COVID-19 Infection in Pregnancy: A Review

Coronavirus disease 2019 (COVID-19), which is a highly contagious viral illness caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has had a catastrophic effect on the world's demographics, resulting in more than 3.8 million deaths worldwide, and establishing itself as the most serious global health crisis since the 1918 influenza pandemic. Several questions remain unanswered regarding the effects of COVID-19 disease during pregnancy. Although most infections are mild in high-risk populations, severe disease frequently leads to intubation, intensive care unit admission, and, in some cases, death. Hormonal and physiological changes in the immune and respiratory systems, cardiovascular function, and coagulation may affect the progression of COVID-19 disease in pregnancy. However, consequences of coronavirus infection on implantation, fetal growth and development, labor, and newborn health have yet to be determined, and, consequently, a coordinated global effort is needed in this respect . Principles of management concerning COVID-19 in pregnancy include early isolation, aggressive infection control procedures, oxygen therapy, avoidance of fluid overload, consideration of empiric antibiotics (secondary to bacterial infection risk), laboratory testing for the virus and co-infection, fetal and uterine contraction monitoring, prevention and / or treatment of thromboembolism early mechanical ventilation for progressive respiratory failure, individualized delivery planning, and a team-based approach with multispecialty consultations. This review focuses on COVID-19 during pregnancy, its management, and the area where further investigations are needed to reduce the risk to mothers and their newborns.

Impact of COVID-19 on Wages of the Labours in India

We know about Plague Pandemic, Cholera Pandemic, Influenza Pandemic and the most recent Covid-19 Pandemic. The Covid-19 pandemic is world’s one of the dangerous human calamities. In the year 2020, Covid-19 have impacted human lives and survival in various ways. One of the ways in which Covid-19 have impacted on human lives in affecting the wages of labour in India. Due to the Covid-19 pandemic, India went under a lockdown condition for over three months. This lockdown has created a big depreciative influence on the economy which eventually impacted on business and their labours. In the year 2020 during second wave of Covid-19, over 10 million people lost their jobs and 97 percent households in the country have witnessed decline in incomes. The government is working hard to recover the loss as well as to secure the lives in the country.

The Turn of 20th Contemporary Art under the Big Social Crisis

The current COVID-19 pandemic has immensely impacted artists and their artwork. Such as the spread of the epidemic has led to the emergence of a new art form-NFT and so on, and also made online art exhibitions and virtual spaces became a popular way of viewing exhibitions. The same applies to the 20th century, artists knew that they had entered a unique and modern age of artistic expression. The modern world would bring both opportunities and challenges to the people. Historical evidence has shown that art is a highly dynamic field characterized by its ever-changing nature. Characterized by various social crises such as the Great Depression, 1918 Influenza Pandemic, First World War, and the Second World War, among many others. The Great Depression of the 1930s influenced art, particularly painting, to a great extent. During the depression, art became a tool for reflecting the current conditions, social critique, and activism.

Multipurpose Drugs Active Against Both Plasmodium spp. and Microorganisms: Potential Application for New Drug Development

Malaria, a disease caused by the protozoan parasites Plasmodium spp., is still causing serious problems in endemic regions in the world. Although the WHO recommends artemisinin combination therapies for the treatment of malaria patients, the emergence of artemisinin-resistant parasites has become a serious issue and underscores the need for the development of new antimalarial drugs. On the other hand, new and re-emergences of infectious diseases, such as the influenza pandemic, Ebola virus disease, and COVID-19, are urging the world to develop effective chemotherapeutic agents against the causative viruses, which are not achieved to the desired level yet. In this review article, we describe existing drugs which are active against both Plasmodium spp. and microorganisms including viruses, bacteria, and fungi. We also focus on the current knowledge about the mechanism of actions of these drugs. Our major aims of this article are to describe examples of drugs that kill both Plasmodium parasites and other microbes and to provide valuable information to help find new ideas for developing novel drugs, rather than merely augmenting already existing drug repurposing efforts.

