Search results for “Sars-CoV-2”

Pyrexia And Liver Injury After A Second SARS-CoV-2 Vaccination: Macrophage Activation Manifested In Liver

Vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-Co V-2) has contributed to control of the coronavirus disease 2019 (COVID-19). On the other side, vaccination of SARS-CoV-2 could trigger autoimmune or inflammatory diseases. We present a 50-year-old female with well-controlled optic neuromyelitis with prednisolone (PSL) maintained at a dose of 2.5 mg/day. She ran a fever and liver injury was indicated 5 weeks after a second COVID-19 vaccination (BNT162b2 mRNA/Pfizer ). Liver biopsy showed accumulation of macrophages around the central veins, identified using anti-CD68 antibodies. As the treatment, cyclosporine A improved liver injury. COVID- 19 vaccination may have triggered liver inflammation due to cytokine storm via macrophage activation in the liver.

Marginal SARS-CoV-2 Spike Protein Increases Interferon and Balances Cytokine Gene Expression

Some evidence confirms the paradoxical beneficial role of harmful antigens when used in highly diluted forms. In this experiment, we observed cytokine gene expression changes in Gallus gallus embryo after challenge with Delta SARS-CoV-2 RBD spike protein antigen, from a concentration of 10 µg/mL to a series of highly diluted forms in ethanol, along with controls. We have also studied pre-and post- experimental combined sets of higher (10 µg/mL) and significantly lower antigen concentrations (attogram level). Attogram and zeptogram level concentrations of the antigen showed consistently remarkable up-regulation of INF-α among different cytokine gene expressions. INF-β gene expressions at the zeptogram level of the antigen showed consistent changes, although not so outstanding. The pre-experimental set having attogram level antigen administered first, followed by a 10µg/mL antigen challenge, showed excellent cytokine balance. Other experimental groups, including the control sets, showed variable results at different concentrations.

First Analytical Solution of Intracellular life Cycle of SARS-CoV-2

SARS-Cov-2 Viral Kinetics in Mild COVID-19 Patients Treated with Chloroquine Regimens or Standard of Care

This study measures the impact of chloroquine (CQ) therapy in reducing SARS-CoV-2 viral load in infected individuals and hence its transmissibility by describing changes in nasopharyngeal SARS-CoV-2 RNA kinetics in patients receiving standard of care (SOC) or CQ +/- ritonavir-boosted lopinavir (LPV/r). The nasopharyngeal (NP) samples were collected from mild COVID-19 patients admitted at Bamrasnaradura Infectious Diseases Institute between March and April of 2020. These patients either received SOC, or a high dose of CQ with loading dose, or high dose of CQ plus LPV/r. The samples were tested at AFRIMS using a quantitative RT-PCR assay. Levels of CQ in the plasma were measured 6 days post initiation of their treatment. In some instances, viral isolation was attempted to determine SARS-CoV-2 viability. Analyses of the clinical outcomes showed that CQ +/- lopinavir did not contribute significantly to decreasing the number of days with detected SARS-CoV-2 RNA. Viral NP GEs declined faster in the CQ group, but benefits diminished rapidly with delays in treatment initiation. Funding Global Emerging Infections Surveillance, Armed Forces Health Surveillance Branch (GEIS-AFHSB) for all research-related activities at the AFRIMS

Use of the Remaining Sample from the Panbio COVID-19 Antigen Rapid Test Device for the Molecular Screening of the SARS-CoV-2 Variant of Concern B.1.1.7

