Background Since the COVID-19 outbreak, various studies have shown that hypokalemia is a common disorder, and it has been established that abnormalities in inflammatory biomarkers and complete blood count test (CBC) parameters are associated with the severity of the disease. So, this study investigates the association between hypokalemia and abnormalities in biomarkers of inflammation and CBC parameters, as well as the severity of COVID-19. Methods This single-centered cross-sectional study was conducted on 527 adult COVID-19 patients admitted to Afzalipour Hospital in Kerman, Iran, between March 2021 and March 2022. All patients had positive PCR tests, and their data was collected from electronic records. The relationship between hypokalemia and laboratory results, length of hospitalization, ICU admission, and mortality was analyzed by SPSS 27. Results A total of 527 COVID-19 patients with an average age of 53.6 years and an average duration of hospitalization of 7.89 days were reviewed retrospectively. Most of the patients were hospitalized in the general wards (90.5%) and recovered (89.2%). In this study, the prevalence of hypokalemia was 12%, and there was no significant correlation with demographic data or laboratory findings, including ESR, CRP, LDH, lymphocyte, and platelet counts. There was also no association between hypokalemia and length of hospitalization, ICU admission, or mortality. Conclusion In total, it was found that 12% of COVID-19 patients had hypokalemia, and no significant association was found between hypokalemia and demographic data, laboratory findings, duration of hospital stay, ICU admission, or mortality.

The prevalence of COVID-19 in the community has become more difficult to gauge utilizing clinical testing due to a decrease in reported test results stemming from the availability of at-home test kits and a reduction in the number of cases seeking medical treatment. The purpose of this study was to examine the trend of diminishing correlation between reported clinical cases of COVID-19 and wastewater-based surveillance epidemiological data as home testing became available in the Eastern Upper Peninsula of Michigan. Wastewater grab samples were collected weekly from 16 regional locations from June 2021-December 2022. Samples were analyzed for SARS-CoV-2 N1 and N2 viral particles using reverse transcriptase digital droplet polymerase chain reaction (RT ddPCR). N1 and N2 gene copies were correlated with clinical cases. The t-test was used to determine correlation deterioration point. Clinical cases post-deterioration were calculated for high-correlated pre-deterioration locations using linear regression. Correlation between the wastewater-based surveillance of SARS-CoV-2 and reported clinical cases deteriorated after February 1, 2022. This corresponds with the timeframe in which commercially available at-home test kits became available in the United States. The increase in at-home testing for SARS-CoV-2 likely contributed to the decrease in reported clinical positive tests in early 2022, providing an unrealistic picture of the presence of Covid-19 in the community. As measures to reduce exposure such as personal masking, clinical testing, social isolating, and quarantining continue to decline, wastewater surveillance for the presence of SARS-CoV-2 may be the best method for public health professionals to remain aware of virus dynamics in localized regions. Time-series modeling adds another layer of information when clinical data is unobtainable or underreported.

Background: We aimed to compare the epidemiological and clinical characteristics of coronavirus disease 2019 (COVID-19) in people living with human immunodeficiency virus (HIV) (PLWH) with those in the general population. Methods: This nationwide descriptive epidemiological study was conducted in South Korea between January 2020 and February 2022. The National Health Insurance claims data covering the whole nation were collected through the Health Insurance Review and Assessment Service. Results: Among 3,653,808 individuals who were diagnosed with COVID-19, 1,311 (0.04%) were PLWH. All the PLWH received antiretroviral therapy, and 26.47% had more than one underlying disease other than HIV infection. The overall in-hospital mortality rates of PLWH and the general population were 0.76% and 0.25%, respectively (P=0.002). According to the Cox proportional hazard model, no significant difference was observed in the in-hospital mortality rate [hazard ratio (HR): 1.80, 95% confidence interval (CI): 0.70–4.67] between PLWH and the general population. However, progression to severe or critical COVID-19 was more common in PLWH (HR: 2.70, 95% CI: 1.37–5.33). In PLWH diagnosed with COVID-19, a multivariable Cox regression analysis found old age (≥60 years old) (HR: 6.9; 95% CI 2.57–18.56) and diabetes mellitus (HR: 5.13; 95% CI: 2.02–13.00) as the independent risk factors for severe or critical COVID-19. Conclusions: PLWH had a significantly higher risk of severe or critical COVID-19 than that of the general population. Our findings suggest the need for applying differentiated strategies to decrease the impact of COVID-19 on PLWH.

