Prolonged infections in immunocompromised individuals may be a source for novel SARS-CoV-2 variants, particularly when both the immune system and antiviral therapy fail to clear the infection, thereby promoting adaptation. Here we describe an approximately 16-month case of SARS-CoV-2 infection in an immunocompromised individual. Following monotherapy with the monoclonal antibody Bamlanivimab, the individual9s virus was resistant to this antibody via a globally unique Spike amino acid variant (E484T) that evolved from E484A earlier in infection. With the emergence and spread of the Omicron Variant of Concern, which also contains Spike E484A, E484T may arise again as an antibody-resistant derivative of E484A.
Introduction Health system resilience is the ability to prepare, manage, and learn from a sudden and unpredictable extreme change which impacts health systems. Health systems globally have recently been affected by a number of catastrophic events, including natural disasters, and infectious disease epidemics. Understanding health system resilience has never been more essential until emerging global pandemics. Therefore, the application of resilience-enhancing strategies with existing frameworks needs to be assessed to identify the management gaps and give valuable recommendations from the lessons learnt from the global pandemic. Methods The systematic review will be reported using the Preferred reporting items for systematic review and meta-analysis protocols guideline (PRISMA-P). Reporting data on health system building blocks and systematic searches on resilience enhancing strategies for the management of Public Health Emergencies of International Concerns (PHEIC) after the establishment of International Health Regulations (IHR) since managing PHEIC after the establishment of IHR in 2007 will be included. The search will be conducted in PubMed, Scopus, Web of Science, and Google Scholar. Discussion Health system resilience is key to coping with catastrophic events, such as the economic crisis and COVID-19 pandemic. The mapping of available literature towards the application of resilience-enhancing strategies with existing frameworks needs to be assessed to identify the management gaps and give valuable recommendations from the lessons learnt from the global pandemic to improve the level of preparedness and response to similar public health emergencies in the future. Conclusion A protocol for a global review of health system resilience for pandemic management is described. This review will add to the body of knowledge about health systems enhancing research and policy formulation.
Background: COVID-19 is a disease caused by severe acute respiratory syndrome coronavirus 2, SARS-CoV-2. Rigorous detection and treatment strategies against SARS-CoV-2 have become very challenging due to continuous evolutions to the viral genome. Therefore, careful genomic analysis is sorely needed to understand transmission, the cellular mechanism of pathogenicity, and the development of vaccines or drugs. Objective: In this study, we intended to identify SARS-CoV-2 genome variants that may help understand the cellular and molecular foundation of coronavirus infections required to develop effective intervention strategies. Methods: SARS-CoV-2 genome sequences were downloaded from an open-source public database, processed, and analyzed for variants in target detection sites and genes. Results: We have identified six unique variants, G….AAC, T….AAC….T; AAC….T; C……C; C……..C; and C……..T at the nucleocapsid region and eleven major hotspot mutant genes: nsp3, surface glycoprotein, nucleocapsid phosphoprotein, ORF8, nsp6, nsp2, nsp4, helicase, membrane glycoprotein, 39-59 exonuclease, and 2-O-ribose methyltransferases. In addition, we have identified eleven major mutant genes that may have a crucial role in SARS-CoV-2 pathogenesis. Conclusion: Studying haplotype variants and 11 major mutant genes to understand the mechanism of action of fatal pathogenicity and inter-individual variations in immune responses is inevitable for managing target patient groups with identified variants and developing effective anti-viral drugs and vaccines.
Using a modified form of the SIR model, we show that, under general conditions, all pandemics exhibit certain scaling rules. Using only daily data for symptomatic, confirmed cases, these scaling rules can be used to estimate: (i) r_eff, the effective pandemic R-parameter; (ii) f_tot, the fraction of exposed individuals that were infected (symptomatic and asymptomatic); (iii) L_eff, the effective latency, the average number of days an infected individual is able to infect others in the pool of susceptible individuals; and (iv) alpha, the probability of infection per contact between infected and susceptible individuals. We validate the scaling rules using an example and then apply our method to estimate r_eff, f_tot, L_eff and alpha for the first phase of the SARS-Cov-2, Covid-19 pandemic for thirty-four countries where there was a well separated first peak in identified infected daily cases after the outbreak of this pandemic in early 2020. Our results are general and can be applied to any pandemic.
