Vol. 39 Special Issue

Mohammad Shahid, Abdel Halim Deifalla, Abdulrahman Yusuf Ismaeel, Khaled Saeed Tabbara, Ali Al-Mahmeed, Mohd. Shadab, Ahmed Ramadan
Purpose: Currency seems to represent an important vehicle for transmission of pathogenic microorganisms, thus a potential in affecting the public health. Digital transactions are more common in developed countries; however, handling cash currency is still very common in many countries including Bahrain. A recent study from Australia reported that SARS-CoV-2 may survive for 28 days on smooth surfaces (including banknotes), however the study was purely experimental and done in controlled laboratory environment. There were worldwide speculations suggesting the possible transmission of SARS-CoV-2 infection through currency notes. A recent study from Bangladesh reported presence of SARS-CoV-2 in approximately 7% of currency samples collected from the community. No such study has been performed on Bahraini currency, so the present study was proposed to screen the cash currency in circulation in Bahrain for the possible presence of SARS-CoV-2. Method: We collected notes and coins of Bahraini currency and a few of Saudi riyals from different public sources of currency exchange. Two time points were selected for collection when percentage of tested positive cases was on its peak. All the samples were tested for the presence of SARS-CoV-2 antigen with rapid antigen detection kit and qRT-PCR method. For initial validation, 5 samples each of potential SARS-CoV-2 RNAs extracted from known positive cases and 5 samples of extracted RNA from known negative persons were tested by rapid antigen detection kit and qRT-PCR. The results of qRT-PCR were interpreted as per the interpretation chart provided by the supplier. Results: During the study period, a total of 250 currency samples were collected including different denominations of currency notes and coins. Majority of the currency samples were collected from grocery stores followed by food outlets. Following validation, the currency samples were tested, and all turned negative for SARS-CoV-2 by rapid antigen detection test as well as by RT-PCR. Conclusion: This study predicts on Bahraini currency posing no threat of SARS-CoV-2 transmission via currency exchange.

Saliha Dassamiour, Widad Ghebache and Hala Gharbi
Purpose: The novel coronavirus disease namely COVID-19 is a viral disease induced by severe acute respiratory syndrome coronavirus (SARS-CoV-2). The cases were first reported in Wuhan, China, by the end of 2019 and subsequently spread worldwide. The virus can be transferred through direct or indirect contact and leads to several manifestations; the most common are fever, dry cough, pneumonia, and acute respiratory distress syndrome (ARDS). COVID-19 has caused massive human and economic losses, posing an ongoing threat. Understanding the current situation and developing a treatment which can be both safe and effective has become essential. In this regard, natural products could be an important resource in the development of treatment for COVID-19, as they have contributed to the treatment of other viruses in the past. This review aims to understand the cellular machinery of SARS-CoV-2 and to identify its drug targets. Methods: Emphasis has been given on the literature survey based on in vitro, in vivo, and in silico studies of natural products as anti-SARS-CoV-2. The important role of these compounds in boosting the immune system was also highlighted. Results: It was found that some natural products showed prominent antiviral activity against coronaviruses through impeding the main machinery used in their pathogenesis and replication cycle. Based on in vitro, in vivo, and in silico investigations, several classes of secondary metabolites, particularly polyphenols, have the ability to disrupt the interaction between SARS-CoV-2 S protein and the ACE2 receptor, resulting in virus entry inhibition. As well as the ability to block the activity of several enzymes involved in the virus replication cycle, including, 3CLpro, PLpro and RdRp. On the other hand, several vitamins and minerals can improve the immune response and are useful for COVID-19 prevention. Essential oils also show the ability to disrupt the fluidity of the virus envelope.

Conclusion: Many phytonutrients are counted as bioactive components against SARS-CoV-2, phenolic compounds by their potent mechanisms of action via the immune system rank first. Group B vitamins, vitamins A, C and E as well as minerals such as zinc, selenium and magnesium also play an important role in in preventing the attack by this virus.

Fatima Khan, Bhanu Chaudhary*, Asfia Sultan, Mohammad Salman Shah, Pushkar Kumar and Haris M Khan

Introduction: Hand Hygiene is the cheapest, easiest and the single most effective measure to reduce cross-transmission of infection from one patient to another and from the healthcare workers to patients and vice versa. Multiple studies have shown a decrease in healthcare-associated infections (HCAIs) rates after improvement in hand-hygiene compliance. Despite being the simplest procedure adherence to the hand hygiene recommendations remains well below 50% and healthcare workers repeatedly observed as being poor compliers.

Objective: This study was planned to access the impact of covid-19 pandemic on the compliance of infection control practices at a tertiary health care centre in India.

Methods: Institution-based cross-sectional study was used to assess the impact of covid-19 pandemic on attitude, knowledge and on the compliance of hand hygiene practices at a tertiary health care centre in India.

Results: A marked difference was observed in the availability of resources for hand hygiene i.e., 48 (96%) locations and the display of instructions for hand hygiene 50 (100%). A significant difference was also observed among the knowledge of the steps of hand hygiene {2019: 16(32%; 2020: 33 (66%)} and of the moments of hand hygiene {2019: 27 (54%); 2020; 44 (88%)}. (ϰ2 = 79.2, df =1, p = 0). In 2020 (during COVID -19 pandemic) a significant increase in compliance was noted in most of the departments with highest compliance rate of ICUs (100%), followed by OTs (91.7%), paediatrics (95.8%) obstetrics and gynaecology (90.6%), surgery (86.5%), blood bank and laboratories (85.7%). However, unlike the other parameters, the compliance of hand hygiene during the previous year (2019) and during 2020 (COVID -19 pandemic, was poor with no significant difference in compliance of hand hygiene practices even during the pandemic. Of all the 5 moments suggested by WHO, maximum compliance (36% in 2019 and 60% in 2020 pandemic) was after body fluid exposure.

