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1514 covid-19 Preprints

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covid-19 pandemic chemokines ai-quantum computing deep learning quantum mechanics evaluation antiretrovirals sars-cov-2 spike d614g b cells rvsv-zebov learning nose and throat phase data mining Africa cheminfomratics epistemology metabolism adverse drug reactions madagascar asthma qsar quantum gates covid translational pharmacology mitochondria lung pathology + show more tags
vero suspension culture ards clinical pharmacology covid19 drug safety bioreactor production pathogenesis causality tmprss2 ear covid 19 flow cytometry surveillance drug discovery/target validation colchicine remdesivir ursolic acid artificial intelligence modulation chern-simons topological ecmo laboratory sinusitis viral life cycle sars-cov machine learning immunopharmacology viral vaccine bioprocess epidemiology pulmonary function testing (pft) sars-cov-2 pharmacokinetics ent (rhinitis psychopharmacology quantum-inspired evolutionary algorithm predictive toxicology philosophy of medicine infectious diseases vaccine 5-hydroxytryptamine/serotonin complement receptors cheminformatics inflammation nasal polyps...)
Please note: These are preprints and have not been peer reviewed. Data may be preliminary. Preprints should not be relied on to guide medical practice or health-related decisions. News media reporting on preprints should stress that the research should not yet be considered conclusive.
The Correlations Between Epidemiological and Clinical Characteristics, laboratory tes...
Bobby Branson
Ramin Tavakoli

Bobby Branson

and 5 more

January 17, 2021
Background: The role of laboratory parameters and the relationship of them with radiology reports, CT scan and clinical outcomes in screening of COVID-19 patients not been definitely established, but this disease presented a major challenge in the field of clinical tests, radiology reports, clinical outcomes that help to monitoring and treatment COVID-19 disease. Methods: This study was performed on 340 suspected COVID-19 patients, who presented to Chamran Hospital, Shiraz University of Medical Sciences Shiraz, Iran from 20 February to 31 August, 2020. Information each patient’s will be completed using a data collection forms based on records. The evaluation of lungs involvement in CT scan and their relationship with laboratory indicator including biochemical and hematological factors, is the best scale for the severity and prognosis of Covid 19 patients. Results and Conclusion: The findings of this study indicated ALT, AST, CRP, NEU, LDH, and Urea have very good accuracy in predicting cases with positive RT-PCR for COVID-19, respectively. In this study we shown the correlation of clinical and laboratory findings with CT-based quantitative score of pulmonary involvement in COVID-19 pneumonia and attempted that our findings could be usable to development future clinical research associated with COVID-19 infection and show the relationship of reports CT scan and clinical outcomes in the diagnosis and severity of patients with COVID-19.
Corticosteroid therapy for 2019-nCoV infected patients: a case series of 8 mechanical...
Mabrouk AL-Rasheedi
Yasir Alhazmi

Mabrouk AL-Rasheedi

and 6 more

January 17, 2021
Objective To report a series of eight cases of severe acute respiratory syndrome due to 2019-nCoV infection (Covid-19- Bilateral infiltration) who were successfully treated with high-dose short-term corticosteroid therapy.
Hospital survival associated with the use of thromboprophylaxis in patients with seve...
Víctor M. Camarillo Nava
José Vicente  Rosas

