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Coronavirus disease-19 (COVID-19) has disproportionately affected certain demographics in England, exacerbating existing health disparities. Effective therapeutics are a critical line of defence against COVID-19, particularly for patients at elevated risk for severe disease. Surveillance systems were established to monitor the usage of COVID-19 therapeutics in hospital and community settings and to inform stewardship. Three antiviral therapies—nirmatrelvir plus ritonavir (Paxlovid®), remdesivir (Veklury®), and molnupiravir (Lagevrio®)—and two neutralising monoclonal antibody therapies (nMAbs)—sotrovimab (Xevudy®) and casirivimab with imdevimab (Ronapreve®)—were in use in England between July 2020 and April 2023. This paper aims to illuminate trends in the utilisation of COVID-19 therapeutics treatment in both hospital and community settings, stratified by the Index of Multiple Deprivation (IMD) in England. Chapter 3 of the English Surveillance Programme for Antimicrobial Utilisation and Resistance (ESPAUR) Report 2022 to 2023 also discusses the epidemiological surveillance of these five directly acting antiviral COVID-19 therapeutics' use in England between 2022 and 2023. [ABSTRACT FROM AUTHOR]

Background: To investigate the efficacy of different doses of corticosteroids in treating severe coronavirus disease 2019 (COVID-19) pneumonia. Methods: Between May 01, 2023, and June 20, 2023, 48 patients with severe COVID-19 pneumonia were treated at the Department of Respiratory and Critical Care Medicine of Jinan Fourth People's Hospital. The observation group (21 patients) received standard care and high-dose corticosteroids, (high-dose group). The control group (27 patients) received standard care and low-dose corticosteroids (low-dose group). We collected baseline data and recorded inflammatory marker levels after 3 days of treatment, body temperature recovery time, length of stay, and 28-day all-cause mortality. The results of outpatient follow-up were recorded after 1 month. Results: There were no significant differences in 28-day mortality and length of stay. The number of days it took for body temperature to return to normal in the high-dose group was less than in the low-dose group. The high-dose group had significantly more reduced inflammatory factors (C-reactive protein (CRP), interleukin-6 (IL-6). A total of 20 discharged patients were given 8–16 mg of methylprednisolone, depending on chest computed tomography (CT) and clinical symptoms after 1 month; in all discharged patients using oral corticosteroids, CT features improved. Conclusion: High-dose corticosteroids had a significantly positive effect on the reduction of inflammatory factors and shortening body temperature recovery time. In the treatment of severe COVID-19 pneumonia, early administration of high-dose, short-course corticosteroids should be implemented. Highlights: The highlights of the paper are: 1. High-dose corticosteroid can shorten the recovery time of body temperature. 2. High-dose corticosteroid can better reduce inflammatory factors (CRP IL-6). 3. Oral hormones in discharged patients with severe COVID-19 pneumonia are beneficial. 4. Initial dosage and course of corticosteroid might be varied case by case. [ABSTRACT FROM AUTHOR]

Competing risks data are commonly encountered in randomized clinical trials and observational studies. This paper considers the situation where the ending statuses of competing events have different clinical interpretations and/or are of simultaneous interest. In clinical trials, often more than one competing event has meaningful clinical interpretations even though the trial effects of different events could be different or even opposite to each other. In this paper, we develop estimation procedures and inferential properties for the joint use of multiple cumulative incidence functions (CIFs). Additionally, by incorporating longitudinal marker information, we develop estimation and inference procedures for weighted CIFs and related metrics. The proposed methods are applied to a COVID‐19 in‐patient treatment clinical trial, where the outcomes of COVID‐19 hospitalization are either death or discharge from the hospital, two competing events with completely different clinical implications. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID‐19) can lead to pulmonary fibrosis due to the inflammatory process in the lung, resulting in a series of respiratory consequences. Patients with underlying systemic diseases or pre‐existing pulmonary diseases are particularly at risk of severe respiratory distress and persistent pulmonary abnormalities. Pirfenidone, a well‐known anti‐fibrotic agent recognized for its therapeutic effect on idiopathic pulmonary fibrosis, could be a feasible option in severe COVID‐19 cases given the similar pathophysiological features shared with interstitial lung diseases. In this paper, we share our experience of early administration of pirfenidone in combination with tofacitinib in a 61‐year‐old female patient with severe COVID‐19 pneumonia. Pirfenidone was initiated because of persistent dependence on high‐flow oxygen support and even the requirement for mechanical ventilation due to disease progression after initial standard COVID‐19 treatment. The patient was successfully extubated 15 days after the initiation of pirfenidone, and 13 days after extubation, she was completely weaned off supplemental oxygen. A series of chest radiographs and computed tomography scans demonstrated notable improvements in her lung condition. We propose a strategy of using pirfenidone plus tofacitinib as a rescue therapy in the management of patients with severe COVID‐19. [ABSTRACT FROM AUTHOR]

Oxidative stress and inflammation are observed in critically ill patients with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2). As oxidative stress is due to free radicals, free radical scavenging agents, such as vitamin C, are used in the hope of mitigating the severity of COVID‐19. In this paper an analytical model of free radical encounters within a cell is derived. It computes the effectiveness of free radical scavenging and the subsequent reduction in oxidative damage due to therapeutic intervention of exogenous antioxidants. Various publications make claims of success, albeit modest, treating critically ill COVID‐19 patients with high doses of vitamin C. The findings cast doubt on these claims and challenge the notion that any benefits attributed to vitamin C are due to free radical scavenging. [ABSTRACT FROM AUTHOR]

We highlighted in this current paper similar prolonged respiratory presentation with COVID-19 pneumonia in four severely immunocompromised patients currently being treated with anti-CD20 monoclonal antibodies (mAbs), such as ocrelizumab and rituximab, for multiple sclerosis or rheumatoid polyarthritis. Real-time reverse transcription-polymerase chain reaction on a nasopharyngeal swab specimen was negative in all patients. SARS-CoV-2 infection was confirmed from bronchoalveolar lavage fluid. A high titer of post-vaccine COVID-19 convalescent plasma was administered with complete recovery in all patients. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic saw unprecedented resources and funds driven into research for the development, and subsequent rapid distribution, of vaccines, diagnostics and directly acting antivirals (DAAs). DAAs have undeniably prevented progression and life-threatening conditions in patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. However, there are concerns of antimicrobial resistance (AMR), antiviral resistance specifically, for DAAs. To preserve activity of DAAs for COVID-19 therapy, as well as detect possible mutations conferring resistance, antimicrobial stewardship and surveillance were rapidly implemented in England. This paper expands on the ubiquitous ongoing public health activities carried out in England, including epidemiologic, virologic and genomic surveillance, to support the stewardship of DAAs and assess the deployment, safety, effectiveness and resistance potential of these novel and repurposed therapeutics. [ABSTRACT FROM AUTHOR]

Ozone therapy (OT), a medical procedure, has been showing good results during the coronavirus disease (COVID-19). We aimed to build an evidence and gaps map (EGM) of OT in the COVID-19 ranking the articles found according to levels of evidence and outcomes. The EGM brings bubbles of different sizes and different colors according to the articles. The OT intervention used was major or minor autohemotherapy, rectal insufflation and ozonized saline solution. EGM was based on 13 clinical studies using OT for COVID-19 involving a total of 271 patients. We found 30 outcomes related to OT in COVID-19. Our EGM divided the outcomes into six groups: 1-clinical improvement; 2-hospitalization; 3-inflammatory, thromboembolic, infectious, or metabolic markers; 4-radiological aspects, 5-viral infection and 6-adverse events. Major autohemotherapy was present in 19 outcomes, followed by rectal insufflation. Improvement in clinical symptoms of COVID-19, improvement of respiratory function, improvement of oxygen saturation, reduction in hospital internment, decrease in C-reactive protein, decrease in ferritin, decrease in lactate dehydrogenase, decrease in interleukin 6, decrease in D-dimer, radiological improvement of lung lesions and absence of reported adverse events were related in the papers. The most commonly used concentrations of OT in major autohemotherapy and in rectal insufflation were 40 µg/mL and 35 µg/mL, respectively. Here, we bring the first EGM showing the efficacy and safety of OT in the treatment of COVID-19. OT can be used as integrative medical therapy in COVID-19 at a low cost and improve the health conditions of the patients. [ABSTRACT FROM AUTHOR]

