Coronaviruses - Volume 5, Issue 3, 2024

Vaccines' discovery, manufacturing, and distribution have been on a historic uptick in response to this worldwide COVID-19 pandemic. A handful of vaccines have been approved on an emergency basis after passing minimal clinical trials. There are voids in the existing body of research and the published body of work on phase II and III clinical trial outcomes, efficacy, and recently developed side effects of the approved COVID-19 vaccines. Furthermore, the immunological and methodological insights of successful vaccinations are still unpopular and are not publicly reported. We have attempted to review some major classes of COVID-19 vaccines, namely inactivated viral particle vaccine (BBV152 - Covaxin), mRNA vaccines (BNT162b2 - Pfizer and mRNA-1273- Moderna), viral vector vaccines (Gam-COVID-Vac-Sputnik and ChAdOx1-S-Astrazeneca) and protein subunit vaccine (NVX-CoV2373-Novavax) and discuss their methodological and immunological formulations. This review intends to address the existing literature's gaps and limitations and the vaccine's safety, efficiency, and effectiveness profiles. This report, by accumulating and comparing the existing publicly available literature and datasheets of the vaccines, concludes that the efficacy of the vaccinations has been found to be 81% for BBV152 (Covaxin), 94.5% for BNT162b2 (Pfizer), 94.5% for mRNA-1273 (Moderna), 91.6% for Gam-COVID-Vac (Sputnik V), 62-90% for ChAdOx1- S (AstraZeneca), and 96.4% for NVX-CoV2373 (Novavax), demonstrating their efficacy in lowering the severity and frequency of SARS-CoV-2 infection. We conclude that while the commercially approved vaccines have a few limitations regarding clinical trials and side effects, they provide immunity with efficacy ranging from 81% to 96.4% against COVID-19.

Background: Rosmarinic acid, a natural compound found in various plants like rosemary and lemon balm, may have potential as a multi-targeted inhibitor for SARS-CoV-2, a strain of virus responsible for COVID-19. SARS-CoV-2, a fusion protein of S1 and S2 subunits, has multiple precursors angiotensin-converting enzyme2 (ACE2), transmembrane serine protease 2 (TMPRSS2), papain-like protease (PLpro), and 3-chymotrypsin-like protease (3CLpro). The chemical interaction of rosmarinic acid with SARS-CoV-2 is of major interest reported here. Objective: The quantitative study of rosmarinic acid with various precursors of SARS-CoV-2 has been accounted for in detail. Furthermore, the conformational flexibility of rosmarinic acid has also been investigated during the interaction with four different precursors of SARS-CoV-2. Methods: This investigation delves deeply into the analysis of various aspects, including geometric parameters, atomic charge, the energy gap between the highest occupied and lowest unoccupied molecular orbitals, dipole moments, and the analysis of non-covalent interactions (NCI). Furthermore, the study incorporates molecular docking techniques in conjunction with thorough quantum chemical calculations to provide comprehensive insights. Results: Rosmarinic acid shows promise as a versatile inhibitor of SARS-CoV-2, the virus responsible for COVID-19. It can target multiple key precursors of the virus, including TMPRSS2, angiotensin- converting enzyme2, 3CLpro, and PLpro, found in the fusion protein comprising S1 and S2 subunits. This study delves into the quantitative analysis of rosmarinic acid's interactions with these precursors. Its adaptable structure allows it to engage with them effectively. Various molecular parameters, including atomic charge, energy gap between molecular orbitals, dipole moment, and noncovalent interactions, are comprehensively explored. Conclusion: Combining molecular docking and quantum mechanics, the findings suggest rosmarinic acid's potential as a multi-targeted SARS-CoV-2 inhibitor.

Background: The severe acute respiratory illness that was brought on because of the outbreak of COVID-19 caused by the SARS-CoV-2 infection has been designated as a public health emergency of worldwide concern. There is an immediate and pressing need to establish an effective therapeutic strategy to bring infections under control. COVID-19 viral spike glycoproteins and proteases both play important roles in the process of viral entrance as well as in the process of virus reproduction. Methods: Benzimidazole derivatives show antiviral activity against various RNA and DNA viruses and stop the early viral replication cycle. Based on this information, we designed eighteen new benzimidazole derivatives and screened them against the proteins S-glycoprotein 6VSB and papain- like protease 6W9C using molecular docking studies. Compounds that bind strongly to these proteins were evaluated again in an in vitro study. Results: When docked with SARS-CoV-2 spike glycoprotein, the binding affinity of R1 and R7 was -7.1 kcal/mol and -7.3 kcal/mol, respectively. This showed that they might be able to stop the SARS spike protein from binding to the ACE2 receptor on the human host, making it harder for the virus to get into the cells. The binding affinity of SARS-CoV-2 papain-like protease with R4, R14, and R15 was -6.7 kcal/mol, -6.5 kcal/mol, and -6.5 kcal/mol, respectively. COVID-19 could stop the protease from working by binding it. Conclusion: It was suggested, on the basis of the binding energy score, that these pharmacologically potent benzimidazole derivatives may be tested against SARS-CoV-2 and utilized in the production of efficient antiviral medicines.