Víctor M. Camarillo Nava

and 6 more

January 17, 2021
Hospital survival associated with the use of thromboprophylaxis in patients with severe COVID-19 infection Survival and thromboprophylaxis in COVID-19 Abstract Introduction: It has been described that patients with severe or critical infection by COVID-19 suffer an inflammatory state that conditions a high thrombotic risk. However, there is little information on how to address thrombotic risk, coagulopathy, and anticoagulant therapy in these patients. Objective: To evaluate the use of thromboprophylaxis in patients with severe COVID-19 infection associated with longer survival. Material and methods: Retrospective cohort study, in a 2nd level hospital. 340 records of patients hospitalized for severe COVID-19 infection were reviewed, and 171 were included in the final analysis. Sociodemographic data, previous pathologies, days of hospital stay, respiratory parameters were evaluated; blood gas, hematic cytometry, DHL, C-reactive protein (CRP), antiviral treatment, thromboprophylaxis, use of steroids and use of antibiotics, the study variable was survival associated with the use of LMWH. Descriptive, inferential statistics, univariate and multiple models were used. Results: Advanced age, PaO2 / FiO2 index> 200 and high CRP were associated with a higher probability of death. And the greater the number of days of use of thromboprophylaxis; the higher the degree of protection. The PaO2 / FiO2 index> 200 (adjusted HR 0.270; 95%CI;. 0.100-0.727) and greater number of days with thromboprophylaxis (adjusted HR, 0.576; 95%CI;. 0.460 – 0.721) during hospitalization, were factors associated with hospital survival. Conclusions: In this study we found evidence to recommend the use of thromboprophylaxis from the first hours of admission in adult patients with severe COVID-19 as long as there are no contraindications for it, due to the increase in hospital survival. KEY WORDS: Thromboprophylaxis, LMWH, SARS-CoV-2, survival, Severe COVID-19 infection.
The COVID-19 Epidemic in Madagascar: clinical description and laboratory results of t...
Rindra Randremanana
Soa-Fy Andriamandimby

Rindra Randremanana

and 29 more

January 17, 2021
Background: Following the first detection of SARS-CoV-2 in passengers arriving from Europe on 19 March 2020, Madagascar took several mitigation measures to limit the spread of the virus in the country. Methods: Nasopharyngeal and/or oropharyngeal swabs were collected from travellers to Madagascar, suspected SARS-CoV-2 cases, and contact of confirmed cases. Swabs were tested at the national reference laboratory using real-time RT-PVR. Data collected from patients were entered in an electronic database for subsequent statistical analysis. All distribution of laboratory confirmed cases were mapped and six genomes of viruses were fully sequenced. Results: Overall, 26,415 individuals were tested for SARS-CoV-2 between 18 March and 18 September 2020, of whom 21.0% (5,553/26,145) returned positive. Among laboratory-confirmed SARS-CoV-2 positive patients, the median age was 39 years (CI95%: 28-52), and 56.6% (3,311/5,553) were asymptomatic at the time of sampling. The probability of testing positive increased with age with the highest adjusted odds ratio of 2.2 [95% CI: 1.9-2.5] for individuals aged 49 years and more. Viral strains sequenced belong to clades 19A, 20A, and 20B in favour of several independent introduction of viruses. Conclusions. Our study describes the first wave of the COVID-19 in Madagascar. Despite early strategies in place Madagascar could not avoid the introduction and spread of the virus. More studies are needed to estimate the true burden of disease and make public health recommendations for a better preparation to another wave.
Evaluation of Iron Deficiency in COVID-19 Pneumonia
Ozge Oral Tapan
Canan Gursoy

Ozge Oral Tapan

and 5 more

January 17, 2021
Background: Inlate 2019, a new coronavirus disease was detected in Wuhan, China and called COVID-19. There are so many unknown factors about the virus. Iron metabolism is one of the topics have to be investigated for the development of therapeutic strategies for COVID-19. The aim of this study is to assess sequential changes in traditional biochemical iron status indicators during COVID-19 pneumonia. Methods: A case-control study. Case group was defined as pneumonia with PCR-confirmed SARS-CoV-2 and the control group consisted of patients with non-COVID-19 pneumonia. Biomarkers of anemia and iron metabolism, CRP, procalcitonin were analyzed. Demographic features, CT findings, SpO2, development of ARDS, ICU admission, duration of hospitalization, discharge status (event free survival or death) were evaluated. Results: 205 hospitalized patients with pneumonia were analyzed retrospectively. COVID-19 group was significantly younger than control group. 23 of 106 patients had critical COVID-19 infection. Comorbidity frequency and mortality rate of patients with COVID-19 pneumonia were significantly higher. Hb, RET-He, iron, TSAT, CRP, PCT and SpO2 were significantly lower. Hb, RET-He, iron, TSAT levels significantly correlated to lung aeration loss, hospitalization day and inflamatory markers in COVID-19 pneumonia. Conclusion: The patients with COVID-19 pneumonia had iron deficiency anemia even they were young. Iron deficiency may effect the lung aeration loss related to paranchimal infiltrations of COVID-19 and mortality of the patients with COVID-19 pneumonia. Our data indicates that iron deficiency is associated with longer hospital stays, lower oxygenation, higher CRP and procalsitonin.
Recurrent Coronavirus Diseases 19 (COVID-19): A Different Presentation from the First...
Saeed Shoar
Siamak Khavandi

