Sareh Keshvardoost; Kambiz Bahaadinbeigy; Farhad Fatehi
Volume 22, Issue 12 , 2020
Abstract
The coronavirus disease 2019 (COVID-19) pandemic illustrated the significance of using telemedicine for medical services to minimize the risk of infection more than ever. The implementation of telemedicine in the realm of eye expertise (teleophthalmology) has made it possible for both ophthalmic patients ...
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The coronavirus disease 2019 (COVID-19) pandemic illustrated the significance of using telemedicine for medical services to minimize the risk of infection more than ever. The implementation of telemedicine in the realm of eye expertise (teleophthalmology) has made it possible for both ophthalmic patients and COVID-19 positive cases to be taken care of in different ways of prevention, diagnosis, treatment, and follow-up. This study aimed to discuss the ophthalmology challenges during the COVID-19 outbreak based on existing evidence, followed by proposing some solutions for utilizing telemedicine.
Guangfei Wang; Qiaofeng Ye; Yidie Huang; Jinmiao Lu; Yiqing Zhu; Lin Zhu; Xiaoxia Li; Junqi Zhang; Ziwei Li; Jianger Lan; Zhiping Li
Volume 22, Issue 11 , 2020
Abstract
Context: Since December 2019, the coronavirus disease 2019 (COVID-19) has broken out in Wuhan, Hubei Province, China. Due to the highly pathogenic and infectious characteristics, COVID-19 spread across China and later globally and became a severe pandemic. To date, there have been no efficacious specialized ...
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Context: Since December 2019, the coronavirus disease 2019 (COVID-19) has broken out in Wuhan, Hubei Province, China. Due to the highly pathogenic and infectious characteristics, COVID-19 spread across China and later globally and became a severe pandemic. To date, there have been no efficacious specialized drugs to treat COVID-19. The China-issued Diagnosis and Treatment of Pneumonia Caused by Novel Coronavirus (Trial version 6) added the chloroquine phosphate to the antiviral treatment protocol for infected adults.
Evidence Acquisition: In this review, government documents and authoritative guidelines on COVID-19 were collected from the official website of organizations related to health and medicine. Research articles related to chloroquine and its application for COVID-19 treatment were searched and acquired from the PubMed platform. Facts and data related to the use of chloroquine were summarized in several parts.
Results: Recently, there has been an increase in research on the use of chloroquine for the treatment of COVID-19. This drug is utilized as an antimalarial and antiviral medication. There are some concerns and cautions on the clinical application of chloroquine, about which clinicians should be informed during this global pandemic. The present review summarized data on the mechanism of action, drug-drug interaction (DDI), and adverse drug reaction (ADR) of chloroquine and pharmaceutical care for special patients in order to provide a reference for the rational use of this drug in COVID-19 patients.
Conclusion: Currently, there is mixed evidence on the efficacy of chloroquine in the treatment of COVID-19. Potential DDIs and ADRs, as well as pharmaceutical care, for special patients should be considered in fighting against the pandemic.
Seyedreza Mirsoleymani; Seyyed Mojtaba Nekooghadam; Milad Ahmadi Marzaleh; Mahmoudreza Peyravi; Ahmad Soltani; Simintaj Sharififar; Rita Rezaee; Mahnaz Ahmadi; Hossein Akbarialiabad
Volume 22, Issue 9 , 2020
Abstract
Background: The outbreak of Coronavirus Disease 2019 (COVID-19) has led to a major concern for those who are more vulnerable to infections.
Objectives: This study aimed to evaluate the most important risk factors for severe COVID-19 pneumonia.
Methods: This retrospective study included information ...
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Background: The outbreak of Coronavirus Disease 2019 (COVID-19) has led to a major concern for those who are more vulnerable to infections.
Objectives: This study aimed to evaluate the most important risk factors for severe COVID-19 pneumonia.
Methods: This retrospective study included information on clinical and epidemiological features of 105 patients with severe COVID-19 pneumonia hospitalized in Tajrish Hospital, Tehran, Iran. Initially, the medical records of the patients were investigated, and an interview was conducted based on a pre-prepared checklist to seek information about symptoms, past medical history, medication history, and behavior before hospitalization.
