2nd World Congress on
COVID & COVID Mutations

All viruses, including SARS-CoV-2, the virus that causes COVID-19, change over time. Most changes have little to no impact on the virus’ properties. However, some changes may affect the virus’s properties, such as how easily it spreads, the associated disease severity, or the performance of vaccines, therapeutic medicines, diagnostic tools, or other public health and social measures.

virus variants identified since the start of the pandemic. Evidence from multiple countries with extensive transmission of VOCs has indicated that public health and social measures (PHSM), including infection prevention and control (IPC) measures, have been effective in reducing COVID-19 cases, hospitalizations, and deaths. National and local authorities are encouraged to continue strengthening existing PHSM and IPC measures. Authorities are also encouraged to strengthen surveillance and sequencing capacities and apply a systematic approach to provide a representative indication of the extent of transmission of SARS-CoV-2 variants based on the local context, and to detect unusual epidemiological events.

Virus entry is a finely regulated process requiring a series of interactions between the virion and host cell. Following the conjunction with the target receptor, COVID fuse its envelope with the membrane of the host cell. These processes are forced by the conformational change of S protein, which is triggered by not only the target receptor binding but also PH acidification and proteolytic cleavage led by cell surface or endosomal proteases such as transmembrane protease serine 2, furin, cathepsin L, elastase, and trypsin. Cleavages of S protein are facilitated at two sites: the boundary between the S1 and S2 subunit and the conserved site upstream of the fusion peptide. The former one is aimed at releasing RBD from the membrane fusion subunit, and the latter one is important for the exposure of the fusion peptide, hydrophobic in general, which acts as an anchor to target membrane. Then the fusion domain adopts two heptad repeats to form a compact coiled-coil conformation called 6-helix bundle or 6HB. Through direct interactions with lipid bilayers, the fusion domain disrupts two apposed membrane layers and fuses the viral envelope to host cell membrane. Ultimately, the viral genome is successfully released into the cytosol of the target cell. In addition to the viral infection through the plasma membrane, the entry of Covid into cells can be accomplished by the endocytic pathway, depending on the virus strains and host cells.

People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. The severity of COVID-19 symptoms can range from very mild to severe. Some people may have only a few symptoms. Some people may have no symptoms at all but can still spread it (asymptomatic transmission). Some people may experience worsened symptoms, such as worsened shortness of breath and pneumonia, about a week after symptoms start.
Some people experience COVID-19 symptoms for more than four weeks after they're diagnosed. These health issues are sometimes called post-COVID-19 conditions. Some children experience multisystem inflammatory syndrome, a syndrome that can affect some organs and tissues, several weeks after having COVID-19. Rarely, some adults experience the syndrome too.

The Coronavirus Disease 2019 (COVID‑19) pandemic has forced the scientific community to rapidly develop highly reliable diagnostic methods in order to diagnose this pathology effectively and accurately, thus limiting the spread of infection. Although the structural and molecular characteristics of the severe acute respiratory syndrome coronavirus 2 (SARS‑CoV‑2) were initially unknown, various diagnostic strategies useful for making a correct diagnosis of COVID‑19 have been rapidly developed by private research laboratories and biomedical companies. At present, rapid antigen or antibody tests, immunoenzymatically serological tests and molecular tests based on RT‑PCR are the most widely used and validated techniques worldwide. Apart from these conventional methods, other techniques, including isothermal nucleic acid amplification techniques, clusters of regularly interspaced short palindromic repeats/Cas (CRISPR/Cas)‑based approaches or digital PCR methods are currently used in research contexts or are awaiting approval for diagnostic use by competent authorities. In order to provide guidance for the correct use of COVID‑19 diagnostic tests, the present review describes the diagnostic strategies available which may be used for the diagnosis of COVID‑19 infection in both clinical and research settings. In particular, the technical and instrumental characteristics of the diagnostic methods used are described herein. In addition, updated and detailed information about the type of sample, the modality and the timing of use of specific tests are also discussed.

