Coronavirus Disease 2019 Therapy Research Articles

Assessment of the potential interactions between favipiravir and radiocontrast agents

BACKGROUND In cases of coronavirus disease 2019 (COVID-19), favipiravir is commonly included to the therapy regimen. Drug interactions between favipiravir and other COVID-19 therapy drugs are frequently researched. However, no research on possible drug interactions between Favipiravir and radiocontrast agents, which have become almost crucial in diagnostic processes while not being part of the treatment, has been found. AIM To determine potential medication interactions between Favipiravir and radiocontrast agents. METHODS The study comprised patients who were taking Favipiravir for COVID-19 therapy and underwent a contrast-enhanced computed tomography (CT) or magnetic resonance imaging (MRI) test while taking the medicine. The computerized patient files of the cases included in the study, as well as the pharmacovigilance forms in the designated hospital, were evaluated for this purpose. RESULTS The study included the evaluation of data from 1046 patients. The study sample's mean age was 47.23 ± 9.48 years. The mean age of cases with drug interactions was statistically significant greater than that of cases with no drug interactions (P = 0.003). When evaluated with logistic regression analysis, a 1-year raises in age increases the risk of developing drug interactions by 1.63 times (P = 0.023). There was no statistically significant difference in the occurrence of medication interactions between the sexes (P = 0.090). Possible medication interactions were discovered in 42 cases (4%). CONCLUSION The findings of this study revealed that the most notable findings as a result of the combined use of contrast agents and favipiravir were increased creatinine and transaminase values, as well as an increase in the frequency of nausea and vomiting. The majority of drug interactions discovered were modest enough that they were not reflected in the clinic. Drug interactions become more common as people get older.

Clinical efficacy of prophylactic intravenous immunoglobulin for elderly DLBCL patients with hypogammaglobulinemia in the COVID-19 pandemic era.

Elderly patients diagnosed with diffuse large B-cell lymphoma (DLBCL) undergoing reduced intensity R-CHOP therapy are at a heightened risk of acquiring infections, notably coronavirus disease 2019 (COVID-19) infection. This study aimed to evaluate the efficacy of intravenous immunoglobulin (IVIG) as prophylaxis against COVID-19 in this vulnerable population. A total of 125 elderly patients with DLBCL undergoing reduced intensity R-CHOP therapy were analyzed in this prospective, multicenter study. Patients with hypogammaglobulinemia were categorized into IVIG and non-IVIG groups, while those with normal immunoglobulin levels constituted the observation group. The study evaluated COVID-19 infection rates, therapy response, and safety outcomes. Among the enrolled patients (median age: 77 years), 89 patients (71.2%) presented with hypogammaglobulinemia at diagnosis, and 56 patients enrolled in the IVIG administration group. IVIG administration remarkably reduced COVID-19 infection rates compared to non-IVIG recipients (8.9% vs. 24.6%; p =0.040). Notably, patients over 80 years old were more susceptible to COVID-19. Patients on IVIG exhibited good tolerance with manageable adverse events. Among patients with hypogammaglobulinemia who received IVIG, 40.5% of patients developed additional immunoglobulin deficiencies during chemotherapy. One or more new hypogammaglobulinemia occurred during chemotherapy in 72% of patients with hypogammaglobulinemia who did not receive IVIG, and in 61.3% of patients who did not have hypogammaglobulinemia at diagnosis. IVIG showed promise in reducing COVID-19 infections among elderly patients with DLBCL receiving reduced intensity R-CHOP therapy. This highlights IVIG's potential as a prophylactic measure, necessitating further investigation to optimize dosing, administration schedules, and potential interactions with vaccination strategies.

