Decoding the evolution and transmissions of the novel pneumonia coronavirus(SARS-CoV-2/HCoV-19)using whole genomic data

The outbreak of COVID-19 started in mid-December2019 in Wuhan, China. Up to 29 February 2020,SARS-CoV-2(HCoV-19/2019-nCoV) had infected more than 85 000 people in the world. In this study,we used 93 complete genomes of SARS-CoV-2 from the GISAID EpiFlu TM database to investigate the evolution and human-to-human transmissions of SARS-CoV-2 in the first two months of the outbreak.We constructed haplotypes of the SARS-CoV-2 genomes, performed phylogenomic analyses and estimated the potential population size changes of the virus. The date of population expansion was calculated based on the expansion parameter tau(τ)using the formula t=τ/2 u. A total of 120 substitution sites with 119 codons, including 79 non-synonymous and 40 synonymous substitutions, were found in eight coding-regions in the SARS-CoV-2 genomes.Forty non-synonymous substitutions are potentially associated with virus adaptation. No combinations were detected. The 58 haplotypes(31 found in samples from China and 31 from outside China)were identified in 93 viral genomes under study and could be classified into five groups. By applying the reported bat coronavirus genome(bat-RaTG13-CoV)as the outgroup, we found that haplotypes H13 and H38 might be considered as ancestral haplotypes,and later H1 was derived from the intermediate haplotype H3. The population size of the SARS-CoV-2 was estimated to have undergone a recent expansion on 06 January 2020, and an early expansion on 08 December 2019. Furthermore,phyloepidemiologic approaches have recovered specific directions of human-to-human transmissions and the potential sources for international infected cases.

The origin, transmission and clinical therapies on coronavirus disease 2019(COVID-19) outbreak——an update on the status

An acute respiratory disease,caused by a novel coronavirus(SARS-CoV-2,previously known as 2019-nCoV),the coronavirus disease 2019(COVID-19)has spread throughout China and received worldwide attention.On 30 January 2020,World Health Organization(WHO)officially declared the COVID-19 epidemic as a public health emergency of international concern.The emergence of SARS-CoV-2,since the severe acute respiratory syndrome coronavirus(SARSCoV)in 2002 and Middle East respiratory syndrome coronavirus(MERS-CoV)in 2012,marked the third introduction of a highly pathogenic and large-scale epidemic coronavirus into the human population in the twenty-first century.As of 1 March 2020,a total of 87,137 confirmed cases globally,79,968 confirmed in China and 7169 outside of China,with 2977 deaths(3.4%)had been reported by WHO.Meanwhile,several independent research groups have identified that SARS-CoV-2 belongs toβ-coronavirus,with highly identical genome to bat coronavirus,pointing to bat as the natural host.The novel coronavirus uses the same receptor,angiotensin-converting enzyme 2(ACE2)as that for SARS-CoV,and mainly spreads through the respiratory tract.Importantly,increasingly evidence showed sustained human-tohuman transmission,along with many exported cases across the globe.The clinical symptoms of COVID-19 patients include fever,cough,fatigue and a small population of patients appeared gastrointestinal infection symptoms.The elderly and people with underlying diseases are susceptible to infection and prone to serious outcomes,which may be associated with acute respiratory distress syndrome(ARDS)and cytokine storm.Currently,there are few specific antiviral strategies,but several potent candidates of antivirals and repurposed drugs are under urgent investigation.In this review,we summarized the latest research progress of the epidemiology,pathogenesis,and clinical characteristics of COVID-19,and discussed the current treatment and scientific advancements to combat the epidemic novel coronavirus.