Innovations in the Insect Cell Expression System for Industrial Recombinant Vaccine Antigen Production

The insect cell expression system has previously been proposed as the preferred biosecurity strategy for production of any vaccine, particularly for future influenza pandemic vaccines. The development and regulatory risk for new vaccine candidates is shortened as the platform is already in use for the manufacturing of the FDA-licensed seasonal recombinant influenza vaccine Flublok®. Large-scale production capacity is in place and could be used to produce other antigens as well. However, as demonstrated by the 2019 SARS-CoV-2 pandemic the insect cell expression system has limitations that need to be addressed to ensure that recombinant antigens will indeed play a role in combating future pandemics. The greatest challenge may be the ability to produce an adequate quantity of purified antigen in an accelerated manner. This review summarizes recent innovations in technology areas important for enhancing recombinant-protein production levels and shortening development timelines. Opportunities for increasing product concentrations through vector development, cell line engineering, or bioprocessing and for shortening timelines through standardization of manufacturing processes will be presented.

Investigating host-virus interaction mechanism and phylogenetic analysis of viral proteins involved in the pathogenesis

Since the emergence of yellow fever in the Americas and the devastating 1918 influenza pandemic, biologists and clinicians have been drawn to human infecting viruses to understand their mechanisms of infection better and develop effective therapeutics against them. However, the complex molecular and cellular processes that these viruses use to infect and multiply in human cells have been a source of great concern for the scientific community since the discovery of the first human infecting virus. Viral disease outbreaks, such as the recent COVID-19 pandemic caused by a novel coronavirus, have claimed millions of lives and caused significant economic damage worldwide. In this study, we investigated the mechanisms of host-virus interaction and the molecular machinery involved in the pathogenesis of some common human viruses. We also performed a phylogenetic analysis of viral proteins involved in host-virus interaction to understand the changes in the sequence organization of these proteins during evolution for various strains of viruses to gain insights into the viral origin’s evolutionary perspectives.

Analyses of Safety Profile and Homologous Antibody Responses to a Mammalian Cell-Based, MF59-Adjuvanted, A/H5N1, Pandemic Influenza Vaccine across Four Phase II/III Clinical Trials in Healthy Children, Adults, and Older Adults

Modern cell culture-based technology eliminates vaccine manufactures reliance on embryonated chicken eggs, which may become compromised during an avian influenza pandemic. Four studies (total N = 6230) assessed the immunogenicity and safety of mammalian cell-based, MF59®-adjuvanted, A/H5N1 vaccine (aH5N1c; AUDENZ™) as two doses administered on Days 1 and 22 in children (NCT01776554), adults (NCT01776541; NCT02839330), and older adults (NCT01766921; NCT02839330). Immunogenicity of formulations at 7.5 μg and 3.75 μg antigen per dose were assessed by hemagglutination inhibition and microneutralization assays on Days 1, 22, 43, and 183 or 387. Solicited local and systemic adverse events (AEs) were recorded for 7 days after each vaccination. Unsolicited AEs were collected for 21 days after each vaccination, and serious and other selected AEs were recorded for one year. Antibody responses after two 7.5 μg doses met CBER licensure criteria in all age groups. Overall, an age-related response was evident, with the highest responses observed in children <3 years old. In children, antibody titers met seroconversion criteria 12 months after vaccination. MF59 allowed for antigen dose sparing. Solicited AEs were mild to moderate in nature, of short duration, and less frequent after the second dose than the first, demonstrating a favorable risk-benefit profile.

Racial Disparities in Mortality During the 1918 Influenza Pandemic in United States Cities

The 1918 influenza pandemic stands out because of the unusual age pattern of high mortality. In the United States, another feature merits scientific scrutiny: against a historical backdrop of extreme racial health inequality, the pandemic produced strikingly small ratios of nonwhite to white influenza and pneumonia mortality. We provide the most complete account to date of these racial disparities in 1918, showing that, across U.S. cities, they were almost uniformly small. We examine four potential explanations for this unexpected result, including [1] socio-demographic factors like segregation, [2] city-level implementation of non-pharmaceutical interventions (NPIs), [3] exposure to the milder spring 1918 “herald wave,” and [4] early-life exposures to other influenza strains resulting in differential immunological vulnerability to the 1918 flu. While we find little evidence for 1-3, we offer suggestive evidence that racial variation in early-life exposure to the 1889-1892 influenza pandemic shrunk racial disparities during the 1918 pandemic. We also raise the possibility that differential behavioral responses to the herald wave may have protected nonwhite urban populations. By providing a comprehensive description and careful examination of the potential drivers of racial inequality in mortality during the 1918 pandemic, our study provides a framework to consider interactions between the natural history of particular microbial agents and the social histories of the populations they infect.

