COVID-19: a new challenge for human beings

Prediction of the COVID-19 epidemic trends based on SEIR and AI models

In December 2019, the outbreak of a new coronavirus-caused pneumonia (COVID-19) in Wuhan attracted close attention in China and the world. The Chinese government took strong national intervention measures on January 23 to control the spread of the epidemic. We are trying to show the impact of these controls on the spread of the epidemic. We proposed an SEIR(Susceptible-Exposed-Infectious-Removed) model to analyze the epidemic trend in Wuhan and use the AI model to analyze the epidemic trend in non-Wuhan areas. We found that if the closure was lifted, the outbreak in non-Wuhan areas of mainland China would double in size. Our SEIR and AI model was effective in predicting the COVID-19 epidemic peaks and sizes. The epidemic control measures taken by the Chinese government, especially the city closure measures, reduced the scale of the COVID-19 epidemic.

Low-dose radiotherapy (LD-RT) for COVID-19-induced pneumopathy: a worth considering approach

PURPOSE

It seems that 2020 would be always remembered by the name of novel coronavirus (designated as SARS-CoV-2), which exerted its deteriorating effects on the health care, economy, education, and political relationships. In August 2020 more than eight hundred thousand patients lost their lives due to acute respiratory syndrome. In the limited list of therapeutic approaches, the effectiveness of low-dose radiation therapy (LD-RT) for curing inflammatory-related diseases have sparkled a light that probably this approach would bring promising advantages for COVID-19 patients. LD-RT owns its reputation from its ability to modulate the host inflammatory responses by blocking the production of pro-inflammatory cytokines and hampering the activity of leukocytes. Moreover, the cost-effective and availability of this method allow it to be applied to a large number of patients, especially those who could not receive anti-IL-6 treatments in low-income countries. But enthusiasm for applying LD-RT for the treatment of COVID-19 patients has been muted yet.

CONCLUSION

In this review, we take a look at LD-RT mechanisms of action in the treatment of nonmalignant diseases, and then through studying both the dark and bright sides of this approach, we provide a thorough discussion if LD-RT might be a promising therapeutic approach in COVID-19 patients.

Perspectives on mechanistic implications of ROS inducers for targeting viral infections

In this perspective, we propose to leverage reactive oxygen species (ROS) induction as a potential therapeutic measure against viral infections. Our rationale for targeting RNA viral infections by pro-oxidants is routed on the mechanistic hypothesis that ROS based treatment paradigm could impair RNA integrity faster than the other macromolecules. Though antiviral drugs with antioxidant properties confer potential abilities for preventing viral entry, those with pro-oxidant properties could induce the degradation of nascent viral RNA within the host cells, as RNAs are highly prone to ROS mediated degradation than DNA/proteins. We have previously established that Plumbagin is a highly potent ROS inducer, which acts through shifting of the host redox potential. Besides, it has been reported that Plumbagin treatment has the potential for interrupting viral RNA replication within the host cells. Since the on-going Corona Virus Disease - 2019 (COVID-19) global pandemic mediated by Severe Acute Respiratory Syndrome Corona Virus-2 (SARS-CoV-2) exhibits high infectivity, the development of appropriate antiviral therapeutic strategies remains to be an urgent unmet race against time. Therefore, additional experimental validation is warranted to determine the appropriateness of repurposable drug candidates, possibly ROS inducers, for fighting the pandemic which could lead to saving many lives from being lost to COVID-19.

Prediction of COVID-19 pervasiveness in six major affected states of India and two-stage variation with temperature

Coronavirus disease knocked in Wuhan city of China in December 2019 which spread quickly across the world and infected millions of people within a short span of time. COVID-19 is a fast-spreading contagious disease which is caused by SARS-CoV-2 (severe acute respiratory syndrome-coronavirus-2). Accurate time series forecasting modeling is the need of the hour to monitor and control the universality of COVID-19 effectively, which will help to take preventive measures to break the ongoing chain of infection. India is the second highly populated country in the world and in summer the temperature rises up to 50°, nowadays in many states have more than 40° temperatures. The present study deals with the development of the autoregressive integrated moving average (ARIMA) model to predict the trend of the number of COVID-19 infected people in most affected states of India and the effect of a rise in temperature on COVID-19 cases. Cumulative data of COVID-19 confirmed cases are taken for study which consists of 77 sample points ranging from 1st March 2020 to 16th May 2020 from six states of India namely Delhi (Capital of India), Madya Pradesh, Maharashtra, Punjab, Rajasthan, and Uttar Pradesh. The developed ARIMA model is further used to make 1-month ahead out of sample predictions for COVID-19. The performance of ARIMA models is estimated by comparing measures of errors for these six states which will help in understanding future trends of COVID-19 outbreak. Temperature rise shows slightly negatively correlated with the rise in daily cases. This study is noble to analyse the variation of COVID-19 cases with respect to temperature and make aware of the state governments and take precautionary measures to flatten the growth curve of confirmed cases of COVID-19 infections in other states of India, nearby countries as well.

Disease transmission through expiratory aerosols on an urban bus

Airborne respiratory diseases such as COVID-19 pose significant challenges to public transportation. Several recent outbreaks of SARS-CoV-2 indicate the high risk of transmission among passengers on public buses if special precautions are not taken. This study presents a combined experimental and numerical analysis to identify transmission mechanisms on an urban bus and assess strategies to reduce risk. The effects of the ventilation and air-conditioning systems, opening windows and doors, and wearing masks are analyzed. Specific attention is paid to the transport of submicron- and micron-sized particles relevant to typical respiratory droplets. High-resolution instrumentation was used to measure size distribution and aerosol response time on a campus bus of the University of Michigan under these different conditions. Computational fluid dynamics was employed to measure the airflow within the bus and evaluate risk. A risk metric was adopted based on the number of particles exposed to susceptible passengers. The flow that carries these aerosols is predominantly controlled by the ventilation system, which acts to uniformly distribute the aerosol concentration throughout the bus while simultaneously diluting it with fresh air. The opening of doors and windows was found to reduce the concentration by approximately one half, albeit its benefit does not uniformly impact all passengers on the bus due to the recirculation of airflow caused by entrainment through windows. Finally, it was found that well fitted surgical masks, when worn by both infected and susceptible passengers, can nearly eliminate the transmission of the disease.

Viral Infections of the Upper Airway in the Setting of COVID-19: A Primer for Rhinologists

BACKGROUND

Viral respiratory tract infections are associated with a significant burden of disease and represent one of the leading causes of mortality worldwide. The current Coronavirus Disease 2019 (COVID-19) pandemic highlights the devastating toll that respiratory viruses have on humanity and the desperate need to understand the biological characteristics that define them in order to develop efficacious treatments and vaccines. To date, Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has infected nearly 600 times more people and resulted in 200 times more deaths relative to Severe Acute Respiratory Syndrome Coronavirus (SARS-CoV) and Middle Eastern Respiratory Syndrome Coronavirus (MERS-CoV) combined.

