Treatment Of Coronavirus Disease 2019 Research Articles

The role and importance of vitamin D in patients with Corona virus disesase (COVID-19)

Severe acute respiratory syndrome novel coronavirus (SARS-CoV-2) has rapidly progressed from an outbreak to a global pandemic, with new variants emerging rapidly. Coronavirus disease 2019 (COVID-19), a disease caused by SARS-CoV-2 infection, can lead to multiorgan damage. Due to the highly contagious and fatal nature of the virus, the priority of medical research has been to find effective treatments. Amid this search, the role of vitamin D in modulating various aspects of the innate and adaptive immune system has been debated.The aim of the work: research on the role of vitamin D in the treatment and prevention of COVID-19. Although there are some conflicting results, the consensus is that vitamin D has a number of immunomodulatory effects that may be beneficial in the context of COVID-19 and that low vitamin D levels may result in dysfunction of key antimicrobial effects, potentially contributing to a poor prognosis. The aim of the paper is to investigate the impact and importance of vitamin D in patients with the corona virus.Work methods: During this retrospective study, data were taken from the Registry of those tested for the presence of the SARS-CoV2 virus, Specialist Center "Health House" in Bijeljina. The research included 30 patients positive for the presence of the SARS-CoV2 virus and 30 patients negative for the presence of the SARS-CoV2 virus. The following parameters were observed in the research: age, gender and vitamin D values, data on the body temperature of the patients and the duration of the disease, as well as the obtained results of the inflammatory parameters (Leukocytes and C- reactive protein CRP). The dana of all patients are anonymous. All patients were tested using the molecular method of polymerase chain reaction known as RT-PCR (Reverse transcription polymerase chain reaction). Separate samples were tested with Arhitectt Vitamin D reagent by the chemiluminescence method (CMIA), manufactured by Abott Arhitectt and 1000sr. Reference values of Vitamin D are from 75 to 150 nmol/L.Results: The concentration of vitamin D was lower in the group of patients with the coronavirus disease (COVID-19) compared to individuals with the absence of the coronavirus disease. There is a tendency towards a negative correlation between the concentration of vitamin D and the duration of the disease in the group of patients with the coronavirus disease (COVID-19), as like as the concentration of vitamin D and body temperature in the group of patients with the coronavirus disease (COVID-19). There is also a tendency towards a negative relationship between the concentration of vitamin D and parameters of inflammation (CRP, Le) in the group of patients with coronavirus disease (COVID-19).

Overview of COVID-19 Infection, Treatment, and Prevention in Children.

Coronavirus disease 2019 (COVID-19), caused by the novel respiratory virus-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-was declared a global pandemic by the World Health Organization on 11 March 2020. Since then, substantial gains have been made in our understanding of COVID-19 epidemiology, disease presentation, and management. While children tend to have less severe disease courses compared to adults, children can still develop severe COVID-19 infections, particularly in those with underlying medical conditions such as obesity, chronic lung disease, or prematurity. In addition, children are at risk of severe complications of COVID-19 infection, such as multisystem inflammatory syndrome in children (MIS-C) or long COVID. The case definitions of MIS-C and long COVID have continued to evolve with the increased understanding of these new entities; however, improved methods of diagnosis and determination of the optimal management are still needed. Furthermore, with the continued circulation of SARS-CoV-2 variants, there remains a need for clinicians to remain up-to-date on the latest treatment and prevention options. The purpose of this review is to provide an evidence-based review of what we have learned about COVID-19 in children since the start of the pandemic and how best to counsel children and their families on the best methods of prevention.

Assessing the efficacy and safety of Yinqiao powder-maxing Ganshi decoction in the treatment of the major symptoms of mild and moderate COVID-19 by telemedicine-study protocol for a randomized, double-blind, placebo-controlled trial.

