scholarly journals Clinical outcomes in vaccinated individuals hospitalized with Delta variant of SARS-CoV-2

2021 ◽  
Author(s):  
Jagadeesh Kumar V ◽  
Divya Tej Sowpati ◽  
Apoorva Munigela ◽  
Sofia Banu ◽  
Archana Bharadwaj Siva ◽  
...  
Keyword(s):  
Risk Factors ◽  
Viral Genome ◽  
Neutralizing Antibodies ◽  
Immune Escape ◽  
Ventilatory Support ◽  
Hospitalized Patients ◽  
The World ◽  
Clinical Profiles ◽  
Severity Of The Disease

Emerging variants of SARS-CoV-2 with increased transmissibility or immune escape have been causing large outbreaks of COVID-19 infections across the world. As most of the vaccines currently in use have been derived from viral strains circulating in the early part of the pandemic, it becomes imperative to constantly assess the efficacy of these vaccines against emerging variants. In this hospital-based cohort study, we analysed clinical profiles and outcomes of 1161 COVID-19 hospitalized patients (vaccinated with COVISHIELD (ChAdOx1) or COVAXIN (BBV-152), n = 495 and unvaccinated n = 666) in Hyderabad, India between April 24th and May 31st 2021. Viral genome sequencing revealed that >90% of patients in both groups were harbouring the Delta variant (Pango lineage B.1.617.2) of SARS-CoV-2. Vaccinated individuals showed higher neutralizing antibodies (545+-1256 AU/ml Vs 51.1+-296 AU/ml; p<0.001) and significantly decreased Ferritin (392.26+-448.4 ng/mL Vs 544.82+-641.41 ng/mL; p<0.001) and LDH (559.45+-324.05 U/L Vs 644.99+- 294.03 U/L; p<0.001), when compared to the unvaccinated group. Severity of the disease (3.2% Vs 7.2%; p=0.0039) and requirement of ventilatory support (2.8% Vs 5.9%; p=0.0154) were significantly low in the vaccinated group despite the fact that these individuals had significantly higher age and risk factors. The rate of mortality was about 50% lower (2/132=1.51%) in the completely vaccinated breakthrough infections although mortality in individuals who had received a single dose was similar to the unvaccinated group (9/269=3.35% vs 23/666= 3.45%). Our results demonstrate that both COVISHIELD and COVAXIN are effective in preventing disease severity and mortality against the Delta variant in completely vaccinated hospitalized patients.

scholarly journals ESC - a comprehensive resource for SARS-CoV-2 immune escape variants

2021 ◽  
Author(s):  
Mercy Rophina ◽  
Kavita Pandhare ◽  
Afra Shamnath ◽  
Mohamed Imran ◽  
Bani Jolly ◽  
...  
Keyword(s):  
Genetic Variants ◽  
Viral Genome ◽  
Neutralizing Antibodies ◽  
Large Scale ◽  
Immune Escape ◽  
Spike Protein ◽  
Genomic Research ◽  
Disease Pathogenesis ◽  
Underlying Mechanisms ◽  
Gain Access

ABSTRACTEver since the breakout of COVID-19 disease, ceaseless genomic research to inspect the epidemiology and evolution of the pathogen has been undertaken globally. Large scale viral genome sequencing and analysis have uncovered the functional impact of numerous genetic variants in disease pathogenesis and transmission. Emerging evidence of mutations in spike protein domains escaping antibody neutralization is reported. We have a precise collation of manually curated variants in SARS-CoV-2 from literature with potential escape mechanisms from a range of neutralizing antibodies. This comprehensive repository encompasses a total of 532 variants accounting for 146 unique variants tested against 75 antibodies and patient convalescent plasma. This resource enables the user to gain access to an extensive annotation of SARS-CoV-2 escape mutations which we hope would contribute to exploring and understanding the underlying mechanisms of immune response against the pathogen. The resource is available at http://clingen.igib.res.in/esc/.

scholarly journals Beyond Vaccines: Clinical Status of Prospective COVID-19 Therapeutics

2021 ◽  
Vol 12 ◽  
Author(s):  
Sriram Kumar ◽  
Duygu Merve Çalışkan ◽  
Josua Janowski ◽  
Aileen Faist ◽  
Beate Claudine Gisela Conrad ◽  
...  
Keyword(s):  
Neutralizing Antibodies ◽  
Immune Escape ◽  
Clinical Status ◽  
World Health ◽  
World Population ◽  
Protective Effects ◽  
Novel Technologies ◽  
Therapeutic Benefits ◽  
Entry Points ◽  
The World