India's pharmaceutical sector has been one of the largest manufacturers of generic drugs globally. During the pandemic, most countries were dependent on imports of generic drugs from India. However, India has been relying on resources from China for Active Pharmaceutical Ingredients (APIs) which are the raw material for preparing generic drugs. We considered, in our analysis, branded product groups of Paracetamol and Amoxicillin due to their extensive use in the treatment of COVID-19. From a thorough market analysis of both the drugs, we conclude that firms have a monopoly over their brands but compete within the same product group and operate in their respective market under varying prices within certain bandwidths which resembles the feature of monopolistic competitive market. We have introduced compensating function a la Helpman (1981) in the pharmaceutical goods market with the assumption that an 'ideal product' exists among the pharmaceutical goods. Given the framework, this paper explores a general equilibrium model set in a monopolistic competitive product market for branded drugs. We concluded through our propositions that expanding the pharmaceutical sector will increase the employment of unskilled labor under no capacity constraint. We will observe an increase in wages of unskilled labor only under full employment conditions wherein we would observe that the expansion of pharmaceutical good will increase wages in the unskilled labor market. However we obtain an intriguing result wherein we obtain that despite instances of limiting trade dependence on China through implementation of policies like 'Aatmanirbhar Bharat' and 'profit linked incentive schemes', yet to maintain the status quo in the global market for generic drugs, India's dependence on China would increase, owing to API imports due to the pandemic crisis. While India can grab the opportunity in the form of increased demand for pharmaceutical goods to increase the employment level of the economy but this improvement in welfare is also dependent on the degree of dependency of API India has on China. The Indian government has recognized the same through the incorporation of 'Covid-Suraksha' and PLI schemes to minimize import dependency, and accelerate the development of APIs and the production of indigenous drugs. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID‐19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2), can manifest itself in several ways, including coagulopathy and thrombosis. These complications can be the first and sometimes only manifestations of SARS‐CoV‐2 infection and can occur early or late in the course of the disease. However, these symptoms are more prevalent in hospitalized patients with venous thromboembolism, particularly those admitted to intensive care units. Moreover, various forms of arterial and venous thrombosis, or micro‐ or macro‐vasculature embolisms, have been reported during the current pandemic. They have led to harmful consequences, such as neurological and cardiac events, nearly all resulting from the hypercoagulable state caused by this viral infection. The severe hypercoagulability observed in patients with COVID‐19 accounts for most cases of the disease that become critical. Therefore, anticoagulants seem to be one of the most vital therapeutics for treating this potentially life‐threatening condition. In the current paper, we present a thorough review of the pathophysiology of COVID‐19‐induced hypercoagulable state and the use of anticoagulants to treat SARS‐CoV‐2 infections in different patient groups, as well as their pros and cons. [ABSTRACT FROM AUTHOR]

The replication of biological systems by mechanical and electronic devices is referred to as bionics. The bionics industry has grown along four primary application areas, in addition to hearing, vision, orthopedics, and a small, dispersed group of implants that enhance cardiac and neurological functions. The SARS‐CoV‐2 virus is the infectious disease known as coronavirus disease (COVID‐19). The virus‐infected people require assistance to better understand the situation caused by COVID‐19 and to bring some easy, efficient, and effective solutions. One of the solutions mentioned for the early stages involves wearable sensors with temperature sensors for early Covid‐19 identification and photos delivered to an AI‐enabled smartphone, robotic sensor, or robot itself. In severe situations, lung X‐ray images are captured by robotic and remote sensors, and the lungs are given the right medication to finish off the virus. The paper presents the study on the overview, applications of artificial intelligence, and deep learning from the bionics point of view. Deep learning and machine learning will be used for reducing the Covid‐19 outbreak. Wearable sensors provide important data by having temperature‐embedded sensors in several physical devices that reveal details about the environment and body that are connected. Covid‐19 probability prediction is aided by smartphones with artificial intelligence and machine learning capabilities. Case history, doctor notes, chest X‐ray reports, details on the sites of breakouts, and other criteria can help forecast the severity of Covid‐19 when it is in its severe phases and direct the administration of medication to a specific area of the lungs. [ABSTRACT FROM AUTHOR]

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic led to rapid vaccine development and large global vaccination schemes. However, patients with immune-mediated kidney disease, chronic kidney diseases and kidney transplant recipients show high non-response rates to vaccination despite more than three vaccinations and, consequently, reduced viral clearance capacity when infected while receiving certain immunosuppressants, carrying an elevated risk for coronavirus disease 2019 (COVID-19)-related morbidity and mortality. SARS-CoV-2 evolution has been characterized by the emergence of novel variants and spike mutations contributing to waning efficacy of neutralizing antibodies. To this end, the therapeutic field expands from vaccination towards a combined approach of immunization, pre-exposure prophylaxis and early post-exposure treatment using direct-acting antivirals and neutralizing monoclonal antibodies to treat early in the disease course and avoid hospitalization. This expert opinion paper from the Immunonephrology Working Group of the European Renal Association (ERA-IWG) summarizes available prophylactic and/or early treatment options (i.e. neutralizing monoclonal antibodies and direct-acting antivirals) of SARS-CoV-2-infected patients with immune-mediated kidney disease, chronic kidney disease and kidney transplant recipients. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has caused significant losses and suffering around the world. Although the SARS-CoV-2 vaccine has largely controlled the spread of the virus, the scientific and sustainable treatment of COVID-19 patients is still necessary to truly end the pandemic. Small-molecule drugs against COVID-19 have attracted the attention of the scientific community and industry owing to their unique advantages such as a simple delivery method, relatively high output, and immune response with lower probability. Fortunately, in the last three years, some potentially effective drugs have been proposed, and have achieved good results in clinical trials. This paper briefly introduces the research progress on small-molecule drugs since 2020 to provide reference for future SARS-CoV-2 research. [ABSTRACT FROM AUTHOR]

Background: During the process of the treatment of COVID-19 hospitalized patients, physicians still face a lot of unknowns and problems. Despite the application of the treatment protocol, it is still unknown why the medical status of a certain number of patients worsens and ends with death. Many factors were analyzed for the prediction of the clinical outcome of the patients using different methods. The aim of this paper was to develop a prediction model based on initial laboratory blood test results, accompanying comorbidities, and demographics to help physicians to better understand the medical state of patients with respect to possible clinical outcomes using neural networks, hypothesis testing, and confidence intervals. Methods: The research had retrospective-prospective, descriptive, and analytical character. As inputs for this research, 12 components of laboratory blood test results, six accompanying comorbidities, and demographics (age and gender) data were collected from hospital information system in Sarajevo for each patient from a sample of 634 hospitalized patients. Clinical outcome of the hospitalized patients, survival or death, was recorded 30 days after admission to the hospital. The prediction model was designed using a neural network. In addition, formal hypothesis tests were performed to investigate whether there were significant differences in laboratory blood test results and age between patients who died and those who survived, including the construction of 95% confidence intervals. Results: In this paper, 11 neural networks were developed with different threshold values to determine the optimal neural network with the highest prediction performance. The performances of the neural networks were evaluated by accuracy, precision, sensitivity, and specificity. Optimal neural network model evaluation metrics are: accuracy = 87.78%, precision = 96.37%, sensitivity = 90.07%, and specificity = 62.16%. Significantly higher values (P < 0.05) of blood laboratory result components and age were detected in patients who died. Conclusion: Optimal neural network model, results of hypothesis tests, and confidence intervals could help to predict, analyze, and better understand the medical state of COVID-19 hospitalized patients and thus reduce the mortality rate. [ABSTRACT FROM AUTHOR]