Background: The Coronavirus disease 2019 (COVID-19) is the largest global epidemic in recent time. Chinese medicine has been recognized by the World Health Organization as an effective treatment for COVID-19, but there is still a lack of high-quality randomized, double-blind trials using placebo as the control to support its application, which may hinder its further promotion locally and internationally. Objectives: This study will evaluate the efficacy and safety of Yinqiao Powder-Maxing Ganshi Decoction with variation in relieving major symptoms of mild and moderate COVID-19 by telemedicine. Methods and design: This clinical study is a randomized, double-blind, placebo-controlled trial that applies telemedicine to evaluate the efficacy and safety of Yinqiao Powder-Maxing Ganshi Decoction in the treatment of mild and moderate COVID-19. Eligible subjects will be randomly divided into either treatment or placebo groups for up to 14 days after stratification according to age (A:18-49, B:50-65) and the number of vaccinations (a: ≥3 doses, b: ≤2 doses). The treatment group will receive Yinqiao Powder-Maxing Ganshi Decoction granules along with certain variation based on their symptoms, and the placebo group will receive the same amount of placebo granules. Subjects will be prescribed different additions based on their symptoms and pathogenesis at the inclusion. The oral temperature, oximeter, result of rapid antigen test and symptom score will be recorded by subjects until they have stopped the medication. Subjects are required to have follow-up assessment by video-conference on days 7, 14 and 35. The time for the body temperature returning to normal will be used as the primary outcome. Discussion: This trial will provide scientific evidence on the use of Yinqiao Powder-Maxing Ganshi Decoction for the treatment of COVID-19, and the results would help raise the awareness in Hong Kong and the international community on the use of Chinese herbal medicine for treating COVID-19. Clinical Trial Registration: clinicaltrials.gov, identifier NCT05787327.

Knowledge, attitude and prevalence of ivermectin use as coronavirus disease treatment: A crosssectional study among a Malaysian population.

During the coronavirus disease (COVID-19) pandemic, there was a widespread public misconception regarding ivermectin use in managing the disease. There is no approval of ivermectin as COVID-19 treatment by the Food and Drug Administration, and the adverse effects of the drug are alarming. This study aimed to evaluate the knowledge and attitude towards and prevalence of ivermectin use as COVID-19 treatment among the Malaysian population. This cross-sectional study was conducted among 391 Malaysians aged ≥18 years. A validated online self-administered questionnaire disseminated via Google Forms was used to evaluate the knowledge and attitude towards and prevalence of ivermectin use as COVID-19 treatment. The socio-demographic characteristics and knowledge and attitude towards and prevalence of ivermectin use among the respondents were evaluated through descriptive analysis. The chi-square test was used to identify the association between the variables. The respondents had moderate levels of knowledge and attitude towards ivermectin use, while the prevalence of ivermectin use was 3.58%. The respondents' sex (P=0.014), age (P=0.012) and monthly income (P=0.049) were significantly associated with their level of knowledge. The respondents' sex (P=0.04) was significantly associated with their level of attitude. Conversely, no socio-demographic characteristics were significantly associated with the prevalence of ivermectin use as COVID-19 treatment. The majority of Malaysians have moderate levels of knowledge and attitude towards ivermectin use as COVID-19 treatment, with a low prevalence of actual use.

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.

Comparative Analysis of Nucleocapsid Antibody Levels, Neutralizing Antibodies, and Spike Receptor-binding Domain in Severe Acute Respiratory Syndrome Coronavirus-2 Patients

ABSTRACT Introduction: Serological testing for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is crucial for detecting antibodies generated in response to infection. Neutralizing antibodies (NAbs) target the receptor-binding domain (RBD) of the spike protein (S-RBD) and can exist in the forms of immunoglobulin G (IgG), IgM, and IgA. This study aimed to assess specific antibody responses to the nucleocapsid protein (N), S-RBD, and NAbs and correlate them with the clinical spectrum of coronavirus disease 2019 (COVID-19). Methods: A cross-sectional design was conducted at the Dr. Soetomo General Academic Hospital, Indonesia. We examined 48 patients with confirmed COVID-19 of varying severity (mild, moderate, severe, and critical) on treatment days 0, 3, and 6. We measured nucleocapsid antibodies, S-RBD, and neutralization using the chemiluminescence immunoassay method. The comparative analysis of IgM, IgG, NAB, and S-RBD levels is adjudicated using the independent t-test. Results: Specific antibody levels on treatment days 0, 3, and 6 showed significant differences (P < 0.05). Notably, significant differences were observed in comparisons such as severe recovery versus severe death groups on day 0 in IgG, mild versus severe recovery on day 3 in IgM, moderate versus severe recovery, severe recovery versus severe death, and mild versus severe recovery on day 3, as well as on day 6 in anti-S-RBD, and mild versus severe recovery on day 3 and day 6 in neutralization of SARS-CoV-2 (P < 0.05). Conclusions: These findings highlight the dynamic antibody responses during COVID-19 treatment and their relevance for clinical outcomes.