Hepatobiliary system and intestinal injury in new coronavirus infection(COVID-19):A retrospective study

BACKGROUND An important area of effective control of the coronavirus disease 19(COVID-19)pandemic is the study of the pathogenic features of severe acute respiratory syndrome coronavirus 2 infection,including those based on assessing the state of the intestinal microbiota and permeability.AIM To study the clinical features of the new COVID-19 in patients with mild and moderate severity at the stage of hospitalization,to determine the role of hepatobiliary injury,intestinal permeability disorders,and changes in the qualitative and quantitative composition of the microbiota in the development of systemic inflammation in patients with COVID-19.METHODS The study was performed in 80 patients with COVID-19,with an average age of 45 years,19 of whom had mild disease,and 61 had moderate disease severity.The scope of the examination included traditional clinical,laboratory,biochemical,instrumental,and radiation studies,as well as original methods for studying microbiota and intestinal permeability.RESULTS The clinical course of COVID-19 was studied,and the clinical and biochemical features,manifestations of systemic inflammation,and intestinal microbiome changes in patients with mild and moderate severity were identified.Intestinal permeability characteristics against the background of COVID-19 were evaluated by measuring levels of proinflammatory cytokines,insulin,faecal calprotectin,and zonulin.CONCLUSION This study highlights the role of intestinal permeability and microbiota as the main drivers of gastroenterological manifestations and increased COVID-19 severity.

Clinical features and potential mechanism of coronavirus disease 2019-associated liver injury

Coronavirus disease 2019(COVID-19),caused by severe acute respiratory syndrome coronavirus 2,has posed a serious threat to global public health security.With the increase in the number of confirmed cases globally,the World Health Organization has declared the outbreak of COVID-19 an international public health emergency.Despite atypical pneumonia as the primary symptom,liver dysfunction has also been observed in many clinical cases and is associated with the mortality risk in patients with COVID-19,like severe acute respiratory syndrome and Middle East respiratory syndrome.Here we will provide a schematic overview of the clinical characteristics and the possible mechanisms of liver injury caused by severe acute respiratory syndrome coronavirus 2 infection,which may provide help for optimizing the management of liver injury and reducing mortality in COVID-19 patients.

Increased alcohol consumption during the COVID-19 pandemic:A cross-sectional study

BACKGROUND The coronavirus disease 2019(COVID-19)pandemic has significantly impacted health,mental well-being,and societal functioning,particularly for individuals with psychiatric conditions and substance use disorders.Recent evidence highlights a concerning increase in alcohol consumption during the pandemic,with a study spanning 2015-2020 indicating heightened usage,especially among young and middle-aged adults,for relaxation and tension relief.Additionally,addressing challenges exacerbated by the pandemic,another study underscored persistent barriers to healthcare access,resulting in increased alcohol and tobacco use rates and limited healthcare options.These findings shed light on the unique vulnerabilities exposed by the pandemic,emphasizing the need to investigate further its impact on alcohol consumption in diverse non-urban American communities.AIM To investigate the impact of the COVID-19 pandemic on alcohol abuse using socioeconomic and medical parameters in diverse non-urban community in America.METHODS Based on a cross-sectional analysis of 416 participants the United States in 2021,the study utilized The Diagnostic and Statistical Manual of Mental Disorders,Fifth Edition criteria to categorize alcohol consumption levels.Participants aged 21 years and above were surveyed through an online platform due to COVID-19 challenges.The survey was conducted from January 14 to January 31,2022,recruiting participants via social media and ensuring anonymity.Informed consent was secured,emphasizing the voluntary nature of participation,and participants could only take the survey once.RESULTS Out of 416 survey respondents,396 met eligibility criteria,with 62.9%reporting increased alcohol consumption during COVID-19.Males(68.8%)and ages 21-29 years(34.6%)predominated.Low alcohol consumption decreased by 2.8%(P=0.237),moderate by 21.4%(P<0.001),and heavy increased by 14.9%(P<0.001).Alcohol abuse rose by 6.5%(P=0.0439),with a 7%increase in self-identified alcohol abusers/alcoholics.Seeking treatment during COVID-19 rose by 6.9%.Easier alcohol access(76.0%)was reported,while 80.7%found it harder to access medical care for alcohol-related issues.These findings highlight the pandemic's impact on alcohol consumption and healthcare access,emphasizing the need for targeted interventions during public health crises.CONCLUSION The COVID-19 pandemic exacerbated alcoholism and abuse,with increased heavy consumption(P<0.001)and abuse(P=0.0439).Access to medical programs for addressing alcohol abuse declined,highlighting the need for targeted intervention.

