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    Antimicrobial and anti-viral effects of selenium nanoparticles and selenoprotein based strategies: COVID-19 and beyond
    (Editions de Sante, 2023-06-08T00:00:00) Khurana, Amit; Allawadhi, Prince; Singh, Vishakha; Khurana, Isha; Yadav, Poonam; Sathua, Kshirod Bihari; Allwadhi, Sachin; Banothu, Anil Kumar; Navik, Umashanker; Bharani, Kala Kumar
    Deficiency of selenium (Se) has been described in a significant number of COVID-19 patients having a higher incidence of mortality, which makes it a pertinent issue to be addressed clinically for effective management of the COVID-19 pandemic. Se nanoparticles (SeNPs) provide a unique option for managing the havoc caused by the COVID-19 pandemic. SeNPs possess promising anti-inflammatory and anti-fibrotic effects by virtue of their nuclear factor kappa-light-chain-stimulator of activated B cells (NF?B), mitogen-activated protein kinase (MAPKs), and transforming growth factor-beta (TGF-?) modulatory activity. In addition, SeNPs possess remarkable immunomodulatory effects, making them a suitable option for supplementation with a much lower risk of toxicity compared to their elemental counterpart. Further, SeNPs have been shown to curtail viral and microbial infections, thus, making it a novel means to halt viral growth. In addition, it can be administered in the form of aerosol spray, direct injection, or infused thin-film transdermal patches to reduce the spread of this highly contagious viral infection. Moreover, a considerable decrease in the expression of selenoprotein along with enhanced expression of IL-6 in COVID-19 suggests a potential association among selenoprotein expression and COVID-19. In this review, we highlight the unique antimicrobial and antiviral properties of SeNPs and the immunomodulatory potential of selenoproteins. We provide the rationale behind their potentially interesting properties and further exploration in the context of microbial and viral infections. Further, the importance of selenoproteins and their role in maintaining a successful immune response along with their association to Se status is summarized. � 2023 Elsevier B.V.
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    COVID-19-associated rhino-orbital-cerebral mucormycosis: A systematic review, meta-analysis, and meta-regression analysis
    (Wolters Kluwer Medknow Publications, 2021-12-30T00:00:00) Bhattacharyya, Anusuya; Sarma, Phulen; Kaur, Hardeep; Kumar, Subodh; Bhattacharyya, Jaimini; Prajapat, Manisha; Prakash, Ajay; Sharma, Saurabh; Reddy, Dibbanti Harikrishna; Thota, Prasad; Bansal, Seema; Gautam, Bhaswati Sharma; Medhi, Bikash
    BACKGROUND: Till now, no meta-analysis is available to address the clinical profile, risk factors, different interventions, and outcomes among COVID-19-associated rhino-orbito-cerebral mucormycosis (C-ROCM) cases. MATERIALS AND METHODS: Eight literature databases were screened using appropriate keywords from November 1, 2019, to June 30, 2021. The objectives were to analyze the clinical and microbiological profile, risk factor/comorbidity, intervention, and outcome. 'R-metafor package' was used for analysis. RESULTS: A total of 23 studies were included. The mean age of presentation of C-ROCM was 54.6 years. The most common presentation was ptosis (72.7%), lid edema (60.6%), proptosis (60.6%), ophthalmoplegia (57.3%), loss of vision (53.7%), facial edema (34.7%), and nasal-blockage (11.8%). Evidence of intracranial spread was seen in 42.8% of cases. Rhizopus was the most common fungus (57.1%) isolated in fungal culture. Among C-ROCM patients, diabetes was the commonest comorbid condition, and the use of corticosteroids related to COVID-19 treatment was the most common risk factor (85.75%). Compared to controlled diabetics, C-ROCM was significantly higher among uncontrolled diabetics (odds ratio [OR] 0.15, 95% confidence interval [C.I.] 0.041-0.544, P = 0.0010). However, no significant association was seen between C-ROCM and COVID-19 severity (OR 0.930, 95% C.I. 0.212-4.087, P = 0.923). For treatment, amphotericin-B was the most common antifungal drug used which was followed by surgical options. However, mortality was high (prevalence 0.344, 95% C.I. 0.205-0.403) despite treatment. CONCLUSION: Although local rhino-orbito symptoms were the first to appear, rapid intracranial extension was seen in a significant number of C-ROCM cases. Uncontrolled diabetes and excessive use of corticosteroid were the most common risk factors present among the C-ROCM cases. High index clinical suspicion is imperative (specifically among COVID-19 patients with diabetes), and routine screening may be helpful. � 2021 Indian Journal of Pharmacology Published by Wolters Kluwer-Medknow.