OBJECTIVE

Through this review, we aim to summarize the key characteristics of respiratory viruses that hold global significance, with a focus on SARS-CoV-2. Our goal is to disseminate our current knowledge of these infectious agents to otolaryngologists, in particular rhinologists, practicing in the COVID-19 era.

METHODS

The general and clinical characteristics of selected respiratory viruses along with available viral treatments and vaccines are reviewed.

RESULTS

There has been significant progress in our understanding of the epidemiology and pathogenesis of various respiratory viruses. However, despite the advancement in knowledge, efficacious vaccines and antiviral treatments remain elusive for most respiratory viruses. The dire need for these scientific discoveries is highlighted by the recent COVID-19 pandemic, which has prompted investigators worldwide to conduct clinical trials at an accelerated timeline in an effort to reduce the morbidity and mortality associated with SARS-CoV-2 infection. Rhinologists will continue to remain on the front-lines of pandemics associated with respiratory viruses.

CONCLUSION

In light of these unprecedented times, the need to understand the nuances of these viral respiratory pathogens, especially SARS-CoV-2, cannot be overemphasized. This knowledge base is of particular importance to otolaryngologists, whose expertise in the upper airway coincides with the anatomic tropism of these infectious agents.

Discovery of cyclic sulfonamide derivatives as potent inhibitors of SARS-CoV-2

Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) continues to spread worldwide, with 25 million confirmed cases and 800 thousand deaths. Effective treatments to target SARS-CoV-2 are urgently needed. In the present study, we have identified a class of cyclic sulfonamide derivatives as novel SARS-CoV-2 inhibitors. Compound 13c of the synthesized compounds exhibited robust inhibitory activity (IC50 = 0.88 μM) against SARS-CoV-2 without cytotoxicity (CC50 > 25 μM), with a selectivity index (SI) of 30.7. In addition, compound 13c exhibited high oral bioavailability (77%) and metabolic stability with good safety profiles in hERG and cytotoxicity studies. The present study identified that cyclic sulfonamide derivatives are a promising new template for the development of anti-SARS-CoV-2 agents.

Disease transmission through expiratory aerosols on an urban bus

Airborne respiratory diseases such as COVID-19 pose significant challenges to public transportation. Several recent outbreaks of SARS-CoV-2 indicate the high risk of transmission among passengers on public buses if special precautions are not taken. This study presents a combined experimental and numerical analysis to identify transmission mechanisms on an urban bus and assess strategies to reduce risk. The effects of the ventilation and air-conditioning systems, opening windows and doors, and wearing masks are analyzed. Specific attention is paid to the transport of submicron- and micron-sized particles relevant to typical respiratory droplets. High-resolution instrumentation was used to measure size distribution and aerosol response time on a campus bus of the University of Michigan under these different conditions. Computational fluid dynamics was employed to measure the airflow within the bus and evaluate risk. A risk metric was adopted based on the number of particles exposed to susceptible passengers. The flow that carries these aerosols is predominantly controlled by the ventilation system, which acts to uniformly distribute the aerosol concentration throughout the bus while simultaneously diluting it with fresh air. The opening of doors and windows was found to reduce the concentration by approximately one half, albeit its benefit does not uniformly impact all passengers on the bus due to the recirculation of airflow caused by entrainment through windows. Finally, it was found that well fitted surgical masks, when worn by both infected and susceptible passengers, can nearly eliminate the transmission of the disease.

Particulate matter and SARS-CoV-2: A possible model of COVID-19 transmission

Coronavirus disease 2019 (COVID-19), an acute respiratory disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has rapidly developed into a pandemic throughout the world. This disease is a highly infectious novel coronavirus and can affect people of all ages. Previous reports observed that particulate matter (PM) provided a platform for intermixing with viruses (i.e., influenza). However, the role of PM in SARS-CoV-2 transmission remains unclear. In this paper, we propose that PM plays a direct role as a "carrier" of SARS-CoV-2. SARS-CoV-2 is reported to have a high affinity for the angiotensin-converting enzyme 2 (ACE2) receptor. Indirectly, exposure to PM increases ACE2 expression in the lungs which facilitates SARS-CoV-2 viral adhesion. Thus, the high risk of SARS-CoV-2 in heavily polluted regions can be explained by upregulation of ACE2 caused by PM. PM could be both a direct and indirect transmission model for SARS-CoV-2 infection.

COVID-19: A Global Challenge with Old History, Epidemiology and Progress So Far

Humans have witnessed three deadly pandemics so far in the twenty-first century which are associated with novel coronaviruses: SARS, Middle East respiratory syndrome (MERS), and COVID-19. All of these viruses, which are responsible for causing acute respiratory tract infections (ARTIs), are highly contagious in nature and/or have caused high mortalities. The recently emerged COVID-19 disease is a highly transmittable viral infection caused by another zoonotic novel coronavirus named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Similar to the other two coronaviruses such as SARS-CoV-1 and MERS-CoV, SARS-CoV-2 is also likely to have originated from bats, which have been serving as established reservoirs for various pathogenic coronaviruses. Although, it is still unknown how SARS-CoV-2 is transmitted from bats to humans, the rapid human-to-human transmission has been confirmed widely. The disease first appeared in Wuhan, China, in December 2019 and quickly spread across the globe, infected 48,539,872 people, and caused 1,232,791 deaths in 215 countries, and the infection is still spreading at the time of manuscript preparation. So far, there is no definite line of treatment which has been approved or vaccine which is available. However, different types of potential vaccines and therapeutics have been evaluated and/or are under clinical trials against COVID-19. In this review, we summarize different types of acute respiratory diseases and briefly discuss earlier outbreaks of coronaviruses and compare their occurrence and pathogenicity with the current COVID-19 pandemic. Various epidemiological aspects of COVID-19 such as mode of spread, death rate, doubling time, etc., have been discussed in detail. Apart from this, different technical issues related to the COVID-19 pandemic including use of masks and other socio-economic problems associated with the pandemic have also been summarized. Additionally, we have reviewed various aspects of patient management strategies including mechanism of action, available diagnostic tools, etc., and also discussed different strategies for the development of effective vaccines and therapeutic combinations to deal with this viral outbreak. Overall, by the inclusion of various references, this review covers, in detail, the most important aspects of the COVID-19 pandemic.