Symptomatic COVID-19 in University Students: A School-Wide Web-Based Questionnaire Survey during the Omicron Variant Outbreak

Aim: To detect risk and preventive factors associated with the Omicron variant infection in university students, a combination of a web-based survey and multivariate logistic regression analysis was introduced as the front-line initiatives by the school health practitioners. Design: Questionnaire survey. Methods: The school-wide web-based questionnaire survey was conducted among our university students as a part of the annual health check-up in April, 2023. The positive outcome was confined to the first symptomatic COVID-19 onset during the Omicron variant outbreak. Results: In this self-administered survey, risk or protective associations were merely estimated statistically in university students (n = 5406). In measured factors, karaoke and club/group activities could maintain the statistical significance in adjusted odds ratios (ORs) as relative risk factors, and science course, measles/ rubella (MR) vaccination, and COVID-19 vaccination remained as relative protective factors in adjusted OR analyses. Club/group activities with member gathering and karaoke sing-along sessions in university students may frequently have WHO’s three Cs. These risk factors are still important topics for the infection control of COVID-19 in university students. Together with some recent reports from other researchers, the significant protective role of MR vaccine in our survey warrants further clinical investigation. If the breakthrough infection continuously constitutes the majority of infection, real data in test-negative case-control or web-based questionnaire design continue to be important for statistical analysis to determine the minimal requirement of our strategies which may be equivalent to or replace COVID-19 vaccines.

Biology of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)and the humoral immunoresponse:a systematic review of evidence to support global policy-level actions and research

Background Both population-level epidemiological data and individual-level biological data are needed to control the coronavirus disease 2019(COVID-19)pandemic.Population-level data are widely available and efforts to combat COVID-19 have generated proliferate data on the biology and immunoresponse to the causative pathogen,severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).However,there remains a paucity of systemized data on this subject.Objective In this review,we attempt to extract systemized data on the biology and immuno-response to SARS-CoV-2 from the most up-to-date peer-reviewed studies.We will focus on the biology of the virus and immunological variations that are key for determining long-term immunity,transmission potential,and prognosis.Data Sources and Methods Peer-reviewed articles were sourced from the PubMed database and by snowballing search of selected publications.Search terms included:“Novel Coronavirus”OR“COVID-19”OR“SARS-CoV-2”OR“2019-nCoV”AND“Immunity”OR“Immune Response”OR“Antibody Response”OR“Immunologic Response”.Studies published from December 31,2019 to December 31,2020 were included.To ensure validity,papers in pre-print were excluded.Results Of 2889 identified papers,36 were included.Evidence from these studies suggests early seroconversion in patients infected with SARS-CoV-2.Antibody titers appear to markedly increase two weeks after infection,followed by a plateau.A more robust immune response is seen in patients with severe COVID-19 as opposed to mild or asymptomatic presentations.This trend persists with regard to the length of antibody maintenance.However,overall immunity appears to wane within two to three months post-infection.Conclusion Findings of this study indicate that immune responses to SARS-CoV-2 follow the general pattern of viral infection.Immunity generated through natural infection appears to be short,suggesting a need for long-term efforts to control the pandemic.Antibody testing will be essential to gauge the epidemic and inform decision-making on effective strategies for treatment and prevention.Further research is needed to illustrate immunoglobulin-specific roles and neutralizing antibody activity.

Updating the diagnostic criteria of COVID-19 “suspected case” and “confirmed case” is necessary

On 6 February 2020,our team had published a rapid advice guideline for diagnosis and treatment of 2019 novel coronavirus(2019-nCoV)infection,and this guideline provided our experience and make well reference for fighting against this pandemic worldwide.However,the coronavirus disease 2019(COVID-19)is a new disease,our awareness and knowledge are gradually increasing based on the ongoing research findings and clinical practice experience;hence,the strategies of diagnosis and treatment are also continually updated.In this letter,we answered one comment on our guideline and provided the newest diagnostic criteria of"suspected case"and"confirmed case"according to the latest Diagnosis and Treatment Guidelines for COVID-19(seventh version)that issued by the National Health Committee of the People’s Republic of China.

