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COVID-19 can cause a range of complications, including cardiovascular, renal, and/or respiratory insufficiencies, yet little is known of its potential effects in persons exposed to toxic metals. The aim of this study was to answer this question with in silico toxicogenomic methods that can provide molecular insights into COVID-19 complications owed to exposure to arsenic, cadmium, lead, mercury, nickel, and chromium. For this purpose we relied on the Comparative Toxicogenomic Database (CTD), GeneMANIA, and ToppGene Suite portal and identified a set of five common genes (IL1B, CXCL8, IL6, IL10, TNF) for the six metals and COVID-19, all of which code for pro-inflammatory and anti-inflammatory cytokines. The list was expanded with additional 20 related genes. Physical interactions are the most common between the genes affected by the six metals (77.64 %), while the dominant interaction between the genes affected by each metal separately is co-expression (As 56.35 %, Cd 64.07 %, Pb 71.5 %, Hg 81.91 %, Ni 64.28 %, Cr 88.51 %). Biological processes, molecular functions, and pathways in which these 25 genes participate are closely related to cytokines and cytokine storm implicated in the development of COVID-19 complications. In other words, our findings confirm that exposure to toxic metals, alone or in combinations, might escalate COVID-19 severity.

A myriad of organ-specific complications have been observed with COVID-19. While racial/ethnic minorities have been disproportionately burdened by this disease, our understanding of the unique risk factors for complications among a diverse population of cancer patients remains limited. This is a multi-institutional, multi-ethnic cohort study evaluating COVID-19 complications among cancer patients. Patients with an invasive cancer diagnosis and confirmed SARS-CoV-2 infection were identified from March to November 2020. Demographic and clinical data were obtained and a multivariate logistic regression was employed to evaluate the impact of demographic and clinical factors on COVID-19 complications. The study endpoints were evaluated independently and included any complication, sepsis, pulmonary complications and cardiac complications. A total of 303 patients were evaluated, of whom 48% were male, 79% had solid tumors, and 42% were Hispanic/Latinx (Hispanic). Malignant hematologic cancers were associated with a higher risk of sepsis (OR 3.93 (95% CI 1.58-9.81)). Male patients had a higher risk of sepsis (OR 4.42 (95% CI 1.63-11.96)) and cardiac complications (OR 2.02 (95% CI 1.05-3.89)). Hispanic patients had a higher odds of any complication (OR 2.31 (95% CI 1.18-4.51)) and other race was associated with a higher odds of cardiac complications (OR 2.41 (95% CI 1.01-5.73)). Clinically, fever, cough, and ≥2 co-morbidities were independently significantly associated with any complication. This analysis evaluated covariates that can significantly predict a myriad of complications among a multi-ethnic cohort of cancer patients. The conclusions drawn from this analysis elucidate a mechanistic understanding of differential illness severity from COVID-19.

The ongoing COVID-19 pandemic has highlighted the need for innovative strategies to mitigate the severe complications associated with infection caused by SARS-CoV-2. Developing empirical studies posited that the gut microbiota play a key role in modulating the immune response and overall health. This review explores the potential of synbiotics, a combination of probiotics and prebiotics, as a promising therapeutic approach to ameliorate COVID-19 complications. We conducted a comprehensive review of the literature to assess the impact of synbiotics on key aspects of the pathogenesis of this disease. Several studies indicate that synbiotics can bolster the gut microbiome, enhance mucosal barrier function, and regulate the immune system. These effects may be particularly beneficial in COVID-19, where immune dysregulation and cytokine storm are implicated in severe disease. We discuss the mechanisms through which synbiotics influence the gut axis, modulating the immune response and potentially reducing the risk of acute respiratory distress syndrome and other complications. Furthermore, synbiotics may help manage gastrointestinal symptoms often associated with COVID-19 and support the recovery of patients. While current research is promising, further clinical trials are needed to validate the safety and efficacy of synbiotics in the context of COVID-19. This review underscores the potential of synbiotics as an adjunctive therapy to conventional treatments for COVID-19, offering a novel and integrated approach to improve patient outcomes and reduce the burden of this health challenge worldwide.

