The novel coronavirus disease 2019(COVID-19)causes serious respiratory illness and related disorders.Vulnerable populations,including those with chronic obstructive pulmonary disease,heart disease,diabetes,chronic kid...The novel coronavirus disease 2019(COVID-19)causes serious respiratory illness and related disorders.Vulnerable populations,including those with chronic obstructive pulmonary disease,heart disease,diabetes,chronic kidney disease,obesity,and the elderly,face an increased risk of severe complications.As the pandemic evolves,various diagnostic techniques are available to detect severe acute respiratory distress syndrome(SARS-CoV-2),including clinical presentation,rapid antigen/antibody testing,molecular testing,supplemental laboratory analysis,and imaging.Based on peer-reviewed data,treatment options include convalescent plasma transfusion,corticosteroids,antivirals,and immunomodulatory medications.Convalescent plasma therapy,historically used in outbreaks like Middle East respiratory syndrome,Ebola,and SARS,is suggested by the World Health Organization for critically ill COVID-19 patients when vaccines or antiviral drugs are unavailable.Neutralizing antibodies in convalescent plasma help control viral load and improve patient outcomes,especially when administered early,though effectiveness varies.The United States Food and Drug Administration has authorized its emergency use for severe COVID-19 cases,but potential risks such as transfusion reactions and transfusion-related acute lung injury require further investigation to establish definitive efficacy.Antiviral agents like Remdesivir,an adenosine nucleotide analog,inhibit viral RNA polymerase and have shown efficacy in reducing COVID-19 severity,leading to its emergency use authorization for hospitalized patients.Other antivirals like ritonavir,lopinavir,and umifenovir disrupt viral replication and entry,but their effectiveness against SARS-CoV-2 remains under investigation.Dexamethasone,a corticosteroid,has been used in critically ill COVID-19 patients to reduce inflammation and prevent respiratory failure,as shown in the RECOVERY trial.Other immunosuppressants like ruxolitinib,baricitinib,and colchicine help modulate the immune response,reducing cytokine storms and inflammation-related complications.However,corticosteroids carry risks such as hyperglycemia,immunosuppression,and delayed viral clearance,requiring careful administration.Systematic reviews of clinical studies revealed that hydroxychloroquine with or without azithromycin did not decrease viral load nor reduce the severity of symptoms,but increased mortality among acutely hospitalized patients.There was no improvement in patients’clinical conditions after 15 days compared to standard treatment.The United States Food and Drug Administration has revoked the authorization for the use of hydroxychloroquine in COVID-19 patients due to the null benefit-risk balance.Monoclonal antibodies like itolizumab,gimsilumab,sarilumab,and tocilizumab are being studied for their ability to reduce the severe inflammatory response in COVID-19 patients,particularly cytokine release syndrome and acute respiratory distress syndrome.These antibodies target specific immune pathways to decrease pro-inflammatory cytokines,with some showing promising results in clinical trials,though their use remains under investigation.The Clustered Regularly Interspaced Short Palindromic Repeats/Cas13 family of enzymes,sequenced from many COVID-19-positive patients,can potentially inhibit SARS-CoV-2 replication,cleave the RNA genome,and aid in the amplification of the genome assay.Cas13 can also target emerging pathogens via an adeno-associated virus vector when delivered to the infected lungs.In addition to pharmacological agents,vaccines effectively prevent symptomatic infection,reduce hospitalizations,minimize mortality rates,and ultimately reduce the severity of the disease.This paper aims to explore the management of patients with underlying conditions who present with COVID-19 to lessen the burden on healthcare systems.展开更多
Monkeypox(mpox),is a disease from the Poxviridae family that can cause several serious medical issues.This mini-review sought to analyze the existing literature regarding the current mpox outbreak with a focus on the ...Monkeypox(mpox),is a disease from the Poxviridae family that can cause several serious medical issues.This mini-review sought to analyze the existing literature regarding the current mpox outbreak with a focus on the prevalence,diagnostics,and containment measures.Mpox cases have been reported to World Health Organization(WHO)from 85 Member States in all six WHO regions during the period of January 1,2022,through August 3,2022.Standardized or optimized guidelines for the clinical care of patients with mpox are limited,particularly in low-resource settings.In an effort to achieve guidance and meet standards,special attention should be paid to this outbreak in order to eradicate such a rare infectious disease by analyzing prevention and control measures.Patient outcomes may also be poor,and their illnesses may last for a long time.The spectrum of clinical symptoms,including complications and sequelae,as well as aspects of the illness may be indicators of sickness severity and complications;therefore,its clinical presentation must be better understood to improve containment measures.In addition,it is important to create and evaluate a standard of care that takes a variety of parameters into account,including antiviral,immune therapies,and clinical metrics that are particular to mpox.The global emergence of mpox has presented new challenges for public health and has called for further investigation into its epidemiological profile across international contexts.展开更多
Omicron,the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)variant that is now spreading across the world,is the most altered version to emerge so far,with mutations comparable to changes reported in earli...Omicron,the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)variant that is now spreading across the world,is the most altered version to emerge so far,with mutations comparable to changes reported in earlier variants of concern linked with increased transmissibility and partial resistance to vaccineinduced immunity.This article provides an overview of the SARS-CoV-2 variant Omicron(B.1.1.529)by reviewing the literature from major scientific databases.Although clear immunological and clinical data are not yet available,we extrapolated from what is known about mutations present in the Omicron variant of SARS-CoV-2 and offer preliminary indications on transmissibility,severity,and immune escape through existing research and databases.展开更多