The heat shock protein 90 inhibitor RGRN-305 attenuates SARS-CoV-2 spike protein-induced inflammation in vitro but lacks effectiveness as COVID-19 treatment in mice.

The inhibition of heat shock protein 90 (HSP90), a molecular chaperone, has been proposed to be a potential novel treatment strategy for Coronavirus disease 2019 (COVID-19). In contrast to other studies, our data demonstrated that RGRN-305, a HSP90 inhibitor, exacerbated the cytopathic effect and did not reduce the viral shedding in VeroE6-hTMPRSS2 cells infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Likewise in a murine model of SARS-CoV-2, transgenic mice treated orally with RGRN-305 exhibited reduced survival by the end of the experiment (day 12) as 14% (1/7) survived compared to 63% (5/8) of those treated with drug-vehicle. Animal weight was not reduced by the RGRN-305 treatment. Interestingly, we demonstrated that inhibition of HSP90 by RGRN-305 significantly dampened the inflammatory response induced by SARS-CoV-2 spike protein in human macrophage-like cells (U937) and human lung epithelial cells (A549). Measured by quantitative real-time PCR, the mRNA expression of the proinflammatory cytokines TNF, IL1B and IL6 were significantly reduced. Together, these data suggest that HSP90 inhibition by RGRN-305 exacerbates the SARS-CoV-2 infection in vitro and reduces the survival of mice infected with SARS-CoV-2, but exhibits strong anti-inflammatory properties. This data shows that while RGRN-305 may be helpful in a 'cytokine storm', it has no beneficial impact on viral replication or survival in animals as a monotherapy. Further animal studies with HSP90 inhibitors in combination with an anti-viral drug may provide additional insights into its utility in viral infections and whether HSP90 inhibition may continue to be a potential treatment strategy for COVID-19 disease.

Adverse Effects of Hydroxychloroquine on Testicular Tissue and Sperm Quality: An Experimental study on Male Albino Rats

Introduction: Hydroxychloroquine (HCQ) is a medicine that has mainly been used to treat malaria. During the recent Coronavirus Disease-2019 (COVID-19) period, an abrupt spike in the sale of HCQ has been found. The repurposing of this drug in the treatment of COVID-19 was not only found to be ineffective but also showed many side effects. The adverse effects of the enormous exposure to this drug should be unveiled. Aim: To evaluate the acute effect of HCQ exposure on the male reproductive system by analysing the changes in antioxidant enzyme levels in testicular tissue, sperm quality, and histopathological assessment of testicular tissue using male albino rats as the subject model. Materials and Methods: The present experimental study was done by using male albino rats as the subject model. It was conducted in the laboratory of the Department of Human Physiology at Raja NL Khan Women’s College (Autonomous) in Medinipur, West Bengal, Kolkata, India, from the last week of June 2023 to the first week of August 2023. A total 10 male albino rats were obtained and randomly divided into two groups (n=5 in each group), control and HCQ-treated, and were given plain drinking water and 33 mg/kg/day HCQ, respectively, for six consecutive days through oral gavage. After the treatment tenures, rats were euthanised, and antioxidant enzymatic activity was measured by a spectrophotometer. Sperm quality and testicular histopathology were studied. A two-tailed t-test was used to compare the parameters of the control and HCQ-treated groups. Results: The total testicular weight of the control group was 2.37±0.17 g, in contrast treated group had a significantly lower testicular weight of 1.98±0.19 g. A significant decrease in total testicular protein in the treated group was found, i.e., 28.86±3.03 mg/g of tissue, compared to the control group, i.e., 60.46±2.85 mg/g of tissue. The sperm count of the control group was 4.51±0.06 million/ml of suspension, while the treated group had a significantly lower sperm count, i.e., 2.73±0.11 million/mL of suspension. The percentages of sperm motility and viability in the control group were 86±1.63% and 94±1.33%, respectively, but in the treated group, the percentages were significantly lower, i.e., 22.66±1.35% and 24±1.78%, respectively. The increasing sperm anomalies after HCQ exposure indicate poor sperm quality. Conclusion: Infertility or reduced fertility can result from testicular dysfunction, in continuation, decrease in sperm count, motility, viability, together with abnormalities in sperm morphology, was observed after this exposure. Thus, the present study provides insight into the adverse effects of the use of this drug, which might be associated with male infertility.

Investigation of Urine Organic Acid Profile in Coronavirus Disease (COVID-19) Patients.