Since the emergence of the COVID-19 pandemic, the effects of SARS-CoV-2 have been extensively researched. While much is already known about the acute phase of the infection, increasing attention has turned to the prolonged symptoms experienced by a subset of individuals, commonly referred to as long COVID-19 patients. This study aims to delve deeper into the immune landscape of patients with prolonged symptoms by implementing single-cell mRNA analysis. A 71-year-old COVID-19 patient presenting with persistent viral pneumonia was recruited, and peripheral blood samples were taken at 3 and 2 years post-acute infection onset. Patients and control peripheral blood mononuclear cells (PBMCs) were isolated and single-cell sequenced. Immune cell population identification was carried out using the ScType script. Three months post-COVID-19 patients’ PBMCs contained a significantly larger immature neutrophil population compared to 2-year and control samples. However, the neutrophil balance shifted towards a more mature profile after 18 months. In addition, a notable increase in the CD8+ NKT-like cells could be observed in the 3-month patient sample as compared to the later one and control. The subsequent change in these cell populations over time may be an indicator of an ongoing failure to clear the SARS-CoV-2 infection and, thus, lead to chronic COVID-19 complications.

Abstract Coronavirus disease 2019 (COVID-19) is an infectious disease caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Most people infected with the virus experience mild to moderate respiratory illness. However, some might become seriously ill and may develop acute respiratory distress syndrome (ARDS), thus requiring non-invasive or invasive mechanical ventilation. Furthermore, COVID-19 disease can involve also other organs and systems, causing several extra-pulmonary manifestations and, thus, negatively influencing the patient’s outcome. Imaging studies play a pivotal role in the monitoring of severely ill patients, especially those admitted to the intensive care unit (ICU), who can develop several potentially life-threatening complications, both from the infection itself and the mechanical supporting system. This widespread utility of imaging modalities calls for a deeper understanding of potential radiologic findings in this disease and the need for multidisciplinary collaboration between radiologists and anesthesiologists to provide actionable guidance to appropriate interventions under such conditions.

