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Physiological changes during pregnancy make the individuals more susceptible to severe respiratory diseases. Hence, pregnant women with coronavirus disease 2019 (COVID-19) are likely at a higher risk. We investigated the effects of COVID-19 on T cell response and serum cytokine profile in pregnant patients. Peripheral blood mononuclear cells (PBMCs) of women with COVID-19 were collected during the first trimester of pregnancy, and the percentage of total lymphocytes, as well as CD4 + and CD8 + T cells, was assessed using flow cytometry. The expression of the programmed death-1 (PD-1) marker for exhausted T cells was evaluated. Additionally, the serum samples were provided to evaluate the levels of antiviral and proinflammatory cytokines, as well as laboratory serological tests. Pregnant women with COVID-19 presented lymphopenia with diminished CD4 + and CD8 + T cells. Besides, high expression levels of the PD-1 gene and protein were observed on PBMCs and T cells, respectively, when compared with normal pregnant individuals. Moreover, serum levels of TNF-α, IL-6, IL-1β, and IL-2 receptor were notably enhanced, while IFN-I α/β values were significantly decreased in the patients when compared with controls. Furthermore, hyperlipidemia, hyperglycemia, and hypertension were directly correlated with the disease although serum albumin and vitamin D3 levels adversely affected the viral infection. Our study showed extreme lymphopenia and poor T cell response while elevated values of serum inflammatory cytokines in infected pregnant women. Moreover, a hypertension background or metabolic changes, including hyperlipidemia, hyperglycemia, and vitamin D3 or albumin deficiency, might be promising prognostic factors in pregnant women with COVID-19., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background: One of the regulators in severe acute respiratory syndrome coronavirus2 (SARS-CoV2) infection is miRNAs. In COVID-19 patients, immunological responses to SARS-CoV2 infection may be impacted by miR-155, a miRNA associated to inflammation., Materials and Methods: Peripheral blood mononuclear cells (PBMCs) of 50 confirmed COVID-19 patients /Healthy Controls (HCs) was isolated by Ficoll. The frequency of T helper 17 and regulatory T cells was analyzed by flowcytometry. The RNA was extracted from each sample and after synthesis of c-DNA, the relative expression of miR-155, suppressor of cytokine signaling (SOCS-1), Signal transducer and activator of transcription 3(STAT3), and Fork Head Box Protein 3 (FoxP3) was evaluated by real-time PCR. The protein level of STAT3, FoxP3 and RORγT in the isolated PBMCs measured by western blotting. The serum level of IL-10, TGF-β, IL-17 and IL21 was assessed by ELISA method., Results: The population of Th17 cells showed a significant rise, whereas Treg cells reduced in COVID-19 cases. The master transcription factor of Treg (FoxP3) and Th17 (RORγT) relative expression showed the same pattern as flowcytometry. STAT3 level of expression at RNA and protein level increased in COVID-19 cases. FOXP3 and SOCS-1 proteins were down-regulated. The relative expression of miR-155, up-regulated in PBMC of COVID-19 patients and revealed a negative correlation with SOCS-1. The serum cytokine profile showed a reduction in TGF-β, on the other hand an increase was seen in IL-17, IL-21 and IL-10 in COVID-19 cases toward control group., Conclusion: Based on the studies conducted in this field, it can be suggested that Th17/Treg in covid-19 patients can be affected by miR-155 and it can be considered a valuable diagnostic and prognostic factor in this disease., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