Since November 2019 the SARS-CoV-2 pandemic has caused nearly 200 million infection and more than 4 million deaths globally (Updated information from the World Health Organization, as on 2nd Aug 2021). Within only one year into the pandemic, several vaccines were designed and reached approval for the immunization of the world population. The remarkable protective effects of the manufactured vaccines are demonstrated in countries with high vaccination rates, such as Israel and UK. However, limited production capacities, poor distribution infrastructures and political hesitations still hamper the availability of vaccines in many countries. In addition, due to the emergency of SARS-CoV-2 variants with immune escape properties towards the vaccines the global numbers of new infections as well as patients developing severe COVID-19, remains high. New studies reported that about 8% of infected individuals develop long term symptoms with strong personal restrictions on private as well as professional level, which contributes to the long socioeconomic problems caused by this pandemic. Until today, emergency use-approved treatment options for COVID-19 are limited to the antiviral Remdesivir, a nucleoside analogue targeting the viral polymerase, the glucocorticosteroide Dexamethasone as well as neutralizing antibodies. The therapeutic benefits of these treatments are under ongoing debate and clinical studies assessing the efficiency of these treatments are still underway. To identify new therapeutic treatments for COVID-19, now and by the post-pandemic era, diverse experimental approaches are under scientific evaluation in companies and scientific research teams all over the world. To accelerate clinical translation of promising candidates, repurposing approaches of known approved drugs are specifically fostered but also novel technologies are being developed and are under investigation. This review summarizes the recent developments from the lab bench as well as the clinical status of emerging therapeutic candidates and discusses possible therapeutic entry points for the treatment strategies with regard to the biology of SARS-CoV-2 and the clinical course of COVID-19.

Outcome of Acute Kidney Injury in COVID-19 Patients – A Prospective Cohort at a Single Centre in Pakistan

2021 ◽  
Vol 2 (3) ◽  
pp. 60-65
Author(s):  
F. Saeed ◽  
A. Alam ◽  
S. Memon ◽  
J. Chughtai ◽  
S. Ahmed ◽  
...  
Keyword(s):  
Risk Factors ◽  
Prospective Cohort ◽  
Health Management ◽  
Renal Involvement ◽  
Ventilatory Support ◽  
Kidney Injury ◽  
P Value ◽  
Health Management Information System ◽  
Male Predominance ◽  
The World

Introduction: There is continuous experience that AKI is very common in COVID-19 patients and that SARS-CoV-2 specifically invades the kidneys with poor outcome. In-hospital AKI is associated with multiple risk factors including DM, CCF, drugs etc. Also, there is difference in the mortality rate all over the world for various reasons. To date no data has been found from Pakistan on outcome of AKI with COVID-19 infection. Therefore, this study was conducted to help determine the outcome and associated risk factors in this part of the world. Material and Method: This is a prospective cohort of COVID-19 adult patients with AKI admitted in Indus Hospital COVID ICU from March 2020 to September 2020. History, clinical examination, laboratory investigations, and ultrasound imaging of the kidneys was acquired from the Health Management Information System (HMIS) record of the patients. The data was analyzed in SPSS version 21. Association between outcomes of AKI with different variables was assessed by applying Chi square test. P value of less than 0.05 was considered significant. Results: There were total 208 patients with AKI in our study, in which 146 (70.2%) were male while 62(29.8%) were female. The mean age was 60.3± 12.7 years and the most prevalent comorbid was HTN 147(70.7%) in our patients, while the most common cause of AKI was sepsis 188(90.4%) and on the same way, oliguria was the most common symptoms of AKI 76(36.5%). Death was the most frequent outcome of our patients 147(70.7%) as compared to recovery 47(22.6%). There was male predominance in patients, who died with AKI as compared to female 112(76.2%) and 35(23.8%) respectively. Also, treatment didn’t show any benefit on worst outcome. Similarly, 124(59.6%) patients needed ventilatory support in which 118(95.2%) died while only 5 (4%) recovered (p <0.001) Conclusion: Renal involvement in SARS-COV-2 infection is more common than initially thought and has been associated with increased morbidity and mortality. We have found significant association of AKI in covid-19 with outcome variables.