Over the past three years, since the onset of COVID-19, several scientific studies have concentrated on understanding susceptibility to the virus, the progression of the illness, and possible long-term complexity. COVID-19 is broadly recognized with effects on multiple systems in the body, and various factors related to society, medicine, and genetics/epigenetics may contribute to the intensity and results of the disease. Additionally, a SARS-CoV-2 infection can activate pathological activities and expedite the emergence of existing health issues into clinical problems. Forming easily accessible, distinctive, and permeable biomarkers is essential for categorizing patients, preventing the disease, predicting its course, and tailoring treatments for COVID-19 individually. One promising candidate for such biomarkers is microRNAs, which could serve various purposes in understanding diverse forms of COVID-19, including susceptibility, intensity, disease progression, outcomes, and potential therapeutic options. This review provides an overview of the most significant findings related to the involvement of microRNAs in COVID-19 pathogenesis. Furthermore, it explores the function of microRNAs in a broad span of effects that may arise from accompanying or underlying health status. It underscores the value of comprehending how diverse conditions, such as neurological disorders, diabetes, cardiovascular diseases, and obesity, interact with COVID-19., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Background and Aims: Immunosuppressed individuals are at higher risk for COVID-19 complications, yet data in patients with inflammatory bowel disease (IBD) are limited. We evaluated the risk of COVID-19- severe sequelae by medication utilization in a large cohort of patients with IBD., Methods: We conducted a retrospective cohort study utilizing insurance claims data between August 31, 2019, and August 31, 2021.We included IBD patients identified by diagnosis and treatment codes. Use of IBD medications was defined in the 90 days prior to cohort entry. Study outcomes included COVID-19 hospitalization, mechanical ventilation, and inpatient death. Patients were followed until the outcome of interest, outpatient death, disenrollment, or end of study period. Due to the aggregate nature of available data, we were unable to perform multivariate analyses., Results: We included 102 986 patients (48 728 CD, 47 592 UC) with a mean age of 53 years; 55% were female. Overall, 412 (0.4%) patients were hospitalized with COVID-19. The incidence of hospitalization was higher in those on corticosteroids (0.6% vs 0.3%; P < .0001; 13.6 per 1000 person-years; 95% confidence interval [CI], 10.8-16.9) and lower in those receiving anti-tumor necrosis factor α therapy (0.2% vs 0.5%; P < .0001; 3.9 per 1000 person-years; 95% CI, 2.7-5.4). Older age was associated with increased hospitalization with COVID-19. Overall, 71 (0.07%) patients required mechanical ventilation and 52 (0.05%) died at the hospital with COVID-19. The proportion requiring mechanical ventilation (1.9% vs 0.05%; P < .0001; 3.9 per 1000 person-years; 95% CI, 2.5-5.9) was higher among users of corticosteroids., Conclusions: Among patients with IBD, those on corticosteroids had more hospitalizations and mechanical ventilation with COVID-19. Anti-tumor necrosis factor α therapy was associated with a decreased risk of hospitalization. These findings reinforce previous guidance to taper and/or discontinue corticosteroids in IBD., (© The Author(s) 2023. Published by Oxford University Press on behalf of Crohn’s & Colitis Foundation. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: In this study, our aim is to investigate the complications caused by COVID-19 disease in the period of 1 month and 3 months after infection and recovery in patients aged 20 to 80 admitted to the special care department of Shariati Hospital in Tehran. Methods: The information of the patients in this research was collected between 1 and 3 months after discharge non-randomly and from among the samples that are available (consecutive), through phone calls and a prospective questionnaire including questions about complications such as fatigue, body pain, joint pain, anorexia, disorders, sleep, headache, depression, dizziness, palpitations, chest pain, cough, diabetes, skin disease, obesity, imbalance, neuropathy, neurological and mental problems, and other cases are collected. Results: In this study, what was observed was those 4 complications of nausea and vomiting, diabetes, depression, and hypothyroidism were significantly related to hospitalization of COVID-19 patients in the hospital's special care department. The frequency of other complications was also investigated in this study. Conclusions: According to the conducted study as well as previous studies, what is clear is that the frequency of complications caused by COVID-19 in patients admitted to the intensive care unit after discharge is high, and more studies should be done in order to reduce these complications.

Over the past three years, since the onset of COVID-19, several scientific studies have concentrated on understanding susceptibility to the virus, the progression of the illness, and possible long-term complexity. COVID-19 is broadly recognized with effects on multiple systems in the body, and various factors related to society, medicine, and genetics/epigenetics may contribute to the intensity and results of the disease. Additionally, a SARS-CoV-2 infection can activate pathological activities and expedite the emergence of existing health issues into clinical problems. Forming easily accessible, distinctive, and permeable biomarkers is essential for categorizing patients, preventing the disease, predicting its course, and tailoring treatments for COVID-19 individually. One promising candidate for such biomarkers is microRNAs, which could serve various purposes in understanding diverse forms of COVID-19, including susceptibility, intensity, disease progression, outcomes, and potential therapeutic options. This review provides an overview of the most significant findings related to the involvement of microRNAs in COVID-19 pathogenesis. Furthermore, it explores the function of microRNAs in a broad span of effects that may arise from accompanying or underlying health status. It underscores the value of comprehending how diverse conditions, such as neurological disorders, diabetes, cardiovascular diseases, and obesity, interact with COVID-19.

Abstract Objective To evaluate the impact of the race (Black versus non-Black) on maternal and perinatal outcomes of pregnant women with COVID-19 in Brazil. Methods This is a subanalysis of REBRACO, a Brazilian multicenter cohort study designed to evaluate the impact of COVID-19 on pregnant women. From February2020 until February 2021, 15 maternity hospitals in Brazil collected data on women with respiratory symptoms. We selected all women with a positive test for COVID-19; then, we divided them into two groups: Black and non-Black women. Finally, we compared, between groups, sociodemographic, maternal, and perinatal outcomes. We obtained the frequency of events in each group and compared them using X2 test; p-values < 0.05 were considered significant. We also estimated the odds ratio (OR) and confidence intervals (CI). Results 729 symptomatic women were included in the study; of those, 285 were positive for COVID-19, 120 (42.1%) were Black, and 165 (57.9%) were non-Black. Black women had worse education (p = 0.037). The timing of access to the health system was similar between both groups, with 26.3% being included with seven or more days of symptoms. Severe acute respiratory syndrome (OR 2.22 CI 1.17–4.21), intensive care unit admission (OR 2.00 CI 1.07–3.74), and desaturation at admission (OR 3.72 CI 1.41–9.84) were more likely to occur among Black women. Maternal death was higher among Black women (7.8% vs. 2.6%, p = 0.048). Perinatal outcomes were similar between both groups. Conclusion Brazilian Black women were more likely to die due to the consequences of COVID-19.

