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      COVID-19 vaccines: A race against time in the middle of death and devastation!

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      , MD, DM, FRCP (Edin), FACP, Master American College of Physicians (MACP, Emeritus) 1 , 2 , 3 , , 1 , , HSC (CBSE) 4 , 2 , , MD (Pathology) 5 , 3 , , HSC (State Board of Education, J&K) 6 , 4 , , Dr., MBBS 7 , 8 , 5
      Journal of Clinical and Experimental Hepatology
      Indian National Association for Study of the Liver. Published by Elsevier B.V.
      COVID-19, SARS-CoV-2, Coronavirus, Vaccine, Platform technology Clinical trials

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          Abstract

          The COVID-19 has turned in to a global human tragedy and economic devastation. Governments have implemented lockdown measures, blocked international travel, and enforced other public containment measures to mitigate the virus morbidity and mortality. As of today, no drug has the power to fight the infection and bring normalcy to the utter chaos. This leaves us with only one choice namely an effective and safe vaccine that shall be manufactured as soon as possible and available to all countries and populations affected by the pandemic at an affordable price. There has been an unprecedented fast track path taken in Research & Development (R&D) by the World community for developing an effective and safe vaccine. Platform technology has been exploited to develop candidate vaccines in a matter of days to weeks and as of now, 108 such vaccines are available. Six of these vaccines have entered clinical trials. As clinical trials are ‘rate-limiting’ and ‘time-consuming’, many innovative methods are in practice for a fast track. These include parallel phase I-II trials and obtaining efficacy data from phase IIb trials. Human ‘challenge experiments’ to confirm efficacy in humans is under serious consideration. The availability of the COVID-19 vaccine has become a race against time in the middle of death and devastation. There is an atmosphere of tremendous hype around the COVID-19 vaccine and developers are using every moment to make claims, which remain unverified. However, concerns are raised about a rush to deploy a COVID-19 vaccine. Applying ‘Quick fix’ and ‘short cuts’ can lead to errors with disastrous consequences.

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          Most cited references40

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          Is Open Access

          COVID-19 infection: Origin, transmission, and characteristics of human coronaviruses

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            Epidemiological, demographic, and clinical characteristics of 47 cases of Middle East respiratory syndrome coronavirus disease from Saudi Arabia: a descriptive study

            Summary Background Middle East respiratory syndrome (MERS) is a new human disease caused by a novel coronavirus (CoV). Clinical data on MERS-CoV infections are scarce. We report epidemiological, demographic, clinical, and laboratory characteristics of 47 cases of MERS-CoV infections, identify knowledge gaps, and define research priorities. Methods We abstracted and analysed epidemiological, demographic, clinical, and laboratory data from confirmed cases of sporadic, household, community, and health-care-associated MERS-CoV infections reported from Saudi Arabia between Sept 1, 2012, and June 15, 2013. Cases were confirmed as having MERS-CoV by real-time RT-PCR. Findings 47 individuals (46 adults, one child) with laboratory-confirmed MERS-CoV disease were identified; 36 (77%) were male (male:female ratio 3·3:1). 28 patients died, a 60% case-fatality rate. The case-fatality rate rose with increasing age. Only two of the 47 cases were previously healthy; most patients (45 [96%]) had underlying comorbid medical disorders, including diabetes (32 [68%]), hypertension (16 [34%]), chronic cardiac disease (13 [28%]), and chronic renal disease (23 [49%]). Common symptoms at presentation were fever (46 [98%]), fever with chills or rigors (41 [87%]), cough (39 [83%]), shortness of breath (34 [72%]), and myalgia (15 [32%]). Gastrointestinal symptoms were also frequent, including diarrhoea (12 [26%]), vomiting (ten [21%]), and abdominal pain (eight [17%]). All patients had abnormal findings on chest radiography, ranging from subtle to extensive unilateral and bilateral abnormalities. Laboratory analyses showed raised concentrations of lactate dehydrogenase (23 [49%]) and aspartate aminotransferase (seven [15%]) and thrombocytopenia (17 [36%]) and lymphopenia (16 [34%]). Interpretation Disease caused by MERS-CoV presents with a wide range of clinical manifestations and is associated with substantial mortality in admitted patients who have medical comorbidities. Major gaps in our knowledge of the epidemiology, community prevalence, and clinical spectrum of infection and disease need urgent definition. Funding None.
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              The COVID-19 vaccine development landscape

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                Author and article information

                Contributors
                Role: Prof. Former Director, Professor and Head, Former Consultant and Head, Director
                Role: Prof.
                Role: Consultant Radiologist/Sonologist
                Journal
                J Clin Exp Hepatol
                J Clin Exp Hepatol
                Journal of Clinical and Experimental Hepatology
                Indian National Association for Study of the Liver. Published by Elsevier B.V.
                0973-6883
                2213-3453
                10 June 2020
                10 June 2020
                Affiliations
                [1 ]Gastroenterology, Chairman Dept., Medicine, Sher-I-Kashmir Institute of Medical Sciences, Soura, Srinagar, Kashmir, India
                [2 ]Gastroenterology and Liver Transplantation, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia
                [3 ]Digestive Diseases Centre, Dr. Khuroo’s Medical Clinic, Srinagar, J&K(UT), India
                [4 ]Indian School Al-Ghubrah, Muscat, Oman
                [5 ]Pathology, Government Medical College, Srinagar, Kashmir, J&K (UT), India 190010
                [6 ]Burn Hall School, Srinagar, J&K (UT), India, 190010
                [7 ]Fellowship Medical Imaging & Radiology, KFSH&RC, Riyadh, KSA
                [8 ]Digestive Diseases Centre, Dr. Khuroo’s Medical Clinic, Sector 1, SK Colony, Qamarwari, Srinagar, Kashmir, J&K (UT), India 190010
                Author notes
                [] Corresponding author. Digestive Diseases Centre, Dr. Khuroo’s Medical Clinic, Sector 1, SK Colony, Qamarwari, Srinagar, Kashmir, J&K, India 190010. Tel.: +91 9906591044 khuroo@ 123456yahoo.com
                [2]

                Tel.: +968 93730786.

                [3]

                Tel.: +91 9906680006.

                [4]

                Tel.: +91 7889770991.

                [5]

                Tel.: +91 9906633966.

                Article
                S0973-6883(20)30090-6
                10.1016/j.jceh.2020.06.003
                7286271
                32837093
                57bfbb56-bf78-4df1-abf8-5865e570b1d9
                © 2020 Indian National Association for Study of the Liver. Published by Elsevier B.V.

                Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

                History
                : 12 May 2020
                : 2 June 2020
                : 5 June 2020
                Categories
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                covid-19,sars-cov-2,coronavirus,vaccine,platform technology clinical trials

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