Previous Coronavirus Outbreaks Research Articles

Perspectives on Post-COVID-19 Pulmonary Fibrosis Treatment.

Pulmonary fibrosis, a critical outcome of chronic inflammatory diseases, has gained prominence in the context of post-coronavirus (post-COVID-19) complications. This review delves into the multifaceted landscape of post-COVID-19 pulmonary fibrosis, elucidating the intricate molecular mechanisms underlying its pathogenesis and highlighting promising therapeutic avenues. Examining the aftermath of severe acute respiratory syndrome-2 (SARS-CoV-2) infection, the review reveals key signaling pathways implicated in the fibrotic cascade. Drawing parallels with previous coronavirus outbreaks enhances our understanding of the distinctive features of post-COVID-19 fibrosis. Antifibrotic drugs, like pirfenidone and nintedanib, take center stage; their mechanisms of action and potential applications in post-COVID-19 cases are thoroughly explored. Beyond the established treatments, this review investigates emerging therapeutic modalities, including anti-interleukin agents, immunosuppressants, and experimental compounds, like buloxybutide, saracatinib, sirolimus, and resveratrol. Emphasizing the critical importance of early intervention, this review highlights the dynamic nature of post-COVID-19 pulmonary fibrosis research. In conclusion, the synthesis of current knowledge offers a foundation for advancing our approaches to the prevention and treatment of these consequential sequelae of COVID-19.

Pyronaridine tetraphosphate is an efficacious antiviral and anti-inflammatory active against multiple highly pathogenic coronaviruses.

Pyronaridine tetraphosphate is on the WHO Essential Medicine List for its importance as a widely available and safe treatment for malaria. We find that pyronaridine is a highly effective antiviral therapeutic across mouse models using multiple variants of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), and the highly pathogenic viruses SARS-CoV-1 and Middle East respiratory syndrome coronavirus responsible for previous coronavirus outbreaks. Additionally, we find that pyronaridine additively combines with current COVID-19 treatments such as nirmatrelvir (protease inhibitor in Paxlovid) and molnupiravir to further inhibit SARS-CoV-2 infections. There are many antiviral compounds that demonstrate efficacy in cellular models, but few that show this level of impact in multiple mouse models and represent a promising therapeutic for the current coronavirus pandemic as well as future outbreaks as well.

Combined effects of inflammation and coronavirus disease 2019 (COVID-19) on the risks of anxiety and depression: A cross-sectional study based on UK Biobank.

Infection-induced perturbation of immune homeostasis could promote psychopathology. Psychiatric sequelae have been observed after previous coronavirus outbreaks. However, limited studies were conducted to explore the potential interaction effects of inflammation and coronavirus disease 2019 (COVID-19) on the risks of anxiety and depression. In this study, first, polygenic risk scores (PRS) were calculated for eight COVID-19 clinical phenotypes using individual-level genotype data from the UK Biobank. Then, linear regression models were developed to assess the effects of COVID-19 PRS, C-reactive protein (CRP), systemic immune inflammation index (SII), and their interaction effects on the Generalized Anxiety Disorder-7 (GAD-7, 104 783 individuals) score and the Patient Health Questionnaire-9 (PHQ-9, 104 346 individuals) score. Several suggestive interactions between inflammation factors and COVID-19 clinical phenotypes were detected for PHQ-9 score, such as CRP/SII × Hospitalized/Not_Hospitalized in women group and CRP × Hospitalized/Unscreened in age >65 years group. For GAD-7 score, we also found several suggestive interactions, such as CRP × Positive/Unscreened in the age ≤65 years group. Our results suggest that not only COVID-19 and inflammation have important effects on anxiety and depression but also the interactions of COVID-19 and inflammation have serious risks for anxiety and depression.

Psychological Impact of the 2022 Round COVID-19 Pandemic on China's College Students.