Computational Prediction of Potential Inhibitors of the Main Protease of SARS-CoV-2

The rapidly developing pandemic, known as coronavirus disease 2019 (COVID-19) and caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has recently spread across 213 countries and territories. This pandemic is a dire public health threat-particularly for those suffering from hypertension, cardiovascular diseases, pulmonary diseases, or diabetes; without approved treatments, it is likely to persist or recur. To facilitate the rapid discovery of inhibitors with clinical potential, we have applied ligand- and structure-based computational approaches to develop a virtual screening methodology that allows us to predict potential inhibitors. In this work, virtual screening was performed against two natural products databases, Super Natural II and Traditional Chinese Medicine. Additionally, we have used an integrated drug repurposing approach to computationally identify potential inhibitors of the main protease of SARS-CoV-2 in databases of drugs (both approved and withdrawn). Roughly 360,000 compounds were screened using various molecular fingerprints and molecular docking methods; of these, 80 docked compounds were evaluated in detail, and the 12 best hits from four datasets were further inspected via molecular dynamics simulations. Finally, toxicity and cytochrome inhibition profiles were computationally analyzed for the selected candidate compounds.

COVID-19 Epidemic in Bangladesh among Rural and Urban Residents: An Online Cross-Sectional Survey of Knowledge, Attitudes, and Practices

As other nations around the world, Bangladesh is facing enormous challenges with the novel coronavirus (COVID-19) epidemic. To design a prevention and control strategy for this new infectious disease, it is essential to first understand people's knowledge, attitudes, and practices (KAP) regarding COVID-19. This study sought to determine KAP among rural and urban residents as well as predictors of preventive practices associated with COVID-19 in Bangladesh. A social media-based (Facebook) cross-sectional survey was conducted to explore these variables among Bangladeshi adults. Of 1520 respondents who completed the questionnaire, low level of good or sufficient knowledge of COVID-19 (70.8%) and practices associated with COVID-19 (73.8%) were found. Despite the low level of knowledge and practices, respondents' attitude (78.9%) towards COVID-19 was relatively high. Results suggest that compared to urban, rural residents are at a particularly high risk of COVID-19 because they were found to have significantly lower knowledge (p = 0.001) and practice levels (p = 0.002) than were urban residents. Multivariable logistic regression analysis identified gender, education, knowledge of COVID-19 transmission, signs and symptoms, and sources of information as factors significantly associated with preventive practices against COVID-19. Further attention and effort should be directed toward increasing both knowledge and practices targeting the general population in Bangladesh, particularly the rural and less educated residents. Findings from this study provide baseline data that can be used to promote integrated awareness of and effective health education programs about COVID-19 prevention and control strategies in Bangladesh, and similar COVID-19 endemic countries.

COVID-19 Epidemic in Bangladesh among Rural and Urban Residents: An Online Cross-Sectional Survey of Knowledge, Attitudes, and Practices

As other nations around the world, Bangladesh is facing enormous challenges with the novel coronavirus (COVID-19) epidemic. To design a prevention and control strategy for this new infectious disease, it is essential to first understand people's knowledge, attitudes, and practices (KAP) regarding COVID-19. This study sought to determine KAP among rural and urban residents as well as predictors of preventive practices associated with COVID-19 in Bangladesh. A social media-based (Facebook) cross-sectional survey was conducted to explore these variables among Bangladeshi adults. Of 1520 respondents who completed the questionnaire, low level of good or sufficient knowledge of COVID-19 (70.8%) and practices associated with COVID-19 (73.8%) were found. Despite the low level of knowledge and practices, respondents' attitude (78.9%) towards COVID-19 was relatively high. Results suggest that compared to urban, rural residents are at a particularly high risk of COVID-19 because they were found to have significantly lower knowledge (p = 0.001) and practice levels (p = 0.002) than were urban residents. Multivariable logistic regression analysis identified gender, education, knowledge of COVID-19 transmission, signs and symptoms, and sources of information as factors significantly associated with preventive practices against COVID-19. Further attention and effort should be directed toward increasing both knowledge and practices targeting the general population in Bangladesh, particularly the rural and less educated residents. Findings from this study provide baseline data that can be used to promote integrated awareness of and effective health education programs about COVID-19 prevention and control strategies in Bangladesh, and similar COVID-19 endemic countries.

Artificial Intelligence in the Fight Against COVID-19: Scoping Review

BACKGROUND

In December 2019, COVID-19 broke out in Wuhan, China, leading to national and international disruptions in health care, business, education, transportation, and nearly every aspect of our daily lives. Artificial intelligence (AI) has been leveraged amid the COVID-19 pandemic; however, little is known about its use for supporting public health efforts.

OBJECTIVE

This scoping review aims to explore how AI technology is being used during the COVID-19 pandemic, as reported in the literature. Thus, it is the first review that describes and summarizes features of the identified AI techniques and data sets used for their development and validation.

METHODS

A scoping review was conducted following the guidelines of PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews). We searched the most commonly used electronic databases (eg, MEDLINE, EMBASE, and PsycInfo) between April 10 and 12, 2020. These terms were selected based on the target intervention (ie, AI) and the target disease (ie, COVID-19). Two reviewers independently conducted study selection and data extraction. A narrative approach was used to synthesize the extracted data.

RESULTS

We considered 82 studies out of the 435 retrieved studies. The most common use of AI was diagnosing COVID-19 cases based on various indicators. AI was also employed in drug and vaccine discovery or repurposing and for assessing their safety. Further, the included studies used AI for forecasting the epidemic development of COVID-19 and predicting its potential hosts and reservoirs. Researchers used AI for patient outcome-related tasks such as assessing the severity of COVID-19, predicting mortality risk, its associated factors, and the length of hospital stay. AI was used for infodemiology to raise awareness to use water, sanitation, and hygiene. The most prominent AI technique used was convolutional neural network, followed by support vector machine.

CONCLUSIONS

The included studies showed that AI has the potential to fight against COVID-19. However, many of the proposed methods are not yet clinically accepted. Thus, the most rewarding research will be on methods promising value beyond COVID-19. More efforts are needed for developing standardized reporting protocols or guidelines for studies on AI.

Role of Nutraceuticals in COVID-19 Mediated Liver Dysfunction

COVID-19 is known as one of the deadliest pandemics of the century. The rapid spread of this deadly virus at incredible speed has stunned the planet and poses a challenge to global scientific and medical communities. Patients with COVID-19 are at an increased risk of co-morbidities associated with liver dysfunction and injury. Moreover, hepatotoxicity induced by antiviral therapy is gaining importance and is an area of great concern. Currently, alternatives therapies are being sought to mitigate hepatic damage, and there has been growing interest in the research on bioactive phytochemical agents (nutraceuticals) due to their versatility in health benefits reported in various epidemiological studies. Therefore, this review provides information and summarizes the juncture of antiviral, immunomodulatory, and hepatoprotective nutraceuticals that can be useful during the management of COVID-19.

Novel corona virus (COVID-19) pandemic: current status and possible strategies for detection and treatment of the disease

INTRODUCTION

In December 2019, a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreak occurred and caused the coronavirus disease of 2019 (COVID-19), which affected ~ 190 countries. The World Health Organization (WHO) has declared COVID-19 a pandemic on 11 March 2020.