Causality Then and Now

1993 ◽  
Vol 10 (2) ◽  
pp. 165-177
Author(s):  
Karen Harding
Keyword(s):  
Quantum Theory ◽  
Common Sense ◽  
Mechanical Model ◽  
Physical World ◽  
Scientific Data ◽  
The World ◽  
The Common ◽  
The Universe ◽  
The Way

Ate appearances deceiving? Do objects behave the way they do becauseGod wills it? Ate objects impetmanent and do they only exist becausethey ate continuously created by God? According to a1 Ghazlli, theanswers to all of these questions ate yes. Objects that appear to bepermanent are not. Those relationships commonly tefemed to as causalare a result of God’s habits rather than because one event inevitably leadsto another. God creates everything in the universe continuously; if Heceased to create it, it would no longer exist.These ideas seem oddly naive and unscientific to people living in thetwentieth century. They seem at odds with the common conception of thephysical world. Common sense says that the universe is made of tealobjects that persist in time. Furthermore, the behavior of these objects isreasonable, logical, and predictable. The belief that the univetse is understandablevia logic and reason harkens back to Newton’s mechanical viewof the universe and has provided one of the basic underpinnings ofscience for centuries. Although most people believe that the world is accutatelydescribed by this sort of mechanical model, the appropriatenessof such a model has been called into question by recent scientificadvances, and in particular, by quantum theory. This theory implies thatthe physical world is actually very different from what a mechanicalmodel would predit.Quantum theory seeks to explain the nature of physical entities andthe way that they interact. It atose in the early part of the twentieth centuryin response to new scientific data that could not be incorporated successfullyinto the ptevailing mechanical view of the universe. Due largely ...

Morbidity and risk factors of microalbuminuria among 1 259 hospitalized patients

2014 ◽  
Vol 35 (7) ◽  
pp. 749
Author(s):  
Hui-fang WANG ◽  
Li YUAN ◽  
Ya-kun WANG ◽  
Peng FU ◽  
Xiao-feng JIANG
Keyword(s):  
Risk Factors ◽  
Hospitalized Patients

scholarly journals The Impact of Ultraviolet Radiation on the Aetiology and Development of Uveal Melanoma

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1700
Author(s):  
Melissa Chalada ◽  
Charmaine A. Ramlogan-Steel ◽  
Bijay P. Dhungel ◽  
Christopher J. Layton ◽  
Jason C. Steel
Keyword(s):  
Risk Factors ◽  
Ultraviolet Radiation ◽  
Uveal Melanoma ◽  
World Health Organisation ◽  
World Health ◽  
Genetic Mutations ◽  
High Incidence ◽  
The World ◽  
The Impact

Uveal melanoma (UM) is currently classified by the World Health Organisation as a melanoma caused by risk factors other than cumulative solar damage. However, factors relating to ultraviolet radiation (UVR) susceptibility such as light-coloured skin and eyes, propensity to burn, and proximity to the equator, frequently correlate with higher risk of UM. These risk factors echo those of the far more common cutaneous melanoma (CM), which is widely accepted to be caused by excessive UVR exposure, suggesting a role of UVR in the development and progression of a proportion of UM. Indeed, this could mean that countries, such as Australia, with high UVR exposure and the highest incidences of CM would represent a similarly high incidence of UM if UVR exposure is truly involved. Most cases of UM lack the typical genetic mutations that are related to UVR damage, although recent evidence in a small minority of cases has shown otherwise. This review therefore reassesses statistical, environmental, anatomical, and physiological evidence for and against the role of UVR in the aetiology of UM.

scholarly journals Cerebral venous thrombosis in a patient with Down syndrome and coronavirus disease 2019: a case report

2021 ◽  
Vol 15 (1) ◽  
Author(s):  
Henry Robayo-Amortegui ◽  
Natalia Valenzuela-Faccini ◽  
Cesar Quecano-Rosas ◽  
Darlyng Zabala-Muñoz ◽  
Michel Perez-Garzon
Keyword(s):  
Risk Factors ◽  
Down Syndrome ◽  
Case Report ◽  
Venous Thrombosis ◽  
Cerebral Venous Thrombosis ◽  
Epidemiological Data ◽  
Thromboembolic Disease ◽  
Hispanic Woman ◽  
Case Presentation ◽  
The World

Abstract Background The new coronavirus disease 2019 pandemic has spread throughout most of the world. Cerebral venous thrombosis is a rare thromboembolic disease that can present as an extrapulmonary complication in coronavirus disease 2019 infection. Case presentation We report the case of a Hispanic woman with Down syndrome who has coronavirus disease 2019 and presents as a complication extensive cerebral venous thrombosis. Conclusions Cerebral venous thrombosis is a rare thromboembolic disease that can present as an extrapulmonary complication in coronavirus disease 2019 infection. In the absence of clinical and epidemiological data, it is important to carry out further investigation of the risk factors and pathophysiological causes related to the development of cerebrovascular thrombotic events in patients with Down syndrome with coronavirus disease 2019 infection.

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