In response to the new round of COVID-19 outbreaks since March 2022, universities with high outbreak rates around the country have taken quarantine measures to contain the epidemic. Evidence from previous coronavirus outbreaks has shown that people under quarantine are at risk for mental health disorders. To better understand the impacts of this round of COVID-19 quarantine on domestic college students and their responses, we conducted a systematic survey to assess the stress and anxiety, and to evaluate effective measurements in this population. We searched relevant documents and literature, and designed a questionnaire from six aspects, including psychological status, epidemic situation, study, daily life, sports, and interpersonal communication, with 51 items in total. We sent the questionnaire on the Wenjuanxing Web platform, from April 2 to 8, 2022. We evaluated the mental status according to parts of the Generalized Anxiety Disorder-7 (GAD-7) and Depression Anxiety Stress Scales-21 (DASS-21), and investigated the influencing risk factors and countermeasures. Statistical analysis was performed by using the Chi-square test and multi-variable logistic regression. In total, 508 college respondents were recruited in our survey, and the pooled prevalence of mild anxiety (GAD score ≽ 5, or DASS-21 anxiety score ≽ 8) or stress (DASS-21 pressure score ≽ 14) caused by the new round of COVID-19 pandemic quarantine was 19.69% (100/508). The prevalence of the anxiety or stress in college students with COVID-19 quarantine between different genders, regions, and majors was not significantly different. Independent risk factors for the mild anxiety or stress of undergraduates by COVID-19 quarantine included learning efficiency or duration [OR = 1.36, 95%CI (1.14-1.62), P = 0.001], based on the combined analysis of Chi-square test analysis with multi-variable logistic regression analysis. Interestingly, the mental well-beings before COVID-19 epidemic quarantine [OR = 0.22, 95%CI (0.13-0.36), P < 0.0001], more low-intensity exercise [OR = 0.36, 95%CI (0.15-0.87), P = 0.02, high-intensity exercise as reference], and good sleep quality [OR = 0.14, 95%CI (0.07-0.30), P < 0.0001: OR = 0.42, 95%CI (0.30-0.59), P < 0.0001] are protective factors for alleviating the quarantine-caused anxiety or stress in Chinese college students for this round of COVID-19 epidemic quarantine. During the round of COVID-19 epidemic quarantine in 2022, a small number of college students have mild anxiety, affected by decreased learning efficiency or duration, which could be mitigated with low-intensity exercise and good sleep quality.

The impact of heating, ventilation and air conditioning (HVAC) design features on the transmission of viruses, including SARS-CoV-2: an overview of reviews.

Background: The 2019 novel coronavirus or severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak was declared a pandemic by the World Health Organization (WHO) in March 2020. Almost two years later (early-February 2022), the WHO reported over 383 million cases of the disease caused by the virus with over 5.6 million deaths worldwide. Debate regarding routes of transmission was substantial early in the pandemic; however, airborne transmission emerged as an important consideration. Infectious airborne agents can spread within the built environment through heating, ventilation, and air conditioning (HVAC) systems. Multiple features of HVAC systems can influence transmission (e.g., ventilation, filtration, ultraviolet radiation, humidity). Understanding how HVAC features influence airborne transmission is critical to mitigate the spread of infectious agents. Objective: Given airborne transmission of SARS-CoV-2, an overview of reviews was conducted to understand what is already known from the scientific literature about how virus transmission may be affected by HVAC design features in the built environment. Methods: Ovid MEDLINE and Compendex were searched from inception to January 2021. Two reviewers independently screened titles and abstracts and full text of potentially relevant reviews, using a priori inclusion criteria. Inclusion criteria were systematic reviews examining effects of HVAC design features on virus transmission. Two reviewers independently assessed methodological quality using AMSTAR2. Results: Searching identified 361 citations, 45 were potentially relevant, and 7 were included. Reviews were published between 2007 and 2021, and included 47 virus studies. Two earlier reviews (2007, 2016) of 21 studies found sufficient evidence that mechanical ventilation (airflow patterns, ventilation rates) plays a role in airborne transmission; however, both found insufficient evidence to quantify minimum mechanical ventilation requirements. One review (2017) of 9 studies examining humidity and indoor air quality found that influenza virus survival was lowest between 40% and 80% relative humidity; authors noted that ventilation rates were a confounding variable. Two reviews (2021) examined mitigation strategies for coronavirus transmission, finding that transmission decreased with increasing temperature and relative humidity. One review (2020) identified 14 studies examining coronavirus transmission in air conditioning systems, finding HVAC systems played a role in virus spread during previous coronavirus outbreaks. One review (2020) examined virus transmission interventions on public ground transportation, finding ventilation and filtration to be effective. Conclusions: Seven reviews synthesizing 47 studies demonstrate a role for HVAC in mitigating airborne virus transmission. Ventilation, humidity, temperature, and filtration can play a role in viability and transmission of viruses, including coronaviruses. Recommendations for minimum standards were not possible due to few studies investigating a given HVAC parameter. This overview examining HVAC design features and their effects on airborne transmission of viruses serves as a starting point for future systematic reviews and identifying priorities for primary research.