Results: Out of 105 participants, 76 (72.5%) cases were male, and 54 (51.4%) patients were older than 54 years old. The majority of the patients (n=18; 17.1%) had both hypertension and diabetes (n=12; 11.4%). Metformin (n=36; 34.3%) was the most used medication amongst the studied patient. In addition, 24 (22.9%) patients were recreational hookah smokers, and the majority (75%) of them were under the age of 46 years old. Eventually, 19 patients were excluded from the study, of whom 11 individuals had diabetes, and 10 cases were using metformin.
Conclusion: Apparently, hookah smoking played a critical role in the spread of COVID-19 in Iran and has made younger people more susceptible. In addition to older age, the immunosuppressive effects of Metformin seem to make diabetic patients with an impaired immune system more vulnerable to severe COVID-19 pneumonia. More studies on the immune system of vulnerable individuals by identifying their differences can help to protect them.
Jianli Cui; Youfu Ke
Volume 22, Issue 8 , 2020
Abstract
Context: Coronavirus disease 2019 (COVID-19) has progressed into a public health emergency of international concern. Passive immunotherapy has been successfully used for the treatment of infectious diseases since the 1890s. It is necessary and constructive to compare and analyze COVID-19 ...
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Context: Coronavirus disease 2019 (COVID-19) has progressed into a public health emergency of international concern. Passive immunotherapy has been successfully used for the treatment of infectious diseases since the 1890s. It is necessary and constructive to compare and analyze COVID-19 convalescent plasma (CCP) randomized controlled trials (RCTs) to help clinicians to have a potential option for COVID-19.
Evidence Acquisition: In this study, eight databases were searched on May 1, 2020, such as China National Knowledge Infrastructure, PubMed, and Cochrane Library, with the search fields of "Title Abstract Keyword" of "Convalescent plasma AND COVID-19" or " Convalescent plasma AND SARS-CoV-2". The outcome of interest was clinical RCTs for COVID-19.
Results: The search retrieved nine relevant CCP protocols for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). All nine trials were randomized, parallel assignment, interventional, clinical treatment studies with NCT04344535, NCT04345289, and NCT04323800 masking and the rest open-label. The estimated enrollment is within the range of 40-1,500 subjects, and five trials will be finished in 2020 as opposed to two in 2021 and two in 2022. Except for NCT04323800 on the prevention of COVID-19, other eight trials will test and verify the effectiveness and safety of CCP for the treatment of COVID-19.
The used dosage of CCP is within the range of 200-600 mL. NCT04344535, NCT04323800, and NCT04346446 use standard donor plasma in controlled groups in comparison to NCT04348656, NCT04342182, NCT04333251, and NCT04345523 without any positive drug in controlled groups. NCT04332835 adds hydroxychloroquine to both groups, and only NCT04345289 is a six-armed placebo-controlled trial.
Primary and secondary outcome measures are differently expressed in the nine trials. Nevertheless, they can be summarized as ? changes in time, day, and number of a 7-point ordinal scale. There are ? changes in SARS-CoV-2 ribonucleic acid (i.e., viral load), anti-SARS-CoV-2 antibody titers (i.e., immunoglobulin M and immunoglobulin G), C-reactive protein, lymphocyte count, lactate dehydrogenase, and interleukin 6 on a specified day or during a specific period.
Conclusion: The nine well-designed RCT trials will establish the efficacy of CCP for the treatment of SARS-CoV-2 from the perspective of evidence-based medicine.
Arezoo Esmailzadeh; shahla Chaichian; Abolfazl Mehdizadehkashi; Kobra Tahermanesh; Samaneh Rokhgireh; Nastaran Khodakarim; Shima Ghafourian; Saeedeh Moslemi; Meisam Akhlaghdoust
Volume 22, Issue 8 , 2020
Abstract
Introduction: Coronavirus disease 2019 (COVID-19), newly emerging in the world as a pandemic disease, can have rare extrapulmonary manifestations. Few studies have reported coagulation disorders, induced by coronavirus; however, hemorrhage is an extremely rare and life-threatening phenomenon in COVID-19.
Case ...
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Introduction: Coronavirus disease 2019 (COVID-19), newly emerging in the world as a pandemic disease, can have rare extrapulmonary manifestations. Few studies have reported coagulation disorders, induced by coronavirus; however, hemorrhage is an extremely rare and life-threatening phenomenon in COVID-19.