Objective Real-time surveillance of SARS-CoV-2 variants of concern (VOC) is of essential public health importance. Rapid Antigen Detection Tests (RAgDT) have become first-line COVID-19 diagnostic methods in many regions, but this strategy can hamper the surveillance of the virus variants due to their decentralized performance. The aim of this study was to assess the usefulness of the remaining sample of a widely used RAgDT (Panbio) for the surveillance of the B.1.1.7 VOC using molecular methods. Methods Symptomatic individuals and asymptomatic close contacts of confirmed cases were routinely screened for SARS-CoV-2 infection using the RAgDT in Primary Health Care Centers. After performing the test, the extraction tubes containing the remaining biological material of RAgDT-positive cases were sent to the clinical microbiology laboratory where RT-PCRs detecting key mutations of the VOC were conducted. Results A valid result was obtained in 1770/1812 (97.7%) RAgDT-positive cases. Variant B.1.1.7 was detected in 34.7% of the patients, increasing from 0% to 87.7% between the weeks beginning January 4 and March 15, 2021. Conclusion The sample remaining after performing the Panbio RAgDT allowed to monitor the emergence and circulation of the B.1.1.7, greatly improving the population screened for the molecular study of SARS-CoV-2 variants.  

Molecular Evolution of the Novel Coronavirus SARS-CoV-2

The coronavirus infectious disease (20)19 (COVID-19) pandemic is caused by a newly identified virus (2019) SARS-CoV-2, a beta coronavirus that shares similarities with other human-infecting coronaviruses. Genomic analysis suggests that SARS-CoV-2 is closely related to SARS-CoV, a bat-related coronavirus, RaTG13, and to other pangolin-associated coronaviruses. The spike protein of coronaviruses are glycoproteins and are responsible for attaching the virus to the host cell and entering. Amino acid changes within the spike protein-encoding gene from SARS-CoV to SARS-CoV-2 enable SARS-CoV-2 to form a stable spike protein, to form a stable complex between the S protein and the receptor ACE2, to increase binding points between the S protein and ACE2, and to survive at higher temperatures. SARS-CoV-2 is zoonotic, with genomic analysis implicating bats as the original host and pangolins as the most likely intermediate host to infect humans. As SARS-CoV-2 infects humans, viral point mutations will continually occur and cause the emergence of new competitive SARS-CoV-2 strains. Two major strains include D614G and N501Y and have increased infectivity and transmission, further complicating the scope of the current COVID-19 pandemic. Vigilant monitoring of viral development and evolution is necessary for developing proper treatment methods and vaccine targets.

An Algorithm to Predict the Possible SARS-CoV-2 Mutations

An algorithm to determine the possible mutations that can occur in the S protein responsible of the Covid-19 in humans is designed. To do that, nine tridimensional sequences available in the Protein Data Bank similar to the initial strain sequenced in Wuhan (December 2019) are identified. The conditions driving this potential mutation are: (1) an accumulated number of mutations greater than (or equal to) 5 in each position; (2), a cumulative value of the different variations of Gibbs free energy less than -2.0 Kcal/mol; and (3), a squared fluctuation greater than 1.6 Å obtained according to calculations for normal mode analysis based on anisotropic network models (ANM) after averaging the first 20 vibration modes. The result is that 491 positions can mutate, while 424 positions did not provide any mutation. Finally, the results reveal that there are mutations that cannot be predicted, so more studies are needed to determine why they are present in the human population.

Molecular Evolutionary Characteristics of the 2019 Novel Coronavirus (SARS-CoV-2) Contracted by Tunisian Citizens : Comparison and Relationship to Other Human and Animal Coronaviruses Based on Spike Glycoprotein-Coding Gene Sequences Analysis