Coronavirus and Pregnancy: The Challenges of the 21st Century: A Review.

Despite many advances in medicine we are still faced with emerging pathogens. Pregnant women have been disproportionately affected by previous coronavirus outbreaks. The COVID-19 pandemic has not affected pregnant women as greatly as SARS-CoV and MERS, but has posed other challenges such as the need for quarantine and isolation, limited access to antenatal care, use of personal protective equipment (PPE), vaccine hesitancy and inequities in vaccine access and therapeutics between rich countries and the global south. This review will describe the impact of the significant coronaviruses on pregnancy, with special focus on the challenges being encountered by the SARS-CoV-2 global pandemic.

Postacute sequelae of SARS-CoV-2 infection. Osteonecrosis must not be overlooked

Recovery from COVID-19 is not always uneventful, especially in critically ill hospitalized patients. Persistent symptoms including fatigue/ weakness, shortness of breath, anxiety, and depression have been described at one-year follow-up. Furthermore, symptoms from the musculoskeletal system like joint pain or stiffness are underreported in studies with long-term follow-up of up to one year. Infection with SARS-CoV-2 itself has been associated with endothelial damage, and together with high-dose corticosteroid treatment, it is predisposed to the dissemination of microthrombi and the development of femoral head osteonecrosis (FHOn), as it has been shown during the previous (2003–2004) coronavirus outbreaks. A resurgence of FHOn cases is anticipated but this is not reflected in the existing studies with long-term follow-up. Prompt diagnosis is critical for early treatment and possibly for the hip joint preservation. Patients with COVID-19 treated with corticosteroids should be screened for avascular necrosis early after discharge from the hospital. Every healthcare worker involved in the management of these patients should maintain a high level of suspicion and should be alert when patients report symptoms such as vague aches at the buttocks, hip area, adductors, and/or above the knee. Studies are needed to identify risk factors for FHOn including disease severity, type of steroid, cumulative dose, and duration of treatment.

EDITORIAL ¿Diabetes post COVID-19?

The appearance of Diabetes Mellitus (DM) in patients who have suffered from COVID-19 could be added, if confirmed by subsequent studies, to the long list of consequences caused by this pandemic. Likewise, the impact of COVID-19 on the endocrine system is poorly studied. Previous coronavirus outbreaks, as well as other previously reported viral infections, have been associated with new-onset DM. However, there is little research in this regard and the question arises again as to how viruses can contribute to the onset of the disease or if they modify factors that ultimately trigger the lack of control of blood glucose, together with insulin resistance (IR). The recent COVID-19 pandemic has made it abundantly clear that DM increases the risk of more frequent and severe viral infections. At the same time, proinflammatory cytokines promote IR and constitute a risk factor for the development of DM. This raises the existence of a reciprocal and harmful interaction between the immune and endocrine systems in the context of DM. It is not clear why these two systems would interact by inducing transient changes in systemic metabolism as a strategy against viral infection. In people with DM, this system fails, negatively affecting the antiviral immune response. In addition, immune-mediated changes in systemic metabolism after infection may worsen glycemic control, laying the groundwork for future research.

