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Recent evidence reported that some dietary compounds like quercetin and apigenin as the most well-known flavonoids with anti-inflammatory effects may inhibit SARS-CoV-2 main protease. The hypothesis of the promising effects and possible mechanisms of action of quercetin against COVID-19 were assessed in this article.

Related papers on the inhibitory effects of quercetin against COVID-19 were collected using the following search strategy: “corona or coronavirus or COVID or COVID-19 or viral or virus” AND “nutrient or flavonoid or Quercetin”.

The findings indicated that quercetin can be considered an effective agent against COVID-19 because of its SARS-CoV-2 main protease and RNA-dependent RNA polymerase inhibitory effects. In addition, quercetin may attenuate angiotensin-converting enzyme-2 (ACE-2) receptors leading to a reduction of SARS-CoV-2 ability to enter host cells. Moreover, the antiviral, anti-inflammatory, and immunomodulatory activities of quercetin have been frequently reported.

Quercetin may be an effective agent for managing the complications of COVID-19. Further longitudinal human studies are warranted.

Interleukin-6 is pro-inflammatory cytokine which plays a role in cytokine storm and brought into notice with corona virus disease of 2019. Lymphopenia and dysregulated immune response were seen in the critically ill patients of corona virus disease of 2019. IL-6 inhibitors were proposed as a treatment option in this pandemic with a concept that it will reduce inflammation, infection and organ failure. Tocilizumab, a monoclonal antibody against soluble and membrane IL‐6 receptors was considered as forefront treatment option as it was used previously in rheumatologic disorder as a licensed agent. Tocilizumab is an immunosuppressive agent and serious or fatal infections could occur. Presence of superimposed bacterial infections in critically ill patients with corona virus disease of 2019 should be aggressively treated. However clinical experiences showed higher rates of superimposed bacterial infections which renders for extreme caution while prescribing such therapies. Perspective is needed when using the rheumatologic literature of IL-6 into corona virus disease of 2019 and their range observed in these conditions.

SARS-CoV-2 is a newly discovered viral infection. It’s still unclear how antibodies react in infected individuals, and there is not enough evidence to support the clinical use of antibody examination. This study evalu- ates the diagnostic value of serologic tests for diagnosing COVID-19.

32 patients for whom serologic testing was performed within 7 to 21 days from symptom onset and whether they were diagnosed with COVID-19 by both PCR and lung HRCT as gold standard tests at the same time, were included in the study.

Serologic tests (IgM / IgG) compared to PCR and lung HRCT scan to diagnose COVID-19, were 89.3% specific and 59.6% sensitive. Positive predictive value (PPV) was 95% and negative predictive value (NPV) was 37%. The diagnostic accuracy index of the serologic test was 0.745 (CI 0.651-0.838) (p-value <0.001).

Serologic testing can be a complementary alternative for SARA-CoV-2 nucleic acid RT-PCR, although it can- not replace it completely. IgG/IgM combo test kits and RT-PCR together can give more insight into the diagnosis of SARS- CoV-2.

Context: 

Multisystem inflammatory syndrome in children (MIS-C) is a severe condition associated with SARS-CoV-2. The underlying reasons why some children develop MIS-C remain unclear.

To review and summarize the existing evidence about the epidemiological and clinical characteristics, laboratory findings, therapeutic management, and outcomes of patients with COVID-19-related MIS-C.

This systematic review followed PRISMA guidelines. We searched PubMed and Google Scholar for studies on COVID-19 and MIS-C. Out of the 2026 research articles generated from our initial search on PubMed and Google Scholar on 20 December 2022, 44 met the inclusion criteria and were included in the review. Data on demographics, clinical features, laboratory findings, treatment, and outcomes were extracted.

The median age of 7297 MIS-C patients was 8.6 years, with 59.2% being male. The most common symptoms were fever (98.7%), rash (55.2%), and conjunctivitis (52.8%). Obesity (27.1%) was the most prevalent comorbidity. Fifty percent of patients were admitted to pediatric intensive care; 631 received inotropes, and 374 required mechanical ventilation. Over 80% received IV immunoglobulin, and 77% received corticosteroids. Abnormal echocardiograms occurred in 77.5% of cases, with coronary artery aneurysms present in 18.5%. Most patients recovered, with a reported mortality rate of 1.7%.