In contributing to the initiative to address the COVID-19 pandemic and in order to enhance the knowledge on driving forces shaping the evolution of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) (isolated from Tunisian patients), a comparison in relation to other coronaviruses infecting humans (SARS-CoV-1, MERS-CoV, HCoV/229E, HCoV/NL63, HCoV/OC43, and HCoV/HKU1) as well as animals (SARS-CoVs in tiger, bats, civet, pangolin, bovine, and MERS-CoV in dromedary/camel), was conducted. In-depth analysis was carried out involving 115 sequences of spike glycoprotein-coding gene extracted from the international databases. Phylogeny inference allowed the reconstruction of a bifurcating tree where four distinct groups were delineated and at the same time, three animal accessions (SARS-CoV-2/tiger, MERS-CoV/camel, and SARS-CoV/bovine) shifted from the animal group and integrated the human coronaviruses clades. Nonetheless, in the presence of reticulate events such as recombination, networks described better the phylogenetic relationships rather than the classic dendrogram. Thus, networks were produced and identified four clusters containing sharply demarcated subgroups (eight subdivisions). Except networked phylogenies of SARS-CoV-1, SARS-CoV-2, and HCoV/HKU1, all the others showed edges and boxes illustrating the occurrence of incompatibilities related to the sequences of spike glycoprotein-coding gene. Thereby and consolidating this result, three methods (RDP package, GARD, and RECCO) were used to detect breakpoints in aligned sequences. Except the clades SARS-CoV-1 and SARS-CoV-2, all the remaining phylogenetic subdivisions were subject to recombination. Furthermore, the screening of selection pressure in all studied sequences by various statistics-based models of the HyPhy package, showed that, similarly, the lineages belonging to the clades SARS-CoV-1 and SARS-CoV-2 were not under selection. In contrast, all members of the remaining clades underwent, to different extents, adaptive selection as well as purifying selection.

Analytical Solutions of the Transmissibility of the SARS-CoV-2 in Three Interactive Populations

This paper resolves analytically a mathematical model that reproduces the transmission of Covid-19 in three interactive populations, i.e. from the initial source of contagion associated with the bat population, subsequently transmitted to unknown host (usually associate with pangolins). The host were sent and distributed to Seafood Market in Wuhan (defined reservoir), and finally infected to the human population. The model is based on a system of ten differential equations reproducing all the possible infection scenarios among all of them, that is: (1) there is no infection in any of the three populations, (2) only the population of bats is infected, (3) only the pangolins, (4) only the human people. Later, combinations between them, this is: (5) both the bat and pangolin populations, (6) bats and humans, (7) pangolins and humans, and finally, (8) all the previous populations. In each scenario, I deduced the critical points as well as the eigenvalues ​​that indicate the equilibrium conditions. Finally, it is demonstrated the validity of the model with the data corresponding to the second wave of infections in Australia.

SARS-CoV-2 affected cells Pathogeny and Therapy

There were compared mechanisms infecting a human organism by different viruses in relation to interaction between human diploid cellular cycle mechanisms and coronaviruses haploid genomic mechanism. Besides there were described mechamism forming combined haploid-diploid cellular cycle of viral affected cells due to interactions between human cellular cycle mechanisms and coronaviruses genomic mechanism. Further there were considered infected way of SARS-CoV-2 from mechanism maintenance stability Internal Energy of an organism’s able-bodies cells and transmutation them into viral affected cells leading to death of affected cells of high respiratory level in nose-trachea-bronchi with transiting coronaviruses through dead cells‘ wall and infecting lungs‘ cells. Taking into account great searches of methods treatments Coronaviruses infected disease, we offered to approved through detail clinical Trial of new efficient method of treatment ill patients with SARS-CoV-2 disease which can rescue of still alive lungs‘ cells. Moreover there was reviewed offered therapy of SARS-CoV-2 induced disease.

Presentation of Neutralizing Antibodies in Single- or Pooled-Convalescent Immune Plasma from Donors to Prevent the Current SARS-CoV-2 Pandemic

As there is no specific treatment yet, the fight against the COVID-19 pandemic is being carried out with great difficulty today. The use of immune plasma is seen as a promising option since there is expectation that it will reduce mortality, as in influenza pandemics experienced in 1918 and 2009. However, the safety and effectiveness of this treatment option against SARS-CoV-2 viruses are not known for certain. In addition, the optimal obtaining methods and protection time of neutralizing antibodies to be used to provide passive immunization are not fully known. Therefore, it would be very useful to investigate the most effective neutralizing antibody collection methods without disrupting the overall structure and effectiveness of the antibodies subject to the use of the convalescent immune plasma. For this purpose, we found it appropriate to prepare a broad review on the structure and properties of antibodies, as well as the principles and storage conditions of antibodies to be used in passive immunization.

