A Review on New Coronavirus Mechanism of Action

The new coronavirus outbreak caused by the severe acute respiratory syndrome coronavirus2 (SARS-CoV2) has resulted in more than 126750 deaths worldwide so far and billions of expenses for the governments. SARS-CoV2, similar to SARS, was transmitted from bats and spread via human to human closed contacts. The virus uses its spike protein to bind to angiotensin-converting enzyme 2 receptors on target cells to replicate. Consequently, it spreads from infected cells to contaminate other cells. The body’s first response toward the virus is to activate the innate immune system, leading to the synthesis of inflammatory mediators. In the next step, the adaptive immune system appears where B lymphocytes produce antibodies specific for the virus, and CD8+ cells kill the infected cells directly. In this article, we try to explain the virus mechanism of action and immune response in detail. Although many questions remain unanswered, we expect this review could help in vaccine and treatment progression, Keywords: COVID-19; SARS-CoV2; Mechanism; Review

The Immune Concerns for Chronicity of Sars-cov-2 Infection in Man

The objective of the p3resent opinion was disclose some immune features of chronic sars-cov-2 human infection. The extension of sars-cov-2 infection manifestation up to 12 months or more beyond the onset of the clinical infection is considered to be chronic. The problem of chronicity gain its importance impart by the residence of infecting sars-cov-2 virus in a reserve organ and frequently releasing it to the blood circulation reaching other body parts causing continual stimulation of hosting immune system with an outcomes of an immune over-reactions, immune weakening and immune mediated diseases. The immune features of the chronicity in covid-19 infections appeared to be different in different patients, though the presence of in-common ones . There was an array of the immune system behavior noted in such chronicity as; Prolonged adaptive immune activation and cellular exhaustion, weakening, over-reaction as well as inflammatory and immune tissue injuries. Gullain Barre autoimmune disease was currently documented to be induced by chronic sars-cov-2 virus infection. Keywords: Chronicity, covid-19, disease ,immune, inflammation ,Sars. DOI: 10.7176/JHMN/86-04 Publication date: February 28th 202

Arritmias cardíacas em pacientes com covid-19

Background: The coronavirus disease 2019 (COVID-19) is associated with cardiovascular clinical manifestations, including cardiac arrhythmias. Objective: To assess the incidence of cardiac arrhythmias (atrial tachyarrhythmia, bradyarrhythmia, and sustained ventricular tachycardia) and cardiac arrest (CA) in a cohort of patients hospitalized with COVID-19 in a tertiary university-affiliated hospital. Methods: Cohort study with retrospective analysis of electronic medical records. For comparison between groups, a value of p <0.05 was considered statistically significant Results: We included 241 consecutive patients diagnosed with COVID-19 (mean age, 57.8 ± 15.0 years; 51.5% men; 80.5% white), 35.3% of whom received invasive mechanical ventilation (MV). The overall mortality was 26.6%, being 58.8% among those on MV. Cardiac arrhythmias were identified in 8.7% of the patients, the most common being atrial tachyarrhythmia (76.2%). Patients with arrhythmias had higher mortality (52.4% versus 24.1%, p = 0.005). On multivariate analysis, only the presence of heart failure (HF) was associated with a higher risk of arrhythmias (hazard ratio, 11.9; 95% CI: 3.6-39.5; p <0.001). During hospitalization, 3.3% of the patients experienced CA, with a predominance of non-shockable rhythms. All patients experiencing CA died during hospitalization. Conclusions: The incidence of cardiac arrhythmias in patients admitted with COVID-19 to a Brazilian tertiary hospital was 8.7%, and atrial tachyarrhythmia was the most common. Presence of HF was associated with an increased risk of arrhythmias. Patients with COVID-19 experiencing CA have high mortality.Fundamento: A doença pelo novo coronavírus (COVID-19) está associada a manifestações clínicas cardiovasculares, incluindo a ocorrência de arritmias cardíacas. Objetivos: Avaliar a incidência de arritmias cardíacas (taquiarritmia atrial, bradiarritmia e taquicardia ventricular sustentada) e de parada cardiorrespiratória (PCR) em uma coorte de pacientes internados com COVID-19 em hospital universitário terciário. Métodos: Estudo de coorte retrospectivo realizado por meio de revisão dos registros de prontuário médico. Para comparação entre os grupos, foi considerado como estatisticamente significativo valor de P < 0,05. Resultados: Foram incluídos 241 pacientes consecutivos com diagnóstico de COVID-19 (idade média, 57,8 ± 15,0 anos; 51,5% homens; 80,5% de raça branca) e 35,3% com necessidade de ventilação mecânica invasiva (VM). A mortalidade geral foi de 26,6%, sendo de 58,8% entre aqueles em VM. Arritmias cardíacas ocorreram em 8,7% dos pacientes, sendo a mais comum taquiarritmia atrial (76,2%). Pacientes com arritmias apresentaram maior mortalidade, 52,4% versus 24,1% (p=0,005). Em análise multivariada, apenas a presença de insuficiência cardíaca foi associada a maior risco de arritmias (hazard ratio, 11,9; IC 95%: 3,6-39,5; p<0,001). Durante a internação, 3,3% dos pacientes foram atendidos em PCR, com predomínio de ritmos não chocáveis. Todos os atendidos em PCR evoluíram com óbito durante a internação. Conclusão: A incidência de arritmias cardíacas em pacientes internados com COVID-19 em hospital terciário brasileiro foi de 8,7%, sendo a mais comum taquiarritmias atrial. A presença de insuficiência cardíaca foi associada a maior risco de arritmias. Pacientes com COVID-19 atendidos em PCR apresentam elevada mortalidade