Booster Study of COVID-19 Protein Subunit Recombinant Vaccine - Condition: COVID-19
Interventions: Biological: SARS-CoV-2 subunit protein recombinant vaccine; Biological: Active Comparator
Sponsors: PT Bio Farma; Faculty of Medicine Universitas Padjadjaran; Faculty of Medicine Universitas Udayana
Recruiting
Efficacy and Safety of ES16001 in Patients With COVID-19 - Condition: COVID-19
Interventions: Drug: ES16001 40 mg; Drug: ES16001 80 mg; Drug: ES16001 160 mg; Drug: Placebo
Sponsor: Genencell Co. Ltd.
Recruiting
Phase 2a Trial to Evaluate Safety and Immunogenicity of COVID-19 Vaccine Strategies in HIV-infected/Uninfected Adults. - Condition: COVID-19
Intervention: Drug: Ad26.COV2.S (VAC31518, JNJ-78436735) Vaccine, SARS-CoV-2 rS (CovovaxTM), BNT162b2 (Pfizer)
Sponsors: The Aurum Institute NPC; Coalition for Epidemic Preparedness Innovations
Recruiting
A Novel Parameter LIT/N That Predicts Survival in COVID-19 ICU Patients - Condition: COVID-19 Pneumonia
Intervention: Diagnostic Test: the LIT test
Sponsors: Gazi University; Oxford MediStress
Completed
A Study to Evaluate the Immunogenicity and Safety of a Recombinant Protein COVID-19 Vaccine SCTV01E-1 in Population Aged Above 18 Years - Conditions: COVID-19; SARS-CoV-2 Infection
Interventions: Biological: SCTV01E-1 on D0; Biological: SCTV01E-1 on D28; Biological: SCTV01E-1 on D150; Biological: SCTV01E on D0; Biological: SCTV01E on D28; Biological: SCTV01E on D150; Biological: SCTV01E-1 on D120; Biological: SCTV01E on D120
Sponsor: Sinocelltech Ltd.
Not yet recruiting
CArdiac REhabilitation for Building Exertional heArt Rate for Chronotropic Incompetence in Long COVID-19 - Conditions: Long COVID; COVID-19
Intervention: Behavioral: Cardiac Rehabilitation
Sponsor: University of California, San Francisco
Not yet recruiting
The Impact of a Web-based Psychoeducation Programme With a Motivational AI Chatbot on Covid-19 Vaccine Hesitancy - Conditions: Vaccine Hesitancy; COVID-19
Interventions: Behavioral: AI-driven Vaccine Communicator; Behavioral: Self-learning of COVID-19 vaccine knowledge
Sponsor: The Hong Kong Polytechnic University
Not yet recruiting
COVID Protection After Transplant - Sanofi GSK (CPAT-SG) Study - Conditions: COVID-19; Kidney Transplant
Intervention: Biological: Sanofi-GSK monovalent (B.1.351) CoV2 preS dTM-AS03 COVID-19 vaccine
Sponsors: National Institute of Allergy and Infectious Diseases (NIAID); PPD; Johns Hopkins University; Sanofi Pasteur, a Sanofi Company
Not yet recruiting
Safety and Immunogenicity of COVID-19 Vaccine, AdCLD-CoV19-1 - Conditions: COVID-19; Vaccines
Intervention: Biological: AdCLD-CoV19-1
Sponsors: International Vaccine Institute; Cellid Co., Ltd.