COVID-19-Induced Changes in the Fibrin Network of Pulmonary and Renal Microthrombi

Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection often causes coagulation disorders that affect highly vascularized organs, such as the lungs and kidneys. Objective The objective of this study was to report the histopathological findings of variations in the fibrin pattern of pulmonary and renal microthrombi in patients who died from SARS-CoV-2 infection. Methods Minimally invasive autopsies were performed on 40 patients to collect lung (n=40) and kidney (n=16) tissue samples. Histochemical and immunohistochemical staining techniques were used for histopathological analyses. Premortem laboratory data were obtained from the patients' electronic medical records. Results The lung tissue showed a patchy pattern, characterized by areas of both minimal and severe damage. The most significant histopathological finding was the detection of thrombi with fibrin structures organized into discrete star-shaped units, which were more frequently observed in areas with severe lung injury than in those with minimal lung injury (p = 0.012). Star-shaped fibrin structures were also observed in the renal glomerular capillaries. Immunohistochemical staining revealed the presence of platelets and the procoagulant proteins von Willebrand factor (VWF) and Factor VIII within the star-shaped fibrin thrombi. Patients with star-shaped fibrin thrombi had higher levels of the systemic inflammatory indicators C-reactive protein (CRP) and neutrophil-to-lymphocyte ratio (NLR). Conclusion Our observations suggest that the inflammatory microenvironment resulting from SARS-CoV-2 infection may contribute to the formation of star-shaped fibrin units in the pulmonary and renal microthrombi.

Primary Membranous Nephropathy Flare After COVID-19 Vaccination

Primary membranous nephropathy (MN) is due to autoantibodies to phospholipase A2 receptor (PLA2R Ab). It is unclear whether COVID-19 vaccines can trigger flares of glomerular diseases such as primary MN. There have been increasing reports of glomerular diseases presenting or flaring after receipt of COVID-19 vaccines. We present a patient with primary MN who developed nephrotic syndrome after receiving her second mRNA-1273 COVID-19 vaccine with positive PLA2R Ab. Renal biopsy confirmed primary MN. She was treated for her primary MN flare with rituximab in a manner similar to non-vaccine-associated MN, which led to significant reduction in both PLA2R Ab level and proteinuria. This case adds to the growing literature on MN flares after receipt of mRNA COVID-19 vaccines. Close follow-up of patients with primary MN and other glomerular diseases after COVID-19 vaccination is warranted. Further research is needed to determine the pathophysiology behind vaccine-induced MN flares and whether there is a potential association between exposure to SARS-CoV-2 antigens and loss of tolerance to the PLA2R antigen.

Comparative Analysis of Five Commercial RT-PCR Diagnostic Assay for Detection of Covid-19

SARS-CoV-2 real-time reverse-transcription PCR (rRT-PCR) is the most effective testing system available to combat COVID-19, given the absence of any specific treatment or vaccine. Moreover, numerous SARS-CoV-2 rRT-PCR kits have been approved under emergency-use-authorization (EUA) worldwide. In this article, we present a comparison of important performance features among five commercial RT-PCR assays. A total of consecutive nasopharyngeal (NPS) samples and oropharyngeal (OP) swabs were collected from 50 COVID-19 patients to analyze sensitivity and specificity. The results showed variations in sensitivity among all the RT-PCR kits examined. The Pishtaz teb assays demonstrated the highest positive percent agreement (PPA) of 95.2% (40/42), followed by Covitech (90.5% - 38/42), DaAn Gene (83.3% - 35/42), Sansure (66.66% - 28/42), and Power check of SARS- CoV-2 panel (64.3% - 27/42). Conversely, all five molecular assays demonstrated a negative percent agreement (NPA) of 100% (8/8). These findings provide a technical baseline for assessing the performance of five distinct commercial PCR assays for detecting SARS-CoV-2. They could prove practical and useful for laboratories seeking to purchase any of these assays for further clinical validation. Highlights ·Compared five COVID-19 RT-PCR kits approved and available by Iran Ministry of Health. ·Pishtaz teb's kit identified the highest number of positive clinical samples.

