The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a pandemic as of March 2020, creating a global crisis and claiming millions of lives. To halt the pandemic and alleviate its impact on society, economy, and public health, the development of vaccines and antiviral agents against SARS-CoV-2 was a dire need. To date, various platforms have been utilized for SARS-CoV-2 vaccine development, and over 200 vaccine candidates have been produced, many of which have obtained the United States Food and Drug Administration (FDA) approval for emergency use. Despite this successful development and licensure, concerns regarding the safety and efficacy of these vaccines have arisen, given the unprecedented speed of vaccine development and the newly emerging SARS-CoV-2 strains and variants. In this review, we summarize the different platforms used for Coronavirus Disease 2019 (COVID-19) vaccine development, discuss their strengths and limitations, and highlight the major safety concerns and potential risks associated with each vaccine type.
Introduction/Objective The recent outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) began in Hubei province, China in December 2019 and has spread worldwide at an alarming rate. With millions of individuals infected and over two hundred thousand deaths, the necessity to develop fast and efficient diagnostic methods is of high importance. Diagnostic modalities rely on a combination of epidemiology, clinical presentation, laboratory examination, and appropriate imaging to diagnose and distinguish SARS-CoV-2 from other pulmonary infections. The purpose of this paper is to report on currently available diagnostic screening methods for patients infected with SARS-CoV-2 to guide frontline healthcare workers involved with COVID-19 patient care. Methods An electronic literature search was performed for peer-reviewed articles published from January 1, 2020, until April 26, 2020. Articles were then reviewed and included based on the applicability to the topic. Results The preferred diagnostic approach is reverse transcription of the virus’ RNA followed by PCR amplification (RT-PCR). This method recognizes the gene-specific primers to target various viral protein genes, such as the envelope protein gene or the nucleocapsid protein gene, which enables this test to be both sensitive and specific toward SARS-CoV-2. However, this method has been proven to be time-consuming taking hours-to-days for the results. In order to improve the speed and efficiency of diagnostics, newer rapid diagnostic serological tests are being developed for testing SARS-CoV-2, each with its own unique advantages and disadvantages. They could potentially be used as triage tests to rapidly identify patients who are very likely to have COVID-19 in combination with other accurate diagnostic methods. Conclusion Therefore, a combination of diagnostic testing used in a timely manner may be beneficial for the rapid and accurate detection of SARS-CoV-2. This was evident in cases where despite initial negative RT-PCR tests for various patients, who later demonstrate chest CT scans with various degrees of consolidation and ground-glass opacity. Thus establishing the need for radiology diagnosis to be complementary to RT-PCR for COVID-19 patients. Hopefully, the continuous development and use of rapid diagnostic tests and the implementation of public health measures will help control the spread of the disease.
As of March 2020, the time when the coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) became a pandemic, our existence has been threatened and the lives of millions have been claimed. With this ongoing global issue, vaccines are considered of paramount importance in curtailing the outbreak and probably a prime gamble to bring us back to ‘ordinary life’. To date, more than 200 vaccine candidates have been produced, many of which were approved by the Food and Drug Administration (FDA) for emergency use, with the research and discovery phase of their production process passed over. Capering such a chief practice in COVID-19 vaccine development, and manufacturing vaccines at an unprecedented speed brought many challenges into play and raised COVID-19 vaccine remonstrance. In this review, we highlight relevant challenges to global COVID-19 vaccine development, dissemination, and deployment, particularly at the level of large-scale production and distribution. We also delineate public perception on COVID-19 vaccination and outline the main facets affecting people’s willingness to get vaccinated.