Saeed Shoar

and 3 more

January 16, 2021
A 31-year-old male Caucasian patient developed reinfection with SARS-CoV-2, 2 ½ months after an initial episode of ICU admission for respiratory support due to COVID-19. The second episode was in the form of malaise, aphthous gingival ulcer, and desquamating palmar lesion.
Detection of SARS-CoV-2 Specific Memory B cells to Delineate Long-Term COVID-19 Immun...
Constantin Thieme
Mohamed Abou-el-Enein

Constantin Thieme

and 15 more

January 15, 2021
Background: The ongoing COVID-19 pandemic, caused by the novel coronavirus SARS-CoV-2, represents a serious worldwide health concern. A deeper understanding of the immune response to SARS-CoV-2 will be required to refine vaccine development and efficacy as well as to evaluate long-term immunity in convalescent patients. With this in mind, we investigated the formation of SARS-CoV-2 specific BMEMORY cells from patient blood samples. Methods: A standard flow cytometry-based protocol for the detection of SARS-CoV-2 specific B cells was applied using fluorochrome-coupled SARS-CoV-2 spike (S) full-length protein. Cohorts of 26 central European convalescent mild/moderate COVID-19 patients and 14 healthy donors were assessed for the levels of SARS-CoV-2 S- specific BMEMORY cells. Results: Overall B cell composition was not affected by SARS-CoV-2 infection in convalescent patients. Our analysis of SARS-CoV-2 specific BMEMORY cells in samples collected at different time points revealed that S-protein specific B cells remain in peripheral blood at least up to 6 months after COVID-19 diagnosis. Conclusions: Detection of SARS-CoV-2 specific BMEMORY cells may improve our understanding of the long-term adaptive immunity in response to SARS-CoV-2, allowing for an improved public health response and vaccine development during the COVID-19 pandemic. Further validation of the study in larger and more diverse populations and a more extended observation period will be required.
A SARS-CoV-2 overview for people in a hurry
Sylvester Jian Ming Lim

Sylvester Jian Ming Lim

and 1 more

January 15, 2021
SARS-CoV-2 is the etiologic agent of the current COVID-19 pandemic which has wreaked unprecedented economic and healthcare calamity. It is a deadly virus belonging to the Coronaviridae family, with high sequence similarity to the 2003 SARS epidemic coronavirus. The global race to produce vaccines to stem the disease-as well as the public health urgency-has spurred tremendous growth in the litany of literature which attempts to uncover the enigma of this deadly virus. Amidst this evergrowing list of literature , this paper seeks to concisely elaborate on key progresses made in the understanding of SARS-CoV-2 in the realms of its life cycle, epidemiology, methods for detection, and vaccine research into an easily assimilable paper for readers.
EVALUATION OF THE INFECTION AWARENESS OF DENTISTS DURING COVID-19 PANDEMIC
SANAZ SADRY
Zeynep Sapan

SANAZ SADRY

and 1 more

January 14, 2021
Background: The present study aims to investigate the state of sterilization, disinfection and infection control of dentists during the COVID-19 pandemic. Methods: The study involved 310 dentists, who were asked to fill in a 19-question, multiple-choice survey on sterilization, disinfection and infection control. The survey results were evaluated statistically using chi-square test. Results: An investigation of the changes in working conditions and occupational experience during the pandemic period showed that 86.7% of the physicians who quit are the ones with occupational experience of 0 to 6 years. 89.3% of the physicians who answered “No idea” to the question about sterilization methods consist of physicians with over 20 years of experience, while 7.1% of them are physicians with 6-10 years of experience. Conclusion: Dentistry is the highest risk profession in the COVID-19 pandemic. And dentists need to reduce this risk by utilizing personal protective equipment and adopting the most appropriate disinfection and sterilization measures. Key Words: Disinfection, dentistry, sterilization.
Quantum Phases and Chern-Simons Geometrics for the generation of a ligand targeting C...
Ioannis Grigoriadis

