Multidrug-resistant tuberculosis (MDR-TB) occurs when strains of Mycobacterium are resistant to the first-line anti-tuberculosis regimen. We present the case of a 22-year-old immigrant female of African descent who presented to her primary care physician complaining of a two-month history of an enlarging neck mass. Aspiration of the mass, analysis, and culture revealed colonization with a strain of Mycobacterium that was resistant to first-line anti-tuberculosis medications. She was subsequently placed on second line anti-tuberculosis medications.

While worldwide efforts for improving COVID-19 vaccines are currently considered a top priority, the role of the genetic variants responsible for virus receptor protein stability is less studied. Angiotensin-converting enzyme-2 is the primary target of the SARS-CoV-1/SARS-CoV-2 spike (S) glycoprotein, enabling entry into the human body. Here, we applied computational saturation mutagenesis approaches to determine the folding energy caused by all possible mutations in ACE2 proteins within ACE2 - SARS-CoV-1-S/ACE2 - SARS-CoV-2-S complexes. We observed ACE2 mutations at residue D350 causing the most stabilizing effects on the protein. In addition, we identified ACE2 genetic variations in African Americans (rs73635825, rs766996587, and rs780574871), Latino Americans (rs924799658), and both groups (rs4646116 and rs138390800) affecting stability in the ACE2 - SARS-CoV-2-S complex. The findings in this study may aid in targeting the design of stable neutralizing peptides for treating minority patients.

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