With the pandemic of COVID-19 being under control, more and more COVID-19 patients have entered the rehabilitation stage. Traditional Chinese medicine (TCM) has always attached importance to the treatment of epidemic diseases in the rehabilitation stage so as to further promote the rehabilitation of patients for a better prognosis, and prevent the recurrence of the disease. It's focal to explore how to carry out accurate rehabilitation treatment for COVID-19 patients in the prevention and treatment of COVID-19 for quite some time to come. This paper systematically sorts out the reported clinical manifestations of the post-COVID-19 syndrome and the current guideline for the practices in COVID-19 rehabilitation. Under the background of the collaborative rehabilitation practices with TCM and western medicine, combined with the unique advantages of TCM in disease rehabilitation, this paper discusses the TCM understanding of epidemic diseases in the rehabilitation stage and its prevention and treatment ideas, and puts forward the collaborative rehabilitation strategy with TCM and western medicine for post-COVID-19 syndrome, so as to promote higher-quality rehabilitation of the patients. [ABSTRACT FROM AUTHOR]

Vaccination is an important tool in the fight against the COVID-19 pandemic in patients with haematologic malignancies. The paper provides an analysis of the course of breakthrough SARS-CoV-2 infection in a group of vaccinated patients with haematological malignancy and a comparison with a historical cohort of 96 non-vaccinated patients with haematologic malignancies and bone marrow failure syndromes (two patients) in the treatment of COVID-19. A severe or critical course of COVID-19 was significantly less frequent in the group of vaccinated patients (10.2% vs. 31.4%, p = 0.003). The need for hospitalisation due to COVID-19 was significantly lower in vaccinated patients (27.1% vs. 72.6%, p < 0.0001) and the duration of hospitalisation was significantly shorter (10 vs. 14 days, p = 0.045). Vaccinated patients were insignificantly less likely to require oxygen therapy during infection. COVID-19 mortality was significantly higher in non-vaccinated patients (15.6% vs. 5.1%, p = 0.047). The paper demonstrated a significant positive effect of vaccination against COVID-19 on a less severe clinical course of infection, lower need for hospitalisation and mortality. However, the results need to be evaluated even in the context of new antivirals and monoclonal antibodies against SARS-CoV-2 or virus mutations with different biological behaviour. [ABSTRACT FROM AUTHOR]

The purpose of this review was to conduct a comparative assessment of the concepts of therapy for pediatric patients with COVID-19 in the framework of global clinical practice. A structural analysis of the range of drugs and treatment strategies in the context of etiotropic, pathogenetic, and symptomatic therapy has shown that in the global context and in real clinical practice, the etiotropic-pathogenetic approach based on information about the effectiveness of individual medical technologies prevails today. It has been established that eight international nonproprietary/grouping names are present in international practice as means of etiotropic therapy for pediatric patients with COVID-19, and 18 positions are used for pathogenetic therapy. In terms of frequency of occurrence, the leading positions are occupied by remdesivir and the combination of nirmatrelvir with ritonavir, as well as dexamethasone and tocilizumab. The paper emphasizes the relevance of research in the field of evaluating the effectiveness of individual treatment regimens as well as the analysis of the delayed consequences of pathology suffered in childhood under the conditions of using various approaches to pharmacotherapy. [ABSTRACT FROM AUTHOR]

Competing risks data are commonly encountered in randomized clinical trials or observational studies. Ignoring competing risks in survival analysis leads to biased risk estimates and improper conclusions. Often, one of the competing events is of primary interest and the rest competing events are handled as nuisances. These approaches can be inadequate when multiple competing events have important clinical interpretations and thus of equal interest. For example, in COVID‐19 in‐patient treatment trials, the outcomes of COVID‐19 related hospitalization are either death or discharge from hospital, which have completely different clinical implications and are of equal interest, especially during the pandemic. In this paper we develop nonparametric estimation and simultaneous inferential methods for multiple cumulative incidence functions (CIFs) and corresponding restricted mean times. Based on Monte Carlo simulations and a data analysis of COVID‐19 in‐patient treatment clinical trial, we demonstrate that the proposed method provides global insights of the treatment effects across multiple endpoints. [ABSTRACT FROM AUTHOR]

Several studies have been directed to find scalable, swift, accurate, and cost‐effective strategies for detecting, monitoring, and treating coronavirus disease 2019 (COVID‐19). Indeed, the lack of a fast and practical method for detecting the infected regions makes decision‐making challenging to combat the critical pandemic‐struck situations. The probable 'wrong', or rather inadequate, decisions not only have a boomerang effect on the economy but also can lead to an increase in the number of infected individuals, degree of hospitalization, and death counts. Although the current clinical methods are effective, they are costly, time‐consuming, and, more particularly, inadequate because of the virus's mutation patterns. In addition, contamination of biomedical wastes with the COVID‐19 virus is a matter of grave concern. Therefore, there is a perpetual need for novel methodologies to delineate the contaminated regions and determine whether those viruses contaminate the wastewater. Although several review papers have been recently published to discuss those concerns, there is a lack of a comprehensive survey of the detection and treatment of the COVID‐19 virus in aqueous media. Herein, we review techniques available as spreading signifiers for detecting the COVID‐19 virus in water resources and wastewater. We classify and integrate techniques into wastewater, sewage, and sludge detection and monitoring. Treatment of COVID‐19‐contaminated wastewater is discussed by classifying and ranking the methodologies nurtured from nanotechnology, including nanoparticle‐based biosensors used in the detection and nanotechnology‐based filtration systems for the removal of COVID‐19 from wastewater. We also highlight the compilation of the detection methodologies in contaminated aqueous media and provide insight into the challenges associated with treating COVID‐19‐contaminated wastewater. The article concludes that international and robust guidelines for virus/bacteria treatment in wastewater are urgently needed to protect the environment and public health, where nanotechnology plays a key role. [ABSTRACT FROM AUTHOR]

Objective: Ephedra herbs are the only extant genus in its family, Ephedraceae, and order, Ephedrales. It has been prescribed in traditional medicine for improving headaches and respiratory infections. On the other hand, because the coronavirus disease 2019 (COVID-19) causes respiratory problems and COVID-19 pandemic is the most widespread outbreak that has affected humanity in the last century, the current review aims using literature search to investigate the effects of the Ephedra herbs compounds on COVID-19 to supply a reference for its clinical application in the inhibition and remedy of COVID-19. Materials and Methods: This review was performed using articles published in various databases, including Web of Science, PubMed, Scopus, and Google Scholar, without a time limit. For this paper, the following keywords were used: "Ephedra", "coronavirus disease 2019", "COVID-19", "Severe acute respiratory syndrome coronavirus 2" or "SARS CoV 2". Results: The results of this review show that the Ephedra herbs have effectiveness on COVID-19 and its compounds can bind to angiotensin-converting enzyme 2 (ACE2) with a high affinity and act as a blocker and prevent the binding of the virus. Conclusion: Some plants used in traditional medicine, including the Ephedra herbs, with their active compounds, can be considered a candidate with high potential for the control and prevention of COVID-19. [ABSTRACT FROM AUTHOR]