The GC-MS Analysis of Kabasura Kudineer: A Vital Siddha Drug in COVID-19 Therapy

ABSTRACT Introduction: This study focuses on the gas chromatography-mass spectrometry (GC-MS) analysis of Kabasura Kudineer, a Siddha formulation renowned for its properties against cold and exclusively utilized during the coronavirus disease 2019 (COVID-19) pandemic. Methods: The medication was obtained from a reputable Siddha vendor in Chennai, India, and subsequently extracted and subjected to GC-MS analysis. Results: The GC-MS profiling revealed the presence of several molecules, including benzoic acid, eugenol, alpha-ylangeneol, trans-2,4-dimethylthiane, S, S-dioxide, humulene, methyl 4,7,10,13-hexadecatetraenoate, 17-octadecynoic acid, 1-hexadecyn-3-ol, 3,7,11,15-tetramethyl, sulfurous acid, butyl heptadecyl ester, chloroacetic acid, tetradecyl ester, n-propyl cinnamate, oleyl alcohol, trifluoroacetate, 1-heptatriacotanol, and fenretinide. These compounds exhibit expansive medicinal roles. Conclusion: Kabasura Kudineer emerges as a highly effective remedy for cold-related ailments, particularly owing to the presence of bioactive compounds such as eugenol and humulene. These constituents play pivotal roles in antimicrobial and anti-inflammatory activities. Further investigations into the individual medicinal efficacy of each identified molecule are warranted to substantiate the therapeutic potential of Kabasura Kudineer, providing valuable insights for future applications.

Unraveling the copper-death connection: Decoding COVID-19‘s immune landscape through advanced bioinformatics and machine learning approaches

ABSTRACT This study aims to analyze Coronavirus Disease 2019 (COVID-19)-associated copper-death genes using the Gene Expression Omnibus (GEO) dataset and machine learning, exploring their immune microenvironment correlation and underlying mechanisms. Utilizing GEO, we analyzed the GSE217948 dataset with control samples. Differential expression analysis identified 16 differentially expressed copper-death genes, and Cell type Identification By Estimating Relative Subsets Of RNA Transcripts (CIBERSORT) quantified immune cell infiltration. Gene classification yielded two copper-death clusters, with Weighted Gene Co-expression Network Analysis (WGCNA) identifying key module genes. Machine learning models (random forest, Support Vector Machine (SVM), Generalized Linear Model (GLM), eXtreme Gradient Boosting (XGBoost)) selected 6 feature genes validated by the GSE213313 dataset. Ferredoxin 1 (FDX1) emerged as the top gene, corroborated by Area Under the Curve (AUC) analysis. Gene Set Enrichment Analysis (GSEA) and Gene Set Variation Analysis (GSVA) revealed enriched pathways in T cell receptor, natural killer cytotoxicity, and Peroxisome Proliferator-Activated Receptor (PPAR). We uncovered differentially expressed copper-death genes and immune infiltration differences, notably CD8 T cells and M0 macrophages. Clustering identified modules with potential implications for COVID-19. Machine learning models effectively predicted COVID-19 risk, with FDX1‘s pivotal role validated. FDX1‘s high expression was associated with immune pathways, suggesting its role in COVID-19 pathogenesis. This comprehensive approach elucidated COVID-19-related copper-death genes, their immune context, and risk prediction potential. FDX1‘s connection to immune pathways offers insights into COVID-19 mechanisms and therapy.

The impact understanding of exosome therapy in COVID-19 and preparations for the future approaches in dealing with infectious diseases and inflammation

Cytokine storms, which result from an abrupt, acute surge in the circulating levels of different pro-inflammatory cytokines, are one of the complications associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. This study aimed to assess the effect of exosomes on the release of pro-inflammatory cytokines in patients with coronavirus disease 2019 (COVID-19) and compare it with a control group. The cytokines evaluated in this study were TNF-α, IL-6, IL-17, and IFN-γ. The study compared the levels of these pro-inflammatory cytokines in the peripheral blood mononuclear cells (PBMCs) of five COVID-19 patients in the intensive care unit, who were subjected to both inactivated SARS-CoV-2 and exosome therapy, with those of five healthy controls. The cytokine levels were quantified using the ELISA method. The collected data was analyzed in SPSS Version 26.0 and GraphPad Prism Version 9. According to the study findings, when PBMCs were exposed to inactivated SARS-CoV-2, pro-inflammatory cytokines increased in both patients and healthy controls. Notably, the cytokine levels were significantly elevated in the COVID-19 patients compared to the control group P-values were < 0.001, 0.001, 0.008, and 0.008 for TNF-α, IL-6, IL-17, and IFN-γ, respectively. Conversely, when both groups were exposed to exosomes, there was a marked reduction in the levels of pro-inflammatory cytokines. This suggests that exosome administration can effectively mitigate the hyperinflammation induced by COVID-19 by suppressing the production of pro-inflammatory cytokines in patients. These findings underscore the potential safety and efficacy of exosomes as a therapeutic strategy for COVID-19.