Coronavirus disease 2019 (COVID-19) is a viral infection caused by severe acute respiratory syn-drome coronavirus 2 (SARS-CoV-2). The high mortality and morbidity rate and its course with a wide variety of clinical symptoms indicate that the disease affects many metabolic pathways. The aim of our study was to investi-gate the metabolic effects of SARS-CoV-2 by evaluating the urinary organic acid profile in patients with SARS-CoV-2 infection. Can metabolites in urine guide the diagnosis, follow-up, treatment, and prognosis of COVID-19? Forty-two patients, including 30 SARS-CoV-2 RT-PCR positive patients and 12 SARS-CoV-2 RT-PCR negative controls, were studied. SARS-COV-2 RT-PCR of nasopharyngeal swab samples was studied. Urines were evaluated in the GCMS-QP2010 SE Gas Chromatograph Mass Spectrometer (SHIMADZU) device for organic acid profile in the metabolism laboratory. Urine organic acid profile was evaluated by studying 117 organic acids in each patient. Tiglylglycine, 2-hydroxybutyric acid, 4-hydroxyphenylpyruvic acid, 3-hydroxypropionic acid, erythro-4,5-dihydroxyhexanoic acid lactone, 2-hydroxyphenylacetic acid, N-acetyltyrosine, 3-phenyllactic acid, 5-hydroxyindolacetic acid, 3-hydroxysebacic acid, palmitic acid, 3-methylglutaconic acid, 3-methylglutaric acid, lactic acid, pyruvic acid-oxime, 3-hydroxysobutyric acid, and organic acids were found to be increased, compared to the control group. Tiglylglycine has been specifically identified as a potential biomarker of respiratory chain disorders. The deterioration in lipid metabolism and pyruvate pathway in COVID-19 patients was evaluated as remarkable.

The Impact of COVID-19 on Mental Health and Sleep Function of Hospital Staff Working With COVID-19 Patients: A Cross-Sectional Nationwide Study.

The coronavirus disease 2019 (COVID-19) pandemic has presented a globally challenging situation for human physical and mental health. Healthcare workers (HCWs) are affected by increased levels of anxiety, stress, and insomnia. This study aimed to evaluate the effect of COVID-19 on HCWs anxiety, stress, and insomnia levels. This cross-sectional study employed the Hospital Anxiety and Depression Scale, Perceived Stress Scale 10, and Insomnia Severity Index to assess anxiety, stress, and insomnia among HCWs at 10 COVID-19 isolation and treatment hospitals/centers after the first COVID-19 wave in Jordan. A web-based survey was used to collect data from 183 participants. Statistical analysis of factors affecting the mean scores of anxiety, stress, and insomnia was carried using student t-test or ANOVA while factors associated with differences in anxiety, stress, and insomnia frequencies were tested using Chi-square/Fisher exact test. Multivariate analysis was performed to determine the independent risk factors. Among participants, 97.3% reported moderate to severe levels of stress, 68% reported borderline to high abnormal levels of anxiety, and 32% had moderate to severe insomnia. The mean of anxiety total score was 9.8 ± 4.8, stress total score was 22.7 ± 4.5, and insomnia total score was 11.0 ± 7.1. Significant positive correlations were noted between anxiety, stress, and insomnia (P < .005). Female gender, migraine, less working years, increased time spent with patients, lower workforce, clinical insomnia and high stress were significant independent factors associated with anxiety (P < .05). Younger age, being single or divorced, heart disease, smoking, occupation (nurses), lower workforce, vaccination dose, and anxiety were significant independent factors associated with insomnia (P < .05). Increased time spent with patients, lower workforce, lower spouse and colleagues support, sadness due to isolation and anxiety were significant independent factors associated with stress. HCWs at COVID-19 centers had high levels of stress, anxiety, and insomnia. Appropriate interventions to maintain HCWs mental health are recommended.

Association of renal function with mortality among hospitalized patients treated with remdesivir for COVID-19.