AREA COVERED

In the review, a comprehensive analysis of the recent developments of the COVID-19 pandemic has been provided, including the structural characterization of the virus, the current worldwide status of the disease, various detection strategies, drugs recommended for the effective treatment, and progress of vaccine development programs by different countries. This report was constructed by following a systematic literature search of bibliographic databases of published reports of relevance until 1 September 2020.

EXPERT OPINION

Currently, the countries are opening businesses despite a spike in the number of COVID-19 cases. The pharmaceutical industries are developing clinical diagnostic kits, medicines, and vaccines. They target different approaches, including repurposing the already approved diagnosis and treatment options for similar CoVs. At present, over ~200 vaccine candidates are being developed against COVID-19. Future research may unravel the genetic variations or polymorphisms that dictate these differences in susceptibilities to the disease.

Chasing COVID-19 through SARS-CoV-2 spike glycoprotein

An ongoing pandemic Coronavirus disease (COVID-19), caused by a newly emerged Coronavirus, SARS-CoV-2 has affected millions of people globally. One of the most crucial structural proteins of SARS-CoV-2 is the Spike glycoprotein (S-glycoprotein), for which the first de novo modelling was envisaged by our group in early 2020, and was superimposed to its predecessor SARS-CoV S-glycoprotein, to determine structural divergence, glycosylation and antigenic variation between SARS-CoV-2 and SARS-CoV. S-glycoprotein is involved in binding with the cellular receptor, membrane fusion, internalization via angiotensin-converting enzyme 2 (ACE2) receptor, and tissue tropism. Upon internalization into the target host cells, the viral genome encodes two precursor polypeptides which get processed into 16 mature nonstructural proteins that play a crucial role in replication and transcription of SARS-CoV-2. Currently S-glycoprotein is one of the most vital targets for vaccine and therapeutics development for COVID-19.

Cutaneous Manifestations in Confirmed COVID-19 Patients: A Systematic Review

There have been increasing reports of skin manifestations in COVID-19 patients. We conducted a systematic review and included manuscripts describing patients with positive RT-PCR coronavirus testing from nasopharyngeal swabs who also developed cutaneous manifestations. A total of 655 patients were selected, with different types of skin rashes: Erythematous maculopapular (n = 250), vascular (n = 146), vesicular (n = 99), urticarial (n = 98), erythema multiforme/generalized pustular figurate erythema/Stevens-Johnson syndrome (n = 22), ocular/periocular (n = 14), polymorphic pattern (n = 9), generalized pruritus (n = 8), Kawasaki disease (n = 5), atypical erythema nodosum (n = 3), and atypical Sweet syndrome (n = 1). Chilblain-like lesions were more frequent in the younger population and were linked to a milder disease course, while fixed livedo racemosa and retiform purpura appeared in older patients and seemed to predict a more severe prognosis. For vesicular rashes, PCR determined the presence of herpesviruses in the vesicle fluid, which raised the possibility of herpesvirus co-infections. The erythema-multiforme-like pattern, generalized pustular figurate erythema and Stevens-Johnson syndrome were most frequently linked to hydroxychloroquine intake. A positive PCR determination of SARS-COV-2 from conjunctival swabs suggest that eye discharge can also be contagious. These cutaneous manifestations may aid in identifying otherwise asymptomatic COVID-19 carriers in some cases or predict a more severe evolution in others.

Biomedical application, drug delivery and metabolic pathway of antiviral nanotherapeutics for combating viral pandemic: A review

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a neoteric virus belonging to the beta coronavirus class has created a global health concern, responsible for an outbreak of severe acute respiratory illness, the COVID-19 pandemic. Infected hosts exhibit diverse clinical features, ranging from asymptomatic to severe symptoms in their genital organs, respiratory, digestive, and circulatory systems. Considering the high transmissibility (R₀: ≤6.0) compared to Middle East respiratory syndrome coronavirus (MERS-CoV) and SARS-CoV, the quest for the clinical development of suitable antiviral nanotherapeutics (NTPs) is incessant. We are presenting a systematic review of the literature published between 2003 and 2020 to validate the hypothesis that the pharmacokinetics, collateral acute/chronic side effects of nano drugs and spike proteins arrangement of coronaviruses can revolutionize the therapeutic approach to cure COVID-19. Our aim is also to critically assess the slow release kinetics and specific target site chemical synthesis influenced competence of NTPs and nanotoxicity based antiviral actions, which are commonly exploited in the synthesis of modulated nanomedicines. The pathogenesis of novel virulent pathogens at the cellular and molecular levels are also considered, which is of utmost importance to characterize the emerging nano-drug agents as diagnostics or therapeutics or viral entry inhibitors. Such types of approaches trigger the scientists and policymakers in the development of a conceptual framework of nano-biotechnology by linking nanoscience and virology to present a smart molecular diagnosis/treatment for pandemic viral infections.

Diffusive process under Lifshitz scaling and pandemic scenarios

We here propose to model active and cumulative cases data from COVID-19 by a continuous effective model based on a modified diffusion equation under Lifshitz scaling with a dynamic diffusion coefficient. The proposed model is rich enough to capture different aspects of a complex virus diffusion as humanity has been recently facing. The model being continuous it is bound to be solved analytically and/or numerically. So, we investigate two possible models where the diffusion coefficient associated with possible types of contamination are captured by some specific profiles. The active cases curves here derived were able to successfully describe the pandemic behavior of Germany and Spain. Moreover, we also predict some scenarios for the evolution of COVID-19 in Brazil. Furthermore, we depicted the cumulative cases curves of COVID-19, reproducing the spreading of the pandemic between the cities of São Paulo and São José dos Campos, Brazil. The scenarios also unveil how the lockdown measures can flatten the contamination curves. We can find the best profile of the diffusion coefficient that better fit the real data of pandemic.

Race to arsenal COVID-19 therapeutics: Current alarming status and future directions

The on-going pandemic of COVID-19 wreaked by a viral infection of SARS-CoV-2, has generated a catastrophic plight across the globe. Interestingly, one of the hallmarks of COVID-19 is the so-called 'cytokine storm' due to attack of SARS-Cov-2 in the lungs. Considering, mesenchymal stem cells (MSCs) therapy could contribute against SARS-CoV-2 viruses attack because of their immune modulatory and anti-inflammatory ability linked to their stemness, to the arsenal of treatments for COVID-19. Another novel therapeutic strategies include the blockade of rampant generation of pro-inflammatory mediators like acute respiratory distress syndrome (ARDS), degradation of viral protein capsids by PROTACs, composed of Ubiquitin-proteasome framework, and ubiquitination-independent pathway directing the SARS-CoV-2 nucleocapsid protein (nCoV N) and proteasome activator (PA28γ), etc. This review is consequently an endeavour to highlight the several aspects of COVID-19 with incorporation of important treatment strategies discovered to date and putting the real effort on the future directions to put them into the perspective.