Despite the limitations, our systematic review provides valuable insights into the characteristics and management of MIS-C based on existing global literature. While a large number of patients required intensive care and various therapeutic interventions, favorable short-term outcomes were demonstrated in the majority of patients, with notably low mortality rates.

The novel Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is primarily a respiratory virus. However, an increasing number of neurologic complications associated with this virus have been reported, e.g., transverse myelitis (TM). We report a case of a 39-year-old man admitted to Namazi Hospital affiliated with Shiraz University of Medical Sciences, Shiraz, Iran. In December 2020, the patient was infected with Coronavirus Disease 2019 (COVID-19). During hospitalization, the patient suffered from sudden onset of paraplegia, and urinary retention, and had a T6-T7 sensory level. TM was diagnosed and an extensive workup was performed to rule out other etiologies. Eventually, para-infectious TM associated with COVID-19 was concluded. The patient received pulse methylprednisolone therapy of 1 g/day for 10 consecutive days followed by seven sessions of plasma exchange without a favorable response. The patient then underwent regular physical rehabilitation and tapering oral administration of prednisolone 1 mg/Kg. As a result, weakness in the lower extremities improved slightly after six months. Overall, we suspect a correlation between COVID-19 and TM, however, further studies are required to substantiate the association.

Introduction:

Several clinical manifestations have been discovered for COVID-19 since the emergence of SARS-CoV-2,which can be classified into early, medium, and long-term complications. However, late complications can be presentafter recovery from acute COVID-19 illness. The present study aims to comprehensively review the available evidenceof late complications related to COVID-19.

A search was conducted, using keywords, through electronicdatabases, which included Scopus, Web of Science, PubMed, and Embase up to August 29, 2022. Study selection wasperformed according to a strict inclusion and exclusion criteria. The Preferred Reporting Items for Systematic reviewsand Meta-Analyses (PRISMA) checklist was followed, and studies were appraised using the National Institute of Health(NIH) quality assessment and risk of bias tool.

In total, 50 studies were included, and nine distinct COVID-19late complication categories were identified. A review of these studies revealed that neurologic and psychiatric (n=41),respiratory (n=27), musculoskeletal and rheumatologic (n=22), cardiovascular (n=9), and hepatic and gastrointestinal(n=6) complications were the most prevalent complications of long COVID-19.

Almost all human bodysystems are affected by late complications of COVID-19 with different severity and prevalence. Fatigue and some otherneuropsychiatric symptoms are the most common late complications among long COVID-19 patients. Respiratorysymptoms including dyspnea (during exercise), cough, and chest tightness were the next most prevalent long-termcomplications of COVID-19. Since these complications are persistent and late, being aware of the signs and symptomsis essential for the healthcare providers and patients.

We report a case of clinically amyopathic dermatomyositis (CADM) with anti-MDA5 positivity associated with rapidly progressive interstitial lung disease. The analogies between CADM-associated interstitial lung disease and coronavirus disease 2019 (COVID-19) pneumonia may hinder the diagnosis and delay the start of immunosuppressive therapy. High-resolution computed tomography revealed an evident worsening of the bilateral consolidation, interlobular septal thickening, and ground-glass opacities, highlighting the diagnosis of rapidly progressive interstitial lung disease. The radiological presentation, combined with the laboratory findings, underscored the diagnosis of CADM. In the following days, the respiratory failure progressed, and the patient required extracorporeal membrane oxygenation and lung transplantation. The typical cutaneous rash of dermatomyositis and non-pulmonary clinical differences can help the physician reach a correct diagnosis. Assessing patients with interstitial lung diseases during the COVID-19 pandemic is difficult. Through experience with systemic autoimmune diseases such as clinically amyopathic dermatomyositis, we can develop new pathophysiology models and therapeutic strategies for COVID-19.

 Currently, the global HIV epidemic remains ongoing, with a significant number of patients having undiagnosed advanced HIV disease. Providing medical care to patients with both COVID-19 and advanced HIV disease presents specific challenges due to the simultaneous lung damage caused by the SARS-CoV-2 virus and opportunistic pathogens.

 This study aimed to explain the rationale behind recommending HIV screening for patients with severe COVID-19.