An imbalance between regulatory T (Treg) and T-helper (Th)-17 cells has been implicated in the pathogenesis of coronavirus disease 2019 (COVID-19). Mesenchymal stem cells (MSCs) exert immunomodulatory properties through secreting exosomes. This study aimed to assess the effect of MSC-derived exosomes (MSC-Exo) on the differentiation of peripheral blood mononuclear cells (PBMCs) into  Tregs from patients with COVID-19. Exosomes were isolated from adipose tissue-derived MSCs. PBMCs were separated from the whole blood of COVID-19 patients (n=20). Treg frequency was assessed before and 48 hours after treatment of PBMCs with MSC-Exo using flow cytometry. Expression of FOXP3 and cytokine genes, and the concentration of cytokines associated with Tregs, were assessed before and after treatment with MSC-Exo. The frequency of CD4+CD25+CD127-  Tregs was significantly higher after treating PBMCs with MSC-Exo (6.695±2.528) compared to before treatment (4.981±2.068). The expressions of transforming growth factor (TGF)-β1, interleukin (IL)-10, and FOXP3 were significantly upregulated in MSC-Exo-treated PBMCs. The concentration of IL-10 increased significantly after treatment (994.7±543.9 pg/mL) of PBMCs with MSC-Exo compared with before treatment (563.5±408.6 pg/mL). The concentration of TGF-β was significantly higher in the supernatant of PBMCs after treatment with MSC-Exo (477.0±391.1 pg/mL) than PBMCs before treatment (257.7±226.3 pg/mL). MSC-Exo has the potential to raise anti-inflammatory responses by induction of  Tregs, potentiating its therapeutic effects in COVID-19.

Background: The number of deaths among people with coronavirus disease 2019 (COVID-19) does not show the true impact of the disease on communities. Therefore, this study aimed to calculate years of life lost (YLL) due to premature death in patients with COVID-19., Methods: We performed a descriptive cross-sectional study based on data from one of the largest provinces of Iran, in the period 13 February 2020 to 17 May 2021. We used WHO proposed guidelines for the calculation of the burden of diseases to calculate the YLL among patients with COVID-19, taking into consideration gender in different age groups., Results: Findings showed that 13 628 deaths were due to COVID-19 with associated 249 309 YLL. The study reported higher mortality among men (1222 cases) in the age group over 85 years than in women (840) of the same age group. The minimum number of YLL for men was 1749 in the 5-9 years age group and that for women was 1551 years in the 14-10 years age group., Conclusion: The high number of deaths due to COVID-19 has led to high YLL due to premature death. The provision of adequate health care and appropriate policies will bring about a decrease in YLL due to COVID-19., (© The Author(s) 2021. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

Background: Measuring the level of antibodies produced post-vaccination in response to the SARS-CoV-2 spike protein is considered a strategy for estimating the effectiveness of the COVID-19 vaccines., Objective: To examine the antibody levels among the healthcare workers in different hospitals in Mashhad, Iran after receiving the second dose of Sputnik V., Methods: In this study, we enrolled 230 healthcare workers for evaluating the Gam-COVID-Vac or Sputnik V after the second administration in different hospitals in Mashhad. Antibody levels of spike protein were quantitatively evaluated in a sample of 230 negative RT-PCR tests for the COVID-19 individuals. The analysis has been done based on an immunological assay using enzyme-linked immunosorbent assay (ELISA). The infection history of the subjects and their families was examined through their medical records., Results: Our results demonstrated a significant association between a higher titer of IgG and a previous history of the COVID-19 infection (P<0.001). Moreover, the chance of detecting antibodies titer more than 50 AU/ml was 16.99 in these people which was significantly higher than in people without a history of infection pre-vaccination [%95CI: (7.38,39.12), P<0.001]., Conclusion: This result demonstrates that the efficacy of antibody production is related to the previous history of the SARS-CoV-2 infections. Ongoing monitoring of the level of antibody among vaccinated populations will help evaluating the effect of vaccines on humoral immunity status.