Background: The prevalence of the COVID-19 pandemic has made the pleasant experiences of pregnancy and childbirth for women a source of fear and anxiety. Objective: To explore the experiences of pregnant women during pregnancy and childbirth in the COVID-19 pandemic. Methods: This qualitative conventional content analysis was conducted in Tehran, Iran, in May and June 2020. The 15 participants were selected via purposeful sampling including: 12 pregnant women, 2 relatives, and one nurse. Data were collected using in-depth and semi-structured interviews and the analysis adopted by Graneheim and Lundman (2004). MAXQDA version 12 was used for data organization. Results: According to the findings, 12 sub-categories, 6 categories, and one theme were extracted. The main theme that was derived from the analysis of the data was " the interweaving of pain and perfection". The categories include "emotional disorders", "obsessive disorders", "psychological disorders", "strengthening the dimension of spirituality" "the need for more support resources", and "inadequacy in presenting the role of motherhood. Conclusion: According to the experiences of pregnant women during pregnancy and childbirth during the outbreak of COVID-19, social, psychological, and emotional support through family and healthcare providers is recommended, as is the formation of virtual counseling groups to answer the questions of pregnant women. Health policymakers and decision-makers can use the results of this research to plan for providing services for pregnant women during future pandemics.

Background: The advent of severe acute respiratory syndrome coronavirus 2 (SARSCoV- 2) triggered a pandemic known as coronavirus disease 2019 (COVID-19) in the twenty-first century. Recent research has revealed several details about SARS-CoV-2 pathogenesis, which has greatly boosted research on COVID-19 vaccines and therapy methods for all the COVID variants. However, significant doubts about its treatment persist due to its fast mutating capability and its resistance to various drugs administered. Thus, there is a need for a cure to treat all the variants and their side effects. Objective: The main aim of this study is to check 1) the effectiveness of Kabasura Kudineer against COVID 19 2) the side effects of Kabasura Kudineer with the help of immune proteins in humans. Methods: The molecular docking was carried out between SARS-CoV-2 proteins and immune proteins in humans against Kabasura Kudineer compounds. The ADMET was also carried out to check the Pharmacokinetics. Results: The results showed that chebulagic acid from Terminalia chebula has good binding capability with all the chosen targets1. The drug likeliness screening also proved it a good drug candidate. Conclusion: Siddha way of treatment has popped out which has been traditionally used for the treatment of viral respiratory infections. The formulation called Kabasura Kudineer has been proven to have antiviral agents and compounds that boost the immune system.

The coronavirus disease 2019 pandemic has brought fundamental changes to our priorities and problems, especially those related to the healthcare sector. The COVID-19 pandemic put even the world's most advanced healthcare systems to the test and India's healthcare system has been rattled as well. In this accordance, the Indian government has introduced many new policies and schemes like free vaccination drive, Atmanirbhar Bharat, and free COVID care under Ayushman Bharat. With the continuation of COVID-19, problems like Self-medication and hoarding of medicines among the common population keep on rising and this was due to flu-like symptoms of COVID-19, miss information on social media, or due to less or no interaction between patients and doctors as the population is now shifting to telemedicine which offers the benefit of consultation at their own home. These situations served as a boon to the Pharma sector as stocks of many pharma companies and industries have been reported to have increased in the past 2 years of the pandemic due to an increase in demand and manufacturing and consumption of pharmaceutical goods and also reportedly being increased by alot in coming years. However, this rapid growth of the pharmaceutical sector is beneficial for pharmacists, businessmen, and others who are directly or indirectly associated with the healthcare fraternity but in our opinion, it will negatively impact the Indian economy or can be viewed as a problem which can lead to the downfall of the qualitative aspect of the pharma sector in the long term.