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    Rhino-orbital-cerebral-mucormycosis in COVID-19: A systematic review
    (Wolters Kluwer Medknow Publications, 2021-08-18T00:00:00) Bhattacharyya, Anusuya; Sarma, Phulen; Sharma, Dibya; Das, Karuna; Kaur, Hardeep; Prajapat, Manisha; Kumar, Subodh; Bansal, Seema; Prakash, Ajay; Avti, Pramod; Thota, Prasad; Reddy, Dibbanti; Gautam, Bhaswati; Medhi, Bikash
    Since the onset of COVID-19 pandemic, parallel opportunistic infections have also been emerging as another disease spectrum. Among all these opportunistic infection, mucormycosis has become a matter of concern with its rapid increase of cases with rapid spread as compared to pre-COVID-19 era. Cases have been reported in post-COVID-19-related immune suppression along with the presence of comorbidity which adds on the deadly outcome. There is no systematic review addressing the issue of COVID-19-Associated mucormycosis. This is the first systematic review of published studies of mucormycosis associated with COVID-19. The aim was to analyze the real scenario of the disease statement including all the published studies from first November 2019 to 30th June to analyze the contemporary epidemiology, clinical manifestations, risk factor, prognosis, and treatment outcome of COVID-19 associated rhino-orbito-cerebral-mucormycosis. A comprehensive literature search was done in following databases, namely, PubMed, Google Scholar, Scopus, and EMBASE using keywords mucormycosis, rhino orbital cerebral mucormycosis, COVID-19, and SARS-CoV-2 (from November 01, 2019 to June 30, 2021). Our study shows that, while corticosteroids have proved to be lifesaving in severe to critical COVID-19 patients, its indiscriminate use has come with its price of rhino-orbito-cerebral mucormycosis epidemic, especially in India especially in patients with preexisting diabetes mellitus with higher mortality. Corticosteroid use should be monitored and all COVID-19 patients should be closely evaluated/monitored for sequelae of immunosuppression following treatment. � 2021 Wolters Kluwer Medknow Publications. All rights reserved.
