IntroductionCoronavirus disease (COVID-19) caused by the novel coronavirus SARS-CoV-2 is an infectious disease which has evolved into a worldwide pandemic. Growing evidence suggests that individuals with pre-existing comorbidities are at higher risk of a more serious COVID-19 illness. Sickle cell disease (SCD) is an inherited hemoglobinopathy which increases the susceptibility to infections and as a consequent has higher risks of morbidity and mortality.The impact of COVID-19 on SCD patients could lead to further increase in disease severity and mortality. Studies that examine the effect of SCD on COVID-19 outcomes are lacking. This study aims to determine whether SCD is a risk factor for severe COVID-19 infection in regards to the requirement of non-invasive ventilation/high flow nasal cannula (NIV/HFNC), mechanical intubation (MV) or death.MethodsRetrospective cohort study which included COVID-19 patients admitted to four Ministry of Health COVID-19 treatment facilities in Bahrain during the period of 24, February 2020, to 31, July 2020. All SCD patients with COVID-19 were included and compared to randomly selected non-SCD patients with COVID-19. Data for the selected patients were collected from the medical records. Multivariate logistic regression models were used to control for confounders and estimate the effect of SCD on the outcomes.ResultsA total of 1,792 patients with COVID-19 were included; 38 of whom were diagnosed with SCD as well. In the SCD group, one (2.6%) patient required NIV/HFNC, one (2.6%) required MV and one (2.6%) death occurred. In comparison, 56 (3.2%) of the non-SCD patients required NIV/HFNC, 47 (2.7%) required MV and death occurred in 58 (3.3%) patients. Upon adjusting for confounders, SCD had an odds ratio of 1.847 (95% CI: 0.39 – 8.83; p=0.442).ConclusionOur results indicate that SCD is not a risk factor for worse disease outcomes in COVID-19 patients.
We have investigated numerically the ability to inhibit spike protein from SARS-CoV-2 to attach and inter the host cell when exposed to energetic photons. The Geometric Progression fitting method have been adopted to calculate the equivalent atomic number for photon energy absorption (Zeq), exposure and absorption buildup factors in the energy range E∈ [15–300] keV for the S2-subunit in the spike protein. The buildup factors have shown a peak value at adsorption resonance energy between 36–60 eV per amino acid of the S2-subunit which depends on the mean free path of the photon within the protein structure and the type of mutation. The resonance energies (between UV and X-ray range) have been found to depend on the protein molecular composition. This opens the possibility of using energetic photons to break up the S2-subunit into small fragments. Our results may contribute to the continues racing for finding noninvasive technique for medical trials using radiotherapy treatment for the COVID-19 virus.
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