The elderly are more prone to mortality from COVID-19 infection, as they are susceptible to develop acute respiratory distress syndrome (ARDS). For COVID-19 patients with ARDS caused by sepsis or septic shock, high-dose parenteral vitamin B12 appears to be a potential new treatment option. Vitamin B12 may play a substantial impact in COVID-19 morbidity and mortality reduction owing to its function in DNA synthesis, cellular control, improvement of anti-inflammatory immune responses, and decrease of pro-inflammatory responses. This review aims to assess the functional role of Vitamin B12 in COVID-19 in terms of its immunomodulatory effect, role in cellular and humoral immunity and maintaining the gut microbe homeostasis. From data inception to June 2021, accessible electronic databases were searched for research/review articles reporting on the function of Vitamin B12 in COVID-19. Scopus, Web of Science, PubMed, WHO worldwide research on COVID-19 and the clinical trials registration “https://clinicaltrials.gov/” were used to conduct the systematic search by using keywords: “COVID-19 and “Vitamin B12”. Also, based on these outcomes, it can be concluded that Vitamin B12 may have a potential role in preventing COVID-19 complications. Further, studies evaluating the role of Vitamin B12 in COVID-19 may open a new array of ideas on the optimal and the well-tolerated dose and timing of its administration in COVID-19 patients.

Background Ethical dilemmas can occur in any situation in clinical medicine. In patients undergoing neuro-anesthesia for surgical procedure evacuation of intracerebral hemorrhage with a history of hemorrhagic stroke, anticoagulants should not be given because they can cause recurrent bleeding. Meanwhile, at the same time, the patient could also be infected with coronavirus disease 2019 (COVID-19), one of treatment is the administration of anticoagulants. Methods A case report. A 46-year-old male patient was admitted to hospital with a loss of consciousness and was diagnosed with intracerebral hemorrhage due to a hemorrhagic stroke and was confirmed positive for COVID-19. Giving anticoagulants to patients is considered counterproductive so, an ethical dilemma arises. For this reason, a joint conference was held to obtain the best ethical and medicolegal solutions for the patient. Results By using several methods of resolving ethical dilemmas such as basic ethical principles, supporting ethical principles, and medicolegal considerations, it was decided that the patient was not to be given anticoagulants. Conclusions Giving anticoagulants to hemorrhagic stroke patients is dangerous even though it is beneficial for COVID-19 patients, so here the principle of risk-benefit balance is applied to patients who prioritize risk prevention rather than providing benefits. This is also supported by the prima facie principle by prioritizing the principle of non-maleficence rather than beneficence, the minus malum principle by seeking the lowest risk, and the double effect principle by making the best decision even in a slightly less favorable way as well as the medicolegal aspect by assessing patient safety and risk management.

