The widespread increase in multiple severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variants is causing a significant health concern in the United States and worldwide. These variants exhibit increased transmissibility, cause more severe disease, exhibit evasive immune properties, impair neutralization by antibodies from vaccinated individuals or convalescence sera, and reinfection. The Centers for Disease Control and Prevention (CDC) has classified SARS-CoV-2 variants into variants of interest, variants of concern, and variants of high consequence. Currently, four variants of concern (B.1.1.7, B.1.351, P.1, and B.1.617.2) and several variants of interests (B.1.526, B.1.525, and P.2) are characterized and are essential for close monitoring. In this review, we discuss the different SARS-CoV-2 variants, emphasizing variants of concern circulating the world and highlight the various mutations and how these mutations affect the characteristics of the virus. In addition, we discuss the most common vaccines and the various studies concerning the efficacy of these vaccines against different variants of concern.

The goal of this study was to analyze the effect of COVID-19 drugs and biologicals on hyperglycemia. A literature search with key terms, such as “COVID-19 drugs and hyperglycemia” and “COVID-19 vaccines and hyperglycemia,” was conducted using PubMed through September 2021. The CDC data were referenced for current COVID-19 profile and statistics. The NIH COVID-19 guidelines were referenced for updated treatment recommendations. Micromedex and UpToDate were used for drug and disease information. Current results suggested that corticosteroids (dexamethasone), remdesivir and antivirals (lopinavir and ritonavir) all have the potential to significantly raise blood glucose levels putting patients at elevated risk for severe complications. In contrary, hydroxychloroquine is associated with hypoglycemia, and tocilizumab decreases inflammation which is associated with improving glucose levels. Other anti-cytokine bioactive molecules are correlated with lower blood glucose in patients with and without diabetes mellitus. Ivermectin, used for mild COVID-19 disease, possesses the potential for lowering blood glucose. Covishield, Pfizer-BioNTech, and Moderna have all been associated with hyperglycemia after the first dose. Individualized /personalized patient care is required for diabetic mellitus patients with COVID-19 infection. Improper drug therapy aggravates hyperglycemic conditions and other comorbid conditions, leading to increased morbidity and mortality.

Background:Kidney injuries caused by several viral diseases have been reported worldwide among all age groups, races, and genders. Of particular importance is coronavirus disease 2019 (COVID-19), and its prevalence in communities infecting all patient populations with symptoms ranging from asymptomatic to severe, including complications and mortality.Methods:Data were acquired from PubMed, Scopus, Google Scholar, Centers for Disease Prevention and Control (CDC), and Lexi-Comp using the following search terms: “COVID-19 and renal pathology,” “COVID-19 induced kidney disease,” “Viral infection induced kidney disease,” and “Viral infection induced renal damage.” Titles and abstracts were manually analyzed as per the exclusion and inclusion criteria of relevant articles; relevance of articles included studies on the pathology of a specific viral infection and the impact of the virus on the adult renal system.Results:The mechanisms for renal disease due to COVID-19 include direct renal tubular injury, cytokine storm, inflammation, thrombosis vs. acute tubular necrosis, thrombotic events, and direct renal injury. Although some mechanisms behind renal dysfunction among the studied viral infections are similar, the prevalence rates of kidney injury or damage differ. This might be described by recommended prophylactic and therapeutic approaches that can alter the viral infection characteristics and possibly the impact a particular organ system.Conclusion:The patient population at risk was old in age and had a high body mass index. The mechanisms associated with renal dysfunction are similar, including direct renal injury through angiotensin converting enzyme 2 (ACE2) entry, inflammation, and thrombosis. The renal pathology of coronaviruses that differs from that of other prevalent viral infections is the activation of cytokine storm, which causes elevations of a greater number and different kinds of cytokines than other viral infections.

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