Case presentation: Herein, we present a 31-year-old woman referring with vaginal bleeding, melena, skin ecchymosis, mucosal bleeding, melena, hematuria, and hypovolemic shock. At our center, she was diagnosed as a case of severe internal hemorrhage due to ovulation site hemorrhage and underwent emergency surgery, complicated by prolonged international normalized ratio, which could be due to the presence of COVID-19 in the patient, detected by spiral computed tomography.
Conclusions: This case showed the importance of examining COVID-19 in any patients referring to the hospital during the pandemic as well as paying greater attention to the effect of COVID-19 on coagulation disorders in these patients.
Youfu Ke; Jianli Cui
Volume 22, Issue 7 , 2020
Abstract
Context: COVID-19 has turned into a pandemic, threatening the lives of millions of people worldwide. Research has found that some COVID-19 patients will suddenly aggravate, resulting in a cytokine storm, respiratory distress syndrome, and death. It is necessary to articulate the mechanism of cytokine ...
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Context: COVID-19 has turned into a pandemic, threatening the lives of millions of people worldwide. Research has found that some COVID-19 patients will suddenly aggravate, resulting in a cytokine storm, respiratory distress syndrome, and death. It is necessary to articulate the mechanism of cytokine storm and propose a Chinese medicine treatment strategy for COVID-19.
Evidence Acquisition: A literature search was conducted using five databases on April 30, 2020, including PubMed, Google Scholar, Cochrane Library, China National Knowledge Infrastructure (CNKI), and Wanfang Data with the keywords of "cytokine storm AND Chinese medicine AND COVID-19 ", "cytokine storm AND Chinese medicine AND SARS-CoV-2". The outcome of interest was the concept and mechanism of cytokine storm, the characteristics, and the Chinese medicine treatment of COVID-19 cytokine storm, etc. A total of 43 articles were retrieved after removing duplicate articles.
Results: The cytokine storm is also called cytokine cascade. The body overreacts with positive feedback without negative feedback, making a variety of abnormal cytokines accumulations, triggering a cytokine storm. COVID-19 cytokine storm does not occur in the early stages, but only after a period of development, it attacks not only the lungs but also the heart, kidneys, and other organs. The key pathogenesis is "toxins and blood stasis, lung failure" in Chinese medicine. The treatment is detoxification, removing blood stasis, and nourishing the lung. Chinese medicine should comprehensively regulate multiple targets and multiple pathways to intervene in the immune regulation of the body to intercept the progress of inflammation and focus on the integration of Chinese medicine with Western medicine to combine anti-virus and anti-inflammatory therapy.
Conclusions: The immune response caused by cytokine storm is a complex signal network with multiple targets and pathways and various cytokines acting together. Immunomodulation can balance the excessive inflammatory response and effectively control the replication and spread of SARS-CoV-2. Returning the immune response to a balanced state is an ideal method for treating COVID- 19 cytokine storm. Chinese medicine can achieve overall coordination and balance. Nevertheless, the pharmacology of Chinese medicine must be further studied, and the mechanism of cytokine storm treatment should be thoroughly clarified
Reza Alizadeh-Navaei; Majid Saeedi; Reza Valadan; Fatemeh Roozbeh; Omolbanin Amjadi; Ehsan Zaboli; Mahmood Moosazadeh; Hossein Ranjbaran; Zinab Qazizadeh; Ali Akbari-Malekshah; Touraj Assadi; Versa Omrani-Nava; Akbar Hedayatizadeh-Omran
Volume 22, Issue 7 , 2020
Abstract
Background: Coronavirus is a single-stranded RNA virus, causing an epidemic of pneumonia and acute respiratory distress syn- drome (ARDS) worldwide in late 2019.
Objectives: In addition to the clinical symptoms, laboratory diagnosis can greatly help diagnose the diseases; therefore, this study aimed ...
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Background: Coronavirus is a single-stranded RNA virus, causing an epidemic of pneumonia and acute respiratory distress syn- drome (ARDS) worldwide in late 2019.
Objectives: In addition to the clinical symptoms, laboratory diagnosis can greatly help diagnose the diseases; therefore, this study aimed to analyze laboratory parameters in patients with COVID-19.
Methods: In this cross-sectional study, the laboratory data of 2563 patients with COVID-19 admitted to hospitals affiliated with Mazandaran University of Medical Sciences were extracted from hospital information systems (HIS). The data were recorded on Excel and analyzed through t-test, chi-squared, and Fishers exact tests in SPSS 19 at the significance level of P < 0.05.