Amubarvimab-romlusevimab is used antiviral regimens currently recommended in China for the treatment of adult patients with mild or moderate SARS-CoV-2 infections who are at a high risk factor for progression to severe COVID-19, but its exact efficacy in patients with severe COVID-19 is not yet known. This is a single-center retrospective cohort study. A total of 121 patients in intensive care units(ICU) diagnosed with severe COVID-19 were evaluated.The amubarvimab-romlusevimab therapy can reduce the 14-day mortality（23.40% vs 41.89%, p=0.037）, 28-day mortality（29.79 % vs 51.35%，p=0.02）, and ICU mortality（29.79% vs 55.41%，p=0.006) of severe COVID-19. To reduce bias and make the two groups balanced and comparable, a 1:1 PSM was performed. In the matched population（n=47), there were no statistically significant differences between the mAbs (monoclonal antibody)group and the Non-antiviral group in 14-day, 28-day, and thromboembolic events in COVID-19 patients. The 40-day survival analysis shows that mAbs therapy can improve patient prognosis (HR=0.45, 95%CI=0.26-0.76, p=0.008). However, no significant intergroup difference in the 40-day cumulative viral conversion rate. In a univariate Cox regression analysis, The Amubarvimab - romlusevimab therapy( HR:0.464; CI:[0.252-0.853];p:0.013),CRP, PCT, PLT, Lactate, PT, PT-INR, and pt% level at admission were risk factors for clinical prognosis. After including the above covariates, Multifactorial COX regression shows that the Amubarvimab - romlusevimab therapy( HR:0.464; CI:[0.252-0.853];p:0.013), CRP, Lactate and PT-INR at admission are independent factors for mortality of severe COVID-19. Based on the current data, we conclude that amubarvimab-romlusevimab therapy is beneficial for patients with severe COVID-19.

Recently we demonstrated that in 452 COVID-19 inpatients higher colchicine doses reduced the mortality about 5 times. Here we report another 333 cases of COVID-19 inpatients, treated with different doses of colchicine. There was a clear trend of reduction in the mortality of inpatients with increasing doses of colchicine between 2- and 7-fold. Colchicine loading doses of 4 mg are more effective than those with 2 mg. Despite higher than the so-called “standard doses” of colchicine, our doses are completely safe. The World Health Organization (WHO)-recommended strategy to inhibit viral replication had partial success because there is no direct link between viral load and the hyperactivation of the NLRP3 inflammasome. The neutralization of the IL-6 effects with anti-receptor antibodies and the inhibition of the tyrosine kinase JAK can be compromised if NLRP3 continues to be hyperactive and generates a cytokine storm. Our treatment strategy to inhibit the SARS-CoV-2 entry into the cell with inhaled bromhexine and the hyperactivated NLRP3 inflammasome with higher doses of colchicine, as the source of the cytokine storm practically solves the problem of treating COVID-19. The timing of initiation of treatment is critical.

Based on the author’s previous work, this article proposed a novel discipline– combinatorial biomedicine. Currently, there are several classical examples. One is a magic “polypill” covering the “Health Essential (HE) 5”, that is, “environment-sleep-emotion-exercise-diet” intervention [E(e)SEEDi] lifestyle; Another is an innovative “traditional Chinese medicine (TCM) Hot Pot”. In addition, the iRT-ABCDEFG program is indeed suitable for better management of human diseases. In fact, combinatorial biomedicine is pivotal in the development of life science, biology and medicine, in particular the pandemic and post-COVID-19 era, and has obvious advantages in screening, diagnosis, treatments, prevention and rehabilitation of both major non-communicable diseases (such as cardiovascular disease, diabetes, cancer, stroke, and neurodegenerative diseases) and major infectious diseases (such as AIDS, Helicobacter pylori infection, and COVID-19). As a novel discipline, combinatorial biomedicine plays a crucial role in combating human diseases and improving population health. It is about time to propose and establish this novel discipline.