Treatment of COVID-19 anxiety by auricular points

Background:In December 2019, a series of acute, atypical respiratory diseases was identified in Wuhan, China. The source of the illnesses was attributed to a novel coronavirus, named the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), and the subsequent disease it causes was named the coronavirus disease 2019 (COVID-19). Evidence from previous coronavirus outbreaks has shown that infected patients are at risk for developing psychiatric and mental health disorders, such as depression, anxiety, and sleep disturbances.Methods:According to the retrieval strategies, randomized controlled trials on auricular points for anxiety in patients with coronavirus 2019 will be obtained from the China National Knowledge Infrastructure, WanFang Data, Chinese Scientific Journals Database, PubMed, Embase, and Cochrane Library, regardless of publication date or language. Studies will be screened based on inclusion and exclusion criteria, and the Cochrane risk bias assessment tool will be used to evaluate the quality of the literature. The network meta-analysis will be performed with the Markov chain Monte Carlo method and carried out with Stata 14.2 and WinBUGS 1.4.3 software. Ultimately, the quality of the evidence obtained from the results will be evaluated.Results:This study will evaluate whether auricular points can effectively treat anxiety in patients with COVID-19.Conclusion:This study will provide evidence for whether auricular points is beneficial to the treatment of anxiety in patients with COVID-19.INPLASY registration number:CRD42022302649.

Circadian rhythm disruption in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Implications for the post-acute sequelae of COVID-19

Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) is a common and disabling disorder primarily characterized by persistent fatigue and exercise intolerance, with associated sleep disturbances, autonomic dysfunction, and cognitive problems. The causes of ME/CFS are not well understood but may coincide with immune and inflammatory responses following viral infections. During the current SARS-CoV2 coronavirus pandemic, ME/CFS has been increasingly reported to overlap with persistent “long COVID” symptoms, also called the post-acute sequelae of COVID-19 (PASC). Given the prominence of activity and sleep problems in ME/CFS, circadian rhythm disruption has been examined as a contributing factor in ME/CFS. While these studies of circadian rhythms have been pursued for decades, evidence linking circadian rhythms to ME/CFS remains inconclusive. A major limitation of older chronobiology studies of ME/CFS was the unavailability of modern molecular methods to study circadian rhythms and incomplete understanding of circadian rhythms outside the brain in peripheral organ systems. Major methodological and conceptual advancements in chronobiology have since been made. Over the same time, biomarker research in ME/CFS has progressed. Together, these new developments may justify renewed interest in circadian rhythm research in ME/CFS. Presently, we review ME/CFS from the perspective of circadian rhythms, covering both older and newer studies that make use of modern molecular methods. We focus on transforming growth factor beta (TGFB), a cytokine that has been previously associated with ME/CFS and has an important role in circadian rhythms, especially in peripheral cells. We propose that disrupted TGFB signaling in ME/CFS may play a role in disrupting physiological rhythms in sleep, activity, and cognition, leading to the insomnia, energy disturbances, cognition problems, depression, and autonomic dysfunction associated with ME/CFS. Since SARS-like coronavirus infections cause persistent changes in TGFB and previous coronavirus outbreaks have caused ME/CFS-like syndromes, chronobiological considerations may have immediate implications for understanding ME/CFS in the context of the COVID-19 pandemic and possibly suggest new avenues for therapeutic interventions.

From SARS to COVID-19: lessons we should have learned (but we did not)

In 2002, a severe acute respiratory (SARS) epidemic, caused by a coronavirus (SARS-CoV), affected a significant number of countries and was interrupted after one year, approximately. Currently, coronavirus disease 2019 (COVID-19), caused by severe acute respiratory coronavirus 2 (SARS-CoV-2), has been a concern for the whole world, and the end of the pandemic does not appear near. In this article, we briefly discussed the lessons learned by the countries which fought the SARS epidemic and which had succeeded in controlling the COVID-19 pandemic. We also discussed some of the main points that resulted in failures to handle the coronavirus disease 2019 (COVID-19) pandemic. In the Brazilian context, we observed that the federal government delayed the necessary measures to be taken, has been less transparent to disclose health data, neglected the facemask usage mandates and refused the COVID-19 vaccine offerings. Despite the previous coronavirus outbreaks, we are suffering during the COVID-19 pandemic because we did not learn with SARS.