Renal dysfunction is associated with poor outcomes in patients with coronavirus disease 2019 (COVID-19). In an effort to improve outcomes, intravenous remdesivir has been broadly used for the treatment of COVID-19 even in patients with low estimated glomerular filtration rate (eGFR). Our study assessed the residual risk of outcomes of patients with low eGFR despite treatment with remdesivir for COVID-19, during a timeframe prior to the expanded label across all levels of renal function. We conducted an observational, retrospective, multi-site cohort study of adults hospitalized with COVID-19 treated with at least one dose of remdesivir between November 6, 2020, and November 5, 2021. Electronic medical records were reviewed to obtain patient characteristics, related laboratory data, and outcomes. The primary endpoint was all-cause mortality by day 28. Multivariable logistic regression was used to evaluate association between groups. The study population consisted of 3024 patients hospitalized with COVID-19 and treated with remdesivir. The median age was 67 [IQR 55, 77] years; 42.7% were women, and 88.6% were white. The median eGFR was 76.6 mL/min/1.73 m2 [IQR 52.5, 95.2]; the majority (67.2%) of patients had an eGFR ≥ 60, while 9% had an eGFR <30. All-cause mortality by day 28 was 8.7%. All-cause mortality rates were significantly higher among patients with impaired renal function (Odds Ratio [OR] 1.63 for patients with eGFR 30-59; OR 1.46 for eGFR 15-29; OR 2.42 for eGFR <15 and OR 5.44 for patients on dialysis) compared to patients with eGFR ≥60 mL/min/1.73m2. Lower eGFR remains an independent risk factor for mortality in COVID-19 even in patients treated with remdesivir.

Investigating the mechanism of Qu Du Qiang Fei 1 Hao Fang Formula against coronavirus disease 2019 based on network pharmacology method

Objective: Qu Du Qiang Fei 1 Hao Fang (QDQF1) is a novel Chinese herbal medicine formula used to treat coronavirus disease 2019 (COVID-19). However, the pharmacological mechanisms of action of QDQF1 remain unclear. The objective of this study was to identify the effective ingredients and biological targets of QDQF1 for COVID-19 treatment. Materials and Methods: The effective ingredients and mechanisms of action of QDQF1 were analyzed by using network pharmacology methods, which included an analysis of the effective ingredients and corresponding targets, COVID-19-related target acquisition, compound-target network analyses, protein-protein interaction network analysis, Kyoto Encyclopedia of Genes and Genomes (KEGG) and Gene Ontology (GO) enrichment analyses, and molecular docking studies. Results: In total, 288 effective QDQF1 ingredients were identified. We identified 51 core targets from the 148 targets through an overlap between putative QDQF1 targets and COVID-19-related targets. Six key components, including formononetin, kaempferol, luteolin, naringenin, quercetin, and wogonin were identified through component-target network analyses. GO functional enrichment analysis of the core targets revealed 1296 items, while KEGG pathway enrichment analysis identified 148 signaling pathways. Nine central targets (CCL2, CXCL8, IL1B, IL6, MAPK1, MAPK3, MAPK8, STAT3, and TNF) related to the COVID-19 pathway were identified in the KEGG pathway enrichment analysis. Furthermore, molecular docking analysis suggested that the docking scores of the six key components to the nine central targets were better than those to remdesivir. Conclusions: QDQF1 may regulate multiple immune-and inflammation-related targets to inhibit the progression of severe acute respiratory syndrome coronavirus 2, and thus, may be suitable for the treatment of COVID-19.

Two new and effective food-extracted immunomodulatory agents exhibit anti-inflammatory response activity in the hACE2 acute lung injury murine model of COVID-19.

The coronavirus disease 2019 (COVID-19) spread rapidly and claimed millions of lives worldwide. Acute respiratory distress syndrome (ARDS) is the major cause of COVID-19-associated deaths. Due to the limitations of current drugs, developing effective therapeutic options that can be used rapidly and safely in clinics for treating severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infections is necessary. This study aims to investigate the effects of two food-extracted immunomodulatory agents, ajoene-enriched garlic extract (AGE) and cruciferous vegetables-extracted sulforaphane (SFN), on anti-inflammatory and immune responses in a SARS-CoV-2 acute lung injury mouse model. In this study, we established a mouse model to mimic the SARS-CoV-2 infection acute lung injury model via intratracheal injection of polyinosinic:polycytidylic acid (poly[I:C]) and SARS-CoV-2 recombinant spike protein (SP). After the different agents treatment, lung sections, bronchoalveolar lavage fluid (BALF) and fresh faeces were harvested. Then, H&E staining was used to examine symptoms of interstitial pneumonia. Flow cytometry was used to examine the change of immune cell populations. Multiplex cytokines assay was used to examine the inflammatory cytokines.16S rDNA high-throughput sequencing was used to examine the change of gut microbiome. Our results showed that AGE and SFN significantly suppressed the symptoms of interstitial pneumonia, effectively inhibited the production of inflammatory cytokines, decreased the percentage of inflammatory cell populations, and elevated T cell populations in the mouse model. Furthermore, we also observed that the gut microbiome of genus Paramuribaculum were enriched in the AGE-treated group. Here, for the first time, we observed that these two novel, safe, and relatively inexpensive immunomodulatory agents exhibited the same effects on anti-inflammatory and immune responses as neutralizing monoclonal antibodies (mAbs) against interleukin 6 receptor (IL-6R), which have been suggested for treating COVID-19 patients. Our results revealed the therapeutic ability of these two immunomodulatory agents in a mouse model of SARS-CoV-2 acute lung injury by promoting anti-inflammatory and immune responses. These results suggest that AGE and SFN are promising candidates for the COVID-19 treatment.