Results: Out of 2563 patients with a mean age of 55.1 ± 16.7 years, 1409 (55%) were male, and 1154 (45%) were female with a mean age of 55.7 ± 16.8, and 54.3 ± 16.6 years, respectively. As the most frequent clinical findings, ESR, CRP, and LDH were increased by 83.5%, 71%, and 69.3% of the patients, respectively. Other research findings included lymphopenia, disturbed INR, abnormal SGOT, abnormal alkaline phosphatase (ALP), and increased lactate dehydrogenase (LDH), which were significantly higher in men than in women and was different between age groups.
Conclusions: Conducting simple, convenient, and inexpensive laboratory tests can be helpful in the diagnosis of COVID-19.
Manouchehr Hekmat; Zahra Ansari Aval; Alireza Omidi Farzin; Ali Dabbagh; Hamid Ghaderi
Volume 22, Issue 6 , 2020
Abstract
Introduction: COVID-19 is an emerging disease that has been spread all over the world. Not all the dimensions and manifestations of the disease have yet been fully explored. One such manifestation is vascular thrombosis that occurs in the lungs and other vessels. However, it is often ignored or mistaken ...
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Introduction: COVID-19 is an emerging disease that has been spread all over the world. Not all the dimensions and manifestations of the disease have yet been fully explored. One such manifestation is vascular thrombosis that occurs in the lungs and other vessels. However, it is often ignored or mistaken for pulmonary manifestations. Herein, we presented a case with dominant pulmonary em- bolism manifestations. The COVID-19 symptoms were detected in the patient a few days after heart surgery, and he was appropriately treated and discharged.
Case Presentation: The patient was a 62-year-old man visiting with the signs and symptoms of pulmonary embolism. In the CT- angiography, massive pulmonary embolism was reported in the right and left pulmonary arteries of the patient. Moreover, the patients echocardiogram showed a clot in the right ventricle in addition to severe right ventricular dysfunction. The patient un- derwent emergency heart surgery to remove the clot. In the 3 - 4 postoperative days, the pulmonary manifestations of COVID-19 emerged. The throat swab test was positive for COVID-19, and the patient received treatment. After receiving appropriate treatments for about two weeks, the patient was discharged with good general health.
Conclusions: The presented case had the primary pulmonary embolism symptoms. However, in the 2 - 3 postoperative days, he showed the COVID-19 symptoms and received treatment. Pulmonary embolism can be a manifestation of COVID-19.
Babak Jamshidi; Mansour Rezaei; Farid Najafi; Azad Sheikhi
Volume 22, Issue 5 , 2020
Abstract
Background: Over 150,000 confirmed cases, around 140 countries, and about 6,000 death occurred owing to coronavirus disease 2019 (COVID-19) pandemic in China, Italy, Iran, and South Korea. Iran reported its first confirmed cases of COVID-19 in Qom City on 19 February 2020 and has the third-highest ...
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Background: Over 150,000 confirmed cases, around 140 countries, and about 6,000 death occurred owing to coronavirus disease 2019 (COVID-19) pandemic in China, Italy, Iran, and South Korea. Iran reported its first confirmed cases of COVID-19 in Qom City on 19 February 2020 and has the third-highest number of COVID-19 deaths after China and Italy and the highest in Western Asia.
Methods: We applied a two-part model of time series to predict the spread of COVID-19 in Iran through addressing the daily relative increments. All of the calculations, simulations, and results in our paper were carried out by using MatLab R2015b software. The average, upper bound, and lower bound were calculated through 100 simulations of the fitted models.
Results: According to the prediction, it is expected that by 15 April 2020, the relative increment (RI) falls to the interval 1.5% to 3.6% (average equal to 2.5%). During the last three days, the RI belonged to the interval of 12% to 15%. It is expected that the reported cumulative number of confirmed cases reaches 71,000 by 15 April, 2020. Moreover, 80% confidence interval was calculated as 35K and 133K.
Conclusions: The screening of suspected people, using their electronic health files, helps isolate the patients in their earlier stage, which in turn helps decrease the period of transmissibility of the patients. Considering all issues, the best way is to apply the model with no modification to model the probable increasing or decreasing acceleration of spreading.
