Severe Respiratory Syndrome Coronavirus Research Articles

Neutrophil to Lymphocyte Ratio on Admission to Predict Mortality of COVID-19 Elderly Patients

Severe Acute Respiratory Syndrome Corona Virus Disease-2 (SARS-COV-2) is the cause of COVID-19, which led to a global pandemic and high mortality rate, especially in elderly patients. The declining immune system in elderly patients and comorbid diseases lead to more severe symptoms and an increased mortality rate. Many studies have shown that a high Neutrophil-Lymphocyte Ratio (NLR) value can predict the severity and mortality of COVID-19. However, studies on NLR in elderly patients in Indonesia have rarely been conducted. This study aimed to determine the role of NLR on admission as a mortality predictor in COVID-19 elderly patients who underwent in-hospital treatment. This research is an analytical observational study with a retrospective cohort method conducted in Bethesda Hospital, Yogyakarta, Indonesia. The research subjects were selected from July 2020 to October 2021 according to inclusion and exclusion criteria. Inclusion criteria were all elderly COVID-19 patients with an age limit of > 60 years old who had complete hemogram data on admission, demographic data, diagnostic criteria, types of comorbid diseases, and patient outcomes (survivor or non-survivor). The exclusion criteria were elderly COVID-19 patients with incomplete Electronic Medical Records (EMR). This study found 122 elderly patients with COVID-19 with a mortality rate of 30.33%. The result showed that NLR on admission significantly increased significantly in the non-survivor group compared to the survivor group. Multivariate Cox regression analysis presented severity (RR: 5.181; CI 1.662-16.154; p=0.005), comorbid diabetes mellitus (RR: 2.829; CI: 1.115-7.178), NLR > 6.04 (RR: 6.356; CI: 2.428-16.639) and other comorbid, namely thyroid, autoimmune, cancer, and anemia (RR: 15.836; CI: 1.841-136.234; p=0.012) as factors of mortality in hospitalized elderly patients.

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

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

Inhibition of SARS CoV 2 using Microbial Metabolites derived from Tannin Rich Fruit Kernels

Severe acute respiratory syndrome corona virus 2 (SARS-CoV2) is a highly pathogenic RNA virus. Inhibition of SARS CoV 2 by molecular docking using the microbial metabolites of tannin rich fruit kernels of Punica granatum, Mangifera indica, Phyllanthus emblica and Syzygium cumini produced using a probiotic bacterium Bacillus coagulans. SARS CoV2 uses its spike proteins to inhibit the viral entry and uses main protease and chymotrypsin like protease to inhibit protein transcription, translation, maturation and replication. The accelerated immune response which is cytokine storm, can be managed by inhibiting the activation of nuclear factor kappa B (NF-κB). Excess of tissue deposition on the lung causing fibrosis can be treated by inhibiting the fibrotic pathological pathway targeting the G coupled receptor protein mediator 40 and 84 (GPR40 and GPR84) to prevent fibroblast. “Autodocking of metabolites extracted from kernel Punica granatum and Mangifera indica results in identifying 1H-Purin-6-amine, [(2-fluorophenyl) methyl] and tricarbonyl (N-cyclopent-2-en-1-yl-N-phe nyl-1-4-.eta.-cyclohexa-1,3-dienecarboxamide)iron of which 1H-Purin-6-amine, [(2-fluorophenyl)methyl] or 6-(3-fluorobenzylamino) purine appears to be very effective against SARS CoV-2 inflammation and fibrosis as evidenced by molecular docking. The role of probiotic bacteria in the synthesis of bioactive metabolites is established as very significant.

Bowel Necrosis in the Setting of COVID-19 Infection, Report of 2 Cases

Severe respiratory syndrome coronavirus 2 (SARS-CoV-2) is well known for causing respiratory and other extrapulmonary manifestations. Patients infected with coronavirus disease 2019 (COVID-19) may demonstrate atypical presentations with gastrointestinal symptoms. Clinicians managing these patients should reserve a high index of suspicion for the rare complication of acute mesenteric ischemia (AMI). It is a challenging diagnosis that is often missed when presenting symptoms are subtle and nonspecific like nausea, emesis, or diarrhea. Outcomes are typically catastrophic and fatal as bowel ischemia progresses to necrosis but may be averted with timely diagnostic and therapeutic methods to swiftly restore blood flow.

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

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

Viral Infections, Are They a Trigger and Risk Factor of Alzheimer's Disease?