ACTIV trials: cross-trial lessons learned for master protocol implementation

Abstract The United States Government (USG) public-private partnership “Accelerating COVID-19 Treatment Interventions and Vaccines” (ACTIV) was launched to identify safe, effective therapeutics to treat patients with Coronavirus Disease 2019 (COVID-19) and prevent hospitalization, progression of disease, and death. Eleven original master protocols were developed by ACTIV, and thirty-seven therapeutic agents entered evaluation for treatment benefit. Challenges encountered during trial implementation led to innovations enabling initiation and enrollment of over 26,000 participants in the trials. While only two ACTIV trials continue to enroll, the recommendations here reflect information from all the trials as of May 2023. We review clinical trial implementation challenges and corresponding lessons learned to inform future therapeutic clinical trials implemented in response to a public health emergency and the conduct of complex clinical trials during “peacetime,” as well.

Effectiveness and safety of azvudine in COVID-19: A systematic review and meta-analysis.

The aim of this study was to assess the effectiveness and safety of azvudine in treating coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-COV-2). A search was carried out in PubMed, Cochrane Library, Web of Science, medRxiv, and Google Scholar until October 20, 2023. The Cochrane risk of bias tools were used to assess the quality of included studies. Comprehensive Meta-Analysis software was used to analyze data. Twenty-one studies including 10,011 patients were examined. The meta-analysis results showed that azvudine and standard of care/placebo (SOC/PBO) were significantly different concerning mortality rate (risk ratio [RR] = 0.48, 95% confidence interval [CI]: 0.40 to 0.57) and negative polymerase chain reaction (PCR) conversion time (standard mean difference = - 0.75, 95% CI: -1.29 to-0.21). However, the two groups did not show significant differences concerning hospital stay, intensive care unit (ICU) admission, and need for mechanical ventilation (P > 0.05). On the other hand, azvudine and nirmatrelvir-ritonavir were significantly different in mortality rate (RR = 0.73, 95% CI: 0.58 to 0.92), ICU admission (RR = 0.41, 95% CI: 0.21 to 0.78), and need for mechanical ventilation (RR = 0.67, 95% CI: 0.51 to 0.89), but the two treatments were not significantly different in negative PCR conversion time, and hospital stay (P > 0.05). The incidence of adverse events between groups was not significant (P > 0.05). The certainty of evidence was rated as low or moderate. The antiviral effectiveness of azvudine against SARS-COV-2 is questionable with regard to the certainty of evidence. Further research should be conducted to establish the effectiveness and safety of azvudine in COVID-19.

Post-COVID-19 Menstrual Abnormalities among Medical Students at a Tertiary Care Medical College in Southern India: A Cross-sectional Study