Cardiac and arrhythmic complications in patients with COVID-19

In December 2019, the world started to face a new pandemic situation, the severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2). Although coronavirus disease (COVID-19) clinical manifestations are mainly respiratory, major cardiac complications are being reported. Cardiac manifestations etiology seems to be multifactorial, comprising direct viral myocardial damage, hypoxia, hypotension, enhanced inflammatory status, ACE2-receptors downregulation, drug toxicity, endogenous catecholamine adrenergic status, among others. Studies evaluating patients with COVID-19 presenting cardiac injury markers show that it is associated with poorer outcomes, and arrhythmic events are not uncommon. Besides, drugs currently used to treat the COVID-19 are known to prolong the QT interval and can have a proarrhythmic propensity. This review focus on COVID-19 cardiac and arrhythmic manifestations and, in parallel, makes an appraisal of other virus epidemics as SARS-CoV, Middle East respiratory syndrome coronavirus, and H1N1 influenza

Th1 and Th17 hypercytokinemia as early host response signature in severe pandemic influenza

Abstract Introduction Human host immune response following infection with the new variant of A/H1N1 pandemic influenza virus (nvH1N1) is poorly understood. We utilize here systemic cytokine and antibody levels in evaluating differences in early immune response in both mild and severe patients infected with nvH1N1. Methods We profiled 29 cytokines and chemokines and evaluated the haemagglutination inhibition activity as quantitative and qualitative measurements of host immune responses in serum obtained during the first five days after symptoms onset, in two cohorts of nvH1N1 infected patients. Severe patients required hospitalization (n = 20), due to respiratory insufficiency (10 of them were admitted to the intensive care unit), while mild patients had exclusively flu-like symptoms (n = 15). A group of healthy donors was included as control (n = 15). Differences in levels of mediators between groups were assessed by using the non parametric U-Mann Whitney test. Association between variables was determined by calculating the Spearman correlation coefficient. Viral load was performed in serum by using real-time PCR targeting the neuraminidase gene. Results Increased levels of innate-immunity mediators (IP-10, MCP-1, MIP-1β), and the absence of anti-nvH1N1 antibodies, characterized the early response to nvH1N1 infection in both hospitalized and mild patients. High systemic levels of type-II interferon (IFN-γ) and also of a group of mediators involved in the development of T-helper 17 (IL-8, IL-9, IL-17, IL-6) and T-helper 1 (TNF-α, IL-15, IL-12p70) responses were exclusively found in hospitalized patients. IL-15, IL-12p70, IL-6 constituted a hallmark of critical illness in our study. A significant inverse association was found between IL-6, IL-8 and PaO2 in critical patients. Conclusions While infection with the nvH1N1 induces a typical innate response in both mild and severe patients, severe disease with respiratory involvement is characterized by early secretion of Th17 and Th1 cytokines usually associated with cell mediated immunity but also commonly linked to the pathogenesis of autoimmune/inflammatory diseases. The exact role of Th1 and Th17 mediators in the evolution of nvH1N1 mild and severe disease merits further investigation as to the detrimental or beneficial role these cytokines play in severe illness

