single nucleotide variants (SNVs) within ELANE with COVID-19 and biochemical markers. The study included 319 SARS-CoV-2-infected patients and 288 controls. Genotyping of ELANE rs17216663C/T (Pro257Leu), rs17223045C/T (As1n30Asn), and rs3761007G/A was conducted using a 5'-nuclease allelic discrimination assay (TaqMan assay). Our findings indicate that ELANE rs17223045C/T (C vs T: odds ratio [OR] 0.08, P = 0.005, and CC vs CT: OR 0.08, P = 0.005) and rs3761007G/A (G vs A: OR 0.38, P = 0.009, and GG vs GA: OR 0.40, P = 0.008) confer protection against COVID-19. However, these variants were not associated with biochemical markers. In conclusion, our data suggests that ELANE rs17223045C/T and rs3761007G/A SNVs may play a protective role against COVID-19.

In silico prediction of preventive activities of bioactive hazelnut peptides against COVID‐19 and Monkeypox 2022

AbstractThe coronavirus 2 (SARS‐CoV‐2), a positive‐sense RNA virus that causes severe acute respiratory illness, is the cause of Coronavirus Disease 2019 (COVID‐19) and Monkeypox is a zoonotic viral disease caused by a double‐strand enveloped DNA virus, a member of the Poxviridae family under the umbrella of the Orthopoxvirus genus. These viruses have harmed global health, societal stability, and global economy prompting the development of new therapeutic options. The purpose of this study was to analyze the potency of hazelnut‐derived bioactive peptides for usage in preventive measures against SARS‐CoV‐2 and Monkeypox infections. Since SARS‐CoV‐2 entry into the host cell takes place through angiotensin‐converting enzyme (ACE) receptors, an in silico attempt was made here to analyze the previously characterized ACE‐inhibitory hazelnut peptides for their anti‐COVID potential. First of all, peptide sequences with PeptideRanker values &gt;0.5 were determined, where 43 of 256 hazelnut peptides met this condition. BIOPEP tools were used to calculate their ACE‐inhibitory characteristics. VPHW and DENPRHF demonstrated the strongest ACE‐inhibitory activity based on BIOPEP analysis. The binding potentials of VPHW (p &lt; 0.001) and DENPRHF (p &lt; 0.001) peptides to ACE were statistically significant based on PepSite2 analysis. The hazelnut‐derived peptides were docked with ACE, spike proteins, SARS‐CoV‐2 proteases, host cell receptors, and Monkeypox 2022 membrane proteins using HPEPDOCK and CABS‐dock. The in silico findings pointed out potential inhibition of SARS‐CoV‐2 main protease in the host cell and Monkeypox 2022 membrane protein and demonstration of multiple bioactivities.

Mesenchymal stem cells therapy for COVID-19: from basic research to clinical trial.

The novel pathogenic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19), a serious challenge for human health. In severe cases, patients suffer from acute respiratory distress syndrome, even organ failure, usually owing to the dysregulated immune response and widespread inflammation. Considering there is no known cure for COVID-19 despite the increased morbidity and mortality rate of COVID-19, modalities targeting immunity and inflammation may be promising therapeutics against COVID-19. Mesenchymal stem cells (MSCs) possessing immunomodulatory, anti-inflammatory, anti-apoptotic, and antiviral properties can be of potential benefit to a subset of severe and critically ill patients with COVID-19. In the present study, we described the underlying mechanisms of MSCs therapy and provided a thorough research study on the recent clinical trials of MSCs for SARS-CoV-2 infection.