Ioannis Grigoriadis

January 14, 2021
SARS coronavirus 2 (SARS-CoV-2) in the viral spike (S) encoding a SARS-COV-2 SPIKE D614G mutation protein predominate over time in locales revealing the dynamic aspects of its key viral processes where it is found, implying that this change enhances viral transmission. It has also been observed that retroviruses infected ACE2-expressing cells pseudotyped with SG614 that is presently affecting a growing number of countries markedly more efficiently than those with SD614. The availability of newer powerful computational resources, molecular modeling techniques, and cheminformatics quality data have made it feasible to generate reliable algebraic calculations to design new chemical entities, merging chemicals, recoring natural products, and a lot of other substances fuelling further development and growth of this AI-quantum based drug design field to balance the trade-off between the structural complexity and the quality of such biophysics predictions that cannot be obtained by any other method. In this paper, we strongly combine topology geometric methods targeting at the atomistic level the protein apparatus of the SARS-COV-2 virus that are simple in machine learning anti-viral characteristics, to propose computer-aided rational drug design strategies efficient in computing docking usage, and powerful enough to achieve very high accuracy levels for this in-silico effort for the generation of the AI-Quantum designed molecule the RoccustyrnaTM small molecule, a multi-targeting druggable scaffold (1S,2R,3S)‐2‐({[(1S,2S,4S,5R)‐4‐ethenyl‐4‐sulfonylbicyclo[3.2.0]heptan‐2‐yl]oxy}amino)‐3‐[(2R,5R)‐5‐(2‐methyl‐6‐methylidene‐6,9‐dihydro‐3H‐purin‐9‐yl)‐3‐methylideneoxolan‐2‐yl]phosphirane‐1‐carbonitrile targeting the COVID-19-SARS-COV-2 SPIKE D614G mutation using Chern-Simons Topology Euclidean Geometric in a Lindenbaum-Tarski generated QSAR automating modeling and Artificial Intelligence-Driven Predictive Neural Networks.
Geometric Hashing and ΑΙ-Quantum Deep Learning functional similarities on Remdesivir,...
Ioannis Grigoriadis

Ioannis Grigoriadis

January 14, 2021
Νovel SARS coronavirus 2 (SARS-CoV-2) of the family Coronaviridae starting in China and spreading around the world is an enveloped, positive-sense, single-stranded RNA of the genus betacoronavirus encoding the SARS-COV-2 (2019-NCOV, Coronavirus Disease 2019. Remdesivir drug, or GS-5734 lead compound, first described in 2016 as a potential anti-viral agent for Ebola diseade and has also being researched as a potential therapeutic agent against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the coronavirus that causes coronavirus disease 2019 (COVID-19). Computer-aided drug design (CADD), Structure and Ligand based Drug Repositioning strategies based on parallel docking methodologies have been widely used for both modern drug development and drug repurposing to find effective treatments against this disease. Quantum mechanics, molecular mechanics, molecular dynamics (MD), and combinations have shown superior performance to other drug design approaches providing an unprecedented opportunity in the rational drug development fields and for the developing of innovative drug repositioning methods. We tested 18 phytochemical small molecule libraries and predicted their synergies in COVID-19 (2019- NCOV), to devise therapeutic strategies, repurpose existing ones in order to counteract highly pathogenic SARS-CoV-2 infection. We anticipate that our geometry hashing driven quantum deep learing similarity approaches which is based on separated pairs of short consecutive matching fragments, can be used for the development of anticoronaviral drug combinations in large scale HTS screenings, and to maximize the safety and efficacy of the Remdesivir, Colchicine and Ursolic acid drugs already known to induce synergy with potential therapeutic value or drug repositioning to COVID-19 patients.
Liver and kidney function in patients with Covid-19 treated with remdesivir
Sylvia van Laar
M De Boer