Background: COVID-19-related immune responses in patients with end-stage renal disease (ESRD) are characterized in detail by the humoral response, but their cellular immunity has not been clarified. Here, we evaluated virus-specific T cells in parallel with serology-related tests., Methods: In this study, 104 ESRD patients at the hemodialysis ward of Imam Reza hospital at Tabriz (Iran) were enrolled. After blood sampling, SARS-CoV2-specific humoral and cellular immune responses were evaluated by SARS-CoV2-specific IgM/IgG ELISA and peptide/MHCI-Tetramers flow cytometry, respectively., Results: Our results showed that 14 (13.5%) and 45 (43.3%) patients had specific SARS-CoV2 IgM and IgG in their sera, respectively. Immunophenotyping for SARS-CoV2-specific CD8 + T lymphocytes revealed that 68 (65.4%) patients had these types of cells. Among SARS-CoV2-specific CD8 + T lymphocytes positive subjects, 13 and 43 individuals had positive results for specific SARS-CoV2 IgM and IgG existence, respectively. Also, there was a relationship between specific SARS-CoV2 IgM (p = 0.031) and IgG (p < 0.0001) existence and having SARS-CoV2-specific TCD8 + lymphocytes in the studied population., Conclusion: Despite not having clinical symptoms, a high rate of SARS-CoV2-specific T-cell response in asymptomatic ESRD patients may reveal a high burden of asymptomatic COVID-19 infection in these patients., (© 2023 The Authors. Journal of Clinical Laboratory Analysis published by Wiley Periodicals LLC.)

After more than 2 years of the coronavirus disease 2019 pandemic caused by severe acute respiratory syndrome coronavirus 2, several questions have remained unanswered that affected our daily lives. Although substantial vaccine development could resist this challenge, emerging new variants in different countries could be considered as potent concerns regarding the adverse effects of reinfection or postvaccination. Precisely, these concerns address some significant and probable outcomes in vaccinated or reinfected models, followed by some virus challenges, such as antibody-dependent enhancement and cytokine storm. Therefore, the importance of evaluating the effectiveness of neutralizing antibodies (nAbs) elicited by vaccination and the rise of new variants must be addressed., (© 2022 International Federation for Cell Biology.)

During SARS-CoV-2 infection, an effective immune response provides the first line of defense; however, excessive inflammatory innate immunity and impaired adaptive immunity may harm tissues. Soluble immune mediators are involved in the dynamic interaction of ligands with membrane-bound receptors to maintain and restore health after pathological events. In some cases, the dysregulation of their expression can lead to disease pathology. In this literature review, we described current knowledge of the basic features of soluble immune mediators and their dysregulation during SARS-CoV-2 infections and highlighted their contribution to disease severity and mortality. Video Abstract., (© 2022. The Author(s).)

Background: The COVID-19 pandemic has become the world's main life-threatening challenge in the third decade of the twenty-first century. Numerous studies have been conducted on SARS-CoV2 virus structure and pathogenesis to find reliable treatments and vaccines. The present study aimed to evaluate the immune-phenotype and IFN-I signaling pathways of COVID-19 patients with mild and severe conditions., Material and Methods: A total of 100 COVID-19 patients (50 with mild and 50 with severe conditions) were enrolled in this study. The frequency of CD4 + T, CD8 + T, Th17, Treg, and B lymphocytes beside NK cells was evaluated using flow cytometry. IFN-I downstream signaling molecules, including JAK-1, TYK-2, STAT-1, and STAT-2, and Interferon regulatory factors (IRF) 3 and 7 expressions at RNA and protein status were investigated using real-time PCR and western blotting techniques, respectively. Immune levels of cytokines (e.g., IL-1β, IL-6, IL-17, TNF-α, IL-2R, IL-10, IFN-α, and IFN-β) and the existence of anti-IFN-α autoantibodies were evaluated via enzyme-linked immunosorbent assay (ELISA)., Results: Immune-phenotyping results showed a significant decrease in the absolute count of NK cells, CD4 + T, CD8 + T, and B lymphocytes in COVID-19 patients. The frequency of Th17 and Treg cells showed a remarkable increase and decrease, respectively. All signaling molecules of the IFN-I downstream pathway and IRFs (i.e., JAK-1, TYK-2, STAT-1, STAT-2, IRF-3, and IRF-7) showed very reduced expression levels in COVID-19 patients with the severe condition compared to healthy individuals at both RNA and protein levels. Of 50 patients with severe conditions, 14 had anti-IFN-α autoantibodies in sera. Meanwhile, this result was 2 and 0 for patients with mild symptoms and healthy controls, respectively., Conclusion: Our results indicate a positive association of the existence of anti-IFN-α autoantibodies and immune cells dysregulation with the severity of illness in COVID-19 patients. However, comprehensive studies are necessary to find out more about this context. Video abstract., (© 2022. The Author(s).)

