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Intravenous treatment exposes the neonates to extravasation due to fragile and small veins and the long period required for treatment. Extravasation is leakage of fluids, nutrition, or drugs from a peripheral intravenous which could cause tissue damage. The injured complications range from local irritation to skin necrosis and severe scar formation after the healing. Several methods have been used to control the complications of extravasation. We used an Amniotic membrane, a biological dressing, for healing the wounds. Our object in this study is to examine whether the amniotic membrane can induce healing wounds following extravasations.This prospective 13-week single-arm clinical trial study was performed on five neonates from February 2020 till May 2021 in the children's medical center of Tehran University. Neonates with any gestational age and diagnosis of the wound due to extravasation entered our study. Neonates with skin disorders and wound stages of 1 and 2 were excluded from the study. Established wounds without necrosis and infection are treated with an amniotic membrane. The amniotic membrane covers the wound, and after 48 hours, the wound is rechecked. The sequence of replacing or removing the bandages is five to seven days until healing occurs.An amniotic membrane was applied to the wounds and the average time for healing was 2.5 weeks. The average gestational age was 33.6 weeks. We did not report any adverse reaction, and healing was without scar formation.Implementing an amniotic membrane for treating wounds due to Extravasation can be a new approach. This treatment route decreases graft requirement and can be implemented by expert nurses, so in remote NICUs, its usage is easy.

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Objectives There are several types of research on the COVID-19 disease which have been conducting. It seems that prevailing over the pandemic would be achieved only by mastering over the virus pathophysiology. We tried to categorize the massive amount of available information for useful interpretation. Evidence acquisition We searched databases with different keywords and search strategies that focus on virulence and pathophysiology of COVID-19. The present review has aimed to gather and categorize all implemented drugs based on the susceptible virulence mechanisms, and the pathophysiological events in the host cells, discussing and suggesting treatments. Results As a result, the COVID-19 lifecycle were categorized as following steps: “Host Cell Attachment” which is mainly conducted with ACE2 receptors and TMPRSS2 from the host cell and Spike (S) protein, “Endocytosis Pathway” which is performed mainly by clathrin-mediated endocytosis, and “Viral Replication” which contains translation and replication of RNA viral genome. The virus pathogenicity is continued by “Inflammatory Reactions” which mainly caused moderate to severe COVID-19 disease. Besides, the possible effective therapeutics’ mechanism and the pharmaceutical agents that had at least one experience as a preclinical or clinical study on COVID-19 were clearly defined. Conclusion The treatment protocol would be occasional based on the stage of the infection and the patient situation. The cocktail of medicines, which could affect almost all mentioned stages of COVID-19 disease, might be vital for patients with severe phenomena. Graphical abstract The classification of the possible mechanism of medicines based on COVID-19 pathogenicity