Infectious Disorders - Drug Targets (Formerly Current Drug Targets - Infectious Disorders) - Volume 22, Issue 8, 2022

Objectives: Mucormycosis is a rare fungal disease, which was known to affect only immunocompromised hosts, but during the COVID-19 pandemic, a surge in the cases of rhino- orbital-cerebral mucormycosis have been reported; however, the cause is still unknown. As the disease was a rare entity, there was no classification considering the spread and proper management at various stages. Methods: Extensive literature search with the terms “mucormycosis,” “invasive fungal sinusitis,” “COVID-19 associated mucormycosis,” and “mucormycosis in COVID-19” was conducted on Pubmed, Scopus, and Embase database, taking into consideration case histories, revealing the site of involvement and treatment based on the disease's extent. Results: Relevant articles were analyzed, and it was found that there is no specific classification of the disease entity and no proper surgical and medical management guidelines to date, Conclusion: This review is an attempt to elaborate on the pathophysiology of mucormycosis and its spread and propose a classification that will help determine policies for the control and prevention of complications, morbidity, and mortality.

The world is still faced with widespread dissemination and many unanswered questions related to Coronavirus disease (COVID-19). Several candidate vaccines have been introduced against COVID-19, mostly requiring the injection of two doses and some with nearly 90-95% efficacy. All strategies against the spread of infection have focused on breaking the chain of virus transmission through protective public health measures and mass vaccination. The current situation emphasizes the global need for carefully designed policies to maximize vaccine access and uptake. The risk compensation theory (Peltzman Effect) states that the decrease in perceived risk through access to preventive measures may lead to increasing frequency of risky behaviors. The current pandemic has exposed people to the sense of risk compensation and behavior change in response to the perceived risk. Risk compensation phenomenon may significantly reverse the benefits of COVID-19 vaccination, especially if the vaccine is not sufficiently effective in real life or among high-risk populations. Recognition and awareness of Peltzman risk compensation are of high importance in counteracting and neutralizing the false complacency of the community, which also lends more weight to public health efforts. The public health messages and practices should be clearly expressed, straightforward, reliable and applicable. It is important to encourage mass vaccination of the population, and other NPIs must be re-established and implemented to ensure education to live with COVID-19 in parallel with daily activities and job tasks.

Infectious diseases are defined as a group of diseases caused by any infecting microorganism which are highly potent to severely affect human life. The end can vary from critical infection to mortality. Most infectious diseases are reported with a rapid rate of transmission. Marburg virus disease is a kind of infectious viral disease usually manifested as hemorrhagic fever. The latest reported case of Marburg virus disease confirmed by WHO was on 6th August 2021 in the south-western province of Guinea. Marburg virus disease exhibit similar manifestations to that of infection with the Ebola virus. Though not widely spread to emerge as a pandemic, Marburg virus disease remains a serious threat to human life. This review emphasizes the novel current facts determined through various studies related to Marburg virus infection. From these promising theories, the review tries to put forward the importance of various study conclusions, which are likely to have a major impact on the health sector in the near future.

It is a formidable challenge to treat tuberculosis as there are increasing cases of multidrugresistant tuberculosis (MDR-TB) and extensively drug-resistant tuberculosis (XDR-TB) cases. Moreover, the emergence of totally drug-resistant tuberculosis (TDR-TB) makes it vital and imperative to develop a new generation of anti-tubercular drugs to have control over resistance. The nitrogencontaining heterocyclic class of compounds is being studied extensively to ascertain their anti-TB potentials. Nitrogen-containing compounds have a broad range of targets; wherein, InhA is the most important one. Hence, the primary focus of this review is to summarize the recent developments in the discovery of nitrogen-containing heterocyclic compounds as InhA inhibitors to combat tuberculosis.

COVID-19 is a new virus of the Coronaviridae family that is now spreading worldwide. Therefore, disseminating information about patients with the virus can help identify the virus, pathogenesis, and find treatments. The current study aimed to review the new coronavirus (COVID-19). To reach this aim, we searched keywords containing COVID-19, coronavirus, respiratory infection, epidemiology in Pub Med, Web of Science Direct, Scopus, Scientific Information Databases, and Google scholar. The results of our search led to the achievement of articles on the study of COVID-19. Based on the results of the study, COVID-19 is a global transmitter with rapid transmission power for which no specific drug has yet been found to treat it. The rapid spread of the COVID-19 virus, the relationship between disease severity and mortality with various factors, respiratory transmission, especially in the short distance, masks, hand washing, and physical distance observance as the most important way to prevent, diversify clinical symptoms and at the same time fever and cough as the most common clinical symptoms, treatment with non-specific antiviral drugs and treatment based on controlling clinical symptoms and strengthening immunity with known drugs, paying attention to children as asymptomatic carriers, and pretentious pregnancy in the event of COVID-19 are the most important findings of this study. The case fatality rate of COVID-19 has varied from 0.08% to 10.8% in the world, but fortunately, the number of patients who have recovered is very promising and more than 66 million people have recovered. There is still no effective drug or vaccine to prevent the disease and investigation in this field is ongoing. The only way to prevent and control the disease is adherence to the health protocols. Due to the need of the medical community to achieve the scientific results of this epidemic in Iran and other parts of the world, this article was written.