 A single-center retrospective cohort study was conducted using electronic medical records from a specialized hospital in Moscow that focused on coinfection with HIV/COVID-19. Among the 3,563 patients hospitalized in the relevant departments during the study period, 408 patients were included based on the inclusion/exclusion criteria. Out of the 408 patients with both COVID-19 and advanced HIV disease, 132 individuals were newly diagnosed with HIV infection, while 276 individuals had a previously established HIV diagnosis.

 The mortality rate in the group of patients with COVID-19 and advanced HIV disease was 31.7% (95% CI, 27.3 - 36.3%). Among patients with COVID-19 and newly diagnosed advanced HIV disease, the mortality rate was 45.5% (95% CI, 37.1 - 54%), while in the group of patients with previously diagnosed advanced HIV disease, the mortality rate was 25% (95% CI, 20.2 - 30.4%). The proportion of individuals with critical CT-4 lung disease in the first group was 32.3% compared to 9.4% in the second group (P < 0.001).="" the="" median="" cd4+="" count="" was="" 20="" cells/µl="" in="" the="" first="" group="" compared="" with="" 88="" cells/µl="" in="" the="" second="" group="" (p=""><>

 The presence of pneumocystis pneumonia increased the risk of death by 2.51 times in patients with COVID-19 and newly diagnosed advanced HIV disease. Additionally, Kaposi's sarcoma increased the risk of death by 1.31 times in the same patient group. Furthermore, the detection of HIV infection for the first time during hospitalization due to COVID-19 in the entire study cohort increased the risk of death by 2.21 times.

 Of all teenage deaths caused by coronavirus disease 2019 (COVID-19), 47% occurred in children aged 0 - 9. Like many other infectious diseases, reducing mortality in children requires widespread vaccination. Despite the availability of the COVID-19 vaccine, a large percentage of children have not received the vaccine.

 This survey aimed to study parents’ reluctance to receive the COVID-19 vaccine for their children in Shiraz, Iran.

 An online questionnaire was sent to parents whose 5 to 11-year-old children had received no COVID-9 vaccine through the health educators of primary schools in Shiraz, Iran. The questionnaire contained demographic questions and 16 beliefs about COVID-19 vaccination that were answered as yes/no.

 We assessed 1093 respondents, including 49.5% (n = 542) male and 50.5% female students’ parents. The mean number of wrong beliefs was 7.21 ± 2.80 in parents who had boys and 7.78 ± 2.95 in girls’ parents. Also, 78.6% of participants had at least five wrong beliefs or excuses for not vaccinating their children. Notably, 82.8% of mothers and 84.3% of fathers were vaccinated with 2 - 3 doses against COVID-19. The most common wrong beliefs were probable vaccines’ side effects in the future, the undesirable effect of vaccination on children’s growth, and the awful effect of the vaccine on fertility, with a prevalence of 82.7%, 81.2%, and 76.7%, respectively.

 This study identified that most participants believed that COVID-19 vaccines have side effects for their children and unfavorable effects on children’s growth and infertility.

The neutrophil-to-lymphocyte ratio (NLR), obtained from a peripheral blood sample, is considered an indicator of subclinical inflammation. The aim of this study was to determine the NLR pattern in the deceased and survivor patients with coronavirus disease 2019 (COVID-19) during hospitalization.

This was a cross-sectional analytical study that was performed in TohidHospital in Sanandaj, Iran, from March to July 2021. In our study, 30 patients had received the treatments for COVID-19 and did not need to be admitted to the intensive care unit (ICU). They were discharged from the hospital and considered "Group A". Besides, 21 patients who were admitted to the ICU but were discharged were considered "Group B". Finally, 40 patients with COVID-19 who were hospitalized in the ICU and died were considered "Group C". Complete blood count (CBC) test was performed for all patients at 3 different times (at the time of admission, mid-hospitalization, and the last day of hospitalization). In the end, the data were analyzed by one-way analysis of variance (ANOVA) and the Kruskal-Wallis H test.

91 patients were included in this study. The NLR index during hospitalization in Group C was significantly higher than in Group B and in Group B was significantly higher than in Group A. On the other hand, in Group C, the NLR was significantly increased at three consecutive times during hospitalization; however, in Group B and Group A, at the end of hospitalization, this ratio was lower than in mid-hospitalization.

The NLR was an important indicator in predicting patients' prognoses. Pulmonary inflammation in patients with COVID-19 will be accompanied dominantly by neutrophils; thus, the NLR parameter could be important in the progress of the clinical status.