文摘The novel coronavirus disease 2019(COVID-19)causes serious respiratory illness and related disorders.Vulnerable populations,including those with chronic obstructive pulmonary disease,heart disease,diabetes,chronic kidney disease,obesity,and the elderly,face an increased risk of severe complications.As the pandemic evolves,various diagnostic techniques are available to detect severe acute respiratory distress syndrome(SARS-CoV-2),including clinical presentation,rapid antigen/antibody testing,molecular testing,supplemental laboratory analysis,and imaging.Based on peer-reviewed data,treatment options include convalescent plasma transfusion,corticosteroids,antivirals,and immunomodulatory medications.Convalescent plasma therapy,historically used in outbreaks like Middle East respiratory syndrome,Ebola,and SARS,is suggested by the World Health Organization for critically ill COVID-19 patients when vaccines or antiviral drugs are unavailable.Neutralizing antibodies in convalescent plasma help control viral load and improve patient outcomes,especially when administered early,though effectiveness varies.The United States Food and Drug Administration has authorized its emergency use for severe COVID-19 cases,but potential risks such as transfusion reactions and transfusion-related acute lung injury require further investigation to establish definitive efficacy.Antiviral agents like Remdesivir,an adenosine nucleotide analog,inhibit viral RNA polymerase and have shown efficacy in reducing COVID-19 severity,leading to its emergency use authorization for hospitalized patients.Other antivirals like ritonavir,lopinavir,and umifenovir disrupt viral replication and entry,but their effectiveness against SARS-CoV-2 remains under investigation.Dexamethasone,a corticosteroid,has been used in critically ill COVID-19 patients to reduce inflammation and prevent respiratory failure,as shown in the RECOVERY trial.Other immunosuppressants like ruxolitinib,baricitinib,and colchicine help modulate the immune response,reducing cytokine storms and inflammation-related complications.However,corticosteroids carry risks such as hyperglycemia,immunosuppression,and delayed viral clearance,requiring careful administration.Systematic reviews of clinical studies revealed that hydroxychloroquine with or without azithromycin did not decrease viral load nor reduce the severity of symptoms,but increased mortality among acutely hospitalized patients.There was no improvement in patients’clinical conditions after 15 days compared to standard treatment.The United States Food and Drug Administration has revoked the authorization for the use of hydroxychloroquine in COVID-19 patients due to the null benefit-risk balance.Monoclonal antibodies like itolizumab,gimsilumab,sarilumab,and tocilizumab are being studied for their ability to reduce the severe inflammatory response in COVID-19 patients,particularly cytokine release syndrome and acute respiratory distress syndrome.These antibodies target specific immune pathways to decrease pro-inflammatory cytokines,with some showing promising results in clinical trials,though their use remains under investigation.The Clustered Regularly Interspaced Short Palindromic Repeats/Cas13 family of enzymes,sequenced from many COVID-19-positive patients,can potentially inhibit SARS-CoV-2 replication,cleave the RNA genome,and aid in the amplification of the genome assay.Cas13 can also target emerging pathogens via an adeno-associated virus vector when delivered to the infected lungs.In addition to pharmacological agents,vaccines effectively prevent symptomatic infection,reduce hospitalizations,minimize mortality rates,and ultimately reduce the severity of the disease.This paper aims to explore the management of patients with underlying conditions who present with COVID-19 to lessen the burden on healthcare systems.
文摘Monkeypox(mpox),is a disease from the Poxviridae family that can cause several serious medical issues.This mini-review sought to analyze the existing literature regarding the current mpox outbreak with a focus on the prevalence,diagnostics,and containment measures.Mpox cases have been reported to World Health Organization(WHO)from 85 Member States in all six WHO regions during the period of January 1,2022,through August 3,2022.Standardized or optimized guidelines for the clinical care of patients with mpox are limited,particularly in low-resource settings.In an effort to achieve guidance and meet standards,special attention should be paid to this outbreak in order to eradicate such a rare infectious disease by analyzing prevention and control measures.Patient outcomes may also be poor,and their illnesses may last for a long time.The spectrum of clinical symptoms,including complications and sequelae,as well as aspects of the illness may be indicators of sickness severity and complications;therefore,its clinical presentation must be better understood to improve containment measures.In addition,it is important to create and evaluate a standard of care that takes a variety of parameters into account,including antiviral,immune therapies,and clinical metrics that are particular to mpox.The global emergence of mpox has presented new challenges for public health and has called for further investigation into its epidemiological profile across international contexts.
文摘Omicron,the severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)variant that is now spreading across the world,is the most altered version to emerge so far,with mutations comparable to changes reported in earlier variants of concern linked with increased transmissibility and partial resistance to vaccineinduced immunity.This article provides an overview of the SARS-CoV-2 variant Omicron(B.1.1.529)by reviewing the literature from major scientific databases.Although clear immunological and clinical data are not yet available,we extrapolated from what is known about mutations present in the Omicron variant of SARS-CoV-2 and offer preliminary indications on transmissibility,severity,and immune escape through existing research and databases.