We report real world use over time in immunocompromised subjects receiving tixagevimab/cilgavimab (T/C) pre-exposure prophylaxis (PrEP). Observational study on participants receiving T/C PrEP stratified: never had COVID-19 (NoC), hybrids (H) and breakthrough infections (BTIs) if COVID-19 before or after PrEP, respectively. Anti-RBD IgG and BA.5 neutralizing antibodies (nAbs), mucosal IgG, T-cell immunity at the administration of T/C (T0), 3 (T1), 6 (T2), and 9 (T3) months after, were measured. Comparison of markers in each group across timepoints, Poisson regression model for BTIs incidence rate ratios were performed. N=231 participants: median age 63 years (IQR 54.0-73.0), 84% hematological disease, median vaccine dose of three. N=72 NoC, 103 H and 56 (24%) BTIs, mostly mild/moderate, IR 4.2 (95%CI 3.2-5.4) BTIs/100 patients-months, no factors associated with. A significant increase of anti-RBD IgG at T1 was observed in all the groups, with a decline at T2. GMTs of anti-BA.5 nAbs were low at T1 for all the groups and around/below the cut off. No changes of IFN-γ. Overall, a mucosal response was observed at T1. An incidence of 24% of mild/moderate BTIs was observed. Anti-RBD IgG levels persistence was ensured, BA.5 nAbs were low/undetectable, cellular T immunity remained stable.

Background: Immediate IgE-mediated hypersensitivity reactions to polyethylene glycol (PEG) are rare. Our understanding of PEG hypersensitivity reactions is limited. We evaluate the clinical characteristics and investigation outcomes of the largest cohort of PEG allergic patients reported so far. Method: 44 patients investigated for suspected PEG allergy across four UK tertiary allergy centres between October 2013 and December 2020 were studied. Clinical characteristics, details of index reaction, and approaches to and outcomes of allergy investigations were analysed. Results: PEG hypersensitivity was confirmed in 42 of 44 cases. Macrogol laxatives were the most common index drugs reported (23%), followed by depo-medroxyprogesterone (19%), oral penicillin V (10%), and depo-methylprednisolone (10%). 61% experienced grade III anaphylaxis. Intradermal testing (IDT) increased the diagnostic sensitivity from 51% to 85%. Five patients experienced systemic reactions during IDT. Of the five patients, two were skin prick test (SPT)-positive to a high molecular weight (MW) PEG. Seven PEG-allergic patients reported tolerance to H1 antihistamines containing PEG. Administration of mRNA COVID-19 (n=5) or AZ COVID-19 vaccines (n=14) was tolerated in 16 patients. Conclusion: PEG hypersensitivity is an uncommon cause of drug-induced anaphylaxis. Four index drugs accounted for two-thirds of cases and reactions to these drugs should prompt PEG hypersensitivity investigations. PEG IDT increases diagnostic yield. The role of SPT with higher MW PEGs requires further attention. We observed no correlation in PEG dose and concentration between the implicated and tolerated PEG-containing drugs. Further studies are required to understand PEG thresholds and PEG equivalent doses of various administration routes. COVID-19 vaccines were tolerated by all exposed.