Background: Since the outbreak of the new coronavirus pandemic, the importance of carrying out an infection check to prevent acquisition and transmission among end-stage renal disease patients (ESRD) under maintenance hemodialysis (MHD) has become a major concern in the health care system. Applying serology screening tests could enlighten the view with regards to disease prevalence in dialysis wards., Methods: We subjected 328 end-stage renal disease patients to maintenance hemodialysis. After dividing patients into suspicious and non-suspicious groups for COVID-19 infection based on their clinical manifestation, they were investigated for SARS-CoV-2 specific IgM and IgG screening against nucleoprotein (NP), spike protein (SP), and receptor-binding domain (RBD), utilizing our recently developed ELISA tests., Results: We found that approximately 10.1% of asymptomatically tested cases were antibody positive. Although IgG positivity showed a higher prevalence than IgM across all three virus antigen subunits, there were no significant differences among mentioned immunoglobulins of the studied groups. The most prevalent antibody was from the IgG subtype against virus nucleoprotein (NP), while the lowest prevalence was attributed to receptor-binding domain (RBD) IgM., Conclusion: High seropositive rate among asymptomatic end-stage renal disease patients, as a sample of high-risk population, reflected the importance of considering SARS-CoV-2 specific antibody screening for disease containment.

The possibility of human reinfection with SARS-CoV-2, the coronavirus responsible for COVID-19, has not previously been thoroughly investigated. Although it is generally believed that virus-specific antibodies protect against COVID-19 pathogenesis, their duration of function and temporal activity remain unknown. Contrary to media reports that people retain protective antibody responses for a few months, science does not exclude reinfection and disease relapse shortly after initiating all immune responses during the primary onset of COVID-19. Despite production of antiviral antibodies, activated CD4+/CD8+ lymphocytes, and long-lived memory B cells, susceptibility to reinfection in humans for extended periods cannot be precluded due to repeated exposures to coronavirus or potential reactivation of the virus due to incomplete virus clearance. However, the mechanism of reinfection remains unknown. The biological characteristics of SARS-CoV-2, such as emergence of multiple mutations in the virus RNA molecules, transmissibility, rates of infection, reactivation and reinfection, can all affect the trajectory of the virus spread. Innate and adaptive immune response variables, differences in underlying diseases, and comorbidities, particularly in high risk individuals, can influence the dynamics of the virus infection. In this article, immune parameters and viral mutations pertaining to reinfection and disease relapse are reviewed and scientific gaps are discussed., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Introduction: The implementation of a dashboard enables managers to make informed and evidence-based decisions through data visualization and graphical presentation of information. This study aimed to design and implement a COVID-19 management dashboard in a third-level hospital in Mashhad, Iran., Materials and Methods: This descriptive developmental applied study was conducted in the second half of 2020 in three stages, using user-centered design methodology in four phases: (1) specification of the application context, (2) specification of requirements, (3) creation of design solutions, and (4) evaluation of designs. Data collection in each phase was performed through holding group discussions with the main users, nominal group techniques, interviews, and questioners. The dashboard prototype for the data display was designed using the Power BI Desktop software. Subsequently, users' comments were obtained using the focus group method and included in the dashboard., Results: In total, 25 indicators related to input, process, and output areas were identified based on the findings of the first stage. Moreover, eight items were introduced by participants as dashboard requirements. The dashboard was developed based on users' feedback and suggestions, such as the use of colors, reception of periodic and specific reports based on key performance indicators, and rearrangement of the components visible on the page. The result of the user satisfaction survey indicated their satisfaction with the developed dashboard., Conclusion: The selection of proper criteria for the implementation of an effective dashboard is critical for the health care organization since they are designed with a high-tech and content-based environment. The dashboard in the present study was a successful combination of clinical and managerial indicators. Future studies should focus on the design and development of dashboards, as well as benchmarking by using data from several hospitals., Competing Interests: None declared., (Thieme. All rights reserved.)