Background:  Coronavirus disease 2019 (COVID-19), a disease caused by the SARS-CoV-2 coronavirus, was declared a pandemic in March 2020, posing significant challenges globally. Homeopathy has historical relevance in epidemic management. In response, the government of the state of Santa Catarina, Brazil, distributed Camphora 1M as a potential prophylactic intervention for COVID-19., Objective:  This study aimed to investigate the possible effects of Camphora 1M as an adjunctive prophylactic measure in managing COVID-19, focusing on mortality and hospitalization rates, during the period April 28 to July 31, 2020, within designated COVID-19 in-patient units in Santa Catarina., Methods:  An ecological study design was applied to this epidemiological research. Five case municipalities (Itajaí, Atalanta, Entre Rios, Rio do Campo, Trombudo Central) were compared with five control municipalities (São José, Galvão, Pedras Grandes, Grão-Pará, Ascurra)., Results:  No statistically significant differences were observed in predictor variables between municipalities that received Camphora 1M and the respective controls. Similarly, no statistically significant differences were observed in outcomes: deaths ( p  = 0.879), hospitalized cases ( p  = 0.537), daily ward admissions ( p  = 0.730) and ICU admissions ( p  = 0.072)., Conclusion:  For the first wave of the pandemic in the state of Santa Catarina, Brazil, city-wide distribution of Camphora 1M was not associated with reduced numbers, severity or mortality among the population hospitalized in designated public hospitals for COVID-19., Competing Interests: None declared., (Faculty of Homeopathy. This article is published by Thieme.)

Mannose-binding lectin (MBL) binds to SARS-CoV-2, inhibits infection of susceptible cells, and activates the complement system via the lectin pathway. In this study, we investigated the association of MBL2 polymorphisms with the risk of hospitalization and clinical worsening in patients with COVID-19. A total of 550 patients with COVID-19 were included (94 non-hospitalized and 456 hospitalized). Polymorphisms in MBL2 exon 1 (codons 52, 54 and 57) and promoter region (−550, −221, and +4) were determined by real-time PCR. MBL and complement proteins were measured by Luminex. A higher frequency of the H/H genotype and the HYPA haplotype was observed in non-hospitalized patients when compared to hospitalized. In addition, critically ill patients carrying haplotypes associated with high MBL levels (HYPA/HYPA + HYPA/LYPA + HYPA/LYQA + LYPA/LYQA + LYPA/LYPA + LYQA/LYQA + LXPA/HYPA + LXPA/LYQA + LXPA/LYPA) were protected against lower oxygen saturation levels (P = 0.02), use of invasive ventilation use (P = 0.02, OR 0.38), and shock (P = 0.01, OR 0.40), independent of other potential confounders adjusted by multivariate analysis. Our results suggest that variants in MBL2 associated with high MBL levels may play a protective role in the clinical course of COVID-19.

Objective: The objective of this study was to evaluate the effects of maternal coronavirus disease 2019 (COVID‐19) vaccination on preventing severe complications of COVID‐19 in pregnant women. Methods: A retrospective study was conducted in pregnant women infected with severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) during pregnancy and/or for up to 6 weeks postpartum between September 1, 2021, to January 30, 2022. The data was retrieved from a national database. The pregnant women were divided into two groups of vaccinated and unvaccinated. The proposed outcomes (the need for hospitalization, intensive care unit admission, and mechanical ventilation and products of conception complications) were compared between the two groups. Results: Approximately 90 000 pregnant women infected with COVID‐19 were included in the study. The data of the vaccinated (19 922) and unvaccinated (70 147) groups were analyzed and compared. Pregnant patients in the vaccinated group had a significantly lower rate of hospitalization (21.2% vs 29.4%) (odds ratio [OR], 0.648 [95% confidence interval (CI), 0.625–0.673], P = 0.0001) and intensive care unit admission (3.7% vs 7.8%) (OR, 0.453 [95% CI, 0.382–0.535], P = 0.0001). The need for mechanical ventilation was also lower, although not statistically significant, in the vaccinated group than in the unvaccinated group (30 of 155 [19.4%] vs 418 of 1597 [26.2%]) (OR, 0.677 [95% CI, 0.448–1.024], P = 0.063). Cesarean section (54.3% vs 58.1%) (OR, 0.856 [95% CI, 0.751–0.977], P = 0.021) and stillbirth (0.4% vs 3.6%) (OR, 0.097 [95% CI, 0.026–0.252], P = 0.0001) were also significantly lower in the vaccinated patients. Most pregnant women in the vaccinated group (18 484–96.14%) received Sinopharm BIBP COVID‐19 inactivated vaccine. No significant differences were seen in the effect of different types of COVID‐19 vaccines on reducing COVID‐19 complications in infected pregnant patients. Conclusion: Maternal COVID‐19 immunization is effective in reducing COVID‐19 complications in infected pregnant women. Synopsis: Maternal coronavirus disease 2019 (COVID‐19) immunization is effective in reducing COVID‐19 complications in infected pregnant women. [ABSTRACT FROM AUTHOR]