SARS-CoV-2 infection among pregnant women causes maternal and neonatal complications. Professional societies endorse the vaccination among pregnant women. This review of the cohort studies aims to assess the short-term maternal and neonatal outcomes among vaccinated vs. non-vaccinated pregnant women with SARS-CoV-2 vaccination. We searched Cochrane Central Registry of Controlled Trials, Scopus, Google Scholar, and PubMed databases. The observational cohort studies published from July 2021 to December 2022 were included. The eligibility criteria were assessed. The studies documenting maternal and neonatal outcomes and the relative risk, and 95% confidence interval were considered. Joanna Briggs Institute data extraction form was used, and the quality assessment of the included study was conducted using the Newcastle-Ottawa quality assessment scale. The quality of the grading was summarised with GradePro software. Data from the five cohort studies are considered. 56% of the un-vaccinated pregnant women experience composite adverse maternal outcomes (RR: 3.97; 95% CI:0.73,21.49; p-value: <0.11). There was a reduced risk of occurrence of the meconium-stained amniotic fluid who are vaccinated (RR: 0.89; 95% CI:0.71, 1.12; p value=0.33). The unvaccinated group is 3.16 times more likely to take infertility treatment (RR: 3.54; 95% CI:2.04, 6.12; p-value: <0.00001). There was no significant difference concerning neonatal outcomes between both groups. The pregnant women who were not vaccinated against SARS-CoV had an increased risk for a composite adverse maternal outcome and meconium-stained amniotic fluid. The vaccine has effectively prevented the disease in the first six months. Additional studies are needed to understand the safety of the SARS-CoV vaccine.

Global health and economy have been severely impacted by the COVID-19 pandemic that was brought on by the SARS-CoV-2 coronavirus. This makes the creation of potent medications for the treatment of COVID-19 disease a top goal. In clinical trials, several medications that have been repurposed for the treatment of COVID-19 have shown promise. Nevertheless, there are a lot of obstacles to overcome in the creation of COVID-19 pharmacological therapy. The inability to pinpoint prospective treatment targets is one difficulty caused by the unclear etiology of COVID-19. Another difficulty is the virus' quick evolution, which can result in the creation of drug-resistant variants. Furthermore, the quick start of clinical trials has been prompted by the strong demand for effective therapies. A lack of reliable data on the safety and efficacy of medications can result from the early start of clinical trials that have been prompted by the strong demand for effective medicines. Despite these obstacles, the development of various promising pharmacological treatments for COVID-19 has advanced. These include immune-modulating medications, like dexamethasone and tocilizumab, as well as antiviral medicines, like remdesivir and favipiravir. Combination therapies using several medications may also be useful in enhancing outcomes for COVID-19 patients. Despite some encouraging advancements, there are still a lot of obstacles to be addressed in the development of pharmacological therapy for COVID-19. Further research is needed to identify the most effective treatment approaches for this disease.

The commonest medication to treat moderate to severe pain and fever in adults and children is paracetamol and it has been observed that there is a rapid increase in the intake of paracetamol- 650 since the COVID-19 pandemic and it is continuing till date. This analgesic and antipyretic medication showed an increase of 150% in its consumption during the pandemic, simultaneously escalating its self-medication. Concerns have been expressed about the indirect advertising of prescription medications, their illogical use, and improper self-medication, which has resulted in overdose and certain serious side effects. Chronic pain and pyrexia are the most common symptoms witnessed during the COVID-19 pandemic. The intake of paracetamol-650 has also been increased as a prophylactic measure due to the widespread fear generated during COVID-19. The usage of paracetamol has been shifted from 500 mg to 650 mg for mild and moderate pain and fever during and after the end of the pandemic. This raises concerns about the misuse of paracetamol-650mg which may cause damage to the liver, stomach, and kidney chronically. So, this review article aims to generate awareness among the public and physicians about the rationale of paracetamol as an analgesic and antipyretic.

Objective: Recently, the COVID-19 (coronavirus disease) pandemic caused by SARSCoV- 2 (severe acute respiratory syndrome coronavirus) gave rise to a public health emergency worldwide. Similarly, other viruses like HIV (Human Immunodeficiency Virus)/AIDS (acquired immunodeficiency syndrome), Zika, Ebola, and Influenza and their mutants have called for an urgent need for a Broad-spectrum antiviral drug, inhibiting the infection by targeting the common essential components of different viruses. Methods: Based on ancient medicinal knowledge, we made an attempt through molecular docking analysis to explore different phytochemical compounds against well-recognized viral receptors. Results: A total of 29 phytochemicals were virtually examined against 4 targets essential in the life cycle of viral infection: CD147 (Cluster of Differentiation 147), CD209L (Cluster of Differentiation 209 Lectin), eIF4A (Eukaryotic Initiation Factor 4A), and RdRp (RNA-dependent RNA polymerase). Providentially, Berbamine was identified as the best-hit lead molecule based on binding energies, conventional hydrogen bonding numbers, and non-covalent interactions. It exhibited binding energies as -8.3 kcal/mol with CD147, -8.2 kcal/mol with CD209L, -9.5 kcal/mol with eIF4A, and - 10.5 kcal/mol with RdRp. Additionally, in-silico drug likeliness (Lipinski's rule) and ADME studies depict high bioavailability and gastrointestinal absorption and follow Lipinski's rule. Conclusion: The data presented by our study illustrate phytochemicals from the selected plants that could target conserved viral components shared across multiple viruses. Berbamine can be designed as a possible drug to target Broad-Spectrum viruses, limiting the effectiveness of different viruses.