Introduction: The emergence of Coronavirus Disease-2019 (COVID-19) caught the world by surprise, leading to a widespread global pandemic that has had profound and distressing effects on various levels. Its impact has been far-reaching, causing severe consequences that continue to unfold. COVID-19 is a multisystem inflammatory disease involving all organs, including the female reproductive system. Aim: To determine the prevalence of COVID-19 among students and compare post-COVID-19 menstrual abnormalities in the home and hospital groups. Materials and Methods: A cross-sectional study was conducted to assess post-COVID-19 menstrual abnormalities among medical students at Department of Obstetrics and Gynaecology, NRI Institute of Medical Sciences, Visakhapatnam, Andhra Pradesh, in southern India from April to December 2022. A total of 600 medical students were approached, and 549 responded, among whom 258 students were reported as COVID-19 positive and 291 reported as COVID-19 negative. After excluding risk factors, 204 COVID-19 positive students were selected as the study population. Data were collected using a prevalidated questionnaire. The COVID-19 study population of 204 (100%) was further stratified into two groups based on the treatment taken at home 162 (79.4%) or in the hospital 42 (20.5%). Chi-square test and Fisher’s-exact tests were used to compare post-COVID-19 menstrual abnormalities, including cycle length abnormalities, Heavy Menstrual Bleeding (HMB), dysmenorrhoea, Premenstrual Syndrome (PMS), and hypomenorrhoea. Results: The prevalence of COVID-19 in the study population was 204, accounting for 37.15% of the total population 204/549. Out of the 204 students, 162 (79.4%) received home treatment, and 42 (20.5%) received hospital treatment. PostCOVID-19 menstrual cycle abnormalities were more prevalent in the hospital group 26/42 (61.9%) than in the home treatment group 76/162 (46.9%). The most common abnormality in both groups was PMS, with a prevalence of 21 (50%) in the hospital group and 38 (23.4%) in the home group. In the home group, 37 (22.8%) experienced longer cycles, 33 (20.3%) had dysmenorrhoea, and 19 (11.7%) had shorter cycles. In the hospital group, 14 (33.3%) had longer cycles, 13 (30.9%) experienced dysmenorrhoea, and 9 (21.4%) had shorter cycles. HMB was reported by 6 (14.2%) in the hospital group and 13 (8%) in the home group, while hypomenorrhoea occurred in 11 (6.7%) in the home group and 5 (11.9%) in the hospital group. A significant association (p=0.001) was found between the COVID-19 treatment groups and PMS. However, for other post-COVID-19 menstrual abnormalities, such as cycle length, dysmenorrhoea, HMB, and hypomenorrhoea, there was no significant association between these abnormalities and COVID-19 treatment groups. Conclusion: Post-COVID-19 menstrual abnormalities were more frequently observed in the hospital group compared to the home group. All post-COVID-19 menstrual irregularities resolved within six months, except for PMS.

Prediction of In-silico ADMET Properties and Molecular docking study of Substituted Thiadiazole for screening of Antiviral activity against protein target Covid-19 main protease

The SARS-CoV-2 virus is the infectious disease known as coronavirus disease (COVID-19). The majority of COVID-19 patients will have mild to moderate symptoms and recover without additional care. However, some people will get serious illnesses and need medical attention. Designing novel medications and testing them for inhibitory action against the corona virus's primary targets could be a successful technique for the advancement of the drug discovery process and the treatment of corona virus disease in the context of the COVID-19 pandemic, which is spreading quickly. The objective of this work was to evaluate the physical-chemical, pharmacokinetic parameters (absorption, distribution, metabolism, excretion and toxicity) and pharmacodynamic parameters (bioactivity and adverse reactions) of Substituted thiadiazole by means of in-silico computational prediction. Online software such as Pre-ADMET, Molinspiration and Rule of Five were used for the analysis. In-silico results allow us to conclude that substituted thiadiazole is predicted to be a potential future drug candidate, due to its relevant Drug-likeness profile, bioavailability, excellent liposolubility and adequate pharmacokinetics, including at the level of CNS, penetrating the blood-brain barrier. Molecular docking studies of 20 designed compounds have also been performed to screen the inhibitory activity towards against protein target COVID-19 main protease (PDB: 6LU7). Among all the compounds C3 exhibited the most significant affinity score against COVID-19 main protease (PDB: 6LU7) and Shown best significant hydrogen bonds interaction at the active site of protein.

Factors associated with small airway obstruction in COVID-19 survivors: A cross-sectional study among health-care providers.

Coronavirus disease 2019 (COVID-19) has been identified for more than two years, yet studies assessing post-infection lung function are limited. Reports on lung function in COVID-19 patients indicate that patients have restrictive defects and small airway dysfunction that can persist and are not necessarily related to the severity of the disease. The aim of this study was to assess the incidence of small airway obstruction and its incidence-associated factors among COVID-19 survivors to better describe the long-term effects of COVID-19. A cross-sectional study was conducted among COVID-19 survivors who less than 50 years at Medan Adventist Hospital between 2020-2022. The data were collected through interview, direct assessment and respiratory examination. A total of 89 COVID-19 survivors were recruited of which the majority of them were female with a mean age of 32.6-year-old with the largest group was 19-30 years. The comorbidities found among the survivors were heart and thyroid disorders, with the most common symptom of post-COVID-19 was fatigue. Most of them had mild COVID-19. The mean forced mid-expiratory flow (FEF25-75%) was 96.3±20.22, with an incidence rate of small airway obstruction was 19.1%. Univariate and multivariate analyses indicated no significant association between age, gender, comorbidities, history of oxygenation during COVID-19 treatment, COVID-19 severity and the type of post COVID-19 syndrome symptoms with the incidence of small airway obstruction. In conclusion, among COVID-19 survivors who were less than 50 years old, those studied variables seems have less association with the incidence of small airway obstruction. Nevertheless, a further study with a bigger sample size is important to be conducted.