To date, no accepted therapy exists for treating the emerging infectious disease nCOVID-19 in a safe and effective way. Although various treatment options are under in the developing phase around the world, several studies concerning convalescent plasma (CP) from recovered patients reported promising effects against nCOVID-19 infected critically ill patients nowadays. The therapy showed very few adverse effects, and it helps diminish the viral load when administered at an early stage of infection. Convalescent plasma appears safe for critically ill nCOVID-19 patients by decreasing serum viral loads, and most cases are virus negative after CP transfusion. The convalescent plasma can be good as it has already been utilized to treat previous pandemics like Ebola, influenza, and SARS-CoV infection. In this review article, we pointed out CP's background, rationality, mechanisms, and safety outcomes to treat nCOVID-19 infected patients.

Introduction: Prisoners represent high-risk behaviors such as injecting drug use, sharing syringes, tattooing, and unprotected sexual intercourse. The authors aimed to study the prevalence of hepatitis B, hepatitis C, and hepatitis D in the prisoners. Methods: We conducted a systematic search using the keywords in online databases of PubMed, Web of Science, Scopus, and Science Direct. Two independent researchers examined the quality of the articles and the probable risk of bias. The most relevant articles by title and abstract were retrieved. Finally, the full text of selected articles was read, and the critical findings were extracted. Results: Reviews of 23 studies showed that most prisoners are susceptible to hepatitis B and hepatitis C. One study also indicated that prisoners could be infected with hepatitis A and hepatitis E. The most common routes of hepatitis transmission in prisons were intravenous drug use, needle sharing, tattooing, and unsafe sex with multiple sexual partners. Conclusion: High-risk sexual behaviors, shared contaminated needles for IV drug injection, and tattooing are the principal routes of hepatitis transmission among prison inmates. Hepatitis treatment is feasible and could be useful for infected prisoners undergoing a well-designed treatment program.

Introduction: Free-living amoebae are opportunistic amoebae that usually live freely in various environmental conditions, including warm water and even in water supply network pipes and reservoirs connected to water. In addition to living freely, these protozoa are able to attack the host's body when they enter a human or animal body. Therefore, it is necessary to identify their presence in water resources. So, this study aimed to identify free-living amoebae isolated from water reservoirs of hospitals in southwest Iran. Methods: A total of 80 water samples were isolated from the hospitals of Ahvaz city, southwest Iran, and their physical and chemical parameters were measured. The samples were then put into non-food agar culture medium and stained using the Wright-Giemsa staining. Finally, the samples were identified by the PCR molecular method. Results: The mean pH and turbidity values were 7.57 ± 0.03 and 3.31 ± 0.26 nephelometric turbidity unit (NTU), respectively. The mean residual chlorine and electrical conductivity were 0.91 ± 0.02 and 1122.39 ± 24.31, respectively. In addition, 9 (11.25%) and 3 (3.75%) samples were contaminated with Acanthamoeba spp. and Naegleria spp., respectively. However, no positive cases of Balamuthia spp. infection were observed. Moreover, two samples were co-infected with Acanthamoeba spp. and Naegleria spp. Conclusion: Due to the existence of free-living amoebae in water storage tanks at hospitals, it is necessary to prevent possible contamination with these amoebae and infectious agents by using new methods of disinfection and purification of water resources.

