Nanotechnology for the management of COVID-19 during the pandemic and in the post-pandemic era

Following the global COVID-19 pandemic, nanotechnology has been at the forefront of research efforts and enables the fast development of diagnostic tools, vaccines and antiviral treatment for this novel virus (SARS-CoV-2). In this review, we first summarize nanotechnology with regard to the detection of SARS-CoV-2, including nanoparticle-based techniques such as rapid antigen testing, and nanopore-based sequencing and sensing techniques. Then we investigate nanotechnology as it applies to the development of COVID-19 vaccines and anti-SARS-CoV-2 nanomaterials. We also highlight nanotechnology for the post-pandemic era, by providing tools for the battle with SARS-CoV-2 variants and for enhancing the global distribution of vaccines. Nanotechnology not only contributes to the management of the ongoing COVID-19 pandemic but also provides platforms for the prevention, rapid diagnosis, vaccines and antiviral drugs of possible future virus outbreaks.     

An Unusual Presentation of Superior Mesenteric Venous Occlusion in Mild COVID-19

SARS-CoV-2, an etiological agent of COVID-19, has been reported to inflict remarkably diverse manifestations in different subjects across the globe. Though patients with COVID-19 predominantly have fever, respiratory and constitutional symptoms, atypical presentations are becoming increasingly evident.COVID-19 may predispose to both venous and arterial thromboembolism due to excessive inflammation, hypoxia, immobilization, and diffuse intravascular coagulation in moderate to severe symptomatic cases. In this case report, we are reporting thromboembolic complications of COVID-19 in a mild symptomatic subject incidentally diagnosed with mesenteric venous occlusion with no abdominal symptoms.Early recognition of the abdominal symptoms, diagnosis, initiation of anticoagulants, and timely surgical intervention may improvise the outcome in a patient with COVID-19 infection-induced mesenteric thrombosis. Superior mesenteric artery and venous thrombosis may lead to subsequent ischemia necessitating emergency laparotomy. Thus, the usage of low-dose anticoagulants in all the patients of COVID-19 irrespective of the categorization into mild, moderate, and severe COVID-19 disease should be considered.     

Seroprevalence of SARS-CoV-2 infection among children in Children’s Hospital Zagreb during the initial and second wave of COVID-19 pandemic in Croatia

IntroductionThe study aimed to investigate the prevalence and titres of anti-SARS-CoV-2 antibodies in children treated at the Children’s Hospital Zagreb in the first and the second wave of the COVID-19 pandemic. Statistical significance of difference at two time points was done to determine how restrictive epidemiological measures and exposure of children to COVID-19 infection affect this prevalence in different age groups.Materials and methodsAt the first time point (13th to 29th May 2020), 240 samples and in second time point (24th October to 23rd November 2020), 308 serum samples were tested for anti-SARS-CoV-2 antibodies by enzyme-linked immunosorbent assay (ELISA) and electrochemiluminescence immunoassay (ECLIA). Confirmation of results and titre determination was done using virus micro-neutralization test. Subjects were divided according to gender, age and epidemiological history.ResultsSeroprevalence of anti-SARS-CoV-2 antibodies differs significantly in two time points (P = 0.010). In first time point 2.9% of seropositive children were determined and in second time point 8.4%. Statistically significant difference (P = 0.007) of seroprevalence between two time points was found only in a group of children aged 11-19 years. At the first time point, all seropositive children were asymptomatic with titre < 8. At the second time point, 69.2% seropositive children were asymptomatic with titre ≥ 8.ConclusionsThe prevalence of anti-SARS-CoV-2 antibodies was significantly lower at the first time point than at the second time point. Values of virus micro-neutralization test showed that low titre in asymptomatic children was not protective at the first time point but in second time point all seropositive children had protective titre of anti-SARS-CoV-2 antibodies.     

Agile and adaptive governance in crisis response: Lessons from the COVID-19 pandemic

Countries around the world have had to respond to the COVID-19 outbreak with limited information and confronting many uncertainties. Their ability to be agile and adaptive has been stressed, particularly in regard to the timing of policy measures, the level of decision centralization, the autonomy of decisions and the balance between change and stability. In this contribution we use our observations of responses to COVID-19 to reflect on agility and adaptive governance and provide tools to evaluate it after the dust has settled. Whereas agility relates mainly to the speed of response within given structures, adaptivity implies system-level changes throughout government. Existing institutional structures and tools can enable adaptivity and agility, which can be complimentary approaches. However, agility sometimes conflicts with adaptability. Our analysis points to the paradoxical nature of adaptive governance. Indeed, successful adaptive governance calls for both decision speed and sound analysis, for both centralized and decentralized decision-making, for both innovation and bureaucracy, and both science and politics.     