Proportion of COVID-19 survivors in 2020-2022 in the Russian population (according to the ESSE-RF3 study)

Aim. To study the proportion of coronavirus disease 2019 (COVID-19) survivors and hospitalization cases of the Russian population for the period 2020-2022, depending on socio-demographic characteristics.Material and methods. The work was performed on random samples of the population aged 35-74 years from 15 regions participating in the Epidemiology of Cardiovascular Diseases and their Risk Factors in Regions of Russian Federation-3 (ESSE-RF3) study. The examination was carried out from February 2020 to March-April 2022 (n=28718, 47% men).Results. According to a survey of sample participants, the proportion of respondents who had COVID-19 by the spring of 2022 among all surveyed was 26,0%. Among 45-54-year-old respondents, this parameter was maximum (28,0%), while among those aged 65-74-year-old — minimal (22,3%). The following categories of people were more likely to have COVID-19: women (27,9 vs 23,9% of men, p&lt;0,001), persons with higher education (30 vs 22,6% persons without higher education, p&lt;0,001), persons with high income (30,0 vs 24,3% low-income, p=0,002), persons with family (26,6 vs 24,8% single, p&lt;0,001), employed persons (28,4 vs 21,7% non-employed, p&lt;0,001), as well as those living in urban areas (26,5 vs 24,5% country people, p=0,003). But those less likely to have COVID-19 (men, people without higher education, low-income, single, unemployed or rural residents) had more severe disease course. The following categories of people had higher hospitalization rates: men (26,0 vs 20,9% women, p&lt;0,001), patients without higher education (27,1 vs 19,6% those with higher education, p&lt;0,001), non-employed (34,3 vs 18,4% workers), p&lt;0,001) and rural residents (27,2 vs 22,0% of city residents, p&lt;0,001). Hospitalization rate was not associated with the level of income and marital status. However, low-income and single people were more likely to require mechanical ventilation.Conclusion. The results obtained by survey reflect the following population data: the proportion of patients after COVID-19, hospitalization rate and the development of severe acute respiratory failure requiring mechanical ventilation among Russians for the period 2020-2022. This can complement the population data demonstrated by state statistics. Special attention from the healthcare system, both during treatment and prevention of COVID-19, requires males, people aged ≥65 years, low-income people, single people (widowers, divorced), unemployed people (pensioners, disabled people, nonemployed), rural residents and people without higher education.

Azithromycin for COVID-19: Pharmacological Mechanisms, Challenges, and Prospects

The coronavirus disease (COVID)-19 pandemic led to a new challenge in the field of effective treatment methods for this disease. Antiviral and immunomodulatory agents were suggested as potential therapeutic methods in this field. Since the most severe clinical symptoms associated with COVID-19 disease appear to be acute respiratory syndrome, azithromycin has been proposed as a potentially effective drug in this context. We have updated the evidence and selected all relevant items to understand the mechanism of role of azithromycin, clinical efficacy, and their side effects in coronavirus disease-19 treatment on July 20th and updated on March 20th, 2020. A literature search of electronic databases including the Web of Science, PubMed, and Google Scholar was conducted by searching keywords such as "Azithromycin", "COVID-19", and "Combination therapy". The ultimate goal of this review was identifying eligible studies about the pharmacological activities, safety, and effectiveness of azithromycin in treating COVID-19 patients. Immunomodulatory properties of azithromycin include the ability to reduce cytokine production, maintain epithelial cell integrity, or prevent lung fibrosis. The use of azithromycin in some studies was associated with a decrease in mortality and need for ventilation in patients. These properties can be useful during the period of COVID-19 infection, especially in patients with underlying diseases. However, the evidence for the use of azithromycin is still scarce and the quality of the studies is low. In some retrospective studies, azithromycin was mainly evaluated in combination with hydroxychloroquine, which showed no particular advantage. The results of this review showed that azithromycin has appropriate and well-known safety characteristics in the treatment of patients with COVID-19. However, the most appropriate dosage in different stages of the disease and the effect of its combination with other drugs are important questions that should be considered in future clinical trials.