Conclusions: Hand Hygiene should be made a national priority. Active involvement by healthcare administrators, national and local governments should be committed to make hand hygiene a mandate for patient safety. Accessibility to hand hygiene products like soap and water and/or alcohol-based hand rubs and written and verbal reminders to staff are essential to improve the compliance of hand hygiene. Thrust should also be given to hand hygiene as a research subject.

Parvez Anwar Khan, Hiba Sami, Nazish Fatima, Syed Haider Mehdi Husaini, Asim Azhar, Mohammad Shahid, Amritesh Kumar Singh, Midhat Ali Khan, S. Zeeshan Ahmad Hashmi, Sanjay Sharma, Haris M Khan

Background: Coronavirus disease 2019 (COVID-19) associated inflammatory cytokine storm that worsens COVID-19, relies heavily on the inflammatory response. IL-6, a TH1 cytokine, PCT and CRP have been linked to serious illness and a higher mortality rate. We further tried to evaluate the role of these indicators and their association with clinical severity in COVID-19 patients.

Material and Methods: Eighty-three consecutive patients with age ≥18 years with RT-PCR test positive for SARS-CoV-2 were included in the study. Demographic characteristics (age and sex), underlying co-morbidities, symptoms, physical findings, and laboratory tests of the patients were recorded. All patients were categorized as having mild, moderate, and severe COVID-19 disease, according to the Indian Council of Medical Research (ICMR). The levels of IL-6 and PCT were estimated by electrochemiluminescence immunoassay (ECLIA) using Cobas-e411 Immunoassay System, and Quantitative CRP was done by Unicorn-230 automated biochemistry analyzer to find out their correlation with disease severity and outcome. Multiple Regression was performed to find out factors associated with the adverse outcome of the disease.

Result: Mean age of patients was 51 years. IL-6, CRP, and PCT levels increased in 73 %, 68.0 %, and 8.2 % patients on admission, respectively. The most common co-morbidity associated with the disease was hypertension (25%), followed by diabetes (24%) and respiratory disease (15%). Increased IL-6, CRP, and PCT levels were found in 77 percent, 79 percent, and 20 percent of patients, respectively. We found that IL-6 (P≤0.05), CRP (P≤0.05), and PCT (P≤0.05) were significantly raised in COVID-19 patients with increasing severity of the disease. The Area under the receiver operating characteristic (AUROC) of these parameters ranged between 0.65 and 0.8 (IL-6, 0.828; CRP, 0.809; and PCT, 0.658), indicating a reliable biomarker to assess clinical severity.

Conclusion: Sequential measurement of blood levels of IL-6, CRP, and PCT levels is useful in determining the severity and predicting the outcome of the patients with severe disease. IL-6 and CRP have an independent prognostic value. On the other hand, the importance of normal PCT concentrations in patients with viral pneumonia needs to be studied further.

Mai Helmy, Tosin Yinka Akintunde, Taha Hussein Musa, Hassan Hussein Musa, Idriss Hussein Musa, Angwi Enow Tassang and Haitham Jahrami

Background: The global outbreak of the COVID-19 pandemic and its impact on the overall health and well-being brought fear, anxiety, worry, and mental health issues. Thus, a bibliometric analysis of COVID-19 and anxiety-related publications was performed to examine the current research trends and prospects to support policymakers, funding agencies, and researchers to safeguard the global population from post-COVID-19 psychological impact.

Methods: We used the Web of Science Core Collection (WoSCC) to search relevant documents in the early stage of the outbreak up to date (October 21, 2021). Mesh heading terms were used to extract the relevant keywords indexed in medical databases: HistCite, R software, and VOSviewer.Var1.6.6 were adopted as bibliometric analysis tools.

Results: A bibliometric analysis was employed to examine 796 COVID-19- anxiety-related documents on WoSCC. Approximately 7,478 citations, average citations per document 0, and h_index 39 were recorded. The publications cover 3858 authors, 166 journals, 71 countries. The finding shows that Chen Lei from Shanghai Jiao Tong University, School of Medicine, Shanghai, China was the most influential author. The International Journal of Environmental Research and Public Health was the most active. Turkey and the USA are the most productive countries for COVID-19–Anxiety-related publications.

Conclusion: The study suggested that more studies should be conducted to address anxiety among developing countries. The network analysis and keyword visualization allowed verification of the current significant research focus and provided a paradigm for future research in the COVID-19 and Anxiety research.

Pratheeba Jeyananthan

Purpose: Evolving technologies allow us to measure human molecular data in a wide reach. Those data are extensively used by researchers in many studies and help in advancements of medical field. Transcriptome, proteome, metabolome, and epigenome are few such molecular data. This study utilizes the transcriptome data of COVID-19 patients to uncover the dysregulated genes in the SARS-COV-2.

Method: Selected genes are used in machine learning models to predict various phenotypes of those patients. Ten different phenotypes are studied here such as time since onset, COVID-19 status, connection between age and COVID-19, hospitalization status and ICU status, using classification models. Further, this study compares molecular characterization of COVID-19 patients with other respiratory diseases.

Results: Gene ontology analysis on the selected features shows that they are highly related to viral infection. Features are selected using two methods and selected features are individually used in the classification of patients using six different machine learning algorithms. For each of the selected phenotype, results are compared to find the best prediction model.

Conclusion: Even though, there are not any significant differences between the feature selection methods, random forest and SVM performs very well throughout all the phenotype studies.