The global health workforce crisis, simmering for decades, was brought to a rolling boil by the COVID-19 Pandemic in 2020. With scarce literature, evidence, or best practices to draw from, countries around the world moved to flex their workforces to meet acute challenges of the pandemic, facing demands related to patient volume, patient acuity, and worker vulnerability and absenteeism. One early hypothesis suggested that the acute, short-term pandemic phase would be followed by several waves of resource demands extending over the longer term. However, as the acute phase of the pandemic abated, temporary workforce policies expired and others were repealed with a view of returning to “normal”. The workforce needs of subsequent phases of pandemic effects were largely ignored despite our new equilibrium resting nowhere near our pre-COVID baseline. In this paper, we describe Canada’s early pandemic workforce response. We report the results of an environmental scan of the early workforce strategies adopted in Canada during the first COVID wave of the COVID 19 pandemic. Within a three-part framework for supporting a sustainable health workforce, we describe 470 strategies and policies that aimed to increase the numbers and flexibility of health workers in Canada, and to maximise their continued availability to work. These strategies targeted all types of health workers and roles, enabling changes to the places health work is done, the way in which care is delivered, and the mechanisms by which it is regulated. Telehealth strategies and virtual care were the most prevalent, followed by role expansion, licensure flexibility, mental health supports for workers, and return to practice of retirees. We explore the degree to which these short-term, acute response strategies might be adapted or extended to support the evolving workforce’s long-term needs.

A useful solution for the management of COVID-19 pneumonia has been identified: oxygen therapy delivered using a high-flow nasal cannula (HFNC). Improved oxygenation and respiratory support are provided by this treatment. In patients who are being associated with HFNC for COVID-19 pandemic, this investigation aims to define whether or not the respiratory rate index (RRI) is useful as an early indicator of how well the treatment is working and how the patient would fare clinically. This study retrospectively examines COVID-19 pneumonia patients maintained with HFNC in a clinical setting. Data on respiratory rate (RR) was used to calculate a respiratory rate index that considered both rate and pattern. Fast respiratory rate index reductions during the first therapy improved oxygenation and reduced mechanical ventilation. The score predicted pharmaceutical responsiveness before other clinical markers made meaningful improvements. RR, OSIXR, and ROX index are questionable ventilator prevention strategies. We treated 128 COVID-19 respiratory failure patients who needed oxygen. A 64 HFNC-treated patients were retrospectively studied. The HFNC group was those who converted from the HFNC therapy to conventional oxygen therapy (COT), while the COT treatment was those who converted from the HFNC group to Non-invasive ventilation (NIV). HFNC patients were successful (24 of 64 (62%)). HFNC success had a considerably greater univariate RR improvement than COT. Logistic regression analysis (LRA) adjusted for respiratory development, age, and ROX index >6.66 showed that an enhanced RR predicted success. HFNC achievement groups had significantly lower COT durations than COT groups.

The EPICO-SEHOP platform gathers data from children with SARS-CoV-2 in Spain, allowing comparison between children with cancer or allogeneic hematopoietic stem cell transplantation (alloHSCT) and those without. The infection is milder in the cancer/alloHSCT group than in children without comorbidities (7.1% vs. 15%), except in children with recent alloHSCT (less than 300 days), of which 35.7% experienced severe COVID-19. These data have been shared with the SEHOP members to support treatment and isolation policies akin to those for children without cancer, except for those with recent alloHSCT or additional comorbidities. This highlights the collaborative registries potential in managing pandemic emergencies.

Objective: This study aims to evaluate the prevalence of long COVID infections and their influencing factors among primary HCWs after epidemic control policy adjustment in Jiangsu. Methods: A self-designed questionnaire was administered through on-site surveys among primary HCWs in five counties and districts within Jiangsu Province from July 4 to July 20, 2023. Results: The prevalence of long COVID among primary HCWs stood at 12.61% (95% confidence interval (CI) of 11.67%-13.55%). The most common long COVID symptoms were hypomnesia (4.90%), sleep difficulties (2.73%), fatigue (2.35%), disturbances in the reproductive system (1.93%), hair loss (1.85%), and myalgia/arthralgia (1.51%). Multivariate logistic regression revealed that older age groups (30-45 years (adjusted odds ratios (aOR) =1.93, 95%CI: 1.44-2.58), 45-60 years (aOR=2.82, 95%CI: 2.07-3.84)), females (aOR=1.26, 95%CI: 1.03-1.55), and higher work stress (high stress (aOR=1.52, 95%CI: 1.24-1.86), extremely high stress (aOR=1.37, 95%CI: 1.03-1.82)) were more prone to long COVID. Conversely, individuals with educational attainment below the bachelor’s degree (aOR=0.67, 95%CI: 0.55-0.82) and those who received four or more doses of the COVID-19 vaccine (aOR=0.55, 95%CI: 0.33-0.92) were at a reduced risk. Conclusion: To mitigate the incidence of long COVID, healthcare providers and authorities should implement effective measures, including optimizing work-rest schedules and actively advocating for vaccination.

