Global Health Systems Research Articles

Precision medicine in Australia: now is the time to get it right.

Precision medicine in Australia: now is the time to get it right.

Human Monkeypox: An Emerging Zoonosis.

Human monkeypox is caused by a zoonotic Orthopoxvirus that resembles smallpox. It is challenging to identify the illness from varicella and smallpox. The rapid spread of cases across countries has raised serious concerns among public health officials around the world, prompting accelerated investigations to identify the origins and causes of the rapid expansion of cases. When people come into contact with infected animals, they may unintentionally contract monkeypox. The monkeypox virus is transferred by direct exposure to lesions, respiratory droplets, body fluids, and contaminated objects like blood. Fever, rash, and lymph nodes frequentswelling are clinical signs of monkeypox, which can cause a multitude of health problems. The disease's worldwide significance is shown by the advent of outbreaks outside of Africa. To understand the constantly shifting epidemiology of this disease that is reemerging, monkeypox cases require improved monitoring and case identification. Before smallpox's eradication and the consequent absence of immunization attempts, vaccinia vaccination provided coincidental protection to the monkeypox virus; however, monkeypox gained therapeutic relevance. Additionally, given that rural Africa is where monkeypox cases are most common, it is possible that underreporting could result in an underestimate of the pathogen's potential impact. In recent months, cases of human monkeypox have alarmingly increased in nations where the illness is not prevalent. The current monkeypox outbreak, in light of the COVID-19 pandemic, represents a fresh threat. Clinicians need to be aware of this novel scenario, which differs from previous epidemics' scenarios. The transmission of monkeypox should be reduced by the development of efficient solutions by global health systems.

A Snapshot of the Experience of Dietitians during the COVID-19 Crisis in Five Arab Countries: Findings from a Regional Cross-Sectional Study.

COVID-19's intimidating spread has challenged the resilience of the global health systems, causing shifts in the practices of healthcare workers, including dietitians. The current study aimed to assess the change in dietitians' practices and duties in hospitals/clinics after the commencement of COVID-19 pandemic. This cross-sectional study was conducted in five Arab countries between November 2020 and January 2021. A convenient sample of 903 dietitians filled an online self-administered questionnaire to meet the study aims. Nearly 40.0% of the dietitians experienced a change in their workload and caseload during the pandemic. Besides, 18.7% of the dietitians had been assigned additional tasks in their facilities. Nearly half the dietitians (46.9%) had started giving remote nutrition consultations, associated with a 21% drop in the number of dietitians offering in-person consultations (p = 0.001). Approximately 58.9% of the dietitians provided nutrition care to COVID-19 patients, with 48.4% having access to personal protective equipment. Moreover, 17.0% of dietitians supported COVID-19 patients with enteral and parenteral nutrition. In addition, 45.0% of dietitians reported that managing COVID-19 was challenging given that it was a newly discovered condition.

Insights on the possibility of SARS-CoV-2 transmission through the eyes.

A novel coronavirus, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2 or 2019-nCOV), causing coronavirus disease 2019 (COVID-19), has rapidly spread to most countries and regions worldwide since it broke out at the end of 2019. Epidemic of the virus produces a tremendous pressure on the global health systems. With progressive insight into SARS-CoV-2, the role of eye tissue has attracted wide attention in the spread of COVID-19. Whether SARS-CoV-2 can enter the human body through eyes and cause infection? The fact that unprotected exposure of the eyes to 2019-nCoV might have allowed the virus to infect the body implies that 2019-nCOV can invade eye tissue and set foot in organism. Facing the severe challenge of preventing spread of the COVID-19, combined with the high-risk environment of ophthalmology, it is crucial to investigate ocular tropism of coronavirus. This paper explores the possibility of coronavirus transmission through the eye from aspects of probable mechanisms, clinical cases, detection of coronavirus; and puts forward precautions for ophthalmologists and nurses. Consequently, this review reveals our understanding of ocular tropism of coronavirus and contributes to determining risk of ocular transmission, raising awareness of necessary eye protection among medical workers and reducing further prevalence of SARS-CoV-2.