Impact of comorbidities and inflammatory markers on mortality of COVID-19 patients.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus that causes coronavirus disease 2019 (COVID-19) is a serious global health concern. The severity of the disease can be determined by serologic indicators such as C-reactive protein, lactate dehydrogenase, D-dimer, ferritin, and interleukin-6. (IL-6). Patients with preexisting conditions such as respiratory, cardiovascular, and pulmonary disease could be at risk of adverse outcomes. It is crucial to provide adequate medical care to manage these patients and increase their chances of survival. The study examined the impact of comorbidity and inflammatory markers on the severity and mortality of hospitalised COVID-19 patients. This retrospective study included 101 COVID-19 patients who had comorbidities and were hospitalised from April 2021 to April 2022. Patients with a severe COVID-19 infection could be anticipated to have higher levels of inflammatory markers in their blood. Patients with chronic kidney and coronary artery disease have a worse prognosis than those with other comorbidities (P value <0.001). However, tuberculosis had no statistically significant effect on mortality and showed a minimal chance of death (P value = 0.303). In addition, tocilizumab performed poorly and was ineffective against the COVID-19 treatment. However, ivermectin exhibited a statistically significant probability of survival in COVID-19 patients. The inflammatory markers D-dimer, ferritin, and IL-6 were identified as valuable indicators of disease severity. Further, chronic kidney disease and coronary artery disease were identified as risk factors for mortality, while tuberculosis showed potential protective effects. The study showed that higher neutrophil levels were linked to mortality in tocilizumab-treated patients, while ivermectin showed promise in increasing survival rates.

SARS-CoV-2-associated T-cell infiltration in the central nervous system.

Infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes coronavirus disease 2019 (COVID-19). Although an acute SARS-CoV-2 infection mainly presents with respiratory illness, neurologic symptoms and sequelae are increasingly recognised in the long-term treatment of COVID-19 patients. The pathophysiology and the neuropathogenesis behind neurologic complications of COVID-19 remain poorly understood, but mounting evidence points to endothelial dysfunction either directly caused by viral infection or indirectly by inflammatory cytokines, followed by a local immune response that may include virus-specific Tcells. However, the type and role of central nervous system-infiltrating T cells in COVID-19 are complex and not fully understood. We analysed distinct anatomical brain regions of patients who had deceased as a result of COVID-19-associated pneumonia or complications thereof and performed T cell receptor Vβ repertoire sequencing. Clonotypes were analysed for SARS-CoV-2 association using public TCR repertoire data. Our descriptive study demonstrates that SARS-CoV-2-associated T cells are found in almost all brain areas of patients with fatal COVID-19 courses. The olfactory bulb, medulla and cerebellum were brain regions showing the most SARS-CoV-2 specific sequence patterns. Neuropathological workup demonstrated primary CD8+ T-cell infiltration with a perivascular infiltration pattern. Future research is needed to better define the relationship between T-cell infiltration and neurological symptoms and its long-term impact on patients' cognitive and mental health.

A Study Comparing the Aerosol Box and Mayo Containment setup During Intubation in COVID-negative Indian Patients as a Learning Curve

ABSTRACT Objective: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19) is highly contagious. The use of other barrier techniques, in addition to personal protective equipment (PPE), to limit aerosolization and protect against contamination may also be helpful. Design: This is a prospective, randomized, single-blind, comparative study to compare the efficacy of aerosol box with the Mayo trolley containment setup during intubation. Materials and Methods: The two setups were compared for ease and time taken for intubation, restriction of hand movement, difficulty in accessing equipment, difficulty in railroading of endotracheal tube (ETT) over a bougie, and general satisfaction of operator during intubation using the C-MAC video laryngoscope. The mean time taken for endotracheal intubation (ETI) was compared using the unpaired t-test, and the rest of the categorical variables were presented as proportions and percentages. Results: The mean time taken for ETI using the Mayo trolley was 42.6 seconds as compared to 54.5 seconds with an aerosol box. The operator was more satisfied with the Mayo trolley setup. Conclusion: The Mayo trolley containment setup is an inexpensive and readily available alternative to the aerosol box in any setting, with a lesser time taken to intubation and lesser restriction of hand movement, easy accessibility of equipment, and easy railroading of ETT over a bougie.