Sylvia van Laar

and 4 more

January 14, 2021
For the treatment of Covid-19 patients with remdesivir, poor renal- and liver function were both exclusion criteria in randomized clinical trials (RCTs) and contra-indication for treatment. Also, nephrotoxicity and hepatotoxicity are reported as adverse events. We retrospectively reviewed renal- and liver functions of covid-19 patients who received remdesivir in the 15 days after treatment initiation. Approximately 20% of the patient population met RCT exclusion criteria. In total, 11% of the patients had a decrease in estimated glomerular filtration rate larger than 10 ml/min/1.73m2. Also, 25% and 35% had increased alanine transaminase and aspartate transaminase levels, respectively. However, serious adverse events were limited. Therefore, contra-indications based on kidney- and liver function should not be absolute for remdesivir treatment in patients with Covid-19 if these functions are monitored regularly.
Cytokine induced modulation of ACE2 and TMPRSS2 expression in primary human nasal epi...
Mahnaz Ramezanpour
Harrison Bolt

Mahnaz Ramezanpour

and 6 more

January 14, 2021
Viral entry of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) via the spike protein enables endocytosis into host cells using the ACE2 receptor and TMPRSS2. The frequent upper respiratory tract symptoms of COVID-19 and the localization of the virus to the nasopharynx, the most common site of swabbing, indicate that the sinonasal mucosa may play an important role in SARS-CoV2 infection and viral replication. This paper investigates the presence of ACE2 Receptor and TMPRESS2 expression in the primary human nasal epithelial cells (HNECs) from Control, CRSsNP, and CRSwNP and maps the expression changes when exposed to Th1, Th2, Th17 associated cytokines. We found that ACE2 and TMPRSS2 expression is higher in control HNECs than CRSwNP HNECs, and that both ACE2 and TMPRSS2 are downregulated further by Th2 cytokines in CRSwNP HNECs. This indicates an immune dysregulated state of CRSwNP mucosa, which normally contributes to a chronic inflammatory state, might support an altered susceptibility to SARS-CoV2 infection and transmission.
Omega-3 polyunsaturated fatty acids supplementation improve clinical symptoms in pati...
Mohsen Sedighiyan
Hamed  Abdollahi

Mohsen Sedighiyan

and 9 more

January 13, 2021
Objective: We hypothesized that omega-3 fatty acids would be an appropriate adjunct therapy for alleviating the inflammatory response and clinical manifestation in hospitalized patients with covid-19 disease. Methods: This was a single-blind randomized controlled trial in Amir-Alam hospital in Tehran. Thirty adult men and women diagnosed with covid-19 were allocated to either control group (receiving Hydroxychloroquine) or intervention group (receiving Hydroxychloroquine plus 2 grams of DHA+EPA) for 2 weeks. Primary outcome of the intervention including CRP, ESR as well as clinical symptoms including body pain, fatigue, appetite and olfactory and secondary outcomes including liver enzymes were determined at the baseline and after omega-3 supplementation. Clinical signs were measured using self-reported questionnaires. There were commercial kits for determination of CRP and liver enzymes concentrations in the serum of patients. For determination of ESR automated hematology analyzer was applied. Results: In comparison to control group, patients receiving omega-3 indicated favorable changes in all clinical symptoms except for olfactory ((p<0.001 for body pain and fatigue, p= 0.03 for appetite and p=0.21 for olfactory). Reducing effects of omega-3 supplementation compared to control group were also observed in the levels of ESR and CRP after treatment (p<0.001 for CRP and p=0.02 for ESR). However, no between group differences in the liver enzymes serum concentrations were observed after supplementation (p>0.05). Conclusion: Current observations are very promising and indicate that supplementation with moderate dosages of omega-3 fatty acids may be beneficial in the management of inflammation-mediated clinical symptoms in covid-19 patients. Key words: Covid-19, omega-3, inflammation, clinical symptoms
Roles of host mitochondria in the development of COVID-19 pathology
Kavya Srinivasan
Ashutosh Pandey