A single-center experience of COVID-19 infection in patients with primary immunodeficiency

Reported outcomes in patients with primary immunodeficiency (PID) infected by coronavirus disease 2019 (COVID-19) have been variable owing to a combination of viral strain heterogeneity, differences in patient populations and health systems, and local availability of vaccination and specific COVID-19 therapies. There are few reports on the experience of Australian patients with PID during the pandemic. In this retrospective study, we describe the baseline characteristics and short-term outcomes of patients with PID who were infected by COVID-19 and known to the Royal Melbourne Hospital, a major tertiary center in Victoria, Australia. Between April 2021 and April 2022, a total of 31 of 138 patients with PID were affected by COVID-19. More than half of them had 3 vaccine doses at the time of infection (which at the time was considered being fully vaccinated) and received COVID-19-targeted treatment. All of the infected patients had ambulatory disease, with no cases of morbidity or mortality. In line with the current literature, the PID subtypes described did not appear to independently predict worse outcomes. Some protective factors include this cohort's relatively younger average age and its high uptake of vaccination and COVID-19 therapies.

Medication adherence of cardiovascular patients after COVID-19: 6-month follow-up

Aim. To evaluate the relationship of various factors with adherence to therapy in cardiovascular patients after a coronavirus disease 2019 (COVID-19).Material and methods. The study included 284 patients (inpatients — 176, outpatients — 108) with cardiovascular diseases (hypertension, heart failure (HF), coronary artery disease, atrial fibrillation) after COVID-19. We collected data on cardiovascular history, made a questionnaire survey about COVID-19 course (symptoms, their severity, self-assessment of the disease severity). Paraclinical diagnostic investigations were carried out. In addition, 1, 3, 6 months after recovery, all respondents were invited for examination, laboratory tests, and survey using the Hospital Anxiety and Depression Scale (HADS). Cardiovascular therapy adherence was assessed at 1, 3 and 6 months after recovery and adherence to COVID-19 treatment 1 month after inclusion in the study by comparing the compliance of the drugs prescribed at discharge with its actual use.Results. In total, 212 respondents continued study participation after 1 month, while 64,2% were adherent to cardiovascular therapy and 56,6% — to COVID-19 therapy. Compliance at 3 and 6 months was 60,4% (n=212) and 52,8% (n=188), respectively. A moderate correlation was found between adherence to treatment and the persistence of apprehension 1 month after recovery (r=0,33, p&lt;0,05), moderate or severe weakness during disease (r=0,31, p&lt;0,05), COVID-19 severity (r=0,39, p&lt;0,05). Inhospital respondents with lung tissue involvement &gt;25% (n=64, 36,4%) were more adherent to standard cardiovascular therapy, prescribed in accordance with clinical guidelines (r=0,336, p&lt;0,05). Adverse events in the form of a hypertensive crisis, arrhythmias, decompensated HF 1, 3, 6 months after recovery significantly increased the compliance with medical recommendations (p&lt;0,05). Medication adherence regarding COVID-19 was associated with the disease severity, HF history, apprehension and anxiety, weakness, and decreased exercise tolerance (p&lt;0,05).Conclusion. After 1 month, adherence to cardiovascular and COVID-19 therapy did not differ significantly (p&gt;0,05). Compliance after 1, 3, 6 months was positively influenced by COVID-19 severity, the subjective feeling of weakness, apprehension and anxiety during disease and the persistence of a subjective feeling of anxiety after recovery. Adverse events (hypertensive crisis, arrhythmia, decompensated HF) during 1, 3 and 6 months after COVID-19 significantly (p&lt;0,05) increased adherence to treatment.