A pharmaceutical is any kind of drug used for medicinal purposes, like cough syrup or sleeping pills. You may have heard of a pharmacy, which is a place where you can buy medicinal drugs, or a pharmacist, which is a person who prepares those drugs.  Pharmaceutical physicians are involved at every stage of the drug development pipeline – using their expertise to advance pioneering medicines and ensure they are effective for patients. 

In the past, herbal medicine has played an important role in controlling infectious diseases. Clinical evidence from a range of studies of herbal medicine in the treatment of SARS coronavirus (SARS-CoV) has shown significant results, and supported the idea that herbal medicine has a beneficial effect in the treatment and prevention of epidemic diseases A Cochrane systematic review reported that herbal medicine combined with Western medicine may improve symptoms and quality of life in SARS-CoV patients A recently conducted meta-analysis also concluded that herbal medicine could reduce the infection rate of H1N1 influenza.

Inspired by previous experience, herbal medicine is considered one of the alternative approaches in the treatment of COVID-19. In China, the National Health Commission has declared the use of herbal medicine combined with Western medicine as a treatment for COVID-19 and has issued many guidelines on herbal medicine-related therapy. To date, there is much clinical evidence that reports favourable effects of the usage of herbal medicine in the treatment of COVID-19 Several systematic reviews that included evidence from case reports, case series, and observational studies have also been conducted, to study the effectiveness of herbal medicine in the treatment of COVID-19 However, in the hierarchy of systematic reviews, reviews of randomized control trials (RCTs) offer the highest level of evidence.

There is little practical clinical guidance for nutritional care during recovery of COVID-19, even though it can impact recovery time and people’s ability to return to doing the things that matter most to them. Nutrition is vital for maintaining skeletal muscle and avoiding metabolic disturbances and when patients are spending around two weeks in ICU, these can become very serious issues. Respiratory difficulties add an extra layer of complexity, preventing patients from eating effectively. A huge proportion of the patients we have treated required assisted ventilation, making it difficult to provide food and oral supplements. Nutrition is vital for maintaining skeletal muscle and avoiding metabolic disturbances - when patients are spending around two weeks in ICU, these can become very serious issues. This has meant that nutrition has had to become an important part of COVID-19 patient’s recovery.

The SARS-CoV-2 pandemic and its unprecedented global societal and economic disruptive impact has marked the third zoonotic introduction of a highly pathogenic coronavirus into the human population. Although the previous coronavirus SARS-CoV and MERS-CoV epidemics raised awareness of the need for clinically available therapeutic or preventive interventions, to date, no treatments with proven efficacy are available. The development of effective intervention strategies relies on the knowledge of molecular and cellular mechanisms of coronavirus infections, which highlights the significance of studying virus–host interactions at the molecular level to identify targets for antiviral intervention and to elucidate critical viral and host determinants that are decisive for the development of severe disease. In this Review, we summarize the first discoveries that shape our current understanding of SARS-CoV-2 infection throughout the intracellular viral life cycle and relate that to our knowledge of coronavirus biology. The elucidation of similarities and differences between SARS-CoV-2 and other coronaviruses will support future preparedness and strategies to combat coronavirus infections.

The virus can affect any organ in the body. In critically ill patients, multiple organs are often affected. The virus binds to angiotensin converting enzyme 2 (ACE2) receptors present in vascular endothelial cells, lungs, heart, brain, kidneys, intestine, liver, pharynx, and other tissue . It can directly injure these organs. In addition, systemic disorders caused by the virus lead to organ malfunction. While managing a patient it is essential to evaluate for injury to multiple organs. Disturbances of coagulation and vascular endothelium are common but may not lead to symptoms in early stages. They contribute to injury to multiple organs. Cardiac and renal dysfunction is common among the patients who die. Injury to the organs may become apparent long after the acute infection has subsided. Different organs may be affected at different times. Chronic injury may occur. Rehabilitation can be long and difficult.

It causes inflammation, endotheliitis, vasoconstriction, hypercoagulability, and edema. Lymphocytopenia, elevated D-dimer, elevated fibrin degradation products (FDPs), and disseminated intravascular coagulation (DIC) are observed. Deep vein thrombosis (DVT), venous thromboembolism, pulmonary embolism (PE), systemic and pulmonary arterial thrombosis and embolism, ischemic stroke, and myocardial infarction (MI) are reported.