COVID-19 and arterial hypertension: whether normal blood pressure is a sign of a benign course of COVID-19

SARS-CoV-2 virus, which causes coronavirus disease 2019 (COVID-19), apart from respiratory manifestations, is able to directly affect the cardiovascular system. Therefore, different from general population target values of blood pressure might be beneficial for the patients with COVID-19. The aim of this study was to investigate whether conventional blood pressure control was associated with the severity of COVID-19. From 260 patients that were hospitalised to the unit subdivision of stable patients of COVID-center between March, 2020, and December, 2020, 163 patients with confirmed infection with SARS-CoV-2 virus and hypertension were selected. The patients were distributed by hypertension control: blood pressure &lt;140/90 mmHg (n=94) and blood pressure ≥140/90 mmHg (n=69). Routine instrumental and laboratory investigations were registered and analysed. The patients were diagnosed and treated according to national and European guidelines. The information about the control of blood pressure was taken from the patients’ medical records. The group of patients with controlled hypertension had higher prevalence of females (p=0.03), 10 years higher median of age (p&lt;0.01) and lower frequency of obesity (p=0.04). The patients with controlled hypertension had lower median of pulmonary injury (p=0.04) and lower frequency of SpO2&lt;92% (p=0.02). Glomerular filtration rate &lt;60 ml/min and proteinuria were detected significantly more frequently in the patients with controlled hypertension (p=0.02). In the presented study blood pressure below 140/90 mmHg before the admission to the hospital was associated with a lower degree of pulmonary injury but with the higher frequency of nephropathy signs. Urine test and blood creatinine monitoring might be beneficial for the patients with COVID-19 and hypertension.

Why Face Masks Should not be Imposed on the Public Again: A Review Article

Viral epidemics of acute respiratory infections pose a global threat. Influenza outbreaks occur almost every year. Specifically, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing coronavirus disease 2019 (COVID-19), emerged in late 2019. This unprecedented event resulted in many countries requiring masks in public spaces to contain the spread of SARS-CoV-2. However, the early and previous systematic reviews of randomized controlled trials (RCTs) found that medical/surgical masks did not appear to reduce respiratory viral infections. Also, N95 respirators did not provide superior protection over surgical masks against viral infections or influenza-like infections among healthcare workers (HCWs), although N95 respirators theoretically provide better protection. This led to the recommendation not to wear facemasks as potential benefits are limited, and there is a risk of self-contamination if misused. However, with the ongoing spread of SARS-CoV-2, several health authorities suddenly shifted their recommendations and advised the general public to wear masks, with some governments even mandating it. By July 2023, the health-protective benefits of wearing facemasks are still conflicting, and debate over the idea of a mask mandate is ongoing. Therefore, this review aims to discuss ten reasons why face masks should not be imposed on the public again, which include the functional weaknesses of facemasks, lack of justification for the sudden change in the recommendations during the COVID-19 pandemic, the effectiveness of facemasks in the community and among HCWs based on the systematic reviews of the RCTs, their effectiveness based on the RCTs, the effectiveness of N95 respirators versus surgical masks in protecting from acute respiratory infection based on the systematic reviews, their potential harms, the poor quality of most masks used by the public, their misuse, the trajectory of the COVID-19 pandemic despite masking, and the importance of acknowledgment of the rights of people in wearing masks or not.

Effectiveness of tixagevimab/cilgavimab in patients with hematological malignancies as a pre-exposure prophylaxis to prevent severe COVID-19: a Czech retrospective multicenter study

Despite lower virulence, the omicron variant of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19) still poses a relevant threat for immunocompromised patients. A retrospective multicentric study was conducted to evaluate the efficacy of pre-exposure prophylaxis with tixagevimab/cilgavimab (Evusheld) with a 6-month follow-up for preventing severe COVID-19 in adult patients with hematology malignancy. Among the 606 patients in the cohort, 96 (16%) contracted COVID-19 with a median of 98.5 days after Evusheld administration. A total of 75% of patients had asymptomatic or mild severity of COVID-19, while just 25% of patients with SARS-CoV-2 positivity had to be hospitalized. Two patients (2%) died directly, and one patient (1%) in association with COVID-19. Eight patients (1.3%) of every cohort experienced adverse events related to Evusheld, mostly grade 1 and of reversible character. It was found that complete vaccination status or positive seroconversion was not associated with lower risk of COVID-19 infection. Previous treatment with an anti-CD20 monoclonal antibody was associated with higher rates of COVID-19, while previous treatment with anti-CD38 monoclonal antibody was not, as was the case for recipients of hematopoietic stem cell transplantation or CAR-T cell therapy. Presence of other comorbidities was not associated with more severe COVID-19. The results support the growing evidence for Evusheld’s efficacy against severe COVID-19 in patients with hematology malignancies.