DEPRESSION AND ANXIETY DISORDERS IN COVID-19 SURVIVORS: ROLE OF INFLAMMATORY PREDICTORS

Infection-triggered perturbation of the immune system, which was observed after previous coronavirus outbreaks, could induce psychiatric sequelae. The spreading of the Coronavirus-19 (COVID-19) pandemic could be associated with psychiatric implications. In this study, we aimed to evaluate the association between inflammatory biomarkers and the levels of depression and anxiety in patients who recovered from COVID-19.We screened 109 COVID-19 survivor adults for psychiatric symptoms on the 15th day of follow-up after discharge from the hospital. The patients were split into two groups, the ones with depression and anxiety, and the ones without depression or anxiety, after the psychiatric interview. Self-rating Beck Depression Inventory (BDI) and Beck Anxiety Inventory (BAI) were applied to assess the levels in patients with depression and anxiety. We collected and recorded the sociodemographic information, clinical data, and baseline inflammatory markers.Higher baseline neutrophil/lymphocyte ratio (NLR) and systemic immune-inflammation index (SII) were found in patients with depression and anxiety. Higher levels of depression and anxiety were found in younger and female patients. Besides, a significant correlation was found between BAI and ferritin levels in patients with anxiety, while no association was found between BAI and other inflammatory biomarkers. Moreover, no significant relationship was found between BDI scores and inflammatory biomarkers in patients with depression.COVID-19 primarily affects the respiratory and cardiovascular systems. Nonetheless, psychiatric involvement is not uncommon and can lead to severe problems if not detected and managed at an early stage. It is recommended that clinicians should be vigilant in terms of psychiatric involvement in COVID-19 patients presenting with high inflammatory parameters.

Promising Effects Of Traditional Chinese Medicines And Isolated Compounds Against SARS-CoV-2

Traditional Chinese Medicine (TCM) was used effectively to treat previous coronavirus outbreaks with minimal side-effects and several TCMs have been highlighted as potential treatments for COVID-19. In particular, Glycyrrhiza glabra L. has been highlighted as useful for decreasing the disease severity in infected people. Here, Cock discusses the effects of TCM and isolated compounds against SARS-CoV-2.

COVID-19 and pregnancy: Lessons from 2020

The outbreak and spread of the coronavirus disease 2019 pandemic has led to an unprecedented wealth of literature on the impact of human coronaviruses on pregnancy. The number of case studies and publications alone are several orders of magnitude larger than those published in all previous human coronavirus outbreaks combined, enabling robust conclusions to be drawn from observations for the first time. However, the importance of learning from previous human coronavirus outbreaks cannot be understated. In this narrative review, we describe what we consider to the major learning points arising from the SARS-CoV-2 pandemic in relation to pregnancy, and where these confound what might have been expected from previous coronavirus outbreaks.

MATERNALAND PERINATAL OUTCOMES WITH COVID-19: A TERTIARY CARE CENTRE STUDY

Background: With the exponential increase in the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2/COVID-19) worldwide, an increasing proportion of pregnant women are now infected during their pregnancy. The knowledge gained from previous human coronavirus outbreaks suggests that pregnant women and their fetuses are particularly susceptible to poor outcomes. The aim of this study was to summarize the maternal and perinatal outcomes of pregnant women infected with COVID-19 during their pregnancy. Methods:Eligibility criteria included pregnant women positive for COVID-19 as detected by real-time polymerase chain reaction (PCR). Results: Atotal of 40 pregnant women positive for COVID-19 as conrmed by RT-PCR, were included in the study. 5% cases had preterm deliveries and LSCS was the preferred mode of delivery in 28 of 40 i.e., 70% cases. There was a tendency for low Apgar score at birth, higher rates of fetal distress, meconium, NICU admissions. There was one IUD only in this study. The treatment patterns of COVID-19 infection among pregnant women during their pregnancy or following delivery was mostly supportive in the form of oxygen and antibiotic therapy. Conclusions: Although the majority of mothers were discharged without any major complications, severe maternal morbidity as a result of COVID-19 were reported. Vertical transmission of the COVID-19 could not be ruled out. Pregnant infected women had different symptoms, and they were given mostly supportive treatments than the general infected population. Careful monitoring of pregnancies with COVID-19 and measures to prevent neonatal infection are warranted.