Background: Adenovirus is a common virus associated with acute gastroenteritis in children. There are certain genotypes that are prevalent in these infections, such as genotypes 40 and 41. Objective: The aim of the present study was to investigate the incidence of adenovirus genotypes 40 and 41 in children with acute gastroenteritis by polymerase chain reaction (PCR) and also to determine the possibility of Adenovirus co-infections with Rotavirus. Methods: The study was a cross-sectional study that included 100 children with acute gastroenteritis. The children were subjected to full history taking and clinical examination. Stool samples from the patients were subjected to detection of adenovirus and rotavirus antigens by enzyme-linked immunosorbent assay (ELISA) and detection of adenovirus genotypes 40 and 41 by polymerase chain reaction (PCR). Results: The most prevalent virus by the used methods was rotavirus antigen in the stool (35%). Adenovirus antigen detection was positive in 23% of the stool samples, with positive PCR for these samples in 22%. The ADv40 was detected in 13 samples, and ADv41 was detected in 9 samples. One positive sample by adenovirus antigen ELISA was negative by PCR for these genotypes. Mixed rotavirus and adenovirus by ELISA were detected in 7% of the children. In patients with positive adenovirus antigen by ELISA, the most common symptoms were vomiting (54.5%) and abdominal pain (45.5%). An insignificant difference between fever (P=0.94) and abdominal pain (P=0.63) was detected in children infected with adenovirus compared to patients infected with other organisms. The adenovirus was detected in 68.2% of children with acute gastroenteritis ≤ 24 months. Vomiting was significantly increased in children with adenovirus (54.5%) compared to children negative for adenovirus (23.1%-P=0.004, OR 4.0, 95%CI: 1.5-10.8). Conclusion: The study highlights the presence of adenovirus genotypes 40 and 41 in the stool of children with acute gastroenteritis. Combined rotavirus and adenovirus infections were detected in our study.

Background: COVID-19, caused by SARS-corona virus-2, is a globally expanded public health risk at a bizarre level. In this current situation, COVID-19 has become a serious emerging pandemic. Drug reusing is a crucial step in identifying the new uses of old established drugs. To achieve a significant and healthy way of treatment in COVID patients within a short duration, drug repurposing is a novel method. Objective: The present study concentrated on the molecular docking of thalidomide and its analogues and Apremilast against Coronavirus infectious symptoms, and evaluated virus proteins (Spike Protein, 3cl Protease, Nucleocapsids). Methods: The present study explores the possibility of repurposing thalidomide for the treatment of SARS-COV-2 infection by assessing and confirming with docking affinity scores of thalidomide and its analogues and Apremilast, with spike protein, 3cl protease, and nucleocapsids. Results: From the study results, thalidomide, pomalidomide, lenalidomide, and Apremilast exhibited better binding affinity to N Protein (4KXJ), Protease (4WY3) and Spike Protein (5WRG). In comparison to targets, N Protein - 4KXJ is the best for the four ligands. It is finalized that all four ligands (Thalidomide -8.6, Pomalidomide -8.8, Lenalidomide, and -8.2,and Apremilast -8.1) have good docking scores with the target N Protein. Conclusion: The present study confirms that thalidomide and its analogues and apremilast are a better fit for treating high risk patients of COVID-19 viral infection, which are supposed to promote beneficial effects for both respiratory illnesses like COVID-19 symptoms as well as improve the pathological state of condition.

Background: Amphotericin B is a pivotal drug for the management of invasive fungal infections. However, it has a significant toxicity profile with acute infusion reactions like fever, chills, vomiting, anaphylaxis, and nephrotoxicity in patients with long-term use. Pulmonary reactions mimicking acute pulmonary edema are unusual with amphotericin. Case Description: We report a case of a 51-year-old male diagnosed with rhinomaxillary mucormycosis, who developed acute onset breathlessness, bilateral diffuse pulmonary infiltrates after amphotericin infusion. The patient recovered spontaneously within a few hours after the cessation of amphotericin, which was parallel with the normalization of Chest X-ray. Furthermore, the Naranjo adverse reaction probability score was 9, which established a definite causal relation between drug use and adverse event. Conclusion: Clinicians should be aware of acute lung injury in patients treated with amphotericin infusion. In cases with no alternative available, a slow infusion of amphotericin with close monitoring is required to prevent life-threatening pulmonary reactions.

Introduction: Initially, COVID-19 was typically concerned with respiratory symptoms and had a mild and asymptomatic to critical clinical course. Over time, many atypical presentations related to cardiac, hepatic, gastrointestinal, renal, musculoskeletal, and neurological features have been reported in COVID-19. Case Presentation: We present three confirmed cases of COVID-19, who developed acute pancreatitis without any other obvious discernible cause. One middle-aged 48-years old male was presented with severe abdominal pain with mild symptoms of COVID-19, who was later diagnosed with acute pancreatitis with a positive outcome. Another 40-year-old male, hospitalized due to moderate COVID-19, developed acute pancreatitis and was managed successfully. The third 58-year-old patient with control diabetes and severe COVID-19 developed acute necrotizing pancreatitis. Unfortunately, he succumbed due to multiorgan failure while on the mechanical ventilator. Conclusion: Acute pancreatitis is uncommon in COVID-19. Although, it should be kept as a highindex clinical suspicion if abdominal pain is reported. Early diagnosis and prompt management can significantly impact the patient's outcome.