Infectious Disorders - Drug Targets (Formerly Current Drug Targets - Infectious Disorders) - Volume 21, Issue 8, 2021

Coronavirus causes severe harm to the health of both humans as well as animals, creating a major global health problem affecting millions of populations. Considering the situational emergency of identifying novel targeted therapy, we have chosen the herbal compound Adhatoda Justicia/ vasica, which is a high potent olden vital compound having a key role in various respiratory conditions with multiple beneficial uses. Adhatoda is promoted and supported by the Ministry of AYUSH for symptomatic management of respiratory ailments in the case of COVID 19. In this study, we focused on the efficacy of Adathoda primary active alkaloid, vasicine against coronavirus infectious symptoms, evaluated by in silico screening studies on virus proteins ACE 2 Receptor, 3CL protease and Spike protein SARS HR1 motif using PyRx tool and AutoDoc 1.5.6. Based on PyRx results, Vasicine with ACE 2 Receptor showed a higher docking affinity score -7.1 K/cal respectively when compared to other virus proteins. AutoDoc 1.5.6 screening study report showed that vasicine promotes good inhibitory constant 486.54 mM on 3CL protease more than others. Results reveal that vasicine could be a potential target for the treatment of COVID 19. This study adds strong evidence to the claim by the advisory released by AYUSH. Based on the results with the available literature, Adhatoda could be a drug helpful in relieving symptoms in non-- COVID cases in those who were quarantined or in lockdown pace, thereby reducing pandemic panic in confirmed asymptomatic or mild cases. For usage in moderate to severe cases, this could be an add-on therapy with existing modern medical therapy.

The novel coronavirus disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2), was announced as a pandemic in March 2020. Different diagnostic laboratory tests have been used to detect the infection. Each diagnostic tool, such as Chest Computed tomography (CT) imaging, genome sequencing, nucleic acid amplification methods, whole genome sequencing, microarray, and serology testing have several advantages and disadvantages. Nucleic acid amplification methods are better diagnostic tools for the detection of SARS-CoV-2 in early stages of the infection, while serological tests are more appropriate for the recognition of previously infected patients. In this review, we will briefly consider each diagnostic method, and discuss its pros and cons.

The Coronavirus Disease 2019, a pandemic caused by novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is seriously affecting global health and the economy. As the vaccine development takes time, the current research is focused on repurposing FDA approved drugs against the viral target proteins. This review discusses the current understanding of SARSCoV- 2 virology, its target structural proteins (S-glycoprotein), non-structural proteins (3-chymotrypsin- like protease, papain-like protease, RNA-dependent RNA polymerase, and helicase) and accessory proteins, drug discovery strategies (drug repurposing, artificial intelligence, and high- -throughput screening), and the current status of antiviral drug development.

Coronavirus Disease (COVID-19) pandemic has affected more than seven million individuals in 213 countries worldwide with a basic reproduction number ranging from 1.5 to 3.5 and an estimated case fatality rate ranging from 2% to 7%. A substantial proportion of COVID-19 patients are asymptomatic; however, symptomatic cases might present with fever, cough, and dyspnoea or severe symptoms up to acute respiratory distress syndrome. Currently, RNA RT-PCR is the screening tool, while bilateral chest CT is the confirmatory clinical diagnostic test. Several drugs have been repurposed to treat COVID-19, including chloroquine or hydroxychloroquine with or without azithromycin, lopinavir/ritonavir combination, remdesivir, favipiravir, tocilizumab, and EIDD-1931. Recently, Remdesivir gained FDA emergency approval based on promising early findings from the interim analysis of 1063 patients. The recently developed serology testing for SARSCoV-2 antibodies opened the door to evaluate the actual burden of the disease and to determine the rate of the population who have been previously infected (or developed immunity). This review article summarizes current data on the COVID-19 pandemic starting from the early outbreak, viral structure and origin, pathogenesis, diagnosis, treatment, discharge criteria, and future research.