新冠肺炎疫情对文旅经济的影响及思考

分析疫情对文旅经济的影响,阐述对疫情过后文旅经济发展的判断和思考,以及疫情之下夜游经济的发展趋势等。     

新冠疫苗核心免疫原的专利分析

本文基于已公布的新冠病毒(COVID-19)疫苗专利或文献,分析了我国目前研发的新型冠状病毒疫苗核心免疫原,着重关注其中可能涉及的S-2P知识产权风险,并对我国利用该技术发展相关疫苗提出了建议.     

The response of total testing process in clinical laboratory medicine to COVID-19 pandemic

IntroductionFollowing a pandemic, laboratory medicine is vulnerable to laboratory errors due to the stressful and high workloads. We aimed to examine how laboratory errors may arise from factors, e.g., flexible working order, staff displacement, changes in the number of tests, and samples will reflect on the total test process (TTP) during the pandemic period.Materials and methodsIn 12 months, 6 months before and during the pandemic, laboratory errors were assessed via quality indicators (QIs) related to TTP phases. QIs were grouped as pre-, intra- and postanalytical. The results of QIs were expressed in defect percentages and sigma, evaluated with 3 levels of performance quality: 25^th, 50^th and 75^th percentile values.ResultsWhen the pre- and during pandemic periods were compared, the sigma value of the samples not received was significantly lower in pre-pandemic group than during pandemic group (4.7σ vs. 5.4σ, P = 0.003). The sigma values of samples transported inappropriately and haemolysed samples were significantly higher in pre-pandemic period than during pandemic (5.0σ vs. 4.9σ, 4.3σ vs. 4.1σ; P = 0.046 and P = 0.044, respectively). Sigma value of tests with inappropriate IQC performances was lower during pandemic compared to the pre-pandemic period (3.3σ vs. 3.2σ, P = 0.081). Sigma value of the reports delivered outside the specified time was higher during pandemic than pre-pandemic period (3.0σ vs. 3.1σ, P = 0.030).ConclusionIn all TTP phases, some quality indicators improved while others regressed during the pandemic period. It was observed that preanalytical phase was affected more by the pandemic.     

Detection of COVID-19 using deep learning techniques and classification methods

Since the patient is not quarantined during the conclusion of the Polymerase Chain Reaction (PCR) test used in the diagnosis of COVID-19, the disease continues to spread. In this study, it was aimed to reduce the duration and amount of transmission of the disease by shortening the diagnosis time of COVID-19 patients with the use of Computed Tomography (CT). In addition, it is aimed to provide a decision support system to radiologists in the diagnosis of COVID-19. In this study, deep features were extracted with deep learning models such as ResNet-50, ResNet-101, AlexNet, Vgg-16, Vgg-19, GoogLeNet, SqueezeNet, Xception on 1345 CT images obtained from the radiography database of Siirt Education and Research Hospital. These deep features are given to classification methods such as Support Vector Machine (SVM), k Nearest Neighbor (kNN), Random Forest (RF), Decision Trees (DT), Naive Bayes (NB), and their performance is evaluated with test images. Accuracy value, F1-score and ROC curve were considered as success criteria. According to the data obtained as a result of the application, the best performance was obtained with ResNet-50 and SVM method. The accuracy was 96.296%, the F1-score was 95.868%, and the AUC value was 0.9821. The deep learning model and classification method examined in this study and found to be high performance can be used as an auxiliary decision support system by preventing unnecessary tests for COVID-19 disease.     

抗疫情助推我国数字化转型：机遇与挑战

近年来,我国数字经济蓬勃发展,赋能实体经济提质增效,成为经济增长的新动能。在2020年的新冠肺炎疫情中,新一代信息技术在疫情防控、生产生活物资保障、复工复产等各环节得到广泛应用,助力科学防控、精准施控,也为我国经济社会全面数字化转型带来新的机遇。文章聚焦当前疫情影响下我国政府、产业、企业、社会的数字化转型机遇,分析了疫情中数字化转型存在的问题与挑战,提出了加快我国经济社会全面数字化转型的政策建议,具体包括:(1)加快推进政府数字化转型,提高政府治理现代化水平;(2)深化新一代信息技术在垂直细分领域的融合发展,丰富应用场景;(3)推动产业互联网建设,促进各产业数字化水平均衡发展;(4)加强数字化转型中的数据治理,保障数据的高效安全使用。     