Global morbidity and mortality of lower respiratory infections: A population -based study

BackgroundThis study provides a comprehensive, comparative and updated estimates of temporal patterns of lower respiratory infections (LRIs) globally over the past three decades. MethodsThe data on morbidity and mortality of patients with LRIs at the global, regional and national levels were retrieved from the Global Burden of Disease (GBD) 2019 study. ResultsGlobally, the incident cases of LRIs increased from 414,342,866 [95% uncertainty interval (UI):383,529,625 to 449, 086,938]in 1990 to 488,902,504(95% UI: 457,572,987 to 522,635,542)in 2019 with the age standardized incidence rate (ASIR) decreased from 8,276/100,000 persons (95% UI: 7,727 to 8,892) to 6,295/100,000 persons (95% UI: 5,887 to 6,737) between 1990 and 2019. Number of LRIs deaths were 2,493,200 (95% UI: 2,268,184 to 2,736,184) in 2019, a decrease of 24.9% (95% UI: −34.4 to −15.4) in the past 30 years. Meanwhile, the age-standardized death rate (ASDR) declined also from 67/100,000 persons (95% UI: 61 to 73) in 1990 to 34/100,000 persons (95% UI: 31 to 38) in 2019. Moreover, the numbers and age-standardized rates per 100,000 persons of morbidity and mortality varied widely by age, sex, Socio-Demographic Index (SDI) quintiles, and geographical locations in 2019. ConclusionLRIs remain a major public health concern . Some differences in age, sex, SDI quintiles, and geographical locations contribute to LRIs-related global health policy development and health system resource optimization.

Mental Health Issues in COVID-19

The present paper discusses the mental health issues during the pandemic situation. It not only looms physical and mental health, global public health and social systems are failing under corona virus spread. The paper tried to explain the impact of pandemic on children and adolescents, parents, impact on student’s life and front-line health workers and employees. Covid-19 is a transmissible (communicable) disease which was spread all over world and later becomes the international pandemic.

Integrated microdroplet array platform with temperature controller and micro-stirring for ultra-fast SARS-CoV-2 detection

The outbreak of COVID-19 has created a huge challenge to global health systems. Experience in fighting the epidemic shows that the development of a rapid and sensitive POCT diagnostic platform for SARS-CoV-2 that can be deployed in situ is crucial to contain the outbreak. Here, we have developed a portable microdroplet detection platform that integrated temperature controller and micro-stirring for high-throughput and ultrafast COVID-19 diagnosis. Such a device uses a p-n junction (PN junction) as the temperature controller to adjust the temperature in a single microdroplet independently and precisely, ensuring the amplification of reverse transcription loop-mediated isothermal amplification (RT-LAMP). Meanwhile, the platform incorporates an ultrasonic micro-stirring unit, greatly increasing the interaction between RT-LAMP molecules and accelerating the amplification. The results show good linearity over a wide linear range (1 to 105 copies/μL) and low LOD (0.48 copy/μL). Our method reports in only 6.1 min for high-viral load samples, and combines with sample preparation, the total detection process could be done within 30 min. Such a portable and fully integrated microdroplet molecular diagnostic platform is a promising tool for point-of-care diagnosis of COVID-19 and other infectious diseases in resource-limited settings.

Abstract 12917: Reproducibility of Use by Physicians and Patients of a Smart Stethoscope for Artificial-Intelligence Enhanced Diagnosis of Heart Failure

Introduction: Early detection of heart failure (HF) is a global health system priority. An artificial intelligence-enhanced stethoscope (‘Eko DUO’), is capable of recording and analysing a single-lead ECG to detect HF with reduced left ventricular ejection fraction (LVEF≤40%) after only 15 seconds of apposition to the chest. Given this simplicity, patient-administered remote HF diagnosis and screening is feasible if performance and reproducibility of use of the Eko DUO is adequate. Hypothesis: We tested hypotheses that: 1. Eko DUO predictions for LVEF≤40% have good intra- and inter- operator reproducibility (intra-class correlation coefficient > 0.75) for both patient and clinician deployment. 2. Eko DUO performance for detection of LVEF≤40% is comparable between patients and clinicians Methods: 98 hospital inpatients undergoing echocardiography at Imperial College Healthcare NHS Trust, UK, performed self-examination with the Eko DUO, using instructions to take three recordings from the left parasternal 2nd intercostal position. A clinician then repeated three recordings. The intra-class correlation coefficient was calculated using the raw numerical artificial intelligence predictions for LVEF≤40%. Performance for detection of LVEF≤40% was measured by calculating the area under the receiver-operating characteristic curves (AUC) using a reference standard of echocardiography-derived percentage LVEF. Results: There was good intra-operator reproducibility for both patients (ICC = 0.817) and for clinicians (ICC = 0.888), and good inter-operator reproducibility between patient and clinicians (ICC = 0.887). The performance of the Eko DUO was comparable between patients and clinicians (AUC = 0.887 vs. AUC = 0.800, respectively). Conclusions: The Eko DUO predictions for LVEF≤40% have good intra- and inter-operator reproducibility between patients and clinicians.