A document by Jorge Quarleri. Click on the document to view its contents.

Since the Brown v. Board of Education decision, the plight of Black educators continues to be one of resilience and resistance. One important question is how Black teachers continue to live out Brown’s mission while navigating the effects of COVID-19. Using Givens’ (2021) Fugitive Pedagogy framework this narrative inquiry explored Black Women teachers’ attempts to fulfill the promise of the Brown decision. We found that participants enacted the following forms of resistance: a) intellectual acts of subversion, b) fictive kinship, and c) enacting shared vulnerability. Findings shine a light on the complexities of exhibiting resistance in anti-Black K-12 classrooms.

Background Considering the course of the current SARS CoV 2 pandemic, it is important to have serological tests for the detection of the anti-SARS CoV-2 humoral immune response for monitoring and prognosis the different stages of the disease. Purpose Herein we describe a novel bridge enzyme-linked immunosorbent assay (b-ELISA) for SARS-CoV-2 antibodies detection in human and other species, employing recombinant Spike protein as a unique antigen, which is produced at high scale in insect larvae. Results Eighty two human control sera/plasmas and 169 COVID-19 patients’ sera/plasmas, confirmed by rRT-PCR, were analysed by the b-ELISA assay. Out of the 169 patient samples, 129 were positive for IgG anti-SARS-CoV-2 and 40 were negative when they were tested by ELISA COVIDAR® IgG. When a cut-off value of 5.0 SDs was established, 124 out of the 129 COVID-19 positive samples were also positive by our developed b-ELISA (sensitivity: 96.12%). A total of 27 animal sera (5 horses, 13 rats, 2 cats and 7 dogs) were employed in order to evaluate the b-ELISA in other animal species. Conclusion The obtained results demonstrate that the method developed herein is versatile, as it is able to detect antibodies anti-SARS-CoV-2 in different animal species without the need to perform and optimize a new assay for each species.

Objective: To describe the prevalence, profile and clinical outcomes of pregnant women with COVID-19 admitted to a tertiary facility in Gauteng, South Africa Design: Retrospective review Setting: An academic hospital in Johannesburg, South Africa Population: Two-hundred and four (204) pregnant women with COVID-19 admitted between 6 March and 30 August 2020 Methods: Patient data was captured on discharge or death from paper-based clinical files onto a digital database Main Outcome Measures: Rates of mortality and/or admission to ICU, symptomatic versus asymptomatic disease, maternal and fetal outcome and mode of delivery. Results: A final cohort of 204 pregnant women were included in the study. Thirty three (16.2%) women were critically ill, with 21 (10.3%) admitted to the ICU and 3 (1.5%) deaths related to COVID-19. Conclusions: COVID-19 related mortality in our cohort was higher than that seen internationally, likely due to differences in background maternal mortality rates and difficulty in accessing care.