Considering the importance of COVID-19 disease pandemic, emerged by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), in line with other studies to find appropriate prevention or treatment methods for this virus infection, our study objective was proposing the use of natural derived ingredients as an approach for COVID-19 disease control. Here we reviewed previous studies on natural derived nasal sprays andfound that some known natural derived ingredients have antiviral properties, so their topical use as a nasalspray is effective in reducing the symptoms of respiratory infections. Moreover, such nasal sprays also have thepotential of decreasing viral load, including titer of coronaviruses, in the nasal cavity. It seems that the use ofcarrageenan or other herbal ingredients in the nasal spray may block the SARS-CoV-2 virus from entering thelung cells of an affected person and can also prevent virus transmission to other susceptible persons. Further,noticing what we know about the novel 2019 coronavirus so far, we suggested carrageenan that has an unspecific physical antiviral activity and some other natural derived ingredients, as a choice in coping with SARS-CoV-2 virus infection.

In late 2019, coronavirus-2 (SARS-COV 2) infection emerged in Wuhan, China and spread to all countries making the first pandemic of the 21st century. It seems that this infection will persist which is long enough to obligate modifications in both lifestyle and health care systems. Because chronic liver diseases (CLD) are prevalent all over the world, it is expected to manage patients with CLD and COVID-19. The aim of this review was to shed light on the impact of COVID-19 pandemic on the management of patients with CLD and how to give medical care to CLD patients during COVID-19 pandemic.

Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) virus, which is a cause of the ongoing pandemic, has the potential to infect the nervous system and cause neurological manifestations. However, patients with primarily neurological symptoms are often overlooked, therefore, they are being tested later. Objective: We aim to summarize all the neurological manifestations that have been reported so far, to aid in early diagnosis and prevent further complications of the disease. Methods: We did a literature search on the topic through Google Scholar, PubMed, and WHO resources by keywords, including coronavirus, SARS-CoV-2, COVID-19, clinical features, stroke, transverse myelitis, encephalitis, encephalopathy, Guillain-Barre syndrome, hypogeusia, hyposmia, anosmia, and neurological manifestations. Discussion: SARS-CoV-2 can affect the neuronal cells by both direct and indirect mechanisms. This can lead to various neurological manifestations ranging from subtle symptoms of myalgia, headache, dizziness, hypogeusia, hyposmia to dreaded complications like stroke, encephalitis, demyelinating disease like Guillain-Barre syndrome. Conclusion: Presentation of COVID-19 with neurological features is not uncommon, and these patients should be tested earlier to help in the prevention of transmission, early diagnosis, and management.

Introduction: Acinetobacter baumannii (A.baumannii) is a ubiquitous pathogen responsible for serious infections in hospitalized patients with a high propensity to develop resistance to antimicrobial agents. The study aimed to determine the antimicrobial resistance patterns and the prevalence of aminoglycoside resistance genes among A. baumannii clinical isolates from patients in different intensive care units (ICUs) in Alexandria, Egypt. Methods: A total of 100 A. baumannii isolates collected from ICU patients were confirmed as A. baumannii by VITEK 2 and the presence of the blaOXA-51 gene has been reported. Antimicrobial susceptibility testing was performed and Multiplex PCR was done for the detection of aminoglycoside resistance genes. Results: Most of the isolates (82%) were resistant to all tested aminoglycosides; resistance was higher for kanamycin and neomycin, followed by amikacin. The predominant AMEs were aphA6 and aphA1 in 86% and 67% of the isolates, respectively; aacA4 and aacC1 were detected in 37% and 8%, respectively, while aadA1 and aadB were present in 34% and 4%, respectively. Furthermore, the armA gene was detected in 83% of the isolates. Conclusion: The results of this study revealed a high level carriage of armA and AMEs, which limit the usage of aminoglycoside as a treatment option for A. baumannii and make treatment extremely difficult.