A General Approach to Modeling Covid-19

The present work shows that it is possible to analytically solve a general model to explain the transmission dynamics of SARS-CoV-2. First, the within-host model is described, and later a between-host model, where the coupling between them is the viral load of SARS-CoV-2. The within-host model describes the equations involved in the life cycle of SARS-CoV-2, and also the immune response; while that the between-Host model analyzes the dynamics of virus spread from the original source of contagion associated with bats, subsequently transmitted to a host, and then reaching the reservoir (Huanan Seafood Wholesale Market in Wuhan ), until finally infecting the human population.

COVID-19 and Hip Osteoarthritis Disability-Linkages and Emerging Practice Implications

Older adults suffering from chronically painful disabling osteoarthritis of one or more joints such as the hip joint continue to experience multiple health issues, commonly progressive debility, and excess disability. This mini review strove to examine current perspectives in the realm of hip joint osteoarthritis, a widespread disabling disease affecting many older adults in the face of the possible repercussions of the multiple COVID-19 restrictions in response to the SARS-CoV-2 pandemic that emerged in late 2019, along with the persistence of multiple evolving COVID-19 variants that remain lethal to many older adults, especially among the older chronically impaired population. Using multiple data bases, results reveal that very little progress has been made in recent times to mitigate hip osteoarthritis, along with very few innovative treatment approaches when severe, other than surgery and medication. Moreover, a multitude of non-pharmacologic approaches have not reduced numbers of cases requiring surgery to any extent, even when employed. In addition, outcomes of hip joint replacement surgery, and other treatments for ameliorating unrelenting pain remain largely suboptimal, especially where those undergoing surgery may now be more impaired than in pre pandemic times, and where high rates of opioid related deaths prevail in this regard. As such, it is concluded that whether in the community or being treated in hospital, exposure to COVID-19 remains risky especially in cases who are now weaker and frail, plus suffering from excess chronic disease manifestations, thus warranting more attention and protection of this high risk group, plus insightful preventive efforts to avert multiple interacting COVID-19 effects in the realm of osteoarthritis suffering, especially where patients are willing to risk infection by undergoing surgery.

Fragiles but Resilient. The Key Strategies to Cope with Pandemic in Persons with Multiple Sclerosis. A Controlled Web Survey

Background SARS-CoV-2 pandemic represented an unexpected psychological stress, being a major threat to health and limiting daily’s life, especially for the fragile population. How could the people with (pw) Multiple Sclerosis (MS) cope with this emergency? Objective To observe the pwMS’s psychological reaction in comparison with non affected persons and to evaluate the impact of lifestyle changes on psychological symptoms, due to the pandemic. Methods The study was observational, retrospective, controlled, focused on good clinical practice and conducted at Niguarda Hospital. PwMS and controls filled a web survey containing anamnestic data, habits, depression and anxiety self-questionnaires. The primary outcome was the pwMS’s psychological anxiety and depression score compared with controls. Results On April, 10 2020, 88/165 pwMS and 187 controls joined the study. Unexpectedly, no significant differences between groups were observed for depression mean score: 6.6(5.2) in pwMS and 6.2(4.8) in controls and for anxiety: 5.9(4.8) and 5.0(4.2). PwMS focused on health concern more often than controls, but they respected the restrictions more easily and benefited from practical activities more than controls. Conclusion PwMS showed a proper psychological resilience in comparison with controls. These findings might guide the clinical interviews and suggest both the areas to be supported and the strengths to be promoted in pwMS.