Alzheimer's Disease (AD), a progressive and debilitating condition, is reported to be the most common type of dementia, with at least 55 million people believed to be currently affected. Many causation hypotheses of AD exist, yet the intriguing link between viral infection and its possible contribution to the known etiology of AD has become an attractive focal point of research for the field and a challenging study task. In this review, we will explore the historical perspective and milestones that led the field to investigate the viral connection to AD. Specifically, several viruses such as Herpes Simplex Virus 1 (HSV-1), Zika virus (ZIKV), and severe cute respiratory syndrome coronavirus 2 (SARS-CoV-2), along with several others mentioned, include the various viruses presently considered within the field. We delve into the strong evidence implicating these viruses in the development of AD such as the lytic replication and axonal transport of HSV-1, the various mechanisms of ZIKV neurotropism through the human protein Musashi-1 (MSI1), and the spread of SARS-CoV-2 through the transfer of the virus through the BBB endothelial cells to glial cells and then to neurons via transsynaptic transfer. We will also explore beyond these mere associations by carefully analyzing the potential mechanisms by which these viruses may contribute to AD pathology. This includes but is not limited to direct neuronal infections, the dysregulation of immune responses, and the impact on protein processing (Aβ42 and hyperphosphorylated tau). Controversies and challenges of the virus-AD relationship emerge as we tease out these potential mechanisms. Looking forward, we emphasize future directions, such as distinct questions and proposed experimentations to explore, that the field should take to tackle the remaining unanswered questions and the glaring research gaps that persist. Overall, this review aims to provide a comprehensive survey of the past, present, and future of the potential link between viral infections and their association with AD development while encouraging further discussion.

Occupational and Return-To-Work Characteristics of Covid-19 Patients After Treated in Udayana University Hospital

Corona virus disease 2019 (COVID-19) is a new disease caused by severe acute respiratory syndrome corona virus 2 (SARS-COV-2). The COVID-19’s symptoms are fatigue, muscle pain, and psychological disorders. The purpose of this study was to describe the occupational characteristics and health conditions of COVID-19 patients who had recovered after being treated at Udayana University Hospital. This study is a descriptive study with a quantitative method and cross-sectional design. The research samples were 110 COVID-19 patients treated at Udayana University Hospital from June to August 2020 and taken using random sampling. The results showed that the highest proportion of respondents were aged between 24-44 years (44.5%), with almost equal proportions of women (50.1%) and men (49.09%). Most of them lived in Denpasar (46.36%). Most respondents work as private sector employees (24.55%), and 70% of them were using personal protective equipment (PPE) while working. Most respondents needed less than seven days to return to work after being declared “in recovery state” (60%), with the remaining 55.5% having a decreased work duration to be less than 8 hours per day. The proportion of respondents with comorbidities was 30.91%. As many as 27.27% were experiencing previously similar symptoms (fever, fatigue, cough) 4 to 5 months after being declared “cured.” COVID-19 patients who have recovered should be monitored for a longer period of time to evaluate the symptom reoccurrence and its impact on their occupational and health conditions.

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

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

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

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

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

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

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

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

Baseline Characteristics And Outcome Of Covid-19 Patients In Bangladesh

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

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

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

Assessment of Peripheral Perfusion in Severe Acute Respiratory Syndrome Corona virus 2 (Sars-Cov-2) Infection: An Exploratory Analysis with Near-Infrared Spectroscopy

Assessment of Peripheral Perfusion in Severe Acute Respiratory Syndrome Corona virus 2 (Sars-Cov-2) Infection: An Exploratory Analysis with Near-Infrared Spectroscopy

In silico evaluation of S-adenosyl-L-homocysteine analogs as inhibitors of nsp14-viral cap N7 methyltranferase and PLpro of SARS-CoV-2: synthesis, molecular docking, physicochemical data, ADMET and molecular dynamics simulations studies

A series of S-adenosyl-L-homosysteine (SAH) analogs, with modification in the base and sugar moiety, have been designed, synthesized and screened as nsp14 and PLpro inhibitors of severe acute respiratory syndrome corona virus (SARS-CoV-2). The outcomes of ADMET (Adsorption, Distribution, Metabolism, Excretion, and Toxicity) studies demonstrated that the physicochemical properties of all analogs were permissible for development of these SAH analogs as antiviral agents. All molecules were screened against different SARS-CoV-2 targets using molecular docking. The docking results revealed that the SAH analogs interacted well in the active site of nsp14 protein having H-bond interactions with the amino acid residues Arg289, Val290, Asn388, Arg400, Phe401 and π-alkyl interactions with Arg289, Val290 and Phe426 of Nsp14-MTase site. These analogs also formed stable H-bonds with Leu163, Asp165, Arg167, Ser246, Gln270, Tyr274 and Asp303 residues of PLpro proteins and found to be quite stable complexes therefore behaved as probable nsp14 and PLpro inhibitors. Interestingly, analog 3 showed significant in silico activity against the nsp14 N7 methyltransferase of SARS-CoV-2. The molecular dynamics (MD) and post-MD results of analog 3 unambiguously established the higher stability of the nsp14 (N7 MTase):3 complex and also indicated its behavior as probable nsp14 inhibitor like the reference sinefungin. The docking and MD simulations studies also suggested that sinefungin did act as SARS-CoV-2 PLpro inhibitor as well. This study’s findings not only underscore the efficacy of the designed SAH analogs as potent inhibitors against crucial SARS-CoV-2 proteins but also pinpoint analog 3 as a particularly promising candidate. All the study provides valuable insights, paving the way for potential advancements in antiviral drug development against SARS-CoV-2. Communicated by Ramaswamy H. Sarma