The Global Outbreak of Monkeypox: Enhancing Public Health Preparedness

The monkeypox (MPX) outbreak has been declared a public health emergency by WHO and the U.S. The zoonotic disease with a similar appearance to smallpox named Monkeypox (MPX) has started to reappear and spread globally in recent times although it was endemic to Africa for decades. It has already spread to 88 countries (81 non-endemic) and infected about 30,000 people. Touching an infected individual who has rashes, scabs, body fluids, or lesions on their skin is the most common way to catch and spread monkeypox. The global health system is already substantially exhausted because of the high volume of Covid-19 patients and is unprepared to execute fast response and emergency interventions to combat a new outbreak. Educating general people and health care workers, creating mass awareness, and preparing public health sectors globally are crucial to controlling the MPX outbreak and avoiding another potential pandemic.

The Global Outbreak of Monkeypox: Enhancing Public Health Preparedness

The monkeypox (MPX) outbreak has been declared a public health emergency by WHO and the U.S. The zoonotic disease with a similar appearance to smallpox named Monkeypox (MPX) has started to reappear and spread globally in recent times although it was endemic to Africa for decades. It has already spread to 88 countries (81 non-endemic) and infected about 30,000 people. Touching an infected individual who has rashes, scabs, body fluids, or lesions on their skin is the most common way to catch and spread monkeypox. The global health system is already substantially exhausted because of the high volume of Covid-19 patients and is unprepared to execute fast response and emergency interventions to combat a new outbreak. Educating general people and health care workers, creating mass awareness, and preparing public health sectors globally are crucial to controlling the MPX outbreak and avoiding another potential pandemic.

The response of primary care practices in rural and urban settings in Poland to the challenges of the COVID-19 pandemic.

In the wake of COVID-19 primary care practices have had to overcome and to adapt to several challenges in providing quality care. An international consortium led by Ghent University, Belgium, set up the PRICOV-19 project to study how primary care practices in 38 countries responded to the new challenges. The aim of the study was to describe how Covid-19 impacted the organisation of primary care practices in rural and urban environments in Poland, including the organisation of patient flows, infection prevention, information processing, and communication. This is cross-sectional questionnaire-based survey among primary care practices. In Poland, the survey was distributed among primary care practices in 16 Polish regions. 180 practices participated in the study. In the analysis of the data U-Mann Whitney or t-test for independent groups, and Wilcoxon test were used to compare the organisation of care before and since the pandemic. Over two-thirds of practices made considerable changes in their structure due to COVID-19; over three-quarters introduced security procedures for phone registrations, but only a quarter still offered consultations without a prior appointment. The use of video consultation quadrupled, and teleconsultations became almost universal. Rural practices were significantly more likely to offer active care for deprived patient groups. A significant increase in infection prevention measures occurred in both urban and rural practices. COVID-19 brought challenges that spurred changes to the organisation of primary care practices as they sought to continue offering quality care. Despite these hardships, new opportunities for effective changes to clinical operations and organization have emerged and will benefit global health systems in the face of new crises.

Potential therapeutic role of pyroptosis mediated by the NLRP3 inflammasome in type 2 diabetes and its complications.

As a new way of programmed cell death, pyroptosis plays a vital role in many diseases. In recent years, the relationship between pyroptosis and type 2 diabetes (T2D) has received increasing attention. Although the current treatment options for T2D are abundant, the occurrence and development of T2D appear to continue, and the poor prognosis and high mortality of patients with T2D remain a considerable burden in the global health system. Numerous studies have shown that pyroptosis mediated by the NLRP3 inflammasome can affect the progression of T2D and its complications; targeting the NLRP3 inflammasome has potential therapeutic effects. In this review, we described the molecular mechanism of pyroptosis more comprehensively, discussed the most updated progress of pyroptosis mediated by NLRP3 inflammasome in T2D and its complications, and listed some drugs and agents with potential anti-pyroptosis effects. Based on the available evidence, exploring more mechanisms of the NLRP3 inflammasome pathway may bring more options and benefits for preventing and treating T2D and drug development.