Background: After the spread of novel coronavirus disease 2019 (COVID-19) from Wuhan to Iran, gastroenterology clinics, was faced with a large number of patients who were suspected of being infected with the SARS-CoV-2. Among refereed patient, the incidence of pure hyperbilirubinemia as rare gastrointestinal (GI) symptoms was obvious. Methods: In this case series, we have reported the clinical data in details for patients with COVID-19 who have been admitted to the Shahid Beheshti Hospital in Qom city, from 3 March to 3 August 2020. COVID infection, be confirmed by using real-time reverse-transcriptase polymerase chain reaction (rRT-PCR) and chest computed tomography (CT) scan, as well. Results: According to the clinical findings, pure hyperbilirubinemia may consider as rare gastrointestinal (GI) symptom of COVID-19. However, it is possible that the other GI enzymes values fall in to the normal range. Conclusion: In some infected patients, GI physicians may face hepatic involvement as pure hyperbilirubinemia. At the age of COVID-19 crisis, all GI physicians should be aware of the possible occurrence of hepatic involvement as an important prognosis of COVID pneumonia and it should be exactly addressed in new referred patients to GI clinic.

Introduction: COVID-19 has caused a great deal of fear in different communities. In this study, we reported the recovery of a diabetic elderly woman with a history of asthma from COVID-19 infection. Case Presentation: A 61-year-old woman was hospitalized due to dyspnea and low blood O2 saturation and was later diagnosed with COVID-19, as confirmed by PCR. The patient had a history of asthma and diabetes and used salbutamol and Atrovent spray. She also had a history of hospitalization at one month prior to the current admission. Despite all these, COVID-19 was successfully managed, and she was discharged with a good clinical condition after the improvement of respiratory complications. Conclusion: Despite having an advanced age and underlying diseases (diabetes and asthma), the recovery of this elderly woman shows that even such patientscandefeatCOVID-19 as long as the disease is not progressed to advanced phases and appropriate therapeutic measures are taken. By reporting such cases, it is possible to give people hope and motivation and reduce their fear of the disease.

Introduction: Immunocompromised patients, especially those hospitalized, are at a higher risk for infection with opportunistic pathogens such as Stenotrophomonas maltophilia (S. maltophilia) which is a multidrug-resistant gram-negative bacillus and can cause a challenge in the management of patients with concomitant COVID-19 and S. maltophilia pneumonia. Case Presentation: A 71-year-old man with Hodgkin's lymphoma presented with severe respiratory symptoms of COVID-19 was intubated upon admission and the initial standard treatment for COVID-19 was started for him. The patient subsequently developed superimposed bacterial pneumonia with S. maltophilia. According to that, the patient's intubation tube was removed and a tracheostomy was performed for him. Also, antibiotic treatment was replaced with Colistin and Co-trimoxazole drugs. Finally, after 31 days of hospitalization in the ICU and the appropriate drug treatment, he was discharged with reduced symptoms and partial recovery. Conclusion: It should be noted that the occurrence of co-infection with multidrug-resistant pathogens such as S. maltophilia requires proper management to select appropriate treatment methods and drugs, so that in addition to proper effectiveness, it does not lead to side effects and complications associated with COVID-19 disease.

Background: Elizabethkingia meningoseptica is a ubiquitous organism rarely associated with human diseases, but its association especially among hospitalized premature neonates and immunocompromised individuals are not so common. Case: We report two cases of neonatal bacteraemia and meningitis among low birth weight premature neonates admitted in neonatal intensive care units (NICU) by E. meningoseptica, a high alert organism associated with such conditions. Conclusions: E. meningoseptica, a high alert organism associated with meningitis among premature underweight neonates. High degree of resistant to most of the broad-spectrum antibiotics makes its management a challenging task. A good communication between the clinician and the microbiologist becomes very important for the proper management of the patients.

At the beginning of 2020, a newly emerged virus, now named SARS-CoV-2, began to spread in China. After four months, it has reached all over the globe, infecting more than 2.5 million people. Currently, there are no proved treatments available. However, in social media, false information about alcohol consumption and its role against the virus is spreading. We described a victim of these false facts, who was present with reduced eyesight due to alcohol drinking. A few days later, he showed symptoms of COVID-19 and, even though received treatment, lost his eyesight partially. Alcohol taking has no preventive or curative effect on COVID-19 and negatively impacts the body and immune system, which, therefore, should not be considered a treatment for COVID-19 disease.