Low-dose radiation therapy for COVID-19

Background. Radiation therapy is one of the most effective treatments in patients with malignant neoplasms, it also plays an important role in the treatment of non-oncological di­seases. The coronavirus disease 2019 (COVID-19) pandemic has prompted a review of the long-forgotten idea of using low-dose radiation therapy (LDRT) in patients with lobar and interstitial pneumonia. Historically, from 1905 to the mid-1940s, LDRT was used to treat pneumonia, and evidence suggests that it might improve survival and provide rapid relief of respiratory symptoms. The purpose was to summarize current information about ­using low-dose radiation therapy in the treatment of patients with ­COVID-19. Materials and methods. A selection of publications was carried out, which covered information on the possibilities of using low-dose radiation therapy in the treatment of patients with COVID-19. At the first stage, a search was conducted for lite­rary sources using the keywords: COVID-19, low-dose radiation therapy. At the second stage, summaries of articles were studied and publications that did not meet the research criteria were excluded. At the third stage, the full texts of the selected articles were studied for compliance with the criteria for inclusion in the reference list and research relevance. Results. As of August 1, 2023, according to ClinicalTrials.gov, among 9,244 clinical trials associated with COVID-19, sixteen are currently being conduc­ted. They examine the effectiveness of LDRT in the treatment of patients with COVID-19 and already involve 1,038 patients. The largest number of studies is conducted in European countries. It has been shown that LDRT selectively attenuates oxidative stress to an inflammatory stimulus and inhibits the nitric oxide production pathway. This may contribute to its anti-inflammatory and vascular effects. At the same time, heme oxygenase 1 and other antioxidants are induced, they are mediated by Nrf2, which is the main regulator of endogenous antioxidant, anti-stress, analgesic reactions, and is also closely related to nicotinamide adenine dinucleotide phosphate and the metabolic pathway of pentose phosphate. Nrf2 may be critical for pain relief associated with edema formation and possibly plays a major role in the effects of LDRT, whereas direct functional effects of low-dose radiation on the autonomic nervous system and nociception are likely to be smaller. Conclusions. From 1905 to 1946, researchers published the results of more than 15 clinical studies on the effectiveness of radiotherapy for inflammatory lung diseases, which included more than 850 patients and demonstrated the high therapeutic effectiveness of radiation therapy in the indicated pathology. Today, there are 16 ongoing clinical trials in the world devoted to the study of LDRT effectiveness in the treatment of patients with COVID-19, in which 1,038 patients have already been involved. The risk of radiation-induced lung and breast cancer in a 25-year-old woman exposed to 1 Gy whole chest radiation may be as high as 5.9 and 5.5 %, respectively.

Good Health and Well- being in the Different Current Treatment Strategies for Coronavirus Disease 2019 (COVID-19): A mini Review

People of all ages must lead healthy lives and advance wellbeing in order for sustainable development to occur. The global economy is being weakened by COVID-19, which is also disrupting the lives of billions of people worldwide. By the end of 2019, the novel coronavirus that causes severe acute respiratory syndrome (SARS-CoV2) abruptly began to spread, giving rise to the term coronavirus disease 2019 (COVID19). There is currently no proven treatment for COVID-19. Finding efficient therapies is urgently needed to care for patients and control the spread of SARS-CoV2 among humans. The treatment medicines that may be employed to fight the SARS-CoV2 infection were emphasized for the current review. Numerous medications have been repurposed for COVID19 therapy since the disease's emergence. Regarding the treatment of COVID-19, existing medications such as chloroquine (CQ), Along with chloroquine, We also investigated monoclonal antibodies, restorative plasma, Chinese herbal treatment, and natural compounds, including remdesivir, hydroxychloroquine (HCQ), and nucleoside analogues. Although initial clinical trials demonstrated that CQ/HCQ had antiviral activities, further investigations revealed significant debate over its suitability for treating COVID-19. Preventing the virus from interacting with human cell receptors for angiotensin converting enzyme 2 is one of these medicinal medicines' biological defenses against SARS-CoV2. Many of studies about the role of nanomaterials in treating Covid-19, based on their unique physical, chemical and biological properties, which depend on shape and size, as the use of nanomaterials is considered a promising future to eliminate viruses, including Covid-19.

The Potential Role of Nitric Oxide as a Therapeutic Agent against SARS-CoV-2 Infection.

The global coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become the greatest worldwide public health threat of this century, which may predispose multi-organ failure (especially the lung) and death despite numerous mild and moderate symptoms. Recent studies have unraveled the molecular and clinical characteristics of the infectivity, pathogenicity, and immune evasion of SARS-CoV-2 and thus improved the development of many different therapeutic strategies to combat COVID-19, including treatment and prevention. Previous studies have indicated that nitric oxide (NO) is an antimicrobial and anti-inflammatory molecule with key roles in pulmonary vascular function in the context of viral infections and other pulmonary disease states. This review summarized the recent advances of the pathogenesis of SARS-CoV-2, and accordingly elaborated on the potential application of NO in the management of patients with COVID-19 through antiviral activities and anti-inflammatory properties, which mitigate the propagation of this disease. Although there are some limits of NO in the treatment of COVID-19, it might be a worthy candidate in the multiple stages of COVID-19 prevention or therapy.