Seyyed Mohammad Miri; Mohammad Ajalloueyan
Volume 22, Issue 5 , 2020
Abstract
Introduction: The pandemic coronavirus disease 2019 or COVID-19 is infecting as fast as possible in more than 200 countries and creating the most horrible domino-like demolition ever seen. From its beginning in Wuhan, China, the SARS-CoV-2 infected the similar groups of 100,000 patients in 67, 11, ...
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Introduction: The pandemic coronavirus disease 2019 or COVID-19 is infecting as fast as possible in more than 200 countries and creating the most horrible domino-like demolition ever seen. From its beginning in Wuhan, China, the SARS-CoV-2 infected the similar groups of 100,000 patients in 67, 11, 4, and 2 days. Healthcare workers are in the frontline of attacking by SARS-CoV-2, especially those who are in close contact with upper respiratory mucosa like otolaryngologists.
Objectives: To describe ear pain as one of the first clinical manifestations of COVID-19, we present two cases of a family (a mother and her daughter) with a positive RT-PCR test for COVID-19 who presented earache as their first symptoms.
Case Presentation: The first case was a 32 years old female patient (stewardess of an international airline, Tehran, Iran) was labeled as at risk due to her air flight to China in Dec 2019. She was first admitted for moderate ear pain in her left ear with mild itching of the external ear to an otolaryngology outpatient clinic by a general practitioner. After 7 days, her test for RT-PCR against COVID-19 was positive. No lung involvement was reported by high-resolution computed tomography (HRCT) of the thorax. Another case was her mother who were in close contact with each other and experienced severe ear pain after 7 days. She acquired mild COVID-19 symptoms with anosmia was a positive test result for COVID-19.
Conclusions: The earache must be considered as their first clinical symptoms during the early phase of the coronavirus outbreak. It seems that local and international scientific groups of otolaryngologists must prepare their national guidelines to protect their practitioners against COVID-19 based on practical strategies. Using personal protective equipment is of utmost importance in reducing the risk of nosocomial infection among otolaryngologists.
Youfu Ke; Zemin Chen; Bo Peng
Volume 22, Issue 4 , 2020
Abstract
Background: Mainland China has adopted the most decisive and proactive measures to contain the SARS-CoV-2 epidemic, which helps control the spread of the virus across the country.
Objectives: Early epidemiological investigations found that the SARS-CoV-2 epidemic was more critical in Hubei ...
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Background: Mainland China has adopted the most decisive and proactive measures to contain the SARS-CoV-2 epidemic, which helps control the spread of the virus across the country.
Objectives: Early epidemiological investigations found that the SARS-CoV-2 epidemic was more critical in Hubei province (Hubei) than in rest parts of mainland China (Rest of China). A cross-sectional study was conducted to answer this urgent question and provide implications for the world.
Methods: Infected cases from Mainland China were divided into two groups: Hubei and the Rest of China. Prevention, quarantine, and treatment were based on The Novel Coronavirus Infected Pneumonia Diagnosis and Treatment Standards. Total confirmed cases, daily severe cases, total deaths, and total discharged cases were collected from January 20 to March 4 for statistical analysis.
Results: Hubei accounted for 83.9% of China's total confirmed cases and 96.3% of China's total deaths. The percentage of severe cases and the rate of fatality in Hubei were higher than those in the Rest of China (P < 0.01). Daily severe cases in Hubei hit the peak at 11,246 cases on February 18, compared to 989 cases on February 10 in the Rest of China. The percentages of daily severe cases in both regions declined throughout the epidemic, from 23.3% to 8.6% in Hubei compared to 15.0% to 1.3% in the Rest of China. The latest fatality rate in Hubei was 4.30%, which was much higher than 0.85% in the Rest of China. Up to March 4, 64.7% of China's total confirmed cases were cured, 3.86% died, and 31.5% were under treatment.
Conclusions: The implications for the world are cutting off the sources of infection and transmission routes, early detection, early isolation, and early treatment that can prevent the spread of SARS-CoV-2 and reduce the severity and fatality rate.
Xianwu Xia; Liang Sheng; Tiejun Yang; Guobing Zhang; Li Ding; Jianmin Shen; Jihong Feng
Volume 22, Issue 4 , 2020
Abstract
Background: Regarding the outbreak of highly contagious the 2019 Novel Coronavirus (2019-nCoV) in various countries and regions, data have been needed on the early chest CT images and clinical characteristics of the affected patients.