Kavya Srinivasan

and 2 more

January 12, 2021
The recent emergence of Severe Acute Respiratory Syndrome-Corona Virus 2 (SARS-CoV-2) in late 2019 and its spread worldwide caused an acute pandemic of Coronavirus disease 19 (COVID-19). COVID-19 pathologies are currently under intense scrutiny as its outbreak led to immense and urgent changes worldwide. Although many theories have been introduced on how SARS-CoV-2 enters the host, the ACE-2 receptor is shown to be the primary mechanism of SARS-CoV-2 entry. However, the mechanism behind the establishment and pathology of infection is poorly understood. As recent studies show that host mitochondria play an essential role in virus-mediated innate immune response, in this review, we will discuss, in detail, the entry and progression of SARS-CoV-2 and how mitochondria play a role in the establishment of viral infection and the development of an immune response, whether it is beneficial or not. We will also review the possible treatments that could be used to prevent the surgency of COVID-19 infection with respect to the role of mitochondria. Understanding the mitochondria-mediated SARS-CoV-2 establishment may provide a unique mechanism and conceptual advancement in finding a novel treatment for COVID-19.
Large Impact of obesity on the disposition of ivermectin, moxidectin and eprinomectin...
Alain Bousquet-Melou
Anne Lespine

Alain Bousquet-Melou

and 4 more

January 12, 2021
Background and Purpose: Based on in vitro data, ivermectin (IVM) has been proposed for the prevention and treatment of COVID-19, a condition for which obesity is a major risk factor. IVM dosage is based on total body weight and there are no recommendations to adjust dosage in obese patients. The objective of this study was to establish, in a canine model, the influence of obesity on the clearance and steady-state volume of distribution of IVM and two analog compounds, moxidectin (MOX) and eprinomectin (EPR). Experimental Approach: An experimental model of obesity in dogs was based on a high calorie diet. IVM, MOX and EPR were administered intravenously, simultaneously in combination, to a single group of dogs in two circumstances, during a control period and when body weight had been increased by 50%. Key Results: In obese dogs, clearance, expressed in absolute values (L/day), was not modified for MOX and reduced for IVM and EPR, compared to the initial control state. When scaled by body weight (L/day/kg), plasma clearance was reduced by 42, 55 and 63%, for MOX, IVM and EPR, respectively. In contrast, the steady-state volume of distribution was markedly increased in absolute values (L) by obesity. Conclusion and Implications: For IVM and MOX, the obese dog model suggests that the maintenance dose should not be adjusted by total body weight in the obese subject but should be based on lean body weight. On the other hand, the loading dose should be computed based on the total body weight of the obese subject.
Potential of Selective Serotonin Reuptake Inhibitors in preventing clinical deteriora...
TATHAGATA BISWAS
BISWA MISHRA

TATHAGATA BISWAS

and 5 more

January 12, 2021
COVID-19 has an unpredictable course with substantial percentage of infected patients developing clinical deterioration and increasing health care burden. With no specific treatment or vaccination, the current search is for drugs that can limit the disease progression. Recently Fluvoxamine has been reported to have disease modifying effects in COVID-19. We suggest the hypothesis that short term routine use of Selective Serotonin Reuptake Inhibitors (SSRIs) can prevent clinical deterioration of asymptomatic or mild COVID-19 cases by the following ways: a) anti-inflammatory actions through sigma-1 agonism and reducing release of pro-inflammatory cytokines, b) anti-coagulant action by reducing platelet aggregation, c) specific antiviral and antibacterial effects, d) Immunomodulation through Serotonin pathway and anti-oxidation. The routine short term use of SSRIs can also alleviate the psychological impact of the disease. We hope our hypothesis will encourage future clinical trials to validate the routine use of SSRIs against COVID-19.
Bioreactor production of rVSV-vectored vaccines in Vero cell suspension cultures
Sascha Kiesslich
Gyoung Kim