BACKGROUND: The pandemic caused by the novel coronavirus disease (COVID-19) since early 2020 is one of the most significant global health issues in history. Although there is currently no specific treatment for COVID-19, researchers have provided a whole array of potential treatments, both from the Western medicine approach, which is molecular target and pathogenesis based, and from the traditional Chinese medicine (TCM) approach, which is based on the exposure to toxins/pathogens and the balance of the body to combat them for recovery. OBJECTIVE: The aim of this research is to find combinations of Western medicine and TCM that may offer better therapeutic efficacy synergystically with a better adverse events profile. The findings of the research may provide a new insight in the development of the treatment of COVID-19. METHODS: From the Western medicine perspective, drugs target the mechanisms of viral infection, including the stages of viral entry (Arbidol, Camostat Mesylate, Convalescent Plasma therapy) and viral replication (Lopinavir/Ritonavir, Redemsivir, Ribavirin). Additional therapies target host defenses, preventing cytokine storms (Tocilizumab) and stimulating the immune system (Interferons). On the other hand, TCM also proposed a number of treatment methods for COVID-19 with new scientific approaches identifying their antiviral and immunomodulatory activities. The novel combination of Western medicine and TCM can be proposed by analyzing their respective molecular targets. RESULTS: Although TCM is not generally accepted in the Western community because of the general lack of knowledge on their detailed mechanisms, studies and clinical trials suggest that TCM could be beneficial in combating COVID-19. CONCLUSION: Based on the principle of combining TCM and Western medicine, two combinations are tested effective in clinical trials, and three possible combinations that might be effective are proposed in the paper. [ABSTRACT FROM AUTHOR]

Background: Patients with coronavirus disease 2019 (COVID-19) undergoing maintenance hemodialysis have a poor prognosis and limited treatment options. Methods: This paper outlines the impact of COVID-19, its treatment, and the efficacy of vaccines in Japanese patients undergoing hemodialysis with a review of the literature. Results: Patients undergoing dialysis in dialysis facilities are at greater risk of exposure to severe acute respiratory syndrome coronavirus 2 than the general population due to limited isolation capabilities. Therefore, vaccines are expected to be effective for patients undergoing dialysis. In addition, effective use of available medications is important because treatment options are limited. Conclusions: Efforts should be made to prevent the spread of the infection to high-risk patients undergoing dialysis while ensuring the effective use of vaccines. [ABSTRACT FROM AUTHOR]

In this paper, we provide a simple ODEs model with a generic nonlinear incidence rate function and incorporate two treatments, blocking the virus binding and inhibiting the virus replication to investigate the impact of calibration on model predictions for the SARS-CoV-2 infection dynamics. We derive conditions of the infection eradication for the long-term dynamics using the basic reproduction number, and complement the characterization of the dynamics at short-time using the resilience and reactivity of the virus-free equilibrium are considered to inform on the average time of recovery and sensitivity to perturbations in the initial virus free stage. Then, we calibrate the treatment model to clinical datasets for viral load in mild and severe cases and immune cells in severe cases. Based on the analysis, the model calibrated to these different datasets predicts distinct scenarios: eradication with a non reactive virus-free equilibrium, eradication with a reactive virus-free equilibrium, and failure of infection eradication. Moreover, severe cases generate richer dynamics and different outcomes with the same treatment. Calibration to different datasets can lead to diverse model predictions, but combining long- and short-term dynamics indicators allows the categorization of model predictions and determination of infection severity. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has presented unique challenges for rapidly designing, initiating, and delivering therapeutic clinical trials. PRINCIPLE (Platform Randomised Trial of Treatments in the Community for Epidemic and Pandemic Illnesses) is the UK national platform investigating repurposed therapies for COVID-19 treatment of older people in the community at high risk of complications. Standard methods of patient recruitment were failing to meet the required pace and scale of enrolment. This paper describes the development and appraisal of a near real-time, data-driven, ethical approach for enhancing recruitment in community care by contacting people with a recent COVID-19 positive test result from the central NHS Test and Trace service within approximately 24-48 h of their test result.Methods: A multi-disciplinary team was formed to solve the technical, ethical, public perception, logistical and information governance issues required to provide a near-real time (approximately within 24-48 h of receiving a positive test) feed of potential trial participants from test result data to the research team. PRINCIPLE was also given unique access to the Summary Care Record (SCR) to ensure safe prescribing, and to enable the trial team to quickly and safely bring consented patients into the trial. A survey of the public was used to understand public perceptions of the use of test data for this proposed methodology.Results: Prior to establishing the data service, PRINCIPLE registered on average 87 participants per week. This increased by up to 87 additional people registered per week from the test data, contributing to an increase from 1013 recruits to PRINCIPLE at the start of October 2020 to 2802 recruits by 20 December 2020. Whilst procedural caveats were identified by the public consultation, out of 2639 people contacted by PRINCIPLE following a positive test result, no one raised a concern about being approached.Conclusions: This paper describes a novel approach to using near-real time NHS operational data to recruit community-based patients within a few days of presentation with acute illness. This approach increased recruitment and reduced time between positive test and randomisation, allowing more rapid evaluation of treatments and increased safety for participants. End-to-end public and patient involvement in the design of the approach provided evidence to inform information governance decisions.Trial Registration: PRINCIPLE is funded by UK Research and Innovation and the Department of Health and Social Care through the National Institute for Health Research. EudraCT number: 2020-001209-22 . 26/03/2020 ISRCTN registry: ISRCTN86534580 . 20/03/2020 REC number: 20/SC/058 IRAS number: 281958. [ABSTRACT FROM AUTHOR]

The World Health Organization (WHO) announced the Coronavirus disease (COVID-19), which is triggered by SARS-CoV-2 virus, on March 11, 2020. Nations all over the world reacted quickly, enacting various mitigation measures such as travel and movement restrictions, prohibitions on meeting, generalized or partial lockdowns, handwashing, and promotion of good hygiene and health. Corona virus outbreaks have claimed the lives of many people globally since 2019, with an estimated of over 5 million people infected. The world health organization since the announcement of the COVID-19 pandemic released statements about nations working towards finding a vaccine for the virus. Furthermore, with 80% of African population depending on traditional medicine, a spotlight was on the WHO about their views on African traditional medicine, which is a component of African indigenous Knowledge Systems as one of the COVID-19 treatments. The WHO therefore declared that traditional medicine would undergo clinical trials to check its potential as COVID-19 treatment. The paper examines the effects of COVID-19 in Africa, as well as existing clinical trials in African traditional medicine to cure and treat the virus, using existing literature. In addition, the paper considers the future of traditional medicine in the pharmaceutical and other medical plant industries. [ABSTRACT FROM AUTHOR]