Not yet recruiting
Smartphone Intervention for Overdose and COVID-19 - Conditions: Substance Use Disorders; Overdose; COVID-19
Intervention: Device: iThrive WI Intervention
Sponsors: University of Wisconsin, Madison; National Institute on Drug Abuse (NIDA)
Not yet recruiting
HRQOL of Life After ECMO Due to COVID-19. - Conditions: ARDS; COVID-19 Pneumonia; Extracorporeal Membrane Oxygenation
Intervention: Other: Phone Interview
Sponsor: Medical University of Vienna
Recruiting
A Study to Evaluate the Safety and Immunogenicity of COVID-19 and Influenza Combination Vaccine - Conditions: COVID-19; Influenza
Interventions: Drug: CIC Vaccine; Drug: qNIV Vaccine; Drug: SARS-CoV-2 rS Vaccine; Drug: Influenza Vaccine
Sponsor: Novavax
Not yet recruiting
Effects of Immulina TM Supplements With PASC Patients - Condition: Post Acute COVID-19 Syndrome
Interventions: Dietary Supplement: Immulina TM; Dietary Supplement: Placebo
Sponsors: University of Mississippi Medical Center; National Institute of General Medical Sciences (NIGMS)
Not yet recruiting
Self-proning and Repositioning in COVID-19 Outpatients at Risk of Complicated Illness - Conditions: COVID-19; COVID-19 Pneumonia; Proning; Hospitalization; Death; Outpatient; Complication
Intervention: Other: Self-proning
Sponsors: Unity Health Toronto; Applied Health Research Centre
Recruiting
Addressing Post-COVID-19 Musculoskeletal Symptoms - Conditions: Telemedicine; Musculoskeletal Disease; SARS-CoV-2; Pain; COVID-19; Exercise
Interventions: Other: Multicomponent exercise program; Other: Tele-health primary care rehabilitation program
Sponsor: Universidad Europea de Madrid
Not yet recruiting
Expression analysis of miRNA hsa-let7b-5p in naso-oropharyngeal swabs of COVID-19 patients supports its role in regulating ACE2 and DPP4 receptors - Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) is the novel coronavirus responsible for worldwide coronavirus disease (COVID-19). We previously observed that Angiotensin-converting enzyme 2 (ACE2) and Dipeptidyl peptidase-4 (DPP4) are significantly overexpressed in naso-oropharyngeal swabs (NPS) of COVID-19 patients, suggesting their putative functional role in the disease progression. ACE2 and DPP4 overexpression in COVID-19 patients may be associated to epigenetic mechanism, such…
The Renshen Chishao Decoction Could Ameliorate the Acute Lung Injury but Could Not Reduce the Neutrophil Extracellular Traps Formation - The acute lung injury (ALI) causes severe pulmonary diseases, leading to a high mortality rate. The Renshen and Chishao have protective and anti-inflammatory effects against the ALI. To explore the protective effects of the Renshen Chishao (RC) decoction against the ALI, we established the lipopolysaccharide-indued ALI model and randomly divided the mice into seven groups: control group, ALI group, high-dose RC group, middle-dose RC group, low-dose RC group, middle-dose RC group + CXCR2…
In silico investigation and potential therapeutic approaches of natural products for COVID-19: Computer-aided drug design perspective - The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused a substantial number of deaths around the world, making it a serious and pressing public health hazard. Phytochemicals could thus provide a rich source of potent and safer anti-SARS-CoV-2 drugs. The absence of approved treatments or vaccinations continues to be an issue, forcing the creation of new medicines. Computer-aided drug design has helped to speed up the drug research and development process by decreasing costs…
Identification of trypsin-degrading commensals in the large intestine - Increased levels of proteases, such as trypsin, in the distal intestine have been implicated in intestinal pathological conditions^(1-3). However, the players and mechanisms that underlie protease regulation in the intestinal lumen have remained unclear. Here we show that Paraprevotella strains isolated from the faecal microbiome of healthy human donors are potent trypsin-degrading commensals. Mechanistically, Paraprevotella recruit trypsin to the bacterial surface through type IX secretion…
Murine Broadly Reactive Antineuraminidase Monoclonal Antibodies Protect Mice from Recent Influenza B Virus Isolates and Partially Inhibit Virus Transmission in the Guinea Pig Model - Current influenza virus vaccines and antivirals have limitations, some of which disproportionately affect their utilization against influenza B viruses. To inform ongoing efforts to address the considerable global burden of influenza B viruses, we previously described five murine monoclonal antibodies that broadly bind conserved epitopes on the neuraminidase of influenza B viruses and protect against lethal challenge in a mouse model when delivered via intraperitoneal injection. Here, we…
Mucosal Immunity After Novel COVID-19 Infection - Virus-Induced Immunosuppression: Preliminary Study - In recovered COVID-19 patients, the state of mucosal immunity remains understudied. Cytological, functional, and metabolic characteristics of neutrophils and the interleukin status will help to correctly assess the need for immunorehabilitation measures. The study objective is to assess the state of mucosal immunity after COVID-19. A comprehensive study of mucosal immunity included the assessment of nasal mucosal neutrophils with the monitoring of destructive and apoptotic changes as well as…