Sascha Kiesslich

and 4 more

January 12, 2021
The Vero cell line is the most used continuous cell line in viral vaccine manufacturing. This adherent cell culture platform requires the use of surfaces to support cell growth, typically roller bottles or microcarriers. We have recently compared the production of rVSV-ZEBOV on Vero cells between microcarrier and fixed-bed bioreactors. However, suspension cultures are considered superior with regards to process scalability. Therefore, we further explore the Vero suspension system for rVSV-vectored vaccine production. Previously, this suspension cell line was only able to be cultivated in a proprietary medium. Here, we expand the adaptation and bioreactor cultivation to a serum-free commercial medium. Following small scale optimization and screening studies, we demonstrate bioreactor productions of highly relevant vaccines and vaccine candidates against Ebola virus disease, HIV and COVID-19 in the Vero suspension system. rVSV-ZEBOV, rVSV-HIV and rVSVInd-msp-SF-Gtc can replicate to high titers in the bioreactor, reaching 3.87 × 107 TCID50/mL, 2.12 × 107 TCID50/mL and 3.59 × 109 TCID50/mL, respectively. Further, we compare cell specific productivities, and the quality of the produced viruses by determining the ratio of total viral particles to infectious viral particles
A single-center experience of steroid therapy for COVID-19 management
Aamir Shaukat
Ahmad Ayaz Sabri

Aamir Shaukat

and 6 more

January 11, 2021
Aim: There is an emerging role of steroids in the management of COVID-19. We aimed to compare the outcome of COVID-19 patients (recovery versus mortality) who were treated with steroids with those who were not treated with steroids during their course of hospital stay. Methods: A retrospective analysis of all moderately to severely ill COVID-19 patients, meeting the inclusion and exclusion criteria, admitted to our center during the study period of four months, was performed. The patients were categorized into two groups: Group I included 25 patients who were given steroids, and Group II also included 25 patients who were not given any steroids during their hospital stay. The primary outcome (recovery versus mortality), length of hospital stay as well as other features were compared between the two groups. Results: The mean length of hospital stay was 9.3 days in the steroids group and 10.9 days in the non-steroids group with a p value of 0.249. None of the patients was shifted to a ventilator in either group. One patient in the steroids group (4%) and two patients in the non-steroids group (8%) needed to be put on high flow nasal cannula. One patient died in the steroids group with a recovery rate of 96%, while two patients died in the non-steroids group with a recovery rate of 92% (p value 0.552). Conclusion: Treatment with steroids in moderately to severely ill COVID-19 patients did not decrease the length of hospital stay or mortality in our study.
Outcomes of Extracorporeal Membrane Oxygenation in Acute Respiratory Distress Syndrom...
Cameron Blazoski
Michael Baram

Cameron Blazoski

and 2 more

January 10, 2021
Introduction: Extracorporeal membrane oxygenation (ECMO) has been used as a refractory treatment for acute respiratory distress syndrome (ARDS) due to COVID-19, but there has been little evidence of its efficacy. We conducted this study to share our experience using ECMO as a bridge to recovery for ARDS due to COVID-19. Methods: All adult patients who were placed on ECMO for ARDS due to COVID -19 between April 2020 and June 2020 (during the first wave of COVID-19) were identified. The clinical characteristics and outcomes of these patients were analyzed with a specific focus on the differences between patients who survived to hospital discharge and those who did not. Results: 20 COVID-19 patients were included in this study. All patients were placed on veno-veno ECMO. Comparing between survivors and non-survivors, older age was associated with hospital mortality (p=0.02). The following complications were observed: renal failure requiring renal replacement therapy (35%, n=7), bacteremia during ECMO (20%, n=4),coinfection with bacterial pneumonia (15%, n=3), cannula site bleeding (15%, n=3), stroke (10%, n=2), gastrointestinal bleeding (10%, n=2), and liver failure (5%, n=1). The complications associated with patient mortality were culture positive septic shock (p=0.01), culture-negative systemic inflammatory response syndrome (p=0.01), and renal failure (p=0.01). The causes of death were septic shock (44%, n=4), culture-negative systemic inflammatory response syndrome (44%, n=4), and stroke (11%, n=1). Conclusions: Based on our experience, ECMO can improve refractory ARDS due to COVID-19 in select patients. Proper control of bacterial infections during COVID-19 immunomodulation therapy may be critical to improving survival.
COVID-19 and intestinal dysbiosis: the proposed mechanism of short-chain fatty acids...
Manon Jardou
Roland Lawson