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    Decorin as a possible strategy for the amelioration of COVID-19
    (Churchill Livingstone, 2021-05-20T00:00:00) Allawadhi, Prince; Singh, Vishakha; Khurana, Isha; Rawat, Pushkar Singh; Renushe, Akshata Patangrao; Khurana, Amit; Navik, Umashanker; Allwadhi, Sachin; Kumar Karlapudi, Satish; Banothu, Anil Kumar; Bharani, Kala Kumar
    Coronavirus pandemic has emerged as an extraordinary healthcare crisis in modern times. The SARS-CoV-2 novel coronavirus has high transmission rate, is more aggressive and virulent in comparison to previously known coronaviruses. It primarily attacks the respiratory system by inducing cytokine storm that causes systemic inflammation and pulmonary fibrosis. Decorin is a pluripotent molecule belonging to a leucine rich proteoglycan group that exerts critical role in extracellular matrix (ECM) assembly and regulates cell growth, adhesion, proliferation, inflammation, and fibrogenesis. Interestingly, decorin has potent anti-inflammatory, cytokine inhibitory, and anti-fibrillogenesis effects which make it a potential drug candidate against the COVID-19 related complications especially in the context of lung fibrosis. Herein, we postulate that owing to its distinctive pharmacological actions and immunomodulatory effect, decorin can be a promising preclinical therapeutic agent for the therapy of COVID-19. � 2021 Elsevier Ltd
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    Role of vitamins and minerals as immunity boosters in COVID-19
    (Springer Science and Business Media Deutschland GmbH, 2021-06-10T00:00:00) Kumar, Puneet; Kumar, Mandeep; Bedi, Onkar; Gupta, Manisha; Kumar, Sachin; Jaiswal, Gagandeep; Rahi, Vikrant; Yedke, Narhari Gangaram; Bijalwan, Anjali; Sharma, Shubham; Jamwal, Sumit
    Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) known as coronavirus disease (COVID-19), emerged in Wuhan, China, in December 2019. On March 11, 2020, it was declared a global pandemic. As the world grapples with COVID-19 and the paucity of clinically meaningful therapies, attention has been shifted to modalities that may aid in immune system strengthening. Taking into consideration that the COVID-19 infection strongly affects the immune system via multiple inflammatory responses, pharmaceutical companies are working to develop targeted drugs and vaccines against SARS-CoV-2 COVID-19. A balanced nutritional diet may play an essential role in maintaining general wellbeing by controlling chronic infectious diseases. A balanced diet including vitamin A, B, C, D, E, and K, and some micronutrients such as zinc, sodium, potassium, calcium, chloride, and phosphorus may be beneficial in various infectious diseases. This study aimed to discuss and present recent data regarding the role of vitamins and minerals in the treatment of COVID-19. A deficiency of these vitamins and minerals in the plasma concentration may lead to a reduction in the good performance of the immune system, which is one of the constituents that lead to a poor immune state. This is a narrative review concerning the features of the COVID-19 and data related to the usage of vitamins and minerals as preventive measures to decrease the morbidity and mortality rate in patients with COVID-19. � 2021, The Author(s), under exclusive licence to Springer Nature Switzerland AG.
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    Can bilirubin nanomedicine become a hope for the management of COVID-19?
    (Churchill Livingstone, 2021-02-15T00:00:00) Khurana, Isha; Allawadhi, Prince; Khurana, Amit; Srivastava, Amit Kumar; Navik, Umashanker; Banothu, Anil Kumar; Bharani, Kala Kumar
    Bilirubin has been proven to possess significant anti-inflammatory, antioxidant and antiviral activities. Recently, it has been postulated as a metabolic hormone. Further, moderately higher levels of bilirubin are positively associated with reduced risk of cardiovascular diseases, diabetes, metabolic syndrome and obesity. However, due to poor solubility the therapeutic delivery of bilirubin remains a challenge. Nanotechnology offers unique advantages which may be exploited for improved delivery of bilirubin to the target organ with reduced risk of systemic toxicity. Herein, we postulate the use of intravenous administration or inhalational delivery of bilirubin nanomedicine (BNM) to combat systemic dysfunctions associated with COVID-19, owing to the remarkable preclinical efficacy and optimistic results of various clinical studies of bilirubin in non-communicable disorders. BNM may be used to harness the proven preclinical pharmacological efficacy of bilirubin against COVID-19 related systemic complications. � 2021 Elsevier Ltd
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    Insight into the liver dysfunction in COVID-19 patients: Molecular mechanisms and possible therapeutic strategies
    (Baishideng Publishing Group Inc, 2023-04-12T00:00:00) Khullar, Naina; Bhatti, Jasvinder Singh; Singh, Satwinder; Thukral, Bhawana; Hemachandra Reddy, P.; Bhatti, Gurjit Kaur