Dental implications of COVID-19 - An insight

COVID-19 is a pandemic viral disease caused by Severe Acute Respiratory Syndrome corona virus 2(SARS -CoV-2). This pandemic has created a massive impact globally and is indeed a challenge to the mass healthcare management. Despite continuous, untiring efforts of the World Health Organisation (WHO) and the Health departments of various countries to curb this zoonotic disease, the propensity of the virus to spread through droplets, replicate and mutate has raised huge public health concerns. Oral cavity is an index of body’s health. Oral manifestations such as ageusia, angular chelitis, periodontal diseases, ulcers and fungal infections have been reported commonly in patients with COVID-19. These oral manifestations are valuable diagnostic criteria for the disease. Periodontal inflammation has been proved to increase the severity of the disease. Also, Periodontitis can present secondary to COVID-19 due to compromised immune system in this viral disease. Proper and adequate oral hygiene, appropriate use of corticosteroids and maintenance of glycemic control can reduce oral infections in COVID-19. Considering the increased risk of contracting the virus due to their proximity to the patients in the operating environment, oral health care providers must be aware of safety protocols and should strictly adhere to the recommendations by the regulatory authorities. This not only ensures higher safety, but also prevents the dental office from being a source of transmission for the virus. This review provides an overview on COVID-19 with an insight on its oral manifestations and a special emphasis on the safety protocols to be followed by dentists.

Transmission of COVID-19 in the presence of single-dose and double-dose vaccines with hesitancy: mathematical modeling and optimal control analysis

IntroductionThe unexpected emergence of novel coronavirus identified as SAR-CoV-2 virus (severe acute respiratory syndrome corona virus 2) disrupted the world order to an extent that the human activities that are core to survival came almost to a halt. The COVID-19 pandemic created an insurmountable global health crisis that led to a united front among all nations to research on effective pharmaceutical measures that could stop COVID-19 proliferation. Consequently, different types of vaccines were discovered (single-dose and double-dose vaccines). However, the speed at which these vaccines were developed and approved to be administered created other challenges (vaccine skepticism and hesitancy).MethodThis paper therefore tracks the transmission dynamics of COVID-19 using a non-linear deterministic system that accounts for the unwillingness of both susceptible and partially vaccinated individuals to receive either single-dose or double-dose vaccines (vaccine hesitancy). Further the model is extended to incorporate three time-dependent non-pharmaceutical and pharmaceutical intervention controls, namely preventive control, control associated with screening-management of both truly asymptomatic and symptomatic infectious individuals and control associated with vaccination of susceptible individuals with a single dose vaccine. The Pontryagin's Maximum Principle is applied to establish the optimality conditions associated with the optimal controls.ResultsIf COVID-19 vaccines administered are imperfect and transient then there exist a parameter space where backward bifurcation occurs. Time profile projections depict that in a setting where vaccine hesitancy is present, administering single dose vaccines leads to a significant reduction of COVID-19 prevalence than when double dose vaccines are administered. Comparison of the impact of vaccine hesitancy against either single dose or double dose on COVID-19 prevalence reveals that vaccine hesitancy against single dose is more detrimental than vaccine hesitancy against a double dose vaccine. Optimal analysis results reveal that non-pharmaceutical time-dependent control significantly flattens the COVID-19 epidemic curve when compared with pharmaceutical controls. Cost-effectiveness assessment suggest that non-pharmaceutical control is the most cost-effective COVID-19 mitigation strategy that should be implemented in a setting where resources are limited.DiscussionPolicy makers and medical practitioners should assess the level of COVID-19 vaccine hesitancy inorder to decide on the type of vaccine (single-dose or double-dose) to administer to the population.