Strategies and processes emergency department nurses consider important to safely manage during an influenza pandemic: A qualitative descriptive study

<p>The influenza virus is responsible for significant morbidity and mortality worldwide each year, with influenza pandemics occurring every 10 to 50 years and responsible for millions of deaths and substantial economic impact. Increasing globalisation through travel and trade means New Zealand is vulnerable to the risks of pandemic influenza, placing a strain on the healthcare system, putting lives at risk and posing a significant cost to the country. Emergency Departments are at the frontline of New Zealand’s healthcare system and are a crucial component in the response to an influenza pandemic, however little research has been done on the impact such an event would have on the nursing staff who work in this area and the care they provide to influenza patients. This study aims to explore what New Zealand Emergency Department nurses perceive as the biggest challenges to nursing care and staff safety during an influenza pandemic, in order to provide information on how to ensure the engagement of these nurses at the frontline of the pandemic response. With a lack of evidence-based research available, a qualitative descriptive design was used to allow an exploration of the first-hand perspectives of Emergency Department nurses, gaining meaningful insights into a phenomena which has been little explored. Sixteen nurses from two Emergency Departments participated in face-to-face interviews conducted using semi-structured questions. Raw data was transcribed, and an inductive approach was taken to data analysis, guided by the principles of both content and thematic analysis. The findings demonstrate that Emergency Department nurses work in an environment that poses risk to patient and staff safety every day, and an understanding of these safety problems is provided in the theme ‘the everyday reality for Emergency Department nurses’. Working within this context shapes the fears that Emergency Department nurses hold about what could happen if an influenza pandemic were to affect New Zealand in the future, and are summarised within the theme ‘fears for a pandemic’. The final theme, ‘strategy and planning for pandemics’ provides insight into how Emergency Department nurses feel these issues could be managed within future pandemic planning at Emergency Department, District Health Board and government level. This thesis identifies both existing and potential future safety concerns in relation to the management of influenza in New Zealand Emergency Departments, affecting the safety of patients and staff. It also provides specific multi-level and multi-agency recommendations for future pandemic plans that could help to mitigate the significant risks highlighted by those who work within the system every day.</p>

Strategies and processes emergency department nurses consider important to safely manage during an influenza pandemic: A qualitative descriptive study

<p>The influenza virus is responsible for significant morbidity and mortality worldwide each year, with influenza pandemics occurring every 10 to 50 years and responsible for millions of deaths and substantial economic impact. Increasing globalisation through travel and trade means New Zealand is vulnerable to the risks of pandemic influenza, placing a strain on the healthcare system, putting lives at risk and posing a significant cost to the country. Emergency Departments are at the frontline of New Zealand’s healthcare system and are a crucial component in the response to an influenza pandemic, however little research has been done on the impact such an event would have on the nursing staff who work in this area and the care they provide to influenza patients. This study aims to explore what New Zealand Emergency Department nurses perceive as the biggest challenges to nursing care and staff safety during an influenza pandemic, in order to provide information on how to ensure the engagement of these nurses at the frontline of the pandemic response. With a lack of evidence-based research available, a qualitative descriptive design was used to allow an exploration of the first-hand perspectives of Emergency Department nurses, gaining meaningful insights into a phenomena which has been little explored. Sixteen nurses from two Emergency Departments participated in face-to-face interviews conducted using semi-structured questions. Raw data was transcribed, and an inductive approach was taken to data analysis, guided by the principles of both content and thematic analysis. The findings demonstrate that Emergency Department nurses work in an environment that poses risk to patient and staff safety every day, and an understanding of these safety problems is provided in the theme ‘the everyday reality for Emergency Department nurses’. Working within this context shapes the fears that Emergency Department nurses hold about what could happen if an influenza pandemic were to affect New Zealand in the future, and are summarised within the theme ‘fears for a pandemic’. The final theme, ‘strategy and planning for pandemics’ provides insight into how Emergency Department nurses feel these issues could be managed within future pandemic planning at Emergency Department, District Health Board and government level. This thesis identifies both existing and potential future safety concerns in relation to the management of influenza in New Zealand Emergency Departments, affecting the safety of patients and staff. It also provides specific multi-level and multi-agency recommendations for future pandemic plans that could help to mitigate the significant risks highlighted by those who work within the system every day.</p>