The world has been suffering from COVID-19 disease for more than a year, and it still has a high mortality rate. In addition to the need to minimize transmission of the virus through non-pharmacological measures such as the use of masks and social distance, many efforts are being made to develop a variety of vaccines to prevent the disease worldwide. So far, several vaccines have reached the final stages of safety and efficacy in various phases of clinical trials, and some, such as Moderna/NIAID and BioNTech/Pfizer, have reported very high safety and protection. The important point is that comparing different vaccines is not easy because there is no set standard for measuring neutralization. In this study, we have reviewed the common platforms of COVID-19 vaccines and tried to present the latest reports on the effectiveness of these vaccines., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Aims: Coronavirus disease 2019 (COVID-19) is a novel viral infection threatening worldwide health as currently there exists no effective treatment strategy and vaccination programs are not publicly available yet. T lymphocytes play an important role in antiviral defenses. However, T cell frequency and functionality may be affected during the disease., Material and Methods: Total blood samples were collected from patients with mild and severe COVID-19, and the total lymphocyte number, as well as CD4+ and CD8 + T cells were assessed using flowcytometry. Besides, the expression of exhausted T cell markers was evaluated. The levels of proinflammatory cytokines were also investigated in the serum of all patients using enzyme-linked immunesorbent assay (ELISA). Finally, the obtained results were analyzed along with laboratory serological reports., Results: COVID-19 patients showed lymphopenia and reduced CD4+ and CD8 + T cells, as well as high percentage of PD-1 expression by T cells, especially in severe cases. Serum secretion of TNF-α, IL-1β, and IL-2 receptor (IL-2R) were remarkably increased in patients with severe symptoms, as compared with healthy controls. Moreover, high levels of triglyceride (TG) and low density lipoprotein cholesterol (LDL-C), were correlated with the severity of the disease., Conclusion: Reduced number and function of T cells were observed in COVID-19 patients, especially in severe patients. Meanwhile, the secretion of proinflammatory cytokines was increased as the disease developed. High level of serum IL-2R was also considered as a sign of lymphopenia. Additionally, hypercholesterolemia and hyperlipidemia could be important prognostic factors in determining the severity of the infection., (Copyright © 2021. Published by Elsevier Ltd.)

In November 2019, the highly infectious coronavirus SARS-CoV-2 emerged in Wuhan, China, and has since spread to almost all countries worldwide. Since its emergence, the COVID-19 infection has led to significant public health, economic and social problems. The current pandemic has inspired researchers to make every effort to design and develop an effective COVID-19 vaccine to provide sufficient protection against the virus and control the infection. In December 2020, the Pfizer vaccine was the first COVID-19 vaccine given Emergency Use Authorization (EUA), and the second FDA so-approved vaccine was the Moderna mRNA-1273 vaccine, which was introduced a week later. Both Pfizer and Moderna vaccines are mRNA-based vaccines, and are estimated to have an efficacy rate of more than 94%. The aim of this article is to provide a review of the attempts made to develop safe SARS-CoV-2 vaccines, highlighting potential challenges and concerns, such as disease enhancement, virus mutations, and public acceptance of the vaccine.