Low-dose radiotherapy for COVID-19 pneumonia treatment: case report, procedure, and literature review

BACKGROUND

The COVID-19 pandemic outbreak has set the emergency services in developing countries on major alert, as the installed response capacities are easily overwhelmed by the constantly increasing high demand. The deficit of intensive care unit beds and ventilators in countries like Peru is forcing practitioners to seek preventive or early interventional strategies to prevent saturating these chronically neglected facilities.

CASE PRESENTATION

A 64-year-old patient is reported after presenting with COVID-19 pneumonia and rapidly progressing to deteriorated ventilatory function. Compassionate treatment with a single 1‑Gy dose to the bilateral whole-lung volume was administered, with gradual daily improvement of ventilatory function and decrease in serum inflammatory markers and oxygen support needs, including intubation. No treatment-related toxicity developed. Procedures of transport, disinfection, and treatment planning and delivery are described.

CONCLUSION

Whole-lung low-dose radiotherapy seems to be a promising approach for avoiding or delaying invasive respiratory support. Delivered low doses are far from meeting toxicity ranges. On-going prospective trials will elucidate the effectiveness of this approach.

Druggability for COVID-19: in silico discovery of potential drug compounds against nucleocapsid (N) protein of SARS-CoV-2

The coronavirus disease 2019 is a contagious disease and had caused havoc throughout the world by creating widespread mortality and morbidity. The unavailability of vaccines and proper antiviral drugs encourages the researchers to identify potential antiviral drugs to be used against the virus. The presence of RNA binding domain in the nucleocapsid (N) protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could be a potential drug target, which serves multiple critical functions during the viral life cycle, especially the viral replication. Since vaccine development might take some time, the identification of a drug compound targeting viral replication might offer a solution for treatment. The study analyzed the phylogenetic relationship of N protein sequence divergence with other 49 coronavirus species and also identified the conserved regions according to protein families through conserved domain search. Good structural binding affinities of a few natural and/or synthetic phytocompounds or drugs against N protein were determined using the molecular docking approaches. The analyzed compounds presented the higher numbers of hydrogen bonds of selected chemicals supporting the drug-ability of these compounds. Among them, the established antiviral drug glycyrrhizic acid and the phytochemical theaflavin can be considered as possible drug compounds against target N protein of SARS-CoV-2 as they showed lower binding affinities. The findings of this study might lead to the development of a drug for the SARS-Cov-2 mediated disease and offer solution to treatment of SARS-CoV-2 infection.

Druggability for COVID-19: in silico discovery of potential drug compounds against nucleocapsid (N) protein of SARS-CoV-2

The coronavirus disease 2019 is a contagious disease and had caused havoc throughout the world by creating widespread mortality and morbidity. The unavailability of vaccines and proper antiviral drugs encourages the researchers to identify potential antiviral drugs to be used against the virus. The presence of RNA binding domain in the nucleocapsid (N) protein of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could be a potential drug target, which serves multiple critical functions during the viral life cycle, especially the viral replication. Since vaccine development might take some time, the identification of a drug compound targeting viral replication might offer a solution for treatment. The study analyzed the phylogenetic relationship of N protein sequence divergence with other 49 coronavirus species and also identified the conserved regions according to protein families through conserved domain search. Good structural binding affinities of a few natural and/or synthetic phytocompounds or drugs against N protein were determined using the molecular docking approaches. The analyzed compounds presented the higher numbers of hydrogen bonds of selected chemicals supporting the drug-ability of these compounds. Among them, the established antiviral drug glycyrrhizic acid and the phytochemical theaflavin can be considered as possible drug compounds against target N protein of SARS-CoV-2 as they showed lower binding affinities. The findings of this study might lead to the development of a drug for the SARS-Cov-2 mediated disease and offer solution to treatment of SARS-CoV-2 infection.

anti-HCoV: A web resource to collect natural compounds against human coronaviruses

BACKGROUND

A novel coronavirus, the SARS-CoV2, was revealed to be the cause of COVID19, the pandemic disease that already provoked more than 555.324 deaths in the world (July 10, 2020). No vaccine treatment has been defined against SARS-CoV2 or other human coronaviruses (HCoVs), including those causing epidemic infections, neither appropriate strategies for prevention and care are yet officially suggested.

SCOPE AND APPROACH

We reviewed scientific literature on natural compounds that were defined as potentially effective against human coronaviruses. Our desk research identified non-chemically modified natural compounds that were shown (in vitro) and/or predicted (in silico) to act against one or more phases of human coronaviruses cell cycle.We selected all available information, merged and annotated the data to define a comprehensive list of natural compounds, describing their chemical classification, the source, the action, the specific target in the viral infection. Our aim was to collect possible compounds for prevention and care against human coronaviruses.

KEY FINDINGS AND CONCLUSIONS

The definition of appropriate interventions against viral diseases need a comprehensive view on the infection dynamics and on necessary treatments. Viral targeting compounds to be exploited in food sciences could be of relevant interest to this aim.We collected 174 natural compounds showing effects against human infecting coronaviruses, providing a curated annotation on actions and targets.The data are available in anti-HCoV, a web accessible resource to be exploited for testing and in vivo trials. The website is here launched to favour a community based cooperative effort to call for contribution and expand the collection. To be ready to fight.

Silver-Based Nanomaterials as Therapeutic Agents Against Coronaviruses: A Review

Since the identification of the first human coronavirus in the 1960s, a total of six coronaviruses that are known to affect humans have been identified: 229E, OC43, severe acute respiratory syndrome coronavirus (SARS-CoV), NL63, HKU1, and Middle East respiratory syndrome coronavirus (MERS-CoV). Presently, the human world is affected by a novel version of the coronavirus family known as SARS-CoV-2, which has an extremely high contagion rate. Although the infection fatality rate (IFR) of this rapidly spreading virus is not high (ranging from 0.00% to 1.54% across 51 different locations), the increasing number of infections and deaths has created a worldwide pandemic situation. To provide therapy to severely infected patients, instant therapeutic support is urgently needed and the repurposing of already approved drugs is presently in progress. In this regard, the development of nanoparticles as effective transporters for therapeutic drugs or as alternative medicines is highly encouraged and currently needed. The size range of the viruses is within 60-140 nm, which is slightly larger than the diameters of nanoparticles, making nanomaterials efficacious tools with antiviral properties. Silver-based nanomaterials (AgNMs) demonstrate antimicrobial and disinfectant effects mostly by generating reactive oxygen species (ROS) and are presently considered as a versatile tool for the treatment of COVID-19 patients. Other metal-based nanoparticles have been primarily reported as delivery agents or surface modifying agents, vaccine adjuvant against coronavirus. The present review summarizes and discusses the possible effectiveness of various surface-modified AgNMs against animal coronaviruses and presents a concept for AgNM-based therapeutic treatment of SARS-CoV-2 in the near future.