Long COVID and mental health.

Long COVID and mental health.

Coronavirus, the King Who Wanted More Than a Crown: From Common to the Highly Pathogenic SARS-CoV-2, Is the Key in the Accessory Genes?

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), that emerged in late 2019, is the etiologic agent of the current “coronavirus disease 2019” (COVID-19) pandemic, which has serious health implications and a significant global economic impact. Of the seven human coronaviruses, all of which have a zoonotic origin, the pandemic SARS-CoV-2, is the third emerging coronavirus, in the 21st century, highly pathogenic to the human population. Previous human coronavirus outbreaks (SARS-CoV-1 and MERS-CoV) have already provided several valuable information on some of the common molecular and cellular mechanisms of coronavirus infections as well as their origin. However, to meet the new challenge caused by the SARS-CoV-2, a detailed understanding of the biological specificities, as well as knowledge of the origin are crucial to provide information on viral pathogenicity, transmission and epidemiology, and to enable strategies for therapeutic interventions and drug discovery. Therefore, in this review, we summarize the current advances in SARS-CoV-2 knowledges, in light of pre-existing information of other recently emerging coronaviruses. We depict the specificity of the immune response of wild bats and discuss current knowledge of the genetic diversity of bat-hosted coronaviruses that promotes viral genome expansion (accessory gene acquisition). In addition, we describe the basic virology of coronaviruses with a special focus SARS-CoV-2. Finally, we highlight, in detail, the current knowledge of genes and accessory proteins which we postulate to be the major keys to promote virus adaptation to specific hosts (bat and human), to contribute to the suppression of immune responses, as well as to pathogenicity.

The Differences in Clinical Presentation, Management, and Prognosis of Laboratory-Confirmed COVID-19 between Pregnant and Non-Pregnant Women: A Systematic Review and Meta-Analysis.

Background: The coronavirus disease 2019 (COVID-19) pandemic has affected millions of people across the globe. Previous coronavirus outbreaks led to worsened symptoms amongst pregnant women, suggesting that pregnant women are at greater risk. Objectives: Our aim is to investigate the differences in clinical presentation, management, and prognosis of COVID-19 infection in pregnant and non-pregnant women. Methods: We ran a search on electronic databases and analysis of the relevant articles was done using Revie Manager 5.4. Results: The review consists of nine studies comprising 591,058 women (28,797 pregnant and 562,261 non-pregnant), with most of the data derived from two large studies. The risk of experiencing fever (RR: 0.74; 95% CI: 0.64–0.85), headache (RR: 0.77; 95% CI: 0.74–0.79), myalgia (RR: 0.92; 95% CI: 0.89–0.95), diarrhea (RR: 0.40, 95% CI: 0.39–0.43), chest tightness (RR: 0.86; 95% CI: 0.77–0.95), and expectoration (RR: 0.45; 95% CI: 0.21–0.97) were greater amongst non-pregnant COVID-19-infected women. Pregnant women with COVID-19 were less likely to be obese (RR: 0.68; 95% CI: 0.63–0.73) or have a smoking history (RR: 0.32; 95% CI: 0.26–0.39). COVID-19-infected non-pregnant women had a higher frequency of comorbidity such as chronic cardiac disease (RR: 0.58; 95% CI: 0.44–0.77), renal disease (RR: 0.45; 95% CI: 0.29–0.71), and malignancy (RR: 0.82; 95% CI: 0.68–0.98), compared to COVID-19-infected pregnant women. The risk of ICU admission (RR: 2.26; 95% CI: 1.68–3.05) and requirement of invasive mechanical ventilation (RR: 2.68; 95% CI: 2.07–3.47) were significantly higher amongst pregnant women. Conclusions: Although the frequency of risk factors and the risk of experiencing clinical symptoms of COVID-19 were higher among non-pregnant women, COVID-19-infected pregnant women had a higher requirement of ICU admission and invasive mechanical ventilation compared to non-pregnant COVID-19-infected women. More well-conducted studies from varying contexts are needed to draw conclusions. Prospero registration: CRD42020204638.