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Myelodysplastic syndrome (MDS) describes a group of bone marrow malignancies with variable morphologies and heterogeneous clinical features. The aim of this study was to systematically appraise the published clinical, laboratory, and pathologic characteristics and identify distinct clinical features of MDS in the Middle East and North Africa (MENA) region. We conducted a comprehensive search of the PubMed, Web of Science, EMBASE, and Cochrane Library databases from 2000 to 2021 to identify population-based studies of MDS epidemiology in MENA countries. Of 1935 studies, 13 independent studies published between 2000 and 2021 representing 1306 patients with MDS in the MENA region were included. There was a median of 85 (range 20 to 243) patients per study. Seven studies were performed in Asian MENA countries (732 patients, 56%) and six in North African MENA countries (574 patients, 44%). The pooled mean age was 58.4 years (SD 13.14; 12 studies), and the male-to-female ratio was 1.4. The distribution of WHO MDS subtypes was significantly different between MENA, Western, and Far East populations (n = 978 patients, p < 0.001). More patients from MENA countries were at high/very high IPSS risk than in Western and Far East populations (730 patients, p < 0.001). There were 562 patients (62.2%) with normal karyotypes and 341 (37.8%) with abnormal karyotypes. Our findings establish that MDS is prevalent within the MENA region and is more severe than in Western populations. MDS appears to be more severe with an unfavorable prognosis in the Asian MENA population than the North African MENA population.
As university students, we read with great interest the article by Aylie et al about the effect of the COVID-19 pandemic on university student mental health. The article highlighted that there has been an increase in depression, anxiety and stress levels and the need for governmental organisations to integrate psychological support into upcoming initiatives. 1 The study is very useful for understanding the impact of the pandemic. We would like to comment on areas of further consideration for this research. Stress was defined by the researchers as per the DASS-S criteria. Compared to the results from the DASS-D and DASS-A, this criterion has been found to be ineffective in other studies including amongst Vietnamese adolescents. 2 Furthermore, stress is a highly subjective experience that can be defined according to multiple parameters which the DASS-S alone may not account for. A study looking at the wellbeing of university students in the UK assessed similar parameters using five questionnaires which allowed for greater validity to their analysis. 3 Additionally, predominant variation in the outcome at different timepoints could have occurred because of the cross-sectional data used. Therefore, a longitudinal study would be a more effective measure. This is highlighted by research from the Mental Health foundation in the UK which demonstrated that the level of poor mental wellbeing was greater during the height of the pandemic (62% of the population had felt anxious or worried in the past two weeks), compared to a few months later at 49%. 4 Finally, although the author indicates that individuals with 'severe mental illness' were excluded, it would be useful to know the criteria for placing a person in to this category. Overall, providing greater insight into the mental health background of the participants would have been valuable to gain an accurate picture of the mental health effect of Covid-19. DisclosureThe authors report no conflicts of interest for this communication.
Background: West Nile virus (WNV) is one of the most widely spread arboviruses worldwide and a highly significant pathogen in humans and animals. Despite frequent outbreaks and endemic transmission being reported in the Middle East and North Africa (MENA), seroprevalence studies of WNV in Qatar are highly lacking. Aim: This study aims to investigate the actual prevalence of WNV among local and expatriate communities in the Qatar using a large sample size of seemingly healthy donors. Method: A total of 1992 serum samples were collected from donors of age 18 or older and were tested for the presence of WNV antibodies. Serion enzyme-linked immunosorbent assay (ELISA) commercial microplate kits were used to detect the presence of the WNV IgM and IgG. The seropositivity was statistically analyzed using SPSS software with a confidence interval of 95%. Results: The seroprevalence of anti-WNV IgG and IgM in Qatar was 10.3% and 3.4%, respectively. The country-specific seroprevalence according to nationality for WNV IgG and IgM, respectively, were Sudan (37.0%, 10.0%), Egypt (31.6%, 4.4%), India (13.4%, 3.2%), Yemen(10.2%, 7.0%), Pakistan (8.6%, 2.7%), Iran (10.6%, 0.0%), Philippines (5.4%, 0.0%), Jordan(6.8%, 1.1%), Syria (2.6%, 9.6%), Palestine (2.6%, 0.6%), Qatar (1.6%, 1.7%), and Lebanon (0.9%, 0.0%). The prevalence of both IgM and IgG was significantly correlated with the nationality (p≤0.001). Conclusion: Among these tested nationalities, Qatar national has a relatively low burden of WNV disease. The highest prevalence of WNV was found in the Sub Saharan African nationalities like Sudan and Egypt. The seroprevalence of WNV is different from the previously reported arboviruses such as CHIKV and DENV, which was highest among Asian countries (India and Philippines). Further confirmatory tests such as viral neutralization assays are needed to confirm the IgM seropositivity in these samples since these samples could be a source of viral transmission through blood donation.
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