CRISPR/Cas-New Molecular Scissors in Diagnostics and Therapeutics of COVID-19

The current pandemic of COVID-19, with its climbing number of cases and deaths, has us searching for tools for rapid, reliable, and affordable methods of detection on one hand, and novel, improved therapeutic strategies on the other. The currently employed RT-PCR method, despite its all-encompassing utility, has its shortcomings. Newer diagnostic tools, based on the Clustered Regularly Interspaced Short Palindromic Repeats/Cas(CRISPR-Cas) system, with its better diagnostic accuracy measures, have come up to fill that void. These assay platforms are expected to slowly take up the place of COVID-19 diagnostics. Further, the current therapeutic options focus mainly on counteracting the viral proteins and components and their entry into host cells. The CRISPR-based system, especially through the RNA-guided Cas13 approach, can identify the genomic characteristics of SARS-CoV-2 and provide a novel inhibition strategy for coronaviruses. In this mini-review, we have discussed the available and upcoming CRISPR-based diagnostic assays and the potential of the CRISPR/Cas system as a therapeutic or prevention strategy in COVID-19. CRISPR-Cas system shows promise in both diagnostics as well as therapeutics and may as well change the face of molecular diagnosis and precision medicine.     

Sequential Profiling of Anti-SARS CoV-2 IgG Antibody in Post COVID-19 Patients

Upon SARS CoV-2 infection, humoral immune system triggers production of anti-SARS CoV-2 IgM and IgG antibodies. Currently, antibodies against SARS CoV-2 spike protein receptor binding domain play a central role in disease protection, making them potential target for in vitro diagnostics applications. This study determines the expression level and sustainability of anti-receptor binding domain (RBD) SARS CoV-2 IgG in post COVID-19 patients. Anti-RBD SARS CoV-2 IgG antibodies in patient serum were analysed by standardised indirect ELISA using SARS CoV-2 spike receptor binding domain protein and HRP conjugated anti-human IgG antibody (anti-h IgG). The study was conducted using 35 adult patient samples with confirmed SARS CoV-2 infection. Additionally, correlation between antibody response after each stage and disease symptoms in post COVID-19 patients were studied. Maximum antibody titre was seen at Day 40 and decreased relatively to Day 180 in antibody positive samples when compared with controls. Overall, more IgG antibody expression is observed in patients who suffered from loss of smell and taste at Day 40. 71% of the positive subjects in this study showed high SARS CoV-2 IgG antibody concentration of above 10 ng/mL and 37% showed strong antibody concentration above 20 ng/mL at the peak of seroconversion.     

The rise in preanalytical errors during COVID-19 pandemic

IntroductionThe COVID-19 pandemic has posed several challenges to clinical laboratories across the globe. Amidst the outbreak, errors occurring in the preanalytical phase of sample collection, transport and processing, can further lead to undesirable clinical consequences. Thus, this study was designed with the following objectives: (i) to determine and compare the blood specimen rejection rate of a clinical laboratory and (ii) to characterise and compare the types of preanalytical errors between the pre-pandemic and the pandemic phases.Materials and methodsThis retrospective study was carried out in a trauma-care hospital, presently converted to COVID-19 care centre. Data was collected from (i) pre-pandemic phase: 1^st October 2019 to 23^rd March 2020 and (ii) pandemic phase: 24^th March to 31^st October 2020. Blood specimen rejection rate was calculated as the proportion of blood collection tubes with preanalytical errors out of the total number received, expressed as percentage.ResultsTotal of 107,716 blood specimens were screened of which 43,396 (40.3%) were received during the pandemic. The blood specimen rejection rate during the pandemic was significantly higher than the pre-pandemic phase (3.0% versus 1.1%; P < 0.001). Clotted samples were the commonest source of preanalytical errors in both phases. There was a significant increase in the improperly labelled samples (P < 0.001) and samples with insufficient volume (P < 0.001), whereas, a significant decline in samples with inadequate sample-anticoagulant ratio and haemolysed samples (P < 0.001).ConclusionIn the ongoing pandemic, preanalytical errors and resultant blood specimen rejection rate in the clinical laboratory have significantly increased due to changed logistics. The study highlights the need for corrective steps at various levels to reduce preanalytical errors in order to optimise patient care and resource utilisation.     