The kidney is one of the main targets attacked by viruses in patients with a coronavirus infection. Until now, SARS-CoV-2 has been identified as the seventh member of the coronavirus family capable of infecting humans. In the past two decades, humankind has experienced outbreaks triggered by two other extremely infective members of the coronavirus family; the MERS-CoV and the SARS-CoV. According to several investigations, SARS-CoV causes proteinuria and renal impairment or failure. The SARS-CoV was identified in the distal convoluted tubules of the kidney of infected patients. Also, renal dysfunction was observed in numerous cases of MERS-CoV infection. And recently, during the 2019-nCoV pandemic, it was found that the novel coronavirus not only induces acute respiratory distress syndrome (ARDS) but also can induce damages in various organs including the liver, heart, and kidney. The kidney tissue and its cells are targeted massively by the coronaviruses due to the abundant presence of ACE2 and Dpp4 receptors on kidney cells. These receptors are characterized as the main route of coronavirus entry to the victim cells. Renal failure due to massive viral invasion can lead to undesirable complications and enhanced mortality rate, thus more attention should be paid to the pathology of coronaviruses in the kidney. Here, we have provided the most recent knowledge on the coronaviruses (SARS, MERS, and COVID19) pathology and the mechanisms of their impact on the kidney tissue and functions., (© 2021 International Union of Biochemistry and Molecular Biology.)

This cross-sectional study was conducted on 359 COVID-19 patients in a public training hospital in Mashhad to assess the level of shared decision-making among the patients with COVID-19 and determine the affecting factors. Shared decision making was evaluated with a questionnaire based on Iranian accreditation standards. Data were analyzed by employing Chi-square test and stepwise logistic. The models were calibrated by the Hosmer–Lemeshow test. The results show that maximum shared decision making does not occur among these patients. 74% of patients stated that they have participated in the doctor's decision for the treatment plan. The results showed that gender, educational status and employment status (had significant relationships with patient participation in physician decisions). [ABSTRACT FROM AUTHOR]

Background: The safety and mental health issues of frontline nurses working during the coronavirus global outbreak must be a first/top priority. The present study aimed to investigate the association between nurses’ occupation stress and organizational support in both infectious and non-infectious intensive care units (ICUs) wards during the COVID-19 crisis. Methods: This was a descriptive-analytical and cross-sectional study. The study population comprised nurses caring for COVID‐19 patients in Imam Reza Hospital complex in Mashhad City, Iran. The sample size was 129 nurses selected through random quota sampling and examined with a standard questionnaire. To analyze the information and test the hypothesis, the structural equation modeling approach using Smart PLS 2.0 software has been used. Descriptive and analytical statistical tests were used in this study. Results: The results indicated a significant negative correlation between stress and perceived organizational support for ICU nurses (P<0.001). Considering subscales in stress, the highest mean occupational stress scores were related to the “death and dying” dimension (n=21, 13.98%). Also, the difference between the two groups of nurses was statistically significant in different workloads (P<0.001) and lack of support (P<0.001). Conclusion: The results of the present study highlighted the importance of organizational support to reduce stress in nurses. To get through this unprecedented situation, nurses need their employers and organizations to support them with action, planning, and resources. [ABSTRACT FROM AUTHOR]

Background: Nurses play a very important role in caring for patients with coronavirus disease-19 (COVID-19). They are on the frontline fighting COVID-19. The objective was to explore the experiences of nurses in the surgical and infectious wards about caring for patients with COVID-19 in a large and tertiary care hospital in Iran. Materials and Methods: This was a qualitative study. Semi-structured qualitative interviews were conducted with 18 nurses in the Imam Reza Hospital Complex from April to May 2020, Mashhad, Iran. Data analysis was performed using the method proposed by Lundman and Granheim. The Maxqda10 software was used. Results: The experiences were summarized into three categories: (1) experiencing new feelings and relationships with colleagues and patients, (2) viewpoints about managers' performance, and (3) concern about getting infected with COVID-19. Findings reflected similar experiences on personal protective equipment between nurses in the surgical and infectious wards. Experiencing new feelings and relationships with colleagues and patients and concern about getting infected and spreading the COVID-19 were mostly expressed by infectious nurses and surgical nurses, respectively. Conclusions: This research results provide evidence of the experiences of infectious and non-infectious disease nurses who are currently caring for COVID-19 patients. Due to some differences between the experiences of these two groups in COVID-19, it is suggested to pay more attention to the needs and required skills in the staff mix during a crisis. [ABSTRACT FROM AUTHOR]