A high body mass index (BMI) is a known risk factor for coronavirus infection in hospitalized patients. Our study examined the association between BMI and complications and the survival rate among COVID-19 patients. This retrospective analysis used data from a tertiary hospital in the Eastern Region of Saudi Arabia during two waves of the COVID-19 pandemic. The study included 600 participants, with the majority being between 41 and 60 years old (41.3%) and men comprising 63.5% of the sample. Approximately 42.5% of patients were obese, and 31.3% were overweight. The results showed that BMI was significantly linked to respiratory diseases (p = 0.013); end-stage renal disease (p = 0.021); and cardiovascular disease (p = 0.003) but not diabetes mellitus (p = 0.064). Death occurred in 10.8% of patients; 33.8% were admitted to the ICU; 13.8% needed mechanical ventilation; and 60.7% had lung infiltration. Obese patients with oxygen saturation levels below 93% were 2.45 times more likely to require mechanical ventilation than those in the normal-weight group. Overweight and obese patients were also more likely to require mechanical ventilation than normal-weight patients, with odds ratios of 3.66 and 2.81, respectively. The BMI categorized was not associated with survival rate in COVID-19-hospitalized patients using Kaplan-Meier survival plots (p = 0.061). However, the BMI categorized was associated with survival rate in COVID-19 ICU patients (p < 0.001). In addition, the overweight showed a statistically significant higher hazard ratio of 2.22 (p = 0.01) compared to normal-weight patients using a Cox regression model. A high BMI was identified as an independent risk factor for reduced oxygen saturation (

Infertility is one of the types of diseases that occur in the reproductive system. Obesity is a state that can be occurred due to excessive fats, the progression in obesity stage results in a change in adipose tissue and the development of chronic inflammation, endocrine glands disorders and women’s reproductive system, and also increase the infection with covid-19. The study aimed to investigate the effect of the obesity, lipid-profile, and IL-6 on hormones-dysregulation in infertile-women with COVID-19 complications. The current study included 70 samples: 50 infertility-women-with-covid-19-infected, 20 healthy-women/control, the ages of both patients and healthy subjects were selected within the range 18-34 years. Levels of FBS, LH, FSH, and testosterone and lipid profile were measured in addition to calculating BMI. The result showed a significant increase in lipid profile but no HDL that revealed a considerable decline in its level (P=0.001) in patients group relative to control group. Also, the results showed highly increase in LH and LH/FSH-ratio (p≤0.05(but no FSH that revealed a considerable decline in its level (p≤0.05). The results also showed that the values of IL-6 (7.46±1.90 ng/ml) and BMI (30.10 ±6.17 kg/m2) in the patients group were significantly higher (P-value=0.001) than their values in the control group (3.13±0.79), (22.09±2.63 kg/m2), respectively. Conclusion: Obesity and Corona-virus-infection negatively affect ovulation in infertile-women due to their effect on the pituitary-gland-hormones, in addition to causing chronic-infections that lead to an increase in the level of interleukin-6, which increases of pituitary gland disorder and the difficulty of treating infertility and increasing of corona complications.