Epidemiological and clinical characteristics of COVID-19 patients in Hengyang,Hunan Province,China

BACKGROUND In December 2019,an ongoing outbreak of coronavirus disease 2019(COVID-19)was first identified in Wuhan,China.The characteristics of COVID-19 patients treated in local hospitals in Wuhan are not fully representative of patients outside Wuhan.Therefore,it is highly essential to analyze the epidemiological and clinical characteristics of COVID-19 in areas outside Wuhan or Hubei Province.To date,a limited number of studies have concentrated on the epidemiological and clinical characteristics of COVID-19 patients with different genders,clinical classification,and with or without basic diseases.AIM To study the epidemiological and clinical characteristics of COVID-19 patients in Hengyang(China)and provide a reliable reference for the prevention and control of COVID-19.METHODS From January 16 to March 2,2020,a total of 48 confirmed cases of COVID-19 were reported in Hengyang,and those cases were included in this study.The diagnostic criteria,clinical classification,and discharge standard related to COVID-19 were in line with the Diagnosis and Treatment Protocol for Novel Coronavirus Pneumonia(Trial Version 7)released by National Health Commission and National Administration of Traditional Chinese Medicine.The presence of SARS-CoV-2 in pharyngeal swab specimens was detected by quantitative reverse transcription polymerase chain reaction.All the data were imported into the excel worksheet and statistically analyzed by using SPSS 25.0 software.RESULTS A total of 48 cases of COVID-19 were collected,of which 1 was mild,38 were moderate,and 9 were severe.It was unveiled that there were 31(64.6%)male patients and 17(35.4%)female patients,with a female-to-male ratio of 1.82:1.The range of age of patients with COVID-19 was dominantly 30-49 years old[25(52.1%)of 48],followed by those aged over 60 years old[11(22.9%)].Besides,29.2%(14 of 48)of patients had basic diseases,and 57.2%(8 of 14)of patients with basic diseases were aged over 60 years old.The occupations of 48 COVID-19 patients were mainly farmers working in agricultural production[15(31.5%)of 48],rural migrant workers from Hengyang to Wuhan[15(31.5%)],and service workers operating in the service sector[8(16.7%)].The mean latent period was 6.86±3.57 d,and the median was 7[interquartile range(IQR):4-9]d.The mean time from onset of symptoms to the first physician visit was 3.38±2.98(95%CI:2.58-9.18)d,with a median of 2(IQR:1-5)d,and the mean time from hospital admission to confirmed diagnosis was 2.29±2.11(95%CI:1.18-6.42)d,with a median of 2(IQR:1-3)d.The main symptoms were fever[43(89.6%)of 48],cough and expectoration[41(85.4%)],fatigue[22(45.8%)],and chills[22(45.8%)].Other symptoms included poor appetite[13(27.1%)],sore throat[9(18.8%)],dyspnea[9(18.8%)],diarrhea[7(14.6%)],dizziness[5(10.4%)],headache[5(10.4%)],muscle pain[5(10.4%)],nausea and vomiting[4(8.3%)],hemoptysis[4(8.3%)],and runny nose[1(2.1%)].The numbers of peripheral blood leukocytes,lymphocytes,and eosinophils were significantly reduced in the majority of the patients.The levels of C-reactive protein,fibrinogen,blood glucose,lactate dehydrogenase,Ddimer,alanine aminotransferase(ALT),aspartate aminotransferase(AST),gamma-glutamyl transferase(γ-GT),myoglobin(MB),and creatine kinase(CK)were increased in 64.6%,44.7%,43.2%,37.0%,29.5%,22.9%,20.8%,21.6%,13.6%,and 12.8%of patients,respectively.The incidence of ALT elevation in male patients was remarkably higher than that in females(P<0.01),while the incidences of AST,CK,and blood glucose elevations in severe patients were remarkably higher than those in moderate patients(P<0.05,respectively).Except for the mild patients,chest computed tomography showed characteristic pulmonary lesions.All the patients received antiviral drugs,38(79.2%)accepted traditional Chinese medicine,and 2(4.2%)received treatment of human umbilical-cord mesenchymal stem cells.On March 2,2020,48 patients with COVID-19 were all cured and discharged.CONCLUSION Based on our results,patients with COVID-19 often have multiple organ dysfunction or damage.The incidences of ALT elevation in males,and AST,CK,and blood glucose elevations in severe patients are remarkably higher.