Objectives: To explore the early clinical and computed ...
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Background: Regarding the outbreak of highly contagious the 2019 Novel Coronavirus (2019-nCoV) in various countries and regions, data have been needed on the early chest CT images and clinical characteristics of the affected patients.
Objectives: To explore the early clinical and computed tomography (CT) characteristics of the 2019 Novel Coronavirus Disease (COVID-19) patients to improve the diagnostic level of this contagious respiratory disease.
Methods: An analysis retrospectively was implemented on the radiological features and clinical characteristics of 12 patients with COVID-19 who had undergone chest CT scanning in the designated hospital from Jan 23, 2020, to Feb 18, 2020. The clinical data on general information, epidemiological, cardinal symptoms, blood test, and CT imaging characteristics were obtained.
Results: According to the relevant diagnostic criteria, the patients were divided into two groups: mild (2 cases), and ordinary type (10 cases). The main symptoms of 2019-nCoV pneumonia were fever (9/12) and cough (8/12) with or without respiratory and other systemic symptoms. The blood test of the patients showed that most of the white blood cell count was normal (10/12), decreased lymphocyte count (6/12), and increased hypersensitive C reactive protein (hs-CRP) (5/12). In the early stage of COVID-19, the chest CT images showed patchy mixed ground-glass opacity (GGO) (8/12), mainly distributed in the periphery and posterior part of both lungs. The internal density of image lesion area was uneven, and lesions primarily manifested as "crazy-paving pattern" (8/12), with grid-like, interlobular septal thickening, thickened bronchovascular bundle and air bronchus sign and multiple fibrosis. A few cases showed pulmonary atelectasis (1/12), bilateral pleural effusion (1/12), no mediastinal or bilateral hilar lymph node enlargement.
Conclusions: The clinical characteristics of 2019-nCoV pneumonia are similar to those of common viral pneumonia. The chest CT images may be helpful for the early detection of novel coronavirus pneumonia.
Narges Karimi; Athena Sharifi Razavi; Nima Rouhani
Volume 22, Issue 3 , 2020
Abstract
Introduction: Coronavirus disease 2019 (COVID-19) is a novel coronavirus that was extracted from patients with respiratory tract infections. The most common symptoms of patients are fever and respiratory tract involvement. In this report, we describe one patient with frequent seizures probably due ...
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Introduction: Coronavirus disease 2019 (COVID-19) is a novel coronavirus that was extracted from patients with respiratory tract infections. The most common symptoms of patients are fever and respiratory tract involvement. In this report, we describe one patient with frequent seizures probably due to COVID-19 infection for the first time.
Case Presentation: A 30-year-old previously healthy female was admitted with generalized tonic-clonic seizure in the neurology emergency room. The patient complained of dry cough five days before the admission. She had seizures (five times) approximately every 8 hours. Brain MRI was normal and chest CT revealed focal ground-glass opacities. The respiratory specimen was positive for COVID-19 using real-time PCR assay. The symptoms of the patient improved with anticonvulsive and antiviral medications.
Conclusions: To the best of our knowledge, this is the first case study to report an association between frequent seizures and COVID-19. In our opinion, there is a hypothesis about this subject that the etiology of seizure may be due to encephalitis and invasion virus to the brain or toxic effect of inflammatory cytokines.
Mohammad Bagher Fathi
Volume 22, Issue 3 , 2020
Abstract
Background: The materials science may come to assist pharmacists to fabricate new drugs for coronavirus disease 2019 (COVID-19).
Objectives: The geometrical structure of elements on the surface of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) is analyzed to illustrate some hints ...
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Background: The materials science may come to assist pharmacists to fabricate new drugs for coronavirus disease 2019 (COVID-19).
Objectives: The geometrical structure of elements on the surface of severe acute respiratory syndrome-coronavirus 2 (SARS-CoV-2) is analyzed to illustrate some hints about the possible choosing the factors captivating the surface of SARS-CoV-2.
Methods: The crystallographic classes and their sub-structures can be indicative of practical selection of macromolecules in drug pharmacy.
Results: The macromolecular structures with hexagonal and its sub-structures are suggested for pharmacists to probe a novel drug for COVID-19.
Conclusions: Any progress in the field of fabricating macromolecular drugs for COVID-19 is strongly dependent on finding the hexagonal and its sub-structures such as triangular and rhombus geometries.