Rates of cardiovascular symptoms are high, owing to the systemic inflammatory response and immune system disorders during disease progression, but acute myocardial injuries may also be related to ACE2 receptors in the heart.  ACE2 receptors are highly expressed in the heart and are involved in heart function. A high incidence of thrombosis and venous thromboembolism have been found in people transferred to Intensive care units (ICU) with COVID‑19 infections and may be related to poor prognosis. Blood vessel dysfunction and clot formation (as suggested by high D-dimer levels caused by blood clots) are thought to play a significant role in mortality, incidences of clots leading to pulmonary embolisms, and ischaemic events within the brain have been noted as complications leading to death in people infected with SARS-CoV-2. Infection appears to set off a chain of vasoconstrictive responses within the body, constriction of blood vessels within the pulmonary circulation has also been posited as a mechanism in which oxygenation decreases alongside the presentation of viral pneumonia. Furthermore, microvascular (arterioles and capillaries) blood vessel damage has been reported in a small number of tissue samples of the brains without detected SARS-CoV-2 – and the olfactory bulbs from those who have died from COVID‑19. COVID‑19 was also found to cause substantial including morphological and mechanical – changes to blood cells such as increased sizes sometimes persisting for months after hospital discharge.

COVID-19 can affect the respiratory system in a variety of ways and across a spectrum of levels of disease severity, depending on a person’s immune system, age and comorbidities. Symptoms can range from mild, such as cough, shortness of breath and fevers, to critical disease, including respiratory failure, shock and multi-organ system failure. It is particularly important that patients who have underlying lung disease can certainly have worsening of those conditions with contraction or exposure to COVID-19. With this, COVID-19 can cause overall worsening of these conditions, such as asthma, chronic obstructive pulmonary disease (COPD), interstitial lung disease, etc.

The initial clinical features of SARS-CoV-2 infection are quite nonspecific and not all suspected patients can be tested to exclude or confirm the diagnosis. Increasing scientific evidence has shown that abnormalities in routine laboratory tests, particularly haematological tests, have the potential to indicate, in a quick, practical and economical way, the need for specific laboratory tests for the diagnosis of SARS-CoV-2 infection, besides assisting in the prognosis of the disease and in the optimization of its clinical monitoring. In order to address in a simple and practical way the various aspects related to SARS-CoV-2 infection, this review reports the history of the virus, the epidemiology and pathophysiology of COVID-19, with emphasis on its laboratory diagnosis, particularly in haematological changes found during the course of the disease.

Many psychological problems and important consequences in terms of mental health including stress, anxiety, depression, frustration, uncertainty during COVID-19 outbreak emerged progressively. Common psychological reactions related to the mass quarantine which was imposed in order to attenuate the COVID-19 spread are generalized fear and pervasive community anxiety which are typically associated with disease outbreaks and increased with the escalation of new cases together with inadequate, anxiety-provoking information which was provided by media. The psychological reactions to COVID-19 pandemic may vary from a panic behaviour or collective hysteria to pervasive feelings of hopelessness and desperation which are associated with negative outcomes including suicidal behaviour. Importantly, other health measures may be compromised by abnormally elevated anxiety.
As the general population became increasingly exposed, anxiety-provoking topics related to this emergence of the health and socio-economic crisis need to be rapidly identified to early detect dysfunctional processes and maladaptive lifestyle changes potentially leading to the onset of psychiatric conditions.

Although most people with COVID-19 get better within weeks of illness, some people experience post-COVID conditions. Post-COVID conditions are a wide range of new, returning, or ongoing health problems people can experience four or more weeks after first being infected with the virus that causes COVID-19. Even people who did not have COVID-19 symptoms in the days or weeks after they were infected can have post-COVID conditions. These conditions can present as different types and combinations of health problems for different lengths of time.