Epidemiological and clinical characteristics of 65 hospitalized patients with COVID-19 in Liaoning, China

BACKGROUND Coronavirus disease 2019(COVID-19)has spread rapidly to multiple countries through its infectious agent severe acute respiratory syndrome coronavirus 2.The severity,atypical clinical presentation,and lack of specific anti-viral treatments have posed a challenge for the diagnosis and treatment of COVID-19.Understanding the epidemiological and clinical characteristics of COVID-19 cases in different geographical areas is essential to improve the prognosis of COVID-19 patients and slow the spread of the disease.AIM To investigate the epidemiological and clinical characteristics and main therapeutic strategy for confirmed COVID-19 patients hospitalized in Liaoning Province,China.METHODS Adult patients(n=65)with confirmed COVID-19 were enrolled in this retrospective study from January 20 to February 29,2020 in Liaoning Province,China.Pharyngeal swabs and sputum specimens were collected from the patients for the detection of severe acute respiratory syndrome coronavirus 2 nucleic acid.Patient demographic information and clinical data were collected from the medical records.Based on the severity of COVID-19,the patients were divided into nonsevere and severe groups. All patients were followed until March 20,2020.RESULTSThe mean age of 65 COVID-19 patients was 45.5 ± 14.4 years, 56.9% were men,and 24.6% were severe cases. During the 14 d before symptom onset, 25 (38.5%)patients lived or stayed in Wuhan, whereas 8 (12.3%) had no clear history ofexposure. Twenty-nine (44.6%) patients had at least one comorbidity;hypertension and diabetes were the most common comorbidities. Compared withnonsevere patients, severe patients had significantly lower lymphocyte counts[median value 1.3 × 10^(9)/L (interquartile range 0.9-1.95) vs 0.82 × 10^(9)/L (0.44-1.08),P < 0.001], elevated levels of lactate dehydrogenase [450 U/L (386-476) vs 707 U/L(592-980), P < 0.001] and C-reactive protein [6.1 mg/L (1.5-7.2) vs 52 mg/L (12.7-100.8), P < 0.001], and a prolonged median duration of viral shedding [19.5 d (16-21) vs 23.5 d (19.6-30.3), P = 0.001]. The overall median viral shedding time was19.5 d, and the longest was 53 d. Severe patients were more frequently treatedwith lopinavir/ritonavir, antibiotics, glucocorticoid therapy, immunoglobulin,thymosin, and oxygen support. All patients were discharged following treatmentin quarantine.CONCLUSIONOur findings may facilitate the identification of severe cases and inform clinicaltreatment and quarantine decisions regarding COVID-19.

Liver injury in COVID-19: A minireview

In December 2019,an outbreak of unexplained pneumonia was reported in Wuhan,China.The World Health Organization officially named this disease as novel coronavirus disease 2019(COVID-19).Liver injury was observed in patients with COVID-19,and its severity varied depending on disease severity,geographical area,and patient age.Systemic inflammatory response,immune damage,ischemia-reperfusion injury,viral direct damage,drug induce,mechanical ventilation,and underlying diseases may contribute to liver injury.Although,in most cases,mild liver dysfunction is observed,which is usually temporary and does not require special treatment,the importance of monitoring liver injury should be emphasized for doctors.The risk of COVID-19 infection of liver transplantation recipients caused more and more concerns.In this article,we aimed to review the available literature on liver injury in COVID-19 to highlight the importance of monitoring and treating liver injury in COVID-19.