Evaluation of Four Strategies for SARS-CoV-2 Detection: Characteristics and Prospects.

The pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has posed an enormous burden on the global public health system and has had disastrous socioeconomic consequences. Currently, single sampling tests, 20-in-1 pooling tests, nucleic acid point-of-care tests (POCTs), and rapid antigen tests are implemented in different scenarios to detect SARS-CoV-2, but a comprehensive evaluation of them is scarce and remains to be explored. In this study, 3 SARS-CoV-2 inactivated cell culture supernatants were used to evaluate the analytical performance of these strategies. Additionally, 5 recombinant SARS-CoV-2 nucleocapsid (N) proteins were also used for rapid antigen tests. For the wild-type (WT), Delta, and Omicron strains, the lowest inactivated virus concentrations to achieve 100% detection rates of single sampling tests ranged between 1.28 × 102 to 1.02 × 103, 1.28 × 102 to 4.10 × 103, and 1.28 × 102 to 2.05 × 103 copies/mL. The 20-in-1 pooling tests ranged between 1.30 × 102 to 1.04 × 103, 5.19 × 102 to 2.07 × 103, and 2.59 × 102 to 1.04 × 103 copies/mL. The nucleic acid POCTs were all 1.42 × 103 copies/mL. The rapid antigen tests ranged between 2.84 × 105 to 7.14 × 106, 8.68 × 104 to 7.14 × 106, and 1.12 × 105 to 3.57 × 106 copies/mL. For the WT, Delta AY.2, Delta AY.1/AY.3, Omicron BA.1, and Omicron BA.2 recombinant N proteins, the lowest concentrations to achieve 100% detection rates of rapid antigen tests ranged between 3.47 to 142.86, 1.74 to 142.86, 3.47 to 142.86, 3.47 to 142.86, and 5.68-142.86 ng/mL, respectively. This study provided helpful insights into the scientific deployment of tests and recommended the full-scale consideration of the testing purpose, resource availability, cost performance, result rapidity, and accuracy to facilitate a profound pathway toward the long-term surveillance of coronavirus disease 2019 (COVID-19). IMPORTANCE In the study, we reported an evaluation of 4 detection strategies implemented in different scenarios for SARS-CoV-2 detection: single sampling tests, 20-in-1 pooling tests, nucleic acid point-of-care tests, and rapid antigen tests. 3 SARS-CoV-2-inactivated SARS-CoV-2 cell culture supernatants and 5 recombinant SARS-CoV-2 nucleocapsid proteins were used for evaluation. In this analysis, we found that for the WT, Delta, and Omicron supernatants, the lowest concentrations to achieve 100% detection rates of single sampling tests ranged between 1.28 × 102 to 1.02 × 103, 1.28 × 102 to 4.10 × 103, and 1.28 × 102 to 2.05 × 103 copies/mL. The 20-in-1 pooling tests ranged between 1.30 × 102 to 1.04 × 103, 5.19 × 102 to 2.07 × 103, and 2.59 × 102 to 1.04 × 103 copies/mL. The nucleic acid POCTs were all 1.42 × 103 copies/mL. The rapid antigen tests ranged between 2.84 × 105 to 7.14 × 106, 8.68 × 104 to 7.14 × 106, and 1.12 × 105 to 3.57 × 106 copies/mL. For the WT, Delta AY.2, Delta AY.1/AY.3, Omicron BA.1, and Omicron BA.2 recombinant N proteins, the lowest concentrations to achieve 100% detection rates of rapid antigen tests ranged between 3.47 to 142.86, 1.74 to 142.86, 3.47 to 142.86, 3.47 to 142.86, and 5.68 to 142.86 ng/mL, respectively.

