Articles: pandemics.
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Indian J Med Ethics · Apr 2020
Non-communicable disease management in vulnerable patients during Covid-19.
It is now well established that non-communicable diseases (NCD), like diabetes mellitus, hypertension,, respiratory and heart disease, particularly among the elderly, increase the susceptibility to COVID-19 disease. Mortality in 60%-90% of the COVID-19 cases is attributed to either one or more of these comorbidities. However, healthcare management for control of COVID-19 involves public health and policy decisions that may critically undermine the existing health needs of the most vulnerable NCD patients. ⋯ In the absence of effective public health interventions, socioeconomically vulnerable patients are likely to become non-adherent increasing manifold their risk of disease complications. In this context, the feasibility of dispensing longer than usual drug refills for chronic NCD conditions at functional government health facilities, home delivery of essential drugs, running dedicated NCD clinics at PHCs, and utilisation of telemedicine opportunities for care and support to patients warrant aggressive exploration. Keywords: Covid-19, NCDs, Medical ethics, epidemic, India.
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The recent outbreak of coronavirus disease (COVID-19) caused by SARS-CoV-2 infection in Wuhan, China has posed a serious threat to global public health. To develop specific anti-coronavirus therapeutics and prophylactics, the molecular mechanism that underlies viral infection must first be defined. Therefore, we herein established a SARS-CoV-2 spike (S) protein-mediated cell-cell fusion assay and found that SARS-CoV-2 showed a superior plasma membrane fusion capacity compared to that of SARS-CoV. ⋯ Here we generated a series of lipopeptides derived from EK1 and found that EK1C4 was the most potent fusion inhibitor against SARS-CoV-2 S protein-mediated membrane fusion and pseudovirus infection with IC50s of 1.3 and 15.8 nM, about 241- and 149-fold more potent than the original EK1 peptide, respectively. EK1C4 was also highly effective against membrane fusion and infection of other human coronavirus pseudoviruses tested, including SARS-CoV and MERS-CoV, as well as SARSr-CoVs, and potently inhibited the replication of 5 live human coronaviruses examined, including SARS-CoV-2. Intranasal application of EK1C4 before or after challenge with HCoV-OC43 protected mice from infection, suggesting that EK1C4 could be used for prevention and treatment of infection by the currently circulating SARS-CoV-2 and other emerging SARSr-CoVs.