European Journal of Molecular & Clinical Medicine

Mucormycosis is an invasive fungal illness associated strongly with COVID-19 and found lethal in many cases. Rhino-orbital-cerebral mucormycosis (ROCM) is the most common mucormycosis infection. The worldwide disease concern for ROCM has grown recently following the spike in incidence during the COVID-19 pandemic. This study shows the clinical characteristics and therapeutic outcomes of patients with ROCM.
Material and Methods: A retrospective observational study on 77 patients with ROCM was performed between March 2021 and June 2021 at a tertiary care hospital. This study only included patients who were microbiologically tested and conformed for ROCM. Numerous clinal diagnosis tests were performed to examine vision, paralysis of the eye muscles, eyeball protrusion, orbital swelling, extra-ocular movements, fundus examination, and extent of orbital involvement on MRI.
Results: This study of 77 patients, showed a higher ratio of male patients (74.04%) for ROCM cases. The average age of all patients was 49.14 years, and 62 (80.52%) were detected for COVID in the past. These patients were hospitalised for a minimum of 1 day to a maximum of 127 days, with an average of 40.48 days. Type 2 diabetes was found in 40 (52%) cases, while hypertension was the second most common comorbid condition observed in 21 (27.27%) cases. Amphotericin B injection was the preferred therapeutic drug shown in this study for 44 patients out of 56 who used any medication. Exenteration was also shown as a possible therapy that was performed on 53.25% of patients.
Conclusion: ROCM is more prevalent in diabetic male patients of 50 years of age infected by SARS-CoV2 who have had a later bacterial or fungal illness exacerbated by SARS-CoV2. Amphotericin B injection and exenteration could be the best possible therapeutic solution for treating ROCM.

Background: Since December 2019, an novel type of pneumonia emergedin
Wuhan,China,and rapidly transmitted to wholeglobe. This pneumonia was verified to
be caused by a different strain coronavirus and named as coronavirus disease
2019(COVID-19) bythe World Health Organization (WHO). Based on
phylogeny,taxonomy and established practice, this novel coronavirus was designated
as severe acute respiratory syndrome coronavirus2 (SARS-COV2).
Objectives: To show the co-relation between inflammatory markers and the severity of
COVID-19 disease

Coronavirus Disease – 2019 (COVID–19) caused by the novel coronavirus, SARS-CoV2 has plagued the world in pandemic for the past few months. Currently, many groups are investigating on a potent candidate for treating this highly infectious disease. Phytocompounds from many medicinal plants are reported to possess anti-viral and anti-inflammatory properties. The current study emphasizes on evaluating the inhibition efficacy of the phytocompounds from Andrographis paniculata against 10 structural and non-structural SARS-CoV2 proteins by virtual screening. Molecular docking, binding interactions, ADME and toxicity profiling of the selected fifty one phytocompounds were analysed and compared against 10 well studied repurposed drugs. The best docked complexes were subjected to MD simulation for 50 nanoseconds and the compound stigmasterol was observed to be outperforming in the simulation studies. We report that A.paniculata constitutes 65.78% druggable phytocompounds against SARS‐CoV2. We found that the two phytosterols, stigmasterol and stigmasta-5,22-dien-3-ol act as potential lead molecules against multiple target proteins of SARS–CoV2. Based on the literature evidence on Andrographis paniculata and our detailed analysis, this plant and its phytocompounds could be repurposed as a potential anti-COVID agent.

The coronavirus 2 (SARS‐CoV‐2) induces severe acute respiratory distress syndrome (ARDS)via the coronavirus receptor angiotensin‐converting enzyme 2 (ACE2) in the host cell to facilitate entry into the lungs Over activation of the renin‐angiotensin system (RAS) and the down regulation of ACE2 expression are involved in SARS‐CoV induced lung injury. RAS is the main system that has a regulatory roleinmaintaining electrolyte balance, blood pressure, vascular tone and cardiovascular remodeling in the body. Angiotensin II receptor blockers (ARBs) and Inhibitors (ACEIs) are vital medications that are widely used for the treatment of cardiovascular diseases (CVDs). The question which now arises is: It is possible to continue using either ARBs or ACEIsor both medications in patients with SARS-CoV2? Both ARBs and ACEIs can facilitate COVID-19 entry into the host cell due to increase expression of ACE2. On the other hand, ARBs have a greater potential to reduce downstream pathogenicity of the SARS-CoV2 via different cell signaling pathways including free radical generation, up regulation of NF-κB pathway, toll-like receptors (TLRs) and pro-apoptotic protein by blocking the renin–angiotensin system more severely compared to the effect of ACEIs. The current hypothesis is that ARBs can perform better therapeutically compared to ACEIs in respiratory disorders such as ARDS which is induced by viral infection especially since more than 40 % of angiotensin II can be synthesized by other enzymes such as chymase, cathepsin. ARBs treatment can increase the levels of both angiotensin II (Ang II) and the ACE2 enzyme making Ang II a target substrate for hydrolysis by ACE2 into Ang 1-7 which in turn exerts anti-inflammatory, anti-apoptotic and anti-oxidant activities. These effects are achieved by the binding of Ang 1-7 to both angiotensin-type 2 receptor (AT2) and receptor mas’ axis (Mas) and also by its ability to block Ang II/AT1 receptor-induced TLR4/MyD88 signaling thereby highlighting the potential therapeutic use of ARB sin preventing injury induced by COVID-19 virus. It is concluded that patients who are already on ARBs medications must continue to use them daily since ARBs have protective effects against COVID-19 virus. Moreover, ARB sexert their beneficial effects via their anti-inflammatory, anti-apoptotic, anti-oxidant and anti-fibrotic properties. On the other hand, those patients who are on ACEIs medications must change to other safe drugs since ACEIs can facilitate