Some people who had severe illness with COVID-19 experience multiorgan effects or autoimmune conditions over a longer time with symptoms lasting weeks or months after COVID-19 illness. Multiorgan effects can affect many, if not all, body systems, including heart, lung, kidney, skin, and brain functions. Autoimmune conditions happen when your immune system attacks healthy cells in your body by mistake, causing inflammation (swelling) or tissue damage in the affected parts of the body.

While most people who get COVID-19 will experience only mild to moderate cold and flu-like symptoms, pregnant women have a higher risk of complications compared to non-pregnant women of the same age. There is an increased risk of being admitted to hospital as well as needing ventilation.
Pregnant women who have other risk factors, including a pre-existing medical condition, are even more likely to need treatment in hospital.
The possibility of having a premature birth also increases if you become ill with COVID-19 and there is also a chance your new-born could need further care in hospital.
However, there is currently no evidence that COVID-19 increases the risk of miscarriage or birth defects.

Vaccines save millions of lives each year and a COVID-19 vaccine could save yours. The COVID-19 vaccines are safe and effective, providing strong protection against serious illness and death. WHO reports that unvaccinated people have at least 10 times higher risk of death from COVID-19 than someone who has been vaccinated? There is also evidence that being vaccinated can help prevent you from spreading the virus, so it protects people around you.
It is important to be vaccinated as soon as it’s your turn, even if you already had COVID-19. Vaccines offer more reliable protection than natural immunity. Getting vaccinated is a safer way for you to develop immunity from COVID-19 than getting infected.
The COVID-19 vaccines are highly effective, but no vaccine provides 100 per cent protection. Some people will still get ill from COVID-19 after vaccination or pass the virus onto someone else. 

In response to COVID-19 pandemic, the role of nurse changes to care or respond to the needs of the patients, their families and their caregivers. They also should take part in policies making, doing procedures and taking care of necessary supply of the material and equipment in the hospitals. All over the world nurses are demonstrating their kindness, care, courage, values and professional responsibility as nursing personnel. Prior to the COVID-19 pandemic in many institutions / organizations, there was a focus on nurses, mental health, physical health and wellbeing such as workload, anxiety, anger, irritability, burnout etc. They have to follow the rules, regulations, ethics and standard of nursing. However, while working in the isolation units or intensive care unit with COVID-19 patients, the nurse has to decide how much quality care they can provide to the patients while taking care of themselves. Hospital authorities have the responsibility to provide optimal work environments for all staff involved in the care of COVID-19 patients and health care professionals must follow the protocols that protect their ethical rights as a health care professional. In a 2018 policy brief, the American Nurses Association, said “nurse leaders are the key to preventing and containing widespread illnesses. They have the skills and education to develop coordinated global networking and properly identifying of infectious diseases”.

Rash of cases of a rare “black fungus” infection affecting thousands of critically ill Covid patients. Now scientists are warning that other dangerous or even deadly fungal infections have spawned in critically ill coronavirus patients globally.

Fungi are ubiquitous – in soil, water, air and human skin. Usually, people’s elaborate, adaptive immune systems are enough of a repellent but when that shield is weakened by disease, congenital conditions or age, they are far more vulnerable to microscopic assailants.

When Covid-19 emerged, doctors found that the best tools in their arsenal to fight the virus were steroids, which happen to be immunosuppressants. Wary of secondary bacterial infections in intensive care units, doctors often gave coronavirus patients broad-spectrum antibiotics as a precaution.

The dissemination of misinformation, aided by social media and other digital platforms, has proven to be a greater threat to global public health than the virus itself, as the COVID-19 pandemic has shown. People can stay safe, informed, and connected thanks to technological improvements and social media. The same instruments, on the other hand, enable and intensify the current infodemic, which continues to erode global response and risk pandemic-control measures.

The COVID-19 epidemic has claimed many lives around the world and poses an unprecedented threat to public health, food systems, and the workplace. The pandemic's economic and social effects are devastating: tens of millions of people are at risk of falling into extreme poverty, and the number of people who are undernourished, which is presently estimated at almost 690 million, might rise to 132 million by the end of the year.