Background: Numerous clinical trials have been initiated to find effective treatments for COVID-19. These trials have often been initiated in regions where the pandemic has already peaked. Consequently, achieving full enrollment in a single trial might require additional COVID-19 surges in the same location over several years. This has inspired us to pool individual patient data (IPD) from ongoing, paused, prematurely-terminated, or completed randomized controlled trials (RCTs) in real-time, to find an effective treatment as quickly as possible in light of the pandemic crisis. However, pooling across trials introduces enormous uncertainties in study design (e.g., the number of RCTs and sample sizes might be unknown in advance). We sought to develop a versatile treatment efficacy assessment model that accounts for these uncertainties while allowing for continuous monitoring throughout the study using Bayesian monitoring techniques. Methods: We provide a detailed look at the challenges and solutions for model development, describing the process that used extensive simulations to enable us to finalize the analysis plan. This includes establishing prior distribution assumptions, assessing and improving model convergence under different study composition scenarios, and assessing whether we can extend the model to accommodate multi-site RCTs and evaluate heterogeneous treatment effects. In addition, we recognized that we would need to assess our model for goodness-of-fit, so we explored an approach that used posterior predictive checking. Lastly, given the urgency of the research in the context of evolving pandemic, we were committed to frequent monitoring of the data to assess efficacy, and we set Bayesian monitoring rules calibrated for type 1 error rate and power. Results: The primary outcome is an 11-point ordinal scale. We present the operating characteristics of the proposed cumulative proportional odds model for estimating treatment effectiveness. The model can estimate the treatment's effect under enormous uncertainties in study design. We investigate to what degree the proportional odds assumption has to be violated to render the model inaccurate. We demonstrate the flexibility of a Bayesian monitoring approach by performing frequent interim analyses without increasing the probability of erroneous conclusions. Conclusion: This paper describes a translatable framework using simulation to support the design of prospective IPD meta-analyses. [ABSTRACT FROM AUTHOR]

Remdesivir (RDV) is the only antiviral drug approved for COVID-19 therapy by the FDA. Another drug LAGEVRIO™ (molnupiravir) though has not been approved yet by FDA but has been authorized on December 23, 2021, for emergency use to treat adults with mild-to moderate COVID-19 symptoms and for whom alternative COVID-19 treatment options are not clinically appropriate. The fact is that the efficacy of RDV is, however, limited in vivo though it is highly promising in vitro against SARS-CoV-2 virus. In this paper we are focusing on the action mechanism of RDV and how it can be improved in vivo. The stability of RDV alone and on encapsulation with our platform technology based polymer NV-387 (NV-CoV-2), were compared in presence of plasma in vitro and in vivo. Furthermore, a non-clinical pharmacology study of NV-CoV-2 (Polymer) and NV CoV-2 (Polymer encapsulated Remdesivir) in both NL-63 infected and uninfected rats was done. In addition, the antiviral activity of NV-CoV-2 and NV-CoV-2-R was compared with RDV in a cell culture study. The results are (i) NV-CoV-2 polymer encapsulation protects RDV from plasma-mediated catabolism in both in vitro and in vivo, studies; (ii) Body weight measurements of the normal (uninfected) rats after administration of the test materials (NV-CoV-2 and NV-CoV-2-R) showed no toxic effects. (iii) Body weight measurements and survival rates of the NL-63 infected rats were similar to the uninfected rats after treatment with NV-CoV-2 and NV-CoV-2-R. Overall, the efficacy as an antiviral regimens were found in this order as below; NV-CoV-2-R > NV-CoV-2 > RDV. Our platform technology based NV-387-encapsulated-RDV (NV-CoV-2-R) drug has a dual effect against different variants of the coronaviruses. First, NV-CoV-2 is an antiviral regimen. Secondly, RDV is protected from plasma-mediated degradation in transit. All together, NV-CoV-2-R is the safest and efficient regimen against COVID-19. [ABSTRACT FROM AUTHOR]

In this paper we document and analyze emergent participatory processes in drug policy, focusing on the relations between established modes of engagement and emergent participatory formats. We do this through analysis of a case example, attending to policy changes to opioid pharmacotherapy treatment in the context of COVID-19 in Australia. Semistructured interviews (n = 22) were undertaken between August 2020 and March 2021 with people closely involved in the recent policy changes and discussions surrounding opioid pharmacotherapy treatment in Australia. The analysis of the interview accounts followed work which has forged relational, co-productionist and materialist understandings of participation. Two figures of participation were encountered in the interview accounts: the tables of participation and the huddles of participation. The tables seemingly represented a standardized set of bureaucratic mechanisms for the inclusion of the "voices" of people who use drugs. The huddles emerged as a responsive and less coherent set of ad hoc participatory collectives in the context of rapid policy changes during COVID-19. Instead of viewing emergence as distinct from existing participatory formats, emergence was conceptualized ecologically in this article—that is in relation to established forms of participation. As the institutionally mandated tables served the basis for the emergent huddles of participation in this case study, it demonstrates that even the most foreclosed participatory structures can adapt and be responsive to evolving situations of need, perhaps also in ordinary times and not just in emergency conditions. [ABSTRACT FROM AUTHOR]

With the extension of the COVID-19 pandemic, the large use of COVID-19 vaccines among adults and the emergence of SARS-CoV-2 variants means that the epidemiology of COVID-19 in pediatrics, particularly among younger children, has substantially changed. The prevalence of pediatric COVID-19 significantly increased, several severe cases among children were reported, and long-COVID in pediatric age was frequently observed. The main aim of this paper is to discuss which types of treatment are presently available for pediatric patients with COVID-19, which of them are authorized for the first years of life, and which are the most important limitations of COVID-19 therapy in pediatric age. Four different antivirals, remdesivir (RVD), the combination nirmatrelvir plus ritonavir (Paxlovid), molnupiravir (MPV), and the monoclonal antibody bebtelovimab (BEB), are presently approved or authorized for emergency use for COVID-19 treatment by most of the national health authorities, although with limitations according to the clinical relevance of disease and patient's characteristics. Analyses in the literature show that MPV cannot be used in pediatric age for the risk of adverse events regarding bone growth. The other antivirals can be used, at least in older children, and RDV can be used in all children except in neonates. However, careful research on pharmacokinetic and clinical data specifically collected in neonates and children are urgently needed for the appropriate management of pediatric COVID-19. [ABSTRACT FROM AUTHOR]

The ongoing COVID-19 pandemic is known to affect several body organs, including the liver. This results from several factors such as direct effect of SARS-CoV-2 on the liver, side effects of drug therapy and pre-existing liver diseases. Drug-induced liver injury can result from a range of drugs used in the treatment of COVID-19 such as antiviral drugs, anti-inflammatory drugs, antibiotics, herbal medications and vaccines. Metabolism of most drugs occurs in the liver, and this leaves the liver at risk of medication-induced liver damage. Being among pathologies from the disease, COVID-19 liver injury presents with abnormally high liver-related enzymes, such as aspartate aminotransferase, alanine aminotransferase, alkaline phosphate (ALP), and gamma-glutamyl transferase. It is reversible, generally not severe and occurs more mildly in children. However, COVID-19-associated liver injury is worsened by chronic liver diseases and vice versa. There is a high risk of abnormal ALT and AST, in-hospital liver injury and prolonged SARS-CoV-2 shedding in COVID-19 patients with previously existing metabolic-associated fatty liver disease. COVID-19-associated liver injury also appears to be severe and significantly associated with life-threatening COVID-19 and mortality in persons with a history of liver transplant. Where necessary, only supportive management is usually indicated. This paper evaluates the aetiology, clinical and laboratory features, occurrence and management of COVID-19-associated liver injury. It also elaborated on the role of drug therapy in the development of COVID-19 liver injury. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID-19) continues to have a negative impact on healthcare systems around the world, though the vaccines have been developed and national vaccination coverage rate is steadily increasing. At the current stage, automatically segmenting the lung infection area from CT images is essential for the diagnosis and treatment of COVID-19. Thanks to the development of deep learning technology, some deep learning solutions for lung infection segmentation have been proposed. However, due to the scattered distribution, complex background interference and blurred boundaries, the accuracy and completeness of the existing models are still unsatisfactory. To this end, we propose a boundary guided semantic learning network (BSNet) in this paper. On the one hand, the dual-branch semantic enhancement module that combines the top-level semantic preservation and progressive semantic integration is designed to model the complementary relationship between different high-level features, thereby promoting the generation of more complete segmentation results. On the other hand, the mirror-symmetric boundary guidance module is proposed to accurately detect the boundaries of the lesion regions in a mirror-symmetric way. Experiments on the publicly available dataset demonstrate that our BSNet outperforms the existing state-of-the-art competitors and achieves a real-time inference speed of 44 FPS. The code and results of our BSNet can be found from the link of https://github.com/rmcong/BSNet. [ABSTRACT FROM AUTHOR]