Current status quo on COVID-19 including chest imaging

With each day the number coronavirus disease 2019(COVID-19)cases continue to rise rapidly and our imaging knowledge of this disease is expeditiously evolving.The role of chest computed tomography(CT)in the screening or diagnosis of COVID-19 remains the subject of much debate.Despite several months having passed since identifying the disease,and numerous studies related to it,controversy and concern still exists regarding the widespread use of chest CT in the evaluation and management of COVID-19 suspect patients.Several institutes and organizations around the world have released guidelines,recommendations and statements against the use of CT for diagnosing or screening COVID-19 infection and advocating its use only for those cases with a strong clinical suspicion of complication or an alternate diagnosis.However,these guidelines and recommendations are in disagreement with majority of the widely available literature,which strongly favour CT as a pivotal tool in the early diagnosis,management and even follow-up of COVID-19 infection.This article besides comprehensively reviewing the current status quo on COVID-19 disease in general,also writes upon the current consensus statements/recommendations on the use of diagnostic imaging in COVID-19 as well as highlighting the precautions and various disinfection procedures being employed world-wide at the workplace to prevent the spread of infection.

How Will the COVID-19 Pandemic Reshape Nursing Education Globally?

The following editorial aims to discuss the transformative impact of COVID-19 on multiple dimensions of nursing education. Nurse educators have a great role in turning the uncertainty into opportunity by adapting to the “new normal” utilizing their expertise to prepare the next generation of nurses and nursing students to face our global health challenges.

Global prevalence,mortality,and main risk factors for COVID-19 associated pneumocystosis:A systematic review and meta-analysis

Objective:Pneumocystis pneumonia(PcP)is a life-threatening infection caused by the opportunistic fungi Pneumocystis jirovecii.The emergence of the COVID-19 pandemic forced the focus of attention of health policymakers on these two infections due to their clinical and paraclinical similarities,which cause diagnostic dilemmas.This study was undertaken to evaluate and estimate the global prevalence and main leading risk factors of coronavirus-associated pneumocystosis(CAP).Methods:We searched related databases between December 2019 and May 2022 for studies reporting CAP.Meta-analysis was performed using StatsDirect software(version 2.7.9)according to the DerSimonian and Laird method applying the random-effects model.We evaluated heterogeneity using theχ2-based Q statistic(significant for P<0.05)and the I2 statistic(>75%indicative of“notable”heterogeneity).Moreover,an odds ratio(OR)analysis was performed for eligible data.Results:Our meta-analysis included eight studies with 923 patients hospitalized with COVID-19;among them,92 were PcP cases.The overall pooled prevalence of CAP was estimated at 11.5%.The mortality among CAP patients was lower than that of non-PcP patients(OR 1.93;95%CI 0.86-4.31).Long-term corticosteroid therapy(OR 28.22;95%CI 0.54-1480.84)was the most predisposing factor for PcP among COVID-19 patients,followed by pulmonary diseases(OR 1.46;95%CI 0.43-4.98),kidney diseases(OR 1.26;95%CI 0.21-7.49),and acute respiratory destruction syndrome(OR 1.22;95%CI 0.05-29.28).Conclusions:The prevalence of PcP among the COVID-19 population is almost similar to the pre-COVID era.However,PcP-related mortality was decreased by the emergence of the COVID-19 pandemic.Women with COVID-19 are more susceptible to PcP than men.Acute respiratory distress syndrome,kidney diseases,pulmonary diseases,and long-term corticosteroid therapy increased the risk of PcP;however,transplantation and malignancy decreased the risk for PcP among COVID-19 patients.Further retrospective,case-control,prospective,and more precisely systematic review and meta-analysis studies are needed in this field.