Bilateral Pulmonary Thromboembolism in a Post-COVID Patient

Pulmonary thromboembolism (PTE) is a disease that is difficult to diagnose, and is a problem in the global health system. It is one of the complications described in COVID-19. We present a case of a 49-year-old man, with a history of being a smoker who, ten days after having suffered from COVID 19, begins with right hemithorax pain, cough with yellowish expectoration, slight shortness of breath and tiredness on exertion. interpreted as post_COVID pneumonia and antibiotic treatment is indicated. He does not improve and an EKG is performed which shows rapid response atrial fibrillation. An AndioCT is performed with which he is diagnosed with bilateral pulmonary thromboembolism. It evolves towards healing with treatment with Fraxiheparin. Pulmonary thromboembolism is a feared complication of COVID-19, which requires rapid diagnosis to ensure adequate treatment to achieve patient recovery and prevent death.

Effect of unifaceted and multifaceted interventions on antibiotic prescription control for respiratory diseases: A systematic review of randomized controlled trials.

Background:The global health system is improperly using antibiotics, particularly in the treatment of respiratory diseases. We aimed to examine the effectiveness of implementing a unifaceted and multifaceted intervention for unreasonable antibiotic prescriptions.Methods:Relevant literature published in the databases of Pubmed, Embase, Science Direct, Cochrane Central Register of Controlled Trials, China National Knowledge Infrastructure and Wanfang was searched. Data were independently filtered and extracted by 2 reviewers based on a pre-designed inclusion and exclusion criteria. The Cochrane collaborative bias risk tool was used to evaluate the quality of the included randomized controlled trials studies.Results:A total of 1390 studies were obtained of which 23 studies the outcome variables were antibiotic prescription rates with the number of prescriptions and intervention details were included in the systematic review. Twenty-two of the studies involved educational interventions for doctors, including: online training using email, web pages and webinar, antibiotic guidelines for information dissemination measures by email, postal or telephone reminder, training doctors in communication skills, short-term interactive educational seminars, and short-term field training sessions. Seventeen studies of interventions for health care workers also included: regular or irregular assessment/audit of antibiotic prescriptions, prescription recommendations from experts and peers delivered at a meeting or online, publicly reporting on doctors’ antibiotic usage to patients, hospital administrators, and health authorities, monitoring/feedback prescribing behavior to general practices by email or poster, and studies involving patients and their families (n = 8). Twenty-one randomized controlled trials were rated as having a low risk of bias while 2 randomized controlled trials were rated as having a high risk of bias. Six studies contained negative results.Conclusion:The combination of education, prescription audit, prescription recommendations from experts, public reporting, prescription feedback and patient or family member multifaceted interventions can effectively reduce antibiotic prescription rates in health care institutions. Moreover, adding multifaceted interventions to educational interventions can control antibiotic prescription rates and may be a more reasonable method.Registrations:This systematic review was registered in PROSPERO, registration number: CRD42020192560.

The Impact of Covid-19 Pandemic on Obstetrics & Gynaecology Specialist Training in Malaysia: Perception of Clinical Postgraduate Students

Introduction: The COVID-19 pandemic that strucked the world had changed the global health system and caused changes in clinical practice and practitioners’ exposure. The aim of this research is to study the perception of UKM Obstetrics and gynaecology postgraduate students about the impact of COVID-19 pandemic on their specialist training. Methods: The survey had been carried out through Google Form among students enrolled in Doctor of Obstetrics & Gynaecology (DROG) program in UKM and consist of three sections; socio-demographic information, changes in role during COVID-19 and perception towards training. Quantitative analysis performed using Statistical Package for the Social Sciences (SPSS). Results: Out of 47 respondents, 13 were working in MOH hospitals, 17 in UKM Hospital and 17 in both MOH and UKM hospitals. Total of 32 students (68.1%) felt increment in seeing obstetric patients and 31 students (65.9%) performed more obstetric procedures during COVID-19 pandemic. For gynaecology, 29 students (61.7%) claimed had been seeing less gynaecological patients and 40 students (85.1%) performed less gynaecological surgeries. Total of 35 students (74.5%) agreed that COVID-19 pandemic had affected their mental well-being and 42 students (89.4%) agreed their social well-being had been affected. Total of 43 trainees (91.5%) agreed that COVID-19 pandemic had negatively impacted their surgical skills in gynaecology and 38 students (80.1%) claimed their overall learning opportunities had been affected. Mean for training perception score is 52.53 and there is no significant difference in score mean among students according to difference in study year and training hospitals. Conclusion: COVID-19 pandemic had caused negative impact to the specialty training among Obstetrics & Gynaecology postgraduate students in UKM.