The corona virus disease 2019 (COVID-19) pandemic, which originated in the city of Wuhan, China, has rapidly spread to various countries, with many cases having been reported. Some existing antiviral agents showed positive results to inhibit the infection and transmission of the novel corona virus 2019 (2019-nCoV) in vitro. Covaxin is India's first indigenous COVID-19 vaccine. In this paper, we introduce the Gourava and hyper-Gourava polynomials of a graph. We compute the Gourava and hyper-Gourava polynomials of some specific class of graphs. Further, we obtain the Gourava and hyper-Gourava polynomials of some chemical structures viz., chloroquine, hydroxychloroquine, remdesivir and theaflavin which were used in the treatment of COVID-19. The Gourava and hyper-Gourava indices are investigated for the aforesaid antiviral drugs using polynomial approach. The Indian Council of Medical Research and Bharat Biotech announced that Phase 3 results of covaxin, developed by them, have shown an interim vaccine efficacy of 81 percent. So, the results obtained may be useful for finding the design of new medicine for the treatment of COVID-19. [ABSTRACT FROM AUTHOR]

Cases of the COVID-19 pandemic have spread throughout the world and caused a high mortality rate. This virus is self-limiting, so the healing process is related to the immune system. One of the medical therapies given to hospitalized COVID-19 patients is vitamin D-based therapy to boost the immune system against the COVID-19 virus. This paper aimed to determine the effectiveness of vitamin D-based therapy to reduce the clinical impact on COVID-19 patients. The clinical impacts observed in this systematic review were the length of hospital stay, length in the ICU stay, cure rate, severity, mortality rate, and signs of inflammation. A literature search was carried out on the Scopus, Sciencedirect, and PUBMED databases. Search articles using the keyword vitamin D therapy in COVID-19 patients. The final result of the search found 6 articles that met the specified inclusion and exclusion criteria. Vitamin D in its active form (1,25(OH)2D3) can enhance chemotaxis, phagocytic response, and production of antimicrobials such as cathelicidin from macrophages as a series of innate immune responses. Administration of vitamin D-based therapy can also reduce the severity, decrease pro-inflammatory cytokines, and mortality in COVID-19 patients. The paper shows that vitamin D-based therapy can reduce the clinical impact in COVID-19 patients. [ABSTRACT FROM AUTHOR]

(SARS-CoV-2), was first identified in December 2019 as the cause of a respiratory illness designated coronavirus disease 2019, or Covid-19. Several therapeutic agents have been evaluated for the treatment of Covid-19, but none have yet been shown to be efficacious. Remdesivir (GS-5734), an inhibitor of the viral RNA-dependent, RNA polymerase with inhibitory activity against SARS-CoV and the Middle East respiratory syndrome (MERS-CoV), was identified early as a promising therapeutic candidate for Covid-19 because of its ability to inhibit SARS-CoV-2 in vitro. Besides, in nonhuman primate studies, remdesivir initiated 12 hours after inoculation with MERS-CoV9,10 reduced lung virus levels and lung damage. In the field of Medical Science, concerning the definition of the topological index on the molecular structure and corresponding medical, biological, chemical, pharmaceutical properties of drugs can be studied by the topological index calculation. In this paper, we compute some of the general temperature topological properties of remdesivir that the results in this paper may be useful in finding new drug and vaccine for the treatment and prevention of COVID-19. [ABSTRACT FROM AUTHOR]

Community is directly responsible for implementing the policy measures against public emergencies such as extreme weather, earthquake, flash flood and pandemic diseases. Summarizing the experience at the urban community level can help promote the global emergency management. This paper, from the perspective of COVID-19 prevention and control, selects three communities with different features to explore an effective response system for public emergency management at the urban community level. It demonstrates that based on a centralized leadership, the multi-level governance (MLG) network combined with information technology has mobilized their participation in combating COVID-19 and ensured the effective and timely response to the public emergencies, which blocked the spread of epidemic to the greatest extent, proving worthy of being promoted as one of the Chinese approaches and Chinese wisdom. [ABSTRACT FROM AUTHOR]

Objective: In the context of the coronavirus disease 2019 (COVID-19) pandemic, telemedicine is a promising tool for providing clinical care for patients. Since the first-line treatment for infertile women with polycystic ovarian syndrome (PCOS) is lifestyle modification, a mobile-based service that provides lifestyle modification education would be helpful in the treatment of PCOS patients. In this observational study, the effect of a mobile Health (mHealth) application for lifestyle modification on PCOS patients undergoing assisted reproductive technology (ART) treatment was evaluated. Methods: A total of 79 overweight/obese patients (40 in the paper group and 39 in the WeChat application group) with PCOS from the First Affiliated Hospital of University of Science and Technology of China were enrolled in the study. The changes in the outcomes of BMI and ART treatment were analyzed between the two groups. Results: After three months of intervention, the BMIs in the control and mHealth groups were 24.5 ± 3.3 and 23.7 ± 3.1, respectively. The percentage of patients who lost weight was higher in the WeChat group than in the control group (87.2% vs. 67.5%). Furthermore, PCOS patients in the WeChat group were found to have a higher live birth rate than those in the control group (p = 0.005). Conclusion: Lifestyle modifications for PCOS patients undergoing ART treatment using the WeChat application improved weight loss and oocyte quality. Infertile patients with PCOS were more likely to make lifestyle modifications based on the usage of mobile applications during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

The sudden outbreak of the novel coronavirus pandemic in 2019 disrupted the normal order of life and work, and the virus is still a major threat prevailing the globe. Confronted with the unknown virus, citizens have been following government policies of COVID-19 treatment and containment, and actively improving their immunity through physical activity (PA). This paper is concerned with ways to guide or promote people's willingness to exercise, one of the most effective means to boost immunity. Based on the "attitude–intention" correlation defined in the theory of planned behaviour (TPB), this study, by synchronizing online data about workouts, explores the influence of people's attitudes towards PA behaviour in promoting their intentions to engage in such behaviours as a means to fight the pandemic. In addition, the attitudes towards the use of sports apps and the epidemic are also reckoned with to investigate influencing factors promoting physical activity during the lockdown. The results of the study have been derived from the data of 1223 valid questionnaires, which are subjected to hierarchical regression analysis. Attitudes towards exercise and the use of sports apps are proven to have a significant impact on PA intentions, and the two variables are in direct proportion, with more positive attitudes leading to higher intentions; in contrast, attitudes towards the epidemic do not exhibit an obvious effect. In this light, it is advisable that when clinicians treat COVID-19 patients and medical departments respond to the epidemic, they actively make affirmative influences on peoples' attitudes towards exercise and formulate appropriate exercise plans based on indicators detected and recorded by sports apps such as vital capacity, heart rate, respiratory index and self-perceived intensity to help them face the risk of the epidemic with more confidence. [ABSTRACT FROM AUTHOR]