In the face of the rapid emergence and spread of new variants of the type 2 coronavirus causing acute respiratory syndrome, it is necessary to seek new pharmacological treatments for the disease, especially for patients infected by the new and more aggressive variants of the virus. In the present work, we selected ~18,000 compounds with similar structure to GRL0617 (Tanimoto index greater than 80 %) from the PubChem database with ~109 million compounds. Molecular docking was used to assess the affinity of the selected compounds, in which GRL0617 was included as an internal control. Then, based on the ligand efficacy index obtained as molecular docking, 500 compounds with higher affinity than GRL0617 for papain-like protease were considered. Finally, based on ADME parameters within the acceptable range for a drug, the seven best compounds were selected. Next, 200 ns molecular dynamics simulation studies, ∆G calculations using generalized Born and surface continuous solvation molecular dynamics, and quantum mechanical calculations were performed with the selected candidates. Using this In Silico protocol, seven papain-like protease inhibitors are proposed: three compounds with binding free energy like GRL0617 (D28, D04 and D59), three compounds with higher binding free energy than GRL0617 (D60, D99 and D06) and one compound (D24) that binds to a region of the enzyme that could block inhibition by the host immune system. The compounds proposed in this study could be used for invitro testing or smart drug design, accelerating the development of an effective treatment for this disease.

Since SARS-CoV-2 emerged in China, it has spread rapidly around the world. Effective vaccines and therapeutics for SARS-CoV-2−induced disease (coronavirus disease 2019; COVID19) are urgently needed. In order to assess the immune response to immunization with SARS-CoV-2 and the ability of the immune serum to neutralize the virus infection, we immunized a llama ( Lama glama) with the inactivated SARS-CoV-2 virus, and tested serum samples with an ELISA assay specific to the SARS-CoV-2, and viral neutralization by plaque-reduction neutralization test (PRNT). An increase in seroreactivity was observed for the immunized llama from week 4 onward, revealing seroconversion induced by the immunization, with the highest antibody titers on the 8 th boost. On the reactive serum sample, we performed Western Blot analysis that confirmed the positive ELISA findings, and antibodies from immune serum recognized various viral proteins. The gold standard PRNT showed a visible viral neutralization corresponding with ELISA results. Thus, our findings suggest this llama hyperimmune serum as a possible source of therapeutically antibodies against the SARS-CoV-2 virus infections to evaluate in further studies.

Objective: To describe the alterations of the composition of vaginal microbiota in pregnant women with COVID-19. Design: Prospective observational single-centre study Setting: Tertiary referral hospital Participants: Pregnant women with COVID-19 Methods: The vaginal swabs were collected during the active phase of infection and consecutively, within a month after recovering from infection. In three patients, longitudinal samples before, in the course, and after infection were also obtained. The microbiome alterations were examined by 16S rRNA gene sequencing. Main outcome measures: Vaginal microbiota profiles in pregnant women with COVID-19 Results: Nineteen pregnant women with COVID-19 and 28 healthy controls who were matched according to the maternal age and gestational week were recruited. Shannon index and inverse Simpson index for cross-sectional cohort indicate that alpha diversity is significantly higher in women with COVID-19 (P=0.007 and P=0.006, respectively). There was a significantly decrease in Firmicutes (P=0.007) and Lactobacillus (P=0.019) with an increase in Bacteroidetes (P=0.024) in women with COVID-19 when compared to those of healthy controls. The higher amounts of Ureaplasma were found in women with the moderate/severe disease, compared to those of the asymptomatic/mild disease (P=0.001). Lactobacillus gasseri disappeared in women with the moderate/severe disease. Prevotella timonensis was identified only in the COVID-19 group. In longitudinal analysis, Actinobacteria was elevated, Firmicutes and Bacteroides depleted during the active phase. Conclusion: The study revealed that vaginal dysbiosis with a low abundance of Lactobacillus and an increase in Bacteroidetes is associated with COVID-19.

A document by Taruna Agrawal. Click on the document to view its contents.

