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The genomic and protein sequences for SARS-CoV-2 are publicly available from the NIH gene data bank4,6,14. Herein, we have selected 3CLpro of SARS-CoV-2 as a target to identify potential inhibitors since this protease is indispensable for viral replication and hence an excellent drug target9. The structure of 3CLpro protein of SARS-CoV-2 in complex with an inhibitor N3 is available in the PDB database (ID: 6LU7). To identify the FDA approved drugs as inhibitors for 3CLpro, in silico drug screening studies were carried out. In all, 3987 FDA approved drugs (SuperDrugs2 database) were sorted as viral protease inhibitors (PIs), viral non-protease inhibitors (VNIs) and off-target drugs (OTDs), and screened for the anti-3CLpro activity using the Molecular Operating Environment (MOE) software. The protein structure-based drug design using computational methods is an alternative for screening of currently approved drugs to rapidly identify potential drug candidates for the treatment of emerging infectious diseases such as COVID-1915,16,17. However, the potential for false positives with computational modeling is one of the most common limitation of docking studies18. Therefore, we have established SARS-CoV-2 3CLpro enzymatic assays for selected drugs using commercially available 3CLpro protease inhibitor screening assay kits to evaluate the in vitro inhibitory activity of the drugs and investigated whether any correlation exist between the computational binding score and the in vitro inhibitory activity. In this report, we have selected 47 from the list of 3987 FDA approved drugs based on binding score, side effects, half-life, active form, immunosuppressant properties, autofluorescence, and availability for an in vitro 3CLpro enzymatic inhibitor-screening assay. We observed that, boceprevir, ombitasvir, paritaprevir, tipranavir, and micafungin exhibited partial inhibitory effect whereas, ivermectin blocked more than 85% of 3CLpro activity of SARS-CoV-2. Although the anti-viral activity of ivermectin mediated through the blocking of α/β1 importin19,20,21,22,23 is established, herein we report the inhibitory effects of ivermectin on 3CLpro enzyme of SARS-CoV-2, suggesting additional anti-viral mechanism of ivermectin towards SARS-CoV-2.

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Transition from F-75 to RUTF during the transition phase for hospitalized children with SAM was possible on first attempt in the majority of children with SAM. The method of first providing half the energy requirements using RUTF and the remaining half by F-75 then gradually increasing to RUTF as the only source of energy during transition provides guidance for practitioners managing hospitalized children with SAM.Younger children, severely wasted, HIV infected and those reported to be severely ill by the caregiver were more likely to fail transition to RUTF on first attempt. The transition process from F-75 to RUTF warrants further research to evaluate the most appropriate method of transition with minimal failures and to advance in more objective and field appropriate methods to determine readiness to transit or stabilization of metabolic alterations in children with SAM. 041b061a72