Molecular targets and system biology approaches for drug repurposing against SARS-CoV-2

BACKGROUND

COVID-19, a pandemic declared by WHO, has infected about 39.5 million and killed about 1.1 million people throughout the world. There is the urgent need of more studies to identify the novel drug targets and the drug candidates against it to handle the situation.

MAIN BODY

To virtually screen various drugs against SARS-CoV-2, the scientists need the detail information about the various drug targets identified till date. The present review provides the information about almost all the drug targets, including structural and non-structural proteins of virus as well as host cell surface receptors, that can be used for virtual screening of drugs. Moreover, this review also focuses on the different network analysis tools that have been used for the identification of new drug targets and candidate repurposable drugs against SARS-CoV-2.

CONCLUSION

This review provides important insights of various drug targets and the network analysis tools to young bioinformaticians and will help in creating pace to the drug repurposing strategy for COVID-19 disease.

Stacked-autoencoder-based model for COVID-19 diagnosis on CT images

With the outbreak of COVID-19, medical imaging such as computed tomography (CT) based diagnosis is proved to be an effective way to fight against the rapid spread of the virus. Therefore, it is important to study computerized models for infectious detection based on CT imaging. New deep learning-based approaches are developed for CT assisted diagnosis of COVID-19. However, most of the current studies are based on a small size dataset of COVID-19 CT images as there are less publicly available datasets for patient privacy reasons. As a result, the performance of deep learning-based detection models needs to be improved based on a small size dataset. In this paper, a stacked autoencoder detector model is proposed to greatly improve the performance of the detection models such as precision rate and recall rate. Firstly, four autoencoders are constructed as the first four layers of the whole stacked autoencoder detector model being developed to extract better features of CT images. Secondly, the four autoencoders are cascaded together and connected to the dense layer and the softmax classifier to constitute the model. Finally, a new classification loss function is constructed by superimposing reconstruction loss to enhance the detection accuracy of the model. The experiment results show that our model is performed well on a small size COVID-2019 CT image dataset. Our model achieves the average accuracy, precision, recall, and F1-score rate of 94.7%, 96.54%, 94.1%, and 94.8%, respectively. The results reflect the ability of our model in discriminating COVID-19 images which might help radiologists in the diagnosis of suspected COVID-19 patients.

A systematic review on recent trends in transmission, diagnosis, prevention and imaging features of COVID-19

As the new cases of COVID-19 are growing every daysince January 2020, the major way to control the spread wasthrough early diagnosis. Prevention and early diagnosis are the key strategies followed by most countries. This study presents the perspective of different modes of transmission of coronavirus,especially during clinical practices and among the pediatrics. Further, the diagnostic methods and the advancement of the computerized tomography have been discussed. Droplets, aerosol, and close contact are thesignificantfactors to transfer the infection to the suspect. This study predicts the possible transmission of the virus through medical practices such as ophthalmology, dental, and endoscopy procedures. With regard to pediatric transmission, as of now, only afew child fatalities had been reported. Childrenusually respond to the respiratory virus; however, COVID-19 response ison the contrary. The possibility of getting infected is minimal for the newborn. There has been no asymptomatic spread in children until now. Moreover, breastfeedingwould not transmit COVID-19, which is encouraging hygiene news for the pediatric. In addition, the current diagnostic methods for COVID-19 including Immunoglobulin M (IgM) and Immunoglobulin G (IgG)and chest computed topography(CT) scan, reverse transcription-polymerase chain reaction (RT-PCR) andimmunochromatographic fluorescence assay, are also discussed in detail. The introduction of artificial intelligence and deep learning algorithmhas the ability to diagnose COVID-19 in precise. However, the developments of a potential technology for the identification of the infection, such as a drone with thermal screening without human intervention, need to be encouraged.

Does intestinal dysbiosis contribute to an aberrant inflammatory response to severe acute respiratory syndrome coronavirus 2 in frail patients?

In a few months, the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has become the main health problem worldwide. Epidemiologic studies revealed that populations have different vulnerabilities to SARS-CoV-2. Severe outcomes of the coronavirus disease 2019 (COVID-19) with an increased risk of death are observed in patients with metabolic syndrome, as well as diabetic and heart conditions (frail population). Excessive proinflammatory cytokine storm could be the main cause of increased vulnerability in this frail population. In patients with diabetes and/or heart disease, a low inflammatory state is often associated with gut dysbiosis. The increase amount of microbial metabolites (i.e., trimethylamine N-oxide and lipopolysaccharide), which generate an inflammatory microenvironment, is probably associated with an improved risk of severe illness from COVID-19. Nutritional interventions aimed at restoring the gut microbial balance could represent preventive strategies to protect the frail population from COVID-19. This narrative review presents the possible molecular mechanisms by which intestinal dysbiosis that enhances the inflammatory state could promote the spread of SARS-CoV-2 infection. Some nutritional strategies to counteract inflammation in frail patients are also analyzed.

Covid-19: The Biggest Threat of the 21st Century: In Respectful Memory of the Warriors All Over the World

Since the first case was diagnosed in China, the new coronavirus infection (COVID-19) has become the number one issue in the world and it seems to remain trend-topic for a long time. Until 17 April, it affected 210 countries, infected over 2 million people and caused approximately 150000 deaths. Although the course of the disease ranges from asymptomatic state to severe ARDS; the majority of patients reveal only mild symptoms. Though adults are the most commonly affected group; it can also be seen in newborns and elderly patients. Unfortunately, elderly patients are the most vulnerable group with higher mortality. Elderly patients, smokers and patients with comorbid conditions are most affected by the disease. In certain diagnostical tool is the real-time reverse transcription-polymerase chain reaction (real-time RT-PCR) test. However, it can be resulted in false-negative results and in this case the computed thorax tomography (CT) is one of the most important tools with high sensitivity. Besides the supportive treatment, most commonly used agents are immunomodulatory drugs such as plaquenil and azitromycin, and anti-virals including oseltamivir, ritonavir-lopinavir, favipiravir. Until a vaccine or a specific therapy invented, the most important intervention to control the disease is to fight against transmission. This is a real war and the doctors are the soldiers.

Systems Biology Approaches for Therapeutics Development Against COVID-19

Understanding the systems biology approaches for promoting the development of new therapeutic drugs is attaining importance nowadays. The threat of COVID-19 outbreak needs to be vanished for global welfare, and every section of research is focusing on it. There is an opportunity for finding new, quick, and accurate tools for developing treatment options, including the vaccine against COVID-19. The review at this moment covers various aspects of pathogenesis and host factors for exploring the virus target and developing suitable therapeutic solutions through systems biology tools. Furthermore, this review also covers the extensive details of multiomics tools i.e., transcriptomics, proteomics, genomics, lipidomics, immunomics, and in silico computational modeling aiming towards the study of host-virus interactions in search of therapeutic targets against the COVID-19.