Laboratory medicine in pandemic of COVID-19

After the outbreak in China in the year 2019, severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) quickly spread around the world causing a protracted pandemic. Approximately one-third of infections appear to be asymptomatic. Symptomatic disease is characterized primarily by symptoms of respiratory tract infection of varying severity. But Coronavirus Disease 2019 (COVID-19) is much more than an acute respiratory disease because SARS-CoV-2 affects many organs inducing a vast number of symptoms such as cardiovascular, neurological, gastrointestinal, dermatological, with numerous complications. Short and long-term effects of infection, severe ones, and especially mild forms of the disease which affect a huge number of patients need to be further investigated. Laboratory medicine has a crucial role in early diagnosis of the disease, recognition of the patients who need hospital care, and close monitoring of hospitalized patients to timely identify associated clinical complications as well as follow-up of patients with long-term COVID-19.     

Dynamic Changes in Circulatory Cytokines and Chemokines Levels in Mild to Severe COVID-19 Patients

Immune dysregulation is a key feature of the coronavirus disease-2019 (COVID-19). However, disparities in responses across ethnic groups are underappreciated. This study aimed to determine the relationship between chemokines and cytokines and the severity of COVID-19. Multiplex magnetic bead-based Luminex-100 was used to assess chemokine and cytokine levels in COVID-19 patients at admission (day-1) and after 4 days. The mean age of the patients recruited was 54.3 years, with 19 (63.3%) males. COVID-19 patients had significantly lower lymphocyte, monocyte, hemoglobin and eosinophil levels than controls (p < 0.05). COVID-19 patients showed significantly higher neutrophil levels than controls (p < 0.05). The baseline levels of IL-2, IL-6, IL-8, IL-10, and IFN-α/γ significantly increased in COVID-19 patients (p < 0.05). Chemokine levels (IP-10, MCP-1, MIG, and CCL-5) were significantly in COVID-19 patients. IL-8, IP-10, and MIG levels were significantly higher in the patients with severe COVID-19 (p < 0.05). Individuals with mild COVID-19 showed significantly higher levels of INF-α, IL-2, IL-6, and IL-8, whereas IL-10 levels were significantly lower (p < 0.05). TNF-levels decreased significantly in individuals with severe COVID-19, whereas IL-6, IL-8, and MIG levels increased (p < 0.05). After 4 days, INFα-, IL-2, IL-6, IL-8, IP-10, and MIG levels were significantly higher in patients with mild disease, whereas IL-6, MIG, and TNF-αlevels were significantly higher in patients with severe disease (p < 0.05). Thus, we conclude that COVID-19 is characterized by INF-α/γ, IL-6, IL-10, IP-10, MCP-1, MIG, and CCL5 dysregulation. IL-8, MIG, and IP-10 levels distinguish between moderate and severe COVID-19. Changes in INF-α, IL-2, IL-6, IL-8, IP-10, and MIG levels can be used to monitor disease progression.Supplementary InformationThe online version contains supplementary material available at 10.1007/s12291-022-01108-x.     

COVID-19 and Gut Microbiota: A Potential Connection

Currently, world is facing a global outbreak causing a pandemic threat known as COVID-19. This infectious disease is triggered by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2). Gut microbiota harbours multi species community with a strong impact on host immune homeostasis. However, our knowledge about this gut microbiota and its symbiotic relationship with immune activation in association with SARS-CoV-2 is limited. Unbalanced bacterial flora with too many opportunistic infections can shift immune system towards a cascade of inflammatory responses leading to multi organ damage. This review will highlight immune-regulation via various mechanisms in SARS-CoV-2 infection. Diet has an unbelievable influence on gut microbiome that allows a new state of homeostasis to be reached through timing, frequency and duration of intake. This review article focuses on gut, lung microbiota and immunomodulation with specific attention on immune activation by gut microbiota.     

Business optimism and the innovation-profitability nexus: Introducing the COVID-19 adaptable capacity framework

In this paper we develop a novel multi-stage integrative framework for technology foresight-planning. This framework integrates econometric analysis and a technology foresight procedure to predict: (i) the most COVID-19 resilient industries at the national level; and (ii) the most adversely affected industries (due to prior investment in innovation) that requires public support. Our econometric results show that the pandemic has induced a ‘double-edge sword’ effect of innovation on firm’s COVID-19 adaptable capacity (CAC). Costly innovation undertaken before the pandemic can be bad for firms if it compounds the problem of declining post-pandemic outbreak profit and optimism. Contrarily, firm level innovation improves firm’s CAC as the prior innovators’ profitability are found to have above-even odds of rebounding quickly post-pandemic outbreak. Our empirical analysis focuses mostly on developing economies, where firms are most likely implementing only incremental (non-frontier) innovation and thus our results should be generalized with caution.