Pulmonary fibrosis (PF) is a feared outcome of many pulmonary diseases which results in a reduction in lung compliance and capacity. The development of PF is relatively rare, but it can occur secondary to viral pneumonia, especially COVID-19 infection. While COVID-19 infection and its complications are still under investigation, we can look at a similar outbreak in the past to gain better insight as to the expected long-term outcomes of COVID-19 patient lung function. In the current article, we review the literature relative to PF via PubMed. We also performed a literature search for COVID-related pathological changes in the lungs. Finally, the paper was reviewed and summarized based on the studies' integrity, relative, or power calculations. This article provides a narrative review that endeavors to elucidate the current understanding of the pathophysiological mechanisms underlying PF and therapeutic strategies. We also discussed the potential for preventing progression to the fibrotic state within the context of the COVID-19 pandemic. With the massive scale of the COVID-19 pandemic, we expect there should more instances of PF due to COVID-19 infection. Patients who survive severe COVID-19 infection may suffer from a high incidence of PF. [ABSTRACT FROM AUTHOR]

Objectives: To document how many pregnant women with COVID-19 reported in the literature had participated in randomised trials, what treatments they received outside such trials and compare the latter with evidence-based treatment recommendations.Study Design: A systematic review of observational studies.Methods: Two clinical trial registries were searched to identify COVID-19 trials open to pregnant women. Studies were then extracted from a regularly updated list of scientific case reports and case series of confirmed or suspected maternal COVID-19 in pregnancy to identify the number of women enrolled into a trial and the pharmaceutical treatments they received outside such trials.Results: 156 studies (case reports, case series and registries) reporting 43,185 pregnant women with COVID-19, after de-duplication. Of these 2,671 (6.2%) were potentially eligible for a randomised trial but only seven women (0.26%) were reported to have enrolled. For 2,839 women the papers included information on treatment received, 1515/2829 (54%) women had received ≥ 1 treatment and in total a COVID-19 pharmaceutical treatment was administered 1,296 times outside of a trial. In 566 (44%) cases the treatments administered to the pregnant women were not recommended by the National Institutes of Health (NIH) at the time of administration. Of 179 case reports of women with COVID 19 in pregnancy, 109/179 women received ≥ 1 COVID-19 pharmaceutical treatment and in total COVID-19 experimental pharmaceutical treatments were administered 274 times.Conclusion: During the early phase of the COVID-19 pandemic, pregnant women excluded from randomised trials did not avoid unproven or ineffective treatments. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 (COVID-19) is a pandemic whose adverse effects have been felt all over the world. As of August 2022, reports indicated that over 500 million people in the world had been infected and the number of rising deaths from the disease were slightly above 6.4 million. New variants of the causative agent, SARS-CoV-2 are emanating now and then and some are more efficacious and harder to manage. SARSCoV-2 main protease (Mpro) has essential functions in viral gene expression and replication through proteolytic cleavage of polyproteins. Search for SARS-CoV-2 Mpro inhibitors is a vital step in the treatment and management of COVID-19. In this study, we investigated whether alkaloids with antiviral and myriad other bioactivities from the genus Lycoris can act as SARS-CoV-2 Mpro inhibitors. We conducted a computer-aided drug design study through screening optimal ligands for SARS-CoV-2 Mpro from a list of over 150 Lycoris alkaloids created from online databases such as ChEMBL, PubChem, ChemSpider, and published journal papers. The In silico study involved molecular docking of Lycoris alkaloids to SARS-CoV-2 Mpro active site, absorption, distribution, metabolism, elimination and toxicity (ADMET) screening and finally molecular dynamic (MD) simulations of the most promising ligand-SARS-CoV-2 Mpro complexes. The study identified 3,11-dimethoxy-lycoramine, narwedine, O-demethyllycoramine and epilycoramine as drug-like and lead-like Lycoris alkaloids with favorable ADMET properties and are very likely to have an inhibition activity on SARSCoV-2 Mpro and may become potential drug candidates. [ABSTRACT FROM AUTHOR]

CCOVID-19 was first reported in late 2019 in Wuhan, China, and spread throughout the world like a pandemic. The population all over the world used lots of medicinal plants for prevention purposes. India has been blessed with cultural wisdom. Social health practices across the country have been utilizing integrative treatments to fight against mild fever and cold flu-like infections. Herbal and Ayurveda medicines have shown their impact on treating such infections in the early stages. The impact of herbal medicines on Covid infection is quite evident and several drug tests and trials have proved its worth of it in treating mild to severe infections. The majority of these plants are used to treat respiratory diseases having the same signs and symptoms as coronavirus symptoms or other flu infections. Our body can fight infections only when immunity is strong and for that herbal drugs as immunomodulators work well. It has worked in boosting the immunity of the patients and normal people to fight against Corona. The paper analyzes such research studies on Covid-19 treatment by herbal medicines. It makes a point that herbal medicine-based treatments and social health practices will play a complementary role in managing Covid-19 and Post-Covid health emergencies. New-Normal social ethics will evolve through such an integrative social health culture. [ABSTRACT FROM AUTHOR]

Background: A global pandemic has been declared for coronavirus disease 2019 (COVID-19), which has serious impacts on human health and healthcare systems in the affected areas, including Vietnam. None of the previous studies have a framework to provide summary statistics of the virus variants and assess the severity associated with virus proteins and host cells in COVID-19 patients in Vietnam.Method: In this paper, we comprehensively investigated SARS-CoV-2 variants and immune responses in COVID-19 patients. We provided summary statistics of target sequences of SARS-CoV-2 in Vietnam and other countries for data scientists to use in downstream analysis for therapeutic targets. For host cells, we proposed a predictive model of the severity of COVID-19 based on public datasets of hospitalization status in Vietnam, incorporating a polygenic risk score. This score uses immunogenic SNP biomarkers as indicators of COVID-19 severity.Result: We identified that the Delta variant of SARS-CoV-2 is most prevalent in southern areas of Vietnam and it is different from other areas in the world using various data sources. Our predictive models of COVID-19 severity had high accuracy (Random Forest AUC = 0.81, Elastic Net AUC = 0.7, and SVM AUC = 0.69) and showed that the use of polygenic risk scores increased the models' predictive capabilities.Conclusion: We provided a comprehensive analysis for COVID-19 severity in Vietnam. This investigation is not only helpful for COVID-19 treatment in therapeutic target studies, but also could influence further research on the disease progression and personalized clinical outcomes. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic poses an ongoing global challenge, and several risk factors make people with multiple sclerosis (pwMS) particularly susceptible to running a severe disease course. Although the literature does report numerous articles on the risk factors for severe COVID-19 and vaccination response in pwMS, there is a scarcity of reviews integrating both these aspects into strategies aimed at minimizing risks. The aim of this review is to describe the risk of vulnerable pwMS exposed to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the issues related to the SARS-CoV-2 vaccine and to evidence possible future strategies in the clinical management of pwMS. The authors searched for papers on severe COVID-19 risk factors, SARS-CoV-2 vaccination and people with multiple sclerosis in support of this narrative literature review. We propose a multilevel strategy aimed at: the evaluation of risk factors for severe COVID-19 in people with multiple sclerosis, identifying the most appropriate vaccination schedule that is safe for people on disease-modifying drugs (DMDs) and a strict follow-up of high-risk people with multiple sclerosis to allow for the prompt administration of monoclonal antibodies to manage COVID-19 risks in this patient population. [ABSTRACT FROM AUTHOR]