Characterization of Patients With Type 2 Diabetes Mellitus and COVID-19

The coronavirus is a pathogen that mainly attacks the human respiratory system Previous coronavirus outbreaks (CoV) include severe acute respiratory syndrome (SARS), the clinical spectrum of COVID19 is very broad ranging from mild symptoms to ARDS to multiple organ failure and death. A history of DM2, advanced age and other comorbidities are considered predictors of higher morbidity and mortality, it is also known that blood glucose and DM levels are independent predictors of morbidity and mortality in patients with SARS. It should be remembered that patients with DM2 suffer from a chronic low grade inflammation that could facilitate the cytokine storm which in turn would be the cause of severe cases of COVID 19 pneumonia and the eventual death of many patients. Glucocorticoids have a stimulating and inhibitory effect on the immune response according to the moment in which it is administered and its circulating levels insulin therapy has been shown to decrease inflammation. For the control of glycemia the objectives must be individualized. Glycemic and individualized targets for non critical hospitalized patients have been established by different scientific societies such as ADA and AACE and Endocrine Society. In Honduras the protocol for the clinical management of adult patients with COVID 19 was developed to establish and standardize timely treatment in patients with suspected or confirmed COVID 19 which consists of the MAIZ scheme and the MAIZ scheme AAA. A retrospective longitudinal descriptive study was carried out with a review of the data obtained from 32 patients diagnosed with DM2 and COVID19 during the months of June through September 2020 at the CAMI Comprehensive Medical Care Clinic located in the city of Tegucigalpa Honduras collecting epidemiological and clinical data. The results of the research show that of the 32 patients with DM2 and COVID 19, 59% (19) belong to the male gender and 41% (13) to the female gender, with an average age of 60 years. In the COVID19 severity classification the evaluated patients presented in the following condition mild 25% (8), moderate 69% (22) and severe 6% (2). The diagnostic method used was detection of anti SARS CoV2 antibodies 56% (17) and TR-PCR 43% (14). 75% (24) received steroids, 8.69% (2) of the patients who used steroids in their management had hyperglycemia and required management with regular insulin. 100% (32) of the patients who were treated recovered without registering any death. Conclusions: are that the pathophysiological factors of DM2 in relation to the immune system of patients can be a determining factor to present a degree of severity greater than that presented by the general population that falls ill with COVID19. Adequate glycemic control can determine a better prognosis in the evolution of the disease despite its degree of severity.

Coronavirus disease 2019 (COVID-19): a brief overview of features and current treatment.

Since the report of the first cases of pneumonia caused by SARS-CoV-2 in December 2019, COVID-19 has become a pandemic and is globally overwhelming healthcare systems. The symptoms of COVID-19 vary from asymptomatic infection to severe complicated pneumonia with acute respiratory distress syndrome (ARDS) and multiple organ failure leading to death. The estimated case-fatality rate among infected patients in Wuhan, the city where the first case appeared, was 1.4%, with 5.1 times increase in the death rate among those aged above 59 years than those aged 30-59 years. In the absence of a proven effective and licensed treatment, many agents that showed activity against previous coronavirus outbreaks such as SARS and MERS have been used to treat SARS-CoV-2 infection. The SARS-CoV-2 is reported to be 80% homologous with SARS-CoV, and some enzymes are almost 90% homologous. Antiviral drugs are urgently required to reduce case fatality-rate and hospitalizations to relieve the burden on healthcare systems worldwide. Randomized controlled trials are ongoing to assess the efficacy and safety of several treatment regimens.