Herbal medicine Eunkyo-san (Yinqiao-san) for COVID-19: A telemedicine case series

Coronavirus disease 2019 (COVID-19) cases surged across South Korea during the omicron-variant wave. We aimed to report the effectiveness of herbal medicine administered through telemedicine consultations as an adjunctive therapy for COVID-19. Patients with confirmed COVID-19 who were self-isolating at home were provided telephone consultations through a Korean Medicine clinic between January and March 2022. On the basis of their dominant symptoms, the patients were prescribed Eunkyo-san for seven days. Patients were asked to evaluate the severity of their COVID-19 symptoms before and after treatment by numeric rating scale. Of ten patients, more than half of them reported cough, fever, headache, and sore throat on the first telephone consultation. Patients reported that all symptoms related to COVID-19 disappeared completely on the second consultation. No severe adverse events were identified. The results of this case series suggest that Eunkyo-san administration can be a beneficial adjunctive therapy for patients with COVID-19.

Effectiveness of remdesivir-based therapy for moderate COVID-19: comparison of Omicron and other variant phases

Remdesivir is an antiviral drug for the treatment of coronavirus disease 2019 (COVID-19), and the sustained antiviral activity against Omicron variants of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has been reported. In this single-center retrospective study, we first compared the clinical effectiveness of remdesivir-based therapy between Omicron and other variant phases of moderate COVID-19 in a real-world setting. Between Dec 2020 and July 2022, a total of 406 patients with COVID-19 pneumonia were treated with remdesivir-based therapy on admission. The oxygen deterioration rate after initiation of treatment significantly decreased in the Omicron variant phase compared to the alpha and delta variant phases. In an adjusted multivariate Cox proportional hazards model, Omicron variant phase was significantly associated with delayed oxygen deterioration and early recovery from hypoxia. These favorable outcomes during the Omicron variant phase, compared to previous variant phases, might be due to the attenuation and the popularization of vaccination.

Blood-derived product therapies for SARS-CoV-2 infection and long COVID.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is capable of large-scale transmission and has caused the coronavirus disease 2019 (COVID-19) pandemic. Patients with COVID-19 may experience persistent long-term health issues, known as long COVID. Both acute SARS-CoV-2 infection and long COVID have resulted in persistent negative impacts on global public health. The effective application and development of blood-derived products are important strategies to combat the serious damage caused by COVID-19. Since the emergence of COVID-19, various blood-derived products that target or do not target SARS-CoV-2 have been investigated for therapeutic applications. SARS-CoV-2-targeting blood-derived products, including COVID-19 convalescent plasma, COVID-19 hyperimmune globulin, and recombinant anti-SARS-CoV-2 neutralizing immunoglobulin G, are virus-targeting and can provide immediate control of viral infection in the short term. Non-SARS-CoV-2-targeting blood-derived products, including intravenous immunoglobulin and human serum albumin exhibit anti-inflammatory, immunomodulatory, antioxidant, and anticoagulatory properties. Rational use of these products can be beneficial to patients with SARS-CoV-2 infection or long COVID. With evidence accumulated since the pandemic began, we here summarize the progress of blood-derived product therapies for COVID-19, discuss the effective methods and scenarios regarding these therapies, and provide guidance and suggestions for clinical treatment.

Adjudicated thrombotic events in a cotemporary multicenter cohort of patients with COVID-19: findings from the CORONA-VTE Registry

Abstract Background Venous thromboembolism (VTE) and arterial thrombosis emerged among the main serious complications of coronavirus disease 2019 (COVID-19) in the early post-infection period and during convalescence. Data are less consistent about how the event rates may have changed over time considering the change in viral variants and COVID-19 therapies, and vaccination status. Purpose To report VTE and arterial thrombotic events in patients with COVID-19, and assess results by vaccination status and over time from a large multicenter patient-level US registry. Methods Adult patients with polymerase chain reaction-confirmed COVID-19 who received inpatient or outpatient care at Mass-General Brigham (MGB) Health system, the largest health system in the Massachusetts that serves 1.5 million patients, were eligible. Data elements were entered into a centralized database by trained research staff. Thrombotic events were adjudicated by two independent physicians. Outcomes were assessed at 30- and 90-day follow-up. Findings were pre-specified to be assessed separately for patients who were hospitalized with COVID-19 vs outpatients. Vaccination status was ascertained for subgroup analysis. Results The study included 4,123 patients from the MGB Health System from 3/13/2020 through 06/03/2022 (age: 53.5 ± 18 years; 55.9% female, Table). Among hospitalized patients, the cumulative incidence of VTE was 7.7% at day 90 (95% CI: 6.2-9.2%). Respective 30-day event rates for arterial thrombosis among hospitalized patients were 4.4% (95% CI: 3.2%-5.5%). Event rates were lower for outpatients (Figure, Panel A). Thirty-day cumulative incidence of VTE and arterial thrombosis/thromboembolism based on history of vaccination (restricted to cohort from 12/14/2020 onward) are presented in Panel B. Conclusions In this multicenter study 30-day adjudicated thrombotic events were frequent in patients with COVID-19, albeit lower among vaccinated patients. Follow-up for 90-day outcomes are being finalized and will be presented at ESC 2023.