ADOPSI DAN IMPLEMENTASI KECAKAPAN LITERASI INFORMASI DAN LITERASI DIGITAL UNTUK AKSELERASI UMKM DI INDONESIA PASCA PANDEMI COVID-19

Almost all countries in the world are facing the Covid-19 pandemic, which is spreading so massively. Affecting various aspects of life and causing a domino effect in many sectors including the economy. Indonesia's economy worsened in the second quarter (Q2) 2020, negative 5.32 percent and only started to recover in the second quarter of 2021, positive 7.07% thanks to investment and increased household consumption. The MSME sector plays a significant and strategic role in supporting and is predicted to be the engine of economic recovery after the Covid-19 pandemic. The positive contribution of MSMEs to GDP before the pandemic could reach almost 60%. However, now in a condition full of uncertainty, it is necessary to strengthen various ideas, innovations and collaboration of various parties so that MSMEs can get out of pressure and support economic growth. This study will look at the potential for the adoption and implementation of digital literacy skills and information literacy by involving librarians (library institutions), academics, and literacy activists supporting MSMEs in contributing to economic recovery after Covid-19. This study uses a qualitative-descriptive approach in order to present a detailed description of the setting and literacy skills for MSME actors. This research is general in nature (generalization) with the scope of its location in Indonesia, without mentioning specific areas. Primary sources of research are obtained from literature studies, studies of various media and journal articles which are assumed to be able to capture the general condition of society. The results show that the idea of adopting and implementing digital literacy skills and information literacy for MSME actors has an urgency to be implemented immediately as a solution to the challenges of possible innovation (behavior) changes in the habits and operations of the MSME sector after Covid-19. Accelerate the transformation of MSMEs through strengthening the digital literacy and information literacy sectors to support MSME business functions (production, promotion, and marketing) after Covid-19

CERTAIN ASPECTS OF IMMUNOPYCHIATRY

Immunopsychiatry is based on the assumption that schizophrenia, bipolar disorders, and major depressive disorders are related with atypical immune reactions or inflammatory processes. It has also been suggested that the neurotoxic effects of COVID-19 due to the perverted autoimmune reaction could offer fresh acumens into psychotic process. Even acute psychotic symptoms have a subtle pre-psychotic phase and unless treatments are aimed at this preceding phase, newer therapies are not going to achieve their targets. Identifying biosignatures of psychotic disorders lead to better understanding of the etiological mechanism involved in such disorders and aid early diagnostic assays. Interestingly, the search for biomarkers also stimulates new experimental treatment strategies as evidenced by the experiments of newer immunological therapies for psychotic disorders. Characterizing biosignatures are thought to play a significant role in the early detection, treatment, and implementation of preventive strategies in psychotic disorders. The search for identifying biosignatures should go hand in hand with newer experimental therapies for psychotic disorders for the benefit of introducing treatments at an early stage of psychosis development. The identification of biomarkers may lead to a shift from symptom based diagnostic category into subtypes based on immunological alterations and brain biology and such a change might have an advantage to make more precise diagnosis aiding better treatment. The field of immunopsychiatry requires more research to put their findings in context