Restoration of vascular endothelial integrity by mesenchymal stromal/stem cells in debilitating virus diseases - Endothelial dysfunction is one of the key cornerstone complications of emerging and re-emerging viruses which lead to vascular leakage and a high mortality rate. The mechanism that regulates the origin of endothelial dysregulation is not completely elucidated. Currently, there are no potential pharmacological treatments and curable management for such diseases. In this sense, mesenchymal stromal/stem cells (MSCs) has been emerging to be a promising therapeutic strategy in restoring endothelial…
RNA G-quadruplex formed in SARS-CoV-2 used for COVID-19 treatment in animal models - The ongoing COVID-19 pandemic has continued to affect millions of lives worldwide, leading to the urgent need for novel therapeutic strategies. G-quadruplexes (G4s) have been demonstrated to regulate life cycle of multiple viruses. Here, we identify several highly conservative and stable G4s in SARS-CoV-2 and clarify their dual-function of inhibition of the viral replication and translation processes. Furthermore, the cationic porphyrin compound 5,10,15,20-tetrakis-(N-methyl-4-pyridyl)porphine…
Hypoxia inducible factors regulate infectious SARS-CoV-2, epithelial damage and respiratory symptoms in a hamster COVID-19 model - Understanding the host pathways that define susceptibility to Severe-acute-respiratory-syndrome-coronavirus-2 (SARS-CoV-2) infection and disease are essential for the design of new therapies. Oxygen levels in the microenvironment define the transcriptional landscape, however the influence of hypoxia on virus replication and disease in animal models is not well understood. In this study, we identify a role for the hypoxic inducible factor (HIF) signalling axis to inhibit SARS-CoV-2 infection,…
Diminished cell proliferation promotes natural killer cell adaptive-like phenotype by limiting FcεRIγ expression - Human adaptive-like natural killer (NK) cells express low levels of FcεRIγ (FcRγ-/low) and are reported to accumulate during COVID-19 infection; however, the mechanism underlying and regulating FcRγ expression in NK cells has yet to be fully defined. We observed lower FcRγ protein expression in NK cell subsets from lung transplant patients during rapamycin treatment, suggesting a link with reduced mTOR activity. Further, FcRγ-/low NK cell subsets from healthy donors displayed reduced mTOR…
Recent advances in molecular biology of metabolic syndrome pathophysiology: endothelial dysfunction as a potential therapeutic target - Current advances in molecular pathobiology of endotheliocytes dysfunctions are promising in finding the pathogenetic links to the emergence of insulin resistance syndrome. Physiologically, human organism homeostasis is strictly controlled to maintain metabolic processes at the acquainted level. Many factors are involved in maintaining these physiological processes in the organism and any deviation is undoubtedly accompanied by specific pathologies related to the affected process. Fortunately,…
NETosis and thrombosis in vaccine-induced immune thrombotic thrombocytopenia - Vaccine-induced immune thrombotic thrombocytopenia (VITT) is a rare yet serious adverse effect of the adenoviral vector vaccines ChAdOx1 nCoV-19 (AstraZeneca) and Ad26.COV2.S (Janssen) against COVID-19. The mechanisms involved in clot formation and thrombocytopenia in VITT are yet to be fully determined. Here we show neutrophils undergoing NETosis and confirm expression markers of NETs in VITT patients. VITT antibodies directly stimulate neutrophils to release NETs and induce thrombus formation…
Beyond the vaccines: a glance at the small molecule and peptide-based anti-COVID19 arsenal - Unprecedented efforts of the researchers have been witnessed in the recent past towards the development of vaccine platforms for the control of the COVID-19 pandemic. Albeit, vaccination stands as a practical strategy to prevent SARS-CoV-2 infection, supplementing the anti-COVID19 arsenal with therapeutic options such as small molecules/peptides and antibodies is being conceived as a prudent strategy to tackle the emerging SARS-CoV-2 variants. Noteworthy to mention that collective efforts from…
Targeting spike protein-induced TLR/NET axis by COVID-19 therapeutic NRICM102 ameliorates pulmonary embolism and fibrosis - The global COVID-19 pandemic remains a critical public health threat, as existing vaccines and drugs appear insufficient to halt the rapid transmission. During an outbreak from May to August 2021 in Taiwan, patients with severe COVID-19 were administered NRICM102, which was a traditional Chinese medicine (TCM) formula developed based on its predecessor NRICM101 approved for treating mild cases. This study aimed to explore the mechanism of NRICM102 in ameliorating severe COVID-19-related embolic…
Computational investigation of potent inhibitors against SARS-CoV-2 2’-O-methyltransferase (nsp16): Structure-based pharmacophore modeling, molecular docking, molecular dynamics simulations and binding free energy calculations - The Coronavirus Disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, has created unprecedented public health and economic crises around the world. SARS-CoV-2 2’-O-methyltransferase (nsp16) adds a “cap” to viral RNA to maintain the stability of viral RNA, and inhibition of nsp16 activity may reduce viral proliferation, making this protein an attractive drug target. Here, we report the identification of several small molecule inhibitors of…