Enhanced fatty acid oxidation through metformin and baicalin as therapy for COVID-19 and associated inflammatory states in lung and kidney

Progressive respiratory failure is the primary cause of death in the coronavirus disease 2019 (COVID-19) pandemic. It is the final outcome of the acute respiratory distress syndrome (ARDS), characterized by an initial exacerbated inflammatory response, metabolic derangement and ultimate tissue scarring. A positive balance of cellular energy may result crucial for the recovery of clinical COVID-19. Hence, we asked if two key pathways involved in cellular energy generation, AMP-activated protein kinase (AMPK)/acetyl-CoA carboxylase (ACC) signaling and fatty acid oxidation (FAO) could be beneficial. We tested the drugs metformin (AMPK activator) and baicalin (CPT1A activator) in different experimental models mimicking COVID-19 associated inflammation in lung and kidney. We also studied two different cohorts of COVID-19 patients that had been previously treated with metformin. These drugs ameliorated lung damage in an ARDS animal model, while activation of AMPK/ACC signaling increased mitochondrial function and decreased TGF-β-induced fibrosis, apoptosis and inflammation markers in lung epithelial cells. Similar results were observed with two indole derivatives, IND6 and IND8 with AMPK activating capacity. Consistently, a reduced time of hospitalization and need of intensive care was observed in COVID-19 patients previously exposed to metformin. Baicalin also mitigated the activation of pro-inflammatory bone marrow-derived macrophages (BMDMs) and reduced kidney fibrosis in two animal models of kidney injury, another key target of COVID-19. In human epithelial lung and kidney cells, both drugs improved mitochondrial function and prevented TGF-β-induced renal epithelial cell dedifferentiation. Our results support that favoring cellular energy production through enhanced FAO may prove useful in the prevention of COVID-19-induced lung and renal damage.

Convalescent Plasma Therapy for COVID-19 with Pregnancy in Sanglah Hospital, Denpasar

The Coronavirus Disease 2019 (COVID-19) was declared a pandemic by the World Health Organization (WHO). Pregnant females are a vulnerable population to contract COVID-19. The most promising therapies for COVID-19 infection are Remdesivir and Convalescent Plasma Therapy (CPT). Convalescent plasma therapy in COVID-19 with pregnancy is rare. A 26-year-old female with 29-30 weeks pregnancy with complaints of shortness of breath and cough was referred. Physical examination showed an increase in respiratory rate. Laboratory tests showed increased WBC (leukocytosis), anemia, thrombocytosis, Neutrophil-Lymphocyte Ratio (NLR), SGOT, and C-reactive protein. The results of the RT-PCR molecular biology test showed confirmed COVID-19. In treatment, complaints worsened with a respiratory rate of 32 beats/minute and oxygen saturation of 93%. The patient was treated with CPT and showed clinical improvement. Convalescent plasma therapy in pregnancy with COVID-19 aims to prevent the binding of spike protein (S) in the virus with the ACE-2 receptor in the host. Convalescent plasma therapy should be carried out in the right conditions according to the agreed criteria. Because clinical and laboratory improvements were observed in this study after convalescent plasma therapy was administered, it can be considered as an alternative therapy in severe clinical conditions.

Coronavirus disease (COVID-19)-associated mucormycosis (CAM): The unholy triad of COVID-19, diabetes mellitus, and corticosteroid therapy.