Cytokine Response in SARS-CoV-2 Infection in the Elderly

The last few months of 2019 witnessed the emergence, rise and rapid spread of a novel coronavirus known as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), causing an acute respiratory disease called coronavirus disease 2019 or Covid-19. Severe pathological manifestations of the disease in the infected population with comorbidities are linked to acute respiratory distress syndrome (ARDS), associated with an exaggerated synthesis and expression of cytokines, leading to a systemic inflammatory response also known as a cytokine storm (CS). Elderly patients (>60 years of age) showed more deaths in Covid-19 infection. Age-related immune imbalance increases patient susceptibility to CS. In acute Covid-19 infection, it is difficult to minimize or control the overproduction of cytokines; hence, limited medical treatments are effective. This review aims to provide an overview of the current knowledge of involvement of cytokines in SARS-CoV-2 infection, susceptibility factors for the accompanying cytokine storm in severe Covid-19 cases and possible treatment strategies.

Clustering and classification of virus sequence through music communication protocol and wavelet transform

The coronavirus pandemic became a major risk in global public health. The outbreak is caused by SARS-CoV-2, a member of the coronavirus family. Though the images of the virus are familiar to us, in the present study, an attempt is made to hear the coronavirus by translating its protein spike into audio sequences. The musical features such as pitch, timbre, volume and duration are mapped based on the coronavirus protein sequence. Three different viruses Influenza, Ebola and Coronavirus were studied and compared through their auditory virus sequences by implementing Haar wavelet transform. The sonification of the coronavirus benefits in understanding the protein structures by enhancing the hidden features. Further, it makes a clear difference in the representation of coronavirus compared with other viruses, which will help in various research works related to virus sequence. This evolves as a simplified and novel way of representing the conventional computational methods.

COVID-19: molecular and serological detection methods

Since COVID-19, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was declared as a pandemic disease by the World Health Organization in early 2020, many countries, organizations and companies have tried to find the best way to diagnose the virus and contain its spreading. SARS-CoV-2 is a positive-sense single RNA (+ssRNA) coronavirus and mainly spreads through droplets, respiratory secretions, and direct contact. The early detection of the virus plays a central role in lowering COVID19 incidents and mortality rates. Thus, finding a simple, accurate, cheap and quick detection approach for SARS-CoV-2 at early stage of the viral infection is urgent and at high demand all around the world. The Food and Drug Administration and other health agencies have declared Emergency Use Authorization to develop diagnostic methods for COVID-19 and fulfill the demand. However, not all developed methods are appropriate and selecting a suitable method is challenging. Among all detection methods, rRT-PCR is the gold standard method. Unlike molecular methods, serological methods lack the ability of early detection with low accuracy. In this review, we summarized the current knowledge about COVID-19 detection methods aiming to highlight the advantages and disadvantages of molecular and serological methods.

In silico exploration of small-molecule α-helix mimetics as inhibitors of SARS-COV-2 attachment to ACE2

The novel coronavirus, SARS-CoV-2, has infected more than 10 million people and caused more than 502,539 deaths worldwide as of June 2020. The explosive spread of the virus and the rapid increase in the number of cases require the immediate development of effective therapies and vaccines as well as accurate diagnosis tools. The pathogenesis of the disease is triggered by the entry of SARS-CoV-2 via its spike protein into ACE2-bearing host cells, particularly pneumocytes, resulting in overactivation of the immune system, which attacks the infected cells and damages the lung tissue. The interaction of the SARS-CoV-2 receptor binding domain (RBD) with host cells is primarily mediated by the N-terminal helix of ACE2; thus, inhibition of the spike-ACE2 interaction may be a promising therapeutic strategy for blocking the virus entry into host cells. In this paper, we used an in-silico approach to explore small-molecule α-helix mimetics as inhibitors that may disrupt the attachment of SARS-CoV-2 to ACE2. First, the RBD-ACE2 interface in the 6M0J structure was studied by the MM-GBSA decomposition module of the HawkDock server, which led to the identification of two critical target regions in the RBD. Next, two virtual screening experiments of 7236 α-helix mimetics from ASINEX were conducted on the above regions using the iDock tool, which resulted in 10 candidates with favorable binding affinities. Finally, the stability of RBD complexes with the top-two ranked compounds was further validated by 100 ns of molecular dynamics simulations.Communicated by Ramaswamy H. Sarma.

COVID-19: Between Past and Present

Since the WHO declared coronavirus disease 2019 (COVID-19) as a pandemic, huge efforts were made to understand the disease, its pathogenesis, and treatment. COVID-19 is caused by severe acute respiratory syndrome (SARS) coronavirus-2 (SARS-CoV2), which is closely related to SARS-associated coronavirus (SARS-CoV). This article attempts to provide a timely and comprehensive review of the coronaviruses over the years, and the epidemics they caused in this century with a focus on the current pandemic COVID-19. It also covers the basics about the disease immunopathogenesis, diagnosis, prognosis, and treatment options. Although almost every single week new clinical findings are published, which change our understanding of COVID-19, this review explores and explains the disease and the treatment options available so far. In summary, many therapeutic options are being investigated to treat and/or ameliorate the symptoms of COVID-19, but none is registered and no sufficient data to support immune-based therapy beyond the context of clinical trials. For that, strengthening our immune system is the best defense at this time.

Study of ARIMA and least square support vector machine (LS-SVM) models for the prediction of SARS-CoV-2 confirmed cases in the most affected countries

Discussions about the recently identified deadly coronavirus disease (COVID-19) which originated in Wuhan, China in December 2019 are common around the globe now. This is an infectious and even life-threatening disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It has rapidly spread to other countries from its originating place infecting millions of people globally. To understand future phenomena, strong mathematical models are required with the least prediction errors. In the present study, autoregressive integrated moving average (ARIMA) and least square support vector machine (LS-SVM) models are applied to the data consisting of daily confirmed cases of SARS-CoV-2 in the most affected five countries of the world for modeling and predicting one-month confirmed cases of this disease. To validate these models, the prediction results were tested by comparing it with testing data. The results revealed better accuracy of the LS-SVM model over the ARIMA model and also suggested a rapid rise of SARS-CoV-2 confirmed cases in all the countries under study. This analysis would help governments to take necessary actions in advance associated with the preparation of isolation wards, availability of medicines and medical staff, a decision on lockdown, training of volunteers, and economic plans.