Manon Jardou

and 1 more

January 08, 2021
The world is currently facing the COVID-19 pandemic that is taking a heavy toll on several countries. While many infected patients have a good prognosis, in some cases the progression can be serious and even lead to death. The commonly seen complications are a cytokine storm and multi-organ failure that require intensive care. The mortality of critically ill patients depends on age (> 65 years), sex (male) or co-morbidities. There is an urgent need to discover a biomarker to identify early on patients at risk of developing serious complications, and to find an effective treatment that could prevent disease progression and critical states. Recent investigations have pointed to the possible contribution of intestinal dysbiosis to the pathophysiology of COVID-19. Herein, we hypothesize that butyrate, a short-chain fatty acid produced by the gut microbiota, can prevent immune system activation and disease progression.
Short Term Respiratory Outcomes in Children with Antibody Positive PIMS -TS
Deevena Chinthala
Chris Hine

Deevena Chinthala

and 11 more

January 07, 2021
Paediatric multisystem inflammatory syndrome: temporally associated with SARS-COV-2 (PIMS-TS) is a well described rare but severe COVID-19 related syndrome. PIMS-TS have been reported in children from geographical areas of high COVID-19 infection. Most children with PIMS-TS require management in an intensive care unit with variable respiratory involvement. Adults recovering from COVID-19 infection have been reported to suffer from respiratory morbidity but such outcomes are unknown in children. We present the first report of normal short term respiratory outcomes as measured by spirometry in children with SARS-COV-2 antibody positive, PIMS-TS syndrome managed at a specialist children’s hospital in the UK.
Drug repurposing for COVID-19: the problem of excessive hypothesis testing
Mariusz Maziarz
Adrian Stencel

Mariusz Maziarz

and 1 more

January 07, 2021
Rationale, aims, and objectives The current strategy of searching for an effective drug to treat COVID-19 relies mainly on repurposing existing therapies developed to target other diseases. There are currently more than four thousand active studies assessing the efficacy of existing drugs as therapies for COVID-19. The number of ongoing trials and the urgent need for a treatment poses the risk that false-positive results will be incorrectly interpreted as evidence for treatments’ efficacy and a ground for drug approval. Our purpose is to assess the risk of false-positive outcomes by analyzing the mechanistic evidence for the efficacy of exemplary candidates for repurposing, estimate false discovery rate, and discuss solutions to the problem of excessive hypothesis testing. Methods We estimate the expected number of false-positive results and probability of at least one false-positive result under the assumption that all tested compounds have no effect on the course of the disease. Later, we relax this assumption and analyze the sensitivity of the expected number of true-positive results to changes in the prior probability (π) that tested compounds are effective. Finally, we calculate False Positive Report Probability and expected numbers of false-positive and true-positive results for different thresholds of statistical significance, power of studies, and ratios of effective to non-effective compounds. We also review mechanistic evidence for the efficacy of two exemplary repurposing candidates (hydroxychloroquine and ACE2 inhibitors) and assess its quality to choose the plausible values of the prior probability (π) that tested compounds are effective against COVID-19. Results Our analysis shows that, due to the excessive number of statistical tests in the field of drug repurposing for COVID-19 and low prior probability (π) of the efficacy of tested compounds, positive results are far more likely to result from type-I error than reflect the effects of pharmaceutical interventions.
Sudden Sensorineural Hearing Loss in COVID-19: A Case Report and Literature Review
Eline Beckers
Pascale Chouvel

Eline Beckers

and 3 more

January 07, 2021
This report describes the case of a 53-year-old man with SARS-CoV-2 infection and occurrence of complete unilateral sensorineural hearing loss, adding new evidence to the association between COVID-19 and hearing loss. Whether this is the result of endothelial cell dysfunction in the cochlea or central auditory pathways remains unclear.
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