Guide to forensic pathology practice for death cases related to coronavirus disease 2019(COVID-19)(Trial draft)

Autopsy is of great significance for elucidating the pathological changes,pathogenesis and cause of death of Coronavirus Disease 2019(COVID-19)and can provide a theoretical basis for scientific and accurate prevention and control of its outbreak.Based on related laws and regulations,such as the Law of the People's Republic of China on Prevention and Control of Infectious Diseases,clinical manifestations and epidemiological characteristics of COVID-19 and guidelines on the prevention and control of this epidemic,combined with the practical work of forensic pathology examinations,we developed the Guide to Forensic Pathology Practice for Death Cases Related to Coronavirus Disease 2019(COVID-19)(Trial Draft).This guide describes the background investigation of the death cases,autopsy room requirements,personal pre-vention and protections,external examinations,autopsy practices and auxiliary examinations,and thus offers a reference for forensic and pathological examination institutions and staff.

Seasonal coronaviruses and SARS-CoV-2:effects of preexisting immunity during the COVID-19 pandemic

Although the coronavirus disease 2019(COVID-19)epidemic is still ongoing,vaccination rates are rising slowly and related treatments and drugs are being developed.At the same time,there is increasing evidence of preexisting immunity against severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)in humans,mainly consisting of preexisting antibodies and immune cells(including T cells and B cells).The presence of these antibodies is mainly due to the seasonal prevalence of four common coronavirus types,especially OC43 and HKU1.The accumulated relevant evidence has suggested that the target of antibodies is mainly the S2 subunit of S protein,followed by evolutionary conservative regions such as the nucleocapsid(N)protein.Additionally,preexisting memory T and B cells are also present in the population.Preexisting antibodies can help the body protect against SARS-CoV-2 infection,reduce the severity of COVID-19,and rapidly increase the immune response post-infection.These multiple effects can directly affect disease progression and even the likelihood of death in certain individuals.Besides the positive effects,preexisting immunity may also have negative consequences,such as antibody-dependent enhancement(ADE)and original antigenic sin(OAS),the prevalence of which needs to be further established.In the future,more research should be focused on evaluating the role of preexisting immunity in COVID-19 outcomes,adopting appropriate policies and strategies for fighting the pandemic,and vaccine development that considers preexisting immunity.

Molecules against COVID-19:An in Silico Approach for Drug Development

A large number of deaths have been caused by the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)worldwide,turning it into a serious and momentous threat to public health.This study tends to contribute to the development of effective treatment strategies through a computational approach,investigating the mechanisms in relation to the binding and subsequent inhibition of SARS-CoV-2 ribonucleic acid(RNA)-dependent RNA polymerase(RdRp).Molecular docking was performed to screen six naturally occurring molecules with antineoplastic properties(Ellipticine,Ecteinascidin,Homoharringtonine,Dolastatin 10,Halichondrin,and Plicamycin).Absorption,distribution,metabolism,and excretion(ADME)investigation was also conducted to analyze the druglike properties of these compounds.The docked results have clearly shown binding of ligands to the SARS-CoV-2 RdRp protein.Interestingly,all ligands were found to obey Lipinski’s rule of five.These results provide a basis for repurposing and using molecules,derived from plants and animals,as a potential treatment for the coronavirus disease 2019(COVID-19)infection as they could be effective therapeutics for the same.

General Considerations for the Practice of Pediatric Dentistry in the Period of COVID-19 Pandemic: A Review

Context: Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-COV-2) has been identified in December 2019. Since then, it has been spreading around the world and has caused a pandemic. Strict safety protocols should be followed to resume dental treatments. Evidence Acquisition: A comprehensive search was conducted on PubMed, Scopus, Medline and google scholar databases using the MeSH words of COVID-19, SARS-COV-2, Dentistry, and Child from December 2019 until July 2020. Results: Among COVID-19 patients, asymptomatic patients still are considered to be serious carriers of the COVID-19 which can play a key role in transmission of the virus. Children are reported to be less than 2 percent of the infected population and are considered as serious potential carriers. Telemedicine can take a key part in educating parents regarding this matter. Chronic and rare diseases such as Kawasaki Disease (KD) might show acute and more frequent symptoms amongst COVID-19 patients. Salivary testing can be a convenient chairside way for COVID-19 and it has been shown to be effective in identifying critically ill patients. Dry mouth and amblygeustia have been reported to be the oral symptoms of the COVID-19. Conclusions: Dentists must make tough decisions in prioritizing patient’s needs in the period of pandemic. They should frequently get updated as the situation is fluid and the protocols might change.