Major marine natural products (MNPs) and marine organisms include sea urchin, sea squirts or ascidians, sea cucumbers, sea snake, sponge, soft coral, marine algae, and microalgae. As vital biomedical resources for the discovery of marine drugs, bioactive molecules, and agents for treatment of infectious diseases and major non-communicable diseases (mNCDs), these MNPs have bioactive potentials of antioxidant, anti-infection, anti-inflammatory, anticoagulant, anti-diabetic effects, cancer treatment, and improvement of human immunity. This article reviews MNPs as huge and novel biomedical resources for anti-infection of coronavirus, SARS-CoV-2 and its major variants (such as Delta and Omicron), as well tuberculosis, H. Pylori, and HIV infection, and as promising biomedical resources for infection related cardiovascular disease (irCVD), diabetes, and cancer. The anti-inflammatory mechanisms of current MNPs against SARS-CoV-2 infection are also involved. Moreover, since the use of other chemical agents for COVID-19 treatment are associated with some adverse effects in cardiovascular system, MNPs have more therapeutic advantages. Herein, it’s time to protect this ecosystem for better sustainable development in the new era of ocean economy, since MNPs are indeed huge, novel and promising biomedical resources for anti-infection of SARS-CoV-2 and its major variants as well as irCVD. The novel potential mechanisms may be through multiple targets and pathways regulating human immunity and inhibiting inflammation. In short, MNPs are worthy of translational research for further clinical application.

We outline the operational model and outcomes of a successful Maternity Virtual Ward (MVW) established during the SARS-CoV-2 pandemic. Between October 2021 and February 2022, 429 patients were referred, of which 228 were admitted to the MVW. Total bed-days was 1,182, mean length of stay was 6 days (SD 2.3, range 1-14 days). Fifteen (6.6%) required hospital admission and one (0.4%) critical care. There were no deaths. Patients alluded to increased safety, comfort, and ease with the technology. Attention should be given to identifying clinical champions, triage criteria, technology selection, and flexible escalation pathways, adaptable to changing patterns of disease.

Remdesivir has appeared to be the most effective medication against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and is broadly administered to the coronavirus disease 2019 (COVID-19) patients around the world. Remdesivir is an RNA polymerase inhibitor with a broad spectrum of antiviral activities against RNA viruses in in-vitro and in-vivo models of SARS-CoV, the Middle East respiratory syndrome (MERS), and SARS-CoV-2. Remdesivir is the first Food and Drug Administration (FDA) approved anti-SARS-CoV-2 treatment for adult and pediatric patients and has been used intravenously for patients requiring hospitalization for COVID-19. However, questions have been raised about the value of remdesivir in treating COVID-19, and governing bodies worldwide have been hesitant to approve this medication. Nevertheless, in the context of the public health emergency and the urgent need for effective treatments for patients with COVID-19, remdesivir has been approved by several authorities worldwide. Here, we discuss characteristics and applications of remdesivir, and various challenging studies with different outcomes about its efficacy are also reviewed.

Aim: To examine the effects of drug use in the last 6 months before contracting coronavirus disease-2019 (COVID-19) on the clinical course of COVID-19. Methods: In this retrospective cohort study, which included 525 patients diagnosed with COVID-19 between March and November 2020 from four different family health centers in Istanbul, the records of the patients were retrospectively analyzed. In addition to demographic information, all medications used by the patients in the last 6 months before the diagnosis of COVID-19 were noted. The effects of demographic data and medications on the three main endpoints of the study, which were hospitalization, intensive care unit (ICU) admission, and mortality, were analyzed by using logistic regression models. Results: Of the 525 COVID-19 patients included in the study, 109 (20.8%) were hospitalized, 18 (3.4%) were treated in ICU, and 11 (2.1%) patients died. While increasing age is associated with hospitalization, ICU admission and mortality; also, the presence of COVID-19 thoracic computed tomography (CT) findings and polypharmacy were associated with an increased hospitalization; living alone and the presence of COVID-19 thoracic CT findings were associated with an increased ICU admission. When adjusted for age and comorbidity, logistic regression models revealed that medications for diabetes mellitus (DM) increased the probability of hospitalization (OR=3.9, 95% CI 1.2-13.0), and calcium channel blockers (CCBs) increased the probability of ICU admission (OR=15.8, 95% CI 2.1-120.2) and mortality (OR=295.1, 95% CI 4.6-18946.6). Conclusion: Previously utilization of DM medications and CCBs may have negative effects on the clinical course of COVID-19.