Viewing the global health system as a complex adaptive system - implications for research and practice.

The global health system (GHS) is ill-equipped to deal with the increasing number of transnational challenges. The GHS needs reform to enhance global resilience to future risks to health. In this article we argue that the starting point for any reform must be conceptualizing and studying the GHS as a complex adaptive system (CAS) with a large and escalating number of interconnected global health actors that learn and adapt their behaviours in response to each other and changes in their environment. The GHS can be viewed as a multi-scalar, nested health system comprising all national health systems together with the global health architecture, in which behaviours are influenced by cross-scale interactions. However, current methods cannot adequately capture the dynamism or complexity of the GHS or quantify the effects of challenges or potential reform options. We provide an overview of a selection of systems thinking and complexity science methods available to researchers and highlight the numerous policy insights their application could yield. We also discuss the challenges for researchers of applying these methods and for policy makers of digesting and acting upon them. We encourage application of a CAS approach to GHS research and policy making to help bolster resilience to future risks that transcend national boundaries and system scales.

Commentary: Investing in advance practice nurses is a global health system solution.

Investment and full utilization of advance practice nurses to maximize universal health coverage, optimize access to primary health care, and for building health workforce capacity and professional leadership is direly warranted globally. Funding advance practice nurse education programs, leadership opportunities, service delivery systems, and rewarding jobs regionally and nationally is a viable value-added solution for our communities, countries, and the nursing profession.

Fast-track development of vaccines for SARS-CoV-2: The shots that saved the world.

In December 2019, an outbreak emerged of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which leads to coronavirus disease 2019 (COVID-19). The World Health Organisation announced the outbreak a global health emergency on 30 January 2020 and by 11 March 2020 it was declared a pandemic. The spread and severity of the outbreak took a heavy toll and overburdening of the global health system, particularly since there were no available drugs against SARS-CoV-2. With an immediate worldwide effort, communication, and sharing of data, large amounts of funding, researchers and pharmaceutical companies immediately fast-tracked vaccine development in order to prevent severe disease, hospitalizations and death. A number of vaccines were quickly approved for emergency use, and worldwide vaccination rollouts were immediately put in place. However, due to several individuals being hesitant to vaccinations and many poorer countries not having access to vaccines, multiple SARS-CoV-2 variants quickly emerged that were distinct from the original variant. Uncertainties related to the effectiveness of the various vaccines against the new variants as well as vaccine specific-side effects have remained a concern. Despite these uncertainties, fast-track vaccine approval, manufacturing at large scale, and the effective distribution of COVID-19 vaccines remain the topmost priorities around the world. Unprecedented efforts made by vaccine developers/researchers as well as healthcare staff, played a major role in distributing vaccine shots that provided protection and/or reduced disease severity, and deaths, even with the delta and omicron variants. Fortunately, even for those who become infected, vaccination appears to protect against major disease, hospitalisation, and fatality from COVID-19. Herein, we analyse ongoing vaccination studies and vaccine platforms that have saved many deaths from the pandemic.

Molecular and Structural Analysis of Specific Mutations from Saudi Isolates of SARS-CoV-2 RNA-Dependent RNA Polymerase and their Implications on Protein Structure and Drug-Protein Binding.

The COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has stressed the global health system to a significant level, which has not only resulted in high morbidity and mortality but also poses a threat for future pandemics. This situation warrants efforts to develop novel therapeutics to manage SARS-CoV-2 in specific and other emerging viruses in general. This study focuses on SARS-CoV2 RNA-dependent RNA polymerase (RdRp) mutations collected from Saudi Arabia and their impact on protein structure and function. The Saudi SARS-CoV-2 RdRp sequences were compared with the reference Wuhan, China RdRp using a variety of computational and biophysics-based approaches. The results revealed that three mutations—A97V, P323I and Y606C—may affect protein stability, and hence the relationship of protein structure to function. The apo wild RdRp is more dynamically stable with compact secondary structure elements compared to the mutants. Further, the wild type showed stable conformational dynamics and interaction network to remdesivir. The net binding energy of wild-type RdRp with remdesivir is -50.76 kcal/mol, which is more stable than the mutants. The findings of the current study might deliver useful information regarding therapeutic development against the mutant RdRp, which may further furnish our understanding of SARS-CoV-2 biology.