Cytokine Profiling in COVID-19 Patients in a Tertiary Hospital in Saudi Arabia; the Pre-Storm Phase

Background As COVID-19 immunomodulation has been a part of interest for studies, it has been found that severe coronavirus disease 2019 (COVID-19) is associated with hyper-inflammatory response and increased levels of interleukin-6 (IL-6) and interleukin-10 (IL-10). This can progress to cytokine storm syndrome and eventually development of acute respiratory distress syndrome (ARDS). Interleukin-1 receptor antagonist (IL-1RA) is a protein that is a member of the interleukin 1 cytokine family. Monocyte chemoattractant protein 1 (MCP1) is a small cytokine that belongs to the CC chemokine family. Interferon gamma-induced protein 10 (IP-10) is a protein secreted by several cell types in response to Interferon-Gamma (IFN-γ). All of these have roles in the immune response and eventually development of a cytokine storm. Methods Serum levels of IL-1RA, MCP-1 and IP-10 were measured in a cohort of 21 patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on admission to a tertiary care hospital in Riyadh, Saudi Arabia, as well as in an approximately age-sex matched group of 4 uninfected controls. The study population was classified into severe, moderate, mild and controls. Results Serum levels of IL-1RA, MCP-1 and IP-10 were found to be elevated before the clinical deterioration. Conclusion These cytokines may play a role in early detection of disease severity especially in the pre-storm phase. Medications that target cytokines may prevent the development of an overt cytokine storm.

RETRACTED: Profile of Children with Covid 19 Infection in our Set Up

This article has been retracted on July 20, 2022. VIEW THE RETRACTION NOTICE (https://doi.org/10.14302/issn.2692-1537.ijcv-25-5866) In December 2019, a novel coronavirus, now named as SARS-CoV-2, caused a series of acute atypical respiratory diseases in Wuhan, Hubei Province, China. The disease caused by this virus was termed COVID-19. The virus is transmittable between humans and has caused pandemic worldwide. The number of death tolls continues to rise and a large number of countries have been forced to do social distancing and lockdown. In humans, COVIDs mostly cause respiratory and gastrointestinal symptoms. Clinical manifestations range from a common cold to more severe disease such as bronchitis, pneumonia, severe acute respiratory distress syndrome, multi-organ failure and even death. Preliminary evidence suggests children are just as likely as adults to become infected with SARS-CoV-2 but are less likely to be symptomatic or develop severe symptoms. in our study , we consider the symptomatology , complications and mortality patterns of this disease in children.

COVID-19 Pandemic: The Causative Agent is New, The Problem is Old

A perspective situates SARS-CoV-2 within longstanding public health challenges, emphasizing preparedness, surveillance, and the recurrent lessons of outbreak management with examples for practice.

To What Extent is it Possible to Respect the Principle of Autonomy in Pandemic Times? A New Approach to Bioethical Principles

Based on two fictitious cases of disregard for the rules to prevent the spread of Sars-Cov-2 in which individuals claim that their autonomy has been disrespected, in Brazil, the authors ask to what extent individual autonomy must be strictly respected and propose a new approach to the bioethics principles, so that they are applied with a view to public health and the common good.

Effect of COVID 19 Pandemic on Stroke Care and Admission - Single Centre Study

Background By the start of year 2020, the whole world was attacked by a rapidly spreading epidemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2(SARS-CoV-2) which later was classified by WHO as Pandemic. some physicians reported multiple neurological manifestations including cerebrovascular strokes in patients with severe infection. Aim to assess the incidence of admitted stroke cases during 2019 in comparison to 2020 during COVID-19 pandemic in King Fahd Hospital, Saudi Arabia. Methodology A record based retrospective comparative study was conducted by reviewing all medical records for patients who admitted with stroke at King Fahd Hospital during March and April 2019 and March and April 2020. All data were extracted from patients’ medical files included personal data, nationality, date of admission, and stroke related data. Results The study included 121 patients whose ages ranged from 33 to 98 years with mean age of 59.9 years. At March 2019, there were 45 cases compared to 26 in March 2020. In April 2019 there were 20 admitted stroke cases compared to 30 in April 2020. Regarding clinical features of admitted stroke cases, Table 3 illustrates that 36.9% of stroke cases in 2019 were small vessel stroke compared to 58.9% of 2020 cases. Conclusions & Recommendations In conclusion, the study revealed there was no recorded significant change in the trend of admitted cases with stroke before and during COVID-19 pandemic.