This article is a critical legal analysis of the proposed TRIPS waiver under World Trade Organization (WTO) law. It reviews the existing TRIPS flexibilities and the "August 2003 TRIPS waiver", highlighting the obstacles to achieving the goals of these legal instruments. It demonstrates that numerous critical TRIPS flexibilities, notably TRIPS Article 31bis, are ineffective, prompting some countries to submit a new waiver proposal to the WTO. It highlights several WTO rules that are also quite ambiguous. This paper argues that a WTO clarification might be an alternative to the new TRIPS waiver proposal if it is ultimately rejected due to a lack of consensus among WTO members. Finally, this article emphasises the importance of adopting a balanced approach that may simplify complicated TRIPS rules, decrease the risk of trade-based retaliation and improve collaboration in knowledge transfer and scaling up the manufacture of and access to lifesaving vaccines, pharmaceuticals and healthcare equipment. [ABSTRACT FROM AUTHOR]

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes Coronavirus Disease 19 (COVID-19), a disease that has affected more than 500 million people worldwide since the end of 2019. Due to its high complications and death rates, there is still a need to find the best therapy for SARS-CoV-2 infection. The dysregulation of the inflammatory response in COVID-19 plays a very important role in disease progression. It has been observed that abnormal activity of Nuclear Factor kappa B (NF-κB) is directly associated with, inter alia, increased synthesis of proinflammatory factors. Therefore, this review paper focuses on the functions of NF-κB in the development of SARS-CoV-2 infection and potential application of NF-κB inhibitors in COVID-19 immunotherapy. A comprehensive literature search was performed using the MEDLINE/PubMed database. In the current review, it is highlighted that NF-κB plays important functions in the modulation of an adaptive inflammatory response, including inducing the expression of proinflammatory genes. Increased activation of NF-κB in SARS-CoV-2 infection was observed. The association between NF-κB activation and the expression of SARS-CoV-2 structural and non-structural proteins were also reported. It was observed that modulation of NF-κB using, e.g., traditional Chinese medicine or glucocorticosteroids resulted in decreased synthesis of proinflammatory factors caused by SARS-CoV-2 infection. This review summarizes the role of NF-κB in COVID-19 and describes its potential immunotherapeutic target in treatment of SARS-CoV-2 infection. However, indisputably more studies involving patients with a severe course of COVID-19 are sorely needed. [ABSTRACT FROM AUTHOR]

COVID-19 together with variants have caused an unprecedented amount of mental and economic turmoil with ever increasing fatality and no proven therapies in sight. The healthcare industry is racing to find a cure with multitude of clinical trials underway to access the efficacy of repurposed antivirals, however the much needed insights into the dynamics of pathogenesis of SARS-CoV-2 and corresponding pharmacology of antivirals are lacking. This paper introduces systematic pathological model learning of COVID-19 dynamics followed by derivative free optimization based multi objective drug rescheduling. The pathological model learnt from clinical data of severe COVID-19 patients treated with remdesivir could additionally predict immune T cells response and resulted in a dramatic reduction in remdesivir dose and schedule leading to lower toxicities, however maintaining a high virological efficacy. [ABSTRACT FROM AUTHOR]

The COVID‐19 pandemic has driven an unprecedented level of global activity in drug discovery and clinical development for effective therapeutics targeting the coronavirus disease. There are currently 744 therapeutics being tested in 2879 clinical trials globally. Almost 90% of these clinical trials are focused on monotherapies. Combination therapies are the mainstay of antiviral therapeutics to increase the potency of the individual compounds and to combat the rapid evolution of resistance, although combination therapies have inherently complex clinical and regulatory development challenges. Increased understanding of the SARS‐CoV‐2 lifecycle and COVID‐19 pathology provides a scientific rationale for evaluating the effectiveness of different combinations. In this paper, we provide an overview of the current clinical trial landscape for combination therapeutics targeting COVID‐19 through weekly scanning of national and international clinical trial registries. Our analysis delves specifically into dual combination therapies in what can be defined as "pivotal clinical trials" (active, randomised, controlled and at least phase II), with a focus on new and repurposed therapeutic candidates that have shown positive signals and/or been granted authorisation for emergency use based on positive efficacy and safety data. [ABSTRACT FROM AUTHOR]

Background: With the Coronavirus becoming a new reality of our world, global efforts continue to seek answers to many questions regarding the spread, variants, vaccinations, and medications. Particularly, with the emergence of several strains (e.g., Delta, Omicron), vaccines will need further development to offer complete protection against the new variants. It is critical to identify antiviral treatments while the development of vaccines continues. In this regard, the repurposing of already FDA-approved drugs remains a major effort. In this paper, we investigate the hypothesis that a combination of FDA-approved drugs may be considered as a candidate for COVID-19 treatment if (1) there exists an evidence in the COVID-19 biomedical literature that suggests such a combination, and (2) there is match in the clinical trials space that validates this drug combination. Methods: We present a computational framework that is designed for detecting drug combinations, using the following components (a) a Text-mining module: to extract drug names from the abstract section of the biomedical publications and the intervention/treatment sections of clinical trial records. (b) a network model constructed from the drug names and their associations, (c) a clique similarity algorithm to identify candidate drug treatments. Result and Conclusions: Our framework has identified treatments in the form of two, three, or four drug combinations (e.g., hydroxychloroquine, doxycycline, and azithromycin). The identifications of the various treatment candidates provided sufficient evidence that supports the trustworthiness of our hypothesis. [ABSTRACT FROM AUTHOR]

Severe Acute Respiratory Syndrome Coronavirus 2(SARS-CoV-2) is a newly discovered infectious coronavirus, which can cause Coronavirus Disease 2019 (COVID-19). The outbreak of the disease has caused severe impact both at home and abroad. Compared with the other three structural proteins encoded by SARS-CoV-2, Nucleocapsid phosphoprotein (Np) is more conservative and plays an important role in pathogen diagnosis, vaccine design, and treatment. This paper aims to predict the spatial structure of Np in Wuhan-Hu-1 strain and its B-cell epitope,and lay a foundation for the development of epitope vaccine and related monoclonal antibody of SARS-CoV-2. In this study, the Neighbor-joining method in MEGA5.05 was used to construct a phylogenetic tree based on the base sequence of Np of SARS-CoV-2 strain. The SARS-CoV-2 Wuhan-Hu-1 strain was used as the research object, and parameters such as hydrophilicity index, flexible region, surface possibility, and antigenic index were analyzed and predicted by the Protean module in the DNAStar software, combined with the spatial structure simulated by the Phyre2 online tool, so as to comprehensively predict the dominant B-cell epitopes of Np of Wuhan-Hu-1. Results show that the gene sequences of Np of SARS-CoV-2 isolated from different regions were highly similar (99.6%-100%). The amino acid sequence of Np in Wuhan-Hu-1 strain was 419 aa.The spatial structure of Np in Wuhan-Hu-1 strain was fairly regular. It contained only a small amount of α-helixes, while most of the structures were β-sheets, β-turns, and random coils. Results of multi-parameter comprehensive analysis showed that the possible antigenic epitope regions of B-cell were located in the amino acid regions of 52-9,9-5,3-9,6-5,9-4,0-6,4-6,7-7,3-9,7-3,9-5,3-9,7-3,9-5,9-401,and 403-411. The results of this study can provide theoretical information for the development of epitope vaccine, rapid diagnostic reagents, and monoclonal antibodies with respect to SARS-CoV-2, and offer new strategies for COVID-19 treatments. [ABSTRACT FROM AUTHOR]

COVID-19 is an infectious disease caused by the novel coronavirus SARS-CoV-2, which rapidly spreads via respiratory droplets and is the cause of the current pandemic. In this alarming situation, it is a delicate matter how to visit patients safely and how to manage their chronic treatments. The aim of this paper is to examine in detail the potential impact on SARS-CoV-2 infection of treatments routinely used in trichology and to provide a useful guide for the therapeutic management of trichological patients in this new COVID-19 era. [ABSTRACT FROM AUTHOR]