The whole world has battled with multiple waves of coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 virus. However, the second wave of COVID-19 had caused a worldwide havoc in terms of disease transmissibility, severity, and mortality. India has been among the worst hit countries during the second wave, which substantially overburdened and overwhelmed the Indian health care system. While secondary infections and co-infections among COVID-19 patients were increasingly being reported, COVID-19-associated mucormycosis (CAM) emerged as a new challenge particularly from India and became a matter of immediate concern. The most common causes attributed to the rise of CAM were undiagnosed/uncontrolled diabetes mellitus, excessive use of corticosteroids, and prolonged hospital stay, all of which create a perfect environment for mucormycosis infection to set in.

Politicization of Medical Care, Burnout, and Professionally Conflicting Emotions Among Physicians During COVID-19

ObjectiveTo evaluate the association of politicization of medical care with burnout, professional fulfillment, and professionally conflicting emotions (eg, less empathy, compassion; more anger, frustration, resentment). Participants and MethodsPhysicians in select specialties were surveyed between December 2021 and January 2022 using methods similar to our prior studies, with additional assessment of politicization of medical care; moral distress; and having had to compromise professional integrity, workload, and professionally conflicting emotions. ResultsIn a sample of 2780 physicians in emergency medicine, critical care, noncritical care hospital medicine, and ambulatory care, stress related to politicization of medical care was reported by 91.8% of physicians. On multivariable analysis, compromised integrity (odds ratio [OR], 3.64; 95% CI, 2.31 to 5.98), moral distress (OR, 2.82; 95% CI, 2.16 to 3.68), and feeling more exhausted taking care of patients with coronavirus disease 2019 (COVID-19) (OR, 3.46; 95% CI, 2.63 to 4.54) were associated with burnout. Compromised integrity, moral distress, and feeling more exhausted taking care of patients with COVID-19 were also statistically significantly associated with lower odds of professional fulfillment and professionally conflicting emotions. Stress related to conversations about non-approved COVID-19 therapies (OR, 1.74; 95% CI, 1.08 to 2.89), patient resistance to mask wearing (OR, 1.84; 95% CI, 1.35 to 2.55), and working more hours due to COVID (OR, 0.66; 95% CI, 0.49 to 0.89) were associated with professionally conflicting emotions. ConclusionMost physicians experienced intrusion of politics into medical care during the pandemic. These experiences are associated with professionally conflicting emotions, including less compassion and empathy, greater frustration, and resentment. COVID-19–related moral distress and compromised integrity were also associated with less professional fulfillment and greater occupational burnout.

In silico Molecular Docking Analysis of some Terpenoids against 3CLpro of SARS-CoV-2

The recent pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has raised global health concerns. The main viral protease called 3-chymotrypsin-like cysteine protease (3CLpro) plays an important role in viral replication by polyproteins processing that are translated from viral RNA. Therefore, the present in silico docking study aimed to assess the inhibitory actions of various terpenoids against 3CLpro of SARS-CoV-2. Molecular docking was performed using ArgusLab 4.0.1. a computational docking program and the protein-ligand interaction was visualized by using Pymol 1.7 software. The inhibitory activity of terpenoids like abietic acid, ferruginol, rosmarinic acid, zingiberine, sugiol, kaempferol and betulinic acid was tested against 3CLpro (PDB ID: 6M2N) using molecular docking paradigm while antiviral drugs- remdesivir, darunavir and hydroxychlorquine- were used as standards for comparison. All phyto-constituents showed an effective binding interaction with 6M2N, and the binding affinity was ranged from –8.854 to –13.398 as compared to remdesivir, darunavir and hyroxychlorquine. Amongst tested compounds, abietic acid, ferruginol and betulinic acid exhibited promising enzyme interaction. Results indicate that based upon the binding energy of abietic acid, ferruginol and betulinic acid could be efficient SARS-CoV-2 3CLpro inhibitors. This is supported by the fact that the effects of some terpenoidal phytochemicals especially abietic acid, ferruginol and betulinic acid showed promising enzyme interaction as compared to remdesivir and darunavir. Therefore, further studies are warranted to confirm the effectiveness of abietic acid, ferruginol and betulinic acid for the therapy of COVID-19.

Immune-Cell-Based Therapy for COVID-19: Current Status.

Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic. The interplay between innate and adaptive immune responses plays a crucial role in managing COVID-19. Cell therapy has recently emerged as a promising strategy to modulate the immune system, offering immense potential for the treatment of COVID-19 due to its customizability and regenerative capabilities. This review provides an overview of the various subsets of immune cell subsets implicated in the pathogenesis of COVID-19 and a comprehensive summary of the current status of immune cell therapy in COVID-19 treatment.