The Only Way to Eradicate COVID-19 Pandemic from the World

The novel Coronavirus disease or COVID-19 is a new contagious, dangerous, and deadly viral/immunological systemic disorder with predominantly respiratory features caused by human infection with SARS-CoV-2, which is rapidly spreading from person-to-person all around the world as a pandemic. If the COVID-19 pandemic is not controlled, and then eradicated, it will probably cause the extinction of the human race in the coming years or decades! It shows the fastest multiple genetic mutation for SARS-CoV-2 in the development of the disease. According to the author of this article, an effective vaccine for SARS-CoV-2 will not be made any time soon or may never be made. If it is made, due to the need to use the vaccine several times a year, the staggering cost of vaccine production, its potentially insufficient effect in preventing COVID-19, its possible side effects, and the complexity of its equitable distribution worldwide, it cannot be a significant success in preventing the COVID-19 pandemic. Hence, the only way to eradicate COVID-19 pandemic is: simultaneous, synchronized, and universal quarantine for at least 40 days for all the people of the planet as staying at home for 99% of them and staying at workplace for another 1%, that because of the need for their key job, they need to be present at work. By applying the COVID-19 Referral System for screening people infected with SARS-CoV-2 and Persian Gulf Criteria for diagnosis of COVID-19, we recommend home isolation for mild cases of COVID-19 and hospitalization in Corona Center for severe cases. Also, along with these, more and more SARS-CoV-2 diagnostic tests should be performed using highly sensitive kits, and the principles of prevention of becoming infected with the SARS-CoV-2 should be followed carefully and as soon as possible. By applying all the above, success in controlling and suppressing the SARS-CoV-2 epidemics is anticipated.

Network pharmacology and molecular docking analysis on molecular targets and mechanism prediction of Huanglian Jiedu Decoction in the treatment of COVID-19

Objective To investigate and predict the molecular targets and mechanism of Huanglian Jiedu Decoction(黄连解毒汤,HLJDD)in the treatment of Corona Virus Disease 2019(COV-ID-19)through network pharmacology and molecular docking analysis.Methods The chemical constituents and action targets of HLJDD were retrieved on Tradi-tional Chinese Medicine Systems Pharmacology Database and Analysis Platform(TCMSP),SymMap v2,Encyclopedia of Traditional Chinese Medicine(ETCM),a High-throughput Ex-periment-and Reference-guided Database of Traditional Chinese Medicine(HERB),and Tra-ditional Chinese Medicine Integrated Database(TCMID).UniProt and GeneCards were used to query the target genes that corresponding to the active compounds,and then a compound-target network was constructed using Cytoscape 3.7.2.Gene Ontology(GO)database was used to annotate GO functions.Kyoto Encyclopedia of Genes and Genomes(KEGG)was used to predict the possible mechanisms of active compounds.The Database for Annotation,Visu-alization and Integrated Discovery(DAVID)was used to analysis the tissue enrichment.The main active compounds in HLJDD are molecularly docked with their corresponding related targets.Results Seventy-six compounds were screened and 458 corresponding targets in the network were obtained.Gene annotation showed that the targets were involved mainly in 1953 biolo-gical processes.884 signaling pathways was enriched,involving signaling by interleukins,cy-tokine signaling in immune system,generic transcription pathway,and RNA polymerase II transcription.The targets mainly distributed in the lung,liver,and placenta,involving a vari-ety of immune cells,such as T cells and B cells.The molecular docking results showed that core compounds such as wogonin,berberine,and baicalein had high affinity with tumor nec-rosis factor(TNF),insulin(INS),and tumor protein 53(TP53).Conclusion The active compounds in HLJDD may have a therapeutic effect on COVID-19 through regulating multiple signal pathways by targeting genes such as vascular endothelial growth factor A(VEGFA),INS,interleukin-6(IL-6),TNF,caspase-3,TP53,and mitogen-activ-ated protein kinase 3(MAPK3).