Background: Increasing hospital capacity to cover the service demands is an important priority during an epidemic or a pandemic. The aim of this study was to increase hospital capacity using the Six Sigma method to improve the patient discharge process. Methods: This was a quantitative study. The Pre- and post-intervention study was conducted in a big hospital designated for COVID-19 patients. The patient discharge process was evaluated and improved based on seven sub-processes and following the Six Sigma model, including defining the problem, measuring time in each of the discharge stations, analysis times and process, improvement process, and control. Results: Implementation of the electronic patient discharge led to a 51.9% decrease in discharge time from 7.3 h during the pre-intervention period to 3.8 h post-intervention (P< 0.0001). According to the Sigma level, the yield and defects per million opportunities of the discharge process also improved to 55%. Conclusion: Increasing hospital capacity by improving the discharge time is a quick action to cover the demand created during pandemics. Also, about 32 beds can be obtained by applying the Six Sigma model to improve the discharge process in a short time and at a very low cost. [ABSTRACT FROM AUTHOR]

Introduction: Coronavirus disease 2019 (COVID-19) emerged in China and spread worldwide. In this study, we assessed the characteristics of markers of the liver in patients with COVID-19 to provide new insights in improving clinical treatment. Patients and Methods: We recruited 279 patients who confirmed COVID-19 and the data of liver biomarkers and complete blood count of patients were defined as the day onset when the patients admitted to the hospital. Results: The average of LDH value was 621.29 U/L in all patients with COVID-19, and CPK was 286.90 U/L. The average AST was 44.03 U/L in all patients, and ALT was 31.14 U/L. The AST/ALT ratio was 1.64 in all patients. The measurement of CRP was increased by 79.93% in all patients. Average ALT and AST values of patients with elevated ALT were significantly increased in comparison to patients with normal ALT (P-value = 0.001), while AST/ALT ratio was significantly decreased compared to patients with normal ALT (P-value= 0.014). In addition, the average LDH of patients with elevated ALT was significantly increased compared to patients with normal ALT (P-value = 0.014). Conclusion: Hepatic injury and abnormal liver enzymes related to COVID-19 infection is an acute non-specific inflammation alteration. [ABSTRACT FROM AUTHOR]

The ongoing COVID-19 pandemic is still a challenging problem in the case of infection treatment. The immunomodulatory effect of Nanocurcumin was investigated in the present study in an attempt to counterbalance the immune response and improve the patients' clinical symptoms. 60 confirmed COVID-19 patients and 60 healthy controls enrolled in the study. COVID-19 patients were divided into Nanocurcumin and placebo received groups. Due to the importance of the role of NK cells in this disease, the frequency, cytotoxicity, receptor gene expression of NK cells, and serum secretion levels of inflammatory cytokines IL-1β, IL-6, TNF-α, as well as circulating C5a as a chemotactic factor an inflammatory mediator was evaluated by flow cytometry, real-time PCR and enzyme-linked immunosorbent assay in both experimental groups before and after the intervention. Given the role of measured factors in the progression and pathogenesis of COVID-19 disease, the results can help find appropriate treatments. The results of this study indicated that the Nanocurcumin could significantly increase the frequency and function of NK cells compared to the placebo-treated group. As an immunomodulatory agent, Nanocurcumin may be a helpful choice to improve NK cell function in COVID-19 patients and improve the clinical outcome of patients. [Display omitted] • Nanocurcumin could significantly increase the frequency and cytotoxicity of NK cell in COVID-19 patients. • Nanocurcumin could remarkably enhance the expression levels of activating receptors of NK cells in COVID-19 patients. • Nanocurcumin could notably reduce the expression levels of inhibitory receptors of NK cells in COVID-19 patients. • Nanocurcumin could meaningfully decline the serum levels of IL-1, IL-6, TNF-, and C5a in COVID-19 patients. • Nanocurcumin would be a potent therapeutic agent in SARS-CoV2 infection by augmenting the NK cell responses. [ABSTRACT FROM AUTHOR]