Into the Dark Serum Proteome: Personalized Features of IgG1 and IgA1 Repertoires in Severe COVID-19 Patients

Serum proteomics has matured and is now able to monitor hundreds of proteins quantitatively in large cohorts of patients. However, the fine characteristics of some of the most dominant proteins in serum, the immunoglobulins, are in these studies often ignored, due to their vast, and highly personalized, diversity in sequences. Here, we focus exclusively on these personalized features in the serum proteome and distinctively chose to study individual samples from a low diversity population: elderly donors infected by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). By using mass spectrometry-based methods, immunoglobulin IgG1 and IgA1 clonal repertoires were monitored quantitatively and longitudinally in more than 50 individual serum samples obtained from 17 Corona virus disease 2019 patients admitted to intensive care units. These clonal profiles were used to examine how each patient reacted to a severe SARS-CoV-2 infection. All 17 donors revealed unique polyclonal repertoires and substantial changes over time, with several new clones appearing following the infection, in a few cases leading to a few, very high, abundant clones dominating their repertoire. Several of these clones were de novo sequenced through combinations of top-down, middle-down, and bottom-up proteomics approaches. This revealed sequence features in line with sequences deposited in the SARS-CoV-specific antibody database. In other patients, the serological Ig profiles revealed the treatment with tocilizumab, that subsequently dominated their serological IgG1 repertoire. Tocilizumab clearance could be monitored, and a half-life of approximately 6 days was established. Overall, our longitudinal monitoring of IgG1 and IgA1 repertoires of individual donors reveals that antibody responses are highly personalized traits of each patient, affected by the disease and the chosen clinical treatment. The impact of these observations argues for a more personalized and longitudinal approach in patients’ diagnostics, both in serum proteomics as well as in monitoring immune responses.

A Concise Review: Nutritional Interventions for Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)

Wuhan, China reported a novel coronavirus-related sickness in late 2019, which quickly spread into a global epidemic. One crucial factor in combating the coronavirus infection appears to be the presence of a robust, long-lasting, and active immune system. The immune response is affected by several factors, including food. Nutritional insufficiency can cause immune deficits, making infections more likely to cause fatality. Thus, understanding numerous behaviors, particularly dietary habits, is essential to determining their capacity to reduce severe acute respiratory syndrome coronavirus 2 risks and improve prognosis. In this paper, the authors summarize the complex interaction between nutritional status and severe acute respiratory syndrome corona virus 2 infections, as well as the consequences of poor nutrients with regard of the extent to which disease is affected. The literature was compiled by searching a number of reputable scientific databases including Scopus, Science Direct, Springer, Nature, PubMed, Web of Science resources. The accumulating evidence demonstrates that malnutrition impairs the immune system's ability to function, weakening the body's infection resistance. This review emphasizes the significance of nutritional status in the care of coronavirus disease patients as well as demonstrates that functional foods may contribute to better outcomes. Ageing, Obesity, Malnutrition, Undernutrition, Lack of exercise are having a devastating effect on people's health in general and during this coronavirus disease. The severity and prognosis of coronavirus illness seem to be significantly influenced by lifestyle choices, nutritional imbalances, and impaired immune response.

Acceptance for coronavirus disease 19 vaccines among pregnant women seeking antenatal care in tertiary care hospital

: Corona virus disease 2019 (COVID -19) is caused by the Severe acute respiratory syndrome corona virus (SARS-COV-2). In the absence of an effective treatment, vaccination becomes the main modality to control the incidence of infectious diseases. Hence, there is a need to estimate the attitudes and willingness among pregnant women for COVID 19 Vaccine.To estimate the frequency of COVID 19 Vaccine acceptance and non acceptance in pregnant women attending antenatal OPD. To describe the factors associated with non acceptance of COVID 19 Vaccine in pregnant women attending antenatal OPDThis is an observational cross-sectional study where 500 pregnant women attending antenatal care were counseled about the COVID-19 vaccine. Women who refused the vaccine were asked about the reasons for refusal and the same was noted. 95.6% accepted the vaccine and 4.4% did not accept. Majority belonged to 21 to 25 years(45% acceptors and 72% non acceptors), were second gravidas (38.7% acceptors and 54.5% non acceptors) and were between 25 to 36 weeks gestation(52.7% acceptors and 50% non acceptors). 13.8% of acceptors and 4.5% of non acceptors had previous history of abortions. Commonest concern was fear of vaccine related complications and fear of harming the fetus. Vaccine reactions followed by fear of harming the baby were the commonest reasons for non acceptance. Vaccine acceptance was high in this study (95.6%). Vaccine induced reactions followed by fear of harming the baby were the commonest reasons for non acceptance.