    As of June 2022, more than 530 million people worldwide have become ill with coronavirus disease 2019 (COVID-19). Although COVID-19 is most commonly associated with respiratory distress (severe acute respiratory syndrome), meta-analysis have indicated that liver dysfunction also occurs in patients with severe symptoms. Current studies revealed distinctive patterning in the receptors on the hepatic cells that helps in viral invasion through the expression of angiotensin-converting enzyme receptors. It has also been reported that in some patients with COVID-19, therapeutic strategies, including repurposed drugs (mitifovir, lopinavir/ritonavir, tocilizumab, etc.) triggered liver injury and cholestatic toxicity. Several proven indicators support cytokine storm-induced hepatic damage. Because there are 1.5 billion patients with chronic liver disease worldwide, it becomes imperative to critically evaluate the molecular mechanisms concerning hepatotropism of COVID-19 and identify new potential therapeutics. This review also designated a comprehensive outlook of comorbidities and the impact of lifestyle and genetics in managing patients with COVID-19. � The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
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    Currently available COVID-19 management options
    (Elsevier, 2023-01-20T00:00:00) Ludhiadch, Abhilash; Yadav, Umesh Prasad; Munshi, Anjana
    The pandemic caused by new coronavirus (COVID-19), i.e., severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), started from the Wuhan state of China. COVID-19 is a novel infectious disease characterized by atypical pneumonia with the symptoms like fever, sore throat, fatigue, cough, and dyspnea. As of January 2022, more than 298 million people have been infected with SARS-CoV-2 (WHO). Changes in personal behavior like the use of face masks, proper hand hygiene, social distancing, and some interventions and control measures led by Governments all over the world resulted in decline of SARS-CoV-2 infections globally. The main concern of this pandemic is the risk of transmission and reinfection with new variants of COVID-19, and therefore, this COVID-19 pandemic is still a matter of great concern. It is a major challenge for clinicians and researchers worldwide to develop a specific strategy to eliminate this virus. The complications on account of COVID-19 disease manifest from mild to moderate. Only 5%�10% of the cases show severe and life-threatening complications with an approximately 2% of death rate worldwide [1]. Based on the severity of infection the National Institutes of Health (NIH) has classified COVID-19 into five different stages: asymptomatic infection, mild illness, moderate illness, severe illness, and critical illness [2]. Currently, many supportive measures such as ventilation systems and fluid management are being followed to save lives, but there is a dire need to develop antiviral treatment strategy to counter the spread of this virus completely. The treatment strategies also include blocking of enzymes or proteins that are essential for the survival of the virus, inhibition of viral structural proteins to prevent the affinity with human cells or virion formation, further by stimulating the immunity of the host, and inhibition of receptors in host that aid in entry of the virus. Currently, battling COVID-19 is the top most priority in the scientific world. Various pharmaceutical companies and research fraternities around the globe are working on interventions to reduce the impact of SARS-CoV-2 and prevent subsequent infections. Many clinical trials and animal studies are being carried out to identify the most potent drug alone or combination against the disease. The management of COVID-19 is being achieved by general treatment, specific treatments, and supplementation of vitamins and essential micronutrients like zinc and magnesium. General treatment strategies basically include antiviral therapies, antiinflammatory therapies and use of corticosteroids. The treatment of critically ill patients includes specific treatment strategies such as the use of anti-SARS-CoV-2 neutralizing antibody products, immunomodulatory agents, and oxygenation and ventilation management. Supplementation with vitamin C, vitamin D, magnesium, zinc, etc., is also being used to reduce the symptoms during the course of infection. SARS-CoV-2 infection also poses a risk of developing post-COVID-19 complications in the patients who suffered severe infection [3]. The management of post-COVID complications is currently under focus and there is a need to manage such patients with proper care. The post-COVID complications affect multiple organ systems such as cardiovascular, pulmonary, gastrointestinal, hepatic, neuropsychiatric, hematologic, and several others. Developing a significantly potent treatment will help the medical fraternity to eradicate the virus without overburdening the existing healthcare system. This chapter has been compiled with an aim to sum up information on currently available treatment strategies and management for COVID-19. � 2023 Elsevier Inc. All rights reserved.