Immuno-epidemiology and pathophysiology of coronavirus disease 2019 (COVID-19)

Occasional zoonotic viral attacks on immunologically naive populations result in massive death tolls that are capable of threatening human survival. Currently, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the infectious agent that causes coronavirus disease (COVID-19), has spread from its epicenter in Wuhan China to all parts of the globe. Real-time mapping of new infections across the globe has revealed that variable transmission patterns and pathogenicity are associated with differences in SARS-CoV-2 lineages, clades, and strains. Thus, we reviewed how changes in the SARS-CoV-2 genome and its structural architecture affect viral replication, immune evasion, and transmission within different human populations. We also looked at which immune dominant regions of SARS-CoV-2 and other coronaviruses are recognized by Major Histocompatibility Complex (MHC)/Human Leukocyte Antigens (HLA) genes and how this could impact on subsequent disease pathogenesis. Efforts were also placed on understanding immunological changes that occur when exposed individuals either remain asymptomatic or fail to control the virus and later develop systemic complications. Published autopsy studies that reveal alterations in the lung immune microenvironment, morphological, and pathological changes are also explored within the context of the review. Understanding the true correlates of protection and determining how constant virus evolution impacts on host-pathogen interactions could help identify which populations are at high risk and later inform future vaccine and therapeutic interventions.

Self-Reporting and Photothermally Enhanced Rapid Bacterial Killing on a Laser-Induced Graphene Mask

Wearing face masks has been widely recommended to contain respiratory virus diseases, yet the improper use of masks poses a threat of jeopardizing the protection effect. We here identified the bacteria viability on common face masks and found that the majority of bacteria (90%) remain alive after 8 h. Using laser-induced graphene (LIG), the inhibition rate improves to ∼81%. Combined with the photothermal effect, 99.998% bacterial killing efficiency could be attained within 10 min. For aerosolized bacteria, LIG also showed superior antibacterial capacity. The LIG can be converted from a diversity of carbon precursors including biomaterials, which eases the supply stress and environmental pressure amid an outbreak. In addition, self-reporting of mask conditions is feasible using the moisture-induced electricity from gradient graphene. Our results improve the safe use of masks and benefit the environment.

Psychological Impact of COVID-19 Emergency on Health Professionals: Burnout Incidence at the Most Critical Period in Spain

BACKGROUND

The health profession is a burnout producer due to the continuous contact with pain and suffering. In addition, excessive workloads can generate stress and psychological distress.

OBJECTIVES

The aim of this study was to determine the degree of burnout and its main triggers in health professionals in Spain at the most critical period of the COVID-19 emergency.

METHOD

A quantitative research was developed through a simple random sampling in different Spanish hospitals through the period of greatest impact of the pandemic (N = 157). Data were collected using a standardized questionnaire from Maslach burnout inventory (MBI) containing 22 items, which measures three subscales: emotional burnout, depersonalization, and self-fulfillment.

RESULTS

depersonalization values reached 38.9%. A total of 90.4% of the health professionals considered that psychological care should be provided from the work centers. Furthermore, 43.3% of the health professionals estimated that they might need psychological treatment in the future. Finally, 85.4% stated that the lack of personal protective equipment (PPE) generated an increase in stress and anxiety.

CONCLUSION

This study demonstrates the need to consider specific mental health care services and training in crises to avoid possible psychological disorders. The information obtained is also valuable for the development of future prevention protocols and training of health personnel to face pandemics of these characteristics or emergency scenarios. Having the necessary physical means for their protection, as well to updated regular and accurate information, is essential to avoid feelings of fear and uncertainty. This would promote the health of these professionals.

A Learning-Based Model to Evaluate Hospitalization Priority in COVID-19 Pandemics

The emergence of the novel coronavirus disease 2019 (COVID-19) is placing an increasing burden on healthcare systems. Although the majority of infected patients experience non-severe symptoms and can be managed at home, some individuals develop severe symptoms and require hospital admission. Therefore, it is critical to efficiently assess the severity of COVID-19 and identify hospitalization priority with precision. In this respect, a four-variable assessment model, including lymphocyte, lactate dehydrogenase, C-reactive protein, and neutrophil, is established and validated using the XGBoost algorithm. This model is found to be effective in identifying severe COVID-19 cases on admission, with a sensitivity of 84.6%, a specificity of 84.6%, and an accuracy of 100% to predict the disease progression toward rapid deterioration. It also suggests that a computation-derived formula of clinical measures is practically applicable for healthcare administrators to distribute hospitalization resources to the most needed in epidemics and pandemics.

A Duty to treat? A Right to refrain? Bangladeshi physicians in moral dilemma during COVID-19

BACKGROUND

Normally, physicians understand they have a duty to treat patients, and they perform accordingly consistent with codes of medical practice, standards of care, and inner moral motivation. In the case of COVID-19 pandemic in a developing country such as Bangladesh, however, the fact is that some physicians decline either to report for duty or to treat patients presenting with COVID-19 symptoms. At issue ethically is whether such medical practitioners are to be automatically disciplined for dereliction of duty and gross negligence; or, on the contrary, such physicians may legitimately claim a professional right of autonomous judgment, on the basis of which professional right they may justifiably decline to treat patients.

METHODS

This ethical issue is examined with a view to providing some guidance and recommendations, insofar as the conditions of medical practice in an under-resourced country such as Bangladesh are vastly different from medical practice in an industrialized nation such as the USA. The concept of moral dilemma as discussed by philosopher Michael Shaw Perry and philosopher Immanuel Kant's views on moral appeal to "emergency" are considered pertinent to sorting through the moral conundrum of medical care during pandemic.

RESULTS

Our analysis allows for conditional physician discretion in the decision to treat COVID-19 patients, i.e., in the absence of personal protective equipment (PPE) combined with claim of duty to family. Physicians are nonetheless expected to provide a minimum of initial clinical assessment and stabilization of a patient before initiating transfer of a patient to a "designated" COVID-19 hospital. The latter is to be done in coordination with the national center control room that can assure admission of a patient to a referral hospital prior to ambulance transport.

CONCLUSIONS

The presence of a moral dilemma (i.e., conflict of obligations) in the pandemic situation of clinical care requires institutional authorities to exercise tolerance of individual physician moral decision about the duty to care. Hospital or government authority should respond to such decisions without introducing immediate sanction, such as suspension from all clinical duties or termination of licensure, and instead arrange for alternative clinical duties consistent with routine medical care.

Challenges of Testing COVID-19 Cases in Bangladesh

Keeping the dynamic nature of Coronaviruses (COVID-19) pandemic in mind, we have opted to explore the importance of the decentralization of COVID-19 testing centers across the country of Bangladesh in order to combat the pandemic. In doing so, we considered quantitative, qualitative, and geographic information systems (GIS) datasets to identify the location of existing COVID-19 testing centers. Moreover, we attempted to collect data from the existing centers in order to demonstrate testing times at the divisional level of the country. Results show that the number of testing centers is not enough to cater to the vast population of the country. Additionally, we found that the number of days it takes to receive the results from the COVID-19 testing centers is not optimal at divisional cities, let alone the remote rural areas. Finally, we propose a set of recommendations in order to enhance the existing system to assist more people under a testing range of COVID-19 viruses at the local level.