In Coronavirus disease 2019 (COVID-19), a decreased number of regulatory T (Treg) cells and their mediated factors lead to a hyperinflammatory state due to overactivation of the inflammatory cells and factors during the infection. In the current study, we evaluated the Nanocurcumin effects on the Treg cell population and corresponding factors in mild and severe COVID-19 patients. To investigate the Nanocurcumin effects, 80 COVID-19 patients (40 at the severe stage and 40 at the mild stage) were selected and classified into Nanocurcumin and placebo arms. In both the Nanocurcumin and placebo groups, the Treg cell frequency, the gene expression of Treg transcription factor forkhead box P3 (FoxP3), and cytokines (IL-10, IL-35, and TGF-β), as well as the serum levels of cytokines were measured before and after treatment. In both mild and severe COVID-19 patients, Nanocurcumin could considerably upregulate the frequency of Treg cells, the expression levels of FoxP3, IL-10, IL-35, and TGF-β, as well as the serum secretion levels of cytokines in the Nanocurcumin-treated group compared to the placebo group. The abovementioned factors were remarkably increased in the post-treatment with Nanocurcumin before pre-treatment conditions. By contrast, it has been observed no notable alteration in the placebo group. Our findings revealed the SinaCurcumin® effective function in a significant increase in the number of Treg cells and their mediated factors in the Nanocurcumin group than in the placebo group in both mild and severe patients. Hence, it would be an efficient therapeutic agent in rehabilitating COVID-19 infected patients. • In COVID-19, a decreased number of regulatory T (Treg) cells and their mediated factors lead to a hyperinflammatory state. • Hyper inflammatory state is derived from overactivation of the inflammatory cells and factors during the infection. • Nanocurcumin product is a nano range formulation of curcumin with anti-inflammatory and immunomodulatory properties. • Nanocurcumin could increase the frequency of Treg cells and Treg cell-mediated anti-inflammatory factors. • Nanocurcumin would be a therapeutic agent by increasing the Treg cell responses and reducing the inflammation in SARS-CoV2. [ABSTRACT FROM AUTHOR]

The recent epidemic outbreak of a novel human coronavirus called SARS-CoV-2 and causing the respiratory tract disease COVID-19 has reached worldwide resonance and a global effort is being undertaken to characterize the molecular features and evolutionary origins of this virus. Therefore, rapid and accurate identification of pathogenic viruses plays a vital role in selecting appropriate treatments, saving people's lives and preventing epidemics. Additionally, general treatments, coronavirus-specific treatments, and antiviral treatments useful in fighting COVID-19 are addressed. This review sets out to shed light on the SARS-CoV-2 and host receptor recognition, a crucial factor for successful virus infection and taking immune-informatics approaches to identify B- and T-cell epitopes for surface glycoprotein of SARS-CoV-2. A variety of improved or new approaches also have been developed. It is anticipated that this will assist researchers and clinicians in developing better techniques for timely and effective detection of coronavirus infection. Moreover, the genomic sequence of the virus responsible for COVID-19, as well as the experimentally determined three-dimensional structure of the Main protease (Mpro) is available. The reported structure of the target Mpro was described in this review to identify potential drugs for COVID-19 using virtual high throughput screening. • COVID-19 is a highly infectious disease associated with high mortality. • Rapid and accurate identification of viruses plays a vital role in selecting appropriate treatments. • The reported structure of the target Mpro was described in this review to identify potential drugs. • Using virtual high throughput screening will help to identify potential drugs. [ABSTRACT FROM AUTHOR]