Post Covid-19 Doctor-Patient Relationship Model. Creation of Social Connection Contexts With Physical Distancing

The coronavirus disease (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) 1 has produced a significant change in the way general medicine is conducted. This shift has been remarkably quick towards telecare. The form of the clinical interview has changed, and with it communication and the doctor-patient relationship; Before COVID-19, all communication techniques and doctor-patient relationship, which were considered tried and true to establish a good relationship with patients, involved physical proximity 2. Now in many European countries and in the United States face-to-face consultations have been reduced to 10-20%, with most contacts now being provided remotely using symptom checkers, electronic messaging, and phone or video consultations 3.

Dynamics of Infections and Number of Vaccines Needed to Avoid Covid-19 in Europe

The work analyzes the dynamics of transmission of infections by the new coronavirus in twelve European countries, including France, Germany, Italy, Spain, UK, Austria, Croatia, Denmark, Greece, Romania, Czech Republic, and Portugal, whose data from contagion were obtained by Johns Hopkins University until September 24, 2020. The study confirmed that this new coronavirus (SARS-CoV-2) surprised all the countries of the world that had to improve their public health policies to confront this disease according to the results obtained from the calculation of the mantissa. Although the countries were able to improve their policies after the first wave of contagion, Spain and France have the highest proportion of cases that stand out significantly with the rest of the countries in the second wave of infections that the world faces again. Likewise, the beginning of the epidemic outbreak was determined, which could help to track the spread of the disease through European countries (not the first case registered in each country), from which it can be inferred that the outbreak begins in Italy and later the rebound begins in Germany, France, and Spain. Within days, it significantly affects Greece and Austria, reaching Denmark, the Czech Republic, Romania, and Croatia. Finally, the number of people who must be vaccinated to counteract the advance of Covid-19 in these European countries was determined based on the calculation of the Effective Reproductive Number, Rt. The number of people that would have to be vaccinated in all these countries to counteract this disease sums up to 206.830.361.

Perception of Health Care Professionals on Transplantation in the Treatment of COVID-19 Patients

Corona virus disease 2019 (COVID-19) caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) has rapidly evolved as a pandemic with a challenge to the entire world for its management. Various modalities of treatment have been tried till date and when all the modalities failed then the only option that has been shown to be successful in some cases is lung transplantation. Decision for Solid-organ transplantation is not only made based upon its therapeutic requirement but also need to be supported by the law of land. In this regard, current Nepalese law is not with the provision for lung transplantation.  Thus, in order to make the concerned authorities aware of it and also as a step toward the preparedness for COVID-19 pandemic, this research has been conducted with an aim to see the perception of health care professionals of tertiary care centre of eastern Nepal regarding the legal aspects of lung transplantation. Conclusion Outcome of this research has supported the therapeutic aspect of transplantation over its legal issue in the emergency conditions like COVID-19 Pandemic.

Adaptive Artificial Passive Immunity as a Suggested Strategy for Treatment of COVID-19 Critical Cases

Currently, the emergence of a novel human corona virus, SARS-CoV-2, has become a global health concern causing severe respiratory tract infections in humans. Human-to-human transmissions have been described with incubation times between 2-14 days, facilitating its spread via droplets, contaminated hands or surfaces, resulting in high spread and death rates according to date, time and place of infection. We therefore reviewed the literature on all available information about the treatment of the cases, especially critical cases to decrease the mortality rate, the spread and incubation time of the virus by using the adaptive artificial passive immunity (anti-bodies from fully recovered patients with COVID-19).