Purpose: This review summarizes the current scope of understanding associated with two common post-infectious complications associated with COVID-19 infection: Multi-System Inflammatory Syndrome in Children (MIS-C) and Post-Acute Sequelae of SARS-CoV-2 infection (PASC). It identifies current gaps in the knowledge and issues that may limit the ability to fill these gaps. This review provides a framework to drive continued research. Methods: A comprehensive review of the current literature was performed, identifying seminal articles describing the emergence of MIS-C and PASC, and works from the literature focused on the clinical implications and pathophysiologic understanding of these disorders. Findings: Although pediatric patients experienced few severe cases of acute COVID-19 infection, the burden of disease from post-infectious sequelae is substantial. Mortality is low, but morbidity is significant. There are still numerous unknowns about the pathophysiology of both MIS-C and PASC; however, with widespread immunity developing after increased vaccination and prior infection, it may be difficult to perform adequate prospective studies to answer pathophysiologic questions. Long-term sequalae of MIS-C seem to be minimal whereas, by definition, PASC is an ongoing problem and may be severe. Implications: The rapid sharing of information regarding novel conditions such as MIS-C and PASC are key to interventions related to future post-infectious sequelae outside of those stemming from COVID-19. Although MIS-C seems unlikely to return as a clinical condition in substantial numbers, there is still significant learning that can be gleaned from existing patients about general aspects of epidemiology, equity, and pathophysiology. There is significant morbidity associated with PASC and additional resources need to be dedicated to determining appropriate and effective therapies moving forward.

Most patients with severe complications from COVID-19 have underlying conditions such as obesity, diabetes, and hypertension. In parallel, there is growing evidence for a link between periodontitis and non-oral systemic diseases. The oral cavity is also a reservoir for respiratory pathogens, and patients with periodontal disease are more likely to develop hospital-acquired pneumonia than healthy individuals. We therefore hypothesize that improving oral health could decrease the severity of COVID-19 symptoms and reduce the associated morbidity.

This article provides a concise review of the potential of synbiotics, a combination of probiotics and prebiotics, in mitigating the complications associated with COVID-19. It discusses how synbiotics can improve gut health, enhance the immune system, and potentially reduce the risk of severe respiratory complications. The article emphasizes the need for further clinical trials to validate the safety and efficacy of synbiotics in the context of COVID-19. Additionally, the document explores the concepts of prebiotics, probiotics, and synbiotics and their potential applications in improving human health. It highlights ongoing research on the benefits of probiotics in preventing respiratory infections and supporting overall health, including their potential role in reducing the risk and severity of COVID-19. However, more research is needed to fully understand the effectiveness of probiotics in these areas. [Extracted from the article]

Targeted drug delivery to SARS-CoV-2 host target proteins for preventing or blocking COVID-19 infection is making serious concern during COVID-19 pandemic and its consequent waves around the globe. People seek reliable, effective folkloric preventive medication for immediate and precautionary relief from COVID-19. These folkloric medicines were effective and saved many patients during the past COVID-19 pandemic. The current research study aims to deliver antiviral Indian spices phytocompounds and their hyaluronic acid conjugates to human host target proteins (ACE-2, TNF-α, IL-6, IL-1β, PAR-1) of SARS-CoV-2 to inhibit virus propagation and also to regulate early clinical complications of COVID-19. Targeted drug delivery of hyaluronic acid conjugated traditional natural bioactive agent produces more effective and fewer side effects in delivering novel drugs to human host proteins of COVID-19. In silico molecular docking study of six phytocompounds from three Indian spices and standard drug atazanavir and its hyaluronic acid conjugates reveals that phytocompounds and its hyaluronic acid conjugates possess high affinity to binding pockets of SARS-CoV-2 human host targets with more binding affinity scores. Most notably HA cyclocurcumin exhibit a docking score -9.9 kcal/mol against ACE-2 (PDB ID 1R42) target protein similarly HA-Hydrazinocurcumin exhibit a docking score -9.8 kcal/mol against PAR-1 (PDB ID 3VW7). ADMET validation of phytocompounds and their hyaluronic acid conjugates reveals its best pharmacokinetic profile over standard antiviral drug especially HA cyclocurcumin conjugate possesses high HIA (86%) and good pharmacokinetic profiles. DFT analysis affirms the reason behind the higher binding affinity of hyaluronic acid conjugates of spices phytocompounds towards all screened target proteins especially HA-hydrazinocurcumin conjugate possess high softness (19.1570 eV) and low hardness (0.0522 eV) values. Finally, MD simulation of best-docked compounds against ACE-2 and PAR-1 target protein revealed that hyaluronic acid conjugates of Indian spices compounds exhibit stable RMSD values and more protein-ligand interactions during simulation than hyaluronic acid conjugates of drug atazanavir.Communicated by Ramaswamy H. Sarma.